84 replies to this topic

[Shepard]

Haven't had a chance to read through it yet, although the abstract makes me hesitant to even link it over. Perhaps something interesting is contained within, however.

http://advances.nutr...nt/4/3/294.full

[Godot]

Was just about to post the link. Here's the abstract:

Dietary Fats and Health: Dietary Recommendations in the Context of Scientific Evidence

Although early studies showed that saturated fat diets with very low levels of PUFAs increase serum cholesterol, whereas other studies showed high serum cholesterol increased the risk of coronary artery disease (CAD), the evidence of dietary saturated fats increasing CAD or causing premature death was weak. Over the years, data revealed that dietary saturated fatty acids (SFAs) are not associated with CAD and other adverse health effects or at worst are weakly associated in some analyses when other contributing factors may be overlooked. Several recent analyses indicate that SFAs, particularly in dairy products and coconut oil, can improve health. The evidence of ω6 polyunsaturated fatty acids (PUFAs) promoting inflammation and augmenting many diseases continues to grow, whereas ω3 PUFAs seem to counter these adverse effects. The replacement of saturated fats in the diet with carbohydrates, especially sugars, has resulted in increased obesity and its associated health complications. Well-established mechanisms have been proposed for the adverse health effects of some alternative or replacement nutrients, such as simple carbohydrates and PUFAs. The focus on dietary manipulation of serum cholesterol may be moot in view of numerous other factors that increase the risk of heart disease. The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs, which are discussed here. This review calls for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary SFAs, for which mechanisms for adverse health effects are lacking.

doi: 10.3945/​an.113.003657 Adv Nutr May 2013 Adv Nutr vol. 4: 294-302, 2013

[Mind]

No doubt you are worried about igniting a flame war. The anti-fat meme has been around decades.

Something I mentioned in another thread is if ApoE genetic variants have corrupted some of the weakly negative research surrounding SFAs

[misterE]

This study is scary because it gives people a green-light to eat foods that are not sustainable and are destroying the environment… There is no doubt that excess omega-6 isn’t healthy, but to say saturated-fat is not harmful goes against the majority of what is documented in the scientific-literature! The only fats we really need are the (ESSENTIAL) polyunsaturated-fats. With an omega-3 to omega-6 ratio of 1 (ideally). Eating excess amounts of others fats leads to lipotoxicity and all the diseases that stem from insulin-resistance.

[niner]

No doubt you are worried about igniting a flame war. The anti-fat meme has been around decades.

Something I mentioned in another thread is if ApoE genetic variants have corrupted some of the weakly negative research surrounding SFAs

Yeah, I couldn't help thinking that this was a little bit like posting a climate change paper... You may be right about the ApoE variants. I think if the studies were stratified on ApoE, the results would look different, and potentially interesting.

Well, I should probably take a look at the paper, if possible.

[Shepard]

No doubt you are worried about igniting a flame war. The anti-fat meme has been around decades.

I probably should have considered that, but I don't generally think (or care) if something like this makes people emotional. I was hesitant to link it over because I didn't agree with some of the wording in the abstract and wasn't sure it would even be applicable to the Longecity audience.

I looked over the review a bit more and it seems to me that the author is a little biased in his interpretations, but I'm a bit biased against extreme positions.

[niner]

This is a fairly new journal, isn't it? I don't remember seeing it around. Does anyone have any experience with either the journal or the author?

[Shepard]

Journal began in 2010. The author.

[Mind]

Higher fat diets associated with lower CVD risk in this large study as well.

[misterE]

Higher fat diets associated with lower CVD risk in this large study as well.

Mind, do you know of any studies that have documented reversal of atherosclerosis on a high-fat diet? I’ve searched the scientific-literature and came up empty handed. The only studies I could find showing reversal of atherosclerosis in humans were conducted using a very low-fat diet (about 10% fat) [1-2]. Are you able to direct me (or anyone reading this) to studies that show high-fat diets regress atherosclerosis?


[1] JAMA. 1998 Dec 16;280(23):2001-7. Intensive lifestyle changes for reversal of coronary heart disease. Ornish D, Scherwitz LW, Billings JH.

