Bandolier - Evidence based thinking for health care

[Chris2041]

Not sure if this has been discussed but the following link takes you to a report on the evidence surrounding LC diets and gives a very positive thumbs up.

http://www.jr2.ox.ac.uk/bandolier/band113/b113-4.html

Quote:

"What are we to learn from all this? First, perhaps, that there is not a huge amount of evidence. What there is suggests that low carbohydrate diets are likely to deliver a larger weight reduction, certainly at about six months. Moreover, more people on low carbohydrate diets stay on them for longer. Neither of the randomised trials did anything in particular about exercise, a very important component of lifestyle changes needed for sustained weight loss.
The higher proportions of protein and fat do not seem to adversely influence risk factors like total and LDL cholesterol, and probably improve risk factors by reducing triglyceride levels and perhaps increasing HDL cholesterol levels. There may be small changes to insulin resistance. "

Chris

[alaskaman]

Interesting- just a random thought here, at my work we subscribe to a database called "Evidence-based medical reviews." Scary thought, do you want anybody doing medicine on you that's NOT evidence based?What's all the other stuff then? Actually, cynically speaking, the answer is 'dogma based" , "base your diet on starches," says the ADA, "eat 6-11 servings of bread/starch daily" says the pyramid. Bill

[Chris2041]

Hi Bill, Too true! I think the terms Dogma, Ritual, follow my leader, because it's always been so!, it's what I was taught, but it couldn't possibly work. Sums it up quite well.

As for evidence based practice it's a good idea if people actually look at the evidence! not much of that going on it appears.

[VALEWIS]

Anyone anti-lc will read this and then say, "yes, but its all because they lost weight...but they are at risk of kidney (liver etc) problems which weren't considered in this research." Someone needs to do a similar study of the literature and put that one to bed as well. Anyone know if its been done?

Val

[Yar]

Val, here is one study, on high protein and kidney.

CONCLUSIONS: High protein intake was not associated with renal function decline in women with normal renal function. However, high total protein intake, particularly high intake of nondairy animal protein, may accelerate renal function decline in women with mild renal insufficiency.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12639078&dopt=Abstract&itool=iconabstr

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The "may accelerate", is not a scientific conclusion, it either does or does not.
I wonder why they always use that phrase, i would like them to change it to "may not" for a change.

Ray

[Chris2041]

Val, a valid point but I would counter with the argument with 'proving a negative is almost impossible, therefore, show me a study that demonstrates Kidney/Liver problems associated with LC diets.'

[VALEWIS]

And that was my question...has anyone studied the literature to see if this has been done or demonstrated? I don't think there is anything other than hearsay, but then I haven't done the research. Yar cites one study, above. I have certainly heard anecdotal evidence that lc actually corrected a kidney problem in one case.

Val

[Yar]

It is difficult to find studies on healthy people, the normal route for studies, is to find new drugs for a particular disease or ailment.
My own thoughts are, that research should be looking at what makes healthy people healthy , that is the road i decided to take..
This has been done in the past by many researchers, Weston Price, to my mind would be in the forefront of these researchers of days gone by, who have found in the majority of cases, that a diet of fresh foods and in the main a diet high in good fats, has been eaten by the healthiest of people.
Within my family we have overcome 2 cases of Diabetes and 1 Lupus, by going low carb as our way of eating, no grain and no manufactured processed foods of any type, which has been of great benefit, this was achieved without a pill, potion or doctor.
My brother recently completed a questionaire on low carb diets, i am sure he wouldn't mind if i post here a couple of his answers.

8/ What are the positive things about the diet

A: Always feel satisfied(food wise)no hunger pangs,increased energy,it has brought me down to my ideal weight,I no longer feel the need to sleep after a large meal,the high natural fat content seems to have made me a lot more tolerant to the suns rays(I no longer get burnt after a short time in the Australian sun).And basically a sense of well being that I have not felt since I was a young teenager. I am 48 years old,and will be 49 in three months.I recently had a health check and the results were as follows,blood pressure 120/70,blood sugar level 4.4,which I am told is quite normal,also as an afterthought, I was prescribed reading glasses two months before I started this diet ,I have never had to use them,my eye sight is fine.



10/ Any other comments?
I read every day the health authorities messages of what we should be eating,and it is the same in most of the western world,and it is almost opposite to my way of eating,which is a natural diet of real food ,nothing processed,and defiantly no grains,by that I mean no bread, cereals, cakes, pies,noodles rice,and so on.I run a small business and meet people every day who are on medication for a vast range of medical problems,gout ,high blood pressure ,arthritis,and all have one thing in common,they eat exactly what the the health authorities tell them to,low fat high fiber,high carb.

Ray

I shall be telling this with a smile,
Somewhere ages and ages hence:
Two roads diverged in a wood,
and I—
I took the one less traveled by,
And that has made all the difference.

[alaskaman]

Dr. Bernstein quotes a number of studies in his book, the appendix "what about dietary restrictions on fat, protein and salt?" I do not feel like typing all those journal citations, but if you do not have access to the book I will be glad to do so. They are all from peer-reviewed journals likeNewEngland Journal of Medicine, Jnl Diabetes and its complications,Diabetes Care, etc.He says, "In summary:Diabetic nephropathy does not appear if blood sugar is kept normal.Dietary protein does not cause diabetic nephropathy, but can possibly(still uncertain) SLIGHTLY accelerate the process once there has been major, irreversible kidney damage.Dietary protein has no substantial effect upon the GFR of healthy kidneys, certainly not in comparison to the GFR increase caused by elevated blood sugar levels." Let me know if you want the journal article cites he talks about. Bill

[NickFender]

I think the most important statement in this study is this:

"Given all this, any analysis could be little more than speculative."

That, unfortunately, sums up so much diet research. The studies are usually too short in duration; it's impossible to ensure adherence to the protocol; it's difficult to establish control over other significant variables; etc., etc.

Most of the conclusions are speculative. So we are left to the undue influence of dogma-based research, anecdotal evidence, and a lot of uncertainty.

I look at it this way: If someone truly understood all of the aspects of human diet and metabolic processes, their knowledge would be akin to a cure for cancer.

[Yar]

I feel that we have ample information on the cause of degenerative diseases, whether this is kidney failure, liver failure,diabetes or cancer.
Our native ancestors did not have any of these diseases, that is according to research carried out between about 1850 and 1950, into native eating habits by many researchers, looking at healthy people and there eating habits.
These natural living people had no hospitals, doctors or dentists, nor did they require them, until they eventually indulged in grains, sugar and proccessed food, after which they sufferred from the same diseases that exist today.
This is about the best long term information available, i for one, find it difficult to ignore, to what seems an obvious benefit of fresh whole foods, as close as we can get to our ancestors diet.
We will still have hospitals, doctors and dentists, but wouldn't it be great, to not have to use those facillities.
Just walk by and wave.

Ray