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  #1   ^
Old Tue, Aug-29-17, 05:47
JEY100's Avatar
JEY100 JEY100 is online now
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Default Time:The Low-Fat vs. Low-Carb Diet Debate Has a New Answer

http://time.com/4919448/low-fat-v-low-carb-diets/

New study in Lancet: http://www.thelancet.com/journals/l...xt?elsca1=tlxpr

Quote:
If there’s one message that most people get about their diet, it’s to cut back on fat. Too much fat, especially the saturated fat and cholesterol found in animal meat, dairy products and cheese, can clog up arteries and lead to heart disease, stroke and obesity. But fat may not be only culprit in those unhealthy conditions.

In recent years, studies have revealed that cutting back on fat doesn’t always contribute to a lower risk of heart disease or reduced chance of dying early. In fact, some studies show the opposite, that people who eat extremely low amounts of fat tend to die earlier.

That may be because of something else they’re eating instead. In one of the most comprehensive studies to date looking at how diet affects health and mortality, researchers led by a team at McMaster University report that rather than lowering fat, more people might benefit from lowering the amount of carbohydrates they eat.

In a study published in the Lancet, they found that people eating high quantities of carbohydrates, which are found in breads and rice, had a nearly 30% higher risk of dying during the study than people eating a low-carb diet. And people eating high-fat diets had a 23% lower chance of dying during the study’s seven years of follow-up compared to people who ate less fat.

The results, say the authors, point to the fact that rather than focusing on fat, health experts should be advising people to lower the amount of carbohydrates they eat. In the study, which involved 135,000 people from 18 different countries, the average diet was made up of 61% carbohydrates, 23% fat and 15% protein. In some countries, like China, south Asia and Africa, however, the amount of carbohydrates in the diet was much higher, at 63% to 67%. More than half of the people in the study consumed high-carbohydrate diets.

Article continues with links to previous Time articles
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  #2   ^
Old Tue, Aug-29-17, 08:28
JEY100's Avatar
JEY100 JEY100 is online now
Posts: 13,370
 
Plan: P:E/DDF
Stats: 225/150/169 Female 5' 9"
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Progress: 134%
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Default

From MedPage this morning.

https://www.medpagetoday.com/Meetin...&eun=g977378d0r

Study discussed at ongoing European Society of Cardiology meeting in Barcelona.

Quote:
ESC: Huge Diet Study Shows Carbs, Not Fats Are the Problem
But PURE also challenges belief that more is better for fruits and vegetables

by Larry Husten, CardioBrief
August 29, 2017


BARCELONA -- An enormous prospective study of food intake in adults, reported here, challenges several staunchly held beliefs about dietary components and their association with health risks: finding, for example that diets rich in fats, including saturated fats, don't increase mortality risk, but high-carbohydrate diets do.
And the study, called PURE (Prospective Urban Rural Epidemiology), also found that the benefits of fruits, vegetables, and legumes top out at just three to four total servings per day.

In sum, the results suggest that nutritional guidelines and conventional wisdom regarding these basic dietary elements may be seriously mistaken.
PURE investigators recorded food intake using questionnaires in 135,000 people in 18 countries, including high-, medium- and low-income nations. The latest findings from the ongoing study, with median follow-up of 7.4 years, were outlined in two separate presentations at the European Society of Cardiology meeting here, which were accompanied by simultaneous publications in The Lancet and in Lancet: Diabetes & Endocrinology.

Carbohydrates and Fats: Unexpected Findings
One presentation and Lancet paper led by Mahshid Dehghan, PhD, of McMaster University in Hamilton, Ontario, focused on the association of fats and carbohydrate intake with cardiovascular disease and mortality.
Defying expectations, PURE found that high carbohydrate intake was associated with a significant increase in the risk of death, while both total fat and saturated and unsaturated fats were associated with a decreased risk of death. However, fat consumption was not associated with cardiovascular disease or cardiovascular mortality, though saturated fat had an inverse association with stroke.

