At the end of last year I reported on the findings of the mammoth Women’s Health Initiative trial. The trial was initiated in 1993, and recruited a total of almost 50,000 post-menopausal women and followed them for an average of about 8 years. About 60 per cent of these women were allowed to continue on their normal diet (the control group). The remaining 40 per cent of women were instructed to make their diet ‘healthier’ but reducing total fat to 20 per cent of calories, to eat at least 5 portions of fruits and vegetables a day, and to eat 6 or more portions of wholegrains a day. This group ” the intervention group ” received frequent group sessions designed to educate these women about healthy eating and support them in their quest.
Overall, the intervention group ended up eating ‘better’, including (compared to the control group) 22 per cent less fat, 23 per cent less saturated fat and 20 per cent less cholesterol. Despite this, as I reported in a blog post in November, this had not impact on risk of many different forms of cancer or body weight. It was also found that the women eating the lower-fat diet did not experience any protection from risk of heart disease or stroke either [1]. Basically, the Women’s Health Initiative results, to date, have shown that lower fat eating has provided no discernible benefits, even in the long term.
Those who have held out hope that the WHI trial may finally turn up some good news and therefore go some way to vindicating the low-fat paradigm were disappointed again, this week, on the publication of yet another study that assessed data from this trial [2]. This time, the focus was diabetes. And, yet again, the group eating the lower-fat diet were not found to be at a statistically significant reduced risk of this major condition compared to those eating, essentially, what they liked.
The authors point out that there was an association between eating less fat and reduced risk of diabetes. The lower-fat consuming group also lost about 2 kg more weight over the course of the study. Weight loss may reduce the risk of diabetes. Once this was accounted for, the relationship between reduced fat intake and lower risk of diabetes disappeared. This led the authors to conclude: ‘Weight loss, rather than macronutrient composition, may be the dominant predictor of reduced risk of diabetes. So, just to summarise, the lower-fat regime utilised in the Women’s Health Initiative study did not protect women against cardiovascular disease, cancer or diabetes. Fat lot of good, then.
If weight loss is the goal, then my advice is generally to opt for a lower-carb approach. See here and here for more details on this, including the results of two long-term studies that have found carbohydrate control to bring superior results in terms of weight loss than low-fat eating in the long term.
References:
1. Howard BV, et al. Low-fat dietary pattern and risk of cardiovascular disease: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA 2006;295(6):655-66
2. Tinker LF, et al. Low-Fat Dietary Pattern and Risk of Treated Diabetes Mellitus in Postmenopausal Women. Arch Intern Med. 2008;168(14):1500-1511
bit of a cross post, but i thnk it is fair to say there is plenty of evidence that a diet low in saturated fat can reduce CHD.
in the context of diabetics, it’s no surprise that weight loss is key to controlling typeII diabetes – but the other known health benefits to a low fat, ‘mediteranean’ type diet are important reasons to consider this diet.
And it is interesting that Tinker et al do not seem to actively recommend a high fat diet.
Some peer reviewed evidence from the literature…..
Mead et al, J Hum Nutr Diet. 2006 Dec;19(6):401-19.
This review concludes
“There remains good evidence that reducing saturated fat reduces morbidity in patients with CVD.”
Khan et al, Can J Cardiol. 2008 Jun;24(6):465-75
recommendations
“……follow a diet that is reduced in saturated fat and cholesterol, and one that emphasizes fruits, vegetables and low-fat dairy products, dietary and soluble fibre, whole grains and protein from plant sources; and consider stress management in selected individuals with hypertension.”
Hu et al, JAMA. 2002 Nov 27;288(20):2569-78
review concludes
“Substantial evidence indicates that diets using nonhydrogenated unsaturated fats as the predominant form of dietary fat, whole grains as the main form of carbohydrates, an abundance of fruits and vegetables, and adequate omega-3 fatty acids can offer significant protection against CHD.”
