RoR: Forum

Bill,

Science proves no such thing! The diet I'm on is no way inferior to a higher protein diet. I used to follow a much higher protein diet, and I was far less healthy than I am today. My blood pressure was higher; my glucose was higher, and my cholesterol was much, much higher than it is today.

13 studies, one conclusion:

There were significant differences between the groups for weight, high-density lipoprotein cholesterol, triacylglycerols and systolic blood pressure, favouring the low-carbohydrate diet. There was a higher attrition rate in the low-fat compared with the low-carbohydrate groups suggesting a patient preference for a low-carbohydrate/high-protein approach as opposed to the Public Health preference of a low-fat/high-carbohydrate diet. Evidence from this systematic review demonstrates that low-carbohydrate/high-protein diets are more effective at 6 months and are as effective, if not more, as low-fat diets in reducing weight and cardiovascular disease risk up to 1 year.

Recap:
Higher protein diets are better for humans than lower protein diets are (when it comes to cardiovascular disease risk).

Are you seriously telling me that Atkins showed that populations on high-fat and high-saturated fat diets had lower rates of heart disease than populations on very low-fat diets? Ed, that is simply fantastic.

See above.

I meant omega-6 oils like safflower, sunflower and corn oil.

Omega-6 oils can't be on a paleo diet because that doesn't fit (not just well, but doesn't fit at all) with our genetic makeup.

I was simply saying that if you eat the kind of meat that's available today in the supermarket, you're going to be getting too much saturated fat and omega-6 fatty acids relative to the omega-3's unless you consume extra omega 3's.

Christ almighty. Do you think I didn't know that? Who do you think you are talking to? I'm not just some cocky punk who thinks he's a nutrition expert because he read a couple issues of Muscle & Fitness magazine. Gimme' a break.

Are you saying that the only way that cholesterol gets deposited on the artery walls is if there is damage to the artery, so that a person could have very high serum cholesterol and not have any atherosclerosis whatsoever?

The only way that cholesterol gets deposited on the artery walls is if it's first modified, most often by oxidation. If your antioxidant status was consistently high enough, then most atherosclerosis -- regardless of blood cholesterol levels -- simply would not occur. Bill, have you ever wondered why 55% of atherosclerosis patients have good cholesterol levels? Have you ever wondered why getting LDL levels down below 70 mg/dl doesn't totally protect against atherosclerosis? The answer involves looking outside of the atherosclerotic theory promoted by Ancel Keys (and by Pritikin).

It's because it's not the amount of LDL that counts the most -- but the type of LDL and its subsequent modification/oxidation.

Ed

(Edited by Ed Thompson on 9/18, 4:46pm)

Post 81

Sunday, September 19, 2010 - 12:44pm

I wrote, "Science proves no such thing! The diet I'm on is no way inferior to a higher protein diet. I used to follow a much higher protein diet, and I was far less healthy than I am today. My blood pressure was higher; my glucose was higher, and my cholesterol was much, much higher than it is today." Ed replied,

13 studies, one conclusion:

There were significant differences between the groups for weight, high-density lipoprotein cholesterol, triacylglycerols and systolic blood pressure, favouring the low-carbohydrate diet. There was a higher attrition rate in the low-fat compared with the low-carbohydrate groups suggesting a patient preference for a low-carbohydrate/high-protein approach as opposed to the Public Health preference of a low-fat/high-carbohydrate diet. Evidence from this systematic review demonstrates that low-carbohydrate/high-protein diets are more effective at 6 months and are as effective, if not more, as low-fat diets in reducing weight and cardiovascular disease risk up to 1 year.
Recap:
Higher protein diets are better for humans than lower protein diets are (when it comes to cardiovascular disease risk).

This is too broad a generalization. How much fat and what kind of carbohydrates? Were the low-fat, high-carb diets comparable to the one that I am on? And how high in fat were the high protein diets? And was it the Pritikin/Ornish diet that was being evaluated, or something along the lines of the American Heart Association diet which contains 30% of total calories as fat. The latter is hardly a bona fide low-fat diet. And as I've also mentioned, the Pritikin/Ornish diet has demonstrated atherosclerotic regression, whereas the low-carb, high protein diets have yet to demonstrate this.

I asked, "Are you seriously telling me that Atkins showed that populations on high-fat and high-saturated fat diets had lower rates of heart disease than populations on very low-fat diets? Ed, that is simply fantastic."

See above.

Doesn't follow, as I indicated.

In a previous post, I wrote, "Btw, I'm glad to see that at least you're diet doesn't include any polyunsaturated vegetable oils." You replied, "Olive oil is on it, and canola and flaxseed oil aren't left out." I replied, "I meant omega-6 oils like safflower, sunflower and corn oil. Olive and canola are predominantly monosaturated oils, and flaxseed is predominantly an omega-3 oil.

Omega-6 oils can't be on a paleo diet because that doesn't fit (not just well, but doesn't fit at all) with our genetic makeup.

It's my understanding that ALL processed vegetable oils are excluded from the paleo diet. After all, these were not something that paleolithic man consumed, were they? And if they weren't, then what is the rationale for including them?

I wrote, "I was simply saying that if you eat the kind of meat that's available today in the supermarket, you're going to be getting too much saturated fat and omega-6 fatty acids relative to the omega-3's unless you consume extra omega 3's."

Christ almighty. Do you think I didn't know that? Who do you think you are talking to? I'm not just some cocky punk who thinks he's a nutrition expert because he read a couple issues of Muscle & Fitness magazine. Gimme' a break.

You're not?? And all this time, I thought you were. Silly me. So am I to understand that you do get your meat at the supermarket, but simply add flaxseed oil or fish oil to compensate? Or do you make a point of eating a lot of salmon, sardines etc. to balance it out?

I wrote, "Are you saying that the only way that cholesterol gets deposited on the artery walls is if there is damage to the artery, so that a person could have very high serum cholesterol and not have any atherosclerosis whatsoever?"

The only way that cholesterol gets deposited on the artery walls is if it's first modified, most often by oxidation.