"Global dietary guidelines should be reconsidered in light of these findings," Dehghan concluded.
These findings may be partly explained by the paper in Lancet: Diabetes & Endocrinology, which looked at the effect of dietary nutrients on lipids and blood pressure. The authors found that high intake of carbohydrates had "the most adverse impact on cardiovascular risk factors" while monounsaturated fats had a beneficial effect and saturated fat had a neutral effect.
"Reducing saturated fatty acids and replacing them with carbohydrates might have an adverse effect on cardiovascular disease risk," they concluded. "Current recommendations to reduce total fat and saturated fatty acids in all populations, which de facto increases carbohydrate intake, are not supported by our data."

Fruits, Vegetables, Legumes: Benefits Limited
The second presentation and Lancet paper, by Andrew Mente, PhD, also of McMaster University, challenges the widely held and nearly religious belief that more is always better when it comes to fruits, vegetables, and legumes.

The study did confirm that fruits and veggies (and legumes) in moderation are good for you, but it did not show that the benefits keep growing with increased consumption. Instead, the PURE researchers found that the maximum benefit was achieved with three to four serving per day. Current guidelines recommend that people consume five servings a day. The authors note that many people in lower income countries are unable to afford this high level of consumption.
"Optimal health benefits can be achieved with a more modest level of consumption, an approach that is likely to be much more affordable," write the PURE investigators.
"For the first time, our study provides a global look at the realities of people's diets in many countries and gives a clearer picture of people's fat and carbohydrate intake," said Dehghan, in a press release. "The current focus on promoting low-fat diets ignores the fact that most people's diets in low and middle income countries are very high in carbohydrates, which seem to be linked to worse health outcomes. In low- and middle-income countries, where diets sometimes consist of more than 65% of energy from carbohydrates, guidelines should refocus their attention towards reducing carbohydrate intake, instead of focusing on reducing fats. The best diets will include a balance of carbohydrates and fats – approximately 50-55% carbohydrates and around 35% total fat, including both saturated and unsaturated fats. "
Interpreting the Data
In an interview, Mente stressed both the strength and limitations of the PURE findings. As an observational study PURE is only capable of finding associations; causation is impossible to prove, though in their multivariate analysis the authors attempted to adjust for every known risk factor.

The PURE results are particularly relevant in poorer countries and in the poorer sections of richer countries, where carbs -- largely low quality -- comprise more than three-quarters of energy intake. "It's that population that needs to reduce carb intake to more moderate levels. Our data doesn't support low carb but certainly it supports a moderate carb intake of 55%," said Mente.
Similarly, he noted that existing guidelines have traditionally called for lower fat intake, below 30%, "but they haven't specified what that should be." The current papers don't give details on individual foods. Mente said that is the next stage of their research.
Mente also emphasized that the PURE results need to be put in the proper perspective. Although the associations have very large long-term population effects, at the individual level the effects are almost negligible, a fact which many people fail to grasp.
"The effects are modest effects, in the neighborhood of a 20% reduction in relative risk. So if the annual [absolute] risk of mortality is 1%, it would be reduced to 0.8%. At the individual level, it is tiny. And nowhere near what you find for smoking and lung cancer -- about 200 times smaller in fact," said Mente.
"Dietary exposures in general have modest effects on clinical outcomes. Even in the PREDIMED trial in 2013, where they evaluated an entire dietary pattern, and presumably an additive effect of multiple foods, they found a 30% reduction in risk. So you might imagine how modest the effect for individual foods would be. Typically most foods or nutrients are associated with about a 10% change in relative risk. Small."
"Having said all that, at a population level, if these small effects are true and not due to confounding, they would translate into thousands or even millions of fewer deaths annually, depending on the size of the population, if the exposure is common which is certainly true for diet. Therefore, from a public health perspective, which deals with policy and impact on populations, the findings are important."


Same story by Larry Huston at Cardio Brief:

http://www.cardiobrief.org/2017/08/...carbs-and-fats/

Last edited by JEY100 : Tue, Aug-29-17 at 08:35.
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  #3   ^
Old Tue, Aug-29-17, 11:45
GRB5111's Avatar
GRB5111 GRB5111 is offline
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Plan: Very LC, Higher Protein
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Wow, who would have thought?

Quote:
Our data doesn't support low carb but certainly it supports a moderate carb intake of 55%," said Mente.
Similarly, he noted that existing guidelines have traditionally called for lower fat intake, below 30%, "but they haven't specified what that should be." The current papers don't give details on individual foods. Mente said that is the next stage of their research.

