More cheese, less meat: The new eating advice for a healthy heart

Poor diet is a leading contributor to heart disease, accounting for about 65 per cent of the total burden.

But what exactly do we need to eat and avoid?

Good news for cheese lovers.

To help Australians reduce their risk and to help those with heart disease maintain their health, the Heart Foundation today released new eating guidelines based on a review of the latest research.

The new advice, based on a two-year review, focuses on dairy, meat and eggs.

“There’s been quite a shift in public health nutrition research and we wanted to ensure our healthy eating guidelines … were underpinned by the best available evidence,” said director of prevention at the Heart Foundation, Julie Anne Mitchell.

“What we found was that in regard to dairy, the effect of low fat versus full-fat milk, cheese and yoghurt on heart disease risk was really quite neutral. So our advice is changing.”

Now, instead of recommending low-fat dairy, they advise that full-fat is fine too.

“There is the caveat that if you have heart disease or you have high cholesterol, we still recommend low-fat options,” she said.

The Heart Foundation's chief medical adviser, cardiologist Professor Garry Jennings, added: “Butter, cream, ice-cream and dairy-based desserts are not recommended as heart-healthy, as
they contain higher fat and sugar levels and less protein.”

They have also removed the limit on the recommended number of eggs healthy people consume per week, but suggest those with high cholesterol and those with Type 2 diabetes stick to seven.

And the advice, which previously had no limit on red meat consumption, suggests swapping it for “proteins that are protective of heart health” such as lentils, chickpeas, beans and fish.

“We’re saying we should reduce our intake to about one to three serves of unprocessed red meat a week because there was some evidence red meat is a moderate risk for heart disease,” Ms Mitchell said. “Broadly speaking, we’re saying about 350 grams a week – that equates to maybe a couple of slices of a good lamb roast or a beef stir-fry or a very lean cut of good quality steak with vegetables.”

Public health nutritionist Dr Rosemary Stanton is “really pleased with the Heart Foundation's new stance”, as it promotes foods rather than nutrients.

“For my part, I am very pleased that the HF got rid of the flawed Tick program a few years ago and has now followed up with what I consider evidence-based information that addresses the whole diet,” Dr Stanton said.

Cheese and yoghurt – being fermented dairy products are different again from milk itself and seem to offer extra benefits.

NHS consultant cardiologist and professor of evidence-based medicine Dr Aseem Malhotra says the lifted restrictions on full-fat dairy for healthy Australians are “welcome”.

However, he adds: “Restricting foods high in saturated fat such as butter for heart attack patients specifically has been proven not to improve outcomes in this group, so this recommendation is not evidence-based.”

He is also sceptical about the link between eggs and heart disease.

“The current best evidence suggests that an extra-virgin olive oil-based Mediterranean diet that is low in sugar and refined carbohydrates, combined with moderate activity and psychological stress reduction, is the best way to prevent and potentially reverse heart disease,” Malhotra said.

In response, Dr Stanton said: “The 'food matrix' in milk, cheese and yoghurt involves protein and calcium (and a number of B vitamins and other factors) in contrast to what is found in butter. Cheese and yoghurt – being fermented dairy products – are different again from milk itself and seem to offer extra benefits … Why eggs increase risks for people with diabetes isn't known, but it has been observed in a number of studies.”

Ms Mitchell insists they “are confident and stand by the evidence review”.

“The take-home advice is to eat a plant-based diet,” she said. “If you can aim to cover half your plate with vegetables and fruit, a third covered with whole grains and then smaller portions of healthy proteins and use of healthier oils, then you’re doing a great job.”

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