Note this from this study:
"Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality"
So if you want low carbs, don't eat too much meat.
Plant based diets, such as the Mediterranean diet have been shown lead to reduced all cause mortality in randomized control trials [1]. Getting your diet right really isn't that hard, just eat fresh plant based food.
When someone mentions Mediterranean diet the first association I have is fish, white cheese, olive oil, fresh fruit and veggies, and whole grain bread. Correct me if I'm wrong - but I wouldn't classify that as a plant based diet.
The mediterranean diet study that was made the diet famous is fundamentally flawed as described in The Big Fat Surprise. It was done on a small population, self-reported, and during a time of war when supplies were short and people were eating atypical altered diet based on available food stuffs.
>>"Nina Teicholz is a journalist who became an advocate opposed to the idea that saturated fat is unhealthy and should be minimized in the American diet."
So, to begin with, she's a journalist who wrote a book about fat. In fact, she advocated that people should load up their diets on fat, particularly saturated fat:
>>Teicholz advised readers to "eat butter; drink milk whole, and feed it to the whole family. Stock up on creamy cheeses, offal, and sausage, and yes, bacon"
This advice runs counter to the advice of public health organisations and the opinionts of scientists:
>> Teicholz' claims were harshly criticized by the DGAC, the US Department of Health and Human Services, the Center for Science in the Public Interest, and others, including a petition signed by 180 scientists, and they called for BMJ to retract the article or issue corrections
My underlining.
I wouldn't trust that lady to tell me what to eat, or to criticise a scientific study's methodology. A journalist with a book has very clear incentives to "shake things up" by going against the scientific consensus. But, it's the opinion of experts that have studied the matter at length, who know the relevant bibliography well and understand its subtleties that one should trust more than outsiders who "rock the boat" for their own reasons.
Finally- it's really dangerous to listen to someone who tells you that, that thing you love to eat (or smoke, or drink, etc) that you always knew was not very good for you is actually very healthy. You have a big, fat incentive to blieve them unconditionally.
I have read her book, and it is fascinating. Go ahead and make your assumptions about her motives, but I believe you are doing yourself a disservice. Before the 20th century, we ate a lot of saturated fats, and it wasn't until the creation of vegetable oils (which are made through extensive industrial processes), was there a move to start restricting saturated fat. The current low-fat diet is an experiment that has America has been on for forty some years. Please take a look at this.
And in general, the American population has been following this diet, and we are fatter than ever before, suffering from Type 2 Diabetes. And the "science" behind our current health policy is driven by organizations like the American Soybean Asociation who are more concerned with making money and less on science. And when you start talking about money, the science research will follow the money, because the scientists need to eat.
>> Before the 20th century, we ate a lot of saturated fats, and it wasn't until the creation of vegetable oils (which are made through extensive industrial processes),
This can't be right. Olive oil is a vegetable oil and it's been known since antiquity. Its preparation requires an olive mill and a donkey to turn the millstone. Not "extensive industrial processes!
Certainly, Olive Oil has been around for a very long time, it wasn't until the 20th century that it became a major food product. Olive Oil was more valued for cosmetics, medicine, and in lamps. Actually, the original Olympic torch burned olive oil. Also, note that Olives are actually a fruit, but I understand why you bring it up as an example.
I am talking about those other vegetable oils, like grapeseed oil, canola oil, sunflower oil, cottonseed oil. Do you remember Crisco short, this was a new product produced from cottonseed oil which had been hydrogenated though intensive industrial processes and sold as a cheaper alternative to the normal saturated fats used as the time.
I hope you actually look at the links and videos I put up in my previous comment. Your ad hominem attacks against Nina Teicholz, like "I wouldn't trust that lady to tell me what to eat" and "she's a journalist" don't go unnoticed.
I also want to point out her BMJ article was not retracted. The petition signed by 180 scientists was found to be without merit. I do find it telling you bring up the petition, yet you fail to say that article was not retracted.
>> Your ad hominem attacks against Nina Teicholz, like "I wouldn't trust that lady to tell me what to eat" and "she's a journalist" don't go unnoticed.
That sounds threatening. Could you please clarify- who is it that noticed and what happens now that they noticed?
I am just saying that when you make these kinds of statements to support your arguments, you are not doing yourself any favors. It is the sign of a weak argument. Am I supposed to assume that because Nina is a woman and journalist that she is a liar? I find these type of statements very sexist. As for who noticed, I did.
I am going to give you another video, you really should watch it.
