Fast-food binge harms liver, but boosts good cholesterol: study

[ReginaW]

I happened across this article this morning:

Fast-food binge harms liver, but boosts good cholesterol: study

http://news.yahoo.com/s/afp/20080214/ts_afp/healthdiseaselivercholesterolfastfood

PARIS (AFP) - A month-long diet of fast food and no exercise led to dangerously high levels of enzymes linked to liver damage, in an unusual experiment inspired by the docu-movie "Supersize Me."

But investigators, reporting their findings on Thursday, were also stunned to find that a relentless regimen of burgers, fries and soda also boosted so-called good cholesterol, seen as a key measure of cardiovascular health.

Researchers in Sweden asked 12 men and six women in their twenties, all slim and in good health, to eat two meals per day at McDonalds, Burger King or other fast-food restaurants over four weeks.

The volunteers were also told to refrain from exercising. The goal was to increase body weight by 10 to 15 percent to measure the impact of an abrupt surge in calorie intake.

Blood samples were taken before, during and after the experiment to monitor levels of an enzyme called alanine aminotransferase, or ALT, a potential marker for liver damage often seen among heavy drinkers and patients with hepatitis C.

Levels of ALT increased sharply after only one week, and quadrupled on average over the entire period, said lead researcher Frederik Nystrom, a doctor at the University Hospital of Linkoping.

"The results scared me," he told AFP. "One of the subjects had to be withdrawn from the study because he had 10 times the normal ALT levels."

For 11 of the 18 subjects, ALT rose to levels that would normally reflect liver damage, even among individuals who did not drink any alcohol, although no such damage occurred, he said.

Two of the individuals had liver steatosis, or fatty liver, in which fat cells build up dangerously in the liver, he said. Steatosis is associated with the risk of developing Type 2 diabetes, which has taken on epidemic proportions, especially in industrialised countries.

Published in the British Medical Association's journal Gut, the study "proves that high ALT levels can be caused by food alone," said Nystrom.

That signs of liver damage were linked to carbohydrates was another key finding, he said.

"It was not the fat in the hamburgers, it was rather the sugar in the coke," he said.

But the most startling result implies that an intensive fast food diet might have some health benefits too, apparently from fat.

"We found that healthy HDL cholesterol actually increased over the four-week period -- this was very counter-intuitive," Nystrom said.

HDL, sometimes called "good cholesterol," seems to clean the walls of blood vessels, removing excess "bad cholesterol" that can cause coronary artery disease and transporting it to the liver for processing.

Nystrom has yet to publish the cholesterol findings, but said they were consistent with the so-called "French Paradox."

For nearly two decades, scientists have wrestled to explain how the French can consume a diet rich in fats -- from abundant butter, cream, cheese and meat -- yet have generally low levels of heart disease and hypertension.

"The study showed that the increase in saturated fat correlated with the increase in healthy cholesterol," he said.

The young Swedish guinea pigs ate at least two fast-food meals a day, and terminated the study once they had gained a maximum of 15 percent in weight.

On average, they tipped the scales 6.5 kilos (14.3 pounds) more, but one ballooned by 12 kilos (26.4 pounds).

Nystrom got the idea for his study from the 2004 Oscar-nominated documentary "Supersize Me," in which filmmaker Morgan Spurlock asked doctors to monitor him over a 30-day period in which he ate at McDonalds morning, noon and night.

Doctors were so alarmed by changes in his blood chemistry -- including skyrocketing levels of ALT -- that they begged him to halt his experiment.

"I wasn't just inspired by the movie, I copied it to the best of my ability," said Nystrom.

The movie helped spur a change of tack by fast-food corporations to include healthier options on their menus.

On their websites, McDonald's and Burger King highlight salads and low-fat products -- alongside the classic burgers and colas -- and offer guidance on balanced diets and a healthy lifestyle.

------------------------

Then decided to see what the paper published said and it's available in GUT for free!

The abstract (http://gut.bmj.com/cgi/content/abstract/gut.2007.131797v1?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Nystrom&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT):

Objective To study the effect of fast food-based hyper-alimentation on liver enzymes and hepatic triglyceride content (HTGC).

Design Prospective interventional study with parallel control group.

Setting University Hospital of Linkoping, Sweden. Participants 12 healthy men and six healthy women with a mean (SD) age of 26 (6.6) years and a matched control group.

Intervention Subjects in the intervention group aimed for a body weight increase of 5-15% by eating at least two fast food-based meals a day with the goal to double the regular caloric intake in combination with adoption of a sedentary lifestyle for four weeks.

