The Danger of Low Carb Diets..

[rgarling]

little pill story vs calories in-out

These things are essentially the same:
1. taking a 4 calorie pill that subsequently makes you eat too much
2. being a calorie counter, keeping track of exactly what you eat, but failing to identify what drives you to eat too much

and

1. withdrawing the 4 calorie pill (having been taking it) and subsequently eating less and losing weight
2. being a calorie counter, identifying what drives you too eat too much and subsequently avoiding the problem food.

To me you are both saying the same thing. If people can identify the food items that cause overeating and subsequently avoid them, they will lose weight (without calorie counting). To that end, I will plug avoiding grains and sugars. Good luck all

[TromboneAl]

Quote:

Originally Posted by REattempt Second, is the heart health and cancer. All the studies I've seen that are randomized and controlled demonstrate the HCLF approach has an impact on both.

Note that a long-term randomized controlled experiment has never been done and is not feasible. That is, you can't take a group of 40-year-olds, and randomly assign them to a diet, and then follow them for 20 years. The best we can do are studies like this:

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease

Results: During 5–23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD.

Studies Proving The Safety and Efficacy of the Low Carb Diet

carb diet cancer: study finds carb diet lowers cancer risk - chicagotribune.com

You can do a randomized controlled experiment for about a year, then measure markers for heart disease. That was what was done in this experiment:

Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women, March 7, 2007, Gardner et al. 297 (9): 969

At 12 months, secondary outcomes [risk factors] for the Atkins group were comparable with or more favorable than the other diet groups.

[rgarling]

Quote:

Originally Posted by REattempt Do you have a source for a randomized controlled study from any peer reviewed source that demonstrates that HF will reverse heart disease? I haven't found one and this is the whole reason I started this thread...can you point me at the results? I provided the randomized controlled study for the Ornish diet...

You can get some places to look (for whatever kind of study that will float your boat) by starting at Dr. Davis' track your plaque website.

Also, you can safely ignore the GI index vs GI load stuff. It is only good for rationalizing your grain and sugar intake. Just avoid grain and sugar entirely.

[TromboneAl]

Is the Glycemic Index a Scam?

But for those of us who care about what is going on in our bodies, a little thought reveals what the problem is with the whole Low GI fad: The Glycemic Index tells you only what these foods do to the blood sugar of a normal person two hours after they eat the food. It does not tell you what they do to that blood sugar one hour after eating them, or--and this can be very important for pasta--four hours after eating them.

And even more importantly, the Glycemic Index does not tell you how much insulin the body had to secrete to process the glucose that resulted from the digestion of this food when it finally did digest.

Because no matter how slowly a carbohydrate-rich food digests, eventually it does digest. And when that food digests, every single gram of carbohydrate it contains turns into one of two substances: glucose or fructose.

If it turns into glucose--and most carbohydrate does--it goes into the bloodstream and raises the blood sugar until it encounters an insulin molecule. That insulin molecule can do one of two things. It can move that glucose into a hardworking muscle cell that burns it for energy or it can move the glucose to a fat cell where it will be stored for later use, in the form of fat. Most of the time insulin does the latter.

If, instead, dietary carbohydrate digests into fructose it won't show up in the bloodstream at all. Instead it will go right to the liver where it will be converted directly into body fat without ever having a chance to be burned off for energy.

Neither of these outcomes is good news if you are trying to avoid gaining weight.

[tangomonster]

And then there is this article that says that scientists haven't found a consensus about what restrictions really aid in weight loss. One researcher compared average protein, low fat and higher carbs; high protein, low fat, and higher carbs; average protein, high fat and lower carbs; or high protein, high fat and lower carbs. Each of the diets was designed to eliminate 750 calories a day from the people's energy needs. The team found no differences in weight loss or fat reductions between the diets. "The major predictor for weight loss was 'adherence.' Those participants who adhered better, lost more weight than those who did not," Bray told Reuters Health in an email.

Counting calories may be the most successful way to lose weight - chicagotribune.com

In the end, I think it's being cutting calories through a diet you can adhere to. For me, as a vegetarian who never really liked meat and always loved good carbs, including beans, tofu, whole grains, fruits and veggies, there isn't much of a decision to be made. And though my diet may be lower in protein than that of carnivores, I'm convinced it's healthy....

[REattempt]

Quote:

Originally Posted by jclarksnakes Americans have been limiting fat in their diets for two decades and during those same two decades metabolic syndrome (obesity, hypertension, sleep and joint problems and diabetes) has become an enormous health problem.

