Food trends through the years: A mixed bag for heart health?

Julie Corliss
Julie Corliss, Executive Editor, Harvard Heart Letter

Remember when packaged foods emblazoned with the words “fat free” seemed to be everywhere? Then came labels boasting “zero grams of trans fat.” “Sugar free” and “low sodium” claims soon joined the chorus. These days, gluten-free foods are all the rage.

For the most part, food industry trends have echoed the nutritional mantras of the time and were designed to improve our health — especially cardiovascular health. But just how successful have these efforts been?

“It’s a mixed picture, but over all, I think we’re going in a good direction,” says Dr. Walter Willett, professor in nutrition and epidemiology at the Harvard T.H. Chan School of Public Health. Here’s a rundown of the major trends over the past few decades.

Terminating trans fat

The biggest change — and greatest success story — is removal of trans fats from processed foods, says Dr. Willett. The main source of these harmful fats is partially hydrogenated oil, a longtime food industry favorite because it’s cheap, it’s easy to use, and it has a long shelf life. For decades, deep-fried fast foods, baked goods, crackers, chips, and margarine were made with partially hydrogenated oils.

But trans fats raise undesirable LDL cholesterol, make blood more likely to clot, and ramp up inflammation in the body — all of which raise heart disease risk. In 2003, the FDA began requiring manufacturers to list trans fat on the Nutrition Facts label to boost consumer awareness. As a result, many companies chose to stop using trans fats in their products. By June 2018, the fats will be banned from our food supply entirely, thanks to a long-awaited FDA ruling.

The carb calamity

The low-fat craze that took hold in the 1980s turned out to have unintended — and very unhealthy — consequences. Following the nutrition dogma of the day, food manufacturers cut fat from their products. But often they replaced it with refined carbohydrates, such as white flour and sugar. Americans also began eating more carbs (think pasta, white potatoes, white bread, and sugary desserts). Eating less fat, however, doesn’t necessarily help you lose weight. And diets high in refined carbohydrates may contribute to weight gain and promote type 2 diabetes and heart disease.

Just as is true for fats, some carbohydrates are far healthier than others. The best choices include unprocessed or minimally processed whole grains, such as whole-wheat or rye bread, brown rice, bulgur wheat, oatmeal, popcorn, and corn tortillas.

Going against the grain?

But some grains — including wheat, barley, and rye — also contain gluten, a protein that’s been getting lots of attention in recent years. “Gluten-free diets have been a big trend lately, but there is no good evidence to support these diets for most people,” says Dr. Willett. Exceptions include people with celiac disease, which affects about 1% of the population.

Many Americans believe that a gluten-free diet could improve their health. In fact, the opposite might be true. A recent Harvard study found that people who avoid gluten may eat fewer whole-grain foods. Also, gluten-free packaged foods may have more sugar, fat, and salt than their gluten-containing counterparts. Gluten-free diets aren’t inherently bad, but the way they’ve been translated into the average diet isn’t necessarily healthy, says Dr. Willett. People who need or want to avoid wheat should be sure to eat gluten-free whole grains such as brown rice, oats, buckwheat, and quinoa.

Sugar: Good news, bad news

The carbohydrates that pose the greatest threat to heart health are the simple, refined ones, especially sugar. High-sugar diets have been linked to a higher risk of heart disease, even in people who aren’t overweight. Sugar-sweetened beverages such as sodas, energy drinks, and sports drinks contribute most of the added sugar in the average American’s diet. But recent data show that consumption of sugary drinks has dropped by about 25% in the United States over the past decade, thanks in part to education campaigns and bans on soda sales in schools.

Unfortunately, other sugar-awareness efforts are on hold. In 2016, the FDA approved a revamp of the Nutrition Facts label that would require food manufacturers to list added sugars in their products, among other changes. But the ruling was shelved earlier this year.

