The problem here is that all those studies are being done in populations with individuals having different genes or make up. That's why some people are hypo responsive or salt sensitive or just respond to specific therapy. Clinical studies compare individuals with different genes which is like comparing apples to pears to pineapples to oranges to grapes (different individuals). Meanwhile all are fruits (humans). They however taste different (respond different to interventions). The best solution is gene guided therapy which is far away from the horizon. For now we need to try different strategies on the same patient and use the one with the best response.
1
I think there are all kinds of reasons why people are fat and there are diets that are fattening for some people that are not for others. What I hope for myself and for others, is to follow the general guidelines Mr. Carroll includes here, but then to personalize the whole thing by tracking what a person eats each day and making a link with how their body feels. I can overeat when I am bored or vacationing, but when I am feeling healthy and dynamic I eat less, and eat more healthy. Following confusing recommendations might be less efficient then paying attention to yourself, how it makes you feel and what you might want to change.
1
Gary Taubes wrote "Why We Get Fat and What to Do About It and " reveals the bad nutritional science of the last century—none more damaging or misguided than the “calories-in, calories-out” model of why we get fat—and the good science that has been ignored. He also answers the most persistent questions: Why are some people thin and others fat? What roles do exercise and genetics play in our weight? What foods should we eat, and what foods should we avoid? Persuasive, straightforward, and practical, Why We Get Fat is an essential guide to nutrition and weight management." ...from Amazon
Strongly recommended.
Strongly recommended.
1
The vilification of fat and the emphasis on eating tons of grains is a huge culprit in the rising rates of weight gain nationwide. The USDA food pyramid long had catastrophic recommendations, like 11 servings of grains, and the like. Eating very low carb, or the right ratio of protein and carb (almost equal amounts of both) and a decent dose of fat is the way to go for the vast majority of people. Our bodies are just not adapted to complex carbs and grains. The agricultural revolution is a recent thing in terms of evolutionary history and we aren't adapted to it.
With too many carbohydrates, blood sugar rises and falls sharply and many people end up hungry all the time.
Keep the carbs low and the protein high and don't be scared of getting 20 or 30% of your caloric intake from fat. Read labels. A food diary is essential. You need to cut 3500 calories to burn 1 lb of fat. If you cut 500 calories a day from your "weight maintenance calories" (find a good book or website to figure out yours), you will lose 1 lb per week. Burn another 500 per day with exercise and you're up to 2 lbs per week. In one month you will lose 4-8 lbs. If you have a lot of weight to lose, you may well lose more at the beginning. I had a total of 20 lbs to lose and it took 6 months. I've never felt or looked better.
With too many carbohydrates, blood sugar rises and falls sharply and many people end up hungry all the time.
Keep the carbs low and the protein high and don't be scared of getting 20 or 30% of your caloric intake from fat. Read labels. A food diary is essential. You need to cut 3500 calories to burn 1 lb of fat. If you cut 500 calories a day from your "weight maintenance calories" (find a good book or website to figure out yours), you will lose 1 lb per week. Burn another 500 per day with exercise and you're up to 2 lbs per week. In one month you will lose 4-8 lbs. If you have a lot of weight to lose, you may well lose more at the beginning. I had a total of 20 lbs to lose and it took 6 months. I've never felt or looked better.
5
Wow! Yet another Brave New World. Red meat, fats.. sounds like something out of an old Woody Allen Movie.
When are we to be told smoking is good for us?
Naf
When are we to be told smoking is good for us?
Naf
5
We aren't just being told it is good for us, we are having it explained to us using rigorously collected scientific evidence. If you can't muster the brain power to read the words on the screen in front of you, don't bother commenting. You have the capacity to employ reason, correct? Then debate the findings, or stay quiet.
Thank you for pointing out the deficiencies in my intellect. I assumed it has been failing for these eighty-five years, and now you've confirmed it.
What a guy.
Gartefully, N.A. Fortis
What a guy.
Gartefully, N.A. Fortis
3
This article is all puffed up around the wrong issue. Yes, before 1983, evidence from six randomized controlled trials (with less than 3,000 white men with health conditions) was the foundation of the federal nutrition guidelines. "None were explicit studies" for nutritional recommendations--and yet the feds and other embraced that misapplied "science" for decades to come.
