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Author Topic:   More on Diet and Carbohydrates
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 131 of 243 (752039)
03-08-2015 9:08 AM


The Players
As they say, you can't tell the players without a program. I've scanned back through the thread a couple weeks, and here, in alphabetical order, are what I think each person's views are on the areas of the topic on which they've expressed an opinion:
  • Caffeine: Believes that increasing rates of obesity are due to a variety of factor and doesn't see dietary advice as a significant factor.
  • Coyote: Believes that public perceptions about nutrition can influence the mix of products offered by the food industry. Believes a low carb diet is effective for weight loss.
  • Faith: Believes that dietary advice against fat has been pervasive over the past half century or so and has driven significant changes in the American diet in an effort to avoid dietary fat. Believes a variety of factors could be behind the rising rates of obesity, diabetes and heart disease.
  • Jon: Believes that the obesity epidemic is due to bad habits gradually taken up by the American public (primarily increased intake of fast food, junk food and calories in general, and decreased amounts of exercise) and that there is little evidence the nutrition advice community (including the government) played any significant role.
  • NoNukes: Believes that public perceptions of nutrition do not have a significant influence on the mix of products offered by the food industry. Regarding the premise that bad dietary advice caused the obesity/diabetes/heart-disease epidemic, seems to be seeking a direct causal chain of evidence linking dietary advice to health, not statistical correlations.
  • Nwr: Believes government guidelines had very little effect on the eating habits of Americans, nor or on the product mix offered in grocery stores.
  • Percy: Believes that nutrition advice (from a variety of sources but anchored by government guidelines) concerning the detrimental health effects of dietary fat on obesity, diabetes and heart disease is responsible for the increased levels of carbohydrates (especially refined carbohydrates) in the American diet. Because carbohydrates, not fat, are responsible for these diseases of western civilization, this advice caused the very health concerns it was meant to address to dramatically worsen.
PM me feedback, I'll make corrections.
--Percy
Edited by Percy, : Correct Faith's entry.

Replies to this message:
 Message 132 by Jon, posted 03-08-2015 3:06 PM Percy has replied

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 133 of 243 (752115)
03-08-2015 6:03 PM
Reply to: Message 132 by Jon
03-08-2015 3:06 PM


Re: The Players
It might help me and Faith more than anyone else. Judging by a couple of the responses we've gotten, it appeared that we hadn't properly ascertained what some people were saying. For instance, we both felt certain that you didn't believe there's been any pervasive "fat is bad" message out there, but you said no. I just wanted to make it easy to avoid getting what different people were saying confused with one another.
--Percy

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Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


