Break free from calorie counting; shift to nutritional value for healthy heart

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Experts, in an editorial published in Journal Open Heart, have suggested that it is high time now for people to stop counting calories and for health professionals to promote nutritional value of foods if we want to tackle the increasing menace of obesity, serious illness and resulting early deaths.

Drs Aseem Malhotra and James DiNicolantonio and Professor Simon Capewell have argued in their editorial that measures such as simple dietary changes will bring about much greater improvement in health of people instead of stopping smoking.

The trio argue that clinicians and health professionals have failed to act for far too long as they are excessively focusing on calorie counting despite the fact that studies have long shown that it is the nutritional content of the food that matters.

With studies establishing that intake of nuts can stave off 90,000 deaths from cardiovascular diseases in the US alone, experts say that there is a need to shift focus on dietary patterns and food quality.

Daily consumption of a sugary drink (150 calories) is associated with a significantly increased risk of type 2 diabetes whereas daily consumption of a handful of nuts (30 g of walnuts, 15 g of almonds and 15 g hazelnuts) or four tablespoons of extra virgin olive oil (around 500 calories) is associated with a significantly reduced risk of heart attack and stroke.

And the Action for Health in Diabetes trial shows that a low calorie diet on top of increased physical activity in patients with type 2 diabetes was not associated with a reduced risk of cardiovascular death despite significant weight loss and a monitoring period of 13.5 years, they point out.

Experts say focusing on qualitative dietary pattern will help to rapidly reduce obesity, related diseases, and cardiovascular risk.

The current increase in obesity, CVDs, diabetes, early deaths is a rather collective failure on the part of primary and secondary care clinicians, the experts have suggested.

Obesity costs the NHS over £5 billion a year, while the costs of type 2 diabetes add up to more than £20 billion and are predicted to double over the next 20 years. Similarly, the cost of diabetes has risen 40% in the past five years in the US, adding up to $245 billion in 2012, they say.

The evidence shows that poor diet is consistently responsible for more disease and death than physical inactivity, smoking and alcohol put together, they say, calling for sugary drinks to be taxed; government subsidies to make fruit, vegetables, and nuts more affordable; and tighter controls on the marketing of junk food.

“Applying these population wide policies might achieve rapid reductions in disease and hospital admissions visible even within the electoral terms of most politicians,” they suggest.

“It is time to stop counting calories, and time to instead promote good nutrition and dietary changes that can rapidly and substantially reduce cardiovascular mortality. The evidence indeed supports the mantra that ‘food can be the most powerful form of medicine or the slowest form of poison’,” they write.

“Recommending a high fat Mediterranean type diet and lifestyle to our patients, friends and families, might be a good place to start,” they conclude.