"Today In Heart Health" newsletter 1/21/08

[Songwriter]

Their most recent newsletter. What errors (lies?) can you spot in here? Put out by the National Heart Lung & Blood Institute (NHLBI). Source at bottom. I figure the circulation of this is quite high. I'd love to see Dr. Eades take this on.

Today in Heart Health

Will a Low-Carb Diet Lower Your Cholesterol?

Can ditching bread and past! a help control your cholesterol? Some studies show that low-carb diets can lower triglycerides, but your overall cholesterol levels depend on how much red meat is in your diet.

As more and more people adopted these diets, food manufacturers and restaurants began promoting products to fit into this eating plan. Some of the low-carb diets (like the South Beach Diet) distinguish between good fats and bad fats, but some (like Atkins) don’t. Without any advice on which fats to eat, people tend to load up on the bad ones that they love: bacon, cheese, steak, and eggs, for example. But this approach leads to an unbalanced diet that’s way too high in saturated fats.

In fact, a study that used various equations to estimate the impact of certain diets on long-term health estimated that the Atkins diet would raise the average American’s cholesterol by 51 mg/dL. However, in more surprising news, some studies found that low-carb diets have a similar effect on cholesterol levels as low-fat diets, or in some cases even a better effect. For example, a six-month study of 79 obese people found that a low-carb diet had a similar effect on HDL and LDL levels compared with a low-fat diet, but the low-carb diet had a more favorable impact on triglyceride levels.

But other studies have found the opposite. So at this point there’s just not enough unbiased information out there to give a green light to eating bacon cheeseburgers (with or without the bun) every day. Plus, with what we do know about diet and cholesterol, it is illogical to conclude that long-term consumption of a low-carb, high-saturated fat, high-protein diet would be healthy:
The link between saturated fat and heart disease is well established; studies also suggest an increased risk for stroke, but the link is not as strong.
Low-carb diets are very low in fiber. Many studies worldwide link a high intake of fiber with a reduced risk of heart disease and diabetes.
The Atkins diet is very low in fruits and vegetables. Many studies link a high intake of fruits and vegetables with a reduced risk of heart disease and stroke.
Low-carb diets are very high in protein. Protein is essential for health. However, in animals, large amounts of protein accelerate the aging of the kidneys, and high-protein diets are harmful for some people with kidney disease. In addition, a high intake of protein causes calcium loss that may increase the risk of osteoporosis and kidney stones.
These diets are likely to be high in sodium (salt). A high intake of sodium is associated with an increased risk of high blood pressure in some people.
The best study to date on the subject found that even though low-carb dieters initially lose weight faster than low-fat dieters, at the end of a year, the two groups are neck-and-neck in the weight-loss race.On the plus side, low-carb diets often do lower triglyceride levels nicely, and they may have a less pronounced effect on lowering HDL, which often happens on low-fat diets. So, if you have high triglycerides, a low-carb diet could lead to a substantial reduction in triglycerides and thus in total cholesterol, although it is unlikely to have a beneficial impact on LDL cholesterol.

Source article (http://www.everydayhealth.com/publicsite/index.aspx?puid=ae5e0d25-b0d9-4ac4-ba65-201a40d469b5&p=12)

About This Newsletter:
The "Today in Heart Health" tip and "Featured Recipe" come from the National Heart, Lung, and Blood Institute (NHLBI). The NHLBI does not recommend or endorse any company advertised in this newsletter.

[maxlharris]

Without even reading it and just skipping to the BPs,

1- Flawed study about the equivalence of low fat and low carb diets focusing on weight loss rather than fat loss.

2- LC is not necessarily high in salt or sodium. Many LC dieters wind up replacing regular table salt with sea salt or lite salt. Most LC dieters wind up eschewing a lot of the packaged goods they used to eat, which are mostly absurdly high in salt and sodium. Nevermind that the link between sodium intake and any mortality is pretty tenuous at best.

3- The protein/kidney myth. It's been thoroughly debunked both in terms of the dietary protein consumed by low carb dieters and in terms of the health risk of high protein quotient.

4- Atkins induction includes 2-3 cups of leafy veggies and 1 cup of other, low glycemic vegetables. For most Atkins dieters, this is a marked increase in veggie consumption. Beyond two weeks or up to six months, Atkins dieters gradually increase vegetable consumption. In fact, a study found that atkins dieters, on average, were eating 5 serves of veggies a day, versus a prior consumption below 3.

5- If you are eating 5 serves of leafy veggies, and not getting enough fiber, you probably have something wrong with you. But, underlying the question of fiber consumption, is the question of the real utility of high fiber diets. As they are generally associated with total cholesterol reduction, not LDL reduction, or particle size improvement, one has to wonder.

