I’ve linked below to a video of a mainstream cardiologist being interviewed as to her thoughts on the best diet for a healthy heart. Listening to her, it’s easy to see what’s happened to mainstream thinking.
For years mainstream thinking was that the low-fat diet was the be-all and end-all for preventing heart disease. Whenever anyone brought up the idea that low-carb diets may be as effective if not more so than low-fat diets, that idea was dashed with the old ‘Show me the studies’ song and dance that the mainstream knew how to perform so well. As Gary Taubes presented so beautifully in Good Calories, Bad Calories, those studies had already been done years before, but were unknown to the mainstreamers of today. But over the past few years numerous studies have accumulated showing that the low-carb diet at the very worst equals the performance of the low-fat diet and at the very best stomps the performance of the low-fat diet in reducing putative risks for heart disease. Now, what is the mainstream to do?
This video answers the question. The mainstream has retreated to the all-things-in-moderation mantra. Let’s eat less and exercise more and we’ll all be thin and happy. And let’s don’t forget to cut sodium from our diets as well. Even though sodium is the most abundant electrolyte in our bodies, we need to be careful. And let’s forget about all those studies showing that salt intake doesn’t do squat in terms of increasing high blood pressure. Let’s just pretend those don’t exist.
Watch this woman’s response when asked about low-carb, high-protein diets. She stammers and stutters for a moment as you can see her try to access the hard drive in her brain for info on low-carb diets. Aha, she’s found it! She trots out the myth that protein is bad for the kidneys. But she’s obviously been around long enough and been hit with the info showing that protein intake has no harmful effect on normal kidneys. So she cleverly makes the case that people who go on low-carb diets are overweight, therefore most of them have high blood pressure and/or diabetes that often accompany obesity. And since both diabetes and high blood pressure are associated with slightly impaired kidney function, it isn’t a good idea to increase protein intake. A clever one, this.
She ignores the fact that low-carb diets are the best diets around for rapidly lowering blood pressure and normalizing blood sugar. And she ignores the fact (or, most likely, is ignorant of it) that low-carb diets are not necessarily high protein diets. If anything low-carb diets are high-fat diets and moderate-protein diets. This is the kind of person who, if asked about a diet of hamburgers, French fries and a Coke, would say that it’s a bad diet. If asked if it would harm the kidneys, she would say no, but it still isn’t a good diet. Now if you ask her about a the same hamburger with the bun removed, a salad instead of the fries, and an unsweetened ice tea or bottled water, she would probably say that said diet was one of those dangerous high-protein diets and would harm the kidneys.
Here is a paper from Nutrition & Metabolism showing how a low-carb diet was used to treat kidneys damaged from diabetes. Based on this paper and my own years of experience, I can tell you that low-carb diets do not cause kidney problems, even in people with less-than-perfect kidneys.
The mainstream is definitely bunkering down into the low-calorie mode because they just can’t bring themselves to even consider the low-carb diet after all the years they scorned it. It’s really too bad they can’t look on the data in an unbiased way.
Here is a link to the video.
It’s beyond my abilities to embed the thing, so you’ll have to go to the link. If the video that opens isn’t the correct one, go to the right of the video and click on the one that says: Is there a single save your heart diet?
According to this expert, the answer is yes and it’s the low-calorie diet.
Jesus wept.
The official website of Drs. Michael and Mary Dan Eades, low carb pioneers and authors of Protein Power.
Gotta love the commitment to “it’s a problem of overeating”….rather than it’s a problem of eating a diet constantly triggering hunger caused by highs and lows of blood sugar. Nope, gotta eat all things in moderation and count those calories – if you eat a diet with adequate protein, which provides increased satiety, your kidneys will essssplode!
Essssplode indeed! You see it happen all the time with those high-protein diets. 🙂
Dr. Eades,
If someone has heart disease, or is at high-risk for heart disease, do you think it’s wise to make any alterations to the basic PP diet? If so, what changes (diet, supplements, lifestyle) would you personally consider to be the most important?
Thanks for your excellent blog and web site!
Along with the basic diet I always made sure that my own high-risk patients got vitamin E, fish oil (I would use krill oil now), alpha lipoic acid, CoQ10, plenty of magnesium, potassium, and at least 5,000 IU of vitamin D3.
Cheers–
MRE
Not to mention that (sea) salt has plenty of the trace minerals that so many people today lack in their diets!
Precisely. But, horror of horrors, it also contains the much despised sodium.
It just doesn’t make sense to be so resistant, does it?
Why do I even ask the question…
Why indeed?
