Thursday, July 20, 2017

The Fat-Free Diet

I have previously mentioned an increasing scientific awareness that carbohydrates, not fats, are the real enemies of good health, at least in part because the sugar industry arranged to get bogus studies published long ago, and many medical researchers bought in to the falsehoods.  An interesting article:
We’re All Guinea Pigs in a Failed Decades-Long Diet Experiment
Recently, research has come out strongly in support of dietary fat and cholesterol as benign, rather than harmful, additions to person's diet. Saturated fat seems poised for a similar pardon.
The stats back him up. Since the US government first published a set of national nutrition guidelines in 1980, rates of obesity and related diseases like diabetes have more than doubled. "Childhood diabetes was basically unheard of, and now it's an epidemic," Lustig said.
"The science that these guidelines were based on was wrong," Robert Lustig, a neuro-endocrinologist at the University of California, San Francisco, told Tonic. In particular, the idea that cutting fat from a person's diet would offer some health benefit was never backed by hard evidence, Lustig said...
By the 1990s, when Teicholz says the epidemiological data started piling up to show that a low-fat, high-carb diet did not help with weight loss or heart disease—calories be damned—much of the damage was already done. The US public was deep in what nutrition experts sometimes call the "Snackwell phenomenon"—a devotion to low-fat and low-calorie processed snack foods, which people pounded by the bagful because they believed them to be healthy.
"This advice allowed the food industry to go hog-wild promoting low-fat, carb-heavy packaged foods as 'light' or 'healthy,' and that's been a disaster for public health," Lustig said.
Take a look at pictures of ordinary Americans in the 1940s and 1950s.  Few are really fat; many are actually a bit thin by modern standards.  Here are some papers analyzing dietary fat guidelines effects. In the British Medical Journal Open Heart:
Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis
2467 males participated in six dietary trials: five secondary prevention studies and one including healthy participants. There were 370 deaths from all-cause mortality in the intervention and control groups. The risk ratio (RR) from meta-analysis was 0.996 (95% CI 0.865 to 1.147). There were 207 and 216 deaths from CHD in the intervention and control groups, respectively. The RR was 0.989 (95% CI 0.784 to 1.247). There were no differences in all-cause mortality and non-significant differences in CHD mortality, resulting from the dietary interventions. The reductions in mean serum cholesterol levels were significantly higher in the intervention groups; this did not result in significant differences in CHD or all-cause mortality. Government dietary fat recommendations were untested in any trial prior to being introduced.
Cholesterol levels dropped but not CHD.
From Annals of Internal Medicine:
Effects of Low-Carbohydrate and Low-Fat Diets
A Randomized Trial

Intervention

The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.
Low Carbohydrate versus Isoenergetic Balanced Diets for Reducing Weight and Cardiovascular Risk: A Systematic Review and Meta-Analysis. PLoS ONE 9(7): :
Trials show weight loss in the short-term irrespective of whether the diet is low CHO or balanced. There is probably little or no difference in weight loss and changes in cardiovascular risk factors up to two years of follow-up when overweight and obese adults, with or without type 2 diabetes, are randomised to low CHO diets and isoenergetic balanced weight loss diets. 
What is isoenergetic? Seems to mean same calorie count.  Carbos are the enemy even at the same calorie level.  You still do not want to order one of Carl's Jr.''s absurd burgers, but a steak without the potatoes seems like it will work as well as the low-fat carbo diet.  Of course, most carbos are fried or served with fat (sour cream or and preferably and butter)

High-protein foods (like steak):
The role of protein in weight loss and maintenance

Several meta-analyses of shorter-term, tightly controlled feeding studies showed greater weight loss, fat mass loss, and preservation of lean mass after higher-protein energy-restriction diets than after lower-protein energy-restriction diets. Reductions in triglycerides, blood pressure, and waist circumference were also reported. In addition, a review of the acute feeding trials confirms a modest satiety effect, including greater perceived fullness and elevated satiety hormones after higher-protein meals but does not support an effect on energy intake at the next eating occasion. Although shorter-term, tightly controlled feeding studies consistently identified benefits with increased protein consumption, longer-term studies produced limited and conflicting findings; nevertheless, a recent meta-analysis showed persistent benefits of a higher-protein weight-loss diet on body weight and fat mass. Dietary compliance appears to be the primary contributor to the discrepant findings because improvements in weight management were detected in those who adhered to the prescribed higher-protein regimen, whereas those who did not adhere to the diet had no marked improvements. Collectively, these data suggest that higher-protein diets that contain between 1.2 and 1.6 g protein · kg−1 · d−1 and potentially include meal-specific protein quantities of at least ∼25–30 g protein/meal provide improvements in appetite, body weight management, cardiometabolic risk factors, or all of these health outcomes; however, further strategies to increase dietary compliance with long-term dietary interventions are warranted.

1 comment:

  1. Most of my life I've been overweight; not obese, but a lot plumper than I liked to be, or wanted to be. There's hardly a "low-fat, low-cal" diet I haven't tried; with a great deal of effort, and facing meals with no enthusiasm for eating a few thimblefuls of cardboard, I'd manage to lose two or 3 pounds.

    Then as soon as I relaxed for one moment, back the weight would come; and more besides, as I threw off the rigid constraint I'd been imposing on myself. My sister gave up the battle, and as an adult ended up obese, weighing several hundred pounds. She finally got her stomach stapled, and is now down to being large but no longer obese. Pretty drastic, and I didn't ever consider that, but was resigned to my fate.

    Finally I chanced to find a discussion of low-carb + high fat diet, on Karl Denninger's site Market-Ticker.org. It sounded good, but I had little hope for success. But then, I'd tried everything else so why not give it a try?

    I've only lost 40 pounds on my low-carb, high fat diet; was at 220, now down to 180. My doctor has never seen me so healthy. My high blood pressure has fallen, and I'm no longer taking some of the drugs I was on. I feel amazingly better. I sleep better. I eat a lot, but am seldom hungry. Maybe I'll even start exercising, one of these days!

    My conclusion is that the government, as it does with so many subjects, is lying to us. Has been lying to us. The government-approved "Food Pyramid" is upside-down; but they're sticking to it, regardless of the suffering and death, because too many applecarts would be overturned if the truth were known.

    I'm no expert; I just know that I'm sold on low-carb, high fat eating. It works for me. I eat lots of bacon, steak, chicken, fish, veggies & salad; I do miss sourdough bread and donuts- and See's chocolates, sigh- but I can live without them. YMMV; good luck!

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