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  #1   ^
Old Sat, Nov-26-05, 08:43
Samuel Samuel is offline
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Default Mediterranean Diet Good for the Heart

http://www.nytimes.com/reuters/news...iterranean.html

Mediterranean Diet Good for the Heart

By REUTERS
Published: November 25, 2005
Filed at 1:29 p.m. ET

NEW YORK (Reuters Health) - Eating a Mediterranean-style diet for three months can reduce the risk of heart disease by 15 percent, a new study shows.

The heart-healthy effects of the Mediterranean diet -- rich in whole grains, fruits, vegetables, nuts and fish and olive oil and light on red meat -- are well documented, Dr. Denis Lairon of the Faculty of Medicine Timone in Marseille, France and colleagues note in the American Journal of Clinical Nutrition. But just one other study has looked at what happens when healthy people are actually put on a Mediterranean-style diet.

To investigate, the researchers assigned 212 men and women at moderate risk for heart disease to eat a Mediterranean diet or a standard low-fat diet for three months. Participants on the Mediterranean diet were instructed to eat fish four times a week and red meat only once a week. Men were allowed two glasses of red wine daily, while women were limited to one.

Recommendations for people on the low-fat diet were to eat poultry rather than beef, pork and other mammal meats; eat fish two or three times a week; stay away from animal products rich in saturated fat; and eat fruit and vegetables, low-fat dairy products, and vegetable oils.

While study participants did not follow all diet recommendations, the researchers found, eating habits did change in both groups. Study participants took in fewer calories and consumed more proteins and carbohydrates and less total fat and saturated fat. Both groups showed a small but significant drop in body mass index.

Among people on the Mediterranean diet, total cholesterol dropped by 7.5 percent, and it fell by 4.5 percent in the low-fat diet group. Based on this reduction, the researchers write, overall cardiovascular risk fell 15 percent with the Mediterranean diet and 9 percent with the low fat diet.

``Both diets significantly reduced cardiovascular disease risk factors to an overall comparable extent,'' the researchers conclude.

SOURCE; American Journal of Clinical Nutrition, November 1, 2005.

Am J Clin Nutr 2005;82:964-971.
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  #2   ^
Old Sat, Nov-26-05, 09:08
Samuel Samuel is offline
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Plan: Atkins
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No diet helps with lipid profile like Atkins. My HDL and Triglycerides readings which have been originally very bad are now in the "excellent" range. My LDL was not improving at first, but now it does.

Before Atkins: I have not been keeping results, but I know that they have been very bad. Doctors have been always warning me about my low HDL.
After Atkins: I have done 3 blood tests, one after 6 months, one after 18 months and the last one which was after 30 months from the start of the diet.

........................ 6 Months ................ 18 Months ..................... 30 Months

HDL: ...................... 48 ......................... 60 ............................... 63
LDL: ..................... 112 ....................... 137 .............................. 121
HDL/LDL: .............. 0.42 ...................... 0.43 ............................. 0.52
Triglycerides: ......... 173 ......................... 75 ............................... 59
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  #3   ^
Old Sat, Nov-26-05, 10:56
LC FP LC FP is offline
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Medical rule of thumb:

--Each one point rise in HDL equals a 3 percentage point decrease in cardiac "risk"--

So Samuel, between 6 months and 30 months after you started Atkins you decreased your cardiac risk by 45%, on top of whatever the risk decrease was for the first 6 months.

I always thought the HDL effect was maybe a little exaggerated, but the point was that it was a greater effect than LDL or TC reduction.

No doubt this HDL worship is a prelude to HDL-raising drugs which are starting to be used or are in development now. But the drug companies never anticipated the amazing improvements we see in our lipids on LC. Their only recourse is to claim that LC is dangerous and their drugs aren't.
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  #4   ^
Old Sat, Nov-26-05, 11:05
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Annabel33 Annabel33 is offline
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Sounds like the South Beach diet to me.
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  #5   ^
Old Sat, Nov-26-05, 13:06
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Dodger Dodger is online now
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Quote:
Participants on the Mediterranean diet were instructed to eat fish four times a week
The 'good' result of the diet may well be due to the additional omega-3s (fats) that were consumed on the Mediterranean as opposed to the low-fat diet. The same effect may well have been seen if the low-fat group was supplemented with fish oil.
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  #6   ^
Old Sat, Nov-26-05, 14:41
Samuel Samuel is offline
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Quote:
Originally Posted by LC FP
Medical rule of thumb:

--Each one point rise in HDL equals a 3 percentage point decrease in cardiac "risk"--

So Samuel, between 6 months and 30 months after you started Atkins you decreased your cardiac risk by 45%, on top of whatever the risk decrease was for the first 6 months.

Thanks. This is great to know.
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  #7   ^
Old Sat, Nov-26-05, 17:15
ceberezin ceberezin is offline
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Two recent articles have shown that there is no connection between LDL levels and cardiac risk since arterial plaque is caused by inflammation, not cholesterol. There is some indication that oxidized particles profile B LDL, the smaller, denser particles associated with high triglycerides can cause the initial damage that leads to inflammation, but there is no correlation between LDL levels and levels of oxidized LDL.

