Effects of a carbohydrate-restricted diet on CVD risk factors

[mcsblues]

http://www.nutritionandmetabolism.com/content/3/1/19 (abstract)

http://www.nutritionandmetabolism.com/content/pdf/1743-7075-3-19.pdf

[Mitra]

Interesting, thank you Malcolm.

The main findings of the study were that a CRD
resulted in a spontaneous reduction in caloric intake in 93% of subjects and favorable effects on a number of non traditional biomarkers including a significant reduction in plasma Lp(a) in 76% of subjects and a significant reduction in the inflammatory markers CRP in 69% and TNF-α in 76% of subjects.

I noticed that while the averages changed, the actual figures seemed to change for about 3/4 of the people, though I think they commented in another place that they weren't necessarily all the same people. I would have liked to know if the ones whose numbers didn't change already had good/normal values, or if they had bad/abnormal levels that didn't respond - or no particular pattern.

It was also interesting to note that fat consumption didn't go up. With the reduced number of calories, the % would be higher, of course, and that's the number people seem to use. It's been my experience too, that as I increase my carbs I increase my fat intake - extra fruit needs cream, grains need butter &c, so my maintenance carb level is the level at which not only do I not get blood sugar imbalances, fluid retention, and the rest, but I automatically eat about the right number of calories. If I ate a lot of low-carb/high fat goodies (either unsweetened ones like cheese, or artificially sweetened), I suppose the number of carbs at which that happens would be lower.

[mcsblues]

It was also interesting to note that fat consumption didn't go up. With the reduced number of calories, the % would be higher, of course, and that's the number people seem to use. It's been my experience too, that as I increase my carbs I increase my fat intake - extra fruit needs cream, grains need butter &c, so my maintenance carb level is the level at which not only do I not get blood sugar imbalances, fluid retention, and the rest, but I automatically eat about the right number of calories. If I ate a lot of low-carb/high fat goodies (either unsweetened ones like cheese, or artificially sweetened), I suppose the number of carbs at which that happens would be lower.
I think the lower fat intake (ie the same as before LC) is a common response during the weight loss phase, and indicates two things. First there is a lingering fat phobia after the many years of listening to the fat police - both health and weight loss gurus:rolleyes: and also the 'healthier low fat options' style food marketing. The other factor is that during the weight loss phase people are ultra keen to ... lose weight!:) - meaning they are less likely to add in extras such as nuts, cheese and cream as they correctly perceive that this will slow or stall weight loss. It is not surprising therefore that subjects enrolled in a weight loss study (I imagine it would have been hard for them to imagine it was anything else) would be influenced by both these factors.

Maintenance is a whole new ball of wax! I agree that some of the extra fat might come as an adjunct to higher carb foods (like cream with fruit), but I think the gradual realization that adding extra fat or using fattier food sources is not as unhealthy as we have been led to believe plays a part (eg. buying fattier cuts of meat or cooking in fat more often than grilling/poaching) as does eating foods like cheese and nuts as snacks and judging them only on their carb count.

[Missy]

Malcom wrote: "The other factor is that during the weight loss phase people are ultra keen to ... lose weight!:) - meaning they are less likely to add in extras such as nuts, cheese and cream as they correctly perceive that this will slow or stall weight loss."



:D ....are you talking about MEEEEEEEEEE...????!!!!!!!!:D :D :D

As a newbie..I must tell you...I'm certainly at ODDS with this very subject...:rolleyes:

I get it in my head that it's okay...and then I think not! :eek: lol

[mcsblues]

As a newbie..I must tell you...I'm certainly at ODDS with this very subject...:rolleyes:
Hi Lynn,

I wouldn't worry about it too much because in a lot of ways it is a pretty good thing (to be wary about adding extra fat calories).

