Rethink CVD risk

In summary, for many patients at high risk of CVD, one of the safest and most effective ways to reduce the risk of heart attack and stroke is to consume a high fat and low glycaemic load Mediterranean diet and engage in regular exercise. At the very least, exercise interventions are often similar to drug interventions in terms of their mortality benefits in the secondary prevention of coronary heart disease, and do not come with side effects[41].

Currently 75% of healthcare dollars are spent treating chronic metabolic disease. Instead of funnelling billions to drug research and development, perhaps more of that money could be spent encouraging the implementation of policy directives that encourage population-wide behavioural change (similar to the efforts to combat tobacco and alcohol) to reverse insulin resistance. Even a 20% reduction in sugar consumption can evidence marked cost savings[42]

Public health should work primarily to support the consumption of real food that help protect against neurohormonal and mitochondrial dysfunction, and not continue to promote calorie-directed messages that blame victims, and exacerbate these pandemics. Then, and only then, might we achieve the goal of attenuating the prevalence of CVD and the other chronic diseases of the metabolic syndrome.

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