Oh for goodness sake...

[August]

Look,

I'm trying to help you out.  My mental health is just fine, as you know if you'd read for comprehension rather than trying to find another way to insult me.  I've lost 120lbs, so it's not like your insults or your diet recommendations are going to phase me.  I eat a high-fat paleo-style diet.  I gravitated to it because, after finding great AS on SLD, I wanted a diet that maximized nutrition in about 1500 calories.  I don't need to calorie restrict anymore, and over the years I found you really can't overeat all that well on this diet.   To belabor the point, I picked this diet and found out about how the body responds to overeating fat later.  Your implications fail to impress me. 

I do, however, know quite well what your diet recommendation lead; failure.  Admittedly, since the advent of SLD, people can probably fail less trying your approach, but they won't lose what they want to.  Have you read up on Omega 6:3 ratios?  Problems with grain, legumes, and dairy?  Have you ever wondered why, if saturated fat is so evil, the body makes it and uses it as a store of energy?  You haven't noticed that exercise makes you hungry, and that the work output versus calorie burned over time ratio on exercise makes it completely useless for weight loss?

Dairy is insulinogenic; if you were serious about taking everything into account, you'd recommend no dairy; low-fat dairy will make the insulin spike worse.

[anacara]

Quite frankly August, I think that Alchemist enjoys trying to be a spanner in the works. I haven't forgotten the time that I mentioned that chimps - our close cousins - do not eat grains as a rule. An Alchemist came back with some study that referrred to their consumption of grains. On closer inspection, it was a reference to some archaeological evidence that indicated that a particular site where grains had been eaten 10,000 years ago, may have been a chimpanzee site rather than a human site. He/she was well aware of this tenuous, one-off connection yet posted it nonetheless. A somewhat dishonest approach, I would say.

[An Alchemist]

August,

Please go back and check my pronouns. It's pretty clear to me that I wasn't referring to you, and I'm not sure how to make it any clearer. Olive branch?

[August]

Inevitably, as it was with Polaroid Doll, and will be with whoever else decides to play this game, there's one incredibly simple fact; you can try my diet.  You can dig up my old page.  You can find plenty of paleo stuff on the internet.  You could try it for a month.  I realize you think saturated fat is bad, but surely you don't think it'll damage you irreparably in one month?  There are too many of us alive to argue with you for that to be true.

The best olive branch would be a thin Alchemist. 

[An Alchemist]

OK August,

I can see an obvious double-standard here. Apparently when I try to explain what I believe to be a healthful way of eating, I’m secretly insulting people and unable to read for comprehension, but when you do it it’s okay, cause you’re just trying to “help” me? Let me set the record straight here, just so it’s clear for you. I’ve been able to help myself. I’ve been steadily losing weight, and am within striking distance of my goal now. This has been easier than the various diets I’ve tried before, and I’m pretty confident the weight will stay off this time, because my way of eating is sustainable long-term. So there’s no need for you to worry that I’m somehow floundering and failing, because I’m not. I let your comment slide when I posted last, because I gave you the benefit of the doubt that you just wrote something that came out wrong.

But even more narcissistic, if not downright cruel, if your implication that somehow “skinny” people might be worth more than those who aren’t skinny. It’s great that you’ve lost a large amount of weight. I know it feels good. But try not to forget what it was like to be overweight. It’s bad enough when society in general treats overweight people like they’re second class citizens—it’s bordering on unforgivable for someone on a weight loss board to suggest that skinny instills greater value in a person, and overweight people are somehow inferior.

And finally, to address your suggestion: No, a month on your diet wouldn’t damage me irreparably. But long term weight maintenance requires eating that way for the long term. Not a month, not a year, but for the rest of your life. People don’t suffer cardiovascular disease in a month. It takes years to develop, and longer for the symptoms to become obvious without medical testing. My cholesterol numbers were borderline high almost a year ago, but they were better when I was rechecked a couple months ago. This was without drugs, the only thing that changed was my diet. Reversing course and eating your diet would not only be setting myself up for serious disease, but could very well be a death sentence over the long term too. Being skinny simply just isn’t worth that, and especially not just to make myself more acceptable to the narcissistic portion of society. And honestly, “skinny” was never my goal.