Main outcome measures Weekly changes of serum aminotransferases and HTGC measured by proton nuclear magnetic resonance-spectroscopy at baseline and after the intervention.

Results Subjects in the intervention group increased from 67.6 (9.1) kg to 74.0 (11) kg in weight (p<0.001). Serum ALT increased from 22.1 (11.4) U/l at study start to an individual mean maximum level of 97 (103) U/l (range 19.4-447 U/l). Eleven of the 18 subjects persistently showed ALT above reference limits (women >19U/l, men >30U/l) during the intervention. Sugar (mono- and disaccharides) intake during week three correlated with the maximal ALT/baseline ALT-ratio (r=0.62, p=0.006). HTGC increased from 1.1 (1.9) % to 2.8 (4.8) %, although this was not related to the increase in ALT levels. ALT levels were unchanged in controls.

Conclusion Hyper-alimentation per se can induce profound ALT elevations in less than four weeks. Our study clearly shows that in the evaluation of subjects with elevated ALT the medical history should include not only questions about alcohol intake but also explore whether recent excessive food intake has occurred.

FREE Full-text PDF can be read if you click the link in the abstract link!

[Nancy LC]

Horray! They actually fingered the correct culprit!

[KJF]

Why are they so surprised that a fattier diet raised HDL, though? Even they should know know that saturated and monounsaturated fats do this.

It's nice that they were able to implicate carbohydrates, but they will probably notice the absence of whole grains in the diets and focus on that to remain politically correct.

[vavcon]

Maybe the researchers did, but the fast food restaurants sure didn't:

"On their websites, McDonald's and Burger King highlight salads and low-fat products -- alongside the classic burgers and colas -- and offer guidance on balanced diets and a healthy lifestyle."

[ReginaW]

Horray! They actually fingered the correct culprit!

That they did!

The numbers in the full-text are powerful.....and intriguing - the subjects BMR increased significantly during the diet, by 11%, as (it seems) a compensentory measure to deal with the increased calories. The increase in calories was remarkable - baseline intake was 2273-calories per day on average and went up to 5753-calories a day during the diet! That they only averaged a gain of 14.3-pounds is, in itself, surprising (based on calories alone, they should have gained nearly 30-pounds in the month at that calorie increase of +3480-calories a day).

ALARMING numbers - waist circumference increased by 6.7cm in just 30-days; HOMA-IR almost doubled from 0.89 to 1.6; body fat increased from 20.1% to 23.8%.....those are all in addition to the liver panel findings!

Their intake of sugar skyrocketed - from an average of 95g a day (just sugars) to 285g a day.....total CHO increased from 275g a day to 644g a day....(fat increased from 91g/d to 273g/d and protein from 89g/d to 180g/d).....the one-two punch of the CHO+FAT.....deadly combo!

[Azlocarb]

Just think how there minds would have been blown if the subjects had drank water or tea instead of the colas and passed on the buns and fries and had a side salad with the hamburger patties.

[deb34]

That signs of liver damage were linked to carbohydrates was another key finding, he said.

"It was not the fat in the hamburgers, it was rather the sugar in the coke," he said.


this should be a headline....this says it all

[oldchick]

Ah, but see what the ABC News take was:

http://abcnews.go.com/Health/PictureOfHealth/story?id=4286176&page=1

"The extra fat is the big enchilada here, the equivalent of about three sticks of butter daily," Ayoob [associate professor of pediatrics at the Albert Einstein College of Medicine in New York] said. "The liver is basically using its compensatory mechanism to accommodate all this extra stuff."

The liver processes fats in the blood. Excessive calories and fats overload the organ, causing fat to build up in the liver cells and leading to liver damage."

[deb34]

there are "none so blind as those that WILL not see".

[Nancy LC]

At first I thought he was full of it but he's right. That is about 3 sticks of butter worth of fat. What on earth could they have been eating to get that much fat? It isn't the burgers. Do fries absorb that much oil?

[ValerieL]

Yes, the fries can add that much fat. The large fry has 30g of fat and the Big Mac has 29g. I wouldn't say it's just the meat.

http://www.mcdonalds.com/app_controller.nutrition.index1.html

[ReginaW]

Yes, the fries can add that much fat. The large fry has 30g of fat and the Big Mac has 29g. I wouldn't say it's just the meat.

http://www.mcdonalds.com/app_controller.nutrition.index1.html

The 5-pice chicken selects look to have 33g of fat......sausage biscuit with egg has got 37g....big breakfast 46g

[Nancy LC]

They were eating only 2 meals a day and getting THAT much fat and calories? Good god. That'd be like 4 large fries, 5 big macs.