[2] Prev Cardiol. 2001 Autumn;4(4):171-177. Resolving the Coronary Artery Disease Epidemic Through Plant-Based Nutrition. Esselstyn CB Jr.

Edited by misterE, 22 May 2013 - 12:44 AM.

[InquilineKea]

For what it's worth - when I asked Rafael de Cabo what fats he fed to mice under a "high-fat" diet - the diet that resulted in decreased lifespans, it was coconut oil that he fed to the mice.

He said that outcomes *do* vary significantly based on what type of fat you feed mice. Coconut oil was seen as bad.

It's not just saturated vs. unsaturated. It's also the type of saturated fat. Stearic acid (e.g. the type in chocolate) is okay. Other types of saturated fats are more worrisome.

Edited by InquilineKea, 22 May 2013 - 03:06 AM.

[misterE]

Other types of saturated fats are more worrisome.

Palmitic-acid is the worst.

[TheFountain]

Why is nobody addressing MisterE's question about studies on high fat diets reversing atherosclerosis? And why are the low fat studies he is citing being ignored?

[Mind]

Why is nobody addressing MisterE's question about studies on high fat diets reversing atherosclerosis? And why are the low fat studies he is citing being ignored?

Most likely because MisterE ignores everyone else in what seems to be religious crusade against fat. People on the Mediteranean diet are some of the longest lived people in the world, eat copious amounts of fat, and do not suffer much heart disease. This fact is completely ignored by MisterE. (Instead of ignoring it completely, one could argue that genetics or other lifestyle factors negate the huge fat intake of these diets, hint, hint)

It might also be that the Ornish study is not super convincing. Small sample size (48) confounded by many variables and only a small effect. After 5 years, stenosis was only reduced by 3.1 percent in the experimental group. This is a nice result, but not astounding. The people were still eating at least 10% of their calories as fat (not sure what percentage they were eating before hand, which is another weakness in the study). The subjects also maintained an intensive aerobic exercise routine (known too help with heart disease), stopped smoking (known too help with heart disease), underwent stress management(known too help with heart disease), ate more vegetables, and attended group support sessions. To say it was ALL (100%) due to the fact that they ate less fat (according to MisterE), is not supported that well by the study, IMO.

[misterE]

It might also be that the Ornish study is not super convincing. Small sample size (48) confounded by many variables and only a small effect. After 5 years, stenosis was only reduced by 3.1 percent in the experimental group. This is a nice result, but not astounding. The people were still eating at least 10% of their calories as fat (not sure what percentage they were eating before hand, which is another weakness in the study). The subjects also maintained an intensive aerobic exercise routine (known too help with heart disease), stopped smoking (known too help with heart disease), underwent stress management(known too help with heart disease), ate more vegetables, and attended group support sessions. To say it was ALL (100%) due to the fact that they ate less fat (according to MisterE), is not supported that well by the study, IMO.

But Ornish did show reversal of atherosclerosis did he not?

3.1% might not seem like that much improvement after 5 years… but there is a law in physics called Poiseuille’s Law, that states the quantity of blood flowing thru a vessel is increased or decreased by the fourth power of the increase or decrease of the given radius. So if you have a blood-vessel that has dilated from a value of 1 to a value of 2… then the blood-flow increases by a value of 16!

So 3.1% might seem like a low value on paper, but when factoring in the Poiseuille-law, the improvement in blood-flow increased by 92.3%!

So, I'll ask you again mind: can you refer us to any studies showing reversal of atherosclerosis on a high-fat diet?


I know I’m being pushy, but this is a serious topic and the outcomes could be life and death for someone reading this.

Edited by misterE, 22 May 2013 - 11:13 PM.

[Godot]

Ornish got a positive result, but not from reducing fat. He got a positive effect on arteriosclerosis via substantial weight loss (20+ pounds, whereas the control group lost no weight), plus regular exercise, plus 1hr/day meditation, plus counseling, in addition to his very low fat diet. So the Ornish study tells us basically nothing about the effects of dietary fat on heart disease. And despite all the mileage Ornish has gotten out of that study, it's not been replicated in 15 years (do you suppose it's for lack of trying?)

