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  #1   ^
Old Sun, Mar-26-17, 10:43
RawNut's Avatar
RawNut RawNut is offline
Lipivore
Posts: 1,175
 
Plan: Very Low Carb Paleo
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Location: Florida
Default The BROAD study: RCT using whole food plant-based for obesity,heart disease,diabetes.


Quote:


Background/Objective:

There is little randomised evidence using a whole food plant-based (WFPB) diet as intervention for elevated body mass index (BMI) or dyslipidaemia. We investigated the effectiveness of a community-based dietary programme. Primary end points: BMI and cholesterol at 6 months (subsequently extended).


Subjects:

Ages 35–70, from one general practice in Gisborne, New Zealand. Diagnosed with obesity or overweight and at least one of type 2 diabetes, ischaemic heart disease, hypertension or hypercholesterolaemia. Of 65 subjects randomised (control n=32, intervention n=33), 49 (75.4%) completed the study to 6 months. Twenty-three (70%) intervention participants were followed up at 12 months.


Methods:

All participants received normal care. Intervention participants attended facilitated meetings twice-weekly for 12 weeks, and followed a non-energy-restricted WFPB diet with vitamin B12 supplementation.


Results:

At 6 months, mean BMI reduction was greater with the WFPB diet compared with normal care (4.4 vs 0.4, difference: 3.9 kg m−2 (95% confidence interval (CI)±1), P<0.0001). Mean cholesterol reduction was greater with the WFPB diet, but the difference was not significant compared with normal care (0.71 vs 0.26, difference: 0.45 mmol l−1 (95% CI±0.54), P=0.1), unless dropouts were excluded (difference: 0.56 mmol l−1 (95% CI±0.54), P=0.05). Twelve-month mean reductions for the WFPB diet group were 4.2 (±0.8) kg m−2 BMI points and 0.55 (±0.54, P=0.05) mmol l−1 total cholesterol. No serious harms were reported.


Conclusions:

This programme led to significant improvements in BMI, cholesterol and other risk factors. To the best of our knowledge, this research has achieved greater weight loss at 6 and 12 months than any other trial that does not limit energy intake or mandate regular exercise.









Full Text: http://www.nature.com/nutd/journal/...nutd20173a.html
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  #2   ^
Old Sun, Mar-26-17, 13:11
bkloots's Avatar
bkloots bkloots is offline
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Plan: Atkins/LCHF
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Default

Without even reading the study (thanks for posting it), I submit that WFPB would be a vast improvement over "normal care" in most cases. Good going!

Around here, we suggest Eat Real Food as a first step in achieving better health. Looks like this study got good results.
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  #3   ^
Old Sun, Mar-26-17, 14:17
teaser's Avatar
teaser teaser is offline
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Plan: ketosis/IF
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The only problem I have with the study is this;

Quote:
However, studies on the effects of low-carbohydrate diets have shown higher rates of all-cause mortality,54 decreased peripheral flow-mediated dilation,55 worsening of coronary artery disease,56 and increased rates of constipation, headache, halitosis, muscle cramps, general weakness and rash.


The blue is based on epidemiological studies comparing lower to higher low-carbohydrate diet "scores," there aren't a lot of people claiming that people eating 200 grams of carbohydrate will be any healthier than people eating 250 grams of carbohydrate, those type of studies don't look at the threshold where lowering carbohydrates starts to be therapeutic. The red--that doesn't look at a low carb diet, it looks at the effect of a single high fat beverage. Jeff Volek has done a study showing that the effect of a high fat beverage of worsening flow mediated dilation disappears in people on a low carb diet--people on low carb diets become more fat tolerant.

Okay, worsening of coronary artery disease, I left that black. According to an old thread on this forum, the study was done by one of the fine individuals who was involved in stealing and publicizing Dr. Atkin's death certificate, a Dr. Richard Fleming. But don't hold that against him, there's something more relevant to the matter at hand that we can blame him for.

Quote:
The Effect of High-Protein Diets on Coronary Blood Flow


This is the study, I don't have access past the abstract.

http://journals.sagepub.com/doi/pdf...331970005101003

Quote:
Patients following recommended treatment for each of the independent variables were able to regress both the extent and severity of their coronary artery disease (CAD), as well as improve their myocardial wall motion (function) while following the prescribed medical and dietary guidelines. However, individuals receiving the same medical treatment but following a high-protein diet showed a worsening of independent risk factors, in addition to progression of CAD. These results would suggest that high-protein diets may precipitate progression of CAI) through increases in lipid deposition and inflammatory and coagulation pathways.