One of the reasons a low carb diet works so well for weight loss (in fact some people would say the main reason) is that natural tendency to eat less due to the greater satiety of a higher protein diet and also the relief from unstable blood sugar fuelled hunger. This is why when you read studies like the one above it is common for there to be a "spontaneous" reduction in intake (in this case 30.5% less calories which is a dramatic difference!) Strangely enough, some of the low carb detractors mark this unconscious and effortless reduction in calories as one of the downsides of this way of eating! As I'm sure you know, anyone with experience of the hunger that results from making a significant reduction in calories on the diet 'they' suggest (ultra low fat/high carb) would agree that this objection is just weird (to say the least!).

So in my view it is a good idea to be wary of adding extra fat and eating high calorie snack foods such as nuts and cheese ... just because you 'can' (ie. it fits within the carb limit on intervention or phase 2). What you need to do to make this WOL a permanent, successful one is not only to modify what you eat, but how much you eat - and if the initial lack of hunger combined with a mistrust of eating too much fat, help you down the path to make that change, so much the better.

[Missy]

Thank you for your advice Malcom!!!:D To be honest with you...I am sorta glad that this very subject has caused me to "stop and think"....because I'm at the very least becoming a very concious thinker about what I place in my mouth. And that is VERY different from the mindless eater I was a month ago. And, I think that's a good place to begin.

I not only have to think about food choices, but quantity within those choices...and the "fats" need that extra thought.

I feel like I'm the lonely uninformed newbie on this board...and everyone else "gets it" already...:redface: so I thank you for helping me understand.

[James L]

I feel like I'm the lonely uninformed newbie on this board...and everyone else "gets it" already..
Lynn,

I've been following this nutritional program, thankfully and successfully, for 8 years now, and I'm still learning.
.

[Missy]

lol...thanks for the encouragement James!!! Phew...then I shouldn't think I'm doing too bad for my first MONTH then!!!!!!!! :D

Eight years! WOW!!!!! :thumbsup: That's encouraging!!!!:D

[Gaelen]

The other factor is that during the weight loss phase people are ultra keen to ... lose weight!:) - meaning they are less likely to add in extras such as nuts, cheese and cream as they correctly perceive that this will slow or stall weight loss.

Actually, Malcolm, the idea that nuts, cheese and cream 'will slow or stall weight loss' is not a 'correct' perception, although it's pretty widespread. Those foods can be a problem for some people during the weight loss phases of learning how to control their carb intakes...but for other people (me for one), they are no issue at all. Even better, incorporating those fats into my menus during the weight loss phases ensured that I got enough healthy fats (saturated fat isn't necessarily evil ;)) to keep weight loss on track. When I don't eat enough fats, I don't take in enough calories...and then I don't lose. If my calorie intake dips below 1300 calories for too many days, I don't lose a thing...I finally figured that out after about six months on plan, by looking back into my journals and matching the weeks of most effective weight loss up to the weeks of most effective food intake. The lower fat, lower calorie weeks were non-loss weeks every time.

Lots of people lose a some pounds quickly, get very excited, and then watch their weight loss slow a bit, maybe even level off after a month or three or six. Their body is trying to catch its breath, but the people immediately think that their weight loss has 'stalled' and they will never lose another pound unless they DO SOMETHING right NOW! 'To stall' may be the single most over-used and improperly applied verb on any forum that discusses weight issues! We're so eager to assume that if weight isn't coming off a little bit every day, then we must be doing something wrong, and there must be something that we need to tweak in order to resume losing again.

The fact is, bodies undergoing weight loss need to readjust, something that will happen frequently if a person's got lots to lose, but can also happen to people who are only trying to lose 20 lbs. The readjustments may take a couple days, a couple weeks, a couple months depending on the individual's general health, exercise levels, and medical conditions. It doesn't mean the eating plan isn't working. It doesn't mean that there aren't other, less visible body improvements happening (like improved lipid profiles, for instance.) But all that low-fat conditioning kicks in, and suddenly the nuts, cream and cheese are the culprits and must be eliminated or severly restricted.