Quote:

Originally Posted by bld999 Strangely, heart disease went up right along with metabolic syndrome, as fat consumption declined. Medicine and science do not see the whole picture yet, and may not for decades. One triumph would be that maybe we could safely return to bacon when the answers are in.

Both of these assertions are false, at least in the absolute.

Note here: In the CDC study of Energy and Macronutrient intake, [ Trends in Intake of Energy and Macronutrients --- United States, 1971--2000 ], the percentage of calories from fat has decreased, but total fat intake has INCREASED!

Quoting the study from 1971 - 2000:
"The decrease in the percentage of kcals from fat during 1971--1991 is attributed to an increase in total kcals consumed; absolute fat intake in grams increased" [Ernst ND, Obarzanek E, Clark MB, Briefel RR, Brown CD, Donato K. Cardiovascular health risks related to overweight. J Am Diet Assoc 1997;97(suppl):S47--S51]

Again, I'm coming back to the assertion that the fat that we continue to eat, along with a higher portion of highly processed carbohydrates is leading the charge.

A low fat, plant based diet that has a high composition of unrefined carbs is the best for weight loss, heart health and cancer reduction.....

[ERD50]

Quote:

Originally Posted by TromboneAl I think you are actually agreeing with me, but perhaps I didn't express it well. We are both saying that what you eat will affect how many calories you end up eating during the day. In other words, we are both saying that people who claim "The only thing that matters is calories in/calories out" are wrong. Perhaps "irrelevant" is too strong, but the calories in/calories out concept isn't helpful unless you live in a cage, and have no control over how much you eat. It isn't a helpful concept if what you eat can force you want to eat more or exercise less.

We are agreeing in a way. What you eat can affect how hungry you are. And if you are hungry, you will likely take in more calories, and not lose weight.

But to me, that in no way says that calories in/out don't matter. Hunger can affect calories in, and that does matter. To me, it is so much more direct to say that different foods can affect how hungry we feel. As I said, that story 'works' whether the pill is 4 calories or 1000 - so the calorie thing isn't what is important - the satiety is. So address it directly with satiety and total calories/day.

It's a little like saying that the amount of wood you put in your wood furnace is irrelevant to the heat output, just because some days you put on a sweater and don't feel the need for heat. It doesn't change how the furnace works, and it is confusing to state it that way. So while you think your 4 calorie pill story makes things clearer - I think it just fogs the issue.


-ERD50

[rgarling]

jclarksnakes' and bld999's comments are true if you read "animal fat" in place of 'fat'.

(the consumption of animal fat is about half what it was in the 1950s.)

[jclarksnakes]

Okay I will be a test subject. I switched from LFHC to HFLC a couple weeks ago. So far the HFLC diet has kept me at an almost okay weight (159 pounds, 5'7"). Only time will tell if I can get down to a healthier 150 on the HFLC diet. I had labs done during a physical exam in august. I will get another physical in 6 to 12 months and report here with a comparison of results. This is a lot of doctor visits for someone like me who no longer has much faith in our health system and has only seen the doctor two times since back surgery in 2007. If I could get the labs done for free without a doctor visit I would.

[TromboneAl]

Quote:

Originally Posted by ERD50 We are agreeing in a way. What you eat can affect how hungry you are. And if you are hungry, you will likely take in more calories, and not lose weight. But to me, that in no way says that calories in/out don't matter. Hunger can affect calories in, and that does matter. To me, it is so much more direct to say that different foods can affect how hungry we feel. As I said, that story 'works' whether the pill is 4 calories or 1000 - so the calorie thing isn't what is important - the satiety is. So address it directly with satiety and total calories/day. It's a little like saying that the amount of wood you put in your wood furnace is irrelevant to the heat output, just because some days you put on a sweater and don't feel the need for heat. It doesn't change how the furnace works, and it is confusing to state it that way. So while you think your 4 calorie pill story makes things clearer - I think it just fogs the issue. -ERD50

OK, thanks, I will refine the argument. The purpose of the story is to demonstrate the problem with saying:

Losing weight is simple and it works like this: If you consume more calories than you burn you store the extra energy as fat.

It's very simple and it works like this: If you consume more calories than you burn you are in a "positive energy balance". When you are in a positive energy balance you will store the extra energy as fat, no matter what source the energy is from- protein, carbohydrates, or fat.

(from: Bodybuilding.com - Fat Loss: Simple Math - Calories In And Calories Out.)

The story demonstrates that that idea will probably not help you lose weight, because, while true, it ignores the kind of thing you and I are talking about.

