Thursday, February 08, 2007

Women and the AHA

Women and heart disease.

I decided to evaluate the AHA's recommendations for the prevention and treatment of heart disease in women.

The AHA, in my opinion, is pretty much a joke. The continuously ignore good scientific findings and allow drug and device companies to steer the way to setting treatment standards.

The AHA recommends exercise. Of course they do, no one will argue that exercise isn't good for you!
"No time to exercise? That's OK. Don’t think exercise — think action. Standing is better than sitting; walking is better than standing. Increase your physical activity to at least 30 minutes a day on most days of the week, even if you do it 10 minutes at a time."

Great to start, but most would argue that at least 30 min a day of some kind of physical movement would be the absolute least amount of exercise required.

And of course the AHA recommends not smoking. Everyone does. There is NO upside to smoking!

How To Love Your Heart

Only you can love your heart. There are some risk factors for heart disease you can control:

  • High blood pressure. This condition can increase your risk of heart attack and stroke.
  • Smoking. If you smoke, your risk of developing coronary heart disease is two to four times that of nonsmokers. Smoking is also a major preventable cause of stroke.
  • High cholesterol. The higher your total blood cholesterol, the greater your risk of coronary heart disease and stroke..
  • Physical inactivity. Lack of physical activity increases your risk of coronary heart disease and stroke..
  • Obesity or overweight. If you have excess body fat — especially at the waist — you’re more likely to develop heart disease or have a stroke.
  • Diabetes. Having diabetes increases your risk of heart disease and stroke, especially if your blood sugar is not controlled.

There are other risk factors to be aware of — talk to your doctor about how your age, race and heredity may affect your risk for heart disease.

Now, just what is a "healthy diet" according to the AHA? Well, check out their No Fad Diet. After drilling down a bit, I was able to find the guidelines:
  • Whole grains and legumes: 6 servings.
  • Vegetables and Fruits: 5 servings.
  • Fat free or low fat dairy: 3 servings.
  • Lean meat fish poultry and vegetarian protein: 2 servings.
What is 1 serving?
  • Whole grains and legumes: 1 servings is generally 1 ounce. A cup of cereal, a slice of bread, 1/2c hot cereal, 1/2c whole grain pasta, 1/2c cookedstarchy vegetable (this surprised me!).
  • Vegetables and Fruits: 1 serving is generally 1 medium piece of fruits, 1 cup raw and 1/2c cooked veggies or 3/4c fruit or vegetable juice.
  • Fat free or low fat dairy: 1 serving is 1 cup milk, 1/2c cottage cheese (fat free or low fat only for milk & cheese) or 1 ounce hard cheese.
  • Lean meat fish poultry and vegetarian protein 3 ounces lean meat, fish, poultry or 1/2c cooked beans or lentils. let's try a menu:
1 6oz container fat free, sugar free yogurt
1 cup sliced strawberries with 1 tsp sugar.

2 slice whole wheat bread with 2 tsp "light tub margarine"

Mid-morning snack:
4 reduced fat or light vanilla wafer-type cookies
10 grapes

Cheese toast made with 1 oz shredded cheddar cheese and 1 whole wheat English muffin.
1/2cup baby carrots

1/2cup fat free or light ice cream

Afternoon snack:
1/2 medium banana

1 serving pork tenderloin with cranberry salsa (recipe included)
1 baked sweet potato with
2 tsp "light tub margarine"
1/2cup green beans cooked in 1 tsp olive or canola oil.

As you probably already guessed, this isn't my choice of a diet, but the AHA's choice. This is the sample recipe they give for a 1200 cal/day diet.

My totals, when I entered everything in Fitday, come out a little higher.

Here are the totals:

Not too bad,
Fat: 42g (27%) with 12g saturated, 10g poly and 15g mono.
Carbohydrates: 202g (55%) with 24g fiber
Protein: 64g (18%)

Well within their guidelines for fat and carbohydrate, under 30% for fat and 45-60% carbs. I'm not sure of the protein level, but it seems low to me. we know we're within the guidelines for fat/protein/carb about the guidelines for grains, fruits and vegetables, dairy and protein?

