Nutrition Myths
Victoria Taylor
Senior Dietitian
British Heart Foundation
Introduction
• Common myths about diet and CVD
• Exploration of the truth behind the myths
• Sources of information for patients and
health professionals for ‘rapid responses’
Where do myths come from?
What makes a good myth?
• Based on absolutes
• A kernel of truth
• A tasty morsel
Top heart health myths
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Eggs will raise cholesterol levels
It’s better to eat butter
Sugar is more dangerous than fat
Sugar is the new tobacco
Fat spreads are full of trans fats
5-a-day isn’t enough
Sea salt is better than table salt
Drinking red wine and eating dark
chocolate will protect my heart
Eggs raise cholesterol
levels
The kernel of truth:
• Eggs, along with other
foods such as prawns and
liver are sources of
cholesterol in the diet.
• Limit on dietary cholesterol
in AHA guidelines and UK
FH NICE guidance
• High cholesterol is a risk
factor for CHD
Busting the myth
• Early feeding studies did not
account for other dietary
factors that could also affect
blood cholesterol levels
• Evidence to support the link
between dietary cholesterol
and CHD is insubstantial
• Current intake is around 2-3
eggs a week
Advice to patients
• Eggs can be included– an egg a day, not a
7 egg omelette- as part of a healthy,
balanced diet
• Avoid adding saturated fat when
cooking…or combining with sausages,
bacon and thickly buttered toast.
• FH – discuss with healthcare team
It’s better to eat butter
• The kernel of truth:
• 3 systematic reviews
looking at a link between
deaths from MI and
saturated fat consumption
have failed to show a link.
• Trans fats should be
avoided
• We are eating too much
sugar
It’s better to eat butter
• Myth busting:
• A meta-analysis is only as good as the
research papers it is based on
• Good evidence shows a link between a diet
high in saturated fat and raised cholesterol,
and raised cholesterol increases risk of
CHD.
• Pre 2007 spreads made from unsaturated
oils contained trans fats
• Sugar intakes have exceeded
recommendations for the last 5 years – but
so have saturated fat intakes
Advice to patients: fat
• Switching from saturated fats like butter to
unsaturated fats is recommended to lower
cholesterol levels
• Use oils for cooking and can also be used
for some baking
• Spreading fats no longer contain trans fats
but not essential to use
• If butter used (and no foods are banned…)–
make it occasional and be sparing
Advice for patients: sugars
• As part of a balanced diet, cut down on
sugar – added and free sugars from juices
and smoothies
• Keep juice to max 1 portion per day
(150ml)
• Other key sources are sugar sweetened
drinks, jams and preserves, yoghurts and
alcoholic drinks
5-a-day isn’t enough – it
should be 7 a day
• The kernel of truth:
– Researchers at UCL used data from HSE
which suggested risk of death (due to
reduction in CVD and cancer) reduced with
each additional portion of fruit and veg
consumed.
– The group eating 7 or more portions a day
had the lowest risk.
• Busting the myth:
– Good awareness of 5-a-day recommendation
– But average intakes of fruit and veg remain at
around 3-4 portions per day
– Still lack of understanding about portion sizes
Advice for patients?
• Don’t let this put you off if you struggle
with eating fruit and veg
• More isn’t a bad thing but the
recommendation hasn’t changed
• Every one portion increase showed a
benefit
• Aim for 5 a day if you aren’t managing it
already
Sea salt is better than
table salt
• The kernel of truth:
• Sea salt, Himalayan pink salt and fleur du sel do
contain small amounts of minerals compared to
standard table salt.
• Busting the myth:
• All salts contain the same amounts of sodium
chloride and so will have the same effect on
blood pressure
• Additional minerals in such small amounts that
they won’t make a difference.
• Natural isn’t another word for healthy (same
goes for sugar)
Red wine and chocolate
are good for me
• The kernel of truth:
– Polyphenolic compounds in red wine and dark
chocolate are associated with heart health benefits.
– Health claim for dark chocolate approved for use by
EFSA –
• ‘The Panel concludes that a cause and effect relationship has been established
between the consumption of cocoa flavanols in the HF cocoa extract (i.e. in capsules or
tablets) and maintenance of normal endothelium-dependent vasodilation.’
– Small amounts of alcohol can be beneficial in terms of
heart health and red wine is an element of the
traditional Mediterranean diet
Red wine and chocolate
are good for me
• Myth busting:
• The beneficial effects of alcohol for the
heart are at low levels of consumption -1-2
units per day
• Milk chocolate is the favourite UK treat, not
high cocoa content chocolate
• Even high cocoa content chocolate is high
in saturated fat and sugar
• One (175ml, 12%ABV) glass of wine =
126kcals, 2.1units
• One 45g bar of chocolate = 237kcal, 14g fat
• Beetroot, dark green veg and berries also
sources of flavanols
Advice for patients
• If you are having chocolate or red wine
this could be an added benefit and there is
no need to ban them……
• But don’t start eating chocolate or drinking
wine or having more to increase the
flavanols in your diet
• Adding some flavanols won’t make up for
an otherwise poor diet - and there are
healthier sources.
Seeking a rapid response?
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BHF news – front page and archive
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Any questions?