But your reporter is blind to the key issue: *why* was this misapplied evidence, gleaned from a very narrow slice of the American public, venerated as nutritional gospel? Who benefited? Or was it pure coincidence that the rise of ag subsidies coincided with this policy--and the downward slide of small farms, along with America's health? A decent reporter would follow the money, not be complicit in spreading this pap.
But your reporter is blind to the key issue: *why* was this misapplied evidence, gleaned from a very narrow slice of the American public, venerated as nutritional gospel? Who benefited? Or was it pure coincidence that the rise of ag subsidies coincided with this policy--and the downward slide of small farms, along with America's health? A decent reporter would follow the money, not be complicit in spreading this pap.
2
That exact angle was covered in a highly publicized article about a year ago- I'm guessing that's why he didn't bother, since it would be redundant.
1
Could you reference the article, please?
1
This has been a long time coming. The facts that eggs aren't bad for you and low fat foods make you fat have been acknowledged for some time.
It might be more appropriate to just say that following the government's advice is hazardous to your health. There is a recent claim that the next set of government guidelines will be aimed at reducing the consumption of meat, not because it is bad for you, but because cow farts contribute to global warming. When the government is offering health advice based on what the green lobby wants rather than what is good for your health, it is safer to ignore them!
It might be more appropriate to just say that following the government's advice is hazardous to your health. There is a recent claim that the next set of government guidelines will be aimed at reducing the consumption of meat, not because it is bad for you, but because cow farts contribute to global warming. When the government is offering health advice based on what the green lobby wants rather than what is good for your health, it is safer to ignore them!
2
Amazing how many medical "practitioners" are ignorant about diet and nutrition. They repeat same 50 year old discredited propaganda and when these criminals give advice to diabetics the results are tragic. I was in a hospital and ask for a diabetic diet and was given toast/pancakes/fruit cocktail/ full sugar milk and hardly any protein. and there is little talk about Americans replacing fats--even good fats--with carbs -processed starches and sugars...and how many diabetic specialists say anything at all about glycemic load. Most advice is eat 'moderately' and then inject more insulin when your blood sugar rises....Malpractice plain and simple. Low Potassium levels are more important than high sodium levels, yet how many PCP routinely test for blood potassium.. You know all calories cannot be equal. Look at the definition of a calorie...Does not take into account where a nutrient is processed, how it is transported and where and why the body processes the nutrients. How many doctors can explain the metabolic biochemistry involved with the connections between insulin release, blood sugar levels, and carbohydrate--sugar/starch processing.
5
In another report on this subject it was stated that of the amount of cholesterol present in the body only 20% comes from food. The remaining 80% is genetically-related. Therefore diet is not the issue. Blame your ancestors!! Meanwhile, it looks like the Atkins diet was dead-on accurate and still is.
As for salt, I've been addicted to it since I was about five minutes old. I'm now 71 with perfectly normal blood pressure, or as my doctor put: "You have the blood pressure of a teenager, albeit a recycled one."
The best medicine in the world is to eat everything in moderation and consume food from ALL the food groups. Anything else is a fad and bad.
As for salt, I've been addicted to it since I was about five minutes old. I'm now 71 with perfectly normal blood pressure, or as my doctor put: "You have the blood pressure of a teenager, albeit a recycled one."
The best medicine in the world is to eat everything in moderation and consume food from ALL the food groups. Anything else is a fad and bad.
2
Additionally, the clinical trials that supposedly showed that statins reduced heart attacks were grossly skewed - google the Jupiter study .The cover has recently been ripped off of that one. Also, the Framingham Heart study, which is one of if not the longest-running heart study, shows that women with lower cholesterol die earlier and have a higher risk for neurodegenerative diseases like dementia. No wonder doctors are the 4th leading cause of death in this country.
5
The only times in my life that I had high cholesterol were when I did not have enough thyroid replacement hormone for severe hypothyroidism. Regarding salt, I have high blood pressure, so a few years ago, I went off all salt, buying only low-salt or no-salt products and not using it at home. I did that for two years. It proved to be a bad choice for me. Among other maladies I got, it gave me muscle cramps like you wouldn't believe. Really horrible and unbelievably painful. It took my blood pressure down only a few points, I now am mindful of the salt I eat, but I eat far more than then. My muscle cramping problem has nearly resolved.