The more things change, the more they stay the same.
What about a low carb diet complimented with Intermittent Fasting? (uh oh…it’s back…)
http://www.circ.ahajournals.org/cgi/content/full/112/20/3115
Probably the best way to do it.
Whenever people trot out the “all things in moderation” statement, I always ask how many cigarettes one can smoke “in moderation” without experiencing complications to one’s health. This usually leaves them stammering. This “all things in moderation” business is one of the biggest cartloads of horse manure I have ever had to shovel in life (I hear it allll the time).
(Next to that the “if it is organic and natural, it must be good for you” myth. I love that one. I usually suggest a salad made of poison ivy and sumac. In moderation, of course.)
My feelings precisely. Well put.
If the recommendation is to eat whatever foods you want, but simply limit portions so that you eat few calories, this is a recipe for disaster for lots of reasons:
1. Appetite and energy fluctuations caused by unstable blood sugar.
2. Lack of eating satisfaction (e.g. small portions of high-calorie, processed foods leave one still hungry).
3. Nutritional deficiencies due to restricted portions of nutrient-poor foods (e.g. grains/starches/sugars).
4. Taking in too many calories despite one’s efforts, because it is very difficult to estimate the calories contained in processed food (unless it is on the label and even then it may be wrong). This is especially a problem in restaurants–unless you stick with simple meals (e.g. steak or a piece of fish, prepared simply, along with salad/steamed veggies), it’s impossible to know how many calories are in that meal.
A single save your heart diet?
Yes, If what’s good for diabetics is good for the heart as well…
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1325029
Results …
Hemoglobin A1c decreased by 16% from 7.5 to 6.3 from baseline to week 16.
Diabetes medications were discontinued in 7 participants, reduced in 10 participants, and unchanged in 4 participants.
The mean body weight decreased by 6.6%
Fasting serum triglyceride decreased 42% from [238 mg/dL] to [139 mg/dL]
Great post Anne! I should have also mentioned in my previous post that, yes, there is a single save your heart diet. It is what traditional inuit/eskimo follow. A diet high in fat, moderate in protein, and virtually devoid of carbs. Such a diet might also remove many of the diet-related diseases that plague Western society, such as diabetes, obesity, arthritis, strokes, and even most cancers.
I agree, anne, that’s driven me crazy for years.
“All things in moderation” is a meaningless utterance.
“Moderation” is a completely relative term. It means exactly what the speaker thinks it means, and carries no quantitative information. My moderate amount of butter might be a tablespoon a day; Lofat Lola’s might be that amount over the course of a month; I know people who consume a stick a day, and for them, that’s a moderate amount. When you point this out to people, they balk; they don’t like the idea that not everyone shares their internalized set of guidelines for moderation. But, I say, that’s exactly what’s at issue: how much of this, that, and the other thing is an appropriate amount and frequency?
Then there’s the “all things” part. Also meaningless. Usually people wield it to disparage people with diets more restrictive than their own. For instance, to say that vegans “go too far” in excluding animal foods from their diet. (I put that in quotes because it presupposes that the direction itself is correct.) However, those people don’t realize that their concept of “all” is also subjective. It doesn’t include every substance under the sun, or even every edible substance. It includes exactly what they think is a fitting foodstuff; no more, and no less. If they don’t happen to think MSG or HFCS is a big deal, they’ll say of it, “Everything in moderation.” If they do happen to think HFCS is unfit for human consumption, they’ll say the exact same thing, but with HFCS specifically excluded from “everything.” Along with chocolate-covered ants, horse meat, and whatever else they don’t happen to like.
I was reading a mouse study the other day that relates to the part of this post about kidney disease. Mice with an analog of lupus which ends in kidney failure and death were fed a low protein diet ad lib, a fifty percent protein diet ad lib, or each of these diets calorie restricted by energy only, so that the third and fourth group mice ate the same amount of protein as the first and second group mice, respectively, but with the carbohydrate portion of the diet reduced. The mice in the third and fourth groups lived about twice as long as the mice in the first and second groups, even though the mice in the fourth group ended up eating 83 percent of their calories as protein.
http://jn.nutrition.org/cgi/reprint/117/6/1136.pdf
Interesting study. I hadn’t seen this one – thanks for sending it.
Best–
MRE
Dear Dr. Mike,
The word “moderation” does have one good use – it shuts up the medical people
who want to give you the lo-fat 9-veggies a day lecture.
Example: “Because of some blood sugar tests, I have to watch the sweets and
starches, but I do all my other foods in moderation.”
It’s worked every time.
