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Opinion: As a cardiologist, I know the dietary guidelines are failing our hearts

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Opinion: As a cardiologist, I know the dietary guidelines are failing our hearts


Meals at a restaurant on the UC San Diego campus. (File photo by Chris Stone/Times of San Diego)

Heart disease — affecting almost half of American adults — is the leading cause of death in the United States, claiming 700,000 lives each year. 

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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next edition of the Dietary Guidelines scheduled for release this month, we have a critical opportunity to move beyond outdated orthodoxy and align federal nutrition policy with modern science and clinical experience.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.

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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. 

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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. 

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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.

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Scripps Oceanography granted $15M for deep sea, glacier science

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Scripps Oceanography granted M for deep sea, glacier science


The Fund for Science and Technology, a new private foundation, granted Scripps Institution of Oceanography at UC San Diego $15 million for ocean science Tuesday.

FFST, funded by the estate of the late Microsoft co-founder Paul Allen, was started in 2025 with a commitment to invest at least $500 million over four years to “propel transformative science and technology for people and the planet.”

“Scripps Institution of Oceanography at UC San Diego is pushing boundaries for exploration and discovery across the global ocean,” Chancellor Pradeep Khosla said. “This visionary support from the Fund for Science and Technology will enable Scripps researchers to advance our understanding of our planet, which has meaningful implications for communities around the world.”

The grant, the largest of its kind since Scripps joined UCSD in 1960, will go toward research in three areas: monitoring of environmental DNA and other biomolecules in marine ecosystems, adding to the Argo network of ocean observing robots, and enhancing the study of ocean conditions beneath Antarctica’s Thwaites Glacier, often referred to as the “Doomsday Glacier.”

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Scripps Institution of Oceanography has used Argo floats for more than two decades to track climate impacts in our oceans. NBC 7 meteorologist Greg Bledsoe reports.

“The Fund for Science and Technology was created to support transformational science in the search of answers to some of the planet’s most complex questions,” said Dr. Lynda Stuart, president and CEO at the fund. “Scripps has a long tradition of leadership at the frontiers of ocean and climate science, and this work builds on that legacy — strengthening the tools and insights needed to understand our environment at a truly global and unprecedented scale.”

Scripps Director Emeritus Margaret Leinen will use a portion of the grant in her analysis of eDNA — free-floating fragments of DNA shed by organisms into the environment — in understudied parts of the ocean to collect crucial baseline data on marine organisms, according to a statement from Scripps.

“In many regions, we know very little about the microbial communities that form the base of the ocean food web or that make deep sea ecosystems so unique,” Leinen said. “Without data, we can’t predict how these communities are going to respond to climate change or what the consequences might be. That’s a vulnerability — and this funding will help us begin to address it.”

Using autonomous samplers that can collect ocean water for eDNA analysis, as well as conventional sampling, scientists will use tools to “reveal the biology of the open ocean and polar regions.”

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According to Scripps, the international Argo program has more than 4,000 floats that drift with currents and periodically dive to measure temperature, salinity and pressure. Standard floats can record data up to depths of 2,000 meters (6,560 feet), while newer Deep Argo floats can dive to 6,000 meters (19,685 feet).

The grant funding announced Tuesday will allow for Scripps to deploy around 50 Deep Argo floats along with Woods Hole Oceanographic Institution and NOAA’s Pacific Marine Environmental Laboratory.

Sarah Purkey, physical oceanographer at Scripps and Argo lead, said this leap forward in deep ocean monitoring comes at a crucial time because the deep sea has warmed faster than expected over the last two decades.

Thwaites Glacier is Antarctica’s largest collapsing glacier and contains enough ice to raise global sea level by roughly two feet if it were to collapse entirely. According to Scripps, prior expeditions led by scientist Jamin Greenbaum discovered anomalously warm water beneath the glacier’s ice shelf — contributing to melting from below. Greenbaum now seeks to collect water samples and other measurements from beneath Thwaites’ ice tongue to disentangle the drivers of its rapid melting.

