The Danger of Low Carb Diets..

[REattempt]

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.

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: [FONT=verdana, arial, helvetica, sans-serif]A low-fat dietary pattern among generally healthy postmenopausal women showed no evidence of reducing diabetes risk after 8.1 years.[/FONT]
Interesting finding no told on Website:[FONT=verdana, arial, helvetica, sans-serif]Trends toward reduced incidence were greater with greater decreases in total fat intake and weight loss.[/FONT]
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...

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.

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: [FONT=verdana, arial, helvetica, sans-serif]A low-fat dietary pattern among generally healthy postmenopausal women showed no evidence of reducing diabetes risk after 8.1 years.[/FONT]
Interesting finding no told on Website:[FONT=verdana, arial, helvetica, sans-serif]Trends toward reduced incidence were greater with greater decreases in total fat intake and weight loss.[/FONT]
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]

@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]

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]

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]

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.

 

[eytonxav]

ReAttempt,

Seems to me, you need sufficient protein to maintain and/or grow muscle and I assume one needs muscle to help metabolize blood sugar. The other variable you need to consider is exercise in conjunction with the diet. So while a high protein diet in itself may be bad, if its lean meat based (turkey, salmon, chicken) and balanced from a macro-nutrient perspective and combined with reasonable exercise, I wonder how bad it is, especially if ones blood work is yielding good, HDL/LDL, triglycerides, and blood glucose #s.

 

[donheff]

Sadly, the RISKS are significant:

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

Unfortunately the link leads to an abstract that doesn't describe the actual diets employed and the links to articles on low card citing this article lead to a pay wall. It would be interesting to know if the subjects actually conformed to LC in practice rather than just high protein (with normal fat and carb). Also, the study involved 16 people - isn't that pretty weak?

I assume you got the whole study somehow since you show images I didn't see so you may have the details.

 

[rgarling]

"... The same rhetoric is being 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. "

OK. Let me get this straight. You were able to review ALL the research findings in nutrition over the past week, and after accomplishing that feat have concluded that a vegetarian lifestyle is not only the best, but apparently the only one supported by "good science". I think you are spending too much time on the Atkins-sucks website.

 

[harley]

Well, sounds to me like no one really has a clue, so I'm sticking with my HCHFDH (high carb, high fat, die happy) diet. Maybe I'll get lucky and they'll come up with a cure for self indulgence before I check out.

 

[REattempt]

"
OK. Let me get this straight. You were able to review ALL the research findings in nutrition over the past week, and after accomplishing that feat have concluded that a vegetarian lifestyle is not only the best, but apparently the only one supported by "good science". I think you are spending too much time on the Atkins-sucks website.

I laughed out loud at this...No I didn't review it all and I haven't spent time on the Atkins sucks website...AND I'll be the first to say that I'm no expert. I'd love to believe in the LCHF approach too...believe me it would be much easier...aside from weight loss, which I will agree, you can lose weight on Adkins or many of the other diets...I just don't see the outcomes.

I will also be the first to admit that I don't trust the Gummint agencies and their "food pyramids" and broad brush stroke nutrition recommendations. I think they have screwed it all up too.

I actually think the jury is out. The human body is so complex and we try to isolate one thing and prove it, when in fact the reality is very different and more complex. I also think that the human behavioral/psycho/social factors play heavily into the obesity/CHD/Cancer problems.

I do believe more whole/raw foods (unrefined foods), fruits, veggies in the diet are better than McDees, Wonder Bread and sugary drinks and foods. I believe that reducing saturated fats and trans fatty acids lead to better heart health. I believe that monounsaturated fats are the best for heart health. I believe that omega-3 fatty acids are helpful to the heart. I believe that grazing is a reasonable solution. I believe that stress reduction and exercise also have a huge impact on weight and overall health. I believe that portion size and Calories in/out has an impact on weight.

I also believe that if you want to reduce/eliminate/reverse CHD, or minimize your chances of getting/or reversing Prostate Cancer a low fat (<10%), plant based diet is the only dietary way that has been demonstrated to do this without drugs or surgical intervention.

I further believe that for day to day living, LF Plant Based diet is difficult. So is saving money for retirement. It's all in what you want your outcome to be!

Either way, it has been a mental challenge and fun to look into the claims...if we have some fun with it and challenge our own thinking, then we've moved ourselves forward.

What is the URL for that Atkins-sucks website?

 

[bld999]

IMO, it's silly to ignore good evidence, but discovering which is good is the problem for me. I get wrapped around the axle trying to sort rct, sample sizes, food frequency questionaires, and the rest. In the thick of it, I usually recall the paper below, which makes me feel better for a few minutes.

PLoS Medicine: Why Most Published Research Findings Are False

And, when I feel or hear expressions of hubris regarding "cures" or certainties about seemingly intractable chronic diseases, I remember Einstein's statement: " As the circle of light increases, so does the circumference of darkness around it"

We're bound to examine this stuff, but it ain't easy.

 

[Sue]

The reason I found the China Study book so compelling was that it was written by a scientist, T Colin Campbell, who changed to a plant-based diet after performing epidemiological studies which showed that perople who ate a plant-based diet were the healthiest. He also published a number of research studies in scientific journals that provided explanations for why people who ate the plant-based diet were healthier. Campbill wrote this book after he retired because he thought it was important that people have access to this information, not for his own profit. Both my husband and myself are scientists. Campbell backed up all his conclusions with scientific arguments. It was very compelling reading.

