Campfire’s octopus, chorizo, and celery-root entrée.
Gage Forster
San Diego, CA
Opinion: As a cardiologist, I know the dietary guidelines are failing our hearts
Heart disease — affecting almost half of American adults — is the leading cause of death in the United States, claiming 700,000 lives each year.
As a practicing cardiologist for more than 20 years, I’ve watched patients do everything “by the book.” They eat according to the Dietary Guidelines for Americans — the federal government’s blueprint for nutrition policy — and still see their weight climb, blood pressure rise, and heart health deteriorate.
The problem isn’t their effort. It’s the guidance itself, which promotes high-carbohydrate, low-fat diets that can actually worsen metabolic health, which can in turn worsen heart disease. Many assume that by following the government’s recommendations they can improve their health — but, too often, the opposite is true.
With the next edition of the Dietary Guidelines scheduled for release this month, we have a critical opportunity to move beyond outdated orthodoxy and align federal nutrition policy with modern science and clinical experience. Done right, this update can turn back the tide of chronic illness and save lives.
Since 1980, the Departments of Agriculture and Health and Human Services have issued the Dietary Guidelines every five years. These recommendations shape not only personal choices but also the food in school cafeterias, military mess halls, hospitals and nursing homes. They inform SNAP and WIC benefits, nutrition education, and even the labels on grocery store shelves.
From the start, however, the guidelines steered Americans in the wrong direction. They marked a sharp departure from prior eating patterns by encouraging Americans to cut back on natural dietary fats and rely more heavily on refined high-carbohydrate foods. Saturated fat — and cholesterol by extension — were unjustly stigmatized, while bread, pasta and cereal became staples of the American diet.
The recommendations were not made with a metabolically vulnerable population in mind. For people already struggling with insulin resistance, obesity or diabetes, a high-carbohydrate diet frequently only compounds the problem by driving up insulin, promoting visceral fat storage around vital organs, and fueling a cycle of weight gain and chronic disease.
Four decades later, the guidelines remain out of step with science and with the health needs of the majority of Americans. They impose arbitrary caps on saturated fat, despite evidence showing no consistent link to higher rates of heart disease or mortality. They recommend dietary protein well below optimal levels for most populations. And they direct Americans to get 45-65% of their calories from carbohydrates — sidelining low-carb or ketogenic diet options proven to support weight loss, stabilize blood sugar, and reduce the risk factors that drive heart disease.
Americans are being pushed toward metabolically damaging eating patterns.
Today, 93% of Americans live with metabolic dysfunction — meaning their bodies struggle to convert food into energy efficiently. This breakdown in basic metabolic processes fuels the country’s epidemic of chronic disease. More than 75% of Americans are now overweight or obese. Heart disease mortality rates have increased from the 2010s to the 2020s, even as cholesterol levels have steadily fallen.
Put plainly: Federal nutrition policy has fallen far short of making Americans healthier. I know this to be true not only from statistics but from my own patients’ journeys. Many of them ate exactly as federal guidance prescribed and still found themselves gaining weight and developing hypertension, diabetes and heart disease. For years, I resisted the idea that fault could lie with the guidelines.
Like most physicians, I was trained to be wary of fat and to consider carbohydrates as the foundation of a healthy diet. I dismissed suggestions that a low-carb or ketogenic diet could improve cardiovascular outcomes.
But then I tried it myself — and my own weight, cardiovascular markers, and energy improved. When I cautiously introduced the approach to my patients, I saw transformations I couldn’t ignore: their insulin sensitivity, blood sugar levels and blood pressure began to improve. These changes struck at the true drivers of coronary heart disease — metabolic dysfunction, obesity and type 2 diabetes — all stronger predictors than cholesterol levels.
Their lives changed without a scalpel or a prescription. And their experiences mirrored what the science was increasingly showing: that the old low-fat, high-starch model had it backwards.
A review of randomized trials found that low-carbohydrate diets significantly improved weight, blood sugar and blood pressure — the very risk factors that drive heart disease.
Another analysis comparing different levels of carbohydrate restriction showed consistent benefits across degrees of reduction. And, in patients with type 2 diabetes, ketogenic approaches have dramatically lowered average blood sugar as measured by HbA1c — a long-term measure of glucose control — while delivering substantial weight loss, all changes known to reduce cardiovascular complications.