True.

If your antioxidant status was consistently high enough, then most atherosclerosis -- regardless of blood cholesterol levels -- simply would not occur. Bill, have you ever wondered why 55% of atherosclerosis patients have good cholesterol levels? Have you ever wondered why getting LDL levels down below 70 mg/dl doesn't totally protect against atherosclerosis? The answer involves looking outside of the atherosclerotic theory promoted by Ancel Keys (and by Pritikin).

Actually, I agree with you here. Antioxidant status is important. For example, smokers with low cholesterol can have atherosclerosis, because of the oxidation caused by the smoking. but the incidence of atherosclerosis is minimal in populations with total cholesterol of 160 or lower and rare among populations with total cholesterol below 120. This is true even among smokers. Keys did a study of the Japanese back in the '40's and '50's, who are heavy smokers, and found relatively little heart disease among them on their traditional diet, but when they migrated to the West and began eating higher-fat diets, the incidence of heart disease increased markedly. The natives of Papua, New Guinea smoke a home-grown tobacco and live in smoke-filled huts, but exhibit no heart disease, although they do have a high incidence of respiratory problems.

It's because it's not the amount of LDL that counts the most -- but the type of LDL and its subsequent modification/oxidation.

Although it's true that oxidation is a factor, I think you're placing too much importance on it. What's most important is the LDL itself. Ed, I'd love to see you when you're my age -- if, that is, you actually get there. THEN we'll see how well your diet has worked for you! ;-)

P.S. Have you read this critique of the Paleo diet?

http://www.ajcn.org/cgi/content/full/71/3/665.

(Edited by William Dwyer on 9/19, 12:48pm)

Post 82

Sunday, September 19, 2010 - 1:50pm

[abstract] Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial.

... and ...

Bill,

This is too broad a generalization. How much fat and what kind of carbohydrates? Were the low-fat, high-carb diets comparable to the one that I am on? And how high in fat were the high protein diets?

What you are saying is that even though a little reduction in fat is bad -- and science proves that point -- that a whole lot of reduction in fat will all of a sudden turn around and be good for us. That's called "bimodality" and if you are going to argue for something like that then you have to back it up with research. Arbitrarily postulating "bimodality" -- when its background frequency is generally rare (say, less than 20% of all nutrition dynamics are bimodal) is wrong. That's like arguing that you can't make a dinner date because you expect to get hit by lightning on the way there. You can't argue with an appeal to low-probability events.

And besides, when you narrow things down and isolate variables, I'm right about protein and cardiovascular risk:

In the setting of a healthful diet, partial substitution of carbohydrate with either protein or monounsaturated fat can further lower blood pressure, improve lipid levels, and reduce estimated cardiovascular risk.

Substituting protein for carbohydrate in the context of a healthy dietary pattern reduced atherogenic apo C-III-containing LDL and its precursor, apo C-III-containing VLDL, resulting in the most favorable profile of apo B lipoproteins.

[abstract] Effect of protein, unsaturated fat, and carbohydrate intakes on plasma apolipoprotein B and VLDL and LDL containing apolipoprotein C-III: results from the OmniHeart Trial.

It's my understanding that ALL processed vegetable oils are excluded from the paleo diet. After all, these were not something that paleolithic man consumed, were they? And if they weren't, then what is the rationale for including them?

The rationale for including them is if they provide monounsaturates (as is found in the bone marrow that cavemen used to suck out of bones) or omega-3 polyunsaturates.

So am I to understand that you do get your meat at the supermarket, but simply add flaxseed oil or fish oil to compensate? Or do you make a point of eating a lot of salmon, sardines etc. to balance it out?

Yes, you are to understand all these things. It's no secret -- I've told you before, maybe a half-dozen times -- that I both eat fish and take fish oil supplements. Are you getting senile? Wait, scratch that question ... you probably couldn't remember if you were (getting senile).

What's most important is the LDL itself.

Spoken like a true, pet-theory dogmatist (ignoring all data to the contrary). You still haven't answered my question about how come lowering LDL to less than 70 mg/dL leaves almost of third of folks still progressing with atherosclerosis. If LDL was most important, then lowering it to sub-physiological levels (<70 mg/dL) would all but eradicate atherosclerotic progression. It doesn't. You can't answer for that. Your theory does not explain that fact. Instead of changing the theory, you ignore the facts of the matter. It's not total cholesterol, or even total LDL cholesterol (as you continue to say), it's the modification of cholesterol along with the modification of blood vessel walls (such as high blood pressure damaging the inside of the vessel wall) that is most important.

How do you explain effects of race, where blacks have lower LDL, but more coronary heart disease?"

Blacks have lower average triglyceride and LDL cholesterol concentrations than do whites but higher rates of coronary heart disease.

[abstract] Dietary interventions that lower lipoproteins containing apolipoprotein C-III are more effective in whites than in blacks: results of the OmniHeart trial.

The explanation is that my theory -- that total LDL content is only minimally important -- is correct (and that modification, of cholesterol and blood vessel wall, is the overriding factor driving all coronary heart disease).

Ed

Post 83

Sunday, September 19, 2010 - 5:37pm

Ed,

I wrote, "This is too broad a generalization. How much fat and what kind of carbohydrates? Were the low-fat, high-carb diets comparable to the one that I am on? And how high in fat were the high protein diets?"

What you are saying is that even though a little reduction in fat is bad -- and science proves that point -- that a whole lot of reduction in fat will all of a sudden turn around and be good for us.

No, that's not what I'm saying. I'm simply asking for precise information on how much fat and carbohydrate and what kind of carbohydrate is in these diets. And where has it been shown that a little reduction in fat is bad? What I would say is that a reduction from 43% to 30% of total calories as fat doesn't make much of a difference, not that it's necessarily bad.

And besides, when you narrow things down and isolate variables, I'm right about protein and cardiovascular risk. In the setting of a healthful diet, partial substitution of carbohydrate with either protein or monounsaturated fat can further lower blood pressure, improve lipid levels, and reduce estimated cardiovascular risk.