My great uncle ate a white bread sandwich every day of his long life for lunch. It was comprised of lots of butter, like an inch thick and onion. He married at 92 and lived for years after.
What I'm getting at is that the scientific community is missing something. It's right before their eyes, but they are missing it. It's called the Individual. Geez, when will they get with it?
Why subject an entire population of 314 hundred million people to a template? Besides the misery of dealing with difficult dietary regimes, it can be completely unhealthy for so many.
I love fat. It is a primal feeling all my own. Sometimes I have the urge to drink it. I resist it. I am not overweight. Your body tells you important health messages like that. I only like real fats, like butter, cream, olive oil, or what is found in meats, especially salmon.
My great uncle ate a white bread sandwich every day of his long life for lunch. It was comprised of lots of butter, like an inch thick and onion. He married at 92 and lived for years after.
What I'm getting at is that the scientific community is missing something. It's right before their eyes, but they are missing it. It's called the Individual. Geez, when will they get with it?
Why subject an entire population of 314 hundred million people to a template? Besides the misery of dealing with difficult dietary regimes, it can be completely unhealthy for so many.
I love fat. It is a primal feeling all my own. Sometimes I have the urge to drink it. I resist it. I am not overweight. Your body tells you important health messages like that. I only like real fats, like butter, cream, olive oil, or what is found in meats, especially salmon.
Part of the problem of the Public being misled by "reports" from government agencies and press releases is that the "reports" themselves come via news media which generally do not accurately or thoroughly communicate the information. This is in part because science and health "reporters" usually are not themselves scientists nor researchers nor clinicians. Even those with doctorate degrees which would suggest authority and accurate knowledge often "report" about studies outside of their areas of expertise. Example: some may have PhDs in public health, but are not medical doctors. Even a popular medical reporter for a cable channel has misled the public significantly recently about cannabis be cause of his lack of expertise in addicition medicine.
As a physician and researcher for many decades I cringe when I watch, hear, read "medical news" expecting the almost inevitable misleading report.
This essay by Dr. Carroll demonstrates the way it should be done.
As a physician and researcher for many decades I cringe when I watch, hear, read "medical news" expecting the almost inevitable misleading report.
This essay by Dr. Carroll demonstrates the way it should be done.
3
Why rely on Government experts to tell us how to eat?
Doctors and diet books, media reporting on nutritional science, government advisories and food pyramids dominate the scene.
It is common sense that those who eat so lots of processed foods and meat, lots of added fat and sugar, lots of refined grains, lots of everything except vegetables, fruits, and whole grains are at a greater risk of obesity, type 2 diabetes, cardiovascular disease, and cancer.
Most Indians rely on tradition and culture a deep reservoir of food wisdom to ensure people are kept healthy and the knowledge has been passed on successive generations in the form of food habits, mannerism, rules and taboos, a culture not exactly relying on science.
Indians who suffer deadly diseases are ones who have flagrantly violated grandma food wisdom.
Conservative India it is hard to teach the science of nutrition to common folks. But very orthodoxy has made people to realize that the foods are more than the sum of their nutrient parts, and those nutrients work together in ways that are still only dimly understood in modern science.
In a way fortunate as it has prevented the large ingress of heavily processed ready to eat food. It very much likely that the degree to which a food is processed is inversely proportional to the healthfulness: Not only can processing remove nutrients and add toxic chemicals, but it makes food more readily absorbent, which can be a problem for our insulin and fat metabolism.
Doctors and diet books, media reporting on nutritional science, government advisories and food pyramids dominate the scene.
It is common sense that those who eat so lots of processed foods and meat, lots of added fat and sugar, lots of refined grains, lots of everything except vegetables, fruits, and whole grains are at a greater risk of obesity, type 2 diabetes, cardiovascular disease, and cancer.
Most Indians rely on tradition and culture a deep reservoir of food wisdom to ensure people are kept healthy and the knowledge has been passed on successive generations in the form of food habits, mannerism, rules and taboos, a culture not exactly relying on science.
Indians who suffer deadly diseases are ones who have flagrantly violated grandma food wisdom.
Conservative India it is hard to teach the science of nutrition to common folks. But very orthodoxy has made people to realize that the foods are more than the sum of their nutrient parts, and those nutrients work together in ways that are still only dimly understood in modern science.