I'm just an internet random, but whenever i load up my diet with such foods, i never fail to lose fat, and a lot of it at that. The problem is sticking to it
Cheese like haloumi and feta are very low in fat, and not necessarily more than a garnish in most cases. For another animal product I’d add yogurt, but you also missed the big plant staples. Lots of pulses like beans and lentils, lots of nuts and seeds, hummus, lots and lots of rice, barley, and wheat products, whole olives in addition to the oil, that kind of thing. Of course lamb and mutton are also a source of protein and fat along with fish, but traditionally greens and beans took up the majority of calories with dairy in second, meat and fish in third.
So you’re not wrong, but cheese, fish, meat are all the tip of the pyramid, not the base. Of course as wealth has spreas people eat more fish and meat and cheese than they used to, and they suffer for it.
This was not a low carb diet study. The lowest carb group were eating at least twice as many carbs as what any reasonable person would consider low carb.
Also, if you look at table 1, you can see the "low carb" group was the highest smoking, most diabetic, more male, highest hypertensive, and least exercising group. Is it really a surprise that these people have higher mortality?
> Participants completed an interview that included a 66-item semi-quantitative food frequency questionnaire (FFQ), modified from a 61-item FFQ designed and validated by Willett and colleagues,16 at Visit 1 (1987–89) and Visit 3 (1993–95).
Retrospective self reported questionaire.
Pah.
Around about the weakest evidence you can get as to what their actual diet was.
A few thoughts regarding today's big carb study in The Lancet:
- This study will get tons of press, with misleading headlines all over the place. Like this one we already saw: "Low carb diets shorten your life unless you are mostly vegetarian."
- Nobody actually knows which diets are best for longevity, as it's an impossible question to answer without a trillion dollar randomized trial. Supercentenarians eat a wide variety of diets, calorie/methionine restriction helps in some animal studies, etc. A collection of observational evidence (like in the Lancet paper) is helpful for noticing overall patterns, but can't say much about actual diets. One high-carb diet could be high in candy and cake, and another high in fruit and tubers. The Lancet study wasn't able to address diet quality.
- The Lancet paper is not one study, but two: a long-term observational study in the US, plus a meta-analysis of international cohorts.
- The "easy" conclusions (low carb bad, high carb bad, high meat bad) are not so easy. The broadest way to cut dietary data is by macronutrient, so the result interpretations aren't always useful. Those with high and low carb intake are more likely to be on a diet, for example, and dieters can be more likely to have health conditions they're trying to address.
- When you meta-analyze heterogeneous data sets, problems arise. There's no good way around this, since the different data sets are from different research groups, and individual-level meta-analysis is thus rarely possible.
> Nobody actually knows which diets are best for longevity, as it's an impossible question to answer without a trillion dollar randomized trial. Supercentenarians eat a wide variety of diets,calorie/methionine restriction helps in some animal studies, etc.
But all of the super centenarians ate very little meat, with the exception of some fish in a few populations.
And we don't know for certain whuch diets will help you live the longest, but the knowledge and evidence we do have very heavily favors a diet that is primarily plant based, low in protein, and has very little chicken/pork/beef.
> but the knowledge and evidence we do have very heavily favors a diet that is primarily plant based, low in protein, and has very little chicken/pork/beef.
Hong Kong has one of the highest life expectancies (Surpasses even Japan) in the world yet their cuisine is mostly based on meat, not plant-based
Furthermore not a single country from this list is a plant-based or low in protein, all of them eat alot of meat, dairy, seafood etc
The only part of that page that discusses diet talks about how okinawa owes it's longevity to "A diet that is heavy on grains, fish, and vegetables and light on meat, eggs, and dairy products.'
The easiest way to do this is to batch prepare things heavy in monounsaturated fats: avocados/guacamole, olives, almond butter, walnuts, etc. Then prepare things with polyunsaturated fats the day of, like wild salmon.
Basically if you don’t eat enough good fats you’ll eat bad fats, and if you don’t eat enough bad fats you’ll eat sugar or carbs. So you want to make it easy for yourself to eat good fats, and then round out the rest of your diet with other stuff.
Things like Israeli/Persian/Arabic salad also store pretty well in the fridge for four days, so that’s another easy way to prepare veggies in advance.
I need some extremely solid textbook on *saturated fat/fatty acids because I've read a few medical books (randomly picked) and ended with contradictory reasonings and conclusion.
