American Heart Updates Dietary Guidance – Almost

Dietary bias can be very slow to fade. The American Heart Association updated its dietary guidance for the first time in more than a decade. The new guidance has a lot of good things in it. There’s less emphasis on individual good and bad foods. More emphasis on healthful patterns for eating. The guidance makes mention of factors beyond individual choice that influence diet and health.

But the AHA remains stuck on a few things. One is the fear of dairy fat. Despite evidence to the contrary, this guidance posits that nonfat or low-fat dairy is the only way to go.

Furthermore, despite a nod to factors beyond individual choice, adherence is a central concept in this guidance. Do what we say.

The Dairy Hangup

It’s now pretty obvious that the low-fat dairy guidance is a holdover from the good old days of the 1980s and 1990s when everything was supposed to be low-fat for good health. Even cookies.

The rationale is simple. It’s a bit of a fig leaf. Folks who pushed the low-fat everything agenda can concede that they went a little too far, so long as they can hang onto their belief that the real problem was good fats versus bad fats. Saturated fats are bad. Unsaturated fats are good. Dairy fats are saturated fats, so by definition, they are bad.

But the problem is that more and more data contradicts this dogma. Just this week at the AHA Scientific Sessions, Fenglei Wang and colleagues presented data that again points to this problem. They found that consuming fats from most animal sources predicts a higher risk of stroke. Dairy fat is the exception – there was simply no link to stroke risk.

This lines up with other studies of dairy fat and health outcomes. Yet AHA remains stuck on recommending low-fat dairy products.

The Imperative to Comply

Mandates to comply with health guidance don’t go down well these days. “Compliance” is out of fashion. So the AHA uses “adherence” instead. Does that feel better?

The authors of this guidance also write at length about systemic problems that get in the way of adherence to their advice. Racism, food insecurity, and unhealthy food marketing are problems because they “impede adherence” to healthy dietary patterns.

That’s one way of looking at it. One might also consider whether dietary patterns are perhaps correlates of bigger problems that do even more to harm health and prospects for life. Food for thought.

Click here for the new guidance from AHA and here for the study by Wang et al. For further perspective, click here and here.

Love Flight of a Pink Candy Heart, painting by Florine Stettheimer / WikiArt

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November 16, 2021