[ReginaW]

They were eating only 2 meals a day and getting THAT much fat and calories? Good god. That'd be like 4 large fries, 5 big macs.

At 180g a day on average for fat, I'm wondering what they ate.....both in the restaurants and for the other meal each day......or did they keep eating as usual and add two more meals? LOL

[mike_d]

"We found that healthy HDL cholesterol actually increased over the four-week period -- this was very counter-intuitive," Nystrom said.Science sometimes finds truth by accident :agree:

WebMD fingered FAT as the expected culprit and left out the HDL part:Their fast-food diet featured hamburgers and other foods high in saturated animal fat. The researchers reimbursed the cost of those meals.Maybe they ate huge meals because they were free?

[M Levac]

It's not the fat-carb combo. Without fats, the situation is even worse. The researchers will just end up asking to more questions. What if we remove the fats? What if we remove the cola?

[ReginaW]

It's not the fat-carb combo. Without fats, the situation is even worse. The researchers will just end up asking to more questions. What if we remove the fats? What if we remove the cola?

Why would the situation necessarily be worse if the fat was removed?

By removing the fat, calorie intake is reduced to 3296-calories on average...and with their HOMA-IR at baseline, they could potentially manage the higher calories, even from carbohydrate, better than you're assuming....these were young, insulin sensitive individuals....which a number of short-term studies finds are able to compensate for increased carbohydrate loads for the short-term.

Would removing the fat exacerbate the development of fatty liver in the subjects? Who knows - the study included fat and carbohydrate at incredible levels of intake.....the researchers (rightly) fingered the carbohydrate as causitive....but that doesn't mean that the dietary fat was benign in the equation - the study did not and cannot answer if similar ALT levels would occur at high carbohydrate levels sans fat, anymore than it can tell us if eating just a ton of fat would do it (which we have data suggesting it won't).

[renegadiab]

Yes, the fries can add that much fat. The large fry has 30g of fat and the Big Mac has 29g. I wouldn't say it's just the meat.

http://www.mcdonalds.com/app_controller.nutrition.index1.html

Plus, fries are cooked in Trans Fat.

[Dodger]

If it's organic trans-fat is it healthy?

I'm always amazed at the amount of garbage foods that are organic and marketed as being healthy.

[M Levac]

Why would the situation necessarily be worse if the fat was removed?

By removing the fat, calorie intake is reduced to 3296-calories on average...and with their HOMA-IR at baseline, they could potentially manage the higher calories, even from carbohydrate, better than you're assuming....these were young, insulin sensitive individuals....which a number of short-term studies finds are able to compensate for increased carbohydrate loads for the short-term.

Would removing the fat exacerbate the development of fatty liver in the subjects? Who knows - the study included fat and carbohydrate at incredible levels of intake.....the researchers (rightly) fingered the carbohydrate as causitive....but that doesn't mean that the dietary fat was benign in the equation - the study did not and cannot answer if similar ALT levels would occur at high carbohydrate levels sans fat, anymore than it can tell us if eating just a ton of fat would do it (which we have data suggesting it won't).

Not assumption.

Knowing what dietary fats do to HDL levels, we don't need to make assumptions. Dietary fats are beneficial to HDL levels. They found HDL levels to increase even though the liver suffered. The liver suffered through high carb intake. Had the fats not been there, HDL levels would be very low and the situation would grow worse faster. Dietary fats are a mitigating factor.

There's another study on the subject. In that one, they took away all the fats and looked at what happened. They found that fatty liver disease occurred quickly. They didn't understand because they made assumptions about the effects of dietary fats. The results went against their assumptions.

Their assumption was : Fats are bad.

[ReginaW]

Not assumption.

Knowing what dietary fats do to HDL levels, we don't need to make assumptions. Dietary fats are beneficial to HDL levels. They found HDL levels to increase even though the liver suffered. The liver suffered through high carb intake. Had the fats not been there, HDL levels would be very low and the situation would grow worse faster. Dietary fats are a mitigating factor.

There's another study on the subject. In that one, they took away all the fats and looked at what happened. They found that fatty liver disease occurred quickly. They didn't understand because they made assumptions about the effects of dietary fats. The results went against their assumptions.

Their assumption was : Fats are bad.

My point, you seem to miss, is that with *this* study you cannot make assumptions - the data is what it is - you said fat+cho wasn't a factor and didn't say for what finding.....weight gain? liver panel? HDL? WHR? BMI?