Let's see:
Grains: 2 slices whole wheat bread, whole English muffin (we'll count as 2) and 1 serving sweet potato that's 5 servings. (6 is the recommended amount)
Fruits and vegetables: strawberries, banana, green beans, grapes and carrots = 5 servings (5 is the recommended amount)
Dairy 3 servings: yogurt, cheese and ice cream. 3 servings (3 is the recommended amount)
Lean meat/fish/poultry: 2 3oz servings. hmmm...3 oz pork is one serving. Yogurt and cheese both contain protein, so maybe that counts for the other serving? (2 is the recommended amount)

OK....below their recommendations on grains, but others are OK.

Now, I must go off on another track at this time. Trans fats. There is absolutely no excuse (in my opinion) for anyone, let alone the AHA, to recommend any food that may contain trans-fats without a warning or notation or something!

Most commercial breads contain at least trace amounts of trans-fats. Cookies, commercial ice cream and tub margarine often contain trans-fats! But not one word about checking labels.

OK....back to the sample menu.

How about RDA, How does it add up?

Shocking, isn't it? RDA is met or exceeded, for only Carbs, fiber, protein, Vitamins A & C, and Manganese. Phosphorus and riboflavin are close with 97 & 99% RDA, so I'll give them those two also. But, it is deficient in every other parameter! Look at Vitamin D! Zinc! B12! the RDA is based on more than 1200 calories, which I agree are too low for the average woman.

Let's take a look at their recommendation for a 2000 calorie diet:
1 omelet made with egg substitute, mushrooms, spinach and milk and canola or olive oil cooked in 2 tsp "light tub margarine".
1/2 whole wheat English muffin with 1
tsp "light tub margarine" and 1 tablespoon light sugar preserves.
6 oz low sodium tomato or fruit juice.

Mid-morning snack:
1 6oz container fat free, sugar free yogurt
1/2cup raspberries

Sandwich with 2 slices whole wheat bread, 3 oz fat free, reduced sodium deli roast beef, lettuce, tomato and mustard
1oz baked potato chips
1/2cup blueberries with 1 tsp sugar
8oz fat free milk

Afternoon snack:
1 medium banana


1 serving bistro chicken with asparagus (recipe included)
1 cup cooked summer squash with
2 tsp "light tub margarine"
1/2 cup couscous (98% fat free, reduced sodium)
1 whole wheat dinner roll with 1 tsp "light tub margarine"
1/2 c fat free or light ice cream with 1/2 cup sliced peaches and 1/4 cup sliced almonds.

Sounds like a pretty reasonable menu. Again with the tub margarine and packaged foods, and I don't get adding sugar to berries! They're sweet enough!

OK so here are the numbers:

Again, my numbers are a tad higher, but again, the guidelines for fat, protein and carb is pretty much on track. Carbs are actually a little low (based on 45-60% of calories from carbs).

Here's the nutrition stats:

And the %RDA:

And, once again, we see some serious deficiencies, especially in Vitamin D, Vitamin A and Folate!! Better than the 1200 calorie example, but still deficient in important nutrients.

So. This is the AHA's idea of a healthy diet?

Even though Folate is very important for women, and Vitamin D is now being implicated in several diseases and disorders (including cancers and heart disease), this diet is below the RDA. And look atcalcium! We hear how important calcium is, but this diet is barely adequate.

So. You follow this "No-Fad Diet" and what happens? Because your carb intake is high, you'll likely have high triglycerides and small denseLDL. Your HDL will likely be low due to the artificial foods and lack of saturated fats. Because you're eating processed foods that likely contain at least HFCS or trans-fats, (not to mention a slew of other chemicals!) you'll have higher levels of inflammation. And because you're deficient in some key vitamins and minerals, you'll have less protection against not only heart disease, but also cancers anddegenerative diseases!!! You're also probably well on your way to developing insulin resistance and possibly even diabetes. If you're already diabetic, you're probably finding it hard to keep your sugars in good control.

And then what?

For the high cholesterol readings, especially the low HDL, they'll tell you to cut saturated fats even more, watch cholesterol intake, and maybe even be given drugs to lower your cholesterol. Drugs, I might add, that show NO benefit to women.