Sounds pretty damning of the "high protein" Atkins type diet intervention. Only problem is, it wasn't an intervention.

https://www.drcarney.com/blog/entry...pair-blood-flow

Dr. Michael Greger--I have nothing against vegans, I do have something against intellectual dishonesty, Gregor is praising Fleming here when he should be doing the opposite;

Quote:
At the conclusion of the study, it became apparent that 10 of the 26 individuals, despite receiving dietary instruction as outlined below, had adopted a high-protein diet throughout the study.


He's quoting the study itself here.

It became apparent? What the heck does that mean? Apparent by confession? Or apparent by results? The people on the high protein diet are likely to have been chastised, not given support. If intent to treat had been the criteria used, rather than splitting so-called high protein dieters into their own group, it's likely that very little overall benefit would have been seen. There are more honest ways to say, look, there seem to be some responders and some non-responders. Ignoring the non-responders would be wrong, dismissing them as "High Protein dieters" is unspeakable, in this context, it's likely high protein just meant off the diet anyways rather than any sort of structured plan, in this case high protein diet likely just means the SAD in most cases.

And of course, the yellow-green is just the keto-flu, it's likely increased salt, potassium and magnesium would make things better, I believe it's from an Eric Westman study that showed great result that were worth short-term discomfort.

Like I said to begin with, no problem with the idea that some vegan or near-vegan diets can be therapeutic compared to the SAD.
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  #4   ^
Old Mon, Mar-27-17, 03:17
M Levac M Levac is offline
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The A-TO-Z experiment contradicts pretty much the whole thing. Rather, this small experiment does not emulate (in its results) one of the best all-time free-range dietary experiments, therefore is suspect on the face of it. I will presume that there were many more subjects enrolled, but only a handful was selected for inclusion in results, with a few dropouts to make it look credible but only as little as possible to enable the use of adherence as a strong factor for choosing the intervention diet. It's been done before to demonize saturated fat, I see no reason why it shouldn't be done again to demonize it yet again.

I realize that it sounds like I'm dismissing the whole thing, but I'm not. The A-TO-Z experiment includes some extraordinary results from several subjects in the Ornish group for example, but unfortunately as a group it still did not surpass the Atkins group which also includes extraordinary results only moreso than the Ornish group.

As a side note, the A-TO-Z experiment is not one of the best because Atkins won, but instead it's because it has the highest quality for the main factors that determine result veracity, i.e. number of total participants, adherence %, length of experiment and follow-up, number of intervention groups, and so forth. It's also one of the best because in spite of Atkins winning overall, lead researcher is an acknowledged vegetarian, thus making the Atkins win that much more credible, but most importantly it makes Gardner look as honest and reliable as can be in light of an opposing diet winning the race, which in turn strengthens the results further. I mean, if I was some major D-bag with an agenda, I would certainly try my best to make Atkins look bad in some way, right? Just like it was almost certainly done in this small experiment.

Call me cynical, but you can also call me lazy and judgemental cuz I am that too.
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  #5   ^
Old Mon, Mar-27-17, 05:56
teaser's Avatar
teaser teaser is offline
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Plan: ketosis/IF
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Default

As a low carber, I want to be more like Christopher Gardner, and less like Dean Ornish. If a study shows a therapeutic effect with a low fat whole food vegan diet vs. the SAD, and if studies keep showing up with these effects, and really, they have, I pretty much have to admit that there's something there.

I don't care about a lot of the results, all the blah about cholesterol, but a 12 kilogram loss without excluding dropouts and without telling people to restrict calories is something we'd cheer for if this was a low carb study. Hba1c dropped from 6.0 to 5.5, waist circumference by 9 cm, these are decent results. Again, compared to the SAD.

Or maybe not technically the SAD, "normal care" might have included some dietary advice. But the SAD is about 35 percent fat, and the standard dietary advice is to keep fat to 30 percent fat, which is always baffling, why anybody would expect such a small decrease in fat intake to have any effect whatsoever is beyond me.
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