Vegetarianism

Vegetarianism threatens those in the meat generation, for sure.

Good point, Bill. One of the healthy changes I've made since talking to you (wondering if YOU'VE made any healthy changes -- since being exposed to my rationally-compelling evidence) -- is to consume more foul, and less beef.

Ed,

Where do you find all of these studies? Google? Studies found on the internet are probably a poor reason to gobble down Big Macs in the name of philosophical triumph.

And, in this regard, I'm not "trusting Google" -- I've reviewed at least 100's of studies, at least 1000's of abstracts, and at least 10's of thousands of peer-reviewed titles.

In short, I don't "trust" Google, I trust my hundreds of hours of reflection on relevant evidence. And, if you had had the time, energy, and inclination to spend hundreds of hours of YOUR lifetime reflecting on scientific evidence -- then I'd expect you to trust that spent effort like I trust mine.

Is the domesticated fowl you're eating comparable in fat to the wild game that early man consumed?

Recap:

A 13.9% saturated fat diet improved heart disease risk -- as quantified by the gold standard "cholesterol : high-density lipoprotein (HDL) ratio" -- overandabove an 11.0% saturated fat diet (ie. the higher saturated fat diet was more healthful here).

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Metabolism. 2005 Jun;54(6):769-74.

Recap:

The saturated fat/fiber ratio predicts total cholesterol changes (ie. you can eat more saturated fat and, if you also eat more fiber, then your total cholesterol won't increase). The saturated fat/fiber ratio predicts LDL cholesterol changes  (ie. you can eat more saturated fat and, if you also eat more fiber, then your LDL cholesterol won't increase). The change in carbohydrate intake predicted the CHOL/HDL-C ratio (ie. the less carbohydrate you eat, the lower your risk of heart disease, as measured by the gold standard ratio of total cholesterol-to-HDLs).

Recap-on-the-recap: You can "get away with" increased saturated fat intakes -- as long as you control for total carbohydrate and fiber intake.

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Ann Intern Med. 2005 May 3;142(9):725-33.

The effect of a plant-based diet on plasma lipids in hypercholesterolemic adults: a randomized trial.

• Gardner CD,
• Coulston A,
• Chatterjee L,
• Rigby A,
• Spiller G,
• Farquhar JW.

Stanford University Medical School and Stanford University Medical Center, Stanford, California, USA. cgardner@stanford.edu

BACKGROUND: A variety of food combinations can be used to meet national U.S. guidelines for obtaining 30% of energy or less from total fat and 10% of energy or less from saturated fat. OBJECTIVE: To contrast plasma lipid responses to 2 low-fat diet patterns.

DESIGN: Randomized clinical trial.

SETTING: 4-week outpatient feeding study with weight held constant.

PARTICIPANTS: 120 adults 30 to 65 years of age with prestudy low-density lipoprotein (LDL) cholesterol concentrations of 3.3 to 4.8 mmol/L (130 to 190 mg/dL), body mass index less than 31 kg/m2, estimated dietary saturated fat at least 10% of calories, and otherwise general good health.

MEASUREMENTS: Plasma lipid levels.

INTERVENTION: Two diets, the Low-Fat diet and the Low-Fat Plus diet, designed to be identical in total fat, saturated fat, protein, carbohydrate, and cholesterol content, consistent with former American Heart Association Step I guidelines. The Low-Fat diet was relatively typical of a low-fat U.S. diet. The Low-Fat Plus diet incorporated considerably more vegetables, legumes, and whole grains, consistent with the 2000 American Heart Association revised guidelines.

RESULTS: Four-week changes in the Low-Fat and Low-Fat Plus groups were -0.24 mmol/L (-9.2 mg/dL) versus -0.46 mmol/L (-17.6 mg/dL) for total cholesterol (P = 0.01) and -0.18 mmol/L (-7.0 mg/dL) versus -0.36 mmol/L (-13.8 mg/dL) for LDL cholesterol (P = 0.02); between-group differences were -0.22 mmol/L (-9 mg/dL) (95% CI, -0.05 to -0.39 mmol/L [-2 to -15 mg/dL]) and -0.18 mmol/L (-7 mg/dL) (CI, -0.04 to -0.32 mmol/L [-2 to -12 mg/dL]) for total and LDL cholesterol, respectively. The 2 diet groups did not differ significantly in high-density lipoprotein cholesterol and triglyceride levels.