Hooper et al, Cochrane Database Syst Rev. 2000;(2):CD002137
Plain Language Summary
“Cutting down how much fat we eat or replacing some saturated (animal) fats by plant oils and unsaturated spreads may reduce risk of heart disease, probably including fatal heart disease. Heart disease includes heart attacks, chest pain, strokes and the need for heart surgery.”
Temple, Biomed Pharmacother. 1996;50(6-7):261-8.
“The prevention and treatment of coronary heart disease (CHD) necessitates vigorous dietary intervention……..The critical dietary change is the reduction in intake of saturated fat and cholesterol.”
Given the comments following this article below on the Israeli study, we can divide opinion in to those who follow a paleo style diet (who have low body fat and reduced risk of a whole host of ‘Western’ diseases), and those who simply refucse to acknowledge that the low fat/refined carbohydrate argument is a busted flush. Sadly those in the latter group include a sizeable portion of th emedical establishment, advisory groups (such as the BHF and various diabetic groups), and others who profit from the business of sickness.
http://tierneylab.blogs.nytimes.com/2008/07/21/good-news-on-saturated-fat/
There’s none so blind as those that will not see.
superburger
What you’ve offered here in support of your assertion that “there is plenty of evidence that a diet low in saturated fat can reduce CHD” are opinions and conclusions, but it’s the studies that these are based on that count.
Can you provide the actual evidence?
dr briffa,
I’m confused. You don’t think that the authors of these (peer reviewed) papers base their conclusions on evidence?
To pick one example, do you think Hooper (the cochrane paper) was wrong to draw the conclusion that
“….Cutting down how much fat we eat or replacing some saturated (animal) fats by plant oils and unsaturated spreads may reduce risk of heart disease, probably including fatal heart disease…..”
based on the analysis of the 37 pieces of work that fitted the previously defined selection crtieria.
Would you draw a different conclsion?
superburger
There’s really no reason for you to be confused: You’ve made a claim that “there is plenty of evidence that a diet low in saturated fat can reduce CHD” and I’m asking for is for you to verify this assertion with actual studies (not conclusions or opinions).
Tell me if you think that’s too much to ask.
I’m also confused. These are conclusions drawn from the research carried out in the listed papers. The actual studies are listed for those who wish to delve into the details of the stats. Where’s the problem?
Rich Scopie
There’s no need for you to be confused either Rich: superburger made a claims but has not provided the evidence to support it (just opinion at this stage). It’s not very scientific, is it?
Can you do any better, or are you content just to hold up opinions and conclusions without actually citing the science on which they are based? Because if you and superburger can’t cite the actual evidence, then the opinion and conclusions you appear to be happy to rely on don’t count for much.
Let’s not go around and around in circles: either quote the actual studies (either of you) or this will be the end of this particular discussion.
Perhaps Dr B you’d like to explain why you think a meta-analysis is not evidence?
“These are conclusions drawn from the research carried out in the listed papers.”
Citing the conclusions of researchers rather than data itself as proof does not take into account researchers who misinterpret the data because of preconceived beliefs about what it should show (happens all the time), the funding source of the research (which tends to want certain outcomes and influences researchers to interpret the data in ways favorable to the funder), how the study was set up, how long it lasted, whether it was a double-blind study, and so forth. In other words, don’t trust the conclusions of researchers in lieu of studying the actual data and having the know-how to interpret it. Dr. Briffa is asking for the facts themselves, not what someone thinks about the facts.
ross
“Perhaps Dr B you’d like to explain why you think a meta-analysis is not evidence?”
Perhaps you’d like to explain what you think the meta-analysis superburger has referred to is evidence of?
Sure. It’s evidence that a review of the effect of reduction or modification of dietary fats on total and cardiovascular mortality and cardiovascular morbidity over at least 6 months using 27 trials selected [using the following criteria 1) randomized with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) healthy adult humans, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available] demonstrated no significant effect on total mortality (rate ratio 0.98, 95% CI 0.86 to 1.12), a trend towards protection form cardiovascular mortality (rate ratio 0.91, 95% CI 0.77 to 1.07), and significant protection from cardiovascular events (rate ratio 0.84, 95% CI 0.72 to 0.99), the latter becoming non-significant on sensitivity analysis and that trials where participants were involved for more than 2 years showed significant reductions in the rate of cardiovascular events and a suggestion of protection from total mortality and the degree of protection from cardiovascular events appeared similar in high and low risk groups, but was statistically significant only in the former.
