Sugar, Processed Meat Raise Risk of Myocardial Infarction

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James J. DiNicolantonio, PharmD Associate Editor BMJ Open Heart Cardiovascular Research Scientist Saint Luke's Mid America Heart Institute

Dr.James DiNicolantonio Interview with:
James J. DiNicolantonio, PharmD
Associate Editor BMJ Open Heart
Cardiovascular Research Scientist
Saint Luke’s Mid America Heart Institute 

Medical Research: What is the background for this study? What are the main findings?
Dr. DiNicolantonio: We comprehensively reviewed the literature looking at the cardiovascular effects of saturated fat and compared them with refined sugars (sucrose and high-fructose corn syrup).  Our main finding is that saturated fat per se is not necessarily unhealthy.  Importantly, people eat foods, not saturated fat, and depending on what foods are consumed determines if saturated fat associates with health risk.  For example, the consumption of processed meat is associated with an increased risk of cardiovascular disease, whereas dairy is not.  Importantly, the replacement of saturated fat with refined sugars seems to increase the risk of myocardial infarction.  Hence, reducing added sugars should be the main focus rather than reducing saturated fat, as the latter could translate to reductions in healthy whole foods that just so happen to also be high in saturated fat (but also provide other healthy fats).

Medical Research: What should clinicians and patients take away from your report?

Dr. DiNicolantonio: Patients consuming foods generally thought of as being high in saturated fat may not be harmful to health, as this depends on processing and how the animal was raised (in the case of animal foods).  Animal foods that are pastured have lower saturated fat content and higher omega-3 and lower omega-6 content, all of these are important differences that affect the health properties of foods that contain saturated fat.  Refined sugar provides zero nutrition and actual are harmful calories, particularly if consumed at over 10% of total calories.  Clinicians should counsel their patients to avoid processed foods, which are generally high in hidden added sugars and to look for those added sugars on the nutrition label.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. DiNicolantonio: Future studies should continue to test the effects of refined sugar.  In particular, studies should focus on reducing the consumption of added sugars to less than 10% of calories and compare that to a second group consuming more calories from refined sugars.  Most trials that give patients a certain amount of sugar are generally null and void because prior to the trial the experimental group has normally consumed that level of sugar for their entire lives, with a high probability of null results to be found.  Thus, we need more “reductionist” studies to ascertain the benefits of restricting added sugar intake, rather than studies that look at what occurs when giving sugar (as the groups being tested have undoubtedly already consumed high levels of sugar intake for their entire lives).


The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease

James J. DiNicolantonio, Sean C. Lucan, James H. O’Keefe
Publication stage: In Press Corrected Proof
Published online: November 13 2015

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James J. DiNicolantonio, PharmD (2016). Sugar, Processed Meat Raise Risk of Myocardial Infarction 

Last Updated on January 14, 2016 by Marie Benz MD FAAD