High-Carb Ornish, Weight Watchers Diets Best For Heart Health? Better Think Again!

Dr. Yunsheng Ma contends high-carb diets best for cardiovascular health

With all the attention being placed on high-fat, low-carb diets again with the release of the new Gary Taubes book Good Calories, Bad Calories last week, you just HAD to know a study like this one was bound to mysteriously show up seemingly out of thin air so it would make headlines. Don't believe for a second this thing was not coordinated with the Taubes book release. It's just too conveniently timed if you ask me.

Lead researcher Dr. Yunsheng Ma, assistant professor of medicine at the University Of Massachusetts Medical School, and his colleagues wanted to pinpoint which of the most popular diet plans over the past five years is best for heart health by rating them in order for their ability to reduce the risk of cardiovascular disease.

Before I share the results of this study with you, let me just ask the obvious--how in the world can you accurately determine which diet plan is best for cardiovascular health when there isn't a consensus on what actually is at the root of heart disease to begin with? Traditional health promoters says it's the fat, but more modern and intelligent-thinking researchers are conducting studies that seem to point to carbohydrates as the culprit. So what good does a ranking of the diets do when the parameters for measuring it are in question, hmmmm?

Think about that as I share the results of this UMass study with you.

The researchers chose the most popular weight loss plans that have hit The New York Times bestseller list since 2002 for this study to analyze them using the creation from Dr. Walter Willett from Harvard University called the Alternate Healthy Eating Index (AHEI) as the standard by which to measure whether these various diets are "heart healthy" or not. This is a bit different from the USDA-recommended Healthy Eating Index which was the basis for the 2005 update to the much-heralded United States Department of Agriculture's newly revamped Food Pyramid.

Dr. Willett felt the USDA was woefully inept in their attempt to help people understand how to make their diet the best it can possibly be, which is why he created the AHEI. Here's what those supposedly new and improved guidelines entail according to the Alternate Healthy Eating Index parameters for the Healthy Eating Pyramid outlined in Dr. Willett's book Eat, Drink, And Be Healthy (let's see if they're any better than what the USDA came up with):

- Whole Grain Foods (at most meals)

The body needs carbohydrates mainly for energy. The best sources of carbohydrates are whole grains such as oatmeal, whole-wheat bread, and brown rice. They deliver the outer (bran) and inner (germ) layers along with energy-rich starch. The body can't digest whole grains as quickly as it can highly processed carbohydrates such as white flour. This keeps blood sugar and insulin levels from rising, then falling, too quickly. Better control of blood sugar and insulin can keep hunger at bay and may prevent the development of type 2 diabetes.

Obviously, I disagree with the "body needs carbohydrates" assertion and have done just fine remaining energetic and alive without the need for the so-called "healthy whole grains" craze that has swept the nation in recent years. Sure, these may be better options than refined carbs, but they STILL turn into sugar in the body.

- Plant Oils

Surprised that the Healthy Eating Pyramid puts some fats near the base, indicating they are okay to eat? Although this recommendation seems to go against conventional wisdom, it's exactly in line with the evidence and with common eating habits. The average American gets one third or more of his or her daily calories from fats, so placing them near the foundation of the pyramid makes sense. Note, though, that it specifically mentions plant oils, not all types of fat. Good sources of healthy unsaturated fats include olive, canola, soy, corn, sunflower, peanut, and other vegetable oils, as well as fatty fish such as salmon. These healthy fats not only improve cholesterol levels (when eaten in place of highly processed carbohydrates) but can also protect the heart from sudden and potentially deadly rhythm problems.

Fats are INDEED healthy and I mean ALL fat sources and not just from plants. Some oils/fats not listed here that should be include butter, coconut oil, lard, animal fat, and other saturated fats. When consumed as part of a low-carb diet, these fats are extremely beneficial to your health and will protect your heart. Believe it or not, eating fat is a major part of a healthy lifestyle.

Vegetables (in abundance) and Fruits (2 to 3 times)

A diet rich in fruits and vegetables can decrease the chances of having a heart attack or stroke; protect against a variety of cancers; lower blood pressure; help you avoid the painful intestinal ailment called diverticulitis; guard against cataract and macular degeneration, the major cause of vision loss among people over age 65; and add variety to your diet and wake up your palate.