Perhaps you’d like to explain why you think a meta-analysis (a study of studies) is not evidence, but a single study is?
ethyl-d
did you read the statement from the cochrane library about the purpose of systematic reviews? The aim is precisely to avoid the problems you allude to.
Dr briffa the Hooper meta-analyis is evidence that, if one considers the 27 RCTs which fitted the selection criteria (which I assume you agree are fair)
Table 2 in the paper lists the results of the meta-analyses, and the statistical test applied (assume you don’t disagree with these).
The conclusions are based inter alia, on these data.
Nothing particularly challenging in seeing how Hooper et al arrived at their conclusions.
Dr Briffa – lets try the yes/no asnwer approach.
do you agree with the conclusions of Hooper’s meta-analyis. Yes or No?
superburger and ross
In reference to post 11.
What in the summary ross has kindly provided for us do you think supports superburger’s assertion that “there is plenty of evidence that a diet low in saturated fat can reduce CHD”? The results were, to put it kindly, dismal.
I suppose it’s also worth pointing out that the review included studies where a reduction in saturated fat was not the only dietary modification. Also included were studies which did not even specifically restrict saturated fat.
I’m just not seeing how this meta-analysis can therefore be used to support superburger’s assertion that “there is plenty of evidence that a diet low in saturated fat can reduce CHD”? Which is why I asked for the specific studies, because clearly you are both seeing something I’m not.
Superburger,
I’m a US resident and I am on the receiving end of a lot of advice to follow a “Mediterranean diet”, whatever that is. The descriptions of that mythical diet bear little resemblance to reality. The diet that is typically described as “mediterranean”, i.e., lots of starch from pasta, bread, and legumes, and minimal meat and saturated fat, not only inaccurate, it is merely less sickening than the Standard American Diet, IMO.
This was especially apparent to me just this month, when I spent a bit over two weeks in Italy. I generally pay close attention to my diet because I tend to run higher and erratic blood glucose levels in response to eating sugars and starches, especially grain flours (even whole grain). If I avoid these BG/insulin spiking foods, my BG remains normal and fairly steady and I can avoid taking diabetes medications or insulin. I also maintain a normal weight range with this carb restricted (but not calorie or fat restricted way of eating). I do try to keep PUFAs low overall, particularly from industrial seed oils), in fact my weight and overall health improves the more naturally saturated fat I eat, because it is a good form of energy for me. My HDL/tryglyceride ratio has improved on this diet, though I do not have low cholesterol (nor would I want it as low chol is associated with cancer, dementia, and overall risk of early death). Additionally, my LDL is the light fluffy kind, not the small dense kind associate with CVD. So I don’t worry about cholesterol for a number of reasons, especially since the evidence linking cholesterol levels to CVD is so incredibly weak.
While in Italy, I shopped for food in ordinary small-town grocery stores and Siena’s outdoor market the first week while I stayed in a rural farmhouse agriturismo apartment and prepared meals for myself and my family. The grocery stores had abundant produce (however, too much was imported, underripe, or past freshness, to my surprise) and I observed a lot of processed convenience food being purchased by ordinary Italian families. We bought very nice free-range eggs from the farm where we stayed, where chickens were free to roam a large penned area and eat grasses and bugs. I mainly purchased and prepared easy meals made with fresh produce, some traditionally cured meats, fresh sausages, cheese, olive oil and vinegar dressing, butter, and eggs from the farm where I stayed, which is a pretty highly saturated fat diet and *very traditionally Italian*, therefore very Mediterranean as far as I can tell. We weren’t near the coast, so I didn’t prepare any fish. Oh yes, we enjoyed a bit of local red wine every day, too, and a fair amount of espresso with heavy cream or whole milk. I consumed no grains and only a minimal qty of refined sugars (my indulgences were some 70-85%dark chocolate squares and locally made gelato). My BG remained in my normal range, except for a few slight blips up after gelato. I even felt like I might have lost a few pounds while enjoying the bounty of the Tuscan countryside, despite a lot of time relaxing by the pool reading and leisurely strolls on the rural road (far less activity than I am accustomed to), plus a bit of touring of the hill towns center squares and museums, etc.