My point is that how you use the furnace is more important than how it works.

[REattempt]

Quote:

Originally Posted by TromboneAl Note that a long-term randomized controlled experiment has never been done and is not feasible. That is, you can't take a group of 40-year-olds, and randomly assign them to a diet, and then follow them for 20 years. The best we can do are studies like this: Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease Results: During 5–23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD.

I never said long-term. I don't think we actually need long term to demonstrate the benefits. Ornish did perform a peer reviewed RCT to demonstrate reversal of CHD, without drugs or surgery, using a low-fat (<10%), plant based diet...without calorie restrictions.

This meta-analysis was not a Randomized Controlled Trial (RCT), even in the short term. This was a meta-EPI Study. Meta-EPI studies prove nothing. They are great for coming up with new hypothesis, but have major flaws for the type of research that is generally accepted as good science. Meta-analysis - Wikipedia, the free encyclopedia BTW, this study only looked at saturated fat intake, not total fat intake.

Quote:

Originally Posted by TromboneAl Studies Proving The Safety and Efficacy of the Low Carb Diet

The devil's in the details. Here is a summary of the first few studies quoted on that website:

First Quoted Study: Low-Fat Dietary Pattern and Risk of Cardiovascular Disease:The Women's Health Initiative Randomized Controlled Dietary Modification Trial Barbara V. Howard et al. JAMAVol. 295 No. 6, February 8, 2006
Quote on that webpage: Over a mean of 8.1 years, a dietary intervention that reduced total fat intake and increased intakes of vegetables, fruits, and grains did not significantly reduce the risk of CHD, stroke, or CVD in postmenopausal women.
Important study content/results: Reduced Fat intake from 38.8% fat to 6yr observed 28.8% Fat. No Where near the 10% of fat demonstrated by Ornish.
Interesting finding not told on Website: "Compared with those in the entire comparison group, a trend was observed toward reduction of CHD risk among those in the intervention group who reached the lowest levels of saturated fat and trans fat or the highest intakes of vegetables and fruits." AND "Collectively, these analyses, despite their inherent limitations, suggest that a diet lower in saturated and trans fat intake and higher in intakes of vegetables and fruits and polyunsaturated fat than what was achieved in this trial might show significant benefit in preventing CHD."
NET NET: The study pointed at confirmation of low-fat impact on CHD

Second Quoted Study: Low-Fat Dietary Pattern and Risk of Treated Diabetes Mellitus in Postmenopausal Women.The Women's Health Initiative Randomized Controlled Dietary Modification Trial. Lesley F. Tinker et al. Arch Int Med. Vol. 168 No. 14, July 28, 2008.
Quote on that webpage: None
Important study content: A low-fat dietary pattern among generally healthy postmenopausal women showed no evidence of reducing diabetes risk after 8.1 years.
Interesting finding no told on Website:Trends toward reduced incidence were greater with greater decreases in total fat intake and weight loss.
NET NET: The study pointed at confirmation of low total fat positive impact on Diabetes. (not sure why they included this on the website in the first place).

Third Quoted Study: Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet: A Randomized Trial Gary D. Foster et al. Annals of Internal Medicinevol. 153 no. 3 147-157 Aug 3, 2010.
Quote on that webpage: A 2010 Study Finds Low Carb Diet Beats Low Fat at Improving Health Long Term. Tlow-carbohydrate diet group had greater increases in high-density lipoprotein cholesterol levels at all time points, approximating a 23% increase at 2 years.
Important study content: Again, another study at 30% or less, not 10%.
Interesting finding not told on Website: This study only measures RISK factors, not actual CHD (outcomes).
NET NET: HDL is part of reverse cholesterol transport. When you eat more saturated fat and dietary cholesterol, your body makes more HDL to remove it. Eating a stick of butter will raise HDL, but butter is not heart- healthy. Pfizer discontinued a study of its drug, torcetrapib, which raised HDL but actually increased risk of cardiac events. I'm not buying this one.

I'll stop there, I think one needs to dig deeper into the results of the studies to understand how the study was constructed and the actual findings before accepting a website that lists the studies as supporting an argument...

Quote:

Originally Posted by TromboneAl carb diet cancer: study finds carb diet lowers cancer risk - chicagotribune.com

The lead in sentence says "Following a low-carb diet, even for only two days a week, was better than following a calorie-restricted diet every day for losing weight and lowering insulin levels, which are both associated with lower risks of breast and other cancers. Ok, this only says it is better than a calorie restricted diet. Again, the findings and recommendations for weight loss, cancer prevention and lower incidence of CHD is to have a low fat <10%, plant based diet. There are no calorie restrictions to the recommendations. This also doesn't demonstrate that LCHF diet is heart healthy or cancer limiting.

