Showing posts with label low carb high fat. Show all posts
Showing posts with label low carb high fat. Show all posts
22.1.18
23.9.17
PURE Study - Time To Change The Guideline to Low Carb Diet!
↑ Lecture by Prof Salim Yusuf, world renowned cardiologist at a recent cardiology meeting.
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| http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32252-3/abstract |
The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3–9·3). Dietary intake of 135 335 individuals was recorded using validated food frequency questionnaires. The primary outcomes were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure). Secondary outcomes were all myocardial infarctions, stroke, cardiovascular disease mortality, and non-cardiovascular disease mortality. Participants were categorised into quintiles of nutrient intake (carbohydrate, fats, and protein) based on percentage of energy provided by nutrients. We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality. We calculated hazard ratios (HRs) using a multivariable Cox frailty model with random intercepts to account for centre clustering
Carbohydrates, Fats, and CVD in the PURE Study
Carbohydrate intake was divided into quintiles. Those in Q5 consumed most, and those in Q1 consumed least. As can be seen from the slide below, presented by Dr. Yusuf, using the lowest carbohydrate intake (Q1) as a reference, there is an increased risk of CVD with increasing carbohydrate consumption.
Dr. Yusuf pointed out that earlier dietary guidelines “said reduce fats and compensate for it by carbohydrates. So essentially we’ve increased carbohydrate intake in most Western countries, and this is likely damaging.”
Furthermore, Yusuf said: “We were in for a big surprise. We actually found that increasing fats was protective. Now, these are all fats. So this very first slide challenges the WHO and the AHA guidelines on diet.”
With regards to carbohydrates as a percentage of daily energy consumption, he also said: “once you get past about 40% or about 55% of carbohydrate intake as percent energy, there is a steep increase in the risk of CVD. The WHO guidelines say that up to about 75% of carbohydrates is ok. But that is wrong.”
Then he adds:
“Again, total fats, if anything, is protective. And the reasons for this are twofold. Too low fat is inadequate, too high fat is probably bad. And the original studies from Finland was at extremely high fat levels, not the usual fat levels that populations consume.
Does the Type of Fat Matter?
Current dietary guidelines recommend that we limit the intake of saturated fats and replace them by mono- and polyunsaturated fats. Low-fat dairy products are recommended for the purpose of avoiding saturated fats. Vegetable oils should be used instead of butter.
As Dr. Yusuf points out, these recommendations are not supported by data from the PURE study:
“Then if you look at the types of fats, saturated fats, you will see there is not really a clear pattern of anything. Within the normal range, saturated fats are not harmful. May even be slightly beneficial. But there is no harm.
With monounsaturated fatty acids which are in olive oil, canola oil, and are part of the key to the Mediterranean diet, you get a clear benefit. Polyunsaturated fatty acids which are largely from vegetable oils, and remember that is processed oil, is largely neutral.
So, fundamentally, our fat story is: some fats are good, some fats may be neutral but it is carbohydrates that are the worst thing.”
“The other thing is; in the US there is this big swing to reduce milk consumption, and even if you consume milk, they want you to consume 2% or 1% of fat. What is the evidence? A big zero. Absolutely no evidence that low-fat milk is better for you. If anything, if you look at dairy sources of saturated fats, it is protective.
If you look at meat sources of fat, saturated fats, it’s neutral. And if you look at white meat such as chicken and fish, there is a trend towards benefit. So, red meat in moderate quantities is not bad and white meat may be moderately beneficial. But dairy fats such as cheese are probably good for you, and milk, there is really no data at all to reduce the fat content of milk.”
Saturated Fats, LDL-Cholesterol, and CVD
Dr. Yusuf says:
“Now, why did we go wrong. We went wrong because of surrogate end-points.
The story on saturated fats vs. LDL is consistent. Our data shows that as you increase the amount of saturated fats, your LDL goes up. But first, look at how much LDL goes up. This is a 150 thousand people in the analysis – from about 2.85 (108 mg/dL) to just under 3 (116 mg/dL). About 0.1 mmol/L (3.9 mg/dL) increase over a huge range of percentage of saturated fat (consumption).
But CVD shows exactly the opposite end-point.
Macronutrients and the ApoA/ApoB Ratio
Dr. Yusuf also addresses the effects of carbohydrate intake on more advanced lipoprotein measurements:
“Now, what about carbohydrate intake? If you look at LDL, there will be an inverse relationship. But if you look at ApoB/ApoA ratio, which today we know is the most sensitive marker for risk prediction there is a steep increase – from about 0.72 to nearly 0.85 with increasing carbohydrate intake. But with saturated fats, if anything, it is neutral or tending to go down.”
Final Remarks
Dr. Yusuf’s final remarks include these words:
“Contrary to common beliefs, the current recommendations to reduce saturated fats have no scientific basis. I’m not the only one saying this. You must have heard of the book called ‘The Big Fat Surprise’ by Nina Teicholz. She shook up the nutrition world, but she got it right.
Did you know that the seven countries studies that actually had a straight line between fat intake and CVD is fudged. I’m using the word fudged because 23 countries participated in that study and they took the seven best that fitted that line, and that’s what’s there. If you go through the literature, you will find that they chose the seven that fitted the line. The nutrition field has been distorted.”