(2)
Message 150 of 243 (758508)
05-27-2015 12:52 PM


Demonstrating that Saturated Fat Doesn't Cause Heart Disease
The primary foundation of the modern nutritional advice of the USDA, AHA (American Heart Association) and ADA (American Diabetes Association) is that intake of saturated fat is associated with elevated risk of heart disease, stroke, obesity and diabetes. For the past couple weeks I've been reading The Big Fat Surprise by science writer Nina Teicholz, which explores how saturated fat got the rap for heart disease. The reasons are instructive in the ways that research can go awry, but near the end of her book she references the 2010 paper Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease by Ronald M. Krauss et al.. It found that saturated fat was not associated with increased risk of CHD [Coronary Heart Disease], stroke or CVD (CardioVascular Disease). This study is evidently beginning to have an impact on the internal scientific debate on the effects of saturated fat in the diet.
While I haven't yet finished The Big Fat Surprise, it's apparent by now that it reaches the same conclusions as Gary Taubes in his book Good Calories, Bad Calories, that the focus on saturated fat as the cause of increased rates of heart disease, diabetes, stroke and cancer (the diseases of civilization) has been misplaced, and that the resulting increased intake of carbohydrates has been largely responsible for the obesity and diabetes epidemic. Death rates from heart disease and stroke have fallen around 35-40% over the past 15 years or so, but much of that is due to improved interventions rather than the success of the dominant nutritional dietary advice to lower saturated fat intake.
Much official dietary advice is just a caution to avoid too much or too little of all kinds of foods, but there are two messages that come across most clearly. One is that saturated fat increases the risk of heart disease and should be avoided. The other is that carbohydrates are better for you, though sugar and refined carbohydrates should be avoided or minimized, and that complex carbohydrates, usually associated with high fiber content, are better for you. But no health risks are associated with carbohydrates. Most people would conclude from guidelines like the USDA's that sugar is better for you than saturated fat, when the reality is that saturated fat is good for health, especially heart health because it improves the HDL/LDL ration, and it increases the proportion of good LDL (low density LDL) versus bad LDL (high density LDL), and it reduces the level of triglycerides in the blood. And saturated fat is far, far more healthy for you than sugar.
In other words, we have enough data now to know the existing nutritional guidelines regarding saturated fat versus carbohydrates is wrong. Vegetable based fats (polyunsaturated fats like corn oil, and excluding the few monounsaturated fats like olive oil) are the ones that were touted as better for you for so long, and this includes the partially hydrogenated fats that were eventually discovered to contain dangerous trans-fats that can substitute for normal fats in cell walls and disrupt the cell's ability to regulate what passes in and out, and that's not the only risk, just the one we understand best. The shift away from partially hydrogenated fats has led to greater use of hydrogenated fats that introduce a host of artificial fatty acids whose health effects have not yet been studied but which are deemed healthy simply because of the logic that because they're derived from vegetable sources that they must be healthy. But dangerous trans-fats also derived from vegetable sources, therefore this logic is wrong. We know no more today about the dangers of fully hydrogenated fats in our foods than we did about the partially hydrogenated fats in our foods 20 years ago.
--Percy
Edited by Percy, : Fix muddled 2nd sentence in the last paragraph about polyunsaturated fats and partially hydrogenated fats.

Replies to this message:
 Message 151 by Jon, posted 05-27-2015 4:07 PM Percy has seen this message but not replied

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 153 of 243 (758521)
05-27-2015 6:08 PM
Reply to: Message 152 by ringo
05-27-2015 4:16 PM


Re: Muffin or Flaky Pastry Type?
ringo writes:
(There's a running joke among my cousins that if you have flour and lard you can cook German food.)
The Big Fat Surprise describes how in the early 20th century before the invention of the process of hydrogenation and the rise of Crisco that the recipes for many baked goods and pie crusts called for lard. The introduction of vegetable oils and the shift away from saturated fats forced the food industry to reformulate their products and caused a reworking of all the recipes in cookbooks.
Interestingly, returning to lard introduces difficulties that didn't used to exist. This past Memorial Day weekend we made mayonnaise from bacon lard and used it to make potato salad which we then stuck in the fridge. At mealtime we discovered that at refrigerator temperatures lard is a solid. We had to wait for the potato salad to warm up before we could eat it.
I just did a quick read of the Wikipedia article on lard, and it mentions in a couple places that lard is making a little bit of a comeback here and there, such as at high end restaurants.
If the first table in that article is to be believed then none of the cooking fats/oils is purely one type of fat. This leads me to wonder how it is possible for a food product to have 0% saturated fats and non-zero amounts of unsaturated fats if all fats/oils have at least some amount of saturated fats. The oil lowest in saturated fat is sunflower oil at 11%.
--Percy

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Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


(3)
Message 155 of 243 (762160)
07-09-2015 12:38 PM


Is fat's bad rap finally coming to an end?
In today's New York Times researchers Dariush Mozaffarian, MD, DrPH1 and David S. Ludwig, MD, PhD argue that it is well past time for the federal government to lift their restrictions on dietary fat (Why Is the Federal Government Afraid of Fat?). They reference their article in the Journal of the American Medical Association (The 2015 US Dietary Guidelines: Lifting the Ban on Total Dietary Fat, unfortunately all but the first page is behind a paywall) and argue that past guidelines have been arguably unhealthy by encouraging increased consumption of carbohydrates and by limiting consumption of a nutrient that better evidence is showing was never bad for us in the first place.
Most significant excerpt from page 1 of the JAMA article:
JAMA writes:
"Randomized trials confirm that diets higher in healthful fats, replacing carbohydrate or protein and exceeding the current 35% fat limit, reduce the risk of cardiovascular disease. The 2015 DGAC report tacitly acknowledges the lack of convincing evidence to recommend low-fat-high-carbohydrate diets for the general public in the prevention or treatment of any major health outcome, including heart diesease, stroke, cancer, diabetes, or obestiy. This major advance allows nutrition policy to be refocused toward the major dietary drivers of chronic deseases."
Bottom line: When you see products labeled "Low Fat" or "Reduced Fat" in the grocery store, leave them be. Better to buy food based on how little processing was involved and how few refined carbohydrates it contains. Cold cuts, cookies, nacho chips, Sugar Frosted Flakes, stay away and instead welcome steak, regular cheese, eggs, whole milk, fruit and anything truly made with whole grains.
--Percy

