In a work called The physiology of taste, or, Meditations on transcendental gastronomy, French lawyer, politician and gastronome Anthelme Brillat-Savarin coined the phrase in 1826 that ‘you are what you eat.’
Some comprehensive and ground breaking international research has cast new meaning on this concept with some heart-felt views and advice.
In the 21st Century the focus, and fascination, has been on the notion of your wellbeing is increasingly defined by what you eat.
Given its importance in keeping your body alive the relationship between diet and heart health has been a primary area of consideration.
There is no argument that cardiovascular disease is a global epidemic with 80% of the burden of disease in low-income and middle-income countries.
Similarly, consensus is that diet is one of the most important modifiable risk factors for cardiovascular disease in addition to other non-communicable diseases.
Desperately seeking solutions
The search for the Holy Grail of creating the ultimate heart-health diet has produced a cornucopia of ideas, fads, recommendations, research and an array of conclusions about what best suits the human physiology.
Along the way what has been considered as bona fide research conclusions have been debated, debunked or totally reconsidered.
In one of the world’s most comprehensive studies—with the matter of fact title of Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study—popular beliefs have been turned upside down.
The PURE in the title is an acronym referring to a Prospective Urban Rural Epidemiology. The last word in the mix refers to the branch of medicine which deals with the incidence, distribution, and possible control of diseases and other factors relating to health.
By any standard the research was a massive undertaking providing a feast of information and findings.
The dietary intake of 135,335 individuals, aged between 35-70, across 18 countries and over a time frame of January 1st 2003 and March 31st 2013 was assessed and analysed. The focus was on the efficacy of existing knowledge as well as fresh information that might produce a change of perspective related to dietary contributions to better health.
For decades, guidelines have focused on reducing total fat and saturated fatty acid intake. This was based on the presumption that replacing the latter with carbohydrate and unsaturated fats will lower LDL cholesterol (the so-called ‘bad’ cholesterol) and should therefore reduce cardiovascular disease events.
This perspective was predominantly based on selective emphasis on some observational and clinical data.
Most of which has stemmed from European and North American populations where nutrition excess is more likely.
Needless to say the applicability of these outcomes and conclusions to other populations has been open to speculation.
In conducting the research the targeted outcomes were two fold.
The primary were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure).
The secondary were all myocardial infarctions, stroke, cardiovascular disease mortality, and non-cardiovascular disease mortality.
The associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality, were also assessed.