Are the new dietary guidelines good for heart health?

DEAR DOCTOR K:

I’m at an increased risk for heart attack and stroke. Will the new dietary guidelines help keep my heart healthy?

DEAR READER:

In late 2015, the U.S. government issued a new edition of the Dietary Guidelines for Americans. This report helps Americans make healthy food choices. But if you’re concerned about having a heart attack or stroke, the advice in the latest update doesn’t entirely agree with what many nutrition experts — as well as the American Heart Association (AHA) — recommend.

I spoke with my colleague Dr. Walter Willett, professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health. He shared his thoughts about where the new guidelines may not be aggressive enough for people at risk for heart disease. Here’s our advice on four dietary components:

RED MEAT. The guidelines say: A healthy eating pattern includes a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds and soy products.

We say: Grouping lean red meat with other types of protein is wrong. The health implications from these foods are very different. Many people assume the saturated fat in beef, lamb and pork is the main problem. That’s certainly one problem. But lean red meat also contains cholesterol, heme iron and other components that likely contribute to heart disease risk. If you like red meat, enjoy it only occasionally as a special treat.

SUGAR. The guidelines say: Consume less than 10 percent of calories per day from added sugars.

We say: The new guidelines are based on research showing that people who eat less sugar tend to have lower rates of heart disease. But the upper limit suggested by the AHA — about 5 percent of calories — is better than the 10 percent recommended by the guidelines. That translates to about 6 teaspoons of sugar a day for women and 9 teaspoons per day for men.

SALT. The guidelines say: Consume less than 2,300 milligrams (mg) per day of sodium.

We say: Excess sodium is closely tied to high blood pressure — a major risk factor for heart disease. You’re better off aiming for the 1,500 mg of sodium per day recommended by the AHA.

CHOLESTEROL (AND EGGS). The guidelines say: No specific limit on cholesterol. (Earlier guidelines recommended a limit of 300 mg per day.)

We say: For your heart’s sake, limit eggs to no more than three a week — especially if you have diabetes.

Remember, this advice applies to people at increased risk for a heart attack or a stroke — not to everyone. The risk factors that increase a person’s risk include age, gender, close relatives with heart disease or stroke, high blood pressure, high total cholesterol or LDL (“bad”) cholesterol, diabetes or prediabetes, or metabolic syndrome. You can calculate your risk of heart disease and stroke over the next 10 years online at: www.reynoldsriskscore.org.