Replies to this message:
 Message 156 by Coyote, posted 07-09-2015 9:46 PM Percy has replied

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 159 of 243 (762266)
07-10-2015 7:16 AM
Reply to: Message 156 by Coyote
07-09-2015 9:46 PM


Re: Is fat's bad rap finally coming to an end?
Coyote writes:
Bacon! You forgot bacon!
D'oh!
Bacon *is* a processed food, and there *are* health concerns about bacon (something about nitrates) and processed foods in general, but I'm wary of the conclusions of health research, plus the processing associated with foods like bacon and sausage (at least when purchased at the butcher shop instead of in plastic wrap at the supermarket) is what I'll call "traditional," going back literally centuries and more.
--Percy

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 Message 156 by Coyote, posted 07-09-2015 9:46 PM Coyote has seen this message but not replied

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 163 of 243 (762783)
07-16-2015 7:42 AM


Bad Research
"Restaurant food not much healthier than fast food" announces a recent article in Philly Voice. Researcher Ruopeng An, a professor of kinesiology and community health at the University of Illinois at Urbana-Champaign, reached this conclusion after data mining NHANES (National Health and Nutrition Examination Survey). Nothing wrong with data mining of this sort, but it made me just a bit curious when I didn't see carbohydrates in the list of factors and nutrients he focused on: calories, fat, saturated fat, cholesterol and sodium.
The bare essentials of his paper are on-line (Fast-food and full-service restaurant consumption and daily energy and nutrient intakes in US adults), and though the details are behind a paywall there was enough to confirm that he did indeed focus only on calories, fat, saturated fat, cholesterol and sodium.
But recent research indicates that saturated fat, cholesterol and sodium should not be on anyone's list of nutrients of concern. Dietary cholesterol has no effect on serum cholesterol. The body manufacturers its own cholesterol, we have known this for over half a century, and the USDA is finally acknowledging this and removing its advice to reduce dietary cholesterol from the Dietary Guidelines for Americans, 2015 that will be released later this year.
We're also learning that saturated fat is actually good for us, and that reducing sodium intake (translation: use less salt) has negative health impacts that we're finally beginning to understand, and that the body fights hard to retain sodium to a certain level.
Although Michael Pollan (he of The Omnivore's Dilemma and In Defense of Food) has not jumped on the "carbs are the cause of the diseases of western civilization" bandwagon, he was way out in front of the current paleo diet craze with his advice to eat the same foods as your great and great great grandparents, who followed no advice to reduce intake of saturated fat, cholesterol and sodium.
--Percy

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 166 of 243 (762992)
07-19-2015 8:38 AM


Just How Ineffective are Dieting and Exercise
An article in today's Business Standard describes research revealing that most obese people are likely to stay fat:
quote:
The chance of an obese person attaining normal body weight is one in 210 for men and one in 124 for women, increasing to one in 1,290 for men and one in 677 for women with severe obesity, the findings showed.
...
"This evidence suggests the current system is not working for the vast majority of obese patients," Fildes said.
The paper, Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records, actually describes the problem much better than the non-technical article:
quote:
Overweight and obesity are growing global health concerns. Strategies to control obesity emphasize obesity management and weight reduction as well as obesity prevention. In the United Kingdom, a national strategy report recommends that the management of obesity be an integral part of clinical practice. This envisages that patients may transition from obesity to a more healthy body weight. A target of 5% body weight loss is often recommended for obese individuals who intend to lose weight. However, access to weight management interventions may be limited, and weight management interventions have only small and poorly maintained effects on body weight. To understand the frequency with which reductions in body mass index (BMI, defined as weight in kilograms divided by the square of height in meters) may occur in a large population, we estimated the probability of an obese individual attaining normal body weight or a reduction of 5% in body weight.
Did you catch the key sentence in the middle of that paragraph. "Weight management interventions have only small and poorly maintained effects on body weight." Ain't it the truth.
If dieting and exercise are such huge failures (see first quote, 1 in 210 for men, 1 in 124 for women, of achieving a normal weight), why do we persist? One possibility is that if we didn't we'd be even fatter, but while this must be true to a degree, we also know that the body seems to pick its own weight range, and that eating more or eating less has a greatly diminished effect outside that range. Certainly you can't blame people for the failure of these strategies - when something works for almost no one, it isn't people's fault.
Until doctors can point to effective weight loss strategies, say at least 50% successful, they should abandon the annual shaming that the annual physical has become.
--Percy
Edited by Percy, : Change author.

