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  #1   ^
Old Wed, Oct-07-15, 08:47
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JEY100 JEY100 is offline
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Default Denise Minger returns....In Defense of Low Fat

True to form though, the article is way too long to quote. Discuss.

http://rawfoodsos.com/2015/10/06/in...t-1/#more-13758
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  #2   ^
Old Wed, Oct-07-15, 10:01
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Nancy LC Nancy LC is offline
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Quote:
and the highlanders of Papua New Guinea (3% of calories as fat),

These folks also have a lot of Kwashiorkor (protein deficiency syndrome) recognizable by bloated belly and skinny legs. In Diamond's Guns, Germs and Steel he talks about how little access they have to protein and that they have to supplement their diet with lots of insects, which I suppose are pretty low fat.

So sure, if you don't mind not getting enough protein, super low-fat is doable, for awhile anyway.

Well... as usual, Denise amazes me. I wonder if I still have a rice cooker? :-)

Last edited by Nancy LC : Wed, Oct-07-15 at 10:46.
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Old Wed, Oct-07-15, 12:03
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I do think there's some therapeutic value in there, somewhere. And she's right that the mainstream trial of low fat diets involves an awful lot of getting people to eat 30 percent instead of 35 percent, as if you could expect any sort of clinically significant therapeutic effect from that.

The low protein part of it is something that really needs to be tested, though. It's hard to add whole food proteins to a diet like that without changing all kinds of other stuff. What if instead of sugar, a bit of whey protein were added?

Another aspect of this diet--the fat level is so low, it verges on an essential fatty acid deficiency experiment. Or at least an essential fatty acid depletion one. In mice at least, if you get linoleic acid down below 1 percent, all sorts of diets that would otherwise be obesogenic/diabetogenic aren't. In a sane human diet, getting linoleic that low might not work, because we'd get some arachidonic acid from various meats. But in Kempner's crazy-ass diet, that's not an issue.

There are also studies where mice fed leucine-deficient diets rapidly lose their fat mass. A diet of rice and sugar sort of qualifies for leucine-deficient as well.
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Old Wed, Oct-07-15, 12:59
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I've only made it halfway through her epic posting. It is quite a good read though. I had to chuckle at: "donít run with scissors while chewing arsenic candy" as her way of explaining "healthy user bias".
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  #5   ^
Old Wed, Oct-07-15, 13:34
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Nicekitty Nicekitty is offline
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We canít categorically blame low-fat, high-carb diets for heart disease and diabetes and obesity. We just canít. NOT EVEN A LITTLE BIT. This needs to go away.
We probably canít even blame refined sugar for that stuff (at least not in isolation). Oh, the pain of shattering assumptions!
We canít ascribe the effects of low-fat, plant-based diets to their lack of animal products. Quite a few of the uber-low-fat studies here still allowed a fairly high animal protein intake, and still managed to whip people into diseaseless shape. Sorry, vegans!
Ancel Keys did not invent low-fat.
Ancel Keys did not invent low-fat.
Once more, with feeling! Ancel Keys did not invent low-fat.
I need to employ the ďdeleteĒ button a little more rigorously. (Can you imagine how computer-crashy this blog post would be if I hadnít split it into two parts?)
Here is I think the crux of what she is saying.

I agree with Teaser in that a very low fat (like 10%!) diet can result in some positive outcomes. But I think a lot of that has to do with calorie deprivation, despite what they say. A die that low in fat is VERY limited in the foods you can ingest and you'd have to eat like a horse to get a decent amount of calories. Doesn't seem like that would be very sustainable in the long term. My mother was fascinated with Pritikin, but never was able to contort her diet enough to fit his guidelines. Just couldn't do it.

But I started thinking about people that are on low fat diets--let's see, who is famous....Bill Clinton, following Dean Ornish, I remember his unappetizing looking plates. Wonder how he is getting along with that diet....Whoa--he's gone over to Paleo!, and has a new doctor, Dr. Hyman! Had no idea!