The second week I spent in Italian cities, without kitchen or food prep options. I walked a lot, sometimes briskly, sprinted for Metro trains, and climbed many, many stairs, often two at a time (hotel rooms on 3th and 5th floors, which really means 4th and 6th). So I would say my activity level, while not “gym” strenuous, was not nearly as leisurely as the previous week.
Our hotels provided a “continental” breakfast at a nearby café, consisting of a hot coffee, tea, or chocolate drink and some sort of pastry or roll, but without additional butter. At first I avoided the pastry and instead went out of my way to purchase antipasto plates of cold meats and cheeses to avoid a BG issue (plus meat and cheese for breakfast delayed hunger development until mid-afternoon).
But then, I thought, this is only one week, it’s a good opportunity to experiment and experience as much of an “Italian”, ordinary Mediterranean diet as I could. So I had the roll/croissant (still hungry after breakfast and even hungrier an hour later), the ubiquitous panini for lunch, and the pasta course with my dinner. Main courses didn’t come with vegetables so in order to have vegetables I had to order those in addition or else there would be few vegetables with dinner.
I immediately began to experience high and erratic BG levels, water retention, and uncomfortable edema in my lower legs and feet (not fun any time and worse while sightseeing), and my formerly comfortable clothes felt too tight. My energy levels were erratic, and I was constantly hungry even though I was eating less meat & saturated fat, more starch, and more like the recommended “Mediterranean diet” as it was most easily available, and certainly more like all the other people that were eating around me (I can only guess what people eat at home but I assume it wasn’t much different).
By the end of the week, my fasting BG was averaging 115 mg/dL, much higher than usual (my average is on the high end of normal at 90-100 mg/dL). My husband also joined me in this lower fat/ higher carb “Mediterranean” experiment (he does not have BG regulation problems – that we know of) and he once again experienced the headaches, bloating and indigestion, and sleeping problems that had gone away when he joined me in a low carb way of eating in 2004.
Note that I didn’t even consume as many carbs as is typically eaten, as I often removed and didn’t eat the top piece of bread of a panini sandwich, only ate a half portion of the pasta course, and perhaps half of the dinner’s dessert course if it was made with flour. And I don’t drink juice or sugary beverages at all. So while that week’s food was high in sugar and starch for me, it was lower than average from what I could observe. And some days I couldn’t just face a starchy sandwich with only a bit of filling at lunch (salads were generally small and without any protein so not suitable for more than a side dish) so I had a kebab plate with salad without bread, just so I could feel a bit more more normal.
Looking around me in the cities, of course it was easy to pick out plenty of relatively fit, healthy Italians of all ages, and overall, the elder citizens did seem a bit fitter and healthier than in the US. But there were also far more overweight and somewhat disabled (by their weight) Italians than I expected to see (though not nearly as many as I see commonly in the US). Lots of “wheat bellies” and “muffin tops”, even on laborers, as well as nearly as high a percentage of overweight children as in the US (and all consuming processed, sugary junk). And I saw clear signs of diabetic disease in progress, with walking problems, skin issues (especially on the lower extremities), acanthosis nigricans, etc. just with my everyday contact with passersby. So if CVD rates are lower in the Mediterranean region, I’m guessing either all the saturated fat is actually protective or it isn’t diet at al, but some other factor or combination of factors.
Interestingly, the very buff, muscular owner of the café where we breakfasted for 4 days, said he didn’t eat pasta, as he patted his 6 pack abs that rippled through his fitted t-shirt.