On the other hand, here's a very large (nearly 50,000 participants), 8-year study which shows no benefit from a low fat diet, even with specific attention to increasing fruit and vegetable consumption. http://jama.jamanetw...rticleid=202339

Edited by Godot, 22 May 2013 - 11:36 PM.

[Chupo]

Well, how about this?

METHODS AND RESULTS:

In a 2-year Dietary Intervention Randomized Controlled Trial-Carotid (DIRECT-Carotid) study, participants were randomized to low-fat, Mediterranean, or low-carbohydrate diets and were followed for changes in carotid artery intima-media thickness, measured with standard B-mode ultrasound, and carotid vessel wall volume (VWV), measured with carotid 3D ultrasound. Of 140 complete images of participants (aged 51 years; body mass index, 30 kg/m(2); 88% men), higher baseline carotid VWV was associated with increased intima-media thickness, age, male sex, baseline weight, blood pressure, and insulin levels (P<0.05 for all). After 2 years of dietary intervention, we observed a significant 5% regression in mean carotid VWV (-58.1 mm(3;) 95% confidence interval, -81.0 to -35.1 mm(3); P<0.001), with no differences in the low-fat, Mediterranean, or low-carbohydrate groups (-60.69 mm(3), -37.69 mm(3), -84.33 mm(3), respectively; P=0.28). Mean change in intima-media thickness was -1.1% (P=0.18). A reduction in the ratio of apolipoprotein B(100) to apolipoprotein A1 was observed in the low-carbohydrate compared with the low-fat group (P=0.001). Participants who exhibited carotid VWV regression (mean decrease, -128.0 mm(3); 95% confidence interval, -148.1 to -107.9 mm(3)) compared with participants who exhibited progression (mean increase, +89.6 mm(3); 95% confidence interval, +66.6 to +112.6 mm(3)) had achieved greater weight loss (-5.3 versus -3.2 kg; P=0.03), greater decreases in systolic blood pressure (-6.8 versus -1.1 mm Hg; P=0.009) and total homocysteine (-0.06 versus +1.44 mumol/L; P=0.04), and a higher increase of apolipoprotein A1 (+0.05 versus -0.00 g/L; P=0.06). In multivariate regression models, only the decrease in systolic blood pressure remained a significant independent modifiable predictor of subsequent greater regression in both carotid VWV (beta=0.23; P=0.01) and intima-media thickness (beta=0.28; P=0.008) levels.
CONCLUSIONS:

Two-year weight loss diets can induce a significant regression of measurable carotid VWV. The effect is similar in low-fat, Mediterranean, or low-carbohydrate strategies and appears to be mediated mainly by the weight loss-induced decline in blood pressure
.

http://www.ncbi.nlm....pubmed/20194883

Edited by Chupo, 22 May 2013 - 11:38 PM.

[misterE]

Ornish got a positive result, but not from reducing fat.

Oh please! How do you explain Esselstyn's results?

[Godot]

You cited the Esselstyn paper as a study which showed a reversal of arteriosclerosis with a low fat diet; it is not. Here's the full text. http://www.heartatta...olving_cade.htm

[misterE]

--Chupo, that study looked at the thickness of the vessel wall in the carotid-artery, not the blockage inside the artery.

[ta5]

Why is nobody addressing MisterE's question about studies on high fat diets reversing atherosclerosis? And why are the low fat studies he is citing being ignored?

It's a repeat.

[misterE]

You cited the Esselstyn paper as a study which showed a reversal of arteriosclerosis with a low fat diet; it is not. Here's the full text. http://www.heartatta...olving_cade.htm

Oops, you’re right… here is the Esselstyn study I meant to cite:



J Fam Prac 1995;41:560-568. A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician's practice. Esselstyn CB Jr, Ellis SG, Medendorp SV, Crowe TD.

Edited by misterE, 22 May 2013 - 11:53 PM.

[Godot]

Here's that study: http://www.ncbi.nlm....pubmed/7500065/

Do you honestly not see statins as a confounding factor in that study? Furthermore, it's an extremely tiny (11 participants) uncontrolled sequential study in the author's own practice (which produces practitioner effects). Plus the dropout rate was 50%. So, that study is no more useful than Ornish.