A funny video clip regarding his switch to Paleo:
https://www.youtube.com/watch?v=oWoa_gcBOpI
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Old Wed, Oct-07-15, 13:41
CodeFarm CodeFarm is offline
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It seems to back up a suspicion that has floated around nutritional musings for years that carbs and fat have an antagonistic relationship in a damaged system. You can eat one or the other, but not both "in moderation." We all know that alcohol is metabolized before anything else, which suggests the body gives other macros a priority number. That may very well not be the case for dietary fat and carbohydrates, which could require multitasking a damaged system is incapable of. The system seems to scream "abandon ship!" and begins dumping all kinds of nasties into itself. Hopefully as the years wear on, scientists will give this notion a bit of credence and really dive in to it.

It overall also questions the idea of a "varied diet" being necessary for health. An animal system is highly adaptable but also enjoys some stability.

I just know, personally, a very low fat diet leaves me feeling terrible. I've tried it and really had a hard time adapting.
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Old Wed, Oct-07-15, 14:00
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I found it interesting that some folks didn't really improve with the the very, very low fat/protein diets and some improved immensely.

Same thing happens on low carb diet. Some folks, maybe even most, do really well. Other folks don't.
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Old Wed, Oct-07-15, 15:24
M Levac M Levac is offline
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Is the premise that humans do equally well on a mostly plant diet or a mostly meat diet? The implication of that premise is that we are both herbivores and carnivores. I know of no species that is both. It's either or. We might be omnivores, but that's just because we intentionally eat all kinds of things, some of which don't actually nourish us, which is what food is supposed to do otherwise. Rather, if it doesn't nourish us, it must not be food for us. Is rice food for humans? Ah, didn't think to ask the question, didja. The rice "diet" is used explicitly as therapeutic. However, we call it a "diet" because we believe rice is food for humans. We don't even question that assumption. If the thing consumed was aspirin, we wouldn't call it a diet, we'd call it a treatment, cuz we're not that dumb to think aspirin is food for humans.

Remember, many, many, many medical treatments are derived from plants, and we're totally not confused about that. We call them drugs. It's quite possible that the rice "diet" is therapeutic, not because rice is food, but because of some other factor, i.e. it displaces the thing that otherwise makes us sick (low-carb does that too, only better), it contains some substance that acts on the disease (low-carb does that too, only better), etc. The Nothing "diet" is equally therapeutic, and we're totally not confused about that either. But we call it fasting, or starvation. It certainly does not nourish us.

It's quite possible to produce the appearance of therapy in the context of obesity for example, but in fact produce the opposite extreme in the form of emaciation. Well, if that's possible with obesity, maybe it's just as possible with diabetes type 2. There's the appearance of therapy, but in fact we have the opposite extreme, that yes give all kinds of indication of improvement, but in fact should be seen as worsening of the existing condition, just on the opposite end of the same spectrum. Just saying.

Alternatively, we could just eat actual genuine food that does what food does, and still see the same, nay better and best improvements possible. For two reasons. 1. It's therapeutic because the thing that makes us sick is removed, just like when we remove arsenic from, eh, an arsenic "diet". 2. It feeds us cuz that's what food does, and in doing so directly acts against the disease.

Let's imagine we go through with any kind of method to treat the disease, what then? If it's merely therapeutic, once the disease is treated, we can cease the therapy, yes? So what then, go back to our arsenic "diet"? That's absurd. Keep up the therapy? Why, the disease is gone, the therapy is now unnecessary, and likely to become detrimental, especially if it takes the form of non-food, which rice probably is, and displaces actual genuine food, which would normally nourish us, we end up malnourished. How about get unconfused, use whatever therapy you want, then stop the therapy, don't go back to our arsenic "diet", eat genuine food for a change. Or just eat genuine food right off the bat, then use whatever therapy we need for whatever else this genuine food can't fix, which is likely to be the case anyway.

So what's food anyways? Can't find out with disease/therapeutic experiments, must use healthy subjects, just like in that famous semi-starvation experiment. It's obvious they stuff they ate ain't food. Just like in that famous all-meat experiment too. It's obvious it's genuine food they ate. Well, between the two, which one can be expected to be most beneficial and the least detrimental in disease/therapeutic experiments?