In a way fortunate as it has prevented the large ingress of heavily processed ready to eat food. It very much likely that the degree to which a food is processed is inversely proportional to the healthfulness: Not only can processing remove nutrients and add toxic chemicals, but it makes food more readily absorbent, which can be a problem for our insulin and fat metabolism.
1
My entire life (60 years) I've ignored dietary recommendations in favor of an "everything in moderation" approach. I never switched to margarine (love butter) nor have I become gluten-free. I have always eaten plenty of fruits and vegs because I like them and am not particularly fond of bread or pasta, but I do eat them as well.
Why this unrestricted approach? One reason is that I'm not a particularly disciplined person and I've never had any weight issues, so I haven't been tempted to alter my diet. But the other reason is that I'm an evolutionary biologist and as such I know that humans are true opportunistic omnivores and extremely adaptable to many different diets.
I've watched with amusement as various food fads have come and gone. Only to come and go again. Finally we have some real science coming in. And what does it say? Basically.....everything in moderation. What a surprise (not).
Why this unrestricted approach? One reason is that I'm not a particularly disciplined person and I've never had any weight issues, so I haven't been tempted to alter my diet. But the other reason is that I'm an evolutionary biologist and as such I know that humans are true opportunistic omnivores and extremely adaptable to many different diets.
I've watched with amusement as various food fads have come and gone. Only to come and go again. Finally we have some real science coming in. And what does it say? Basically.....everything in moderation. What a surprise (not).
4
If that works for you, then great! Honestly.
But some of us found ourselves fat, sick, and pre-diabetic on the "everything in moderation" approach. My background in biology led me to read and take seriously the ideas of paleo/primal/ancestral health, and trying out those ideas produced immediate and tangible benefits to my health. Now I know that even a moderate amount of wheat or wheat products will make me sick, and send my blood sugar through the roof.
But some of us found ourselves fat, sick, and pre-diabetic on the "everything in moderation" approach. My background in biology led me to read and take seriously the ideas of paleo/primal/ancestral health, and trying out those ideas produced immediate and tangible benefits to my health. Now I know that even a moderate amount of wheat or wheat products will make me sick, and send my blood sugar through the roof.
1
The Paleos may be as flakey as it is possible for cereal eschewers to be, but even a blind hog finds some acorns. And both the hog and the acorn are fine in the diet, while the bun for the pulled pork is poison. It's that simple. One can substitute the acorn for the hog for moral and environmental reasons, and admirably so, but there is no health benefit to the human. (Rather more to the hog) Done and dusted.
1
It seems to me that if most people avoid, or significantly limit consumption of trans fats (partially hydrogenated oils) in processed foods, and minimize intake of sugary foods and drinks, and don't splurge on salty foods, then it may be o.k. to eat somewhat moderate amounts of foods containing fat or cholesterol, IF they also eat lots of whole plant vegetables, fruits, beans, whole grains, nuts and seeds - many of which contain plentiful micronutrients and healthy fibers.
Regarding the importance of soluble fibers, I recommend article -
- "11 Foods That Lower Cholesterol" - health.harvard.com -
This list high lights plant foods which contain soluble fiber, "which binds to cholesterol and its precursors in the digestive system and drags them out of the body before they get into circulation."
- Article - "Atherosclerosis" - whfoods.com -
Research at the Manchester school of Medicine in Ontario, Canada - involving 16,407 participants from 52 countries - showed that foods which best reduced the risk of sudden heart attack, were - "green leafy vegetables, raw vegetables, cooked vegetables, and fresh fruits."
Regarding the importance of soluble fibers, I recommend article -
- "11 Foods That Lower Cholesterol" - health.harvard.com -
This list high lights plant foods which contain soluble fiber, "which binds to cholesterol and its precursors in the digestive system and drags them out of the body before they get into circulation."
- Article - "Atherosclerosis" - whfoods.com -
Research at the Manchester school of Medicine in Ontario, Canada - involving 16,407 participants from 52 countries - showed that foods which best reduced the risk of sudden heart attack, were - "green leafy vegetables, raw vegetables, cooked vegetables, and fresh fruits."
3
Did you not read the article??
