The Danger of Low Carb Diets..

[rgarling]

Science will progress one funeral at a time. Dr. Ornish's heyday was 15 years ago and he is still fighting with a dead man (Atkins). Yes, he showed that the Ornish diet & exercise can reverse heart disease. High fat diets will too.

The problem with Ornish's diet is that people who try it can't sustain it (high carb with calorie restriction). Further more, his assertion that complex carbs don't spike your blood sugar is bogus. Just get a glucose meter two slices of whole-wheat toast and give it a go. For most people, two slices of healthy-whole-wheat bread will spike their blood sugar more than a can of high-fructose corn syrup soda. A typical candy bar is better for controlling blood sugar. So why does he say these things?

Fixing the current dietary mess is definitely going to need a grassroots effort because there is an entire population of government officials, scientists, nutritionists, physicians and pharmaceutical companies that have made a living espousing incorrect advice. They will not go down without a (face-saving) fight.

 

[BigNick]

So in conclusion: Nobody really knows for sure.

There's a lot to be said for eating food, not too much, mostly plants. Article.

 

[FinanceDude]

There's a lot to be said for eating food, not too much, mostly plants. Article.

One of the best overview articles I have seen in awhile.......... I could post some interesting stuff my food scientist sister passed along to me, but no doubt it would be pooh-poohed on here........

 

[jclarksnakes]

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.

Sorry for my glaring omission of heart disease in the list of the metabolic syndrome pathologies. I started buying bacon again after not having it in the fridge for several years. I love bacon. I am kicking myself for all that bacon I missed out on while wasting my time counting fat grams. I am still new at this HFLC diet and am trying to find good food I like to replace all the carbs I was eating before.

 

[haha]

Further more, his assertion that complex carbs don't spike your blood sugar is bogus. Just get a glucose meter two slices of whole-wheat toast and give it a go. For most people, two slices of healthy-whole-wheat bread will spike their blood sugar more than a can of high-fructose corn syrup soda. A typical candy bar is better for controlling blood sugar.

To me this is key. Why try to decode the mysteries of the universe when an inexpensive and at least somewhat accurate device can tell you where you personally stand? I suppose it is possible, but IMO not likely, that a diet that spikes one's personal blood sugar might actually be better for his health, but I will put my bet on the "not".

Then we don't need to decide what diet is categorically better, as this may well not be possible, particularly if we need agreement from the experts.

Ha

 

[bld999]

@jclarksnakes

There are probably other chronic conditions that could be added to the list past heart disease, maybe cancers of some type, the ironies are numerous. We crave guidance from research, and behave under various social pressures about food every day.

Deprivation is not usually discussed, but to me becomes a big factor [Nords alluded to this above] Even if there was a certain, immutable diet or behavior set the would save us all from diet related chronic disease, many of us would fail anyway. [ok, maybe I should speak for myself .<G>]

 

[haha]

@jclarksnakes

Deprivation is not usually discussed, but to me becomes a big factor [Nords alluded to this above] Even if there was a certain, immutable diet or behavior set the would save us all from diet related chronic disease, many of us would fail anyway. [ok, maybe I should speak for myself .<G>]

To me it is huge. I am not a big eater, but I could not avoid food if I were hungry. To me life is not for deliberate deprivation, especially just to get a few more years of deprivation. I would likely be trying to shorten that life as much as I could.

Ha

 

[TromboneAl]

So in conclusion: Nobody really knows for sure.

The only thing that we know definitely works is to eat less calories than you burn. The source (protein/carbs/fat) is secondary, if it indeed matters at all.

You say that it's just "calories in/calories out," and you're 100% right. But I'm going to give you an example, that I think will make you realize, that while true, that law is actually irrelevant to weight loss, and that all calories are not equivalent.

Let's say I gave you a pill to eat every morning. This pill contains only four calories. However, this pill affects your hormonal balance, and it makes you ravenously hungry all the time, and also quite lethargic. Perhaps it's related to your thyroid, but that doesn't matter for this example. What matters is that it makes you hungry and sedentary.

As a result, you are going to gain weight. The pill is only a few calories, but you have gained weight because it has made you to eat a lot more food and move around less.

Has your "calories in/calories out" thermodynamic law been violated? No, because, as a result of your extra eating, you have taken in a lot more calories, and expended fewer. But because of the nature of these calories that you've eaten, namely those four calories in the pill that affects your metabolism, you have gained weight. If you were to stop taking that four-calorie pill, you'd lose weight.

In other words, calories in/calories out is true, but not helpful in understanding weight gain or loss.

By the way, in a similar way, eating lots of carbohydrates can force your body to store energy in fat cells, which in turn forces you to eat more and expend less.

 

[TromboneAl]

There's a simple solution to this Low-Fat versus Low-Carb question: Try one yourself. Get a physical, and go on one of these diets for a year. Measure your weight and dimensions, and after a year, measure again and get another physical and see how you did. Of all the studies in the world, this is the only one that will tell you whether it will work for you. If not satisfied try the other one.

Even if the diet is dangerous, you probably won't do too much damage in a year.

 

[Alan]

I could post some interesting stuff my food scientist sister passed along to me, but no doubt it would be pooh-poohed on here........

Are you saying that it has laxative properties?

 

[ERD50]

You say that it's just "calories in/calories out," and you're 100% right. But I'm going to give you an example, that I think will make you realize, that while true, that law is actually irrelevant to weight loss, and that all calories are not equivalent.

....
In other words, calories in/calories out is true, but not helpful in understanding weight gain or loss.

I totally disagree with your conclusion. I think this little story misses the point entirely.