An ounce of pan fried bacon (3 slices, give or take or 28g) has 11g of fat--an ounce of half and half only has 3g and an oz. of heavy cream has 10g fat. An ounce of cheddar or brie cheese has 8g fat to bacon's 11g. An ounce of raw peanuts or blanched almonds has 14g fat to bacon's 11g...granted, macadamias are nearly double the fat content of the ounce of bacon, but they're the tasty exception. ;) But seldom do low carbers tell other low carbers to cut back on the bacon--although in the last four years, I've heard literally hundreds of posts counseling people to cut back on nuts, cheese and cream to 'get those pounds falling off again.'

For someone who's got lots to lose, or anyone with more than 10% of their bodyweight to lose who is just beginning, if fat were truly the issue in preventing weight loss, then ANY fat would be a problem...not just nuts, cream and butter. ;)

Gaelen...who used to be able to easily eat a half-pound of bacon on days when food looked good ;)

[Missy]

lol....thanks Gaelen. Eventually I'll GET IT! :D Promise. :D

[mcsblues]

For once Gaelen I think we are going to disagree. While its true some people may go to the extreme of lowering calories too far, and in so doing lower their BMR in the so called (and IMO highly overrated) 'starvation response', the reality for the vast majority is that the calorie reduction as evidenced by the subjects in this study is very good news indeed. Yes it is important to concentrate on the quality of the fats we eat (regardless of the intake level) and any remaining fat phobic responses to certain types of fat (yes, like saturated) needs to be dealt with (as the Eades do better than any other low carb writers).

But to suggest that items like cheese cream and nuts don't present significant challenges to weight loss and maintenance for many people is rather misguided in my view. Lets just look at cheese shall we? In theory (and sadly in practice) I could eat a kilo of cheese a day given half a chance. Is that a problem from a carb perspective? - no it it isn't - that would amount to less than 10cg - in fact looking at carbs alone I could eat a kilo 3-4 times a day!:lol: - and still be on intervention. Now obviously I'm not going to do that, but the sad fact about all these high fat high calorie items is that they are quite often added extras - in other words we can easily fall for the trap of eating 3 good meals a day and then add in these things as snacks between meals or as deserts we might not need.

Its a hard lesson for anyone new to low carb to learn, but while you probably don't need to count calories (just carbs) ... calories certainly count! Weight loss requires an energy/calorie deficit and for anyone either habitually or emotionally prone to overeating things like cheese cream and nuts represent danger foods that undoubtedly can slow, stall or even reverse weight loss. At some point we want the fat that we are burning to come from stored body fat - and this won't happen if we are getting more than enough in our diet to fuel our energy demands. Does that mean we should not eat them at all? Does it mean we should shy away from all healthy sources of fat? Of course not - but as I said to Lynn, being wary about adding too may fat rich foods to a healthy low carb diet and taking the opportunity that the initial satiating effect has to learn new eating habits is anything but a bad thing.:)

And Lynn, as James said, don't worry about the need to learn - I'm sure even our science guru Gabe would tell you he is still learning and it would be a sad day if any of us stopped!

[Gabriel Guzman]

True... I'm still learning... sometimes is science, and most of the time is about people.

I've read so many comments of people discussing fats and eat more fats and then you lose more or the opposite; don't over do your fats during your weight loss phase. Hardly ever I read that people choose, say, salmon as a source of fat instead of cheese or nuts. Ok, there is the expense but the example is not about the fish itself but about the type of fat. Perhaps the difference is that we still need to recognize that fats are not made equal, even the healthy ones. Since the only type of fat that's unhealthy in my book are the trans-fats, I don't demonize saturated fats but I do recognize that their fate in the body is a different than that of polyunsaturated ones, for example. Some fats are ideal for storage (saturated fats), whereas some are ideal for heat production when they're 'burned energy as heat' (omega-3 fats). I don't think this important difference is recognized completely and whereas neither type of fat is 'unhealthy', if the main intersest is weight loss or weight maintenance, then it's important to recognize that the type of fat itself can infulence whether we gain weight or burn more energy as heat.

