The Diet Wars: Low Carb or Low Fat

Jim_Smith · Aug 11, 2019

What I have read is that the "new" findings that "vindicated" saturated fats is more complicated than is often represented in the media. What they found I think is that when people gave up saturated fats they would replace them with carbohydrates which increases health risks. But if you replace saturated fats with unsaturated fats that lowers your health risks.

This quote is not exactly what I wrote but it is focused on heart disease risk and does not consider diabetes risks, but it sort of supports what I wrote:
https://www.webmd.com/heart-disease/news/20140320/dietary-fats-q-a#1
"If you replace saturated fat with carbohydrates or refined starch or sugar, you are not changing your heart disease risk," he says. ''If you replace saturated fat with polyunsaturated fat, you do get a reduction in heart disease risk."

If you add the risks of diabetes to this I think you get what I wrote.

I have a broken molar and I am trying to keep it functioning as long as possible because root canals are expensive and I don't like going to the dentist. So I make my own peanut butter. Where I buy groceries I can get 5 pounds of peanuts in the shell for $5.99. I shell them by hand and grind them in a food processor. The final price is $1.58 per lb of peanut butter (20 ounces of peanuts weigh approximately 26.5 ounces in the shell).

I am enjoying it. Thanks.

David Bailey · Aug 12, 2019

Jim_Smith said:

This is where things become messy, and I am really talking second hand from things I picked up at Kendrick's site and in his books.
Perhaps the main problem is that all dietary science has to operate using 'observational studies'. I.e. you can't take a large group of people and split them into two groups and enforce different diets for each group, so you try to observe what each person consumes, and look at the outcome many years later.

Kendrick gives a very interesting example of how this can go badly wrong. In the early days of hormone replacement therapy, many women reaching the menopause elected to receive prescriptions for hormones that would replace the ones their bodies were no-longer making. Then studies compared these women against others that did not choose to take the therapy - so it was an observational study. The outcome seemed clear - women taking the hormones got less cancer and less cardiovascular events than those not taking the hormones! In fact Kendrick says, it was getting close to the point where it would be considered unethical not to offer women these hormones (and therefore impossible to study the effect of these hormones using a randomly controlled trial (RCT).

However, fortunately a proper RCT was performed, in which all women got tablets to take, but some where placebo. Amazingly this reversed the outcome of the previous observational studies - women taking the hormones suffered more cancers and more cardiovascular events than those that took placebo tablets! The explanation seems to be that well off women took the hormones but poorer women were less likely to do so, but of course, for some undetermined reason better off people have considerably better health than those lower down the ladder (on average of course).

Thus while you can get useful information from observational studies of really harmful things - like smoking - this is really the exception, most studies are drowned in noise.

https://med.stanford.edu/news/all-n...lls-for-more-rigorous-nutrition-research.html

Kendrick seems very cautious about all dietary studies, except for the consequences of consuming too much sugar. In particular, you would only find out that saturated fat was uniquely bad for you if it was really bad - maybe not as bad as smoking, but going that way. Subject to the restriction on sugar, it is probably best to just eat what you like, in moderation.

The problem for medical science, is that most researchers in this area would become redundant - so you will never hear this officially.

David

Jim_Smith · Aug 12, 2019

David Bailey said:

Here is Kendrick's article where he says replacing saturated fats with unsaturated fats leads to lower cholesterol and higher mortality:
https://drmalcolmkendrick.org/2016/04/13/

Here is the study he cites as a reference:
https://www.bmj.com/content/353/bmj.i1246

"Though the MCE intervention effectively lowered serum cholesterol in all prespecified subgroups, there was no clinical benefit in any group. Paradoxically, MCE participants who had greater reduction in serum cholesterol had a higher rather than a lower risk of death.
...
Summary and conclusion
Available evidence from randomized controlled trials shows that replacement of saturated fat with linoleic acid effectively lowers serum cholesterol but does not support the hypothesis that this translates to a lower risk of death from coronary heart disease or all causes. MCE findings add to growing evidence that incomplete publication has contributed to overestimation of benefits, and underestimation of potential risks, of replacing saturated fat with vegetable oils rich in linoleic acid."