Yet our national guidelines remain stuck in an outdated paradigm.
The upcoming 2025-2030 Dietary Guidelines offers a chance to finally get it right — to align federal recommendations with the latest, most rigorous evidence. That means prioritizing whole foods, removing limits on saturated fats, optimizing protein intake, and including low-carbohydrate and ketogenic options for the metabolically vulnerable.
The nation’s leading killer isn’t inevitable. If the Dietary Guidelines are updated to reflect modern science, millions of Americans could soon be on the path to reclaiming their heart health.
Bret Scher, MD, is a board-certified cardiologist and lipidologist, and the founding medical director of the Coalition for Metabolic Health.
San Diego, CA
Solans, Luna, Guilavogui help RSL beat slumping San Diego, extend unbeaten streak to 6 games :: WRALSportsFan.com
SANDY, Utah — SANDY, Utah (AP) — Sergi Solans had two goals and an assist, Diego Luna added a goal and two assists, and Real Salt Lake beat San Diego FC 4-2 on Saturday night to extend its unbeaten streak to six games.
Morgan Guilavogui scored his first goal in MLS and had an assist for Real Salt Lake (5-1-1). The 28-year-old designated player has five goal contributions in his first six career games.
RSL hasn’t lost since a 1-0 defeat at Vancouver in the season opener.
San Diego (3-3-2) has lost three in a row and is winless in five straight.
Luna opened the scoring in the fifth minute when he re-directed a misplayed pass by Duran Ferree, San Diego’s 19-year-old goalkeeper, into the net.
Moments later, Solans headed home a perfectly-placed cross played by Luna from outside the right corner of the 18-yard box to the back post to make it 2-0. Solans, a 23-year-old forward, flicked a header from the center of the area inside the right post and past the outstretched arm of Ferree to make it 3-1 in the 37th minute.
Guilavogui slammed home a first-touch shot to give RSL a three-goal lead in the 45th.
Marcus Ingvartsen scored a goal in the 14th minute and Anders Dreyer converted from the penalty spot in the 66th for San Diego.
Ingvartsen has five goals and an assist this season and has 10 goal contributions (seven goals, three assists) in 16 career MLS appearances.
Rafael Cabral had three saves for RSL.
Ferree finished with five saves.
___
AP soccer: https://apnews.com/soccer
When John Resnick opened Campfire on a quaint little street in Carlsbad, Calif., in 2016, some locals weren’t sure what to think. The coastal enclave wasn’t exactly awash in innovative, chef-driven establishments, so it was a shock to see the dining room consistently full. Early on, one woman wondered aloud to Resnick, “Where did all these people come from?”
It’s a moment he remembers vividly. “I was struck by her statement, because I think she was surprised that so many other people in Carlsbad were there,” Resnick says.
The rest of the culinary world would take some time to catch up to what was happening. In 2019, when Michelin expanded to rate restaurants throughout all of California—not just the San Francisco area—Addison was the only one in San Diego to earn a star. But since emerging from the pandemic, the region’s food scene has grown dramatically. Driven by outstanding farms, ingredients, a bumper crop of talented chefs, and a G.D.P. approximately the size of New Zealand or Greece, San Diego County has become one of America’s most underrated dining destinations.
Perhaps no single restaurant is a better emblem for this shift than chef William Bradley’s Addison, which opened in 2006. After landing his first star, Bradley knew he wanted more. To get them, he transformed his French-leaning fare to serve what he calls California Gastronomy, which combines the cultures of SoCal with impeccable ingredients and wildly impressive techniques, prizing flavor over flair. Michelin responded, awarding Addison a second star in 2022, and making it the first Southern California three-star restaurant just a year later. The accolade has created a halo effect, attracting culinary tourists from around the world.
Berry beet tartlets at San Diego’s three-star stalwart Addison.
Eric Wolfinger
“Earning three stars forces the global dining community to pay attention to a place that may not have been on their radar before,” says chef Eric Bost, a partner in Resnick’s four Carlsbad establishments.