I wonder if people that find themselves oon stalls or sudden increases of weight when they turn to cheese or nuts as their favorite carb-controlled snack, would experience the same if the turn to avocado or fish, for example. Would the effect be the same if the snack is a protein-rich snack all toghether... One thing is for sure; the fear of fats is so ingrained in our minds that it does take time and a virtual leap of fait to 'unlearn' what we've been told and step out of the anti-fat box to discover the new and exciting possibilities of becoming healthier every day eating what we're designed to thrive on.

[Mitra]

(eg. buying fattier cuts of meat or cooking in fat more often than grilling/poaching)

Well, we had pork sort of braised in olive oil last night :o so you may have a point. (It's a kind of duck confit way of cooking it.)

[lyn64]

Perhaps the difference is that we still need to recognize that fats are not made equal, even the healthy ones. Since the only type of fat that's unhealthy in my book are the trans-fats, I don't demonize saturated fats but I do recognize that their fate in the body is a different than that of polyunsaturated ones, for example. Some fats are ideal for storage (saturated fats), whereas some are ideal for heat production when they're 'burned energy as heat' (omega-3 fats). I don't think this important difference is recognized completely and whereas neither type of fat is 'unhealthy', if the main intersest is weight loss or weight maintenance, then it's important to recognize that the type of fat itself can infulence whether we gain weight or burn more energy as heat.



Hello Gabriel,
What about Omega 9's. Where do monounsaturates figure in the 'storage/heat production' stakes?

lyn

[Gabriel Guzman]

Hello Gabriel,
What about Omega 9's. Where do monounsaturates figure in the 'storage/heat production' stakes?

lyn

Omega-9 fats are somewhere in the middle. Apart from the number of insaturations, the length of the carbon chain also plays an important role in how the different fatty acids are handled. Much of this information was generated in the 80s and similar resutls have been obtained more recently. However, the comparison of the degree of insaturation between fatty acids with the same cain length is probably what is more relevant to your question. Ineed, the oxidation of alpha-linolenic acid (that's an omega-3 fat, precursor of EPA and DHA) in liver mitochondria was shown to be greater than that of linoleic (an omega-6 fat) and oleic (and omega-9 fat) acids. Several studies, even some dating from the mid 60s have shown the same; of the three types of fatty acids with the same chain lengh, the omega-3 type is oxidized faster than the omega-9 type with the omega-6 type somewhere in the middle. An important thing to remember here is that omega-3 and omega-6 fats we normally talk about are polyunsaturated, which means they have more than one insaturation. Monosaturated fats have only one. Perhaps the most famous monosaturated, omega-9 fat is oleic acid present in olive oil.

Of course, one could argue that since walnuts are rich in linolenic acid (an omega-3 fat), and since omega-3 fats seem to be burned at a higher rate thanthen there wouldn't be a problem in snacking on nuts that are rich in this polyunsaturated fatty acid. As discussed many times, linolenic oil is a precursor of the actual polyunsaturated fats we need, not 'the' one we need. If we're not in reasonably good health, then that omega-3 fat is not efficiently used to produce EPA and DHA, so that needs to be taken into consideration.

Another aspect of saturated fats that has to do with chain lenght is that those with shorter chain lengths tend to also be used not so much for storage and tend to be burned faster than longer chain fats. One of the best examples to illustrate that is coconut oil, which has a high content of saturated fat, only that such fat is a medium-chain saturated fat (10-carbon atoms). Short-chain fats, such as that of butter (called butyric acid; 4-carbon atoms in its chain) are always saturated and are handled different in the body. These short chain fats are directly absorbed for quick energy and are less likely to cause weight gain than fats with longer chains, even if they are monosaturated as olive oil. Some of them even have anti-bacterial effects.

So, the type of fat may influence whether it's used for storage or for energy and two characteristics seem to have an important role; insaturation and chain lenght. Before limiting a source of saturated fat becase of the fear that it will end up stored instead of burned, maybe we should look deeper into the characteristics of the fat; chain length in case of saturated fats, and insaturations in the case of mono- and/or polyunsaturated fats.

