Last week, the venerable New England Journal of Medicine published the results of a study showing that your diet can have as significant an effect on your risk of cardiovascular disease as any prescription drug. The response from the medical industry was immediate. The New York Times called it “a watershed moment in the field of nutrition.” Neil J. Stone, MD, former chair of the American Heart Association’s nutrition committee, said, “This is the start of where we need to go with nutritional clinical trials.”
I have no medical training or credentials whatsoever, and all I could think was, Duh! In the world of alternative and integrative medicine, diet has always been seen as a key ingredient in a healthy lifestyle. I’d say it’s about time conventional medicine got a clue.
For the past 50 years, doctors have been pushing surgery and pharmaceuticals as the only way to prevent heart attacks and strokes. And when they did talk about diet, they preached the gospel of low-fat foods, despite numerous studies showing the nutritional value of healthy fats. (Check out “A Big Fat Mistake” for more on this.) So it’s hard to understand why a single study from the University of Barcelona, involving about 7,500 people, would have such an impact on the industry.
But, according to Dr. Daniel J. Rader, a heart disease specialist at the University of Pennsylvania, the Barcelona study tested the Mediterranean diet hypothesis in a way it had never been tested before. “Given the importance of diets and given the decades of dietary recommendations we have given to people, you would think we would have had more dietary studies with hard endpoints to get at these questions,” Rader told the Times. The best of these earlier studies looked only at intermediate markers of risk, like cholesterol levels (the results of which, it turns out, were mostly misinterpreted).
I might also suggest that there’s little incentive for researchers to turn their attention to dietary changes, when pharmaceutical remedies are far more lucrative. And I have to say that I’m not optimistic that organizations like the American Heart Association are going to change their views on this anytime soon. As Alice Lichtenstein, lead author of AHA’s dietary guidelines, told the Times, “We definitively need to test plausible diets, within the context of what is available and consumed in the U.S., that could lower the risk of heart disease.”
But when asked whether she thought a study of vegan diets and their effect on heart disease might be in the offing, Lichtenstein was not optimistic. “Given the high cost of conducting a long-term diet study, we have to think about what is feasible for the majority of the U.S. population,” she said. “From past experience, we know it is highly unlikely people are going to make radical changes in their diet and stick with those changes long term.”
Not exactly a ringing endorsement of the Barcelona study.
In fact, the medical industry is far behind the curve when it comes to nutrition and its impact on health. Michael Lauer, MD, director of the division of cardiovascular sciences at the National Heart, Lung and Blood Institute, says it reminds him of where heart attack research was 50 years ago, when victims were placed on bed rest and given lidocaine and nitroglycerin — a treatment regimen that tended to shorten, rather than lengthen, life spans.
The good news is that we don’t have to wait for Western medicine to catch up with functional medicine pioneers like Mark Hyman, Frank Lipman and others, who long ago began helping people regain their health through dietary and lifestyle changes. All we need to do is to educate ourselves about this approach, shift our eating habits and wean ourselves from a medical model that I fear is destined to forever be surprised by the obvious.