Salt: Still too high

In 2016, the FDA proposed voluntary guidelines for the food industry to slash the amount of sodium in our food supply. Excess sodium (which pairs with chloride to form salt) is linked to high blood pressure, heart attacks, and stroke. The average American eats about 50% more sodium than nutrition experts recommend, and much of is already in their food before it reaches the table.

Time will tell if the FDA guidelines will make a difference. But a recent study suggests that we’ve been moving in the right direction: the average amount of sodium that households acquired from packaged foods and beverages decreased by 400 milligrams per capita between 2000 and 2014.

Related Information: Healthy Eating for a Healthy Heart

Comments:

  1. rose

    I just want to ask, my doctor prescribe for my triglyceride atorvastatin20 mg and lipway sr250mg, is it okay to take these medicine at the same time?

  2. Mary Maloy

    Rye breads are often incorrectly recommended as “whole grain” or “fiber-rich” which is untrue. There is no FDA standard guiding these contents in rye breads and many grocery store varieties have more white flour than rye and less than 1 g fiber/serving. Much of the dark coloring of rye breads–pumpernickel, too–is derived from caramel coloring

  3. Glenn Sargent

    What seems to be missing in comments and the article is fiber. It is also missing in the modern western diet. Which means that the microbiome is not performing as it should and is likely influencing many unhealthy aspects of our metabolism and general well being, including obesity.

  4. Toluwalase Ogunlade

    This is very interesting and educative article and I must confess, I have also learnt from the comments. In Nigeria, the salt scare is very much around, even though there are no suitable data to back up some of the claims on reduction in consumption of salt. People are very careful of inclusion of too much salt in their diet

  5. Richard Harding

    The comment that “by June 2018, the fats will be banned from our food supply entirely, thanks to a long-awaited FDA ruling” is incorrect. Trans-fats are still present in meat, dairy and eggs.

    As the National Academies of Science (2005) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Protein and Amino Acids states:

    —————————————–
    A UL [Upper Limit] is not set for trans fatty acids because any incremental increase in trans fatty acid intake increases CHD risk. Because trans fatty acids are unavoidable in ordinary, non-vegan diets, consuming 0 percent of energy would require significant changes in patterns of dietary intake. Nevertheless, it is recommended that trans fatty acid consumption be as low as possible while consuming a nutritionally adequate diet.

    —————————————–

    As Eric Rimm, a nutritional epidemiologist at the Harvard School of Public Health, stated “We can’t tell people to stop eating all meat and all dairy products.Well, we could tell people to become vegetarians. If we were truly basing this only on science, we would, but it is a bit extreme.”.

    Perhaps it is time to start looking at the science instead of basing your guidelines on preferences.

    • Sabrina K

      You said trans fats are present in meat dairy and eggs. That is incorrect. Trans fats are created in the laboratory by adding hydrogen to oils (which is why they are also called hydrogenated oils).

      • Richard

        Beef. lamb and butterfat have naturally occurring trans fats. Whether they are as dangerous to health as the artificial ones you mention is unknown at this time.

    • BJ

      This is false….meats, dairy and eggs dont contain trans fats…they may contain saturated fats, which can be harmful, but they dont contain trans fats

    • BJ

      This is misleading…there arent any significant amount of trans fats in meat, eggs or dairy. There are miniscule ruminant trans fats in nature that have not been shown to be linked to any chronic illness the way commercially produced trans fats are.

  6. Richard Harding

    The “low-fat craze” is a myth. The US has never had a “low-fat” diet. The average (and median) fat content of the diet (as % of energy) has reduced from 40% in the 1950s to 33%. The total amount of fat has increased due to an increase in the amount of calories consumed.

    This is NOT a low-fat diet.

    The US has tried to manipulate their diet by removing fat, such as removing skin from chicken and consuming “low-fat” dairy. The amount of animal-based protein has actually increased to about 70% compared with 7% in China.

    Figures calculated from “What We Eat in America”.

    U.S. Department of Agriculture (2014) What We Eat in America, NHANES 2011-2012

  7. J.M. Paris

    400 mg of salt reduction per capita from 2000 to 2014. Is this per day, per week, per month?