Can you post the link to the study you're talking about that eliminated fat as part of the protocol?

[M Levac]

My point, you seem to miss, is that with *this* study you cannot make assumptions - the data is what it is - you said fat+cho wasn't a factor and didn't say for what finding.....weight gain? liver panel? HDL? WHR? BMI?

Can you post the link to the study you're talking about that eliminated fat as part of the protocol?

Yeah. I'm the one missing the point.

[Jayppers]

First I just wanted to say that I too am glad the correct culprit has been identified. I remember seeing 'Supersize Me' and the doctor looking at the gentleman's lab results after being on the fast-food diet. I remember him saying something like 'this shows that a high fat diet is killing him/destroying his liver.' I remember thinking... 'no, it's the MSG, additives, chemicals, sugar, starch, poly. unsaturated oils, and trans fats!'

Why are they so surprised that a fattier diet raised HDL, though? Even they should know know that saturated and monounsaturated fats do this.This is interesting to me.

The last time I had my cholesterol levels checked, my HDL had improved more than 10 points. My LDL had also increased substantially, much more so than my HDL.

I told my doctor that I had been trying to positively influence my cholesterol by way of diet, particularly by eating more cholesterol and eating a high saturated fat diet (b/c my cholesterol before was under 130 total, and higher cholesterol has been associated with higher health & longevity). He, of course, responded as being very surprised. He told me that 'you can't raise HDL with diet.' And, well, I guess I believed him.

So, the fact that there is at least one person that believes that HDL can be positively influenced by diet is of interest to me. Because, my HDL increased, even though my overall level of physical activity had not, which is what most people say contribute to increased levels of HDL.

Can anyone shine some light on this for me, or perhaps provide some resources for me to peruse?

Thanks ya'll,

[Jayppers]

The researchers (rightly) fingered the carbohydrate as causitive....but that doesn't mean that the dietary fat was benign in the equation - the study did not and cannot answer if similar ALT levels would occur at high carbohydrate levels sans fat, anymore than it can tell us if eating just a ton of fat would do it (which we have data suggesting it won't).I have been eating a VERY high fat diet of natural animal fats for over a year now, and the last liver panel I had showed everything to be within normal ranges. No high ALT levels. I know others who also eat a very high natural animal product fat diet as well who do not suffer with these touted liver troubles. My daily fat intake averages approximately 70-80% of my daily ingested calories, with the other 20-30 being protein.

I think it is absolutely essential to not just look at just the macro-categories such as fat, carbohydrates, and proteins, but also all the other components in such a diet. The types of fats that the subjects were ingesting probably included trans fats and polyunsaturated oils at best, in addition to the probably smaller amount of good natural saturated fats in the meats. The oils were invariably heated at high temperatures, which we all know is a no-no.

I think it would be interesting to see a deeper analysis of the ratio of natural saturated fats and poly/trans fats in these subject's diets. For anyone to say the blame is saturated fat is clearly overlooking the fact that there is a substantial dose of polyunsaturated and/or trans fats in these types of meals.

The refined starch and sugar are no doubt big troublemakers here, and when coupled with high heat and poly/trans fats, it is a disaster. But also to blame are probably all the chemicals and additives in the meat, condiments, etc. Have you ever looked at the nutritional panel for the foods served at a Wendy's or Burger King? I was absolutely amazed at the list of ingredients contained in just one breaded chicken sandwich. Honestly, it must have had HUNDREDS of chemicals and additives in it.

And indeed, 3 sticks of butter is a lot of fat, but is that really outrageous, when the fat is butter? I'm of the opinion that it is not. I eat a lot of butter daily, but three sticks in a day is kind of pushing it, I agree. Even though equating the amount of fat in the fast food meals to three sticks of butter is a totally incorrect correlation. Butter (for those who are dairy tolerant, or course ;)), as opposed to the fats found in a typical fast food meal (with the exception of the animals meat's natural fats) would be excellent - the short and medium chain fatty acids have antimicrobial qualities and are easily absorbed and assimilated by the body to be used as energy. Butter also contains fat soluble vitamins, minerals, and other nutrients which are NOT found in the majority of the fats found in a typical fast food meal.

I think the key is nutrients, being in balance. A fast food meal not only is mostly nutrient devoid, the typical ones usually contain components that rob a body of nutrients in order for it to be processed. The exceptions being the egg yolks, animal meats and fats, greens & minimally processed plant foods (I suppose ;)) in the meals.