In the case of cheese, if you think of a 30-35% fat-containing cheese made from milk with with a rough fat composition of 11% myristic acid (C14, long chain saturated); 26% palmitic acid (C16, long chain saturated), 10% stearic acid (C18, long chain saturated), 20% oleic acid (C18, long chain monosaturated), and 11% short chain fatty acids including butiryc (C4), caproic (C6), caprylic (C8) and capric (C10), the actual amount of short chain fatty acids is low. Thus, one could argue that because there are more long chain saturated fats than monosaturated, then the type of fats would influence whether they will end up being stored rather than burned quickly. Even goat cheese, which contains ~ 5 gr of butyric acid per oz has four times more oleic acid (cheese made with cow's milk contains approsimately the same amount of oleic acid per oz but only ~2 g of butryric acid acid). So, one could think that since the amount of monosaturated fatty acids is higher and there is virtually no omega-3 or 6 fats fats, then overdoing on cheese, while may represent a good carbohydrate bargain, may not be the best thing if losing weight is the main goal, particularly if no other effort is made to increase energy expenditure.

In the case of nuts, walnuts contain more omega-6 and omega-3 fats than omega-9 fats. However, in terms of how good a carb-bargain they are, they come with 2-4 ECC per oz. Compared to macadamias, which come with less than 2 gr ECC per oz, walnuts may not be the best snacking choice. On the other hand, macadamias have very little omega-6 or omega-3 fats and quite a bit of omega-9, even though they are the best carb-bargain in the nuts department. So, what would it be the best snack? I suppose it depends on what you want to focus on. In general, I focus on ECC more than fat content but I am aware that different foods come with different fats and some of those are preferably stored than burned. But in my thought process, there are other factors that I consider, such as the amount of protein as well. The reason being is that if I feel the need to snack to begin with, then before I start relying on cheese and/or nuts, maybe I should start by re-examining if I'm eating enough protein, which ultimately is what helps more with satiety.

In any case, my choice of snack would always be something that has more protein than either carbohydrate or fat... chuncks of boiled or roasted (with or without skin) chicken breast always does the trick for me.

[mcsblues]

Sorry to sound like a cracked record;), but you keep talking about the likelihood of various types of fats being stored or burned quickly - which is interesting, but weren't you saying on the energy balance thread that if carbs are kept low enough weight gain through storing excess fats couldn't happen?

[Missy]

Mcsblues wrote: And Lynn, as James said, don't worry about the need to learn - I'm sure even our science guru Gabe would tell you he is still learning and it would be a sad day if any of us stopped!

~ Thanks for saying so and reassuring me Mcsblues...:) I just have this overwhelming need right now to "get it right"...or nearly right as best as I can anyways...and by asking things specifically and hearing the different perspectives..I think I do have a much clearer "handle" on how I should approach it now.

Here I thought it would be the "carbs" that I'd have issue with, and it's really that gray area of the sat fats:rolleyes: ....But, I think you all have cleared it up for me. I can have it, but not get carried away...and let's face it, I was a personality that used to indulged with sugar/fat and get carried away with no regard....and as I begin this new woe... sat/fats it's one area that I needed to know the "in's and out's" of.

I suppose that it's a natural thing to be drawn to the cheese and dairy, nuts aspect of it...and it's just a phase you go through as you adjust? I'm finding I'm leveling out already...and it's just going on my first full month. If you in the "loosing" mode it's one thing...and maintaining it's another. I am solidly focused on the losing aspect for a long while...so, I enjoy diary/nuts to a certain degree...but make sure it's not overly consumed.