For the inflammation, you'll also be given anti-inflammatories and possibly be pushed into taking statins as they have a strong anti-inflammatory effect.

And for the diabetes and insulin resistance, you'll be given prescriptions and told to eat less and exercise more.

What about taking vitamins? minerals? anti-oxidants?
"The American Heart Association doesn't recommend using antioxidant vitamin supplements until more complete data are available. "
“Our study does not suggest that taking folic acid, B6 or B12 primarily to prevent cardiovascular disease (CVD) would be worthwhile. Women who are taking them solely for that purpose may want to discontinue,”
The possibility that magnesium deficiency has a role in the development of coronary heart disease is only an interesting and provocative hypothesis."

In summary,
The American Heart Association, which is "a national voluntary health agency whose mission is to reduce disability and death from cardiovascular diseases and stroke". is recommending the intake of a diet that is deficient in several key nutrients.

Statins. Even though there is NO evidence that statins do anything for women, or even that lowering cholesterol naturally benefits women, the AHA continues to recommend statins for women. There are articles on the AHA website that extol the virtues of statins:
Statin drugs lower heart disease risk in postmenopausal women
"Treatment with a cholesterol-lowering statin can significantly reduce the risk of heart disease and possibly death in postmenopausal women taking hormone replacement therapy (HRT), investigators report in the rapid access issue of Circulation: Journal of the American Heart Association."

American Heart Association's Guidelines At-A-Glance for Preventing Heart Disease and Stroke in Women
  • ACE inhibitors and beta-blockers are recommended for all high-risk women.
  • High-risk women should be prescribed statin therapy even if their LDL cholesterol levels are below 100 mg/dL.
  • Niacin and fibrate therapies are given a strong recommendation for high-risk women with specific cholesterol abnormalities.
In the 12 guidelines, 6 of them, fully half, recommend some kind of medication. Only two are diet related, and says "In addition to a heart-healthy diet, supplementation with omega-3 fatty acids and folic acid may be considered in some high-risk women." and "Smoking cessation, regular physical activity, a heart-healthy diet and weight maintenance are given a strong priority in all women." It specifically excludes the use of antioxidants too! "Hormone therapy and antioxidant vitamin supplements are not recommended for CVD prevention for women at any level of risk." Now I can see the HRT, but antioxidants!?!?

Nothing about limiting processed foods. Nothing about avoiding HFCS (high fructose corn syrup) and trans-fats that are present in many processed foods.

For more information about statins and their effects, I strongly recommend Dr Graveline's website.
For information about lowering blood sugar levels, I would check out Dr Mary Vernon, Dr Michael Eades and Dr Mary Dan Eades. Also nutritionists Jonny Bowden.
For information on the truth about dietary and blood cholesterol, and the "risk" of heart or other diseases, see Dr Michael Eades, Joseph Mercola and
Uffe Ravnskov.
The Weston A Price Foundation is a great source of information on the benefits of natural foods vs the dangers of industrial foods.


Calianna said...

This quote from them made me laugh:

"... reduce the risk of heart disease and possibly death in postmenopausal women.."

They seem to be blithly unaware of the fact that LIFE is always 100% fatal! The older you get (such as if you're a post menopausal woman), the closer that death will be.

I don't mean to be a fatalist, but sheesh, you follow their ill-concieved dietary and medication recomendations, it'll very likely be fatal a lot sooner, rather than later.

They're trying to cheat death by doing everything they can to make you as unhealthy as possible.

Aaauuugghhh!! Somebody's gotta stop the insanity!

Cindy said...

I agree calianna!!

I fear, however, that we have a long time of continued insanity ahead of us. They're not going to change until they have no choice!

Sara said...


Great blog! I'm glad you mentioned it over at the MDA. Keep up the great work - you are doing the right things!



Cindy said...

Sara, thank you for your kind words.

Stay tuned for more posts on the AHA and the recent absurd new recommendations for women!

Sherrie said...

My gosh and here they are blaming our low carb diets for deficiency in folate!

Cindy said...

They have to have something to demonize, and of course it can't be the diet THEY recommend!!!