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The official website of Drs. Michael and Mary Dan Eades, low carb pioneers and authors of Protein Power.

It's lame

A couple of weeks ago I posted on the large JAMA study showing that, contrary to what we’ve heard ad nauseum over the past decade, fiber consumption produced no protective effect against colon cancer. Now comes one of the more bizarre studies that I’ve ever read.

The British journal Colorectal Disease published a paper a few months ago with the promising title “Diet and colorectal cancer: implications for the obese and devotees of the Atkins diet.” Hey, now were getting somewhere thinks I when this little baby fell into my hands through the agency of the university inter-library loan department. Then I began to read it.

I don’t know if medical journals have the equivalent of slow news days or if this particular journal, which I hadn’t previously seen, is a lower tier journal, but I can’t figure how this paper got published. I’m glad it did because most people will only get to read the abstract (my university didn’t have a subscription to the journal, thus my reliance on inter-library loan), and the abstract implies much that isn’t developed in the paper. I’m sure many people writing articles on low-carb diets will in the future reference this paper as one that shows low-carb diets to reduce the risk of colorectal cancer. The paper, however, doesn’t really do that. In fact, it doesn’t do much of anything.

When we take a look at the abstract, we – as low-carb devotees – see some exciting stuff:

Colorectal cancer (CRC) is the second most common cause of cancer-related death in the Western world and its prevalence is increasing. Potential causes of this increase are changes in diet and the increases in obesity seen. This paper looks at the literature surrounding diet and obesity and the links to this increase in CRC. Heralded as a weight loss miracle we investigate whether the literature suggests the Atkins diet may actually do more harm than good by acting to increase an individual’s risk of CRC. Obesity has been demonstrated to be a major factor in the increase in CRC although links to changes in diet are more tenuous. Published studies on diet suggest the Atkins diet may help reduce rather than increase the risk of CRC.

As we go through the paper, however, excitement wanes.

Basically, the paper can be summarized pretty quickly. Here is the Cliff Notes version.

Obesity is a huge problem worldwide. Many people looking for a solution have tried the Atkins and other low-carbohydrate diets. These low-carbohydrate diets recommend meat accompanied by non-starchy vegetables. Studies have shown a correlation between meat consumption and colorectal cancer (CRC). Other studies have shown no correlation between meat consumption and CRC. Studies have shown that consumption of non-starchy vegetables and fruits are protective against CRC. Some studies have shown a correlation between fat consumption and CRC; others have shown no such correlation. some studies show that carbohydrate intake, especially of sugars and refined starches, increase the risk for CRC; these findings have not been confirmed in other studies. The paper then makes a strange comment:

The reduction in carbohydrate on this diet (Atkins) may result in less fruit and vegetables ingested and for this reason the Atkins diet may actually increase the risk of CRC. This should not be the case for the phases where more carbohydrate is permitted; the problem is that as with many diets, there tends to be high rates of noncompliance and the initial induction phase may deter people from eating fresh fruit and vegetable, despite some public health measures of encouragement to do otherwise. Of additional concern is that dieters may solely utilize the ‘induction’ phase of the Atkins diet plan as an effective weight loss strategy before reverting back to an unhealthy regime of sugary foods.

More Cliff Notes:

Once again studies have shown dietary fat to cause increased risk for CRC; others don’t. Most studies have shown that obesity is a risk factor for CRC. In fact, obesity is probably the most significant risk factor. Low-carbohydrate diets are lower in calories than non-diets. Consuming fewer calories brings about weight-loss. Weight-loss reduces risk for CRC. And, therefore, the Atkins and other low-carb diets are a go. As the authors conclude:

Until there is more conclusive evidence, it does not appear that the Atkins diet plan should be rejected. Indeed, from the current evidence it may actually be beneficial by reducing the risk of developing CRC; total energy intake may be a more significant risk factor and any diet conferring a decreased calorie intake would presumably decrease this risk.

There is so much data out there showing that low-carb diets reduce the risk of CRC in so many ways that it’s really a shame that this kind of wishy washy crapola uses up valuable ink.

Reading this paper makes me recall the one and only time I ever listened to Howard Stern when I heard him say the following to a Star Trek fanatic who had spent God only knows how much time trying to derive the language of Klingons:

It’s lame, Dude. It’s really lame.

7 Comments

  1. Michael Sayre on January 9, 2006 at 10:07 pm

    Are you a fellow Trekkie?

  2. Michael R. Eades, MD on January 9, 2006 at 11:41 pm

    No

  3. Vito Stronzetto on January 10, 2006 at 5:34 am

    Interesting post. I thought that most science on diet and diseases was just as ambiguous as the article suggest so I would be very interested in seeing some of your links to articles that convincingly link lowcarb to decreased risk of CRC. Thanks

  4. Mark Levin on January 10, 2006 at 11:37 am

    One thing I have noticed reading yours and other reviews of the low fat and low carb literature is the emergence of the ‘scientician’, the scientist who wants to have it both ways, i.e appear both low fat and low carb at the same time so that he can still get his research moneys and acceptance from the low fat establishment and still appear to be on the cusp of scientific discovery covering his bets as to who will be proven correct. In this article they have sprinkled ‘sound bites’ that will keep both camps happy. There is as you noted almost no science involved.

  5. Michael R. Eades, MD on January 10, 2006 at 4:23 pm

    What a wonderful term, ‘scientician.’ I fear there are far too many of them.

  6. Michael R. Eades, MD on January 10, 2006 at 4:24 pm

    I plan a major post on this entire subject in the near future. Stay tuned.

  7. Gabriel E. Guzman, Ph.D. on January 11, 2006 at 7:39 am

    Perhaps the problem is in the way money is granted to conduct research, at least with respect to research related to diabetes and/or diabetes (or metabolism for that matter). If the reviewing committee is formed by a majority of “main stream” scientists, there is little chance for radically different ideas to get passed. The radically differnt idea behind research on carbohydrate control and its effect on particular conditions is that “fat consumption per se is not the root of the problem”. So simple… yet so difficult for some “experts” to grasp the concept regardless of the amount of evidence that supports that.

    This leads researchers to use ingenious ways to present the same idea in different words and sometimes even “disguised” within the main project. Pittiful, but true, particularly if your ideas go against those of the elite that decides who gets money and for what. This reminds me of a project I once knew about it; the main objective was to study tuberculosis but since there was little money for that (after all it used to be a “poor country disease”), the proposal was written to conduct studies on AIDS/HIV for which there was a lot of money and included a strong component about understanding the biology of the parasite that causes tuberculosis.

    The days of scientific research being conducted because 1) we need to learn and understand our own nature (which means we’re curious) and 2) we need to solve a problem that affects our societies, are gone. It would seem that science is not about being curious any more; doesn’t seem to be about proposing viable alternatives to solve an important problem (and improvement of health in 60+ percent of an entire country should be “important”); it seems to be about bias-oriented instead of evidence-based. If it goes along with the current dogmas then it’s fine… even if not true! Research nowadays seems to be about having something to market that can be mass-produced in the end.

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