This is the earlier Sidney study.
https://www.bmj.com/content/346/bmj...3df812a0697c5440d14d6ad7&keytype2=tf_ipsecsha
"In this cohort, substituting dietary linoleic acid in place of saturated fats increased the rates of death from all causes, coronary heart disease, and cardiovascular disease."

David Bailey · Aug 12, 2019

Jim_Smith said:

Here is Kendrick's article where he says replacing saturated fats with unsaturated fats leads to lower cholesterol and higher mortality:
https://drmalcolmkendrick.org/2016/04/13/

Here is the study he cites as a reference:
https://www.bmj.com/content/353/bmj.i1246

"Though the MCE intervention effectively lowered serum cholesterol in all prespecified subgroups, there was no clinical benefit in any group. Paradoxically, MCE participants who had greater reduction in serum cholesterol had a higher rather than a lower risk of death.
...
Summary and conclusion
Available evidence from randomized controlled trials shows that replacement of saturated fat with linoleic acid effectively lowers serum cholesterol but does not support the hypothesis that this translates to a lower risk of death from coronary heart disease or all causes. MCE findings add to growing evidence that incomplete publication has contributed to overestimation of benefits, and underestimation of potential risks, of replacing saturated fat with vegetable oils rich in linoleic acid."

This is the earlier Sidney study.
https://www.bmj.com/content/346/bmj...3df812a0697c5440d14d6ad7&keytype2=tf_ipsecsha
"In this cohort, substituting dietary linoleic acid in place of saturated fats increased the rates of death from all causes, coronary heart disease, and cardiovascular disease."

Thanks - exactly!

I mean this is the problem - the whole cholesterol hypothesis seems to be wrong - otherwise lowering it by diet adjustment would presumably be of benefit! This mess in medicine seems typical of so much modern science.

David

The Ethical Skeptic · Aug 12, 2019

That cholesterol point exemplifies exactly what bothers me.

My doctors spent 3 decades chasing cholesterol, A1C, blood pressure, weight, etc. - looking for maladies around which they can derive lots of revenue. MEANWHILE, I had a case of pernicious anemia the ENTIRE TIME... (low red blood cell count, but not low hemoglobin)

This comes from food nutrient dilution malnutrition (our food plants are accelerated in their growth, and the transport phyla in the soil are both killed and cannot uptake nutrient fast enough, to attain the same levels of nutrient as in a naturally grown plant).

Three decades of suffering and fighting the extra weight, ... but they would not look for it because they did not stand to make a lot of money off the condition.

Criminal...

Jim_Smith · Aug 12, 2019

David Bailey said:

I tracked down the research I had read about.

They found higher intakes of sugar was associated with higher risk of coronary heart disease and that replacing saturated fats with sugar had no effect on risk, but replacing saturated fats with unsaturated fats or complex carbohydrates from grain lowered the risk of coronary heart disease. Polyunsaturated fats showed the greatest reduction in risk 25%.

They found saturated fats were just as bad as refined sugar.

https://www.sciencedirect.com/science/article/pii/S0735109715046914

"During 24 to 30 years of follow-up, we documented 7,667 incident cases of CHD. Higher intakes of polyunsaturated fatty acids (PUFAs) and carbohydrates from whole grains were significantly associated with a lower risk of CHD comparing the highest with lowest quintile for PUFAs (hazard ratio [HR]: 0.80, 95% confidence interval [CI]: 0.73 to 0.88; p trend <0.0001) and for carbohydrates from whole grains (HR: 0.90, 95% CI: 0.83 to 0.98; p trend = 0.003). In contrast, carbohydrates from refined starches/added sugars were positively associated with a risk of CHD (HR: 1.10, 95% CI: 1.00 to 1.21; p trend = 0.04). Replacing 5% of energy intake from saturated fats with equivalent energy intake from PUFAs, monounsaturated fatty acids, or carbohydrates from whole grains was associated with a 25%, 15%, and 9% lower risk of CHD, respectively (PUFAs, HR: 0.75, 95% CI: 0.67 to 0.84; p < 0.0001; monounsaturated fatty acids, HR: 0.85, 95% CI: 0.74 to 0.97; p = 0.02; carbohydrates from whole grains, HR: 0.91, 95% CI: 0.85 to 0.98; p = 0.01). Replacing saturated fats with carbohydrates from refined starches/added sugars was not significantly associated with CHD risk (p > 0.10).

