John Tierney, science blogger for the New York Times, was as taken aback by the abject stupidity hostility of the comments to his recent post on fat in the diet that included a response from Gary Taubes about the Israeli low-carb study as I was in my recent post about his post. He decided to post on the subject again, specifically addressing the comments quibbling with the findings on saturated fat. And he included more feedback from Gary.
What we have to keep in mind here is that nutrition is a science (or at least should be) and science is about generating hypotheses, making predictions from our hypotheses, and then seeing if they hold true. The relevant hypothesis here — i.e., what we’ve believed for the past 30-odd years — is that saturated fat causes heart disease by elevating either total cholesterol or LDL cholesterol, specifically. So our prediction is that the diet with the higher saturated fat content will have a relatively deleterious effect on cholesterol. We do the test; we repeat it a half dozen times in different populations. Each time it fails to confirm our prediction. So maybe the hypothesis is wrong. That seems like a reasonable conclusion. No one is proving anything here — as some of your respondents like to decry — we’re just looking at the evidence and trying to decide which hypotheses it supports and which it tends to refute.
The knee-jerk response — as exemplified by quite a few respondents — is to assume that sometime in the not-too-distant past, maybe the 1960s or 1970s, before this low-fat dogma set in, such trials, or far better trials, were done and found the opposite — that the higher the saturated fat in the diet, the lower the cholesterol and the better the cholesterol profile. Or the higher the saturated fat, the greater the mortality. But that’s simply not the case, as I point out in my book. In fact, I’ve been criticized (by Gina Kolata, among others) for going on and on in the book about all the different studies. But I did so precisely because I didn’t want to be accused of cherry picking the data. (I was anyway, but that’s just the nature of this business.) When Ancel Keys, for instance, reported in the 1950s reported that saturated fats raised total cholesterol, which they did in his studies, he based it on comparisons of butter fat to polyunsaturated oils in studies that lasted only two to nine weeks. (He also reported, curiously enough, that the saturated fats had no significant effect on LDL.)
These latest trials just happen to be the best data we have on the long-term effects of saturated fat in the diet, and the best data we have says that more saturated fat is better than less. It may be true that if we lowered saturated fat further — say to 7 % of all calories as the American Heart Association is now recommending — or total fat down to 10 percent, as Dean Ornish argues, or raised saturated fat to 20 percent of calories, as Keys did, that we’d see a different result, but that’s just another hypothesis. The trials haven’t been done to test it. It’s also hard to imagine why a small decrease in saturated fat would be deleterious, but a larger decrease would be beneficial.
Gary’s full commentary here.
In scrolling through the ever-increasing list of comments to this Tierney post, it appears that there has been an outbreak of good sense. There are still a host of overbearing, know-it-all, self-righteous idiots out there (witness the comments below), but, thankfully, they are in the minority.
Bull. Utter Bull. When will the public stop trying to blame their waistlines on some mythical nutrient (or lack thereof) and realize that food…real actual food that does not come from a box, is the only thing you should eat. Eat Food. Not Much. Mostly Plants. How hard is that to recognize?
I noticed a few regular commenters on this blog had commented there, too. All were in the good sense camp.
I suppose that I shouldn’t be too hard on these commenters who are, I assume, just people out there with opinions based on little knowledge and a lot of prejudice when those who should know better make equally idiotic comments.
Here is Robert Eckel, M.D., former president of the American Heart Association (AHA) and professor of Medicine at the University of Colorado medical school, commenting on this study to Medscape (a site available to physicians only) and rejecting the idea that saturated fats could possibly be harmless (or, God forbid, beneficial). Before you read the comments of this influential physician/scientist, go back and read Gary’s comments (or reread GCBC) about how there is no evidence that saturated fat causes heart disease.
Anything that would endorse the Atkins-type of food-intake pattern would not be something that the AHA would back. Saturated fats raise LDL cholesterol — I don’t think many people would disagree with that. . . . At this point limiting saturated fats is still a position the AHA would claim, and I think that’s consistent with the National Cholesterol Education Program guidelines, the American Diabetes Association, the US Department of Agriculture. I don’t think there is any major professional organization at this point that’s willing to throw in the towel on saturated fats and say they are unimportant.
