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next edition of the Dietary Guidelines scheduled for release this month, we have a critical opportunity to move beyond outdated orthodoxy and align federal nutrition policy with modern science and clinical experience.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
More Thoughts on ‘Yes on A’
By Dave Rice
Is Measure A going to affect a significant number of properties? Is it going to affect affordable housing in any meaningful way? Come now, let’s not be dense – this hits a handful of rich people who can absolutely afford to drop $10K in the city coffers if they’re leaving a vacation home vacant on purpose – let’s say that’s their civic contribution that would be realized in other ways if they actually lived, worked, and shopped here full-time.
Or it hits STVR hosts, who can either factor the cost into their business model or give it up if margins are really that thin (maybe not everyone needs to fancy themselves an amateur hotelier). But let’s not kid ourselves and believe the kind of housing this will free up will be plentiful or affordable.
In the exceedingly rare instances where someone might be eligible for an exemption, will it be too hard to apply for? That’s something we can argue and refine but that’s the bathwater, or just the little bit of it that splashes out of the tub, not the baby. An argument that the whole proposal is DOA because military members are too stupid to file for an exemption is either dismissive of or telling tales out of school about what we really think of military intelligence.
Poor, poor grandma who needs a home near her doctor? If she’s really poor why does she have multiple houses, and if she’s not does this really affect her? I live in a neighborhood where “aren’t you afraid you’re going to get shot?” is the first thing outsiders ask me about where I’m from, and if Grandma has owned her mostly-unoccupied vacation house for any significant time I probably pay a lot more property tax than she does. You couldn’t trip over the limbo bar to gain my sympathy, it’s buried a few feet deep.
This is a tiny nod toward taxing the rich, but that’s all. It’s not significant or meaningful, it won’t do a lot, most of the housing stock in question even if returned to actual residents won’t make a dent in the astronomical cost of living in or anywhere near this city. But it’s a tiny step in the right direction – and watching how hysterical the moneyed class is about the rest of us asking for even the tiniest drop in the goddamned bucket we’re trying to fill without their help is telling.
Related
San Diego, CA
Annual Rock ’n’ Roll races bring 30,000 runners to San Diego streets
Skip to content
Contact Us
San Diego, CA
Dining Out — series Part 1: A look at the evolution of La Jolla’s restaurant scene
This is the first installment in a series of stories on the history of dining out in La Jolla, how it’s changed and how it continues to evolve.
It’s hard to imagine La Jolla without its restaurants, from the lines stretching down the block at The Taco Stand to the iconic views at George’s at the Cove.
But the way La Jollans eat and where has changed dramatically since the area’s founding in the 1800s.
In this first part of the new month-long series “Dining Out,” the La Jolla Light looks at local restaurants from the 1880s (when La Jolla was first developed and settled) to the early 1920s.
“La Jolla had very few people at that time,” according to local historian Carol Olten. “There weren’t a lot of restaurants, as far as we know.”
Olten said she gets information about La Jolla’s earliest days from the diaries of local pioneer Anson Mills.
“He kept track of where he went and what he did … but he did a lot of home cooking,” she said. “So when they went to a restaurant for dinner, it was a big occasion. It was something people mainly did on holidays or … a social occasion.”
One restaurant Mills would go to — believed to be one of the first in La Jolla — was Montezuma Cottage. Olten said it is believed to have opened in 1895 near the intersection of Prospect and Jenner streets.
Mills described the restaurant as a popular eating and gathering spot for locals and tourists, Olten said. He wrote an entry about a Thanksgiving dinner there with about 60 people.
Montezuma Cottage later became known as the Seaside Inn and Ocean View restaurant. It was torn down in 1931.
Culturally, eating at a restaurant was a more formal occasion at the time, Olten said.
“You didn’t go to a restaurant just to hang out with friends like you would today. It was purposeful then,” she said.
Around 1900, a restaurant known as the White Rabbit opened near the corner of Girard Avenue and Prospect Street. In addition to a rooftop garden, it featured a tea room, joining a national trend.
“Tea rooms went with the suffragette movement because in those days, [women] didn’t have a place to gather without an escort, so tea rooms started opening in hotels and women could go there and sit down and have a social tea or lunch,” Olten said. “La Jolla got in on the tail end of that thanks to [Green Dragon Colony founder] Anna Held and [La Jolla philanthropist] Ellen Browning Scripps.”
One of them, called The Cricket, opened in the early 1900s with white tablecloths. Olten said it was near what it is now Eddie V’s restaurant.
“It was originally part of the Green Dragon Colony … and was sold to a British woman named Daisy Mitchell,” she said. “It stayed a tea room for many years, and she kept a guest book that was decorated with reds and greens and had a medieval theme. So it was very British.”
Joining a trend toward more upscale dining, one of La Jolla’s “most well-established and well-known restaurants” opened in 1912 at 1227 Prospect St. The Brown Bear had “stylish, fashionable service and a menu to please the gods,” Olten said.
A house specialty was Welsh rabbit served in a silver chafing dish. The restaurant was in operation until 1941.
Several restaurants opened around 1915, about the same time as the Panama-California Exposition, a world’s fair-type event held in 1915-16 that brought 3.7 million people to San Diego.
One of La Jolla’s new restaurants, the Spindrift Inn, opened in 1916 and was considered a “last stop” out of town.
“Most restaurants at that time were located in the immediate Village area,” Olten said. “The one that was astray would have been the Spindrift Inn [in La Jolla Shores]. This was in the very early days of automobiles, so not very many people had cars, but those that did would … drive their cars and the last stop before you got out of town was Spindrift Inn.”
The Spindrift Inn later became The Marine Room, which still stands.
Olten said the restaurant was operated by the Hannay family for about 20 years. Their “rambunctious” fox terrier, Jiggs, would roam the dining room.
Another Expo-era restaurant was the Dining Car, which operated in an old trolley car parked near Goldfish Point. Dinner was $2 per person. It burned down on Halloween night in 1923.
Next installment: With new hotels being built in La Jolla in the 1920s came new hotel restaurants. But later, World War II would have an impact on La Jollans and San Diegans in general and on where and how they ate. ♦
-
Oklahoma5 minutes agoCity leaders break ground on MAPS 4 multipurpose stadium in downtown Oklahoma City
-
Oregon8 minutes agoFBI Special Agent Bobby Gutierrez named Freedom 250 Hometown Hero in Oregon
-
Pennsylvania13 minutes agoPennsylvania House approves bill to restrict cellphones in schools
-
Rhode Island20 minutes agoRhode Island Senate approves bill requiring staffed lanes alongside self-checkout
-
South-Carolina23 minutes agoSouth Carolina early voting surges ahead of primary election
-
South Dakota28 minutes agoRoberta Cahill
-
Tennessee35 minutes ago
How Karen Weekly explained Tennessee pitching strategy in WCWS losses to Texas
-
Texas38 minutes agoExpress LHP Robby Ahlstrom Promoted to Texas