The Skeptical Cardiologist Gives Dietary Thanks

On this fourth Thursday of November, 2015 the skeptical cardiologist would like to record some Thanksgiving thanks.

• I’m thankful I’m not a turkey today.

I hear Americans consume 45 million turkeys on Thanksgiving, one sixth of the total during the year.
Americans have embraced turkeys nutritionally because they are low in saturated fat and provide lots of protein. Most nutritional advice suggests avoiding the dark meat and the skin, but I prefer to seek those portions out because they taste better and as I pointed out here last Thanksgiving, Up To Date, the major medical reference for physicians, now says “Don’t Worry About Saturated Fat Consumption.”

• I’m thankful that dairy fat is good for you.

The eternal fiancee’ and I took a cooking class in New Orleans (New Orleans School of Cooking) recently, and butter seemed to be the basis for every dish we cooked: from dark roux in our gator sauce piquante’, to the blonde roux in the Louisiana meat pies.
When the  teacher of the class, chef Austin, asked the students to introduce themselves, I told him I was the skeptical cardiologist and I was there to evaluate New Orleans dishes for my patients.
Chef Austin didn’t think I would be recommending the dishes to my patients, but I heartily endorsed them ( See here and here).

• I’m thankful that cholesterol is no longer considered by the Dietary Guidelines for Americans Committee (DGAC) a nutrient of concern.

All may eat eggs and crustaceans without fear now.
However, there is a backlash from the vegans on this revelation: the weirdly named Physicians Committee for Responsible Medicine (PCRM’s goal seems to be elimination of all animal testing and consumption, not responsible medicine) has erected billboards in Texas targeting the chairman of the House Agriculture Committee (K Michael Conoway (R-TX)).
The final guidelines have yet to be issued, but I’m betting on the egg industry over the vegans on this one, despite the billboards.

• I’m thankful that studies continue to come out showing coffee is not bad for you.

This study, for example, followed 90 thousand Japanese for 19 years and found that the more coffee you drink, the lower your risk of dying-from cardiac, respiratory and cerebrovascular disease. Those consuming 3-4 cups/day were 25% less likely to die than those who never drank coffee.
-I’m thankful that correlation does not equal causation.
This means that I don’t have to stop eating bacon or beef brisket (assuming I am insensitive to global sustainability concerns). On the other hand, that association between higher coffee consumption  and lower risk of dying over 19 years doesn’t mean that drinking more coffee is actually lowering the risk; but it’s certainly not increasing it.
Finally, I’m thankful that moderate alcohol consumption is good for your heart and I raise a toast of gratitude to patient patients, readers and correspondents.
-ACP