It's very easy for people to just nod their head in agreement with the fruits and vegetables recommendation, but my problem with this is WHICH ONES? There's never a distinction between the good fruits and veggies (non-starchy, green leafy, low-glycemic) and the bad fruits and veggies (starchy ones like potatoes and corn and sugary like bananas and oranges). To me it's just an irresponsible copout to say "eat your fruit and vegetables" and never explain the differences between the good and the bad.

Fish, Poultry, and Eggs (0 to 2 times)

These are important sources of protein. A wealth of research suggests that eating fish can reduce the risk of heart disease. Chicken and turkey are also good sources of protein and can be low in saturated fat. Eggs, which have long been demonized because they contain fairly high levels of cholesterol, aren't as bad as they're cracked up to be. In fact, an egg is a much better breakfast than a doughnut cooked in an oil rich in trans fats or a bagel made from refined flour.

Yes, protein is indeed power food for your body, especially from fish because of the healthy omegas they contain, but I wouldn't get too worked up over saturated fat. Chicken and turkey are good choices if you like them, but there is absolutely nothing wrong with the saturated fat-heavy beef and pork either (we'll get to those in just a moment). I'm pleased to see eggs and their BENEFIT on satiety mentioned in a positive light because the dietary cholesterol contained in them does NOT raise your cholesterol as has been widely believed by most people.

Nuts and Legumes (1 to 3 times)

Nuts and legumes are excellent sources of protein, fiber, vitamins, and minerals. Legumes include black beans, navy beans, garbanzos, and other beans that are usually sold dried. Many kinds of nuts contain healthy fats, and packages of some varieties (almonds, walnuts, pecans, peanuts, hazelnuts, and pistachios) can now even carry a label saying they're good for your heart.

Almonds have been found to be as healthy as fruits and vegetables and you certainly can't go wrong with eating nuts as a healthy snack on your low-carb lifestyle. But beans are another story entirely. I don't eat beans and haven't in the four years since I began my low-carb journey. Their high-carb counts are not conducive for my weight management program.

Dairy or Calcium Supplement (1 to 2 times)

Building bone and keeping it strong takes calcium, vitamin D, exercise, and a whole lot more. Dairy products have traditionally been Americans' main source of calcium. But there are other healthy ways to get calcium than from milk and cheese, which can contain a lot of saturated fat. Three glasses of whole milk, for example, contains as much saturated fat as 13 strips of cooked bacon. If you enjoy dairy foods, try to stick with no-fat or low-fat products. If you don't like dairy products, calcium supplements offer an easy and inexpensive way to get your daily calcium.

Again, the saturated fat issue isn't something to worry about. Getting the higher fat sources of dairy is BETTER for you than the low-fat ones. Besides, fat-free cheese is disgusting and the fat-rich ones are not only delicious but nutritious, too! Skip the regular milk and opt for low-carb ones like Calorie Countdown or even heavy cream instead to reduce the carbs. Don't skimp on the fat when you're reducing the carbs because it is your body's fuel on a ketogenic diet.

Red Meat and Butter (Use Sparingly)

These sit at the top of the Healthy Eating Pyramid because they contain lots of saturated fat. If you eat red meat every day, switching to fish or chicken several times a week can improve cholesterol levels. So can switching from butter to olive oil.

I couldn't DISAGREE with Dr. Willett more about red meat and butter because the saturated fat is NOT an issue when carbohydrates are reduced. This is something Gary Taubes illustrates beautifully in his book despite cutesy attempts by health groups like the American Heart Association and their "Bad Fat Brothers" campaign which I saw a television commercial about the other day. PUH-LEEZ! Keep eating butter and red meat while limiting your carbs and something amazing will happen--your HDL "good" cholesterol will go WAY up (a VERY good thing!) and your triglycerides will plummet to below 100. And recent studies have shown that these are better markers for cardiovascular health than LDL and total cholesterol anyway.

White Rice, White Bread, Potatoes, White Pasta, Soda, and Sweets (Use Sparingly)

Why are these all-American staples at the top, rather than the bottom, of the Healthy Eating Pyramid? They can cause fast and furious increases in blood sugar that can lead to weight gain, diabetes, heart disease, and other chronic disorders. Whole-grain carbohydrates cause slower, steadier increases in blood sugar that don't overwhelm the body's ability to handle this much needed but potentially dangerous nutrient.