Perhaps he should work on specifying what should constitute the 55% carb intake as well. A carb is not a carb is not a . . . .
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  #4   ^
Old Tue, Aug-29-17, 12:39
JEY100's Avatar
JEY100 JEY100 is online now
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Plan: P:E/DDF
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This study is being torn apart by every side of the debate. 60 % carbs is defined as the high-carb risk, but 55% is OK? Really?

Low Fat proponents are unhappy with the headlines (Low fat diets could kill you!) low carbers read this study as not LC enough

http://www.telegraph.co.uk/news/201...et-study-finds/

http://www.cbc.ca/beta/news/health/...ancet-1.4266130

Last edited by JEY100 : Tue, Aug-29-17 at 12:45.
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  #5   ^
Old Tue, Aug-29-17, 12:54
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cotonpal cotonpal is online now
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Quote:
Originally Posted by JEY100
This study is being torn apart by every side of the debate. 60 % carbs is defined as the high-carb risk, but 55% is OK? Really?

Low Fat proponents are unhappy with the headlines (Low fat diets could kill you!) low carbers read this study as not LC enough

http://www.telegraph.co.uk/news/201...et-study-finds/

http://www.cbc.ca/beta/news/health/...ancet-1.4266130


Which goes to show that unless you clearly define your terms there is no way of knowing what this all means. Language can be used to obfuscate rather than elucidate.

Jean
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  #6   ^
Old Tue, Aug-29-17, 13:13
locarb4avr locarb4avr is offline
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This is why I kept saying we don't have answers yet?
I want to see the data from
Cholesterol level vs
Low Carb High Fat
High Carb High Fat
Low Carb Low Fat
High Carb Low Fat
...

And any arguments with those conditions vs carb/fat above.

FYI
Grizzly Bears Are Turning Vegetarian Thanks to Climate Change
https://www.thedailymeal.com/grizzl...te-change/82917
...
Berries are higher in sugar than salmon. They contain less protein and are easier for the body to break down, and scientists say the bears are gaining weight as a result.
...

Last edited by locarb4avr : Tue, Aug-29-17 at 13:29.
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  #7   ^
Old Tue, Aug-29-17, 14:35
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deirdra deirdra is offline
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Grizzly bears go from being vegetarian to carnivorous depending on what's available. How long were these scientists watching? I've done a lot of fieldwork in grizzly country over the past 40 years and when wild raspberries are at their peak, that is all they eat for ~3 wks ... the better to put on fat for hibernation. You ain't seen nothing until you've come upon a knee-high pile of steaming grizzly sh!t full of raspberry seeds (hint ... start walking backwards the way you came from). Other times, like late winter/early spring, the turds contain only fur and bones. And some years there are better berry crops depending on spring rainfall and absence of killing frosts during flowering.
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  #8   ^
Old Tue, Aug-29-17, 17:51
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Nancy LC Nancy LC is offline
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CBS too. All the mainstream media! Whoa!
https://www.cbsnews.com/news/large-...ts-bad-for-you/
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  #9   ^
Old Tue, Aug-29-17, 22:02
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TucsonBill TucsonBill is offline
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Default Large diet study suggests it's carbs, not fats, that are bad for your health

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  #10   ^
Old Wed, Aug-30-17, 07:43
GRB5111's Avatar
GRB5111 GRB5111 is offline
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After reading the articles, it's clear that the experts are still on the quest to find the ideal human diet that applies to everyone. Also, the emphasis on lean meat indicates that many still have a negative prejudice towards fat. It's a small step in the right direction.
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  #11   ^
Old Wed, Aug-30-17, 21:00
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mike_d mike_d is offline
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What, no mention of the Mediterranean Diet?
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  #12   ^
Old Thu, Aug-31-17, 04:56
JEY100's Avatar
JEY100 JEY100 is online now
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This story is everywhere.

PBS/Nova http://www.pbs.org/wgbh/nova/next/b...ates-study-says

Today from MedPage: https://www.medpagetoday.com/Meetin...977378d0r&pos=3

Quote:


ESC: Yusuf, Lloyd-Jones Square Off Over Diet Guidelines


PURE not going to change AHA fat recommendations?

