The article is the result of a collaboration between a team of cardiologists, including: Dr. Aseem Malhotra, of Lister Hospital in Stevenage, in the United Kingdom; Prof. Rita Redberg, of the University of California-San Francisco School of Medicine and editor of JAMA Internal Medicine; and Pascal Meier, of University Hospital Geneva in Switzerland and University College London, who is also the editor of BMJ Open Heart.
The team cited reviews that show no association between intake of saturated fat and a greater risk of heart disease, in order to support their argument against the existence of artery-clogging saturated fat.
"It is time to shift the public health message in the prevention and treatment of coronary artery disease away from measuring serum lipids and reducing dietary saturated fat," say the authors. Instead of focusing on lowering blood fats and cutting out dietary saturated fats, the importance of eating "real food," partaking in regular physical activity, and minimizing stress, should all be emphasized.
According to Malhotra, Redberg, and Meier, the current approach to managing heart disease echoes the practice of plumbing, but the notion of improving the condition by "unclogging a pipe" has been invalidated by a series of clinical trials. The trials found that when a stent was inserted to widen narrowed arteries, the risk of heart attack or death was not lessened.
"Decades of emphasis on the primacy of lowering plasma cholesterol, as if this was an end in itself and driving a market of 'proven to lower cholesterol' and 'low fat' foods and medications, has been misguided," the panel contends. These misconceptions may stem from "selective reporting of data," they suggest.
Coronary artery heart disease is the most common type of heart disease and the leading cause of death for men and women in the United States. The chronic inflammatory condition responds positively to a Mediterranean-style diet, rich in the anti-inflammatory compounds often found in extra virgin olive oil, vegetables, oily fish, and nuts, the researchers note.
Coronary heart disease reduced with regular exercise, eating 'real' food
The best predictor of heart disease risk involves a high total cholesterol (TC) to high-density lipoprotein (HDL) ratio, not low-density lipoprotein. Dietary changes, such as substituting refined carbohydrates with healthful high-fat foods including olive oil and nuts, can significantly reduce the high TC to HDL ratio, the experts explain.
Exercise plays an essential role in preventing heart disease and may increase life expectancy by 3.4 to 4.5 years. Just 30 minutes of moderate activity per day on more than three occasions each week has been shown to make a difference to risk factors for inactive adults. Furthermore, the researchers point out that regular brisk walking may be more effective at preventing coronary disease than running.
Chronic stress is a risk factor for coronary heart disease that "should not be overlooked," the team underline. Chronic stress puts the body's inflammatory response on a continuous state of high alert. Research has shown that environmental stress, such as childhood trauma, can decrease life expectancy by up to 20 years. The authors write:
"Combining a complete lifestyle approach of a healthful diet, regular movement, and stress reduction will improve quality of life, reduce cardiovascular, and all-cause mortality."
The researchers add that spending just 22 minutes per day walking and eating healthful food can prevent coronary artery disease. However, "there is no business model or market to help spread this simple yet powerful intervention," the authors conclude.