Expert Q&A: Heart-Healthy Eating
An interview with Dean Ornish, MD.
Are unsaturated fats beneficial?
I don't know that unsaturated fats are necessarily good. That is one of the
few differences I have with people like Walt Willett at the Harvard School of
Public Health. They say it does not matter how much fat you eat as long as it
is unsaturated -- but it does.
First of all, fat is very dense in calories, and it doesn't matter whether
it is unsaturated, monounsaturated, or saturated. Fat has 9 calories per gram,
protein and carbohydrates have only 4 calories per gram, so when you eat less
fat you are going to consume fewer calories without having to eat less
And studies show that total fat is related to diseases, such as breast
cancer, and not just to saturated fat. So it is important to be mindful of
Are any fats good for you?
The truly good fats are not so much the unsaturated fats as the omega-3
fatty acids you find in fish oil and salmon and in some plant-based foods like
flax. Part of the problem when you eat unsaturated fat is that much of the
unsaturated fat people consume is rich in the omega-6 fatty acids, which
promote inflammation and autoimmune responses. The truly good fats are not so
much unsaturated fats as omega-3 fats.
And you don't need that much of it. You can take 3 or 4 grams a day of fish
oil and that is really what most people need. And you can also buy the fish oil
that has all the bad stuff in fish removed -- the omega-6, the PCBs, the
dioxins, and the mercury. Then you get all the benefits of eating the fatty
fish but without the extra toxicities that are found in most fish these
Why is fiber an essential component of a heart-healthy diet?
Soluble fiber, in things like oat bran, is important for lowering
cholesterol levels. It has a direct effect on cholesterol metabolism in your
bile and in your liver.
Insoluble fiber is important for two main reasons: First, because it helps
to push food through the intestinal tract faster. Second, fiber affects your