Brilliant!
I think that we, as a collective group of low carb supporters, are not doing enough to promote each others work on the subject. We’re all still too fragmented. Thincs.org is just too primitive. Personal blogs are just that – personal. We need to create a professional, medically oriented web site that caters to their sensibility and at the same time offers them the info we know to be true.
We also need to, little by little, build a data base of information so that medical professionals can easily access what we know to be true giving them a solid foundation on which to stand and learn.
Mike, you should be the surgeon general. C’mon get movin’! 🙂
I’ll be sitting by my phone waiting for the call when the next president takes office.
Check out the Nutrition & Metabolism Society.
Cheers–
Mike
A couple of years I was diagnosed with aortic stenosis, as a very active 53-year old male this came as quite a shock. Since then to help my ticker along I’ve been living the low-carb lifestyle and have not only lost over 30 pounds, but have also brought my blood pressure well into the normal healthy range. Bi-annual tests reveal the stenosis hasn’t progressed and I remain asymptomatic. My cardiologist and my personal physician say there is nothing to do but monitor the situation and let the stenosis do what its going to do until that time that surgery has to be done. I prefer the stay active and eat healthy (low-carb, quasi-paleo) approach to at least delay any progression of the disease. Any other dietary suggestions? I do take fish oil for its coronary health benefit. Thanks for a great website and forum!
If you’re not already taking it I would add some magnesium, potassium, acyl-L-carnitine, arginine, alpha-lipoic acid and vitamin D3. All under your physicians supervision, of course. Your objective is to remain asymptomatic, which it looks like you’re doing with your current regimen.
Keep me posted.
Cheers–
MRE
My response to “I believe in all things in moderation” is “So do I. Now define “moderation.” I point out that if you drank one 12-ounce Coke per day, and consumed no other refined sugar at all — no cakes, candies, cookies, cold cereal, ketchup, canned baked beans, nada — you’d still be getting twice as much sugar as your Victorian ancestors.
In short, I *am* moderate. It’s the American diet that is wildly, suicidally immoderate.
My response to “It’s natural” is “So are rattle snake venom. Death angel mushrooms. Tobacco. Cocaine. Heroin.”
Let’s not forget another popular assertion: “You need a balanced diet.” So far as I can tell, this simply means “A diet like my parents and grandparents ate.” No one suggests that a tiger needs to balance his diet with plenty of grains and salad. No one suggests that a rabbit needs to balance his diet with plenty of muscle meat, organ meat, and bones. Why, then, should we assume that the proper diet for human kind consists of this arbitrary ideal of a “balanced diet?”
Oh, and one more: “Any diet that calls for you to omit whole food groups is a fad diet.” So, low fat diets, vegetarianism and especially veganism are fad diets? So glad we agree.
Indeed!
There’s an upcoming documentary film that I think will be of interest to you and others who read your blog. For the record, I have nothing to do with the film.
It’s called “My Big Fat Diet” and will be aired on CBC television on Tuesday evening, March 11 at 10pm ET. The film is about Dr. Jay Wortman’s year-long dietary intervention program with the Namgis First Nations people of Alert Bay, BC. He promoted their going back to the ancestors’ way of eating – basically low-carb.
Unfortunately, this broadcast won’t be available to most viewers in the U.S., but there are now a few web pages about the film on the CBC web site at:
http://www.cbc.ca/thelens/bigfatdiet/index.html
Menu links at the right of the article include a clip from the film and more info about Dr. Wortman and “the diet”.
There are also 3 short clips on YouTube:
http://www.youtube.com/mybigfatdiet
Dr. Wortman’s new blog is now active at
http://www.drjaywortman.ca
Barbara
Thanks for the heads up on this Barbara. I got an email about it from Dr. Nicolai Worm from Germany a few days ago.
Best–
MRE
April’s Prevention magazine has a little blurb on page 78 about “The worst diet for your heart”. It mentions a University of Maryland School of Medicine study comparing Atkins, Ornish and South Beach diets. Atkins was the poorest, as subjects experienced increased LDL and “hardening of the arteries” (how measured?) within one month. The other diets lowered LDL, and subjects experienced improved flexibility in their arteries. Any comments??
Sure. Read here.
“Now if you ask her about a the same hamburger with the bun removed, a salad instead of the fries, and an unsweetened ice tea or bottled water, she would probably say that said diet was one of those dangerous high-protein diets and would harm the kidneys.”
