Sat, Oct-22-11, 03:09
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Lipivore
Posts: 1,208
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Plan: Very Low Carb Paleo
Stats: 270/185/180
BF:
Progress: 94%
Location: Florida
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Saturated fat, carbohydrates and cardiovascular disease
Quote:
Abstract
The dietary intake of saturated fatty acids (SAFA)
is associated with a modest increase in serum total
cholesterol, but not with cardiovascular disease (CVD).
Replacing dietary SAFA with carbohydrates (CHO), notably
those with a high glycaemic index, is associated with
an increase in CVD risk in observational cohorts, while
replacing SAFA with polyunsaturated fatty acids (PUFA)
is associated with reduced CVD risk. However, replacing
a combination of SAFA and trans-fatty acids with n-6
PUFA (notably linoleic acid) in controlled trials showed
no indication of benefit and a signal toward increased
coronary heart disease risk, suggesting that n-3 PUFA may
be responsible for the protective association between total
PUFA and CVD. High CHO intakes stimulate hepatic
SAFA synthesis and conservation of dietary SAFA. Hepatic
de novo lipogenesis from CHO is also stimulated during
eucaloric dietary substitution of SAFA by CHO with high
glycaemic index in normo-insulinaemic subjects and
during hypocaloric high-CHO/low-fat diets in subjects
with the metabolic syndrome. The accumulation of SAFA
stimulates chronic systemic low-grade inflammation
through its mimicking of bacterial lipopolysaccharides
and/or the induction of other pro-inflammatory stimuli.
The resulting systemic low-grade inflammation promotes
insulin resistance, reallocation of energy-rich substrates
and atherogenic dyslipidaemia that concertedly give rise to
increased CVD risk. We conclude that avoidance of SAFA
accumulation by reducing the intake of CHO with high
glycaemic index is more effective in the prevention of CVD
than reducing SAFA intake per se.
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Quote:
Co n c lu s i o n s
The total body of evidence suggests that attention should
be shifted from the harmful effects of dietary SAFA per
se, to the prevention of the accumulation of SAFA in
body lipids. This shift would emphasise the importance
of reducing dietary CHO, especially CHO with a high
glycaemic index, rather than reducing dietary SAFA. The
chronic interaction of SAFA with our immune system
elicits so-called chronic systemic low-grade inflammation,
which underlies the metabolic changes referred to as the
(atherogenic) dyslipidaemia of the metabolic syndrome or
the lipidaemia of sepsis. The ultimate goal of the ensuing
insulin resistance is the re-allocation of energy-rich
substrates, such as glucose, to the immune system while
the change in our lipoprotein profile aims at the limitation
of the inflammatory responses and the repair of the
resulting tissue damage. Dietary SAFA belong to the
many false triggers of inflammation that result from
the conflict between our slowly adapting genome and
our rapidly changing lifestyle, but among these many
factors they are not the most important. A reduction
in the consumption of CHO with a high glycaemic
index, trans-fatty acids and linoleic acid, and an increased
consumption of fish, vegetables and fruit, and a reduction
of inactivity, sleep deprivation and chronic stress seem
more realistic approaches to fight the current pandemic of
cardiovascular disease resulting from chronic systemic low
grade inflammation.
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http://www.njmonline.nl/getpdf.php?t=a&id=10000756
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