Testing my signature.

Replies to this message:
 Message 167 by Jon, posted 07-19-2015 9:49 AM Percy has replied

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 171 of 243 (763011)
07-19-2015 1:43 PM
Reply to: Message 167 by Jon
07-19-2015 9:49 AM


Re: Just How Ineffective are Dieting and Exercise
Jon writes:
If dieting and exercise are such huge failures (see first quote, 1 in 210 for men, 1 in 124 for women, of achieving a normal weight), why do we persist?
Because we know the ill effects obesity has on overall health.
Are you saying we should persist in trying to reduce obesity? If so, sure, everyone agrees with that.
What I was actually asking is why we persist in promoting obesity amelioration strategies that have such extreme and demonstrated records of failure.
Well, just 'cause the doctor doesn't have a treatment up her sleeve doesn't mean she shouldn't tell you there's something wrong.
Are you saying doctors should continue warning patients about the dangers of obesity? If so, sure, probably everyone agrees with that, too. What doctors shouldn't be doing is pretending they have effective solutions.
--Percy

This message is a reply to:
 Message 167 by Jon, posted 07-19-2015 9:49 AM Jon has replied

Replies to this message:
 Message 172 by Jon, posted 07-19-2015 2:16 PM Percy has replied

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 173 of 243 (763022)
07-19-2015 4:07 PM
Reply to: Message 172 by Jon
07-19-2015 2:16 PM


Re: Just How Ineffective are Dieting and Exercise
Jon writes:
What are 'obesity amelioration strategies'?
Dieting and exercise.
When you said If dieting and exercise are such huge failures ... , why do we persist?, what exactly did you mean?
Rephrasing without the confusing "obesity amelioration strategies" phrase, what I was actually asking is why we persist in promoting dieting and exercise when they have such extreme and demonstrated records of failure.
If that's the position you want to take now,...
I apparently wasn't as clear as I hoped, but if in clarifying my meaning I'm to be accused of changing my position then you'll soon be talking to yourself.
..., but I will still disagree with the position you took in Message 166 which argued that doctors without solutions at least 50% successful should just keep their mouths shut:
Until doctors can point to effective weight loss strategies, say at least 50% successful, they should abandon the annual shaming that the annual physical has become.
I didn't say they should keep their mouths shut. I said they shouldn't engage in shaming, i.e., blaming the victim for the problem.
--Percy

This message is a reply to:
 Message 172 by Jon, posted 07-19-2015 2:16 PM Jon has replied

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 Message 174 by Jon, posted 07-19-2015 5:09 PM Percy has seen this message but not replied

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 175 of 243 (763027)
07-19-2015 5:44 PM
Reply to: Message 174 by Jon
07-19-2015 5:09 PM


Re: Just How Ineffective are Dieting and Exercise
Jon writes:
Rephrasing without the confusing "obesity amelioration strategies" phrase, what I was actually asking is why we persist in promoting dieting and exercise when they have such extreme and demonstrated records of failure.
What alternatives do you suggest?
I'm not suggesting alternatives. I'm suggesting that the health and medical establishments not promote alternatives with a demonstrated record of abject failure. If they don't have any effective answers then they should say so.
Some medical conditions are entirely the result of the patient's actions. Obesity is one such problem.
You'd make a great GP, shaming your patients and sending them on their way with solutions that don't work so that next year they can return in the same overweight state and you can shame them again. Bravo.
--Percy
Edited by Percy, : Change author.