Uh, earth to Bob, earth to Bob, I think a lot of people who actually bothered to read the scientific literature would disagree that saturated fats do squat in terms of causing heart disease. If all you talk to is other statinators and lipophobes who are willing to believe the worst about fats without a shred of evidence other than these shared conversations, then I guess you could come away with this idea. But not if you read the scientific literature, which I always thought was what scientists did. This example glaringly demonstrates the point Gary made in GCBC when he wrote that nutritional science as practiced today can’t really be called science.
Dr. Eckel does make another strange point that I found intriguing in his diatribe against the findings of this study. He first adopts the Ornish argument that you can’t really call the low-fat diet a low-fat diet because it isn’t low-fat enough to qualify as a real low-fat diet. But Eckels morphs this argument into one that says this diet isn’t really an AHA diet because the AHA changed its dietary guidelines. Said he:
The AHA updated its dietary guidelines in 2005, which are quite different from the diet that’s quoted here. The dietary fat restriction at 30% of calories is no longer part of the AHA guidelines, and the saturated-fat content has been reduced from 10% to 7% and the cholesterol content from 300 to 200 mg/day. I think it’s a little bit unfair to kind of generalize that the AHA, number one, stands for a low-fat diet; that’s no longer the case.
Hmmm. Number one. Unfair to generalize that the AHA stands for a low-fat diet. Please.
And number two? Hold on to your seat. Here’s where it really gets interesting. The number two reason that the low-carb, higher-fat diet shouldn’t be compared to the AHA diet:
And number two, there is some kind of mysterious benefit of being on the Mediterranean and low-carb diets over time that doesn’t necessarily at this point have any explanation.
I am not making this up. That is a direct quote. Make of it what you will. I suppose the fact that insulin is a fat-storage hormone and that it decreases on a low-carb diet doesn’t “necessarily…have any explanation” in Dr. Eckel’s world, but I’ll bet that any low-carb newbie could probably set him straight.
Does anyone know definitively please , if thats poss, that if one does anaerobic exercise and one has a moderate cal deficit(3-500 off RMR) one is ‘telling’ the body that the muscles are not to be broken down as they’re being used ?
Was told this and dunno if its gibberish..sounds at least plausible if the cals aren’t too low.
supachramp at yahoo dot com
thankee and i would be so indebted i might send you 3 dozen goat
What were the responses to Dr. Eckel’s comments?
Medscape doesn’t have comments.
Great post. Thank you.
It makes one wonder how long it will take before the “ostriches” will pull their heads out of the sand. Obviously they are deaf to any evidence that contradicts their base-less assumptions.
The part that hurts is that most people see these ‘scientific’ opinions as factual. For me the wake-up call was simply that the harder I tried to follow the NCEP II guidelines, the more I gained weight, the more I was hungry, and the more my lipid profile got out of wack. The direction I was given did not make sense with what I was experiencing.
First I gave up trying, but later I started to search, and I came across your web-site, amongst others.
Your advise made logical sense. I started to follow it. The results were very obvious, very positive.
One person is a study with sample size one. Maybe this is what is takes: more and more folks getting frustrated with medical advise that does not help them. It is to be hoped that they start searching and find the answers they need for themselves.
Your history is pretty common, and is the reason so many people ultimately drift into the low-carb way of life after meeting with a lot of failure trying to follow the mainstream guidelines. I’m glad you’re finally on track and are doing so well.
“I suppose that I shouldn’t be too hard on these commenters who are, I assume, just people out there with opinions based on little knowledge and a lot of prejudice”
I sometimes wonder whether the battle to help these people understand is just as important as the battle with those who are supposedly knowledgeable. Perhaps I am naive to think that if there is a sufficient groundswell of opinion then it would influence a proportion of the ‘experts’ to look again at their position. If they were democratically elected like politicians perhaps this would hold true!
In any case, I find this video an invaluable way to get the point across to friends and colleagues who get bored of my attempted explanations….but I have never really taken the trouble to validate its content. Since you feature in it, perhaps you can comment on the extent to which everything else in the video is sound…
Pay Now Live Later
The video is spot on. It’s a funny and enlightening short history of why we are in the grip of the lipid hypothesis despite the fact that there is no supporting evidence.