Quote:

Originally Posted by TromboneAl You can do a randomized controlled experiment for about a year, then measure markers for heart disease. That was what was done in this experiment: Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women, March 7, 2007, Gardner et al. 297 (9): 969 At 12 months, secondary outcomes [risk factors] for the Atkins group were comparable with or more favorable than the other diet groups.

I love this one and I was waiting for someone to bring it up....Here is the author in an hour and 16 minute presentation on youtube....

The Battle of the Diets: Is Anyone Winning (At Losing?) - YouTube

Here are the significant points he makes during his speech:
1) 15:00 His primary outcome was weight change. Not a big deal, but I'm not arguing that you won't lose weight on LCHF diet, I'm arguing whole health.
2) 17:00 at 8 weeks the Ornish group were at 21% Fat and at 6 months and 1 year, they were 29% fat. There is no way that this is a demonstration that Atkins outperforms Ornish on any level. Ornish is clearly a 10% fat advocate. At best, with that mix of Carbs/Fat, it is a demonstration that Atkins outperforms the national guidelines. [Note that the baseline diet was 35% fat...so the comparison is to a shift of 35% fat to 29% fat ("low carb") vs. 35% fat to 46% fat (Atkins).]

At this point, the game is over. This is not a comparison of Atkins (LCHF) and Ornish (LFHC). There is no conclusion you can make from this study about the weight loss, heart benefits or cancer benefits of either.

But, the biggest issue I have with this study...

27:30 It was not a controlled study and the author admits that the study showed that "If you buy this book from the book store, this is what is likely to happen...One is more controlled and one is more public health oriented, we picked the public health oriented approach"

This is the most damning admission of the tape.He is admitting that it is a test of whether people can follow the advice, not a test of the impact of the dietary approach on weight loss (primary outcome).

This is just bad science and even worse mis-representation of secondary outcomes...it did not demonstrate that the Atkins diets were better or comparable than the others. It didn't test the others, it didn't even control them, it tested them against what people's interpretations of them were!

T-Al...all due respect, but...

Most of what you have presented are reasonable science misrepresented by the LCHF proponents as supporting the cause, when in fact, the tests are not valid test of the Ornish approach...all are high fat (20-30%) content tests. Nor is it a demonstration of the health benefits of LCHF beyond weight loss.

Some of it proves nothing or are too narrow (ie. the meta-epi).

Some of it is interesting social commentary that might prove it is hard to get people to maintain a low-fat (<10%) diet, but in no way demonstrates the heart health or cancer reducing capabilities of the dietary approach.

I'll still stick by the original Thread Title....The Danger of Low Carb Diets.

and oh BTW....

Bacon!

[bld999]

"Second Quoted Study: Low-Fat Dietary Pattern and Risk of Treated Diabetes Mellitus in Postmenopausal Women.The Women's Health Initiative Randomized Controlled Dietary Modification Trial. Lesley F. Tinker et al. Arch Int Med. Vol. 168 No. 14, July 28, 2008.
Quote on that webpage: None
Important study content: A low-fat dietary pattern among generally healthy postmenopausal women showed no evidence of reducing diabetes risk after 8.1 years.
Interesting finding no told on Website:Trends toward reduced incidence were greater with greater decreases in total fat intake and weight loss.
NET NET: The study pointed at confirmation of low-fat impact on CHD"

@REattempt,

The link above makes no mention of any conclusions related to CHD [coronary heart disease] What am I missing?

[REattempt]

Quote:

Originally Posted by bld999 @REattempt, The link above makes no mention of any conclusions related to CHD [coronary heart disease] What am I missing?

You are correct, my apologies, I will correct my statement. It will/should read: The study pointed at confirmation of low-fat diet's impact on diabetes.

[haha]

Quote:

Originally Posted by REattempt You are correct, my apologies, I will correct my statement. It will/should read: The study pointed at confirmation of low-fat diet's impact on diabetes.

you seem to have a pretty heavy ego involvement here. Backstory?

Ha

[REattempt]

Quote:

Originally Posted by haha you seem to have a pretty heavy ego involvement here. Backstory?

Ha, You are correct on the ego, but no real backstory. I just detest the media, bad science and conjecture held out as truth...and I get really curious at times. For the most part, I ignore it an move on.

