A Commentary from the Journal of the American College of Nutrition
27 March 2014 Taylor & Francis
Many Americans are led to believe that high blood cholesterol as a result of heavy saturated fat intake causes cardiovascular disease. As such, Statin drugs are often prescribed to curb CVD risk by lowering cholesterol. This conventional knowledge is boldly challenged, however, by a new paper available from the Journal of the American College of Nutrition, the Official Publication of the American College of Nutrition and a publication from Routledge.
While many studies show a correlation between high cholesterol and CVD, this alone does not prove a “cause-and-effect” relationship. “In fact,” the authors point out, “if analyzed carefully, there are more studies that disprove the ‘cause and effect’ hypothesis than even come close to proving it.” A trend of vilifying saturated fats based on flawed research is traced back through the second half of the 20th century, eventually meeting overdue criticism in a 2010 meta-analysis and a 2012 paper contrasting scientific literature with U.S. and European advisory committee guidelines.
While saturated fats have been blamed for causing CVD, more recent scientific literature points instead to processed sugars, trans-fats, and starchy/processed high-glycemic carbs as the more likely culprits. “Our nutritional courts,” the authors claim, “tried and convicted the wrong man.”
Statin drugs designed to treat high levels of LDL cholesterol began to be widely prescribed in 2001. The commentary authors suggest that “We must treat the patient thoughtfully and choose statin drugs carefully with extreme diligence to avoid unnecessary side effects.”
While these drugs have been linked to lower risk of CVD, numerous studies and clinical trials over the past decade have forced the medical community to re-examine the role of LDL cholesterol in statin use benefits. Some even began to demonstrate that reducing LDL alone was counterproductive in reducing some measures of CVD risk. As such, the authors advocate a more creative and thorough approach to addressing CVD risk, free of the “dogmatic polices” built around saturated fat and cholesterol centric thinking.
The commentary authors invoke legendary physician Francis W. Peabody in support of their convictions, quoted as saying, “The most important aspect in the care of the patient, is the care of the patient.”
New guidelines highlight the amount of exercise under tens should take to reduce the risk of developing cardiovascular disease (CVD) later in life. Sixty to 85 minutes of physical activity is recommended per day, including 20 minutes of vigorous activity, reports a study published in the open access journal BMC Medicine.
Childhood obesity is reaching epidemic proportions, paving the way for a generation of adults prone to ill health and CVD. Exercise is well known to reduce the risk of CVD, but current guidelines for children are based on youngsters over ten years old, and it’s unclear what would most benefit younger children.
Jiménez-Pavón and colleagues are the first to look at the link between physical activity and CVD risk in children 9 years and younger as part of the IDEFICS Study. They calculated their risk of CVD by looking at factors such as blood pressure, cholesterol levels and skinfold thickness, and found that around 15% of the 3000 or so 2 – 9 year old European kids studied had adverse CVD risk profiles.
Unhealthy profiles were even spotted in very young children, aged 2 to 6 years old, and differed between the sexes. The team recommend gender- and age-specific guidelines to help counter these unhealthy profiles.
Boys under 6 years old need over 70 minutes of moderate-to-vigorous exercise per day, whereas boys aged 6 to 9, need over 80 minutes. Girls in either age group need around the 60 minutes suggested in the previous guidelines.
The findings refine the previous more generalized guidelines for children, which estimated that kids require around an hour of daily moderate-to-vigorous exercise to improve health. They also highlight the inappropriateness of a ‘one recommendation to fit all’ policy for youngsters – there are children who meet the previous guidelines yet still have unhealthy CVD profiles. In a linked commentary also published in BMC Medicine, Robert McMurray highlights that when clinicians recommend physical activity for children they should evaluate at-risk kids on a case-by-case basis rather than by using generalized guidelines.
Full bibliographic information Physical activity and clustered cardiovascular disease risk factors in young children: a cross-sectional study (The IDEFICS study)
David Jiménez-Pavón, Kenn Konstabel, Patrick Bergman, Wolfgang Ahrens, Hermann Pohlabeln, Charalampos Hadjigeorgiou, Alfonso Siani, Licia Iacoviello, Dénes Molnár, Stefaan De Henauw, Yannis Pitsiladis and Luis A Moreno
BMC Medicine 2013 11:172, doi:10.1186/1741-7015-11-172