Greetings, Dr Eades !! This is not specifically related to your recent post (though I read it with interest) but it seems that few others are up at 2 am reading and I have the privilege of being the first to comment. I recently bought a small “Magic Bullet” blender and have been using it daily to make my dose of Paleolithic Punch ! Just this afternoon, after making my first blood donation in quite some time, I downed my cod liver oil and supplements (CoQ10, Magnesium, ALA, etc) with my antioxidant packed punch. It’s great stuff !! If you’re not familiar with the “Magic Bullet” – it’s a small blender that makes the smoothie right in the plastic cup you drink the finished product out of. Clean up is 100 times easier than a regular full size blender. It costs about $60. It would also be incredibly easy to add a splash of vodka, but that’s a topic for another forum, I suppose.
Now, I can’t swear that I have completely overcome the “addictive lure of grains” (to use one of your phrases that I thought was so on target !!) but I am taking steps in the right direction and really enjoying your updates on the war against cholesterol & fat misinformation. I am totally on board intellectually, I just need to get my taste buds and stomach to join in !!
Getting the taste buds and stomach to join the battle is probably the toughest part. Good to hear from you. Are you ready for me in September?
I have been reading and enjoying your blog for a while now. I’m 36, and I became a convert to the low-carb idea after reading a copy of the South Beach Diet book 4 years ago, and have had a much better time controlling my weight and blood lipids since then (though the diet I follow is much closer to Atkins than SB).
5 years ago… HDL/Total Cholesterol: 37/190
18 months ago: 50/170
1 week ago: 56/220, Triglycerides (NONfasting): 98, Glucose: 94
As you might guess, the recent result was accompained by a form letter from my PCP informing me that the increases in LDL and total cholesterol were cause for concern and that I should try to follow a “low fat, weight reducing diet”. No mention of the HDL and triglyceride levels (which were within normal range even though I ate normally the day I was tested).
Both my father and my grandfather died of heart disease at age 68, and my father spent the last 10-15 years of his life following a low fat (even stopped eating meat entirely), high carb diet and watching his cholesterol and triglyceride levels spiral out of control.
My question: How do I go about finding a primary care physician who believes in controlled carbohydrate approach and understands more about cholesterol than “over 200 is bad”? Frankly, I don’t know whether to be concerned about the LDL or reassured by the HDL/triglycerides, and my current doctor’s advice is not likely to be helpful.
It’s tough to find a doc that’s on board with the idea that the lipid hypothesis is bunkum. It seems that they all want to put you on a statin and be done with it. If they do so, they limit their liability whereas is they work with you to improve your lipids by a diet (other than the standard low-fat diet) and you have a heart attack, some lawyer will be there suing them for not putting you on a statin. At least that’s the fear.
If you are concerned, I would find somewhere that does EBT scans of the heart and get one. If your calcium score is zilch, then pretty much irrespective of your lipids, you don’t have heart disease.
Roam through Dr. Davis’s blog for more info.
Leo Tolstoy wrote ”I know that most men, including those at ease with problems of the greatest complexity, can seldom accept even the simplest and most obvious truth if it be such as would oblige them to admit the falsity of conclusions which they delighted in explaining to colleagues, which they have proudly taught to others, and which they have woven, thread by thread, into the fabric of their lives.”
People get their egos so wrapped up in their beliefs that they can’t back down for fear of losing face.
Without objectivity, any scientific facts that disagree with with their particular point of view are either incorrect or irrelevant.
It’s bad enough when it’s Joe Six-Pack commenting on a blog article, but when men of science (or women) ignore facts in order to protect their egos, it’s something more than sad.
Agreed. I’ve always loved that Tolstoy quote. If it weren’t so long I would try to figure out how to incorporate it into the heading of my blog.
Our company sponsored a health screening this past week. It consisted of checking cholestrol from a finger prick (I did a fasting sample), height, weight, blood pressure and measuring body fat and a BMI calculation. Since I’m a low carber my blood numbers were excellent. When I told the “counselor” how I achieved such great results, she cautioned me that the Atkins (she just assumed I was on Atkins) diet was very harmful in the long run. I’ve been low carbing for only 8 years, so I guess I’m going to wake up dead one of these days from eating all that nasty saturated fat.
More evidence that advice from ‘counselors’ should be taken with a large grain of salt.