Conclusions
Our findings indicate that unsaturated fats, especially PUFAs, and/or high-quality carbohydrates can be used to replace saturated fats to reduce CHD risk."

Jim_Smith · Aug 12, 2019

Jim_Smith said:

I don't know which research is right. But here is a theoretical argument, it might sound silly at first but there is a serious argument to it at the end of it....

Once I clogged my kitchen drain by pouring bacon and hamburger fat (saturated fat) into it. I had to pay a plumber to clean it out. I learned my lesson and don't pour fat down the drain anymore.

Unsaturated fats are liquid at room temperature they don't clog drains.

https://www.webmd.com/heart-disease/clogged-arteries-arterial-plaque#1

My point about the melting temperature of fats is that saturated fats are stickier than unsaturated fats. That is why they have a higher melting point. If they are stickier they are going to stick to the gunk accumulating on the inside of arteries more than unsaturated fats.

David Bailey · Aug 13, 2019

Jim_Smith said:

This is what I used to think, but (again from Kendrick) this argument is totally naive - arteries do not get clogged by fat, but by a complex mixture of blood clots, cholesterol and other things. His theory - which I think is fairly widely held - is that portions of the artery walls get damaged, snd blood clots form over that point. This is part of the normal repair process. The plaque is a bit like a scab, but it can't be shed as the arterial wall heals for obvious reasons, and the cholesterol is part of a process that absorbs the plaque into the arterial wall. This all goes well unless the amount of damage to the artery walls is so frequent that the repair can't keep up.

Fats are esters of fatty acids and glycerol, they are hydrolysed in the gut to free fatty acids.

Kendrick comments somewhere that one of the things that has sustained the theory that saturated fat is bad for you, is the false analogy with blocked sewers etc.

This reminds me of the false analogy between the greenhouse gas effect and the operation of actual greenhouses. In a real greenhouse heat is prevented from being convected away from the surface and the surrounding air because the glass forms a barrier. To cool the greenhouse, all you need to do is open the windows!

David

Jim_Smith · Aug 13, 2019

David Bailey said:

This is what I used to think, but (again from Kendrick) this argument is totally naive - arteries do not get clogged by fat, but by a complex mixture of blood clots, cholesterol and other things. His theory - which I think is fairly widely held - is that portions of the artery walls get damaged, snd blood clots form over that point. This is part of the normal repair process. The plaque is a bit like a scab, but it can't be shed as the arterial wall heals for obvious reasons, and the cholesterol is part of a process that absorbs the plaque into the arterial wall. This all goes well unless the amount of damage to the artery walls is so frequent that the repair can't keep up.

Fats are esters of fatty acids and glycerol, they are hydrolysed in the gut to free fatty acids.

Kendrick comments somewhere that one of the things that has sustained the theory that saturated fat is bad for you, is the false analogy with blocked sewers etc.

This reminds me of the false analogy between the greenhouse gas effect and the operation of actual greenhouses. In a real greenhouse heat is prevented from being convected away from the surface and the surrounding air because the glass forms a barrier. To cool the greenhouse, all you need to do is open the windows!

David

I am not saying fats are the main cause of plaque. But fats are part of the material in plaque. Stickier saturated fatty acid chains could be more likely to be drawn into the plaque and cause the plaque to devleop faster and thicker.

Jim_Smith · Aug 13, 2019

Here is a slightly off topic question. Does anyone have a digital bathroom (body weight) scale? I bought one that said it could measure .2 lb increments but is seems to only recognize .6 lb increments. Does anyone have a scale that can really measure in .2 lb increments or is that an industry wide fiction? I have to figure out if I should try a different brand or if they are all the same.

Wormwood · Aug 14, 2019

Here’s how I went from “skinny fat” to lean with some muscle tone. I try to eat as many vegetables as possible. Adding a dash of salt and butter is okay. I snack on them throughout the day as much as I can and prepare them as full meals. I eat fruit in moderation (mostly berries). I eat healthy raw nuts. And healthy non-processed grains. When following this plan, I’ve found it impossible to overeat. Who gets fat from eating too much broccoli?