2
A close look at legitimate research published in medical journals such as JAMA , the New England Journal of Medicine, Annals of Internal Medicine and the Journal of Epidemiology all show coffee has way more perks than pitfalls. To this day, one of my all-time favorite coffee health trivia tidbits comes from a Japanese cohort study published in the Journal of Epidemiology that showed coffee consumption was associated with a decreased risk of death from ALL causes. Beyond life extension, legitimate research shows coffee helps protect against Parkinson's disease, type 2 diabetes, gallstones, liver disease and much more! I actually just posted an article with more info and resources on this here: http://www.cleancuisineandmore.com/is-coffee-good-for-you/
1
Within a week of statin medication, I noticed 2 distinct episodes of cognitive dysfunction. As a 3rd generation woman (no family history of heart disease, either), I decided I'd rather take my chances with cholesterol.
9
This is been known since the 1970's, the fact that most of us are hypo responders to dietary cholesterol. I have sky high cholesterol, genetic in origin no doubt. I tried to lower it in the era BEFORE statins, and nothing i did lowered it. 80 mg a day of atorvastatin brings my levels to below normal.....and I can eat all the eggs I want and it doesn't change my cholesterol.
In addition there is little data actually relating blood cholesterol to heart disease directly. The whole dietary thing has been a disaster.....changing the way some people eat with no scientific basis.
Most people, of course eat TOO MUCH, which is the main culprit in obesity. What you eat isn't as important as how much you eat. And of course moderate exercise is essential. But most people want pills, not moderation and exercise.
And so it goes.
In addition there is little data actually relating blood cholesterol to heart disease directly. The whole dietary thing has been a disaster.....changing the way some people eat with no scientific basis.
Most people, of course eat TOO MUCH, which is the main culprit in obesity. What you eat isn't as important as how much you eat. And of course moderate exercise is essential. But most people want pills, not moderation and exercise.
And so it goes.
1
Eating less can come as downstream effect of eating better.
1
"In addition there is little data actually relating blood cholesterol to heart disease directly."....It has been well established that people with a genetic predilection for high cholesterol are prone to the early development of atherosclerosis and heart disease.
eating 'less' does not always equal weight loss or better health. It depends on what is eaten, in what amounts, When a food is eaten, how the food is prepared..and what combination of foods are eaten at a certain time...For the 40% predisposed to metabolic syndrome and diabetis, it makes a big difference.
Eating simple, fresh food and staying away from fried and processed food will do wonders. Americans have been eating chemical concoctions called "food" for so long that we're all sick and miserable and it is now time to stop. If you can't understand your food labels without an advanced degree in chemistry, don't eat it. This should be the only food guideline we really need.
4
Two points.
A. I believe it is necessary to consider diet in conjunction with related factors, notably exercise and weight/BMI to make inferences about what patterns should be recommended.
B. No trial is perfect whether randomized, prospectively, triple-blind placebo-controlled or large, simple epidemiologic in design. The latter are cheaper and faster and are useful for guiding the design and performance of the more expensive clinical trials.
Only if/when we develop an adequate knowledge base of (normal) human system biology will we be able to define AND INDIVIDUALIZE dietary recommendations. We are far from that at present.
Steve Rinsler, MD
A. I believe it is necessary to consider diet in conjunction with related factors, notably exercise and weight/BMI to make inferences about what patterns should be recommended.
B. No trial is perfect whether randomized, prospectively, triple-blind placebo-controlled or large, simple epidemiologic in design. The latter are cheaper and faster and are useful for guiding the design and performance of the more expensive clinical trials.
Only if/when we develop an adequate knowledge base of (normal) human system biology will we be able to define AND INDIVIDUALIZE dietary recommendations. We are far from that at present.
Steve Rinsler, MD
3
As a dietitian, I'm happy to see the cap on total fat lifted. But it is incorrect to say that the problem with low fat diets is that they end up being too high in carbs. The problem occurs only when people replace fat with *refined* carbs. Populations that eat high-carb diets--most notably vegetarians and especially vegans--have lower average body weights and less diabetes, which suggests that carbohydrates, when they come from unrefined foods, aren't all that bad. They answer isn't low fat or low-carb; it's carbohydrate from whole plant foods plus good fats.
7
and yet there are a significant number of 'vegans' who eat lousy food...and arrogantly profess their moral excellence to meat eaters...and their biochemistry isn't any better or even worse than a person who eats a healthy diet which includes natural meats. Eating processed sugars and starches negates any gain that a vegan exclusive diet may offer.