Interesting. What kind of carbohydrate and what kind of protein? I did notice that in the protein group, half the protein came from plant sources, I would have classified plant food as carbohydrate, even though legumes and (for example) quinoa (which is a seed not a grain) contain a fair amount of protein. In any case, given the success of the Ornish diet in promoting regression, I would like to see a head-to-head comparison of his diet with the protein and monosaturated diets.

I wrote, "It's my understanding that ALL processed vegetable oils are excluded from the paleo diet. After all, these were not something that paleolithic man consumed, were they? And if they weren't, then what is the rationale for including them?"

The rationale for including them is if they provide monounsaturates (as is found in the bone marrow that cavemen used to suck out of bones) or omega-3 polyunsaturates.

Oh, interesting.

I wrote, "So am I to understand that you do get your meat at the supermarket, but simply add flaxseed oil or fish oil to compensate? Or do you make a point of eating a lot of salmon, sardines etc. to balance it out?"

Yes, you are to understand all these things. It's no secret -- I've told you before, maybe a half-dozen times -- that I both eat fish and take fish oil supplements. Are you getting senile?

Sorry, if I misunderstood you, but when I asked about the diet that included salmon, you said that it was one that Cordain gave as an example. It wasn't clear to me that you followed it to the letter, so I was just checking.

I wrote, "What's most important is the LDL itself."

Spoken like a true, pet-theory dogmatist (ignoring all data to the contrary). You still haven't answered my question about how come lowering LDL to less than 70 mg/dL leaves almost of third of folks still progressing with atherosclerosis.

Perhaps the one-third whose atherosclerosis stopped progressing had high-blood pressure which continued to damage the artery walls and cause subsequent plaque formation. In any case, lowering the LDL to <70 mg/dL) did stop the progression of the remaining two-thirds, which is significant.

If LDL was most important, then lowering it to sub-physiological levels (<70 mg/dL) would all but eradicate atherosclerotic progression.

Not necessarily; it may simply eradicate most of it.

It doesn't. You can't answer for that. Your theory does not explain that fact. Instead of changing the theory, you ignore the facts of the matter. It's not total cholesterol, or even total LDL cholesterol (as you continue to say), it's the modification of cholesterol along with the modification of blood vessel walls (such as high blood pressure damaging the inside of the vessel wall) that is most important.

I agree with you that high blood pressure is important. When I said that LDL was most important, I was referring to your point about the importance of oxidized LDL; I wasn't even thinking of high blood pressure, which is itself a very important factor. What I was saying is that the LDL (rather than oxidized LDL) tends to be the most important indicator of risk -- that even heavy smokers, whose LDL is presumably more oxidized than that of non-smokers, don't get heart disease if their LDL is very low.

How do you explain effects of race, where blacks have lower LDL, but more coronary heart disease?

Good question. I would say that it's probably high blood pressure, which afflicts blacks more then whites. I'm less confident that antioxidant status is a major factor in the difference.

I'd be curious as to your take on the critique of the Paleo diet that I cited in my previous post: http://www.ajcn.org/cgi/content/full/71/3/665.

Post 84

Sunday, September 19, 2010 - 10:06pm

Bill,

And where has it been shown that a little reduction in fat is bad?

13 studies, one conclusion:

There are few studies comparing the effects of low-carbohydrate/high-protein diets with low-fat/high-carbohydrate diets for obesity and cardiovascular disease risk. This systematic review focuses on randomized controlled trials of low-carbohydrate diets compared with low-fat/low-calorie diets.

Trials were included if they lasted at least 6 months and assessed the weight-loss effects of low-carbohydrate diets against low-fat/low-calorie diets.

There were significant differences between the groups for weight, high-density lipoprotein cholesterol, triacylglycerols and systolic blood pressure, favouring the low-carbohydrate diet.

There was a higher attrition rate in the low-fat compared with the low-carbohydrate groups suggesting a patient preference for a low-carbohydrate/high-protein approach as opposed to the Public Health preference of a low-fat/high-carbohydrate diet.

Evidence from this systematic review demonstrates that low-carbohydrate/high-protein diets are more effective at 6 months and are as effective, if not more, as low-fat diets in reducing weight and cardiovascular disease risk up to 1 year.

Recap:
In 13 different studies, higher fat diets were better than lower fat diets at reducing cardiovascular risk.

Interesting. What kind of carbohydrate and what kind of protein?

The good kind of carbohydrate and the good kind of protein. A DASH-friendly diet was manipulated so as to contain either more protein or more fat. In both cases, it outperformed the lower-protein/lower-fat version.

In any case, given the success of the Ornish diet in promoting regression, I would like to see a head-to-head comparison of his diet with the protein and monosaturated diets.

Me, too.

What I was saying is that the LDL (rather than oxidized LDL) tends to be the most important indicator of risk -- that even heavy smokers, whose LDL is presumably more oxidized than that of non-smokers, don't get heart disease if their LDL is very low.

But 30% of every patient with very low LDL levels get (more) heart disease. You can't sit there and say that smokers don't get heart disease if their LDL is very low. That's not even true of non-smokers.

I'd be curious as to your take on the critique of the Paleo diet that I cited in my previous post ...

Here are quotes with my responses:

They conclude that most such societieslikely derived more than half of their subsistence energy fromanimal foods and that because wild plant foods have a relativelylow carbohydrate content, protein intake was elevated at theexpense of carbohydrate (4). The take-home message seems tobe that if we emulated such hunter-gatherers and derived moreof our energy from animal foods, we might be able to avoid someof the "diseases of civilization" (eg, obesity, coronary heartdisease, and type 2 diabetes).

Katharine is ignoring all of the other evidence leading to the same conclusion. Harriman, in his book: "The Logical Leap" talks about skeptics who perform this mental/rhetorical trick. They wail and bemoan the following:

"The conclusion you have doesn't follow, necessarily, from the evidence you cite. I can find alternative theories to fit the facts you presented."