LIMITATIONS: 4-week duration.

CONCLUSIONS: Previous national dietary guidelines primarily emphasized avoiding saturated fat and cholesterol; as a result, the guidelines probably underestimated the potential LDL cholesterol-lowering effect of diet. In this study, emphasis on including nutrient-dense plant-based foods, consistent with recently revised national guidelines, increased the total and LDL cholesterol-lowering effect of a low-fat diet.

PMID: 15867404 [PubMed - indexed for MEDLINE]

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Recap:

A narrow focus on the quantity of saturated fat in a diet -- turning a blind-eye to the level of fruits and vegetables in said diet -- was a thinking error and is wrong. Or, said another way, total fiber intake trumps total saturated fat intake.

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Diabetologia. 2005 Jan;48(1):8-16.

Comparison of high-fat and high-protein diets with a high-carbohydrate diet in insulin-resistant obese women.

• McAuley KA,
• Hopkins CM,
• Smith KJ,
• McLay RT,
• Williams SM,
• Taylor RW,
• Mann JI.

Edgar National Centre for Diabetes Research, Medical and Surgical Sciences, University of Otago, PO Box 56, Dunedin, New Zealand. kirsten.mcauley@stonebow.otago.ac.nz

AIMS/HYPOTHESIS: A diet low in saturated fatty acids and rich in wholegrains, vegetables and fruit is recommended in order to reduce the risk of obesity, cardiovascular disease and type 2 diabetes mellitus. However there is widespread interest in high-fat ("Atkins Diet") and high-protein ("Zone Diet") alternatives to the conventional high-carbohydrate, high-fibre approach. We report on a randomised trial that compared these two alternative approaches with a conventional diet in overweight insulin-resistant women.

METHODS: Ninety-six normoglycaemic, insulin-resistant women (BMI >27 kg/m(2)) were randomised to one of three dietary interventions: a high-carbohydrate, high-fibre (HC) diet, the high-fat (HF) Atkins Diet, or the high-protein (HP) Zone Diet. The experimental approach was designed to mimic what might be achieved in clinical practice: the recommendations involved advice concerning food choices and were not prescriptive in terms of total energy. There were supervised weight loss and weight maintenance phases (8 weeks each), but there was no contact between the research team and the participants during the final 8 weeks of the study. Outcome was assessed in terms of body composition and indicators of cardiovascular and diabetes risk.

RESULTS: Body weight, waist circumference, triglycerides and insulin levels decreased with all three diets but, apart from insulin, the reductions were significantly greater in the HF and HP groups than in the HC group. These observations suggest that the popular diets reduced insulin resistance to a greater extent than the standard dietary advice did.

When compared with the HC diet, the HF and HP diets were shown to produce significantly (p<0.01) greater reductions in several parameters, including weight loss (HF -2.8 kg, HP -2.7 kg), waist circumference (HF -3.5 cm, HP -2.7 cm) and triglycerides (HF -0.30 mmol/l, HP [corrected] -0.22 mmol/l). LDL cholesterol decreased in individuals on the HC and HP diets, but tended to fluctuate in those on the HF diet to the extent that overall levels were significantly lower in the HP group than in the HF group (-0.28 mmol/l, 95% CI 0.04-0.52, p=0.02). Of those on the HF diet, 25% showed a >10% increase in LDL cholesterol, whereas this occurred in only 13% of subjects on the HC diet and 3% of those on the HP diet.

CONCLUSIONS/INTERPRETATION: In routine practice a reduced-carbohydrate, higher protein diet may be the most appropriate overall approach to reducing the risk of cardiovascular disease and type 2 diabetes. To achieve similar benefits on a HC diet, it may be necessary to increase fibre-rich wholegrains, legumes, vegetables and fruits, and to reduce saturated fatty acids to a greater extent than appears to be achieved by implementing current guidelines. The HF approach appears successful for weight loss in the short term, but lipid levels should be monitored. The potential deleterious effects of the diet in the long term remain a concern.

PMID: 15616799 [PubMed - indexed for MEDLINE]

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Recap:

High-fat (low-carb) diets are likely better for type 2 diabetics -- than high-carb diets are (in terms of disease risk).

Ed

Bill D.,

Good point about the malnourished Kenyans.

Ed