The original article claims that the Mediterranean diet lowers cardiac risk since it lowers LDL, but this is incorrect. Feinman and Volek point out that the best assessment of cardiac risk is TAG/HDL≤3.5, so Samuel’s numbers look pretty good.

Anthony Colpo’s Article, “LDL Cholesterol: ‘Bad’ Cholesterol of Bad Science is available at http://www.theomnivore.com/

Feinman and Volek’s article, “Carbohydrate Restriction Improves the Features of Metabolic Syndrome. Metabolic Syndrome may be Defined by the Response to Carbohydrate restriction.” Is available at http://www.nutritionandmetabolism.c...cles/browse.asp
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  #8   ^
Old Sat, Nov-26-05, 19:30
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Mandra Mandra is offline
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Probably they're getting good results with the mediterranean diet because it's better than the fast food diet most people eat.
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  #9   ^
Old Sat, Nov-26-05, 19:55
ceberezin ceberezin is offline
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"Good results" by what standards? The only result the article mentions is the lowering of cholesterol. We now know that there is no correlation between cholesterol levels and cardiac risk. They are using an outdated standard. The study is meaningless.
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  #10   ^
Old Sun, Nov-27-05, 01:12
LC FP LC FP is offline
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ceberezin, I don't think it's fair to say there is no correllation between cholesterol values and heart disease. A correlation is just that, a correlation. It doesn't imply causation. I agree that heart disease is probably caused by inflammation.

Many studies show a correlation between total cholesterol, HDL, triglycerides and even LDL cholesterol (although LDL is the weakest correlation) with heart disease.

For example, here's part of the abstract of an interesting study by a guy named Ridker that appeared in JAMA this summer. Ridker's disclosure is that he holds patents on cardio-CRP, your inflammatory marker, which is also highly correlated with heart disease. This was a 10 year observational study of 15,000 women age 45-65 with no known heart disease upon entry. So it's a pretty big well done study (It was part of the Women's Health Initiative, which also "proved" that post-menopausal estrogen doesn't help prevent heart disease and may actually make it worse, along with increasing breast cancer rates).


"After adjustment for age, smoking status, blood pressure, diabetes, and body mass index, the HRs for future cardiovascular events for those in the extreme quintiles (the lowest 20% versus the highest 20%) were 1.62 (95% CI, 1.17-2.25) for LDL-C, 1.75 (95% CI, 1.30-2.38) for apolipoprotein A-I, 2.08 (95% CI, 1.45-2.97) for total cholesterol, 2.32 (95% CI, 1.64-3.33) for HDL-C, 2.50 (95% CI, 1.68-3.72) for apolipoprotein B100, 2.51 (95% CI, 1.69-3.72) for non–HDL-C, and 2.98 (95% CI, 1.90-4.67) for high-sensitivity CRP (P<.001 for trend across all quintiles). The HRs for the lipid ratios were 3.01 (95% CI, 2.01-4.50) for apolipoprotein B100 to apolipoprotein A-I, 3.18 (95% CI, 2.12-4.75) for LDL-C to HDL-C, 3.56 (95% CI, 2.31-5.47) for apolipoprotein B100 to HDL-C, and 3.81 (95% CI, 2.47-5.86) for the total cholesterol to HDL-C (P<.001 for trend across all quintiles)."

"HR" is hazard ratio, meaning the amount of increased risk. for example a HR of 1.62 means a 62% increased risk, and a HR of 2 means 100% extra risk.

"apolipoprotein A-1" is the protein attached to HDL

"apolipoprotein B-100" is the protein attached to VLDL and LDL

"Non HDL-C" is the total cholesterol minus HDL

"total cholesterol to HDL ratio" is the one included on most fasting lipid tests. It's interesting that this is the most predicitve number on the cholesterol test, and most doctors don't pay any attention to it.


I also think it's interesting that apo B-100 has such a high HR, compared with LDL, since it's found on LDL. But it's also found on VLDL, which makes me think VLDL is probably a pretty good marker for cardiac risk. Another factor is that since each particle of LDL carries apo B, for any given total LDL value if you have more small dense LDL, you'll have more LDL particles, and therefore you'll have more apo B. You may not think LDL correllates with cardiac risk, but small dense LDL probably does...
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  #11   ^
Old Sun, Nov-27-05, 09:11
Dodger's Avatar
Dodger Dodger is online now
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Quote:
the HRs for future cardiovascular events for those in the extreme quintiles (the lowest 20% versus the highest 20%) were 1.62 ... for LDL-C, ... 2.51 ... for non–HDL-C
As non-HDL-C is just LDL and triglycerides, this would imply that triglycerides are highly correlated with future cardiovascular events with approximately an HR of 4.5.
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  #12   ^
Old Sun, Nov-27-05, 10:05
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Kristine Kristine is offline
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I really want to tour the Mediterranean and see for myself whether or not the so-called Mediterranean diet is for real. I somehow doubt it. The Mediterranean diet-pushers always seem to casually ignore the richness of the food - full fat dairy, eggs and meat that aren't factory-farmed...
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  #13   ^
Old Sun, Nov-27-05, 13:23
Samuel Samuel is offline
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Quote:
Originally Posted by LC FP
ceberezin, I don't think it's fair to say there is no correllation between cholesterol values and heart disease. A correlation is just that, a correlation. It doesn't imply causation. I agree that heart disease is probably caused by inflammation.