Then the skeptic ignores all of the other data in support of the conclusion. For instance, I have cited reams of studies (studies which have nothing to do with the paleolithic diet, by the way) showing how higher protein and/or higher fat (and therefore, lower carbohydrate) diets have outperformed lower protein or lower fat diets with respect to:

1) obesity
2) coronary heart disease
3) type 2 diabetes

Katharine turns a blind-eye to such reams of studies.

Such a suggestion, however wellintentioned, seems ill advised given the high fat content ofdomesticated livestock relative to that of wild prey ...

Katharine's thinking mistake here is to assume that man can't fix his total fat intake -- by modifying other components of his diet -- in order to include domesticated livestock. Adding fish oil, for example, fixes most of the problem.

Katharine turns a blind-eye to such solutions.

Oh ... crap. I just noticed that the primary authors responded to Katharine's criticisms. They did a great job responding, too. Here is the link to that.

Ed

Post 85

Monday, September 20, 2010 - 12:50pm

Ed,

This seems to fly in the face of a lot of other evidence that high-fat diets cause heart disease and that very low-fat diets are beneficial. For years, I was on a high-fat, high protein diet along with good carbs -- whole grains, vegetables and fruit. Yet, my blood pressure was high, my cholesterol was extremely high, and this was true even though I was exercising a lot -- running and lifting weights. After being on the Pritikin diet, my cholesterol dropped 50%, and my blood pressure fell from 134/90 to 100/70. Pritikin and Ornish report similar results from their studies as well as outright regression of atherosclerosis.

Then there are the epidemiological studies on populations who follow a very low-fat diet and have very low cholesterol, low blood pressure and no evidence of heart disease versus populations who follow high-fat diets and have very high rates of heart disease. For instance, in the late '40's and early '50's, Ancel Keys reported the findings of more than 25 investigations. Without exception, he found heart disease to be rare in populations on very low-fat, low-cholesterol diets. (Keys, A., Kimura, N., Kusukawa, A., Bronte-Stewart, B., et al. Lessons from serum cholesterol studies in Japan, Hawaii, and Los Angeles. Ann. Int. Med., 1958, 48:83-94).

In addition, we know that saturated fat causes the liver to increase its production of LDL, which has been implicated in atherosclerosis. There are also studies showing that high-protein, high-fat diets worsen heart disease. See, for example,

http://www.ncbi.nlm.nih.gov/pubmed/11108325?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

and

http://circ.ahajournals.org/cgi/content/meeting_abstract/116/16_MeetingAbstracts/II_819?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Ornish&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT%3E

How do you explain these facts given your view that a high-protein, high-fat diet diet is better than a very low-fat diet?

The studies that you cite are interesting and provocative, but they raise more questions than they answer. I would still like to know more of the specifics -- the amount and kind of fat, protein and carbohydrate in each of these diets and how reliable the controls were. What was the percent of calories as fat, protein and carbohydrate? If the higher-fat diet included omega-3 and monosaturated fats added to other fats that were not as healthful, then that could explain some of the benefits associated with the higher-fat diet. There was also a higher attrition rate on the low-fat, high carb diets. Could that have affected the controls and the results? And how strict was the adherence. There have been diet studies published with poor controls, in which adherence was spotty and inadequate. At the very least, the studies you've presented are not a slam-dunk. They simply complicate the picture. What is needed is a more in-depth examination of the controls, the diets and the results.

I wrote, "What I was saying is that the LDL (rather than oxidized LDL) tends to be the most important indicator of risk -- that even heavy smokers, whose LDL is presumably more oxidized than that of non-smokers, don't get heart disease if their LDL is very low."

But 30% of every patient with very low LDL levels get (more) heart disease.

I assume that this statistic refers to those on cholesterol-lowering medication who were being examined clinically. Cholesterol-lowering medication is not the same as a very low-fat, low-cholesterol diet which, unlike the medication, can also lower blood pressure. Drugs can lower cholesterol as much as the Ornish diet, but they don�t result in regression in as many people or the same degree of regression.

You can't sit there and say that smokers don't get heart disease if their LDL is very low. That's not even true of non-smokers.

I'm not saying that no smokers get heart disease if their LDL is very low. Obviously, some do. All I was saying is that the Japanese who are heavy smokers had a very low incidence of heart disease before moving west and adopting a higher-fat, higher-cholesterol diet. It's also worth noting that although they are first among developed nations in salt intake, hypertension and strokes, the Japanese have the lowest incidence of heart disease in the developed world, which is evidently due to their very low-fat diets. This would suggest that oxidation and even high blood pressure is less important for heart disease than LDL and the kind of diet that lowers it.

Post 86

Monday, September 20, 2010 - 1:05pm

And Bill, what do you think about the response to Katharine Milton's editorial -- specifically this part?:

Milton's editorial repeated the same error that has occurredcontinually in the anthropologic community since Lee publishedhis work 32 y ago (3). Lee did not report the total food intakesderived from animal sources because he did not sum hunted andfished animal foods. This is one of the reasons our reanalysisof the Ethnographic Atlas is original and noteworthy. Althoughwe did not report it in our article, we analyzed Lee's sampleof 58 hunter-gatherer societies as a subset and obtained resultsalmost identical to those of our analysis of the entire sample(n = 229). The dependence on hunted and fished foods for subsistencewas 86�100% (modal value) and 66�75% (median value).

In other words, what do you think of a professional error which has been repeated for 32 years in a row? Do you think it might point to a bias? I mean, the repeated error leads one to believe that animal food isn't two-thirds or more of pre-industrial diets (even though it was). It is as if the carbohydrate enthusiasts and pundits and bureaucrats -- the left-liberal vegetarian-friendly crowd in government -- wanted to continue to make the error (because "evidence" of reduced animal food intake makes them look good).

Ed

Post 87

Thursday, September 23, 2010 - 9:24am

Bill,

This seems to fly in the face of a lot of other evidence that high-fat diets cause heart disease ...

It's not true that "high-fat diets cause heart disease" -- I can't believe you are still saying this! Most pre-industrial peoples on the planet eat a high-fat diet (28-47% fat) according to you. And most pre-industrial peoples do not get (much) heart disease. In the face of such overwhelming evidence (229 pre-industrial societies), it's amazing that you still say "high-fat diets cause heart disease".