I think people make this way too difficult. Eat healthy and whole unprocessed foods and exercise. If you avoid trigger foods (in most people this means sugar and processed flour/wheat etc) and focus on eating very healthy foods, I think it’s nearly impossible to over eat, at least significantly. In this sense I don’t count any calories. I just put good things in my mouth and move. Adding muscle can also be an extremely potent form of fat control as increased muscle increases your resting metabolic rate.

Jim_Smith · Aug 16, 2019

Wormwood said:

Different people have different metabolic characteristics which can also change as they get older. What true for you may not be true for someone else.

Jim_Smith · Aug 16, 2019

The way a person responds to carbohydrates has a large impact on their body weight because insulin signals the body to store fat and too much insulin can cause a blood sugar crash that can cause in food cravings.

Here is a research paper about findings that show different individuals can have very different responses to the same carbohydrates. The research involved multiple experiments that got similar results - so it would seem to be reliable.

https://www.cell.com/cell/fulltext/S0092-8674(15)01481-6
"In this work we measured 46,898 PPGRs to meals in a population-based cohort of 800 participants. We demonstrate that PPGRs are highly variable across individuals even when they consume the same standardized meals. "

PPGR = glucose response after a meal

Jim_Smith · Nov 22, 2019

https://twitter.com/i/web/status/1191432591905132544

The article is here but you have to pay to read it in full: https://jamanetwork.com/journals/jama/article-abstract/321847

The Ethical Skeptic · Nov 22, 2019

Wormwood said:

Here’s how I went from “skinny fat” to lean with some muscle tone. I try to eat as many vegetables as possible. Adding a dash of salt and butter is okay. I snack on them throughout the day as much as I can and prepare them as full meals. I eat fruit in moderation (mostly berries). I eat healthy raw nuts. And healthy non-processed grains. When following this plan, I’ve found it impossible to overeat. Who gets fat from eating too much broccoli?

I think people make this way too difficult. Eat healthy and whole unprocessed foods and exercise. If you avoid trigger foods (in most people this means sugar and processed flour/wheat etc) and focus on eating very healthy foods, I think it’s nearly impossible to over eat, at least significantly. In this sense I don’t count any calories. I just put good things in my mouth and move. Adding muscle can also be an extremely potent form of fat control as increased muscle increases your resting metabolic rate.

Good stuff Wormwood.

The Ethical Skeptic · Nov 22, 2019

Jim_Smith said:

I have one which specifies this...

But I think it means '.2 lbs for a given temperature and humidity'.

Jim_Smith · Nov 22, 2019

The Ethical Skeptic said:

I tried a total of four different scales and they all did the same thing. When I tried to return them, 3 of the manufacturers let me keep the scales but gave me a refund. One manufacturer sent me a replacement and let me keep both the original and the replacement.

I asked about this on an electronics forum and someone thought it might be because a standard 10 bit analog to digital converter will only have 1024 values and a scale that measures 400 lbs to the nearest .2 pounds would need 2000 levels. In that case, the scales should be able to measure approximately .4 lb increments but they typically measure .8 lbs increments.

I made .1 lb weights using coins in plastic bags and I subtract the number of tenths I need to cause the scale to reach to the next increment. It seems to work well enough for relative measurements.

I am assuming this is an industry wide "scam". If one company misrepresents their product, other manufacturers have to because they can't compete if they are honest - because most consumers won't notice the problem. The lack of awareness puzzles me unless this is a recent phenomenon. I was educated as a scientist and worked as an engineer so it is not surprising that I noticed the defect. But I can't find anything about this on the internet.

Wormwood · Nov 25, 2019

Jim_Smith said:

Jim, the reason people have gotten so much fatter on average over the past 60 years isn’t because we’ve suddenly developed vastly differing metabolic needs. It’s because we are eating too many calories and moving less.

The diet I propose is really hard to follow and most people won’t do it because they feel they feel
they need more taste in their food. Basically people
Enjoy eating crappy foods. If you largely eat nothing but plants, lean meats, nuts, and legumes etc (with the focus being on non-processed full vegetables), you’re not going to get fat. I’ve yet to encounter any body who has gotten fat because their systemic metabolism is such that they get fat from eating broccoli. It’s essentially impossible to over eat these foods due to their fiber content and low caloric content. Fiber is very filling and if you’re constantly eating these foods, you’ll be so full of fiber that it becomes impossible to over eat. You’ll eat less. If you feel you need more carbs than this eat a handful of berries, or try a couple of servings of quinoa or perhaps ancient grains.