Salim Yusuf, MD and Donald M. Lloyd-Jones, MD by Crystal Phend, Senior Associate Editor, MedPage Today August 30, 2017 BARCELONA --

(Video interviews at link if have MedPage )

The large and already controversial PURE (Prospective Urban Rural Epidemiology) study challenges long-held dietary recommendations on saturated fat and carbohydrates, but will it impact guidelines? "The AHA [American Heart Association] guidelines need to be rethought in the context of all studies in total, including PURE," PI of the PURE study Salim Yusuf, MD, DPhil, of McMaster University in Hamilton, Ontario, argued in this exclusive MedPage

Today point-counterpoint video. However, observational data like this "doesn't drive to specific recommendations we can make," countered Donald Lloyd-Jones, MD, ScM, of Northwestern University in Chicago, and a spokesperson for the American Heart Association who has been involved with prevention guideline development. Greater intake of total fat and saturated and unsaturated fats was associated with a decreased risk of death, while high carbohydrate intake was associated with a significant increase in the risk of death in PURE. And, fat consumption did not correlate with cardiovascular disease or cardiovascular mortality as expected, whereas higher saturated fat intake actually was associated with less stroke risk.

The study, which was reported this week at the European Society of Cardiology meeting here and simultaneously online in The Lancet and in Lancet: Diabetes & Endocrinology, assessed self-reported food frequency questionnaires in 135,000 people in 18 countries, including high-, medium- and low-income nations.


DietDoctor has a summary of study and four of the media links. https://www.dietdoctor.com/low-fat-...-new-pure-study

Long article in MedScape.
PURE Shakes Up Nutritional Field: Finds High Fat Intake Beneficial
http://www.medscape.com/viewarticle...ntWA%3D%3D#vp_1

Good article in The Irish Times by Domini Kemp, co-author of the Ketogenic Kitchen.

New fat findings signal dietary guidelines need an overhaul

The conclusions are that a high carbohydrate diet is associated with a higher risk of mortality, whereas saturated fat (yes, saturated!) had ‘an inverse association with stroke’
https://www.irishtimes.com/opinion/...rhaul-1.3203697

The New Zealand Herald. Too many carbs worse than fat, study finds.

Includes comments from Prof Grant Schofield
http://www.nzherald.co.nz/lifestyle...jectid=11913172

The People's Pharmacy: Is the Bread Worse for You Than the Butter?
A new study including more than 135,000 adults shows that a high-carb diet is linked to a higher risk of premature death–the bread IS worse than the butter.

https://www.peoplespharmacy.com/201...than-the-butter

FoodMed: PURE’ PROOF FATS DON’T KILL, DIETARY GUIDELINES WRONG?
http://foodmed.net/2017/09/01/pure-...idelines-wrong/

Last edited by JEY100 : Fri, Sep-01-17 at 03:38.
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  #13   ^
Old Fri, Sep-01-17, 11:19
Bonnie OFS Bonnie OFS is offline
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Quote:
Originally Posted by deirdra
Grizzly bears go from being vegetarian to carnivorous depending on what's available.


Black bears, too. They love dry cat food, layer pellets, scratch, and rabbit pellets, but tear apart old stumps looking for insects. Our local bears haven't gotten hungry enough to try for our chickens or rabbits, but I suppose they could.
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  #14   ^
Old Sat, Sep-09-17, 08:27
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WereBear WereBear is offline
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Quote:
Originally Posted by deirdra
You ain't seen nothing until you've come upon a knee-high pile of steaming grizzly sh!t full of raspberry seeds (hint ... start walking backwards the way you came from).


This cracked me up. Imaging the scary sight of grizzlies on a sugar high craving meat -- you better get out of there
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  #15   ^
Old Sat, Sep-09-17, 09:29
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teaser teaser is offline
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Plan: mostly milkfat
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Quote:
However, observational data like this "doesn't drive to specific recommendations we can make," countered Donald Lloyd-Jones, MD, ScM, of Northwestern University in Chicago


He's right. It can't. So let's stop making recommendations to eat a low fat, plant based, low-heme, boiled instead of barbecued, "Mediterranean," "Nordic," "prudent," hearthealthywholegrain etc. diet based on observational studies like this one, let's not just apply that criticism of endlessly pointless, stupid, money-wasting epidemiology to the studies that don't feed our bias.
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