Health & Medicine / Nutrition

I’ve read pieces suggesting that animal protein may also be a cause of chronic illness. Which is worse, protein or 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 a great question, and like many great questions, has no definitive answer. (If there was one, the number of diet books at your local bookstore would probably be 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 for most people not easy to achieve over the long haul.

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

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

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

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

It’s tough to assess the risk of heart disease without knowing the whole story. Hypertension, diabetes, lipids, family history, and cigarette smoking are all important risk factors in the development of vascular disease. The more of these you ”inherit“ from your parents, the higher your risk is going to be. I put ”inherit“ in quotes because the term implies that the consequences are out of your control. This is not the case.

You can make a huge difference in your cardiac risk by getting screened for hypertension, diabetes, and high cholesterol and then taking the appropriate steps to treat them before they become problems. That’s the real reason for the new diagnoses of prediabetes and prehypertension—to give patients the knowledge and the tools to prevent, rather than treat, problems like heart disease and stroke.

Robert W. Lash, M.D. is an associate professor of internal medicine at the University of Michigan Medical School. His clinical interests include thyroid disease, diabetes, endocrine disorders in pregnancy, osteoporosis and metabolic bone disease, and medical education. A member of the LLuminari team of experts, a board certified internist and endocrinologist, Dr. Lash has an active clinical practice and is a hospitalist at the University of Michigan.

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