Over the last thirty years, I have transitioned to eating a plant-based diet, partly because of personal perference and partly for health reasons. I see how suddenly switching from a typical Western diet to a plant-based diet would be a radical lifestyle change. Sometimes I find myself yearning for bacon or ice cream (which I could have as an occasional treat), but I rarely do so because now I have new "comfort foods". It seems to me that the type of food one eats, can evoke all sorts of emotional associations which makes it difficult to discuss this subject rationally.

On the other hand, I have watched several realtives and friends suffer through the complications of chronic illness (cancer, heart problems, diabetes etc) before their death. It wasn't pretty. I would prefer to live the rest of my years in the best health possible. The possibility that a plant-based diet could help me avoid these health problems made it a no-brainer for me to change my diet.

One way to decide whether the low-carb or plant-based diet is the healthest for you might be to read the China Study book. There is evidence that a plant-based diet not only prevents chronic diseases but can also reverse heart disease, diabetes etc

 

[rgarling]

Sue -- if you appreciate scientific argument you may like:
Final China Study Response (HTML Version) « Raw Food SOS: Troubleshooting on the Raw Food Diet

warning: you might change your mind about the china study

 

[haha]

Sue -- if you appreciate scientific argument you may like:
Final China Study Response (HTML Version) « Raw Food SOS: Troubleshooting on the Raw Food Diet

warning: you might change your mind about the china study

Don't bank on it!

 

[REattempt]

ReAttempt,

Seems to me, you need sufficient protein to maintain and/or grow muscle and I assume one needs muscle to help metabolize blood sugar. The other variable you need to consider is exercise in conjunction with the diet.

+1 on the need for protein.
++1 on the exercise.

 

[Nemo2]

Bottom line:

Eat to live, don`t live to eat.

 

[REattempt]

Unfortunately the link leads to an abstract that doesn't describe the actual diets employed and the links to articles on low card citing this article lead to a pay wall. It would be interesting to know if the subjects actually conformed to LC in practice rather than just high protein (with normal fat and carb). Also, the study involved 16 people - isn't that pretty weak?

I assume you got the whole study somehow since you show images I didn't see so you may have the details.

I didn't have the entire study when I posted it...like you, I had lots of question too. I too wanted to see the Fat consumption of the diets. 16 isn't a lot of people, but the quote from the abstract "The differences between progression and extension of disease in the HPG and the regression of disease in the TG were statistically (p < 0.001) significant." is significant....that is a low p value.

I did not get the whole study when I posted, I googled for the image after going through the abstract and seeing the scans shown on the Taubes/Ornish Video.

Well, after the your question and @rgarlings comment about too much time on the atkins sucks website...I found the study on the Atkins sucks website... LOL!

Atkins Facts - Richard M. Fleming, M.D.

Who knows if the actual content was modified before it was posted, For our purposes, I'll assume not...likely Fleming would have issue with it if it mis-represented his work.

I think the study and the findings are significant.

 

[TromboneAl]

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! ​

To keep this simple, let's take this one thing, and look at it. There are two problems with what you have said.

First, you are not understanding the meaning of "controlled." This is a very clearcut thing. Gardner's study was a randomized, controlled study. At that point in the video, he is saying that what the people ate was not controlled. That is, the people were not housed and fed -- their environment was not controlled. That does not mean that the study was not controlled. Each of the diet groups was a control for the other groups. The experiment was controlled.

In science, "control" is defined as:

To verify or regulate (a scientific experiment) by conducting a parallel experiment or by comparing with another standard.

​

That's exactly what he did. He compared the results between the different parallel experiments.

If he had just had one group, had them follow the Atkins diet, and said "Look they lost weight!" that would not have been a controlled experiment. There would have been no control group to compare the results to.

In his experiment, he had three control groups for every diet type.

So, to say that the experiment was not controlled is incorrect.

Second, just because he didn't do the experiment you wanted to see, doesn't mean that it was damning or bad science.

He said he had a choice: he could feed and house the people (essentially putting them in a cage) and control exactly what they ate to find out which diet worked best under those circumstances, or he could teach subjects from the diet books, and have them follow what they were taught.

The first experiment (housing and feeding) would have no value in the real world. Who care what happens if people are in a cage?

The second experiment has value to you and me. As a result, he chose to scientifically answer the question "Which diet will work best for me?" Which diet will be most effective, in the real world, at helping people to lose weight?

He did this with a controlled scientific study, and found that the Atkins diet was best. He incidentally found that traditional markers of health, such as blood pressure and cholesterol, we better after subjects followed the Atkins diet a compared with the controls. He reported those results. There was no misrepresentation.

That's all he set out to do, and he did it following the best principles of science.

No one can do this experiment testing cardiovascular results over 20 years. That would be nice, but it's not feasible. The best we can do is look at marker that correlate with CVD.

In summary, it was a randomized, controlled experiment that looked at how different diets would affect subjects' weight and health markers in the real world. It was excellent science.

 

[jclarksnakes]

While I was catching up on this thread I had a nice lunch. I was out running errands earlier and stopped by Wendys and picked up a double cheeseburger "baconator". When I got home I removed the patties and cheese and bacon from the bun and placed them on a big bed of lettuce. It was a great lunch. I fed the bottom half of the bun which had some cheese stuck to it to the dog. I want her to have a good balanced diet and so did not feed her the top half of the bun which had no cheese on it. Life is good!

 

[bld999]

So the dog is the control group, eh? <G>