So, is there a time for a reappraisal of public recommendations regarding the relationship between diet and heart disease following the presentation of the PURE date on macronutrients.
Obviously, this is a rhetorical question. Let’s get to work.
Time to change. period
14.9.17
Low Carbohydrate Approach: A Paradigm (for a healthy lifestyle)
Kuliah dari Prof. Dr. Nafeeza Ismail dari UITM mengenai kepentingan diet rendah karbohidrat dalam menangani masalah diabetis dan obesiti..
10.5.17
Therapeutic Fasting
And this is from Dr Eric Berg
6.5.17
30.4.17
29.4.17
Why Saturated Fats is GOOD for you!
by Donald W. Miller, Jr., MD
(Donald Miller is a cardiac surgeon and Professor of Surgery at the University of Washington School of Medicine in Seattle)
Types and Structure of Fats
Crisco
Evidence Supporting the Lipid Hypothesis
Rabbits, Cholesterol, and Atherosclerosis
In 1913 a Russian physiologist fed high doses of cholesterol to rabbits and showed that cholesterol caused atherosclerotic changes in the rabbit’s arterial intima like that seen with human atherosclerosis. Over the ensuing decades other investigators did atherosclerosis research on cholesterol-fed rabbits, which they cited in support of the diet-cholesterol theory of heart disease.
Framingham Heart Study
In 1948, government-funded investigators began following some 5,000 men and women in Framingham, Massachusetts to see who developed coronary heart disease. They found that people with elevated cholesterol were more likely to be diagnosed with CHD and die from it.
Six years later the American Heart Association began promoting what it called the Prudent Diet, where "corn oil, margarine, chicken, and cold cereal replaced butter, lard, beef, and eggs."
Ancel Keys Six-Country and Seven-Country Studies
Ancel Keys, the father of K-rations for the military, published a study in 1953 that correlated deaths from heart disease with the percentage of calories from fat in the diet. He found that fat consumption was associated with an increased rate of death from heart disease in the six countries that he studied.
McGovern Report
The U.S. Senate Select Committee on Nutrition and Human Needs, chaired by Senator George McGovern, released, in 1977, its "Dietary Goals for the United States," designed to reduce fat intake and avoid cholesterol-rich foods. These dietary goals became become official government policy.
Further Developments
McDonalds and the Center for Science in the Public Interest
Next, in 1984 the Center for Science in the Public Interest, a consumer advocacy group, joined the fray and started to coerce fast-food restaurants and the food industry to stop baking and frying food with animal fats and tropical oils. McDonalds fried its French fries with beef fat and palm oil. That's why they tasted so good. But the Center for Science in the Public Interest’s well-orchestrated saturated fat attack coerced McDonalds and other fast-food chains to switch to partially hydrogenated, trans-fat vegetable oil.
USDA Food Pyramid
Dietary Guidelines for Americans 2010
Beginning in 1980, the U.S. Department of Agriculture and Department of Health and Human Services has published every five years an updated Dietary Guidelines for Americans. The most recent one, published in December 2010, recommends reducing saturated fat intake to 7 percent of caloric intake, down from its previously recommended 10 percent.
Meet the Fats
Other Countries with CHD-Death and Fat Consumption Data
Evidence against fat wilts upon close scrutiny. In his Six Country Study, Ancel Keys ignored data available from 16 other countries that did not fall in line with his desired graph. If he had chosen these six other countries [on the left side], or even more strikingly, these six countries [on the bottom right] he could have shown that increasing the percent of calories from fat in the diet reduces the number of deaths from coronary heart disease.
22 Countries with Such Data including four other groups of people
If Keys had included all 22 countries in his study, the result would have been a clutter of dots like this.
The Hunter-Gatherer Diet
Reasons Why Saturated Fats Are Good For Us
The Biologic Importance of Saturated Fat
There is good reason why 54 percent of the fat in mother’s milk is saturated fat. Cell membranes need saturated fatty acids to function properly and be "waterproof." The heart prefers saturated long-chain 16-carbon palmitic and 18-C stearic acid (over carbohydrates) for energy. Bones need them to assimilate calcium effectively. They protect the liver from the adverse effects of alcohol and medications like Tylenol. Lung surfactant is composed entirely of saturated 16-C palmitic acid, and when present in sufficient amounts prevents asthma and other breathing disorders. Saturated fats function as signaling messengers for hormone production.
Cracks in the Wall of Diet-Cholesterol Heart Orthodoxy
The American Journal of Clinical Nutrition is a leading establishment medical journal that defends the lipid hypothesis. Even this journal has backed down and is now reporting cracks in the wall of diet-cholesterol-heart orthodoxy. A meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease does not support the notion that saturated fats increase the risk of coronary heart disease, stroke, or peripheral vascular disease.
And this journal also recently published a prospective cohort study of 53,000 women and men comparing their intake of carbohydrates and saturated fats and found that replacement of saturated fats with high glycemic index carbohydrates significantly increases the risk of heart attacks.
If not cholesterol, then what causes heart disease?
Atherosclerosis is an inflammatory process brought on by eating too many carbohydrates and omega-6 vegetable oils. Stress plays a role and possibly also bacterial infection.
A deficiency of various vitamins shown here may also play a role in causing atherosclerotic heart disease, as may an excess or deficiency of various minerals.
Prevalence of Obesity among US adults 1950-2010
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