I try to consider diet is the context of how we evolved. We didn’t evolve to eat excess sugars because they weren’t readily available. But we also didn’t evolve to eat saturated fats, for the same reason. Where did the caveman find saturated fats? As a hunter he lived on lean (low fat!) game meat. I’ve been told he ate the brain and marrow; sources of saturated fat? But when the tribe sat down to a hearty dinner of Gemsbok the meat was divided among them and essentially the saturated fat made up a small portion of the individual meal. Just a guess.
For such reasons I eat little sugar, some fatty fish and a lot of lean meat.
Uh, as a rule of thumb, the larger the animal, the greater the percentage of saturated fat. It took early man about a thousand years to go from the far north of Alaska (where he crossed the Bering Strait) to the bottom of South America wiping out the entire population of large game animals on th two continents. And I mean large animals. Go to the Museum of Natural History in New York and wander among the skeletons of these beasts to see what roamed our continent 15,000 years ago and was hunted to extinction. Then tell me that early man didn’t eat saturated fat.
Plus, early man (and primitive man today) didn’t limit their consumption of animals to the steaks and chops, but ate the entire carcass sans horns, hoofs, hair and bones. There is a lot of saturated fat there.
There may be hope for Dr Eckel. Reread his first group of quotes. He dosen’t say what he thinks he just refers to the pc way that the AHA, NCEP, ADA, and the USDA think. His last statement about the big guns throwing in the towel sounds almost like wishfull thinking. He spoke about the “mysterious benefit” which i am sure he is smart enough to figure out just what that is. He is also smart enough to not go against the “major professional organizations ” because it wouldn’t be a fair fight. If he did then he might as well apply for a job at Pizza Hut and five years from now people would be saying oh yeah i remember that guy he went crazy just like that Eades guy.
One way to look at the fat versus carbohydrate as the preferred fuel debate is to look at the 3 potential sources of energy (protein, fat and carbohydrate) from a functional perspective:
1. Minimal storage capacity for glycogen, which can be converted, to glucose.
2. Extensive and very large storage capacity for fat.
3. Gram for gram, fat has more than twice as much energy as carbohydrate – a clear evolutionary efficiency advantage in terms of dietary sources of energy and storage in the human body.
4. The human body can go for weeks without food.
5. When food is not available the body runs on stored fat and after a point protein, not glycogen.
6. The management of dietary sources of glucose derived from carbohydrate presents significant challenges to human system.
7. The metabolism of carbohydrate drives insulin secretion.
8. High blood levels of glucose and insulin are exceedingly toxic.
9. There is a threshold blood insulin level after which fat burning is shut down.
10. Carbohydrates can be converted in the body to fat and stored as saturated fat.
11. Fat cannot be converted in the body to carbohydrate.
12. There is no requirement in human nutrition for carbohydrate.
13. The body can produce all the glucose it requires through the process of gluconeogenisis.
14. Abdominal fat synthesized from glucose is the first fat to be burned when carbohydrate consumption is reduced to the point that insulin drops below the threshold level.
The above strongly suggests that fat, not glucose, is the preferred fuel for the human system, that carbohydrate can act as a supplementary fuel in small quantities to augment fat and that carbohydrate can act as a source of stored fat when consumed in large quantities at sporadic intervals when dietary sources of fat are in short supply. In other words, carbohydrates are intended to keep us going so we can hunt for sources of dietary fat.
Excellent summary. I have only one quibble and it’s a matter of semantics. #11 states that fat cannot be converted to carbohydrate. It is true that fatty acids cannot be converted to carbohydrate. But fat, as in triglycerides stored in adipose tissue and circulating as serum triglycerides can be partially converted to carbohydrate. In triglycerides three fatty acids are attached to a glycerol backbone, and this glycerol backbone can be converted to glucose.
I’m grateful for all the low-carb blogs that keep me up to date, given the backwardness of the main stream health and medicine.
“But fat, as in triglycerides stored in adipose tissue and circulating as serum triglycerides can be partially converted to carbohydrate.”
I truly believe that if the current low fat (which is aways high carb) vs. low carb controversy were to be waged on functional merits the low fat camp would be hard pressed to mount an offense or even much of a defense against the low carb camp.