  8. Maureen

    Sugar is rarely called that …high fructose corn syrup, Fructrose, etc etc… it is nearly impossible to find any processed foods, frozen dinners, pizzas, breads that do not have sugar of some sort in them. Just thought it would be prudent to mention this in your mixed bag.

  9. Glenda Hallstone

    I agree and think professionals should do more teaching to the public.
    For example writing for newspapers and posting on internet
    G Hallstone, retired MS, RD, CDE

    • Thomas Turk

      Your RD title means what? It means that you belong to Assns. worldwide following the dictates of the US Assn. Recently the US Assn was exposed as a totally corrupt, self-appointed organization fully . funded by food growers; by manufacturers of beverages; of processed foods; of confectionaries; by fast food companies; by a biotech giant, and indirectly by big pharma. After getting exposed, they quickly changed their name to the important sounding The Academy Of Nutrition and Dietetics.

      Professionals to advise? Well surely not RDs. Then docs? What with their 6 hours of nutrition in 6-12 years of med school and only taught the calories, cholesterol, food groups etc baloney, that by Profs who know better but must teach ‘what’s in he book’, as one admitted to me. My son got 10 minutes of nutrition. Vienna Med U.

      • Richard

        Aside from all the misinformation on the Internet there are some medical doctors that actually practice science.
        One such is Dr Greger who has a site with thousands of videos and articles. You might also read his book “How Not To Die” if you are interested in the current science and not fad diets.

  10. sonia k guterman

    What about fat as an endocrine tissue, and improving the diet by eliminating sugar/refined carbs and increasing protein and good fats, as a way of controlling appetite and flow of calories out of fat tissue? See works by David Ludwig.
    Sonia

  11. A.David Barnes, MD,MPH

    Surely what counts is the out-come? I am celebrating my 80th birthday this year with my 20th (26.2 mile) marathon.

    I have NEVER been seriously ill nor have had a major surgery.

    2017 and I am delivering babies for the 54th year.I believe in the fruit and veggie diet taught years ago.

  12. eric solomon

    Trans fats are problematic from all accounts, but I see no mention of saturated fats as being causative.This whole high fat-low carb fiasco (Banting) never seems to point a finger at saturated fats. Is this intentional?

  13. Sandy H.

    Correction to my previous comment: “Natural foods advocates said trans fats WERE worse than butter.”

  14. Sandy H.

    Back in the 1970s, margarine was pushed by doctors and mfrs as being much better for cardiovascular health than butter. Natural food advocates said the trans fats in margarine were NOT worse than the saturated fat in butter. They were ignored for … how many years? Glad I listened to them instead of conventional doctors.

  15. Robin

    Why are we still talking about salt?

    The current recommendations for salt intake are not supported by science. Even the former president of the American Heart Association, Suzanne Oparil, agrees: “The current [salt] guidelines are based on almost nothing…Some people really want to hang onto this belief system on salt. But they are ignoring the evidence.”

    That quote and more on the lack of evidence for current salt recommendations can be found in this article:
    https://www.washingtonpost.com/news/wonk/wp/2015/04/06/more-scientists-doubt-salt-is-as-bad-for-you-as-the-government-says/?utm_term=.79cb2fc35872

    • Ted

      I’ve noticed that there’s a tendency on the internet to toss in a weblink in support of an argument when it’s not entirely clear whether the material in the link has been read very carefully.
      Here’s the final section of the WP article on salt:

      >The authors of the PURE study took steps to minimize such bias, but at the end, Anderson said, the weight of the evidence favored the old salt warning.

      “We can’t take any one study in isolation,” Anderson said. “We placed the new ones in the context of the body of literature on sodium – and we put the strongest recommendations forward.”<

    • Richard

      Enjoy your salt Robin but I am convinced that I get all the salt I need from whole plant-based products which at 2000 calories provides over 300 mg.
      When you have proof that I need more salt than that and no detrimental impacts I will change my ways.