FINALLY! Something Dr. Willett and I agree on regarding a healthy diet. But he says to "use sparingly." I would contend DON'T USE AT ALL if you want to do your health a big favor. You don't need these empty, garbage carbs anymore, so why even bother with them. They only lead to heartache and pain--both figuratively and LITERALLY!

Multiple Vitamin

A daily multivitamin, multimineral supplement offers a kind of nutritional backup. While it can't in any way replace healthy eating, or make up for unhealthy eating, it can fill in the nutrient holes that may sometimes affect even the most careful eaters. You don't need an expensive name-brand or designer vitamin. A standard, store-brand, RDA-level one is fine. Look for one that meets the requirements of the USP (U.S. Pharmacopeia), an organization that sets standards for drugs and supplements.

Again, couldn't agree more about taking supplements, including fish oil. Couldn't and wouldn't live without them!

Alcohol (in moderation)

Scores of studies suggest that having an alcoholic drink a day lowers the risk of heart disease. Moderation is clearly important, since alcohol has risks as well as benefits. For men, a good balance point is 1 to 2 drinks a day; in general, however, the risks of drinking, even in moderation, exceed benefits until middle age. For women, it's at most one drink a day.

I'm personally not a drinker, but clearly alcohol is not a good choice for a healthy lifestyle. But the 1-2 drink a day recommendation by Dr. Willett must come with one disclaimer that people should know about before taking that drink--you WILL get kicked out of ketosis and fat-burning will cease until all the alcohol is used for fuel. Think of it as a super-charged carbohydrate that the body has to get rid of before stored fat will begin melting again.

Okay, now that you understand the criteria by which all of these diets were measured, each was given a score of 0-10 for each of the following seven conditions:

1. the ratio of white to red meat
2. ratio of polyunsaturated fat to saturated fat
3. quantities of fruit
4. quantities of vegetables
5. quantities of nuts and legumes
6. quantities of cereal fiber
7. quantities of trans fats.

As you can see, these are not a very low-carb friendly set of dietary stipulations from the get go, so the results should surprise no one. With 70 being the "perfect score," here's how the top ten diets did in a head-to-head face off using Dr. Willett's guidelines (and it shouldn't surprise anyone!):

Ornish (ultra low-fat diet)--64.6
Weight Watchers high carbohydrate--57.4
New Glucose Revolution--57.2
South Beach/Phase 2--50.7
Zone--49.8
2005 Food Guide Pyramid--48.7
Weight Watchers high protein--47.3
Atkins/100g carbohydrate--46
South Beach/Phase 3--45.6
Atkins/45g carbohydrate--42.3

The results of this "study" reminded me the Consumer Reports survey that came out about the various diets in June ranking them according to what is considered a "healthy" diet. Their criteria? Of course, it was the 2005 U.S. Food Pyramid! Obviously livin' la vida low-carb is NOT gonna do well and it didn't coming in DEAD LAST in that list just like it did this one.

The results of this "study" were published in the October 2007 issue of The Journal of the American Dietetic Association (not exactly friends of the low-carb lifestyle, mind you!).

All the ooohs and aaahs of the researchers about what they have done proclaiming to the world what they have "discovered" is nothing more than a meaningless attempt to denigrate and smear low-carb all over again. It would be like ranking Democrats and Republican candidates for president using the GOP platform as the standard. Obviously, the Democrats would not fare well in that list because the criteria is different for them.

And the same goes for livin' la vida low-carb. Actually, it quite a badge of honor that the Atkins and South Beach diets did so poorly because they DON'T adhere to the conventional wisdom regarding diet and health. Instead, they are an alternative way of eating that is helping people not just lose weight, but control their blood sugars, reduce their insulin production, and effectively manage their diabetes with reduced or completely eliminated medications.

Additionally, we've seen so many other areas of health improved from eating a low-carb diet which I have documented quite extensively here at my blog. Browse through my past articles and you will see some truly remarkable research into low-carb living that will make you wish you had been eating this way a long time ago!

Unfortunately for Dr. Ma, he wants nothing of the good news about low-carb diets to be seen or heard and is only interested in his narrow-minded view of heart health despite studies that clearly show the heart health risks of low-carb over the long-term are futile. But he turns a blind eye to this astounding research and instead acts surprised when the Food Pyramid doesn't do very well in his study.