I couldn’t wait to get off the bread, pasta, and sugar and back to my best energy sources – eggs, full fat dairy, meat, some fish and poultry, and good old fashioned natural fats, with plenty of fresh non-starchy vegetables and big salads. Italy and the Mediterranean region provide these nutrient dense, traditional foods in abundance, but I have serious doubts about the healthiness of the starches and sugars that make up too much of the food supply there diet. In two days back on low carb foods, the edema in my legs/feet was greatly reduced, and my BG was closer to my normal range and steadier. Phew, despite enjoying good crusty bread and croissants again, I’m glad that experiment is over, though I can’t wait to go back to Italy for more of the rustic prosciutto (hand sliced from the leg, covered with a fine green mold), the wonderful mascarpone cheese, and anything made with pork or lamb, along with a big arugula salad with pine nuts and gorgonzola. That’s my kind of Mediterranean diet, not the bowls of sugar and starch.
Oh yes, I almost forgot the Cortadella, a very traditional Italian dish of lamb offal (heart, kidney, liver, and lung. We were clearly the only tourists at that restaurant, where they specialize in the “fifth quarter”. No one mentions those dishes when they talk about the lauded “Mediterranean diet”.
Dr B, are you going to respond to superburger’s question?
If the answer is ‘yes’ then it supports superburger’s assertion that “there is plenty of evidence that a diet low in saturated fat can reduce CHD”.
If the answer is ‘no’ then could you please set out the reasons why you think the conclusions the study authors drew from the data were wrong.
Perhaps you could also explain why you think that a single study is evidence but a study of studies isn’t?
Dr B,
The Womens health Initiative intervention group not only reduced intake of (“harmful”) saturated fats, but also reduced intake of monounsaturated and polyunsaturated fats, which are thought to be beneficial.
In your opinion, would this have had any impact on the outcome?
ross
What precise “conclusions” are you referring to?
And I think we all need to note your inability or reluctance to quote the actual evidence. And superburger remains quiet on this matter too.
Dr Briffa,
the evidence is the meta-analysis that Hooper et all perform on the 27 pieces of work which meet their selection criteria. To say that paper X from the 27 is the evidence of Y is not an appropriate use of the meta-analysis data.
The point (as you are well aware) is that the combined results (shown in table 2) are the basis for Hooper’s conclusion – it is a systematic review of the existing literature.
So, as enquiring minds want to know,
“Do you, or do you not agree with Hooper et al’s conclusions?”
superburger
What conclusions, specifically, are you referring to.
Also, could I ask you again to cite the evidence that supports your assertion that “there is plenty of evidence that a diet low in saturated fat can reduce CHD”. Come on, it can’t be that difficult (just show us the studies).
The (plain language summary) conclusion which Hooper et al make is
“Cutting down how much fat we eat or replacing some saturated (animal) fats by plant oils and unsaturated spreads may reduce risk of heart disease, probably including fatal heart disease. Heart disease includes heart attacks, chest pain, strokes and the need for heart surgery”
do you agree with the methodology that Hooper et al emply. Yes or No?
do you agree with the results (e.g. table 2) shown by Hooper et al. Yes or No.
do you agree with the conclusions drawn by Hooper el al, as described in their review. Yes or no.
superburger
“Cutting down how much fat we eat or replacing some saturated (animal) fats by plant oils and unsaturated spreads may reduce risk of heart disease, probably including fatal heart disease.”
Yes, it “may” do, and then again, it may not. And the reason is the results of this meta-analysis were dismal. Once the Oslo Heart Trial was excluded, it showed (though you must know this, no?) no statistically significant reduction in risk of CV mortality, total mortality or CV events.
In studies over two years in duration, same results, but CV events were lower. Oh, but only those deemed at high risk (not those at moderate or low risk), and only in men (no data in women).
So, what in here, superburger, supports your assertion that: “there is plenty of evidence that a diet low in saturated fat can reduce CHD”. Just to remind you, many of the studies included here did not explicitly reduce saturated fat, or utilised other interventions.