This season’s Antarctic fieldwork will “test hypotheses about the drivers of Thwaites’ rapid melt with implications for sea-level rise projections,” the statement from Scripps said.

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“The ocean holds answers to some of the most pressing questions about our planet’s future, but only if we can observe it,” said Meenakshi Wadhwa, director of Scripps Institution of Oceanography and vice chancellor for marine sciences at UCSD. “This historic grant will help ocean scientists bring new tools and approaches to parts of the ocean we’ve barely begun to explore.”



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Southern California’s Jewish community reacts to war in the Middle East

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Southern California’s Jewish community reacts to war in the Middle East


The Jewish community in Southern California is sharing their fears and hopes following the weekend’s strikes on Iran and retaliatory attacks on Israel, U.S. military bases and other targets in the Middle East.

The exchange of missiles in the Middle East is having a devasting effect on Iran’s defense capability, but retaliatory strikes in the region are taking a toll. 

“Weapons of enormous capacity that are targeting civilian areas,” said Elan Carr, CEO of Los Angeles-based Israeli American Council.

Carr says toppling the Iranian regime, taking out its nuclear capabilities and freeing the Iranian people from this oppressive rule should have been done decades ago.

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“This is about seeing the most evil regime, the world chief state sponsored terrorism to no longer have the ability to do what it’s been doing,” Carr said.

Sara Brown, regional director of the American Jewish Committee, said the U.S. and Israel are concentrating strikes on Iran’s missile sites and military industrial complex. Iran’s retaliatory strikes are focused on many civilian targets.

“We are hearing from our partners from around the region, who are terrified,” Brown said. “Across the Middle East right now, I think there is a tremendous amount of fear, but also hope and also resolve.”

AJC is the advocacy arm for Jewish people globally. Many members and partner groups are in harm’s way. Brown says the risk is great, but the potential reward is world changing.

“That Iranian people will get to choose leadership for themselves, that we will finally see a pathway forward for peace across the Middle East,” Brown said.

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If wars of the past hadn’t produced lasting peace, then why now? Carr says Iran’s nuclear capabilities are destroyed and Iran’s military and proxies are weakened after Israel’s response to the Oct. 7 Hamas ambush.

“No more terrorist network throughout the Middle East. Think of what that could mean. Think of the normalization we could see,” Carr said.

President Donald Trump expects fighting to last several weeks. Some critics are concerned about a drawn-out conflict that could spread.

Carr is not convinced.

“Who is going to enter a war against the U.S. and Israel? Russia is plenty busy. China has no interest in jeopardizing itself this way,” Carr said.

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Besides the six Americans killed as of Monday night, government officials say 11 people were killed in retaliatory strikes in Israel.



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San Diego Zoo Safari Park’s Elephant Valley: Get closer to elephants

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San Diego Zoo Safari Park’s Elephant Valley: Get closer to elephants


San Diego — Before we see elephants at Elephant Valley in the San Diego Zoo Safari Park, we come face to face with destruction, only the wreckage is beautiful. A long, winding path takes guests around and under felled trees. Aged gray tree hunks form arches, for instance, over bridges that tower over clay-colored paths with hoof prints.

The design is meant to reorient us, to take us on a trail walked not by humans but traversed and carved by elephants, a creature still misunderstood, vilified and hunted for its cataclysmic-like ability to reshape land, and sometimes communities.

“It starts,” says Kristi Burtis, vice president of wildlife care for the Safari Park, “by telling the story that elephants are ecosystem engineers.”

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Elephant Valley will open March 5 as the newest experience at the Escondido park, its aim to bring guests closer than ever to the zoo’s eight elephants, which range in age from 7 to 36, while more heavily focusing on conservation. The centerpiece of the 13-acre-plus parkland is a curved bridge overlooking a savanna, allowing elephants to walk under guests. But there are also nooks such as a cave that, while not previewed at a recent media event, will allow visitors to view elephants on their level.

