The dietary guidelines have been changed — what are the faithful to believe now ?

While we were in China dietary guidelines shifted. Cholesterol is no longer bad. Shades of Woody Allen and “Sleeper”. It’s life imitating art.

Sleeper is one of the great Woody Allen movies from the 70s. Woody plays Miles Monroe, the owner of (what else?) a health food store who through some medical mishap is frozen in nitrogen and is awakened 200 years later. He finds that scientific research has shown that cigarettes and fats are good for you. A McDonald’s restaurant is shown with a sign “Over 795 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 Served”

Seriously then, should you believe any dietary guidelines? In my opinion you shouldn’t. In particular I’d forget the guidelines for salt intake (unless you actually have high blood pressure in which case you should definitely limit your salt). People have been fighting over salt guidelines for decades, studies have been done and the results have been claimed to support both sides.

So what’s a body to do? Well here are 4 things which are pretty solid (which few docs would disagree with, myself included)

l. Don’t smoke
2. Don’t drink too much (over 2 drinks a day), or too little (no drinks). Study after study has shown that mortality is lowest with 1 – 2 drinks/day
3. Don’t get fat — by this I mean fat (Body Mass Index over 30) not overweight (Body Mass Index over 25). The mortality curve for BMI in this range is pretty flat. So eat whatever you want, it’s the quantities you must control.
4. Get some exercise — walking a few miles a week is incredibly much better than no exercise at all — it’s probably half as good as intense workouts — compared to doing nothing.

Not very sexy, but you’re very unlikely to find anyone telling you the opposite 50years from now.

It’s off topic, but I’d use the same degree of skepticism about the dire predictions of the Global Warming (AKA Climate change) people, particularly since there has been no change in global mean temperature this century.

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Comments

  • neil  On March 18, 2015 at 10:06 pm

    Thanks for the commentary. This is largely in line with what Swedish researchers found in a retrospective analysis of Swedish men (reported in JACC 2014;64(13)1299-1306. Following 21,000 men for >10 yrs showed adopting 5 healthy behaviours could reduce MI by approx 80%. They suggested a healthy diet (described in paper) as a 5th point, with some variance to your descriptor 🙂

  • Stefan  On April 15, 2015 at 3:19 pm

    Not that we disagree on much, but if you’re going to make dietary guidelines is it wise to look only at mortality? From what I’ve read morbidity is can be greatly affected by things like being overweight, though I would point the finger more at physical inactivity then diet, so strictly we don’t necessarily disagree except that things won’t change in the near future. There is a lot we don’t know about health, so I think more will be revealed in the next 50 years.

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