I am in complete agreement with Dr Eades as to saturated fat consumption by our ancestors — think about it this way, if I am not mistaken, when humans store fat, they store it as saturated fat. This would suggest that perhaps saturated are beneficial/natural/optimal?
I’m quite certain that saturated fats are beneficial.
Hi Dr. Eades,
Are you aware that Jimmy Moore has started an online list of low-carb doctors? Many states don’t have one listed yet, but there’s quite a few so far. Perhaps your reader Michael and others could find a doc close to them at http://lowcarbdoctors.blogspot.com/. Scroll down for the list of states and doctor’s names on the right hand side.
Although I don’t post much, I am am avid fan of yours and read everything you write. Thanks so much for the great service you provide us!
I didn’t realize this. Thanks for the heads up.
All the claims against saturated fat are nonsense, because most are based on epidemiology and modern people don’t eat a high saturated fat diet. Most eat lean meat, reduced-fat dairy, fried chicken, soybean oil, canola oil, margarine, and other crap. Saturated fat is the best fat and it reverses heart disease and artery narrowing. PUFAs accelerate heart disease, cancer, and loss of arterial function. Most of our fats should come from large mammals, lesser amounts from the small mammals, and even lesser amounts from poultry and fish. Vegetable oils should be strictly limited to coconut, macadamia, cocoa butter, olive oil, avocados, and hazelnuts. Other oils, as well as nuts and seeds, are too high in PUFAs and should be limited or avoided.
When animal studies actually test a saturated fat like coconut oil, butter, or beef tallow, in 9 times out of 10 they will add an equal amount of corn oil, soybean oil, safflower oil, canola or rapeseed oil, sunflower oil, or some other worthless polyunsaturated vegetable fat. Also, the studies are usually filled with refined carbohydrates like table sugar, corn starch, or flour, so it’s impossible to say whether fat or carbohydrate is to blame. But they never bother to even isolate all of their independent variables. They test one fat (corn oil) and they extrapolate to other fats, when they should compare like a dozen animal and vegetable fats.
Most studies also fail to distinguish between processed cooked fats (like lard) and fresh meat eaten raw or rare or medium. As a result, they introduce dozens of confounding variables so the results can’t be extrapolated to a diet based on fresh natural foods.
I’m not sure I would classify lard as a processed, cooked fat. Lard is simply rendered pork fat just as beef tallow is rendered beef fat. Granted, it is heated in the process, but I don’t think enough so that the fats are structurally changed. Lard has about the same fatty acid profile as olive oil.
If I may pitch in here because I normally get the same question from students when reviewing biochemical pathways. Strictly speaking, mammals cannot convert fat to carbohydrate ‘directly’ because we don’t have the necessary enzymes for that pathway. That is a fatty acid cannot be processed directly by an enzyme to change it into a carbohydrate molecule. Plants, however, can do that. I think that because the terms ‘fat’ and ‘lipid’ are use interchangeably to talk about fats in general (hence the misconception that cholesterol is a fat), the biochemistry of these distinct types of molecules is also confused sometimes. The fact that glycerol is obtained after a triglyceride molecule loses its three fatty acids, and then is used to fuel a gluconeogenic process doesn’t constitute evidence that fats per se can be ‘turned’ into carbohydrate. So I agree with Mike’s use of the term ‘partially’ in his reply to that great summary. GlycerOL, which is not a fat needs to undergo a few transformations before it can enter the gluconeogenic pathway. The glycerol backbone of triglycerides stored in fat cells is ensured of being used as a gluconeogenic substrate since fat cells lack the enzyme that would be needed to phosphorylate the glycerol molecule. Just my 0.02.
Thanks for the elaboration, Gabe.
Can you think of a metabolic or biochemical reason why adding more saturated fat to the diet in the form of coconut oil that is labelled as extra virgin/unrefined/no trans fats would result in constipation and painful, dry, cracked, skin and lips? The only explanation I can think of involves inaccurate labelling and/or adulteration of the product.
[Apologies for the semi-blatant non sequitur.]
No, I can’t think of a reason. Others out there have any ideas?
An interesting chart on the apparent changes in the American diet over the last 40 years or so:
Thanks, John. I saw this in the paper yesterday and plan to post on it soon.
Dr. Mike, thank you as always for your posts. Besides your amazing ability to break down even the most complicated of reports into something the layman can follow, they’re always an enjoyable read as well.
