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