Come on, superger, be a man (or woman) and just admit that you’re unable to support your assertions with science. We’d all think more of you if you just put your hands up. (If, of course, we knew your true identity. It’s dawning on me why you like to hide behind anonymity: I would too, if I were making hopelessly unscientific assertions in the name of science).
Hmm how long has the low fat been around? How long ago did people start getting fat? How long ago did diabetes start climbing? After 3 mild attacks doing low fat/veggie eating I’m enjoying my steaks n eggs and keep carbs <50 PER DAY….1yr so far…
John Briffa said of superburger,
“It’s dawning on me why you like to hide behind anonymity: I would too, if I were making hopelessly unscientific assertions in the name of science).”
Dr Richard Horton, the esteemed editor of The Lancet, wrote an interesting chapter in his book ‘MMR: Science & Fiction’ called ‘The Dawn of McScience’. The chapter is about the financial conflicts of interest in science and the threats inherent in its commercialisation. However, I’m still not sure whether Horton was referring to the McCarthyism of science or its McDonaldisation. Nevertheless, I am of the opinion that ‘superburger’ is that BigMac in the sky, fully representing ‘the risen son of McScience’.
Superburger : Plant oils as sold in supermarkets for cooking (apart from olive)are plastic and found nowhere in nature. When hydrogenated they are actually saturated as hydrogen is stuck onto the free bonds. Spreads are even worse and will block arteries and cause cancer faster than anything.
You keep quoting from a particular source as if that source is definitive proof. There are different sorts of sat fats. In fact coconut oil is highly saturated but with medium chain fatty acids and is one of the best oils.
Hilda says:
Superburger : Plant oils as sold in supermarkets for cooking (apart from olive)are plastic and found nowhere in nature. When hydrogenated they are actually saturated as hydrogen is stuck onto the free bonds. Spreads are even worse and will block arteries and cause cancer faster than anything.
You keep quoting from a particular source as if that source is definitive proof. There are different sorts of sat fats. In fact coconut oil is highly saturated but with medium chain fatty acids and is one of the best oils.
August 1, 2008 @ 12:12 pm
Personally I would appreciate seeing a tabulated comparison of what we know a low fat diet doesn’t do as against what a high carb diet does do?
I have posted this before – but here we go again. About two years ago I gave up a decade of vegetarianism and went ‘paleo’. My body fat has fallen to well under 10%. I sustain this with ease. I no longer get ‘hunger-shakes’ unlike when I was a grain eater. When I eat, I eat until I am full. I don’t do calorie counting or that whole dieting and chronic hunger thing.
In a typical week I will eat a whole (free-range) chicken, saving the juices and using the fat for frying and the rest of the juice as a stock for soup. I also put away two large steaks (grass fed beef), a pack of lamb’s liver, a pack of bacon, upto 12 eggs, about 10 tins of tuna/sardines/mackerel. In addition I will eat a mix of barzil, pecan, walnut and almond nuts most days (this actually forms a ‘meal’ along with some fruit). Each meal of meat is accompanied by some veggies – broccoli, caulifllower etc.. and the fish is usually eaten with a salad. I moderate fruit consumption.
What I want to emphasise here is the meat content of my diet (inclujding the chicken juices) and the absence of bread, rice, pasta, cereal, grains and potatoes. After a year of eating this way I went for a cholesterol test (judged against the Framingham templated), the results of which the doctor described as “excellent”.
I know that dietary choesterol is of little significance to your cholesterol levels, but I went for another test today as it is now about two years since my adoption of a paleo diet. I get the results on Tuesday and will post them on here.
All supporters of the low fat diet way of eating need to remember one thing. That our bodies are actually made up of guess what yes saturated fat!! what is natural & normal is good for us. huge amounts of grains & starches (sugars) aren’t. get over it, but by all means eat it if that is what you want. just don’t expect those of us who would rather eat grain & starch free diets to follow you down the path of obesity, heart disease, cancer & diabetes problems that the resulting low fat diet experiment over the last 30 to 40 years has produced. Now there’s a meta analysis for you the human population over the last 40 years eating the low fat diet way!!