"One of the unexpected findings is that the 2005 USDA Food Guide Pyramid, the current government recommendation, fared significantly worse than the New Glucose Revolution, Weight Watchers High Carbohydrate and Ornish plans," Dr. Ma noted. "The USDA dietary guidelines were originally devised to prevent nutrient deficiencies and it's clear that we need to modify or rebuild the pyramid to look into cardiovascular disease prevention, as it is the leading cause of death and disability for Americans. Americans deserve a better dietary guideline and recommendation."

Oh, I wholeheartedly agree that "Americans deserve better," Dr. Ma! But they also deserve to hear the truth regarding saturated fat and animal fat being a MAJOR part of a healthy lifestyle. The insistence of people like Dr. Willett to continually hammer the supposed harm that comes from saturated fat intake while all but ignoring the detrimental impact of all those carbohydrates he recommends is despicable. I know he's a highly-respected health "expert" in the United States, but that doesn't make him immune to being questioned.

Study co-author Dr. Sherry Pagoto, who is also an assistant professor of medicine at UMass as well as a clinical psychologist at the UMass Memorial Weight Center, said people should not only choose a diet plan for weight loss, but also for their health.

"Patients can lose weight with most dietary plans in the short term, but whether the plan they choose maximizes cardiovascular risk reduction over the long term should also be a consideration for patients and health care providers," he concluded.

I couldn't agree more, Dr. Pagoto! That's why I CHOOSE to be eating low-carb because my health has never been as good as it is today. Before I started on the Atkins diet in January 2004, I was on prescriptions medicines for high cholesterol, high blood pressure, and breathing. I was 410 pounds on well on my way to diabetes, heart attack, and quite possibly even death.

But one year later, I had lost 180 pounds, cut 20 inches off my waistline, dropped FIVE sizes in my shirts, was more active than I had EVER been (and still am!), and, oh by the way, ditched all of those drugs and haven't taken a single one since! That's what that last-place ranking Atkins diet did for me, baby, and I'm proud of it, too.

Nobody--not Dr. Willett, not Dr. Ma, and DEFINITELY not Dr. Dean Ornish--will EVER be able to take this accomplishment away from me and so many others who have made low-carb their permanent and healthy lifestyle change. We did it despite those recommendations to eat a low-fat, low-calorie diet which had failed to keep the weight off of me over the years because I was constantly hungry and MISERABLE on those diets.

If people can hack the Ornish diet and they like it, then I tell them to GO FOR IT! But this study no more helps people decide which diet is best for them than it would for a city to put a stop light that stays red all the time at a busy intersection would. My advice? IGNORE THIS RIDICULOUS STUDY (and read a REAL comparison study instead) and keep on livin' la vida low-carb. You'll be so glad you did.

You can e-mail your comments and concerns about this study to Dr. Yunsheng Ma at Yunsheng.Ma@umassmed.edu. Let him hear how disappointed you are with him about this research that is nothing more than a not-so-veiled attack against low-carb.

10-3-07 UDDATE: The high-carb, low-fat apologists are delirious about this study as this WCAV-TV story with comments from a University of Virginia exercise physiology professor named Dr. Glenn Gaesser takes the findings and runs with it as gospel.

Check out these absurd statements he makes during the feature:

"I think there is a place for all types of food, it's a matter of balance and proportion."

Um, Dr. Gaesser, livin' la vida low-carb gives me all the "balance" I'll EVER need!

"Most studies indicate that people who consume a lot of carbohydrates generally are thinner than those who do not."

"Most studies" is a rather unilateral statement to make and I would challenge you to look at ALL the preponderance of the evidence concerning diets that are reduced in carbohydrates. While it is arguable those high-carb eaters are thinner, but I can say with confidence that the low-carb eaters are HEALTHIER! And that is more important!

If you want to keep the weight off Gaesser said try a low fat diet not low carb.

Nah, after losing a couple hundreds pounds, keeping it off for several years, and feeling healthier and better than ever before, I'm gonna keep on livin' la vida low-carb, Dr. Gaesser. No more suffering on a low-fat diet for me!

How about sharing with Dr. Gaesser how the low-carb lifestyle has changed your life by e-mailing him at gag2q@virginia.edu? I'm sure he'd be interested in hearing from people who have done very well eating this way. Tell him YOUR story!