Then there are the epidemiological studies on populations who follow a very low-fat diet and have very low cholesterol, low blood pressure and no evidence of heart disease versus populations who follow high-fat diets and have very high rates of heart disease.

See above.

... Ancel Keys reported the findings of more than 25 investigations. Without exception, he found heart disease to be rare in populations on very low-fat, low-cholesterol diets. (Keys, A., Kimura, N., Kusukawa, A., Bronte-Stewart, B., et al. Lessons from serum cholesterol studies in Japan, Hawaii, and Los Angeles. Ann. Int. Med., 1958, 48:83-94).

Keys-schmeeze. Can we look at data that's less than a half-century old, please? There were unfrefined assumptions and sub-optimal techniques used back then.

In addition, we know that saturated fat causes the liver to increase its production of LDL, which has been implicated in atherosclerosis.

We've already had this discussion.

There are also studies showing that high-protein, high-fat diets worsen heart disease. See, for example,

http://www.ncbi.nlm.nih.gov/pubmed/11108325?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

and

http://circ.ahajournals.org/cgi/content/meeting_abstract/116/16_MeetingAbstracts/II_819

The first study only had 10 people on a high-protein/high-fat diet and the second study only had 18 on it for a month. These 2 studies pale in comparison to my 13. The weight of evidence lies on my side of the debate.

How do you explain these facts given your view that a high-protein, high-fat diet diet is better than a very low-fat diet?

See above.

I assume that this statistic refers to those on cholesterol-lowering medication who were being examined clinically. Cholesterol-lowering medication is not the same as a very low-fat, low-cholesterol diet which, unlike the medication, can also lower blood pressure.

A good point.

All I was saying is that the Japanese who are heavy smokers had a very low incidence of heart disease before moving west and adopting a higher-fat, higher-cholesterol diet. It's also worth noting that although they are first among developed nations in salt intake, hypertension and strokes, the Japanese have the lowest incidence of heart disease in the developed world, which is evidently due to their very low-fat diets.

You can't just look at a Japanese diet and an American diet and, retroactively, blame health differences on the difference in fat and cholesterol? Who are you to be able to pick the supposed 2 ingredients (fat & cholesterol) -- out of the dozens of ingredients which changed -- as being precisely the cause of the increased heart disease?

Ed

Post 88

Thursday, September 23, 2010 - 10:26am

So, Ed, how do you explain the fact that when I reduced the fat and protein in my diet and increased the carbs, my cholesterol dropped by 50%, my fasting glucose dropped from the mid-80's to the low '70's, and my blood pressured dropped from 134/90 to 100/70? And if carbs are the culprit and fat the benefactor, how do you explain similar results on the subjects enrolled in the Pritikin Longevity Center and those involved in Dean Ornish's programs. And how do you explain the regression in atherosclerosis that Pritikin and Ornish get on their diets?

The Tarahumara Indians living in the Sierra Madre of Northern Mexico have zero heart disease. Fat makes up 10 percent of their total calories; protein, 13 percent; and carbohydrates, 75-80 percent. Adult cholesterol levels range from 100 to 140 mg/dl, and HDL levels average only 34 mg/dl. (Cerqueira, M.T., Fry, M.M., and Connor, W.E. The food and nutrient intakes of the Tarahumara Indians of Mexico. Amer. J. Clin. Nutr., (1979), 32:905-15. And: Connor, W.E., Cerqueira, M.T., Connor, R.W., Wallace, R.B., et al. The plasma lipids, lipo-proteins, and diet of the Tarahumara Indians of Mexico. Amer. J. Clin. Nutr., 1978, 31:1131-42.)

The natives of Papua, New Guinea follow a diet consisting largely of sweet potatoes and sweet potato leaves. Ninety-three percent of their total calories come from carbohydrates and only 2.6 percent come from fat. Yet they are free of heart disease. and their cholesterol levels average 110 mg/dl.

As for your 229 case studies of pre-industrial civilizations on relatively high-fat diets, I am unable to evaluate them, because I was not able to access the studies. Are these primitive populations living in the 21st Century?

Also, do you deny that LDL plays a role in heart disease and is produced by the liver in response to the intake of saturated fat? That seems to be a pretty well established fact and one that is now overwhelmingly accepted by the medical profession.

(Edited by William Dwyer on 9/23, 12:13pm)

Post 89

Friday, September 24, 2010 - 5:09pm

Bill,

So, Ed, how do you explain the fact that when I reduced the fat and protein in my diet and increased the carbs, my cholesterol dropped by 50%, my fasting glucose dropped from the mid-80's to the low '70's, and my blood pressured dropped from 134/90 to 100/70?

Most (>50%) of your improved profile stems from "cleaning up" your diet -- such as reducing sugar and trans fatty acids, and increasing fiber. Most top diets nowadays are already in agreement on these things and are already "clean" though, so it's difficult to draw more conclusions without performing big studies. You performed a "study-of-one" and you got great results. Good for you.

And if carbs are the culprit and fat the benefactor, how do you explain similar results on the subjects enrolled in the Pritikin Longevity Center and those involved in Dean Ornish's programs. And how do you explain the regression in atherosclerosis that Pritikin and Ornish get on their diets?

See above.

The Tarahumara Indians living in the Sierra Madre of Northern Mexico have zero heart disease. Fat makes up 10 percent of their total calories; protein, 13 percent; and carbohydrates, 75-80 percent.

Not according to my data. My data is from the latest study on Tarahumara diets publicly-viewable from PubMed. The main study is here:

http://www.nejm.org/doi/full/10.1056/NEJM199112123252405

... and the breakdown is here:

http://www.nejm.org/doi/full/10.1056/NEJM199112123252405#t=article+Methods.

... where fat made up 20 percent of their total calories; protein, 15 percent; and carbohydrates, 65 percent. Note that sugar was only 3 percent of total calories and these Tarahumarans choked down a whopping 102 grams of fiber a day!