Basically, some say that having single bond chains leads to less viscous molecules => less deposits. But some say that is double bonds which leads to less deposits.
ps: I'm reading 'fats of life' by Glen Lawrence. I'll report if it gives a clear picture. One good thing from the first pages, is that it explains that fat is implied in a lot of subsystems. Fatty acids that are bad for your vascular system can help to avoid cancer, arthritis and other kinds of conditions... so it's not a one dimensional question. I like that.
Other than credential-spotting ( looking up how many esteemed institutions a person is associated with ) how does one decide whose book to even peruse and whose to dismiss.
Its really mind numbing that we have so much confusion in such an important space as nutrition.
Just look at the credentials of the expert that Ms.Teicholz [1] blames for this mess:
Alice H. Lichtenstein is a senior scientist and director
of the Cardiovascular Nutrition Laboratory at the HNRCA,
as well as a Stanley N. Gershoff Professor of Nutrition
Science and Policy at the Friedman School.
Lichtenstein also serves as the executive editor of the
Tufts University Health & Nutrition Letter.
Education
Hon. Ph.D., 2005, Faculty of Medicine, University of Kuopio (Finland)
D.Sc., 1979, Nutritional Biochemistry, Harvard University
M.S., 1975, Nutritional Biochemistry, Harvard University
M.S., 1973, Nutrition, State College, Pennsylvania State University
B.S., 1971, Nutrition, Cornell University
Ms. Teicholz was mentioned earlier in the discussion in the threads above.[2]
That's indeed an issue. I believe science is not immune to information overload (just like mainstream with internet). This creates spots / schools of thoughts, and only people working or studying the field can have an opinion whether a book or paper is worth its weight.
I guess it's a bit like music, unless you have genius talent out of the box, you will only be able to parse things clearly after 5-10 years of swimming in the pool. Unless we have something to connect the dots for us, for instance something that can cross correlated data from biological pathways, chemistry, physics, maths, so you know what is solid or not.
Also nutrition is too tied to economics and politics, that doesn't help.
You need to remember that a lot of the people like Alice H. Lichtenstein are heavily invested in the current thoughts on nutrition. I can not stress enough that "The Big Fat Surprise" is very informative about the current state of our nutrition policies here in the United States (and this leaks out of our country into many others that follow it by default). Just watch that "The Real Food Politics" video (see above).
Here is another article that specifically addresses this study,
Zoe Harcombe takes a hard look at this study, and there are so many problems with this study, I am amazed that it was published, but wait, I would take a look at this,
Humm one is cardiology book (in french) by jacques de praepe (I bought it), the others I don't remember, a mix of pubmed publications, lab textbooks on researchers webpage, youtube videos.
Basically if you don’t eat enough good fats you’ll
eat bad fats, and if you don’t eat enough bad fats
you’ll eat sugar or carbs. So you want to make it easy
for yourself to eat good fats, and then round out the
rest of your diet with other stuff.
This seems so intuitive for some reason but have you come across any reading to suggest that this is indeed the case.
Any large study or trial?
Have you observed this first-person, anecdotally atleast in someone, over a sizable period of time?
Well, anecdotally for me it is just because of how I feel on such a diet. It takes a while for the body to adjust, but once it does I feel like I am on a high that never ends. No ups & downs, just pure focus and energy. Would it be like that for everyone? Who knows. But I have never felt this before on any other diet. That's why I stick with it. (Note I do about 5% carbs, 80% fat, 15% protein)
Even if this ends up with higher mortality (which I highly doubt this claim, there is a lot of research and results it is in conflict with) - I'd rather live feeling like this than the alternative.
I also question the meat claims because there is also a lot of evidence to the contrary. It seems like there may be a confounding variable in there that is skewing the results.
>'The findings "will disappoint those who, from professional experience, will continue to defend their low carb cult, but contributes to the overwhelming body of evidence that supports a balanced approach to caloric intake recommended globally by public health bodies," Collins added.'https://www.cnn.com/2018/08/17/health/low-carb-high-carbohyd...
Given the obvious problems with this study (their definition of "low carb" is wrong), this is just an astounding display of hubris.
That to me read more as CNN getting someone uninvolved in the research to give a quote that makes for good copy. I agree that it's not a particularly useful thing to say, but it's important to note that Collins is not involved in the core study.
And 37% is not low-carb. If anything what this shows is that if you have moderate carbs, you won't be doing so well. But if you have moderate carbs + more plant-based food, you'll be healthier.
So all this study showed has nothing to do with carbs, but everything to do with eating more veggies = you'll be healthier.