I looked into this topic about 8 years ago. I was a triathlete and wanted to understand the best way to eat, to fuel my body, lose weight and do it with the best impact on overall health, including the biggest killers in this country: Heart Disease and Cancer. I found Ornish and the science was really good. This was also the peak of the Atkins diet (2003-2004) craze and I was stunned then that people would follow this diet then...without the scientific support.

Here is one of the things I ran across at the time, written in 2004 and is well supported with references: http://www.atkinsexposed.org/pdf/atkins-exposed.pdf. While some of it has changed (Atkins no longer recommends Saturated Fats), it is a better foundation on the research than most.

However, when I saw the thread about "Low-Carb gains respect" and the number of people here eating low-carb diets, I absolutely didn't agree based on my understanding of the science. BUT, I wanted to see, based on this group's collective wisdom, where the "new" good science was behind this dietary approach. I was truly open to learning something new...

I figured that with all the knowledge and energy put into understanding AA, SWRs, HC etc, all the stuff we generally talk about here, there would be some good solid analysis in support of low carb diets. I figured I'd learn something.

I was disappointed. The same rhetoric is being posited regurgitated here, without the scientific support. The responses forced me to do the research again in 2012, almost 10 years later, nothing has changed. There is no "new good science" to support the conjecture about LCHF diets on heart health and cancer. I guess it is no different than paying high advisory fees, buying individual stocks, timing the market, selling out at the bottom. I will never understand human behavior/psychology. Given this group's "show me the evidence" mentality, I thought I'd get a different response.

I guess in the end, I really care about everyone here. You've helped me immensely and in ways you will never know. I don't want to see people blindly follow a weight loss regime that might help you lose weight, but in the end cause Heart Disease and an increase in cancer...by far, the biggest killers around.

We care about our portfolio and its performance, we don't pay advisors, we index for the most part, all the things we should do to protect our portfolios...yet we play with fire with the most important part that drives longevity...our health.

If I get one person to look at the data and it has an impact on their life, quality of life and longevity. They get one more day, week, year with their DW/DH, it was worth the "ego" in the thread.

[donheff]

Interesting thread. It looks to me like REattempt has good science for the benefits of a difficult regimen. For me virtually impossible since most vegetables make me gag (except various salads). I don't mean that to denigrate vegetarian (or close) approaches to whole health, just that they could be very difficult for most people. The LCHF approach could be just as hard for some but, I suspect that it is more achievable for most. The reason I say that is that (anecdotal, non-scientific evidence coming) it has been pretty easy for me for me, albeit only for a week so far, which is a shocker since I am such a carb addict. I guess I am satisfied to accept a "public health oriented," not perfect, approach that works well for weight control and general (subjective) feelings of well being, with pretty good mix of studies and personal reports to show that it is significantly better than the average diet for CHD, diabetes and other general health markers.

The real test will take about 6 months - do I stay with it or drift back to my bad habits?

[eytonxav]

It seems to me that no one plan is necessarily the right answer for everyone. Everyone's body is most likely different in the way it metabolizes food, so isn't it logical to conclude that there are many paths to Rome in the world of best diet for a particular individual and some individual testing as Al suggests may be warrranted?

[Chuckanut]

The science is the issue. I remember hearing an interview with a doctor who is very adamant that sugar is the main problem in our modern food supply. He certainly used science to argue his point. He pointed out that the low-fat and low-carb diets almost all end up severly reducing added sugars in the diet. He would love to see some tests comparing low-fat and low-carb diets against a diet that was simply low-added-sugars. Alas, that has not been done to my knowldedge.

[LRDave]

+1 on "Interesting thread". A civil and insightful discussion on an issue that I have seen get contentious and petty elsewhere on the interwebs.

For now, I am inclined to strive for: "Eat food, mostly plants, and less of it".

[REattempt]

Quote:

Originally Posted by donheff with pretty good mix of studies and personal reports to show that it is significantly better than the average diet for CHD.

Sadly, the RISKS are significant:

The 1 year study here: The Effect of High-Protein Diets on Coronary Blood Flow

The bottom two images are those of a patient who went on the Atkins Diet. Images indicate reasonable blood flow before following the high-protein diet and compromised blood flow and heart damage after adopting the high-protein diet.


Blood flow measurements collected by nuclear cardiologist Richard M. Fleming MD, FICA, FACA, FASNC, of the Fleming Heart and Health Institute, Omaha, Neb. and published in the October 2000 issue of the medical journal Angiology, Journal of Vascular Disease.