Now that's a clean diet. If you eat 102 grams of fiber a day, it almost doesn't matter what else you eat -- you won't get heart disease. You could eat a french fries and ice cream ... and 102 grams of fiber ...

... and you won't get heart disease.

You could eat a pizza and hot dogs ... and 102 grams of fiber ...

... and you won't get heart disease.

You could eat green eggs and ham ... and 102 grams of fiber ...

... and you won't get heart disease.

:-)

The natives of Papua, New Guinea follow a diet consisting largely of sweet potatoes and sweet potato leaves. Ninety-three percent of their total calories come from carbohydrates and only 2.6 percent come from fat.

The natives of Papua, New Guinea are thought to be infected with a nitrifying bacteria that recycles protein in their bodies. This is what it is that lets them be muscular (they are "hard-bodied"!) while eating such a little amount of protein -- no other population could accomplish this feat.

Because of their likely, nutrition-affecting infection, they are a terrible choice from which to make any kind of inferential generalization. It's just too weird when someone can be that muscular with hardly any protein in their diet. There are biophysical limitations and an 'obligatory nitrogen loss' which these folks seem to somehow sneak past.

At best they are a fun oddity to study.

As for your 229 case studies of pre-industrial civilizations on relatively high-fat diets, I am unable to evaluate them, because I was not able to access the studies. Are these primitive populations living in the 21st Century?

Primitive populations living in the 20th Century. The source of the diet data is:

Gray JP. A corrected ethnographic atlas. World Cultures J 1999; 10:24�85.

... which I got from here:

http://www.ajcn.org/cgi/content/full/71/3/682

Also, do you deny that LDL plays a role in heart disease and is produced by the liver in response to the intake of saturated fat?

Yes and no. Non-modified LDL hasn't ever been shown to play a necessary role in heart disease (indeed, you can even increase your LDL and, simultaneously, decrease your heart disease risk!**), but the liver does make it in response to the intake of saturated fat.

Ed

**If you would like to see studies of folks who got more LDL and less heart disease risk -- let me know. For instance, in fish oil studies, folks often end up with more LDL but -- at the same time -- less heart disease risk (as measured by concrete end-points, such as heart attacks and fatal heart attacks).

(Edited by Ed Thompson on 9/24, 5:19pm)

Post 90

Saturday, September 25, 2010 - 10:14am

Bill,

As for your 229 case studies of pre-industrial civilizations on relatively high-fat diets, I am unable to evaluate them, because I was not able to access the studies. Are these primitive populations living in the 21st Century?

I answered this above, but wanted to add to it.

The Ethnographic Atlas utilized had included the several hundreds of known societies in the world. 414 of them just in Africa. 164 of them in or around the Mediterranean (e.g., Turkey). 126 of them in East Eurasia (e.g., Madagascar). 168 of them in the Insular Pacific (e.g., Australia). 286 of them in N. America. And 109 of them in S. America. Of the 1000 or so societies in the Ethnographic Atlas, Cordain et al. parsed out the 229 societies which rely on hunting (including fishing)/ gathering only. They did this in order to get a pre-agricultural view of what man ate.

Here is a link where you can use the "Scribd pop-up bar" at the bottom of the page in order to view page 37 out of 50:

http://www.scribd.com/doc/9285782/Ethnographic-Atlas-Codebook

This will show you entry # 92 in the ethnographic atlas code entitled "Area within each region." There is a further breakdown of the society locations there.

Ed

Post 91

Saturday, September 25, 2010 - 11:09am

Using Australian Aborigines for a source diet for plant food, and percentage of plant-dependence at a maximum, and an average composition of meat & fish; it is possible to estimate the lowest amount of fat that man could have ever ate before agriculture:

In the present model, we used a fixed plant-food macronutrientvalue of 62% of energy from carbohydrate, 24% from fat, and14% from protein, derived entirely from Australian Aboriginalplant foods.

http://www.ajcn.org/cgi/content/full/71/3/682

Composition of Aboriginal plant food:
62% carbohydrate
14% protein
24% fat

Highest percent of plant-subsistence: 85% (with the remain 15% from hunting/fishing). Multiply values above by 0.85% in order to get the relative proportion of macronutrients from plants (later to be added to that found from meat/fish, culiminating in the full 100% of food intake):

The relative contribution of fat energy from huntedanimal food was determined by using the equation from Figure3; thus, an animal with 10% body fat would derive 51% of itsenergy from fat, or 2243 kJ (4393 kJ x 0.51). The relative contributionof protein energy from hunted animal food was also determinedby using the equation from Figure 3; thus, an animal with 10%body fat would derive 49% of its energy as protein, or 2155kJ (4393 kJ x 0.49).

--ibid.

Composition of meat/fish:
0% carbohydrate
51% fat
49% protein

Multiplied by 0.15 and added to the plant-food macronutrient intake, we get the following:

carbohydrate
plant: 62% x 0.85 of total diet = 53%
+
animal: 0% x 0.15 of total diet = 0%
=
total carbohydrate (plant + animal) intake = 53%**

**53% is also the highest carbohydrate intake possible on a large scale in hunter-gatherer societies (because you'd need more plant food to increase it, and no hunter-gatherer society ate more than 85% plant food)

protein
plant: 14% x 0.85 of total diet = 13%
+
animal: 49% x 0.15 of total diet = 7%
=
total protein (plant + animal) intake = 20%**

**20% is also the lowest protein intake possible on a large scale in hunter-gatherer societies (because you'd need more plant food to decrease it, and no hunter-gatherer society ate more than 85% plant food)

fat
plant: 24% x 0.85 of total diet = 20%
+
animal: 51% x 0.15 of total diet = 8%
=
total fat (plant + animal) intake = 28%**

**28% is also the lowest fat intake possible on a large scale in hunter-gatherer societies (because you'd need more plant food to decrease it, and no hunter-gatherer society ate more than 85% plant food)

Putting it all together
Combining two assumptioins (i.e., Aboriginal plant food is representative of all plant food; & meat/fish calories are split evenly between protein and fat), the lowest fat diet available to pre-agricultural peoples was:

53% carbohydrate
20% protein
28% fat

Therefore, diets with around 28-30% fat need to be classified as "low-fat" diets. Diets with as little as 20-27% fat need to be classified as "very-low-fat" diets (to capture the fact that they go definitely beyond what pre-agricultural man could have ate). Diets with as little as 10% fat need to be reclassified as dangerously experimental (less than half the lowest level of fat that pre-agricultural man could have ate).