Resnick recruited Bost, who spent time at award-winning outposts of Restaurant Guy Savoy, to run Jeune et Jolie, which he led to a star in 2021. They’ve since taken over an old boogie-board factory down the street and converted it to an all-day restaurant and bakery, Wildland. The space also hosts an exquisite tasting-counter experience called Lilo, which was given a Michelin star mere months after opening in April 2025. And as Resnick and Bost grew their successful Carlsbad operation, chef Roberto Alcocer earned a Michelin star for his Mexican fine-dining spot Valle in nearby Oceanside.
The stylish tasting counter at Michelin one-star Lilo in Carlsbad.
Kimberly Motos
About 25 miles to the south, another affluent coastal community is going through its own culinary glow up. In La Jolla, chef Tara Monsod and the hospitality group Puffer Malarkey Collective opened the stylish French steakhouse Le Coq. Chef Erik Anderson, formerly of Michelin two-star Coi, is preparing to launch Roseacre. And last year, Per Se alums Elijah Arizmendi and Brian Hung left New York to open the elegant tasting-menu restaurant Lucien, lured by the ingredients they’d get to serve. “A major reason we chose San Diego is the quality and diversity of the produce,” Arizmendi explains. “San Diego County has more small farms than anywhere else in the U.S., and its many microclimates allow farmers to grow an incredible range of ingredients year-round.”
Wildland’s spicy Italian sandwich.
Gage Forster
Chef Travis Swikard has also been a tireless advocate for the region’s ingredients since he returned to San Diego, his hometown, and opened Mediterranean-influenced Callie in 2021. There’s no sophomore slump with his latest effort, the French Riviera–inspired Fleurette in La Jolla, where he’s serving his take on classics like leeks vinaigrette and his San Diego “Bouillabaisse” with local red sheepshead fish and spiny lobster. Its food is bright, produce-driven, and attentive in execution, while the dining room maintains a relaxed and unpretentious style of service. And Swikard sees that approach cohering into a regional style with a strong network of professionals behind it.
“It’s really nice that we are developing our own identity, not trying to be like L.A. or any other market, just highlighting what’s great about the San Diego lifestyle and ingredients,” he says. “Similar to New York, a chef community is starting to develop where chefs are supporting each other. There is a true sense of pride to be cooking here.”
Top: In La Jolla, Lucien serves ocean whitefish with tomatoes turned into concasse, sabayon, and other expressions.
Authors
Little Debbie is officially expanding its doughnut range.
On April 14, the brand announced a new sweet snack: Chocolate Old Fashioned Donuts. The company says there was “massive consumer demand” for the original Big Pack Old Fashioned Donuts, which quickly became a top seller. Now, they’re just giving the people what they want.
The new snack is a chocolate old-fashioned cake doughnut finished with a sweet glaze and is launching in two formats:
- The Big Pack Carton: This box contains six doughnuts in a retro-inspired package that reflects the brand’s heritage.
- Single-serve doughnuts: There are also 3-ounce, individually wrapped Chocolate Old Fashioned Donuts, which the brand suggests pairing with a morning coffee or eating on a midday break.
The original, which includes six individually wrapped cake-style doughnuts with a vanilla glaze, first hit stores in June 2025 and, according to the brand, has been “consistently selling out.”
“We saw an incredible response to the Old Fashioned Donut we introduced last year,” said Scott Brownlow, Little Debbie’s brand manager, in a press release. We’re doubling down on what works and giving both loyalists and new fans an irresistible reason to head back to the store.”
Little Debbie’s Chocolate Old Fashioned Donuts are rolling out now to major retailers, grocery stores and convenience stores nationwide. As with the original Old Fashioned Donut, they become a permanent addition to the brand’s snack lineup.
This story first appeared on TODAY.com. More from TODAY:
-
Pennsylvania2 minutes agoPennsylvania utilities appreciate market signals — but not market prices
-
Rhode Island8 minutes agoPulled funding creates a bike path to nowhere. Let’s hope RI fixes it.
-
South-Carolina14 minutes agoMid-amateur from South Carolina wins Terra Cotta Invitational in Florida
-
South Dakota20 minutes agoNature: Prairie chickens in South Dakota
-
Tennessee26 minutes agoTennessee baseball vs Ole Miss score, live updates, start time, Game 3
-
Texas32 minutes agoTexas needs at least $174 billion to avoid water crisis, state says
-
Utah38 minutes agoMultiple earthquakes detected near Kanosh
-
Vermont44 minutes agoWrong-way driver stopped on I-89, charged with DUI