Right, so let's start with the correct premise, Denise.
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  #9   ^
Old Wed, Oct-07-15, 15:35
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It really is worthwhile to read the entire thing. I thought her theory about something missing in all these diets and the possible link to MS was very interesting.
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  #10   ^
Old Wed, Oct-07-15, 15:36
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Rice is food. We don't have to like that, but it's food.

But who cares about semantics, if there are lives that can be saved? I'd rather be alive than right.
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  #11   ^
Old Wed, Oct-07-15, 15:47
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Quote:
I'd rather be alive than right.
Amen!
I do sort of understand her discomfort with all this info after being so vocally against the low-fatters.
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  #12   ^
Old Wed, Oct-07-15, 16:15
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I adore Denise.

I think she may have a little bit of the kickback of a guilt trip from how fast and hard and fully she was dragged to the other side of her social line and this is a bit of the rubber band apologetic effect.

I could be wrong. I don't mean to invalidate her opinions -- she's a smart woman -- I just mean that some of these things are straw men.

It doesn't matter if Keys was the first person to bring up low fat or not. He's not infamous because he was the first. He's infamous because he became the talking head for an agency then government then country then much of planetary change in eating habits which, after many decades now, was pretty evidently not a good thing.

And in fact, another strawman is that nothing can be blamed 'out of context' for poor health -- it isn't merely "low fat high carb" diets that have contributed to the downfall of modern civilization's health, it's also everything from sulfur and magnesium and iodine deficiencies to lead and mercury and plastics poisoning to the egregiously artificially 'improved' wheat and corn and soy that seriously muck up the proteins our body is forced to handle to the profound increase in sugars esp. fructose and increase of halides in drinking water and reduction of exercise in the younger generation to the "generational" thing -- as Martin said in a different thread -- kicking in bigtime with mothers having issues and passing them on.

So in that regard of course she is right, a mere "shift in macronutrients" did not cause the downfall in health. But although that is referred to a bit generically sometimes, nobody would say, if you sat them down to the details, that this is the only thing going on the last 50 years, like it's in a vacuum.

Still we are the largest experimental population in history, our food statistically HAS changed to less fat (and more of it non-sat) and more carbs and our health statistically has changed so monumentally that even without correlation being causation, there's still such an overwhelming effect we'd be dense not to take the hypothesis seriously at least.

*

I think sugars and grains are as addictive as alcohol, maybe slightly moreso but at a lower level of "obvious" when intoxicated by them -- a more delayed and gradual effect. I think getting a lot of people off sugar and grains -- including "rice and fruit" -- is as difficult as getting some people off alcohol. And unfortunately a lot of the testing one can do suffers not just the million other things all nutrition studies do, but suffers the "timing" issue:

That there is a period where if you dramatically change someone's diet away from something addictive, they are usually miserable and craving, sometimes a bit sick from detox, and if you change something that affects body processing like going ketogenic you're going to have to give their bodies time to adjust, or the measures being taken have confounding factors.

Also though, when you take out a lot of junk, most people improve fairly quickly in at least some ways, and it doesn't matter if you make a diet better by going paleo or vegan, just the shift to eating something closer to food than 'ingestible entertainment' usually has good results for some time.

So really you almost have to put people on a diet for about five weeks and only then start measuring. Of course then you have the confounding factor that if you change them to another diet, the 'effects' of the first one may linger into the second (for better or worse), too.

And then there's history. If a person has a history of high sugars, diabetes tendencies, cancer tendencies, putting them on the rice and fruit diet might be a disaster. They'll die with a better looking corpse if the sugar is enough to keep them on that diet (satiation certainly won't be) but it's going to happen sooner that's for sure.

Some other guy might torque his blood sugar handling but good on that diet eventually, but initially would lose weight from the endless pizza he'd been eating after years of football resetting his eat-till-you-can't-move expectations about food, and due in part to losing the weight and so on he'd seem vastly better off and feel great on that diet. For awhile.