My own interesting take on this is that recently, while fishing around the internet, I found a couple of research papers on studying cardiovascular disease in South Africa in the 1950's. It was clear that back then researchers already knew that 1. cigarettes are bad for the heart and 2. the standard western diet is bad for the heart (diets rich in sugar, fats and carbs). They even showed a picture of an artery with fat streaks on it. It's shocking that we haven't moved the needle since then. The one thing that we do every day (eat) is the least understood thing that we do.
2
The author comments: "It’s hard to overestimate the effect of the dietary guidelines. Hundreds of millions of people changed their diets based on these recommendations. They consumed less fat, they avoided cholesterol and they reduced their intake of salt."
How can this be true when Americans spend 1/2 of their food budget dining out? Even appetizers have more than 1,000 mg of sodium. Sodium recommendations are 2,300 mg, or 1,500 mg in the presence of certain illnesses. No way, no how are Americans achieving this.
How can this be true when Americans spend 1/2 of their food budget dining out? Even appetizers have more than 1,000 mg of sodium. Sodium recommendations are 2,300 mg, or 1,500 mg in the presence of certain illnesses. No way, no how are Americans achieving this.
4
It's true because when they eat the Standard American Diet, wind up with metabolic disease, and see their physician, their physician puts them on a low-fat, low-salt diet. And that is unhealthful. Millions DO follow it.
4
It's a toughie, the evidence, the data, the studies, are complex. But at the current time, the major experts are all in favor of a diet high in unrefined plant foods, especially fruits and vegetables. And if you can afford it, and/or have more cooking and cleaning time, it's a great way to get and stay thin.
Generally:
1) With these studies, do they look at just small differences -- a little more of this or that -- or big? Because the marginal effects can be huge. Likewise, did they look at short term or long term, or decades, or through childhood, when crucially, the body and brain are developing.
2) Again, instead of what? Red meat is not bad, compared to what? People who ate less red meat but more white pasta and potato chips instead, were no better off? Does this mean red meat is not much worse than unrefined plant food, and at the high levels Americans eat red meat and low levels they eat unrefined plants (marginal benefits and costs!)?
Generally:
1) With these studies, do they look at just small differences -- a little more of this or that -- or big? Because the marginal effects can be huge. Likewise, did they look at short term or long term, or decades, or through childhood, when crucially, the body and brain are developing.
2) Again, instead of what? Red meat is not bad, compared to what? People who ate less red meat but more white pasta and potato chips instead, were no better off? Does this mean red meat is not much worse than unrefined plant food, and at the high levels Americans eat red meat and low levels they eat unrefined plants (marginal benefits and costs!)?
3
What we don't know is the quality of the baseline, control diet in the studies discussed in the meta-analyses. If everyone in these studies is an American man, it's likely that most are eating the typically American over processed, high calorie, high saturated-fat, high sugar diet (compared to what much of the world and most of humankind in the past ate). If the baseline diet for all the participants, treatment and control group alike, is too high in fat, then you would likely see little difference in adding or taking away small percentages of fat from their essentially unhealthy diets. The appropriate comparison is with a population that eats a whole foods, varied, plant-based diet, low in fat, sugar, and alcohol. Overwhelming evidence from studies of populations that eat whole-food, plant-based diets show very low incidence of the degenerative diseases (heart disease, diabetes, cancer, dementia, stroke) that plague industrialized societies. Studies of single nutrients divorced from overall diet style are inherently flawed: this is why the type of analysis discussed in this article, and the purported conclusions, are so dangerous and misleading.
7
Ancestral human diets ranged from mostly plants to mostly animal foods (including lots of saturated fats). Both ends of this spectrum were relatively free of chronic/degenerative diseases, what they have in common is nutrient density and lack of processed foods.
http://ajcn.nutrition.org/content/71/3/682.full
http://www.marksdailyapple.com/how-hunter-gatherer-diets-varied/#axzz3Si...
If we compare groups that are different in a dozen or more diet and lifestyle variables, we'll see some different outcomes, but we can't ever be sure which (if any) of those variables affected the outcomes. Was it the meat? The carbs? The fat? The lack of exercise? The alcohol? The amount of plant foods? Two or more of those factors combined? Something else that we forgot to measure? This is why we have the scientific method. One major point of the article was that experimental trials are our best chance of disentangling the possible effects of all those variables.