Yes, this is my favorite defense against the “moderation” people, though you’ve articulated it better than I usually do. I don’t really talk much about what I eat outside the blogosphere unless someone asks. But if people do comment on my food choices, I say, “Look, I’m eating exactly what you’re eating, except I ordered a salad instead of fries and got extra vegetables instead of the hamburger bun. What’s the problem here?”
Now, this defense doesn’t work on the extremists, because they’re going to point to that big hunk of delicious juicy red meat. So here’s how I try to handle those people. In response to a comment from a vegetarian/fishatarian who thought Atkins was “the craziest thing” she’d ever heard of, I invited her to a dinner party where I didn’t serve a single thing I would not, myself, eat. (She is a very good friend, in spite of her soy-eating ways.) I used a Provençal theme. We had tapenade served in endive leaves; bouilliabaisse with rouille (I cut down drastically on the amount of breadcrumbs – about a tablespoon versus the usual whole slice of bread); a giant salad with fennel, red bell peppers, and homemade vinaigrette; and for dessert a plate of several varieties of sliced oranges sprinkled with a little lavender and homemade crème fraĂ®che on the side. No sugar, no grains (other than a few breadcrumbs), no potatoes. Piles of seafood, piles of veggies, piles of healthy fats, and a small amount of fresh fruit.
Unfortunately, I never got the opportunity to say, “So, do you still think Atkins is the craziest thing you ever heard of? Because you just ate a 100% Atkins approved meal!” In a way, I’m glad I didn’t – I was nervous planning this meal that people would balk at its lack of bread and sweets. But if anyone noticed, they weren’t rude enough to say so. If I’d pointed it out, I might have become that person who feeds her friends weird food. Never mind that the food was nearly restaurant worthy (restaurants can get better seafood than I can); I would’ve still been a weirdo for failing to serve bread.
If that’s a definition of weirdo, MD and I are weirdos in the extreme. We never serve bread at dinners we put on – not even at large, non-diet dinner parties.
Your meal sounds fabulous, BTW.
Cheers–
MRE
Help! My wife and well meaning friends are throwing this study in my face as the latest “proof” that my low-carb regimen will kill me:
http://www.medpagetoday.com/PrimaryCare/DietNutrition/tb/8663
If I understand it correctly, its saying that a low-fat diet improves arterial dilation, while a low-carb diet makes it worse. Unfortunately, I’m not a doctor and don’t have the training to interpret the results to know if this is yet another spurious attempt to prove the researchers assumptions. Any analysis you can provide to calm them down would be appreciated.
I may post on this study later. It’s a real non starter as far as I’m concerned, and I almost hate to waste the time. Just remember, even if valid, it’s only one study. It has to be considered along with the dozens of other studies that show the opposite effect. The medical data needs to be considered as a whole, not just by individual studies.
And, due to the nature of this study, I doubt seriously that your wife and well-meaning friends have a clue as to what this study really says. They are simply parroting what the press says, which is often as ill informed as anyone else who is not a scientist.
will i just heard about the natives in alert bay off vancover isand, the have gone on a diet that is helping them. i would like to know more about this diet .do you know about it and what do you think about it. robin
There are links on some of the other comments that will take you to the videos, blogs and articles about this experiment. I think it is great, and I will predict a huge improvement in health.
Guys I found that beans help reduce a lot of cholesterol level in your vessels at
http://www.octanmen.com/articleDetail/124/Beneficial-effects-of-Beans-on-one%E2%80%99s-health.htm
Is it really so???
Can anyone tell me…
I can tell you: No, it ain’t really so.
Hi Dr Mike,
I know that you cannot comment on this, b/c I am not your patient, but I simply have to post it, b/c I am so upset I am on the verge of tears. And I have to put this out there, in the hopes that someone can tell me something good about this.
I got my most recent round of labs back today in a letter from my Dr.
Total: 230
LDL: 154
HDL: 64
Tri: Not shown, will call for them on Monday (have to assume normal/LC low, b/c no comment was made)
Everything else (diabetic studies, electrolytes, kidney, liver) all said “normal
18 months ago:
Total: 199
LDL: 126
HDL: 58
Tri: 73
Both on low-carb, clean food (no grains, legumes, limited high-casein dairy), moderate protein intake (right around my PP requirement), only “good” fats (meat, butter, cream, olive oil, nuts, avocados, etc).
The letter says that she doesn’t think I need medication at this point, but I should respond to a low-fat diet and exercise.
My entire family has some combination of horrible blood values, heart disease, peripheral vascular disease, diabetes and they all take statins. (I’m 43 yo female, very healthy, at healthy weight).
