What a Difference A Day Makes (Well, 60 years!)

In almost all my books since 1985, I have been preaching that giving up BAD stuff has more health benefits than adding in GOOD stuff. Unfortunately, modern “science” has us giving up good stuff (fats) to be replaced by toxic deadly substitutes (polyunsaturated vegetable oils).

Now a new large-scale study, called the PURE (Prospective Urban and Rural Epidemiological) Healthy Diet, has rather proven that WHOLE FAT is good for us!¹ Drink full-fat milk! Enough of that “saturated fat will kill you” nonsense from ignorant or self-serving “experts”, who won’t admit they swallowed a porky when taking on the fat and cholesterol myth of crooked Ancel Keys.

In fact the new study rather startlingly recommends full-fat milk and will NOT condemn red meat as a villain! Contentious stuff here!

A prospective study is the most definitive, scientifically. You don’t set out to “prove” something, you just take a bunch of people and follow them through time, to see what happens!

Analysis of the data of 245,000 people in 80 countries over 20 years indicated that eating more fruit, vegetables, nuts, legumes, fish, and whole-fat dairy was associated with lower cardiovascular disease and mortality in all world regions, especially in lower-income countries where consumption of these foods is low,” says first author Andrew Mente of the Population Health Research Institute at McMaster University in Hamilton, Ontario.

Andrew Mente

PURE Score

To make their point, the researchers came up with “PURE scores”. Those with higher PURE scores are considered protective of heart disease. 

Unlike previous diet scores, the PURE Healthy Diet score does not penalize eating red meat. With a maximum score of 6, the PURE score simply awards one point each for above-median consumption of fruit, vegetables, nuts, legumes, fish, and whole-fat dairy.

For individuals with and without cardiovascular disease (CVD), higher intake of protective foods (i.e., PURE diet score ?5 points out of 6) compared with lower intake (diet score ?1 point) was associated with lower risks of death from all causes.

PURE was found to be slightly more predictive of health problems than the Mediterranean, 2010 and 2015 Healthy Eating Index, and DASH diet scores — and substantially more predictive than the Lancet Planetary diet score, Mente and colleagues noted in the European Heart Journal.

“These findings suggest that an inadequate level of consumption of key healthy foods is a larger problem than over-consumption of some nutrients or foods (such as saturated fats or whole-fat dairy and meats — all of which are consumed in lower amounts with a lower diet score) for mortality and CVD risk around the world,” the authors wrote.

“On this basis, given the low intake of fats and especially saturated fat (i.e., whole-fat dairy) among people with the lowest diet score … current targeted dietary guidance limiting the consumption of saturated fat and dairy in many populations of the world may not be warranted,” they suggested.

Hooray. This is the first time in recent memory a study has said limiting consumption of saturated fats is NOT GOOD. And they have the evidence to prove it. This was a BIG study.

Also, their results are in line with recent evidence showing that dairy may protect against high blood pressure and metabolic syndrome.

And the new PURE score takes out the meat intake component that had been part of a prior dietary quality score from the PURE investigators. In 2018, they had reported that balanced consumption of various food groups, assessed by that older score, was linked to reduced CVD and mortality worldwide.

In their latest report, Mente and colleagues again stressed “variety and moderation” in a healthy diet. I have promoted the “rotatory diversified foods regimen almost my whole working life. Whole grains and unprocessed meats may still be consumed in moderation, or about one serving daily, they recommended.

Well red meats are, of course, healthy but nobody supposes that means eating meat 2 or 3 times daily!

Based on current data, the authors’ findings and conclusions appear sound, providing evidence that unprocessed red meats are not a priority target for health to either avoid (as strongly emphasized by the EAT-Lancet report) or to include (as strongly emphasized by ‘paleo’ and ‘keto’ diets).

“This was by far the most diverse study of nutrition and health outcomes in the world and the only one with sufficient representation from high-, middle- and low-income countries. The connection between the PURE diet and health outcomes was found in generally healthy people, patients with CVD, patients with diabetes, and across economies,” Mente said in a press release.

Acknowledging that there is no one-size-fits-all approach to healthy eating across cultures, Mente’s group asserted that the PURE Healthy Diet generally translates to an eating pattern including:

Fruits and vegetables: 4-5 servings daily

Legumes: 3-4 servings weekly

Nuts: 7 servings weekly

Fish: 2-3 servings weekly

Dairy: 14 servings weekly

There’s your classic 5-a-day then!

A PURE score of 4 is the threshold for healthy eating beyond which there are modest additional gains in heart health and survival, they found. Thus, vegetarians and non-vegetarians alike may reach this score by consuming as many food groups as possible out of the six.

In the PURE cohort of 147,642 people on five continents, the mean PURE Healthy Diet score was 2.95.

Overall the study, according to Salim Yusuf, MBBS, DPhil, also of McMaster University and PURE’s principal investigator, suggests that a large proportion of deaths and CVD in adults around the world may be due to undernutrition, that is, low intakes of energy and protective foods, rather than overnutrition. This challenges current beliefs,” he said in a statement.

The PURE authors acknowledged that their observational study design is not perfect, since it relied on self-reported diet data being accurate, coming from food frequency questionnaires.

“It is time for national nutrition guidelines, private sector innovations, government tax policy and agricultural incentives, food procurement policies, labeling and other regulatory priorities, and food-based healthcare interventions to catch up to the science. Millions of lives depend on it,” says Dariush Mozaffarian, MD, DrPH, of Tufts Medical Center in Boston.²

Don’t hold your breath. Corporate interests want PROFIT and don’t care how many people they kill while grabbing it.

Mozaffarian is keen to write out the novel revelations of this study and “protect” the status quo position. That’s not surprising, when you look at his conflicts of interest! (see below)

I love a good steak (actually had one last night, cooked by a kitchen angel!)

Prof. Keith Scott-Mumby
The Official Alternative Doctor

1. There’s a short (2 min) video about this study here: 

LINK: https://www.phri.ca/research/pure/

Disclosures

The PURE study is an investigator-initiated study that is funded by the Population Health Research Institute, Hamilton Health Sciences Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, the Canadian Institutes of Health Research’s Strategy for Patient Oriented Research through the Ontario SPOR Support Unit, and the Ontario Ministry of Health and Long-Term Care, as well as through unrestricted grants from several pharmaceutical companies, with major contributions from AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, and GlaxoSmithKline, and additional contributions from Novartis and King Pharma and from various national or local organizations in participating countries.

Mente and colleagues had no relevant conflicts of interests.

Mozaffarian disclosed receiving research funding from the National Institutes of Health, the Gates Foundation, the Rockefeller Foundation, Vail Innovative Global Research, and the Kaiser Permanente Fund; personal fees from Acasti Pharma and Barilla; participation in scientific advisory boards for Beren Therapeutics, Brightseed, Calibrate, Elysium Health, Filtricine, HumanCo, Instacart Health, January Inc., and Perfect Day; equity in Calibrate and HumanCo; and chapter royalties from UpToDate.

References:

1. Source Reference: Mente A, et al “Diet, cardiovascular disease, and mortality in 80 countries” Eur Heart J 2023; DOI: 10.1093/eurheartj/ehad269/7192512.
2. Mozaffarian D “Identifying nutritional priorities for global health: time for a more PURE focus on protective foods” Eur Heart J 2023; DOI: 10.1093/eurheartj/ehad325/7192538.