Calories in/calories out is helpful in understanding weight gain or loss. And in this case, you should try to understand why some foods leave you hungry, and drive you to take in more calories. In your example, let's say that pill was 1000 calories instead, and still made you hungry. At the end of the day, it is the total calories you took in that seems to be most important. So how can "calories in/calories out" be irrelevant?

I've looked into the 'satiety index' stuff a bit, and I think that may be very important to all this. FWIW, baked potatoes score very well on that index. The last time I looked, I think the studies were based on hunger after two hours, and I'd like to see something further out as well. The following is anecdotal, few data points, and subjective not scientific, but... it sure seems to me that a breakfast of an egg, some bacon or sausage, and some carbs (pan-fried potatoes or whole grain bread) keeps me satisfied well past my normal lunch time, while the same breakfast w/o the carbs has me hungry before lunch.

My fasting glucose is always in the mid 90s, I recently had a chance to get it tested at the local pharmacy, so I went in ~ 1 hour after my typical breakfast/lunch (oatmeal with nuts&fruit, sandwich) and my glucose was still mid 90's.

-ERD50

 

[Alan]

The following is anecdotal, few data points, and subjective not scientific, but... it sure seems to me that a breakfast of an egg, some bacon or sausage, and some carbs (pan-fried potatoes or whole grain bread) keeps me satisfied well past my normal lunch time, while the same breakfast w/o the carbs has me hungry before lunch.

Over the past few months we have taken to at least once a week going somewhere and having a big cooked breakfast and then not eating until late afternoon and then only eating very light. On Saturday we rode 13 miles to a Denny's and had 2 scrambled eggs, sausage and bacon plus 2 pancakes. Ate only oatmeal in the evening, and was not hungry at all until then.

Today we had a visitor staying so we drove out to Cafe Express and I had a SW breakfast - scrambled eggs, beans, guacamole, and again don't expect to feel a need to eat until late afternoon.

FWIW, we tend to eat little red meat and avoid refined sugars, but are not obsessed with that regime. (Last night DW cooked us a lamb curry over basmati rice.)

Thanks to OP for the link, I did enjoy watching it.

 

[REattempt]

There's a simple solution to this Low-Fat versus Low-Carb question: Try one yourself. Get a physical, and go on one of these diets for a year. Measure your weight and dimensions, and after a year, measure again and get another physical and see how you did. Of all the studies in the world, this is the only one that will tell you whether it will work for you. If not satisfied try the other one.

Even if the diet is dangerous, you probably won't do too much damage in a year.

I think there are two fallacies with this approach and thinking.

I think this is the equivalent of taking half your money and putting it into Clyatt's RIP AA portfolio and half your money into a Permanent Portfolio AA and at the end of a year seeing which one made more money...then putting all your money into the AA that made more money. I think more people here would want longer results to validate the AA. This is one of the reason I started this thread. I felt that people were putting the LCHF diet up as the "end all" based only on weight loss. I think the ramification of heart health and cancer to be more important than the weight loss.

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. You may have perfectly reasonable bloodwork, but still have an impact on your coronary function. See these studies: http://engine2diet.com/~engine2/usrfiles/files/publishedstudies/obesity/comparative-effects-of-3-diets.pdf and The Effect of High-Protein Diets on Coronary Blood Flow

One of these was a 6 month study and one was a 1 year study. Both demonstrated that you can do damage in a year.

 

[TromboneAl]

I totally disagree with your conclusion. I think this little story misses the point entirely.

Calories in/calories out is helpful in understanding weight gain or loss. And in this case, you should try to understand why some foods leave you hungry, and drive you to take in more calories. In your example, let's say that pill was 1000 calories instead, and still made you hungry. At the end of the day, it is the total calories you took in that seems to be most important. So how can "calories in/calories out" be irrelevant?

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.

 

[REattempt]

Yes, he showed that the Ornish diet & exercise can reverse heart disease. High fat diets will too.

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...

The problem with Ornish's diet is that people who try it can't sustain it (high carb with calorie restriction). Further more, his assertion that complex carbs don't spike your blood sugar is bogus. For most people, two slices of healthy-whole-wheat bread will spike their blood sugar more than a can of high-fructose corn syrup soda. A typical candy bar is better for controlling blood sugar. ... So why does he say these things?

While I'm no expert, I think you have to look beyond the glycemic index to the glycemic load. For example, most candy has a relatively high Glycemic Index, eating a single piece of candy will result in a relatively small glycemic response because your body's glycemic response is dependent on both the type AND the amount of carbohydrate consumed. This concept, known as Glycemic Load, was first identified in 1997 by Dr. Walter Willett and associates at the Harvard School of Public Health. Glycemic Load is calculated this way:
GL = GI/100 x Net Carbs
(Net Carbs are equal to the Total Carbohydrates minus Dietary Fiber)

GL's less than 10 are considered low and GL's above 20 are considered high.

While Wheat bread's GI is about 74, Wheat bread's GL is 10 (considered low) because of the dietary fiber content. [ from the original study: International table of glycemic index and glycemic load values: 2002 ]. A snickers bar has a GI of about 55, but because of the net carbs being so high due to lack of dietary fiber (64) the GL is 35, which is considered very high Glycemic Index – NutritionData.com.

Again, I'm no expert, I'm trying to figure this out for myself. Do you have any type of data to support that candy bars "control" blood sugar better than whole wheat bread? [I'm assuming that you mean I have a smaller spike in blood sugar with a candy bar than whole wheat bread]

 

[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]

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]

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]

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.

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]

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]

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.