I do have a question that’s been bugging me for sometime, and maybe if you don’t know you could point me in the right direction to start pulling studies.
I’ve been on a low carb diet for the past 3 years, with the occasional cheat for holidays/event(average of 1 day every 5-6 weeks). I keep my carbs quite low, sub 35grams a day.
I’m also an avid weightlifter, 4x a week. The thing that has gotten me as that after giving up carbs, my strength has gone up quite a bit, bench press/deadlift/squats have all reached new numbers I never reached back when I did a regular low fat/high protein/mod carb bodybuilding diet. I’ve never been able to figure out why that is as it seems to go against the whole carbs for quick bursts of energy/bodybuilding dogma, unless my body has become just that more adept at burning fat for fuel over this time? Any thoughts?
And also, from the standpoint of lifting weights, with the lack of carbs in my diet, am I short changing myself as far as building new muscle? I always read about how important insulin as an anabolic signal to increase muscle repair/growth. I have noticed that while the lbage I lift is going up, I wouldn’t say my muscle size is that much bigger than before. Protein intake is good (200+grams daily). I’m 5’8 170lb, 11% bf.
Thanks for any advice you can give or point me to. I love how I feel on this diet and it’s put me in the best health I’ve ever been.
You are probably one of the lucky ones who carb adapt easily and quickly. Plus with the amount of protein you are eating you have plenty of substrate to convert to glucose if you need it.
You are building muscle because you’re a) getting plenty of good quality protein, which is what muscle is made of, and b) you are getting plenty of l-leucine, the branched-chain amino acid that is sort of the trigger for muscle growth. If you are getting stronger, you are building muscle. You probably don’t notice the size difference yet because you are replacing intramuscular fat with muscle. I suspect that if you keep at it, you’ll begin to see a difference in size. Plus, I’m not sure that hard resistance workouts four times per week is the best strategy to build muscle. The workouts tear muscle down – the rest periods rebuild them. Maybe spend a few days between workouts and see what happens.
Hi Dr. Eades,
I have a questions that isn’t realated to this post but I can’t find a place to mail you directly so here goes.
What are your thoughts on Kefir? I’ve been reading a lot about it and it looks like it’s pretty good stuff.
I feel about Kefir the same as I do about yogurt. It’s okay as long as it’s the plain stuff and not sweetened with a bunch of HFCS. it has some good probiotic value for the gut ad some folic acid. But I don’t eat it myself because I’m not a big fan of fermented dairy products. I would rather eat the cow (or sheep) it comes from.
Where did paleolithic eaters find saturated fat? They found it on the game animals that they hunted. The bison’s hump is basically tallow.
Fatty portions, including the viscera and adipose tissue, were the most desirable portions and were reserved for the chiefs and others first in line for the meat. The lean muscle meat was the poorest and least appealing part of the animal. If possible, the lean meat was commonly fed to animals or thrown away (according to Stefansson, Samuel Hearne, Cabeza de Vaca, Weston Price, who documented aboriginal diets).
In the early springtime, when animals tended to be leaner, there were well-known problems with eating too much protein, and the fatty parts of the animals were even more precious. In these times, hunting was discouraged except in emergencies. Just eating lean meat leads to symptoms including severe fatigue, malaise, susceptibility to infection, etc. Australian Aborigines are known to discard a kangaroo carcass if the animal does not have sufficient fat to make it worth slaughtering.
I aim for 70% of calories from fat, 25% from protein, 5% from carbs. So far, I’ve lost 35 lbs, and my cholesterol numbers are as good as they’ve ever been.
Dr. Eades. Thanks for the feedback. A nutritionist friend of mine had recommended I take a cocktail of l-glutamine, bcaa’s, and a little bit of creatine 2-3x a day centered close to my workouts and first thing when I wake up. It’s what he puts bodybuilders on that are low carbing for competition. He had mentioned the l-leucine as a signaling agent, and had recommend the bcaa’s because they don’t need to be broken down in the liver first to be used, they can basically uptake right into the bloodstream. (I could be paraphrasing/butchering that statement, but it was something to that extent)
It’s interesting you mention the rest, cause I had wondered about that element. I wasn’t sure if the lack of carbs might mean the body needs more time to recover since fat isn’t as an efficient energy source as carbs and it might need for recooperation time.