[August]

I thought you were on these boards because you wanted to lose weight.  I thought anyone reading my last sentence would interpret it to mean I wanted you to achieve your goal.  Your nutritional information is highly inaccurate.  Curiously though, you can't actually have a discussion about, say low-fat dairy, without psychoanalyzing those who disagree with you.  Are you aware that narcissists can tell the truth about low-fat dairy?  Do you realize your paragraphs of fiction about me wouldn't prove your point even if I were thinking what you claim I'm thinking?

Paleo dieters improve their cholesterol as well, so don't worry about losing any ground on that measure, if you ever change your mind.

[nougat]

ok
noone is going to convince the other.
lets agree to disagree.

and congratulations to both for losing weight.

[An Alchemist]

So I’ve done a bit of independent reading to determine the true story on saturated fat intake and its relationship with cardiovascular disease.

The main points from a current review examining the issue (Am J Clin Nutrition 2010;91:502–9):

•   Reducing saturated fat to 9% of calories is associated with a reduction of cardiovascular disease compared to diets with higher levels of saturated fats. Reducing saturated fat to 7% or lower does not provide any greater reduction than a diet of 9%, because reducing below 9% is typically accompanied by an increase in refined carbohydrates, which can negate the benefit of the reduced saturated fat consumption.
•   The review also points out that although a couple studies exist suggesting that reducing saturated fat does not reduce cardiovascular disease, these studies had small sample sizes and limited duration of follow-up, hence the quality of the studies is poor.
•   The Mediterranean diet (high omega-3 intake, but low saturated fat intake) was found to reduce recurrent cardiovascular events by 72%.
•   Comprehensive diet/lifestyle changes, including vegetarian diet low in total fat, smoking cessation, stress reduction techniques and moderate exercise lead to a reduction of coronary atheroschlerosis after 1 yr and at a follow up of 5 yr compared to a control group. It is not certain which of these factors was responsible for the reduction, but it is seen that in combination these factors has a positive effect on cardiovascular health.

Studies have also shown that high saturated fat consumption impairs insulin sensitivity and increases inflammation (Clin. Nutrition 2004;23:447-56, Atheroschlerosis 2003;167:149-58, Mol. Cell Biochemistry 2003;246:155-62) and  is associated with accumulation of lipids in muscle tissue (Mol. Cell Biochemistry 2003;246:155-62).

These impartial sources suggest that moderating saturated fat consumption without increasing refined carbohydrate intake is indeed beneficial for reducing the risk of cardiovascular disease. This means whole grains, lean proteins, etc, should be used to replace the calories (if neccessary) from reducing saturated fat intake. The conclusions of the reviews and scholarly articles are based on (a sum of) hundreds of studies, taking into consideration multiple viewpoints, which would improve the accuracy of their conclusions.

[anacara]

But another article in the very same issue of the Americal Journal of Clinical Nutrition concludes the very opposite: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.

Here is the abstract:

Am J Clin Nutr 91: 535-546, 2010. First published January 13, 2010; doi:10.3945/ajcn.2009.27725
American Journal of Clinical Nutrition, doi:10.3945/ajcn.2009.27725
Vol. 91, No. 3, 535-546, March 2010
--------------------------------------------------------------------------------

ORIGINAL RESEARCH COMMUNICATION

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease1,2,3,4,5

Patty W Siri-Tarino, Qi Sun, Frank B Hu and Ronald M Krauss
1 From the Children's Hospital Oakland Research Institute Oakland CA (PWS-TRMK)the Departments of Nutrition (QSFBH)Epidemiology (FBH) Harvard School of Public Health Boston MA.

2 PWS-T and QS contributed equally to this work.

3 The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view of the National Center for Research Resources (http://www.ncrr.nih.gov) or the National Institutes of Health.

4 Supported by the National Dairy Council (PWS-T and RMK) and made possible by grant UL1 RR024131-01 from the National Center for Research Resources, a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research (PWS-T and RMK). QS was supported by a Postdoctoral Fellowship from Unilever Corporate Research. FBH was supported by NIH grant HL60712.

5 Address correspondence to RM Krauss, Children's Hospital Oakland Research Institute, 5700 Martin Luther King Junior Way, Oakland, CA 94609. E-mail: rkrauss@chori.org.


Background: A reduction in dietary saturated fat has generally been thought to improve cardiovascular health.