6- After reading Good Calories, Bad Calories, you have to come away with the impression that the link between Sat Fat consumption and anything is pretty tenuous at best. Sat fat is an overly broad category. Many sat fats improve HDL. Many have no impact on cholesterol or heart disease. But Sat Fat is essential to cell wall construction.

I could go on and on, but when you figure that the 6 central objections of the post are based on junk, why bother.

Lastly, My LDL got a LOT better on my LC diet. I dropped something like 80 points in a month and change. My doc was amazed, expecting something like 10-15 points of LDL to be gone based on weight loss. The LDL drop doesn't happen for everyone, but I know more than a few it has happened for.

[bluejay111]

They (like many other publications) state a lot of BS without any references to the facts. If we listened to them we'd be eating burgers and fries for every meal.
Do they really think that all we eat is meat? I think they know that we eat a lot of veggies but if they admitted that they couldn't spread their lies.
Now that some of the truth is coming out about some of the cholesterol lowering drugs (Zetia and Vitorin) maybe some of the truth about fats and carbohydrates will follow. We can only hope.

[dvdmon]

I love how they are so tentative about recommending low-carb diets because of potentially conflicting studies and not enough "unbiased" information out there. But the whole history of the diet-heart hypothesis as laid out by Taubes in GCBC is rife with studies refuting the very foundations of this hypothesis, as well as numerous examples of adherents like Keyes, Stamler, etc., selectively choosing to ignore these because they don't fit with their beliefs.

I also like this:

On the plus side, low-carb diets often do lower triglyceride levels nicely, and they may have a less pronounced effect on lowering HDL, which often happens on low-fat diets.

Less pronounced Effect? Don't they mean that LC diets generally increase HDL whereas lowfat diets decrease it?

Oh well, at least they are starting to give LC points for something, which I guess is amazing in and of itself!

Unfortunately, no matter how many studies come out indicating LC can be a healthy way to live, I think we will still see a lot of this old mythology cropping up in all kinds of places for a long time, even when the medical establishment "officially" vindicates LC as a healthy option, I'm sure you will still see qualifications like "but remember to not skimp on fruits and veggies!" or "but try to keep your saturated fat levels moderate because there is still some evidence they may be harmful!" Or some such nonsense...

[maxlharris]

It took about 20 years for the Low Fat insanity to go from insanity to dogma. Take the 2002 Taubes article (Big Fat Lie) as the start point for a shift in understanding. By 2020, we should see the paradigm mostly shifted. But it's gonna be a long 12 years.

[dvdmon]

It took about 20 years for the Low Fat insanity to go from insanity to dogma. Take the 2002 Taubes article (Big Fat Lie) as the start point for a shift in understanding. By 2020, we should see the paradigm mostly shifted. But it's gonna be a long 12 years.

Max, I can only hope that the current generation are faster learners and with the advent of the Internets where information is shared, scrutinized and accepted/rejected at a much faster pace, that we might actually get there before this. GCBC is a nice step in this direction, and the new Businessweek article on statins also helps, so we'll see. Maybe we're starting to see the beginnings of an avalanche that the low-fat adherents simply can't keep from happening anymore...

Even so, the dogma was so universal for a while, I think it will be hard for a lot of people to let go of their assumptions, even when it is no longer the "official" line...

[maxlharris]

There was a piece about GCBC in the Times Science section when it first came out about Information Cascades. Informative read if you want to understand how memes change.

I have read, it takes 30 repetitions of a contradictory fact to change your understanding. That's 30 without hearing something reinforcing in between. So, you start with a ubiquitous Taubes post GCBC. On Larry King and other media outlets. Then you need to build. Any wonder why something like 4 months ago, Dr. Mike was talking about the difficulty in finding a publisher for a new LC book and this week, it was announced that a publisher won an auction to publish their belly erasing program, which you know will be LC. Clearly, something has shifted in the publishing world.

I'm not saying it's tomorrow, but I'm looking for 2022, plus/minus 5 years for some version of low carb to be the dogma.

[bluejay111]

One of the main problems I see is with information on tv. Everyday on the morning shows they bring in so called specialist in diet and nutrition and these people preach the same old dogma, low fat/high carb diet with plenty of whole grains and fiber. Makes you want to slap them along side the head and say wake up. But in reality they are only spewing the crap they were taught in school. Only when the schools for these people start teaching the facts will things change.

[maxlharris]

Tides change slowly. And in vogue experts change just as slowly. Again, 12-17 years and we should see a tipping point.

If you missed it, Sweden just adopted LC (or LCHF as they call it) as the national weight loss diet. Imagine the USDA advocating for LCHF. That's whats happened in Sweden.