On the other hand, here's a very large (nearly 50,000 participants), 8-year study which shows no benefit from a low fat diet, even with specific attention to increasing fruit and vegetable consumption. http://jama.jamanetw...rticleid=202339

Edited by Godot, 23 May 2013 - 12:22 AM.

[niner]

For what it's worth - when I asked Rafael de Cabo what fats he fed to mice under a "high-fat" diet - the diet that resulted in decreased lifespans, it was coconut oil that he fed to the mice.

He said that outcomes *do* vary significantly based on what type of fat you feed mice. Coconut oil was seen as bad.

It's not just saturated vs. unsaturated. It's also the type of saturated fat. Stearic acid (e.g. the type in chocolate) is okay. Other types of saturated fats are more worrisome.

Stearic acid is ok for mice but coconut oil is bad? That doesn't seem like a normal mouse diet. Is this another case of "mice aren't people"?

[Chupo]

--Chupo, that study looked at the thickness of the vessel wall in the carotid-artery, not the blockage inside the artery.

The thickness of the vessel wall is mainly determined by how much plaque is in it. Anyway, if fat were the culprit for everyone, the low carb group would have had a progression in thickness while the low fat group would have had a regression. The Med group would have been somewhere in between. We didn't see that. Regardless of diet, the people who lost weight and lowered their blood pressure, saw a reduction.

Also something to consider is ApoE. The people who continue to progress on Ornish type diets may be ApoE2. They would likely have high TG and LDL-P despite lower LDL-C on that type of diet. One diet doesn't fit all. I'm glad you're doing well with your diet, misterE. I think it's a great diet for some people but I would and have gained weight on your diet (starch-based vegan, no overt fats). That cannot be good. Would you agree at least that gaining excess weight is not a good thing?

[misterE]

The thickness of the vessel wall is mainly determined by how much plaque is in it.

Not necessarily, usually when there is plaque build-up, there is stenosis (or narrowing) of arteries.

Regardless of diet, the people who lost weight and lowered their blood pressure, saw a reduction.

So would you say eating fast-food is healthy as long as you stay in a calorie-deficit?

Would you agree at least that gaining excess weight is not a good thing?

Gaining excess body-fat is defiantly not a good thing. This is much easier to do on a high-fat diet compared to a high-carbohydrate diet:


Am J Clin Nutr. 1995 Jul;62(1):19-29.
Fat and carbohydrate overfeeding in humans: different effects on energy storage.

Horton TJ, Drougas H, Brachey A.
Abstract

Both the amount and composition of food eaten influence body-weight regulation. The purpose of this study was to determine whether and by what mechanism excess dietary fat leads to greater fat accumulation than does excess dietary carbohydrate. We overfed isoenergetic amounts (50% above energy requirements) of fat and carbohydrate (for 14 d each) to nine lean and seven obese men. A whole-room calorimeter was used to measure energy expenditure and nutrient oxidation on days 0, 1, 7, and 14 of each overfeeding period. From energy and nutrient balances (intake-expenditure) we estimated the amount and composition of energy stored. Carbohydrate overfeeding produced progressive increases in carbohydrate oxidation and total energy expenditure resulting in 75-85% of excess energy being stored. Alternatively, fat overfeeding had minimal effects on fat oxidation and total energy expenditure, leading to storage of 90-95% of excess energy. Excess dietary fat leads to greater fat accumulation than does excess dietary carbohydrate, and the difference was greatest early in the overfeeding period.

[zorba990]

http://www.nutrition.../content/3/1/24
Compared to weight loss on a LF diet, the high saturated fat CR diet with no weight loss resulted in better improvements in LDL peak size, TAG, HDL, and the ratios total cholesterol/HDL and apoB/ApoA-1, that is, the effects are not equivalent; CR is significantly better than weight loss in the presence of LF for atherogenic dyslipidemia.

[TheFountain]

Why is nobody addressing MisterE's question about studies on high fat diets reversing atherosclerosis? And why are the low fat studies he is citing being ignored?