I bet that if had they replaced not just part of the meat/animal fat with veggies, but also another 20% of those "low carbs", they would've gotten even healthier people (and on an actual low-carb diet, too!).
Look at their figure 1, it cuts off at 20% energy from carbohydrates. I don't think there was a single person in this study on an actual low carb diet.
+1. Keto is vastly lower, typically 5%. Someone eating a 37% carb diet will receive none of the health benefits that spending substantial periods in ketosis can bring, e.g. lowering cholesterol.
What about it? I'm just saying this study has nothing to do with a low carb diet.
They made up their own definition of "low carb", then people who read the results get confused and try to apply the conclusions to actual "low carb" diets.
If you're looking to make dietary choices based on the results of high-quality dietary studies, my goto is "How Not to Die"[1] and the author's non-profit website at, http://nutritionfacts.org
I found that the author used a lot of animal/mouse studies to draw conclusions and make recommendations... most things that work in mice, don't work in humans.
What specific quantitative reasons do you have to suggest a questionnaire is not appropriate for this type of study? Did I miss some other study somewhere that suggests a questionnaire can never produce good science?
Who uses a certain (previously uncommon) diet that is said to help with diabetes and other serious issues? Those who are of average good health or those who experience some issues that already start to manifest? I wonder if the study corrects for those factors. Does the average person even participate in those studies?
We really need multiple long-running (50+ years) randomized study that controls for all influence factors to really answer the questions. Something that is unlikely to be accomplished in our current political lifetime and unlikely to be completed within our lifetime.
> "We really need multiple long-running (50+ years) randomized study that controls for all influence factors to really answer the questions. Something that is unlikely to be accomplished in our current political lifetime and unlikely to be completed within our lifetime."
This would be a waste of money. Its not going to tell you anything about the effect of diet in any real people, only "average" people.
That's how most dietarey studies are conducted, including ones contradicting this study. It's not that this kind of study is very accurate; but it's nearly impossible to conduct a study of peoples' diet that will be more accurate.
I know the majority of those who read that study will either ignore it,
dismiss it out of hand, or "study it carefully" and find all sorts of problems
with it, the best to convince themselves that it's not conclusive, or that
it's badly designed and its results can't be trusted, etc.
The truth is, it is extremely hard to accept that something that directly hits
your fabled pleasure centers -like fat, sugar, salt, nicotine, alcohol etc- is
so bad for you it's decreasing the time you have to enjoy it. There is an
extreme form of denial that seizes the human mind when someone tells you "this
thing you really like, it's very bad for you".
Our pleasures are immense sources of bias. Take what your heart
desires with, um, a huge pinch of salt and don't listen to the people who tell
you salt, fat, sugar, smoking, drinking etc are good for you when this
contradicts years of research and hundreds of trials, especialy when the
evidence for keeping your dietary habits unchanged is based on a couple of
studies with poor practices and few participants.
Sorry, but there is really no debate about this study. Their definition of "low-carb" is not the one used by people who are adopting a "low carb" diet, so there is no reason to think their conclusions apply.
I think "the people who adopt a low-card diet" would do well to pay attention to a study that reports increased mortality for people who reduced their carbohydrate intake less than they have.
If a moderate reduction of carbohydrates in your diet is bad for you, almost entirely eliminating them does not look very promising.
According to the study, because minimal risk was observed at 50-55% carbohydrate intake. So extreme consumption on either end can't be very close to the minimum.
>"According to the study, because minimal risk was observed at 50-55% carbohydrate intake. So extreme consumption on either end can't be very close to the minimum."
Your conclusion does not follow from the premise, so there are some additional assumptions you are making somewhere.
I think it's reasonable to expect that if a small reduction is bad, a big reduction is worse. The opposite is not impossible, but it would be surprising.
>"I think "the people who adopt a low-card diet" would do well to pay attention to a study that reports increased mortality for people who reduced their carbohydrate intake less than they have."
You think the low carb diet people would be mistaken if they dont pay attention to this study that contains no data for low carb diet people at all.
I didn't say anything about anyone making any mistakes. If I thought that X people are making a mistake by doing Y, wouldn't it be simpler for me to just say that, rather than say something else that could possibly be interpreted as my saying that?
Now, this is passing judgement and I apologise, but I don't think you replied to the strongest interpretation of what I wrote.
Results vary so widely in this field. My general understanding is:
• Polyunsaturated fats, the supposedly "good" fats in the classical model, actually go rancid really easily and cause damage.