Well I went low carb and it made me feel ill and full of wind! I wonder, are there any studies comparing gender differences in response to low carb diets? I think women need carbs more than men and are not so happy to eat a lot of meat. Am I correct in thinking that carbs help to create serotonin, so that low carbs means low seratonin levels?
My results were ‘normal’ with no further action necessary:
Serum Cholesterol 4.8
Triglycerides: 0.5
So two years in to eating a chicken (including the skin), a couple of steaks (including the fat), 8 rashers of bacon (fried in the chicken fat saved from the fowl above), one lamb’s liver and upto 12 eggs a week I have a normal cholesterol level and body fat well under 10%. I should also point out that I do not eat whole grains, pasta, rice, cereal, bread or potatoes.
I can’t understand how my diet can go against the advice from the BDA, BHF, NHS and AHA, yet my health is so good. I hope that any readers from these esteemed organsiations can explain these seemingly contradictory results.
SkepTicTacToe said,
“My results were ‘normal’ with no further action necessary”
What is the ‘meaning’ of a ‘normal’ cholesterol in relation to ‘good health’? Personally, I think a cholesterol ‘level’ is meaningless.
“Well I went low carb and it made me feel ill and full of wind!”
It’s always amazing to me how many people “think” they went low carb, but actually didn’t (still consuming well over 75 gms or more of CHO per day, or LC one day, not LC the next because there was birthday cakes or something silly like that). Or that they lowered carbs for a few days or even a week or two, without realizing that the body needs a fair amount of time to convert over to burning fatty acids for fuel most of the time, instead of rarely. It is not uncommon to feel a bit out of sorts for 3-4 weeks while the metabolism makes the fuel transition. Here’s a link for an explanation of some research on this: www dot nutritionandmetabolism dot com/content/1/1/2
My husband and I actually find the “wind” increases *with starch* consumption, after our years of LC eating (I can always tell when he eats the bread at dinners out). My guess is it is due to not having the starch enzyme (amylase) production up during our regular LC diet, because it isn’t often needed in qty.
For those who tend to not eat much of the non-starchy foods, it might take time to get lipase, etc. in sufficient production, with “wind” to deal with in the transition. Use it or lose it, in essence. But it does come back, with sufficient demand.
Cybertiger, I broadly agree with you. IIRC Triglyceride levels and LDL Sub-type B cholesterol levels are the main indicators of risk of CHD.
As for my results – they are presented exactly as the doctor’s receptionist fed them back to me. I can’t really expand on them much more, other than to say that they compared my results against the Framingham template and in doing so, concluded that my levels were ‘normal’ – whatever that means.
I only took a cholesterol test to reassure those around me (who think I am a endangering my health by eating ‘paleo’ ), that the medical establishment may not agree with my diet, but by their own indicators, I am healthy.
Dr Briffa,
Two questions:
I notice that many of the studies you’ve been citing (in fact, most studies of this sort) refer to weight loss and BMI but not to waist-hip ratio. I vaguely recall that in fact you’ve been a proponent of waist-hip ratio as a better indicator of health than absolute weight or BMI. Is that now yesterday’s theory, or is it just that waist-hip still hasn’t caught on, and we make do with what scientific research we can get?
My other question is about food combining. You haven’t said much about it over the past few years, but your last post suggested that anecdotally it could help those with indigestion. It does strike me that food combining has some similarities to Atkins, in that it supports a diet high in fat and protein – but restricts carbs to meals which do not include fat and proteins. Has anyone tried comparing these two diets to other diets, and indeed controls? Although current theories about GI/GL would suggest that food combining would only help for the carb-free meals, I wonder whether anyone has actually tested this. Most of the carb-heavy meals in conventional diets are high in fats (e.g. pasta with olive oil-based sauce) and would not be a good test of food combining theory.
Thanks,
JL