Most likely because MisterE ignores everyone else in what seems to be religious crusade against fat. People on the Mediteranean diet are some of the longest lived people in the world, eat copious amounts of fat, and do not suffer much heart disease. This fact is completely ignored by MisterE. (Instead of ignoring it completely, one could argue that genetics or other lifestyle factors negate the huge fat intake of these diets, hint, hint)

It might also be that the Ornish study is not super convincing. Small sample size (48) confounded by many variables and only a small effect. After 5 years, stenosis was only reduced by 3.1 percent in the experimental group. This is a nice result, but not astounding. The people were still eating at least 10% of their calories as fat (not sure what percentage they were eating before hand, which is another weakness in the study). The subjects also maintained an intensive aerobic exercise routine (known too help with heart disease), stopped smoking (known too help with heart disease), underwent stress management(known too help with heart disease), ate more vegetables, and attended group support sessions. To say it was ALL (100%) due to the fact that they ate less fat (according to MisterE), is not supported that well by the study, IMO.

I agree that the Ornish study is not a thorough study of the dietary implications of low fat vs high fat because it does not rely entirely on the dietary aspect to prove its point, but that is not the only research or study he referenced. He referenced several other's. And he asked what solid evidence the other side has against these references. I am curious myself.

For what it's worth - when I asked Rafael de Cabo what fats he fed to mice under a "high-fat" diet - the diet that resulted in decreased lifespans, it was coconut oil that he fed to the mice.

He said that outcomes *do* vary significantly based on what type of fat you feed mice. Coconut oil was seen as bad.

It's not just saturated vs. unsaturated. It's also the type of saturated fat. Stearic acid (e.g. the type in chocolate) is okay. Other types of saturated fats are more worrisome.

Stearic acid is ok for mice but coconut oil is bad? That doesn't seem like a normal mouse diet. Is this another case of "mice aren't people"?

Funny.

[DR01D]

I just want to add my 2 cents which is largely based on "bro science"

Our human ancestors were not vegetarians. Therefor it doesn't make evolutionary sense to believe that vegetarianism is going to reverse diseases like heart disease. If it did it would be a fluke because vegetarianism It's not a natural or optimal diet for humans.

We live in a Malthusian world. Calorie restriction is the natural diet that most organisms including humans are optimized for. There is every evolutionary reason to suspect that eating a low calorie, balanced diet might help prevent or reverse disease.

Science is going to go back and forth on nutrition for many decades. In the meantime I'm going to stick with what evolution designed my body for. Scarcity. If low cal + physical activity doesn't keep me healthy, probably nothing will.

Edited by DR01D, 24 May 2013 - 05:01 AM.

[misterE]

Our human ancestors were not vegetarians. Therefor it doesn't make evolutionary sense to believe that vegetarianism is going to reverse diseases like heart disease. If it did it would be a fluke because vegetarianism It's not a natural or optimal diet for humans.

Our human ancestors were primarily herbivore. Many aspects of our physiology says so… for instance our jaws can move side to side, carnivores jaws do not. Our teeth are flat, meant for grinding plant-fibers, not biting into a cow. Our hands don’t have claws to rip into pray. Our intestines are long, contrary to a true carnivore like a lion. The largest digestive enzyme in our body (amylase) is designed to digest plant-matter (specifically starch). Humans contain seminal-vesicles; carnivorous creatures don’t have seminal-vesicles. I can go on and on.

However I don’t believe humans were strictly herbivores, we did eat a tiny bit of meat throughout our existence. But the ratio of meat to plants was very very low. It wasn’t until the industrial-revolution that humanity had access to lots of meat, and it wasn’t until after WWII that Americans had a lot of access to cheese. Now in modern-times people neglect the plant-foods (like whole-grains) in favor of meat and cheese, and we have an epidemic of disease to show for it.

The burden of proof falls on folks like Shepard and Mind to prove that saturated-fat doesn’t contribute to disease (as they suggest). The scientific-literature is so strong, and the works of Esselstyn and Ornish confirm that heart-disease is a result of eating rich foods, high in fat.

I know this isn’t a popular message. People would much rather eat bacon, eggs, cheese and steak instead of oats, barley, rice and pasta, and that is the main reason why these low-carb/paleo-diets are so damn popular!

Edited by misterE, 24 May 2013 - 05:23 PM.