Objective: The objective of this meta-analysis was to summarize the evidence related to the association of dietary saturated fat with risk of coronary heart disease (CHD), stroke, and cardiovascular disease (CVD; CHD inclusive of stroke) in prospective epidemiologic studies.

Design: Twenty-one studies identified by searching MEDLINE and EMBASE databases and secondary referencing qualified for inclusion in this study. A random-effects model was used to derive composite relative risk estimates for CHD, stroke, and CVD.

Results: During 5–23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD. The pooled relative risk estimates that compared extreme quantiles of saturated fat intake were 1.07 (95% CI: 0.96, 1.19; P = 0.22) for CHD, 0.81 (95% CI: 0.62, 1.05; P = 0.11) for stroke, and 1.00 (95% CI: 0.89, 1.11; P = 0.95) for CVD. Consideration of age, sex, and study quality did not change the results.

Conclusions: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.

[anacara]

I just noticed that both of the articles in Am J Clin Nutr (both my reference and An Alchemist's) are by the same authors. Unfortunately I do not have access to the full texts, however judging from the abstract of the study An Alchemist refers to, s/he is being very selective in the "main points" as s/he has outlined them.

Here is the abstract for Am J Clin Nutrition 2010;91:502–9. Quite a different focus from the points chosen by An Alchemist.

A focus of dietary recommendations for cardiovascular disease (CVD) prevention and treatment has been a reduction in saturated fat intake, primarily as a means of lowering LDL-cholesterol concentrations. However, the evidence that supports a reduction in saturated fat intake must be evaluated in the context of replacement by other macronutrients. Clinical trials that replaced saturated fat with polyunsaturated fat have generally shown a reduction in CVD events, although several studies showed no effects. An independent association of saturated fat intake with CVD risk has not been consistently shown in prospective epidemiologic studies, although some have provided evidence of an increased risk in young individuals and in women. Replacement of saturated fat by polyunsaturated or monounsaturated fat lowers both LDL and HDL cholesterol. However, replacement with a higher carbohydrate intake, particularly refined carbohydrate, can exacerbate the atherogenic dyslipidemia associated with insulin resistance and obesity that includes increased triglycerides, small LDL particles, and reduced HDL cholesterol. In summary, although substitution of dietary polyunsaturated fat for saturated fat has been shown to lower CVD risk, there are few epidemiologic or clinical trial data to support a benefit of replacing saturated fat with carbohydrate. Furthermore, particularly given the differential effects of dietary saturated fats and carbohydrates on concentrations of larger and smaller LDL particles, respectively, dietary efforts to improve the increasing burden of CVD risk associated with atherogenic dyslipidemia should primarily emphasize the limitation of refined carbohydrate intakes and a reduction in excess adiposity.

[An Alchemist]

Actually, I've posted an accurate summary. You would see this if you would delve in a bit farther than just the abstract--the devil is in the details (not the abstract), as they say. Perhaps be less quick to judge negatively.

[anacara]

I did say that I don't actually have access to the article - it's not a matter of "delving further" - I simply can't afford it. Perhaps you may wish to post it since you do have access. I have also noticed on past occasions that you tend to fudge issues when it suits you, hence my mistrust.

[An Alchemist]

Certainly you have access to a public library too? I don't care to make myself vulnerable to copyright issues by posting it here or elsewhere--I'm sure you understand. I did obtain a copy of the meta-analysis too, but haven't yet had time to analyze this.

As far as 'fudging' the facts...not true. I've been forthright, and have on all occasions supplied the references for verification. What does seem true is that certain people hold different standards for when they do or don't agree with a person. Case in point: many studies on paleo-type diets rely on highly speculative analysis of untestable data. This doesn't bother anyone when they agree with the conclusion, but when data contrary (but of equal quality) is presented, they cry "but it's too speculative!". You can't have it both ways.

I'll continue to post my references where appropriate--if you can find access (I found it without cost...), you can verify it too.

[anacara]

I am in Athens, Greece, so no, I do not have access to a public library that stocks Am J Clin Nutr.

I've specified earlier what I mean by you fudging facts. The chimps and grains incident if you remember...

[An Alchemist]

Universities probably carry the journal. Many allow the public access to their stacks with a photo identification. Just a general hint--you may have access to resources you were unaware were available to you.