The Main Artery

Vegan, South Beach or balanced? 

From years of working in healthcare marketing, I know that diet information dominates when it comes to creating great content and great offers. (Have you heard my story about the online cookbook that generated more than 7,000 responses?)

That’s a tale for another day.

But it seems to me that lately, there’s new controversy swirling among cardiologists about what constitutes a heart healthy diet today. South Beach, the “right-protein, right-carb” brainchild of Dr. Arthur Agatson, has been popular for a few years now, and it seems to have staying power. In fact, my brother-in-law’s doctor just prescribed it for him last week. A lot of meat eaters say it satisfies their cravings but still allows them to lose weight.

Recently, though, it seems that strict vegans are duking it out with those who espouse a more balanced diet. I got a heart health newsletter recently that touted the benefits of both diets in the same issue.

One camp led by Dr. Cadwell B. Esselstyn Jr., M.D. of the Cleveland Clinic claims that his plant-based, oil-free diet not only prevents heart disease but reverses it. Items we’ve all been led to believe are healthy, e.g., olive oil, fat-free dairy and even egg whites are all outlawed on Dr. Esselstyn’s plan. His son seems to be making a pretty good living with the Engine 2 diet, a version of his dad’s diet that he sold to his firefighter comrades in an effort to show “plant-based solidarity” for a fallen brother. Dr. Esselstyn’s plan is very strict, but former President Bill Clinton says it saved his life.

On the other hand, we see people like cardiothoracic surgeon, Dr. Mehmet Oz promoting a balanced diet that includes lean protein, fat-free dairy and tons of fruits and veggies.  Several sources have recently published Dr. Oz’s top 100 foods for hearth health.

Most of the items on the list consist of fresh, whole foods – with the exception of soy hot dogs, which I personally find a little odd. But the list definitely includes items that are banned by Dr. Esselstyn: lean meats, low-fat dairy, eggs and even real butter in moderation.

Who is right? Dr. Esselstyn would have us believe that even in moderation, all animal products and oils are dangerous. Dr. Oz says animal proteins fill us up and that vitamins in milk fat are beneficial.

It’s a conundrum, especially for heart patients who are trying to make changes. How can they decide, and what’s our role as marketers in helping them sort it out?

I’m not really sure. At this point, I think it’s incumbent on us to continue to publish information put forth by reliable sources even if it’s contradictory. I admire aspects of each of these diet plans. Both emphasize a move away from America’s obsession with processed, high-fat, high-sodium, low-nutrition foods. And both can point to patients who have had great success following their plans.

I guess I still subscribe to the theory that it’s our job to publish information and then let people decide what is right for them.

What do you think?

Increasing your fitness level may counteract some of the consequences of being a little heavy.

The effects of exercise on people who carry a few extra pounds prompted a new study that focused on aerobic fitness and weight swings.

This is not a new debate. Several previous studies have debated the relative risks of being fat but fit. Results have been mixed with some suggesting that physical fitness essentially eliminates the risks of extra pounds. Others have concluded the exact opposite; saying that extra weight contributes greatly to heart disease even if someone regularly exercises.

A problem with many of these studies is that they have compared aerobic fitness and weight at only one point in time, which does not account for the changes in people’s bodies over time.

In the new study, researchers from the University of South Carolina looked at data from a Dallas clinic that followed more than 3,100 adults for at least six years and three check ups. Physicians recorded several cardiovascular health measures, including blood pressure, cholesterol profile, abdominal girth and body fat percentage. They also measured the patients’ aerobic fitness using treadmill tests.

Most of the subjects were in their 40s and had no indications of heart disease or risk factors, like high blood pressure or cholesterol, at the beginning of the study.

Next, they compared the same patients’ body fat and fitness levels two or three years later, during a second checkup. At this second data collection point, most patients had gained body fat. Surprisingly, many also had become more fit, possibly because they were hearing regular reminders about exercise from their doctors. None during that second visit yet showed discernible risk factors for heart disease.

Things were different by the third checkups a few years later, though. At this point, almost a quarter had developed high blood pressure, high cholesterol or metabolic syndrome.

Not surprisingly, those who’d both lost fitness and gained fat now had a 71 percent greater chance of suffering from metabolic syndrome than those who’d lost fat.

But staying fit helped even if a person had gained weight. A person who had improved fitness but added fat had a 22 percent lower risk than someone who was both fat and unfit. Dropping fat also helped, but very few people in the study actually lost fat.

 “What this tells us is that both fitness and fatness matter, separately and together, for heart health,” says Duck-Chul Lee, a research fellow at the University of South Carolina who led the study.

Perhaps one of the most encouraging findings for an aging population is that just maintaining fitness might be about as good as showing major improvement:

• People who improved their aerobic fitness had 28 percent less risk of developing high blood pressure than people who had gotten out of shape.
• Those who’d simply maintained their baseline fitness throughout the study, adjusted for age (aerobic capacity declines with age, even among people who exercise regularly) had 26 percent less risk of the condition.

Not much of a difference.

The study’s lead researcher says this is good news for most people because reducing body fat is really hard. “Maintaining your fitness over your lifetime is just as important, and for most people is probably more achievable.”