Ed

Post 92

Saturday, September 25, 2010 - 2:51pm

I asked, "So, Ed, how do you explain the fact that when I reduced the fat and protein in my diet and increased the carbs, my cholesterol dropped by 50%, my fasting glucose dropped from the mid-80's to the low '70's, and my blood pressured dropped from 134/90 to 100/70?"

Most (>50%) of your improved profile stems from "cleaning up" your diet -- such as reducing sugar and trans fatty acids, and increasing fiber.

But I didn't consume sugar before, nor did I consume refined carbs like pastries, donuts, pies, cakes, cookies, pizza, etc. I was a health nut before I ran into Pritikin. I ate only natural unrefined foods, whole grains, fruits and vegetables and lots of fiber. The only thing different from the Pritikin diet was that I consumed a lot of fat -- a lot of meat, organ meats like liver; fish, sardines, butter, cheese, nuts, peanut butter, wheat germ, wheat-germ oil, sunflower seeds and pumpkin seeds. No sugar, no white flower, no white rice; only brown rice and whole grain breads and cereals. I thought sugar was bad, but that fat was good. That was until I read Pritikin, and my diet underwent a sea change.

Virtually, the only thing I changed was the fat. Initially, it was very hard. I was craving fat like there was no tomorrow. I remember walking by a store and seeing a bag of sunflower seeds in the window. I experience a craving for that bag of sunflower seeds like you wouldn't believe. But I resisted. I had very strong resolve, and stuck to the diet. Gradually, my craving for fat subsided, and I began to enjoy the low-fat diet. I noticed that when I went off it occasionally, I didn't like the extra fat. It tasted too rich. Yuk! So, your body adjusts. And, of course, I loved the clinical confirmation -- as I worked in lab and could get my blood tested whenever I wanted, which was frequently to see how the diet affected the results. It was amazing at how varying the amount of fat even slightly caused the test results to change noticeably for better or for worse.

I wrote, "And if carbs are the culprit and fat the benefactor, how do you explain similar results on the subjects enrolled in the Pritikin Longevity Center and those involved in Dean Ornish's programs. And how do you explain the regression in atherosclerosis that Pritikin and Ornish get on their diets?"

See above.

But you don't get the same results on the American Heart Association diet, which is a reasonably healthy low-fat diet, except for the fact that the percent of calories as fat is higher (30% versus 10-15%).

I wrote, "The Tarahumara Indians living in the Sierra Madre of Northern Mexico have zero heart disease. Fat makes up 10 percent of their total calories; protein, 13 percent; and carbohydrates, 75-80 percent."

Not according to my data. My data is from the latest study on Tarahumara diets publicly-viewable from PubMed. The main study is here:

http://www.nejm.org/doi/full/10.1056/NEJM199112123252405

... and the breakdown is here:

http://www.nejm.org/doi/full/10.1056/NEJM199112123252405#t=article+Methods.

... where fat made up 20 percent of their total calories; protein, 15 percent; and carbohydrates, 65 percent. Note that sugar was only 3 percent of total calories and these Tarahumarans choked down a whopping 102 grams of fiber a day!

Now that's a clean diet. If you eat 102 grams of fiber a day, it almost doesn't matter what else you eat -- you won't get heart disease. You could eat a french fries and ice cream ... and 102 grams of fiber ... and you won't get heart disease.

I dunno! I think that has to be substantiated. Fiber is certainly good, but I don't know that it provides ironclad protection against atherosclerosis. Right now that's just speculation. As for the discrepancy in your results and mine, your figures may reflect as slight modification in their diets. Still 20% of total calories as fat isn't bad.

You could eat a pizza and hot dogs ... and 102 grams of fiber ...

... and you won't get heart disease.

You could eat green eggs and ham ... and 102 grams of fiber ...

... and you won't get heart disease.

:-)

If only that were true! You could take metamucil and never have to say you're sorry! Remember the Woody Allen scenario -- you know, where he wakes up in the future, and they've discovered that everything that was formerly thought unhealthy is now healthy? Pizza and beer and greasy hamburgers and H�agen-Dazs ice cream and chocolate cake and god knows what else!

I wrote, "The natives of Papua, New Guinea follow a diet consisting largely of sweet potatoes and sweet potato leaves. Ninety-three percent of their total calories come from carbohydrates and only 2.6 percent come from fat."

The natives of Papua, New Guinea are thought to be infected with a nitrifying bacteria that recycles protein in their bodies. This is what it is that lets them be muscular (they are "hard-bodied"!) while eating such a little amount of protein -- no other population could accomplish this feat.

Yeah, I know, you pointed this out to me before. But I wasn't focusing on the protein. I was focusing on the fat content of their diet. Are you saying that their low-fat diets are also compensated for by this nitrifying bacteria? How is that?

As for your 229 case studies of pre-industrial civilizations on relatively high-fat diets, I am unable to evaluate them, because I was not able to access the studies. Are these primitive populations living in the 21st Century?

Primitive populations living in the 20th Century. The source of the diet data is:

Gray JP. A corrected ethnographic atlas. World Cultures J 1999; 10:24�85.

... which I got from here:

http://www.ajcn.org/cgi/content/full/71/3/682

Okay. I'll see if I can access it. I wasn't able to read the articles in the journal because I wasn't a subscriber.

I wrote, "Also, do you deny that LDL plays a role in heart disease and is produced by the liver in response to the intake of saturated fat?"

Yes and no. Non-modified LDL hasn't ever been shown to play a necessary role in heart disease (indeed, you can even increase your LDL and, simultaneously, decrease your heart disease risk!**), but the liver does make it in response to the intake of saturated fat.