In a shift from, say, the Safari Park’s popular tram tour, there are no fences and visible enclosures. Captive elephants remain a sometimes controversial topic, and the zoo’s herd is a mix of rescues and births, but the goal was to create a space where humans are at once removed and don’t impede on the relative free-roaming ability of the animals by keeping guests largely elevated. As an example of just how close people can get to the herd, there was a moment of levity at the event when one of the elephants began flinging what was believed to be a mixture of dirt and feces up onto the bridge.

“Our guests are going to be able to see the hairs on an elephant,” Burtis says. “They can see their eyes. They can see the eyelashes. They can see how muscular their trunks are. It’s really going to be a different experience.”

Elephant Valley, complete with a multistory lodge with open-air restaurants and bars, boasts a natural design that isn’t influenced by the elephant’s African home so much as it is in conversation with it. The goal isn’t to displace us, but to import communal artistry — Kenyan wood and beadwork can be found in the pathways, resting spaces and more — as a show of admiration rather than imitation.

“We’re not going to pretend that we’re taking people to Africa,” says Fri Forjindam, now a creative executive with Universal’s theme parks but previously a lead designer on Elephant Valley via her role as a chief development officer at Mycotoo, a Pasadena-based experiential design firm.

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“That is a slippery slope of theming that can go wrong really fast,” she adds. “How do we recognize where we are right now, which is near San Diego? How do we populate this plane with plants that are indigenous to the region? The story of coexistence is important. We’re not extracting from Africa, we’re learning. We’re not extracting from elephants, we’re sharing information.”

But designing a space that is elephant-first yet also built for humans presented multiple challenges, especially when the collaborating teams were aiming to construct multiple narratives around the animals. Since meetings about Elephant Valley began around 2019, the staff worked to touch on themes related to migration and conservation. And there was also a desire to personalize the elephants.

“Where can we also highlight each of the elephants by name, so they aren’t just this huge herd of random gray creatures?” Forjindam says. “You see that in the lodge.”

That lodge, the Mkutano House — a phrase that means “gathering” in Swahili — should provide opportunities for guests to linger, although zoo representatives say reservations are recommended for those who wish to dine in the space (there will also be a walk-up, to-go window). Menus have yet to be released, but the ground floor of the structure, boasting hut-like roofing designed to blend into the environment, features close views of the elephant grazing pool as well as an indoor space with a centerpiece tree beneath constellation-like lighting to mimic sunrises and sunsets.

Throughout there are animal wood carvings and beadwork, the latter often hung from sculptures made of tree branches. The ceiling, outfitted with colorful, cloth tapestries designed to move with the wind, aims to create less friction between indoor and outdoor environments.

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There are, of course, research and educational goals of the space as well. The Safari Park works, for instance, with the Northern Rangelands Trust and Loisaba Conservancy in Kenya, with an emphasis on studying human-elephant conflict and finding no-kill resolutions. Nonprofits and conservation groups estimate that there are today around 415,000 elephants in Africa, and the African savanna elephant is listed as endangered by the International Union for Conservation of Nature.

Studies of the zoo’s young elephants is shared with the Reteti Elephant Sanctuary in the hopes of delivering care to elephant youth to prevent orphanage. Additionally, the Safari Park has done extensive examination into the endotheliotropic herpes virus. “The data that we collect from elephants here, you can’t simply get from elephants in the wild,” Burtis says.

One of the two entrances to Elephant Valley is outfitted with bee boxes; bees are known to be a natural elephant deterrent and can help in preventing the animals from disrupting crops or communities. To encourage more natural behavior, the plane is outfitted with timed feeders in an attempt to encourage movement throughout the acreage and establish a level of real-life unpredictability in hunting for resources. Water areas have been redesigned with ramps and steps to make it easier for the elephants to navigate.

With Elephant Valley, Forjindam says the goal was to allow visitors to “observe safely in luxury — whatever that is — but not from a position of power, more as a cohabitor of the Earth, with as much natural elements as possible. It’s not to impose dominance. Ultimately, it needed to feel natural. It couldn’t feel like a man-made structure, which is an antiquated approach to any sort of safari experience where animals are the product, a prize. In this experience, this is the elephant’s home.”

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And the resulting feel of Elephant Valley is that we, the paying customers, are simply their house guests.



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