• Saturated fats are associated with high cholesterol, which is a marker of some misunderstood kind of arterial and vascular inflammation. Not everyone gets an increase in cholesterol from consuming saturated fats, and we don't know why. It may be determined by the intestinal flora. But these "bad" fats are actually very stable, and do not appear to cause damage via oxidation as they don't go rancid easily.
• Monounsaturated fats have the best qualities of both.
tl;dr (imho): Have some of everything in moderation and with the due awareness of what you're having vs. your particular body.
Consume limited PUFA and be very aware of the potential rancidness vs. the effectiveness of antioxidants present in the source. Whole foods with antioxidants e.g. fruits tend to mitigate the oxidation of any PUFA that they contain. Consume limited saturated fat as per your propensity for LDL. You can't go wrong with monounsaturated fats, which are relatively stable and tend to come in high-antioxidant sources, and also do not cause LDL to rise. But overall, eat a moderate amount of fat.
Don't go too low carb as it causes a stress state (cortisol + damage-inducing free fatty acids). Get your carbs from buffered, whole food sources (e.g. fruits, whole wheat bread), but don't go high carb because it's damaging.
Have as much fiber (incl. resistant starches / FOS / FODMAP / "soluble fiber") as you can stomach. If they make you feel especially sick, you probably have gut fermentation (SIBO or similar). Some people like myself cannot tolerate anything fermentable.
Be aware of your idiosyncrasies, e.g. I can't tolerate histamines, so I must avoid high histamine or histamine-releasing foods like avocado, as well as anything fermentable or fermented.
Moderate exercise is superior to intense exercise. Exercise that is too intense is damaging and is linked with poorer health.
I asked above but since you seem to be knowledgeable, I'm looking for some super solid textbooks on fats/fatty acids. Because as you say, you can read contradictory statements in different books.
“There are limitations to this study that merit consideration. This study represents observational data and is not a clinical trial; however, randomised trials of low carbohydrate diets on mortality are not practical because of the long duration of study required. Another limitation of this study is that diet was only assessed at two time intervals, spanning a 6-year period, and dietary patterns could change during 25 years.”
This study is based on a 66 question FFQ (food frequency questionnaire) spanning a six year period. Do you remember what you ate last month? A year ago? Six years ago? Maybe a more modern version of these types of studies can be done if the subjects are required to take pics of everything they ate instead of reporting from memory on a questionnaire.
“LMS receives grant funding from the California Walnut Commission”
Oh?
“SC reports grants from the National Institutes of Health (NIH), and personal fees from Novartis and Zogenix”
Novartis and Zofenix are in the business of making statin drugs.
This study's definition of low carb diet doesn't reach ketosis though.
I do want a proper study on a keto diet, on one hand it's an unnatural biochemical process for the majority of non-starving humanity, on the other hand there seems to be no downside to ketosis under than the Flu in the short term.
It is really great to see more studies regarding low carbs diets. They are widely used in the fitness industry based on ‘Broscience’ and many Instagram models are paid to promote this kind of lifestyle.
What's eye opening about this as well is low carb diets lose you 4 years of life, compared to 1 year of life in a high carb diet.
we estimated that a 50-year-old participant with intake of less than 30% of energy from carbohydrate would have a projected life expectancy of 29·1 years, compared with 33·1 years for a participant who consumed 50–55% of energy from carbohydrate (difference 4·0 years [95% CI 2·6, 5·3]). Similarly, we estimated that a 50-year-old participant with high carbohydrate intake (>65% of energy from carbohydrate) would have a projected life expectancy of 32·0 years, compared with 33·1 years
No, it means that the people who were compelled to follow a low carbohydrate diet for one reason on another lived shorter. It doesn't tell you anything unless you know why they followed the diet they followed.
Wha? I was never into paleo, I think it's stupid, every damn vegetable and animal has changed since, and it's not like we are sure people actually were so much better of back then...
I assume you already know that correlation does not equal causation.
In this study, the higher smoking, higher diabetic, lowest exercising, and higher male cohort were more likely to die. To ascribe causality on the diet, one that is not even a low carb diet is absolute bullshit.
It's possible to control for these factors by adjusting your expected outcomes accordingly. Not saying they did since I haven't bothered to read the study though.
So if you want low carbs, don't eat too much meat.
Plant based diets, such as the Mediterranean diet have been shown lead to reduced all cause mortality in randomized control trials [1]. Getting your diet right really isn't that hard, just eat fresh plant based food.
[1]https://www.nejm.org/doi/full/10.1056/NEJMoa1800389?query=fe...