Lift weights three times per week to gain muscle to increase lean muscle mass, thus increasing your basal metabolic rate, do cardio 3 times per week for general health and added caloric defecit, and you’ll be on the fast track to weight loss. This will work for virtually everybody in the world. If it doesn’t, you’re an outlier and probably suffer from a metabolic disorder of some sort.

Here’s a typical day for me

-Several handfuls of almonds in the morning
-I might eat an apple or some berries for a mid morning snack
-lunch is homemade vegetable soup from a crockpot, every day, so thick on fibrous veggies that it’s basically a stew, generally I bulk it up with lentils to provide extra calories
-Supper might be a quinoa bowl with tons of veggies and soy sauce
-Snack might be almond butter on celery sticks
-If it’s weight lifting day I will take pea protein before, during, and after the workout

If the rest of the country followed this similarly our obesity epidemic would be no more. And there wouldn’t be millions of people so confused about what to eat.

This takes some effort on food prep, which is where people struggle. People don’t take the time to shop for and prepare their foods. They order out, and it’s not easy to do things right ordering out.

David Bailey · Nov 25, 2019

Wormwood said:

From what I have read - and this is all second hand knowledge - I am not a dietician, but some of the science sounds reasonable,
The easiest way to put on weight is to eat a lot of carbs and sugars. They also seem to be bad for you because they all dump a lot of glucose into the blood.

Saturated fats are healthy, polyunsaturated fats such as vegetable oils are less so.

Animal fats, such as butter, are a lot less fattening, and most but not all people lose weight on a keto diet (extremely low carb).

People who have T2 diabetes usually manage much better on a keto/low carb diet, and this is quantifiable because they measure their blood sugar levels.

Your diet sounds very spartan, and I am sure you are thin, but do you have a lot of energy for sports etc?

I am sure that people vary. I have remained reasonably thin all my life without any effort, except that nowadays I try to avoid sugary things as far as possible.

A lot of people criticise the "a calorie a calorie" doctrine. Things that break down into sugar, are rapidly transported into fat cells by insulin - it is converted into fat. I am not sure what happens to excess fat calories, but one aspect of foods containing fat, is that people tend to feel satiated more easily, so they don't eat as much.

I can gather together some references to all this, if you want them. Obviously this has yet to become the mainstream view.

I think the question as to becoming Vegan/Vegetarian is more of a moral question.

David

The Ethical Skeptic · Nov 25, 2019

David Bailey said:

Yes, I am a critic of the black box model of weight management, CICO, or calories in/calories out. It is serving to obfuscate the damage being done to our endocrine systems - and serving to protect two large industries seeking to derive profits by destroying our health and causing obesity.

I operated for years under this model and nearly killed myself, working out 2 hours a day and eating 1600 calories, just to maintain weight. Eventually, the nutrient starvation and anemia got so bad, that I had to quit. CICO does not work for more than the short term, if one has a metabolic injury.

For my genetics/circumstance, my blood glucose level is chronically low. ~45-55 mg/dL or so. Normally between meals - when glucose is not present from food directly, the pancreas releases glucagon, which stimulates the liver to release a steady supply of glucose to the brain (which can burn, glucose, lactose and ketones). In this regard, your liver acts as sort of a battery, like in your cellphone. If either the pancreas or the liver is injured through autoimmune antibodies or environmental toxicity, then this release of fasting glucose will not occur, the blood sugar plummets when one is not eating, and the brain places the body into a condition called mitochondrial suppression.

In other words the brain believes that it does not have enough energy to function and signals that the mitochondria in the muscles and other tissues should stop burning energy. The body never goes into ketosis consequently, and cannot lose weight in normal fashion. The resulting mitochondrial suppression equates to about a 650 calorie per day deficit in ability to burn off weight (in an adult male), versus a normal metabolism.

One gets stuck in a Catch 22 at this point in the injury cycle wherein - if you eat enough to get adequate nutrition and be able to function as a human, you gain weight steadily - and if you restrict intake enough to maintain weight, you end up with chronic diseases of malnutrition and anemia (macrocytic anemia from methylcobalamine and methylfolate starvation).

As you might suspect, you do not want to be my doctor and offer up a pat lecture about 'exercising and cutting out desserts'...