Many studies show a correlation between total cholesterol, HDL, triglycerides and even LDL cholesterol (although LDL is the weakest correlation) with heart disease.

Anyway, We all know that Atkins diet greatly improves HDL and Triglecyrides, but what does it do to LDL? Does it cause it to go up, down or it has no effect?

As you can see in my profile, my LDL amount went up upto a year ago then it went down. I'm not sure what the reason was. So, I think I must mention here some of the factors which could have contributed to it in order to make sure nobody comes up with inaccurate conclusions:

(1) During my first year and half, after many years of low fat eating, I have had a strong appetite for rich food. I have been eating plenty of low carb ice cream, butter, nuts and heavy cream. With time this appetite has faded away. Now I eat less amounts of these items.

(2) Since October of last year I go to the Gym 1-1.5 hours daily. I do both cadio and strength exercises. Please note that I have not been exercising until the "After 18 months" test was done.

Last edited by Samuel : Sun, Nov-27-05 at 15:23.
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  #14   ^
Old Sun, Nov-27-05, 16:09
ceberezin ceberezin is offline
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Thanks for the translation LC FP, it was helpful.

In my understanding, VLDL and LDL are the same particle at different points in its life cycle. The VLDL contains both triglycerides and cholesterol while the LDL contains the cholesterol that remains in the particle once the triglycerides have been deposited wherever it is they’re going, usually to adipose tissue. It stands to reason that if your triglycerides are high, if your liver is putting out a lot of triglycerides, then the VLDL particle is going to have a higher ratio of TAG to cholesterol than otherwise. After the TAG gets deposited, you’re left with a smaller denser LDL particle than if the ratio of TAG to cholesterol were better. That’s how triglycerides are correlated with small, dense LDL type B, the kind that tends to oxidize and get stuck in the endothelium. However, Colpo has pointed out that while there is a correlation between amounts of oxidized LDL and heart disease, there is no correlation between overall LDL levels and amounts of oxidized LDL, which is more dependent on the efficacy of the body’s anti-oxidant system.

At this point, any correlation between LDL levels and cardiac risk is tenuous at best and mainly believed in by lipid hypothesis dead-enders.
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  #15   ^
Old Sun, Nov-27-05, 21:43
LC FP LC FP is offline
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Plan: Atkins
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ceberzin, the lipid hypothesis dead-enders aren't listening to us. It reminds me of Firing Line debates. The liberal scores a point, the conservative scores a point, and neither has answered the question posited by the other.

Your understanding of VLDL and LDL is the same as mine, essentially. The liver produces (normal sized) VLDL on a regular schedule, to keep some TAG (fat) available to any cells that want it, especially between meals when no chylomicrons are circulating. This VLDL contains mostly TAG and some cholesterol. The cholesterol is basically all that's left after the TAG has been removed by the endothelium (capillary lining cells) in the tissues that want it. It's now a smaller particle and is called LDL, (which is normal-sized), but it has the same protein coat as when it left the liver, apo B-100.

In conditions of carb excess, the liver makes a ton of TAG from all the ingested carbs, mostly because that's all it can do with all the glucose. The VLDLs made in this circumstance are very large and TAG-enriched. For some reason, these large VLDLs dump their TAGs very efficiently, shrink quickly, and become the small dense LDLs that are apparently more prone to oxidation, and are more prone to stick in the sub-endothelial space and get eaten by macrophages that then become "foam cells" which form the soft core of the atherosclerotic lesions in blood vessell walls.

So when we eat high carb diets, our blood TAG levels are sky high because our liver is pumping out a lot of the large TAG- enriched VLDLs even when we are fasting for 12 hours, when the blood test is drawn. At the same time the previously secreted large VLDLs have degenerated into a lot of small dense LDLs which have not cleared the circulation yet. Although they are small, and may not carry a lot of cholesterol in them individually, each one has an apo B-100 protein on it. So our LDL cholesterol may be only moderate in this situation, but our apo B count is high.

That's why LDL cholesterol is a lousy predictor for heart disease. It doesn't tell us if it is mostly composed of small dense LDL or regular sized LDL. (If Apo B is high, however, there are probably a lot of small LDLs carrying the LDL cholesterol. That makes apo B a better predictor of heart risk.) But we know what the proportions of small dense to regular LDL are if we know the TAG level. If TAG is high we know that a lot of the LDL is small dense, and we're in trouble even if our LDL is 130. As opposed to the low carb dieter with a LDL of 140, and a TAG of 80, which means very little small dense LDL.

So, yes, as you say with Colpo, there is no corellation with LDL levels and oxidized LDL, just as there is no corellation with LDL levels and small dense LDL. The corellation is with the TAG levels.
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