Thanks again for the feedback. And thanks as always for your hard work, your blog is one of the few I checked eagerly everyday in hope of an update 🙂
Regarding the study, the fasting glucose and insulin levels of diabetics for the Mediterranean diet was the only one that improved.
Weight loss was comparable, though there was a slightly more pronounced benefit for women on the Mediterranean diet and this is somewhat significant since weight loss for women is generally more difficult.
Weight control (not getting heavier) was effective across the board so carbohydrates didn’t make anyone fat. The Mediterranean diet had moderate carbohydrates (equal to low-fat) and lowest saturated fat and positively affected glycemic profiles. Since weight loss was about the same, or better for low-carb, decreased body fat was not the cause otherwise low-carb would have done as well, or according to low-carb proponents better, since carbohydrate intake is supposed to be solely (or mostly) responsible for insulin response.
Taubes’ theory rests on carbohydrates that drive insulin levels that he states affects everything else. The Mediterranean Diet yielded the best insulin control and improved insulin sensitivity.
From the study we gather:
– Carbohydrates don’t make people fat so long as people follow some sort of diet plan.
– Calorie restriction for (minimal) weight loss and sustained weight control worked, at least for two years. Long term is still up for debate. The low-carb diet was not calorie restricted but for some reason had the highest dropout rate (25%) which implies that calorie restriction isn’t necessarily the reason people fail to adhere to diet plans.
– It was demonstrated that best insulin control was with a diet including moderate carbohydrates and mindful of saturated fats.
Am I missing something here? The study reported that fasting glucose decreased in the Mediterranean diet but increased in the low fat diet. Low carb does not seem to be mentioned. So we do not know what happened here. The paper goes on to state:
“In contrast, insulin levels (Figure 4E) decreased significantly in participants with diabetes and in those without diabetes in all diet groups, with no significant differences among groups in the amount of decrease.”
It then states:
“Among the participants with diabetes, the decrease in HOMA-IR at 24 months (Figure 4F) was significantly greater in those assigned to the Mediterranean diet than in those assigned to the low-fat diet (2.3 and 0.3, respectively; P=0.02; P=0.04 for the interaction among diabetes and Mediterranean diet and time).”
Again, no mention of the low carb group.
“Among the participants with diabetes, the proportion of glycated hemoglobin at 24 months decreased by 0.4±1.3% in the low-fat group, 0.5±1.1% in the Mediterranean-diet group, and 0.9±0.8% in the low-carbohydrate group. The changes were significant (P<0.05) only in the low-carbohydrate group (P=0.45 for the comparison among groups).
In other words, the improvement in glycated hemoglobin, a key marker that reflects average blood sugar levels over a 2-3 months period was significant only in the low carb group whose carbohydrate intake was in the order to 3 – 4 times what is considered appropriate for diabetics. To me this is much more significant than an improvement in fasting glucose.
Taubes’s position on carbohydrate driving insulin secretion is basic chemistry. It is fact, not ‘Taubes’s theory’.
I agree with you on the glycated hemoglobin.
Unfortunately, it seems that there was as much left out of this paper as there was included.
“I’m not sure I would classify lard as a processed, cooked fat. Lard is simply rendered pork fat just as beef tallow is rendered beef fat. Granted, it is heated in the process, but I don’t think enough so that the fats are structurally changed.”
I think there would be a difference between eating fresh pork ribs or belly and eating lard or bacon or salt pork, because of the processing and additives. Meat breaks down when cooked and stored. Salt-preserved meat promotes scurvy, according to Stefansson. Eating fresh meat free of additives seems like the best choice. It would also be best to cook it minimally, surely not well-done or browned or burnt or blackened. Plus, most of the lard I have seen in stores had BHA/BHT or other preservatives. And about 2/3 of the lard I’ve seen was had a mix of lard and partially hydrogenated lard, which is definitely not ideal. I would get leaf lard, which is a similar type of fat to kidney suet in beef. It’s about 25% more saturated than regular pork fat, 50% saturated vs 40%. So it’s similar to red palm oil.
That statement is by far the funniest thing I have ever read on a nutrition blog….ever 🙂
Thanks for making my day Doc.
Glad you enjoyed it.