Okay, but how do you explain the heart attacks that very young children experience who are hypercholesterolemic (either homozygote or heterozygote). These children inherit extremely high cholesterol from one or both parents. If they inherit it from one parent, they can have total cholesterol of 500 mg/dL; from both parents, they can have it up to 1000 mg/dL. These children often experience heart attacks at a very early age. A dental assistant at one of my visits, who was young (25), petite and very pretty (not that that's relevant! ;-), told me that she had already had a heart attack. Her cholesterol was 500. She did say that fish oil seemed to help her symptoms. My point is that in these cases, it would appear to be the amount of the LDL. I don't think that there would be much modification of the LDL at an early age.

**If you would like to see studies of folks who got more LDL and less heart disease risk -- let me know. For instance, in fish oil studies, folks often end up with more LDL but -- at the same time -- less heart disease risk (as measured by concrete end-points, such as heart attacks and fatal heart attacks).

Interesting. Yeah, cite the references, if you would.

(Edited by William Dwyer on 9/25, 4:23pm)

Post 93

Saturday, September 25, 2010 - 5:44pm

Bill,

Interesting. Yeah, cite the references, if you would.

Okay:

Controversy surrounds omega-6 polyunsaturated fatty acids, because even though they lower LDL cholesterol levels, excessive intakes do not appear to be correlated with cardiovascular benefit. The omega-3 fatty acids [which can raise LDL levels] are known to exert cardiovascular protective effects ...

[abstract] Fatty acids and cardiovascular disease.

Omega-3 PUFAs raise LDL levels without concomitant changes in lipid particle size. Changes seen in conventional risk factors are insufficient to explain the cardiovascular disease risk reductions suggested to occur with omega-3 PUFAs.

[abstract] Potential impact of omega-3 treatment on cardiovascular disease in type 2 diabetes.

Serum total cholesterol and LDL cholesterol concentrations in adults who followed the walnut diet (4.87 +/- 0.18 and 2.77 +/- 0.15 mmol/L, respectively) were lower than in those who followed the control diet (5.14 +/- 0.18 and 3.06 +/- 0.15 mmol/L, respectively) and those who followed the fish diet (5.33 +/- 0.18 and 3.2 +/- 0.15 mmol/L, respectively; P < 0.0001). ... Including walnuts and fatty fish in a healthy diet lowered serum cholesterol and triglyceride concentrations, respectively, which affects CHD risk favorably. [even though fatty fish led to more LDL than controls]

[abstract] Walnuts and fatty fish influence different serum lipid fractions in normal to mildly hyperlipidemic individuals: a randomized controlled study.

We used a principal component analysis with data from FFQ collected in 2000-2004 to determine dietary patterns of Alaska Eskimos. Four dietary patterns were identified: a traditional pattern, plus 3 patterns based on purchased food, one of which reflected healthy food choices. The traditional dietary pattern was associated with lower triglycerides (P < 0.001) and blood pressure (P = 0.04) and slightly higher LDL cholesterol (LDL-C) (P = 0.05) ... Our data show that the traditional diet [with more LDL than controls] is related to a better profile of cardiovascular disease risk factors and should be encouraged.

[abstract] Dietary patterns are linked to cardiovascular risk factors but not to inflammatory markers in Alaska Eskimos.

Ed

(Edited by Ed Thompson on 9/25, 5:46pm)

Post 94

Wednesday, October 6, 2010 - 3:10pm

In the face of contradictory evidence: Report of the Dietary Guidelines for Americans Committee.

Ed

And here is what we used to eat:

We found (range of medians in en%) intakes of moderate-to-high protein (25-29), moderate-to-high fat (30-39) and moderate carbohydrates (39-40).

The fatty acid composition was SFA (11�4-12�0), MUFA (5�6-18�5) and PUFA (8�6-15�2). The latter was high in �-linolenic acid (ALA) (3�7-4�7 en%), low in LA (2�3-3�6 en%), and high in long-chain PUFA (LCP; 4�75-25�8 g/d), LCP n-3 (2�26-17�0 g/d), LCP n-6 (2�54-8�84 g/d), ALA/LA ratio (1�12-1�64 g/g) and LCP n-3/LCP n-6 ratio (0�84-1�92 g/g). ...

We conclude that compared with Western diets, Paleolithic diets contained consistently higher protein and LCP, and lower LA.

Estimated macronutrient and fatty acid intakes from an East African Paleolithic diet.

Recap:
We should try to get more protein, more omega-3 fatty acids, and less linoleic acid.

Now, I know what you are thinking. You are thinking that if it's so damn beneficial to eat more protein and omega-3 fatty acids, then shouldn't that call into question the very state of the research used in support of our own official Dietary Guidelines for Americans, bestowed upon us by the lofty Dietary Guidelines Advisory Committee (DGAC)? After all, we've been told to cut fat and to watch out for too much protein (especially animal protein).

Well, actually, yes. And that very thing -- questioning the foundations for most of the nutritional advice given by accepted "experts" in this country -- is just what has now happened:

Although appealing to an evidence-based methodology, the DGAC Report demonstrates several critical weaknesses, including use of an incomplete body of relevant science; inaccurately representing, interpreting, or summarizing the literature; and drawing conclusions and/or making recommendations that do not reflect the limitations or controversies in the science. An objective assessment of evidence in the DGAC Report does not suggest a conclusive proscription against low-carbohydrate diets. The DGAC Report does not provide sufficient evidence to conclude that increases in whole grain and fiber and decreases in dietary saturated fat, salt, and animal protein will lead to positive health outcomes.

Post 95

Wednesday, October 6, 2010 - 4:17pm

I love the reference to the "Lofty DGAC". Outstanding group of bureaucrats...lol.

I started eating paleo (not strict mind you, I do eat cheeses and breads I make myself from whole grains) when I started doing crossfit. They recommend it strongly.

I have never felt better. :)

Post 96

Wednesday, October 6, 2010 - 8:41pm