For some reason, I have been in deep DEEP denial that this was going to happen to me, I believed that my numbers were going to stay “normal,” b/c they have always been normal up till now, and I started LC/PP in the mid 1990’s.
Shocked does not begin to describe how I feel right now…devastated, however, does.
Yes, I’ve read everything I can get my hands on about ratios, which are all fine, I think. About the lipid hypothesis being wrong. About elevated LDL being nothing to worry about.
But I am still terrified beyond words, when you’ve watched your family drop like flies, and your bloodwork is beginning to look just like theirs…with no LC doctor to help me sort this out.
Thank you for listening.
If you’re this worried about it, spring for the bucks to get the test showing LDL particle size. If you have a predominantly Type A (large fluffy) pattern, you should feel a lot better.
Long-time Low-Carber,
I don’t know if this will reassure you, but I’ve got similar stats – female (46 yo), normal weight, fairly healthy despite some of the medical care I have received, except my total chol is a bit higher at 261 as is my LDL at 183 (by calculation, not actual measurement); HDL is also 68, Trig are a bit lower than your at 52. VLDL is quite low, but I can’t remember it, might have been 12. My ratios are excellent, which is probably why my various doctors have left me alone about blood lipids (my endocrinologist was more concerned, but when I told him I thought the lipid hypothesis was flawed and I gave him a list of addition tests he could run to gather more specific information *to reassure him*, he said it didn’t warrant that and dropped the subject).
I actually find this lipid pattern *reassuring* (I would worry far more about lower cholesterol totals, because that is associated with other issues like dementia and cancer, especially in females, and certainly about higher triglycerides). I also recently had my vit D level tested (25 OHD) and it was 44 after about 9 mos of supplementing at 2000-4000 units/day plus getting a bit more sun than in the past decade (I live in So Cal so that is easier for me). My endocrinologist was happy with the level, but it just told me it must have been rather low before supplementing and I’m going to try to get it up a bit higher. You might consider checking your Vit D level.
I consider my LC lipid pattern of the past few years a huge improvement over my high carb days a decade and a half ago when I had what was then considered great lipid numbers – my total chol was under 200, but my HDL was too low, and Trig were creeping to 200, and I was gaining weight. Also at that time, I probably was mildly hyperglycemic a lot of the time, but didn’t know it (but I now see there were lots of mild symptoms that were brushed under the carpet or attributed to other causes). I now know I was headed straight for T2 diabetes (I also had gestational diabetes in ’98, well-controlled with a LC diet), which would greatly increase my risk of heart attack later, unless well controlled. With low carb I have stopped that progression to full-blown diabetes ( at least for now) without meds. Now I get normal or nearly normal glucose levels with a careful whole food LC diet & self-glucose monitoring (but really abnormal levels with high carb foods), so I shudder to think of what my health would be like if I hadn’t gone LC and read up on how glucose metabolism works and instead followed the same advice my family members follow. I figured this out without the help of my doctors, in fact, they were most unsupportive (and clueless about the post-natal glucose issues, actually, because LC was already treating it and keeping my labs in the high normal range).
Like you, I have many family members, especially the females) with numerous progressive health problems who worry a lot about their “abnormal” lipid numbers. They have spent years on strict low fat-high carb diets, taking statins (incl a younger sister who started on them in her early 30s! and had to stop nursing her infant – I think it was actually undiagnosed post-natal hypothyroidism). None of them ever see any “improvement” in their numbers without statins, and from my perspective they have a lot of health issues that I think are directly caused by the things they do to “correct” their lipids, but they don’t see the connection. Like many other people, my extended family members have a hard time accepting that the medical and nutritional advice they get is flawed, unsubstantiated, or even plain wrong and they tend to separate medical issues and treat the symptoms, instead of looking at the big picture and getting to the root cause. There is just no way I could do what they are doing – from my perspective following the conventional advice has just made their health worse.
I’ll bet your blood work doesn’t look as much like your unhealthy family members as you think, once you get beyond the high total chol and LDL. They probably don’t have good ratios, high enough HDL, nor low triglycerides. If they are eating low fat and high carb, they probably have the numerous small dense LDL particles that are worrying. I think Dr. Eades is right, determining your particle size and number might reassure you. Keep in mind, stressing over your labs isn’t good for you either, either :-). I’m not suggesting you have to see things my way, but I am pointing out that we have a lot of similarities, both follow a LC WOE, yet we have a very different perspective what the labs might mean or not mean. Everything about my health improved when my numbers got “worse” (by worse I mean by the lipid theory standards). It sounds like your paradigm hasn’t quite completed shifting yet.