Part of this adjustment to this woe is portion control too...and that has to be a learned behavior as well. There are many "balls" to keep in the air, and it may feel impossible sometimes, but eventually it will be come second nature...I feel very hopeful. Thanks to this "place" where I can talk it out and get feedback. Without it, I don't know if I'd hang in there to be honest with you. :rolleyes:


Gabe wrote: One thing is for sure; the fear of fats is so ingrained in our minds that it does take time and a virtual leap of fait to 'unlearn' what we've been told and step out of the anti-fat box to discover the new and exciting possibilities of becoming healthier every day eating what we're designed to thrive on.

Each time you all (each of you) reply to me it's helping me personally feel like I'm taking the right step and stepping away from those ingrained untrue messages. Who'd EVER think that was so difficult? As I said, I have to dig deep and reroute the river to achieve what I must and thanks to you all I know it's possible.

[Gabriel Guzman]

Sorry to sound like a cracked record;)

Yes... I'm afraid you are going down that route... ;)


...but you keep talking about the likelihood of various types of fats being stored or burned quickly - which is interesting, but weren't you saying on the energy balance thread that if carbs are kept low enough weight gain through storing excess fats couldn't happen?

You should be a lawyer! (or maybe you are...) :) You focus on the tree and sometimes miss the whole forest. Yes, fat internalization is insulin dependent so if insulin is not in excess then that process is not the 'main' metabolic event. So, if fat internalization is under control, then it doesn't matter which kind of fat comes in, does it? That is also the idea behind that little part in Protein Power (paraphrased), that 'fat synthesis is pretty much shut down' when insulin is not running the metabolic show.

Stalls, which is the context of the discussion in some of the post in this thread, is not fat internalization; is actually the preference for using the fat that comes from the diet instead of the fat in store. Can that happen even when insulin is not running the metabolic show? Sure! When the body uses what comes in the diet before tapping into the sources. During a stall, knowing that some fats tend to burn 'quicker' than others would help to make better choices of snacks. My point, however, is that if you really need that you'd die without a snack, then there is something else that needs to be changed in the first place, something needs to be tweaked so hunger is efficiently curbed. But even if you think you're doing everything right and still feel the need to snack, then your choices should consider that different fats are used differently in the body. Or better yet, your choice of snack should be protein-rich instead.

[lyn64]

Thanks for the detailed fat utilization lowdown Gabriel. I take it then that as fats go the shorter the saturation the better. So full fat goat cheese (for weight loss) gm for gm, (AOTBE etc.;)) is going to be a better choice than cow cheese? What are some of the other concentrated sources of short saturated fats? I appreciate that the length of saturation is not the be all and end all of fat selection for health in the context of a low carb diet.

Even if the goat cheese is only to make the chunks of chook more appealing:D .

Lyn

[LisaS]

coconut oil is said to be mostly MCT
the USDA breakdown is for saturated fat is about 45g/100g at 12:0 and 17g/100g 14:0,
compared to something like the saturated fat in beef tallow at 25g/100g of 16:0, 19g/100g 18:0

[Gabriel Guzman]

Thanks for the detailed fat utilization lowdown Gabriel. I take it then that as fats go the shorter the saturation the better. So full fat goat cheese (for weight loss) gm for gm, (AOTBE etc.;)) is going to be a better choice than cow cheese? What are some of the other concentrated sources of short saturated fats? I appreciate that the length of saturation is not the be all and end all of fat selection for health in the context of a low carb diet.

Even if the goat cheese is only to make the chunks of chook more appealing:D .

Lyn

Although is very tempting to think that goat cheese (that's one kind of cheese that I really love!) is a better choice than cow cheese because it has more butyric acid (short chain, antibacterial effects, etc.), it still has the same amount of omega-9 fats (in this case oleic acid). So the benefit is only in the other properties of butyric acid.

I agree with LisaS; coconut oil is one of the best sources of fats, apart from the fact that cooking with it adds an incredible flavor. The practicalities of having a coconut oil snack, however, is another story.

Nonetheless, and going back to the issue of choosing snacks, I keep on the protein-rich side because for me is more about curbing hunger than choosing between fat that burns more efficiently than others. True... my bias is protein.