*

One problem with dietary studies is that outside of the starvation study there is so little attention to overall well being over an extended period of time. They look at things like cholesterol and fat loss, but they cannot tell you that someone was really chipper for a few months but now has unreasonable asthma and is emotionally irrational -- symptoms of a poor diet that may not be so evident in normal measures.

Even in the to-me kinda laughable studies where people are supposed to estimate what they ate for a whole year (then evaluators stick 'pastries and fast food' and 'meat' in the same category under the assumption 'cause it's all high fat'), they can tell you 8-zillion nurses had X fat gain/loss results and their intake went up or down for protein, but can they tell you how many of them got divorced? Got medicated for depression? You see where I'm going with this.

What I notice is that when lowcarb diets don't work well for someone, usually they say "I feel physically crappy" and everyone assumes (probably rightly) it's something about their diet (though it may be leaning on an existing weakness and nutritional lack of something, as much as anything they're intaking).

But when lowfat diets don't work well for someone, it's usually blamed on the person not the diet, which often causes a cult-like effect where everybody pretends to be happy with the eating plan despite freezing-shaking-dizzy misery, and then your vegan friends explain to you why their teeth are falling out but it's because they're detoxing, and why they're bursting into tears over facebook but it's just because {insert political party X here} is so evil they're going to ruin the world and it's just too much to bear.

Many of the most obvious "symptoms" of a poor diet on low-fat are hormonal (due to lack of cholesterol and fats probably!) and hence show up more, I think, in personality anomalies, than in the metrics usually used for nutritional studies. There might be some measure of them in other ways but nobody is measuring those other ways if so.

I consider this important because I have known a lot of people who have been on a low-fat, high-carb diet, and most of them eventually ended up not only fatter but sick and miserable and an emotional wreck.

So someone pointing at any study(s) and saying see, their cholesterol was better (or whatever) I just find eye-rolling, because clearly there is a whole lot more to the question of whether a given diet is good for you.

PJ

Note: I haven't read it all yet, gotta wait till I have more time. I will, I read all her stuff. Will comment more once I've seen more.

PS: One reason I complain about the psyche component of this is that in the starvation study, I would hedge a theory that -- at least 'not always' -- it might not be so much about calorie deprivation as protein and/or fat deprivation. These men began acting like teenage girls -- all the psychological stuff inherent in that. But I am mostly sure that if they had been living on steak and eggs, it might have been different even on the same or fewer calories.

I say this partly because I have chronically under-eaten (I have some hormonal issue that leads to anorexic lack of hunger) for eons and under-eating on lowcarb still left me feeling better in every way, including psychologically, than even eating sufficiently (and over-eating) had on high-carb SAD.

I observe fewer seeming psyche side effects in people who avoid carbs, than in people who avoid fats. So regardless of the measures they choose to take about this, I think there is still room for doubt on whether lowfat diets are good for very many people. {There are likely always exceptions.}

Last edited by rightnow : Wed, Oct-07-15 at 16:30.
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  #13   ^
Old Wed, Oct-07-15, 17:45
M Levac M Levac is offline
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Originally Posted by teaser
Rice is food. We don't have to like that, but it's food.

But who cares about semantics, if there are lives that can be saved? I'd rather be alive than right.

Of course, me too. But Denise uses for premise that rice is food in those rice diet experiments, but in fact rice is used therapeutically, not nutritionally. Her entire point is to explore low-fat as nourishment when in fact she explores low-fat as therapy for specific medical conditions. Should I accept her logic that since it treats a medical condition, it must therefore be food? This ain't just semantics, it's foundational.
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Old Wed, Oct-07-15, 19:41
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I sort of get you on that. The Rice Diet certainly isn't nutritionally complete, it's not a complete food in that sense. Hard to tell a sixty year old in New Guinea who's been living on a 93 percent carbohydrate diet most of his life that it didn't count as food, though.

But its not the sort of diet most people would choose. Lots of people ate less than 15 percent dietary fat, not that long ago, as Denise points out. Just about nobody keeps at it, once there's any other option.