Testing my signature.

This message is a reply to:
 Message 174 by Jon, posted 07-19-2015 5:09 PM Jon has replied

Replies to this message:
 Message 176 by Jon, posted 07-19-2015 7:36 PM Percy has replied

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 177 of 243 (763053)
07-20-2015 6:17 AM
Reply to: Message 176 by Jon
07-19-2015 7:36 PM


Re: Just How Ineffective are Dieting and Exercise
Jon writes:
A solution unlikely to succeed is better than no solution at all.
Except that the diet and exercise solution may actually be worse than no solution, since there is gathering evidence that weight cycling (the usual result for most people who try dieting and exercise) is bad for one's health (see, for example, Weight Cycling, Weight Gain, and Risk of Hypertension in Women).
--Percy

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 Message 176 by Jon, posted 07-19-2015 7:36 PM Jon has not replied

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


(1)
Message 179 of 243 (766236)
08-15-2015 10:01 AM


Low-fat Diets Fight Back
A recently published study in Cell Metabolism indicates that low-fat diets are more effective for losing weight than low-carbohydrate diets. The study was by the National Institutes of Health (Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity). Here's a couple popular press articles about the study:
If this holds up (the study was small, only 19 subjects) then we're beginning to see a more complete but complex picture:
  • For weight loss, caloric reduction through decreased fat intake is more effective than through decreased carbohydrate intake.
  • This would imply that replacing fat in the diet with carbohydrates would be a good weight reduction strategy, but most people's experience says this isn't true. I propose that this is because most people end up replacing fat in the diet with *refined* carbohydrates, which are very difficult to avoid in the grocery store these past few decades.
  • Dietary advice from many sources, but primarily the diet industry and the USDA guidelines, has pushed people away from fat and toward carbohydrates. The intention wasn't to push people toward refined carbohydrates (and in fact they advise minimizing them), but that has been the result, particularly because they highlighted the dangers of fats but not carbohydrates.
  • The origin of the advice against fat was because of its supposed negative health benefits (heart disease and stroke), but research is now telling us that the dangers of fat are not just exaggerated but in some cases even 180° wrong. Trans fat, an invention of the food industry, *is* bad for you, but natural fats, particularly saturated fats, are not.
--Percy
Edited by Percy, : Grammar.

Replies to this message:
 Message 180 by nwr, posted 08-15-2015 8:43 PM Percy has seen this message but not replied

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 184 of 243 (766282)
08-16-2015 8:01 AM
Reply to: Message 181 by Faith
08-15-2015 10:04 PM


Faith writes:
I'm facing the fact that I have to diet again now and the idea of eating LEAN meat is the hardest part of my doctor's idea of how to go about it. I can't do it that way. I can personally do a lot better if I just chuck the pasta and bread.
I wish it were possible around here to buy non-lean meat. 40 years ago it was easy to buy a cheap cut of meat with plenty of fat. Since I liked fat marbled in with my meat it made no sense to pay for leaner cuts, plus as a student I couldn't afford it anyway. Now even the cheap cuts are lean and expensive.
--Percy

This message is a reply to:
 Message 181 by Faith, posted 08-15-2015 10:04 PM Faith has replied

Replies to this message:
 Message 187 by Faith, posted 08-16-2015 8:55 AM Percy has seen this message but not replied

  
Percy
Member
Posts: 22391
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.2


Message 185 of 243 (766283)
08-16-2015 8:08 AM
Reply to: Message 182 by Coyote
08-15-2015 11:20 PM


Re: On diets
I try to avoid combining fat and carbs in the same meal. There's something about the combination that is very bad for weight control for me. My worse food ever? Chinese fried rice. The white rice is a refined carbohydrate, and everything else they put in it is full of fat. It's also one of my favorite foods.
--Percy

This message is a reply to:
 Message 182 by Coyote, posted 08-15-2015 11:20 PM Coyote has seen this message but not replied

Replies to this message:
 Message 186 by Faith, posted 08-16-2015 8:53 AM Percy has replied

  
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