Health

Health FAQs: Diet and Genetics

If protein, fat, and carbs are bad, what do you eat?

By Robert W Lash MDJun 6, 2007 12:00 AM

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I’ve read pieces suggesting thatanimal protein may also be a cause of chronic illness. Which is worse, proteinor fat? If I can’t eat fat, and I can’t eat protein, and I can’t eat carbs,what am I supposed to eat?

This is agreat question, and like many great questions, has no definitive answer. (Ifthere was one, the number of diet books at your local bookstore would probablybe cut in half overnight.) Here’s what we do know, at least today.

For fat:Lower is better, within reason. Twenty percent is probably a good goal but formost people not easy to achieve over the long haul.

Protein:Generally, we eat far more protein than we need. Vegetable protein is probablybetter for you than animal protein, but a vegan diet requires supplementationin adults and is not safe for small children.

Carbs:They’re not evil, they just need a better PR agent. Consume modest amounts ofcarbs, emphasizing whole grains.

Bottomline: Most diets we consider ”healthy” (for example, Mediterraneanand Asian) are moderate carb, reasonable protein, and low fat.

I don’t have diabetes, but both ofmy parents do. I understand that they have an increased risk of having a heartattack. How much of that risk have I inherited?

It’stough to assess the risk of heart disease without knowing the whole story.Hypertension, diabetes, lipids, family history, and cigarette smoking are allimportant risk factors in the development of vascular disease. The more ofthese you ”inherit“ from your parents, the higher your risk is going to be. Iput ”inherit“ in quotes because the term implies that the consequences are outof your control. This is not the case.

You canmake a huge difference in your cardiac risk by getting screened forhypertension, diabetes, and high cholesterol and then taking the appropriatesteps to treat them before they become problems. That’s the real reason for thenew diagnoses of prediabetes and prehypertension—to give patients the knowledgeand the tools to prevent, rather than treat, problems like heart disease andstroke.

Robert W. Lash, M.D. is anassociate professor of internal medicine at the University of MichiganMedical School. His clinical interests include thyroid disease,diabetes, endocrine disorders in pregnancy, osteoporosis and metabolicbone disease, and medical education. A member of the LLuminari team ofexperts, a board certified internist and endocrinologist, Dr. Lash hasan active clinical practice and is a hospitalist at the University ofMichigan.

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