When I ate a low fat diet, I actually did feel better, compared to the SAD. But I can't say I liked actually eating that way, nothing like eating ketogenically, this way I feel better, and I prefer the taste.

I've said this before, but I really think that if there's something to this low-fat "magic" Denise is talking about, it might be worth it for open-minded people to look at some sort of intermittent approach. When they take mice and feed them a diabetes-inducing diet one week, and low-fat chow the next, back and forth, they're protected from the development of diabetes. Planned phases of different approaches could help steer clear of some of the deficiencies likely to develop, later if not sooner, on a really restrictive, low meat and fat diet.
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Old Wed, Oct-07-15, 20:25
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Replies from Zooko, a zero carber, of Ketotic.org:

zooko
October 6, 2015 at 7:16 pm
Dear Denise:

Thank you very much for writing this. I really appreciate that you are willing to publicly change your mind and admit you were wrong about something. I really appreciate how you mostly refrained in this article for advocating for a new replacement theory to explain everything and allowed yourself instead to dwell on evidence against a current theory. And I really appreciate that you forced your attention onto uncomfortable evidence, and that in doing so you forced me to do likewise. I do indeed find these results surprising and discomforting, and Iím glad to be forced to think about them.

I do have two objections, but before I launch into them I want to emphasize that these objections do not give my weary brain an ďoutĒ and let me shove this uncomfortable evidence out of sight and forget about it.

The first objection is that these results are all from an earlier era, when randomization was not practiced, and so itís hard for me to know how this kind of treatment would compare to alternative treatments under better-controlled, randomized conditions. I did a quick bit of googling and hit upon this updated, randomized trial from McDougall:

https://www.drmcdougall.com/2014/07...clerosis-study/

Apparently the results were disappointing ó no improvement in brain imaging or in disease burden for the low-fat diet arm. So disappointing, apparently, that they didnít get written up into a paper but instead merely a poster:

http://www.neurology.org/content/82...pplement/P6.152 .
The actual results arenít all there (it says ďClick to enlargeĒ but it doesnít enlarge for me). The excuse from McDougall at the end of that web page about randomization resulting in too many more-sick patients going into the test group doesnít make any sense. They could still have reported improvement in those patients, if they had improved, or if their rate of decline had been lower than expected.

So my first objection is that as far as I know (which isnít far), these phenomenal results have failed to replicate when attempted under better-controlled conditions.

My second objection is this: ďWe canít categorically blame low-fat, high-carb diets for heart disease and diabetes and obesity. We just canít. NOT EVEN A LITTLE BIT. This needs to go away.Ē

No, thatís wrong. Earlier in your post you argued that reducing fat from 34% to 30%, and finding no improvement, shouldnít be used as an argument that reducing fat to 10% wouldnít be beneficial. Thatís a good argument! And for the same reason, the fact that increasing carbohydrate to 90% was beneficial (in these non-randomized experiments) should not be used as an argument that increasing carb from 48% to 54% is not a chief cause of our current health crises.

Sincerely,

Zooko

REPLY
  • http://0.gravatar.com/avatar/fa611b...d=identicon&r=Gzooko



    October 7, 2015 at 6:10 am



    Two follow-ups to my own comment:



    1. I realized that I didnít find that McDougall trial through Google ó I found it by reading admgmís comment. Sorry to have forgotten that, admgm.



    2. Thereís another way that trials from this era are unreliable, and thatís selection effects by the experimenter after the beginning of the experiment. For each subject who did well under their care, the experimenter would take credit for it, and for each subject who did badly, the experimenter would investigate and find some way that the subject was not following the protocol and blame the subject for it. Then they would write up a report showing that their treatment had a nearly perfect track record. To prevent such shenanigans is why nowadays we require Intention To Treat analysis.



    Some of the parts of your post about just counting the results in adherers reminded me of this, and so did the part about whipping the patients, because those experimenters who blamed patients for their failure would also tend to be the ones who bullied patients.



    (As an aside, I think that *both* Intention To Treat *and* adherer analysis should be standard instead of just ITT, but thatís a topic for another day.)
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