Another major point of this article is that we've had 40 years of dietary recommendations proclaimed to the public with absolute certainty, when in fact the science behind those recommendations was a tangled mess of murky associations and confounded variables.
http://ajcn.nutrition.org/content/71/3/682.full
http://www.marksdailyapple.com/how-hunter-gatherer-diets-varied/#axzz3Si...
If we compare groups that are different in a dozen or more diet and lifestyle variables, we'll see some different outcomes, but we can't ever be sure which (if any) of those variables affected the outcomes. Was it the meat? The carbs? The fat? The lack of exercise? The alcohol? The amount of plant foods? Two or more of those factors combined? Something else that we forgot to measure? This is why we have the scientific method. One major point of the article was that experimental trials are our best chance of disentangling the possible effects of all those variables.
Another major point of this article is that we've had 40 years of dietary recommendations proclaimed to the public with absolute certainty, when in fact the science behind those recommendations was a tangled mess of murky associations and confounded variables.
5
Actually, no. Studying a single nutrient in isolation, as in these trials, is a poor way to understand the interaction of thousands of micronutrients--especially when most of them are undiscovered by science. It is an even poorer idea to do comparison studies of single macronutrients when the full dietary pattern of neither group of people is understood, and the diets of both are likely full of junk food.
4
Let's pick a question: what dietary approach(es) would minimize the risk of heart disease (on average, for a given population)? So, lay it out for us. Sketch a design for a study that would answer this question.
If your baseline comparison is a diet "full of junk food," then I predict _almost anything_ will reduce the risk of heart disease. But that seems like a low bar to set, doesn't it? "All junk food" vs. "low fat low sugar mostly plants" is a false dichotomy -- there many other possible diets, which means there are many other comparisons we could be making in our studies.
If your baseline comparison is a diet "full of junk food," then I predict _almost anything_ will reduce the risk of heart disease. But that seems like a low bar to set, doesn't it? "All junk food" vs. "low fat low sugar mostly plants" is a false dichotomy -- there many other possible diets, which means there are many other comparisons we could be making in our studies.
One thing that the recommendations and this article do not address is the effect of too much saturated fat on those of us carrying one or two copies of the APOE 4 “Alzheimers” gene. Research has shown that carriers of this gene do not process fat well. Another study showed a high saturated fat diet can increase the brain “tangles” in a relatively short time.
I tried low carb, high protein and high fat for a while and my cholesterol zoomed into the stratosphere. One diet still doesn’t fit all, it seems.
I tried low carb, high protein and high fat for a while and my cholesterol zoomed into the stratosphere. One diet still doesn’t fit all, it seems.
4
So the settled science of nutrition has changed because of new data? Imagine that!
2
That's not so much the point. The data that dietary cholesterol was harmless is from the 1950's, but the recommendation to avoid it only changed last week. Studies clarifying the historically/anthropologically obvious conclusion that saturated fat was harmless were done in the 1990s, but the target for dietary sat fat has just been ratcheted down even further. The point of this article (and similar) is that the dogma has been and still is being driven by dogma, not by data.
10
The point of this article (and similar) is that the dogma has been and still is being driven by dogma, not by data.
------
Really? Dogma and not data? Who knew?! I wonder if that happens in any other "scientific" fields. What do you think?
------
Really? Dogma and not data? Who knew?! I wonder if that happens in any other "scientific" fields. What do you think?
1
Science is never settled. It's always open to new evidence.
2
I believe the low carb, plenty of vegetables, no processed food part of the new guidelines is correct for everyone. However, approximately one-fifth of Americans carry an Alzheimer's gene, apoe4. High saturated fat in those people can accelerate cardiovascular disease and memory problems. The new guidelines giving the green flag to saturated fat are wrong for them and they may be better off eating fish and shellfish instead of lots of red meat. It is wrong to issue guidelines that are inappropriate for 20% of the population. If we are to slow the Alzheimer's epidemic and its cost on our society it is important to make that distinction.
3
Yeah, well, it was also wrong to recommend a high carb, low fat diet to the (arguably) 80% of the population that that diet is harmful for. Obviously swinging the pendulum the other direction for a few decades wouldn't be ideal, but how about recommendations that admit that we don't know everything and all people are not the same?
6
For the people with this gene, is it the saturation that's the problem, or animal fat? I know that saturated fats are not all alike in their chemical structures and how they operate in the body, and that saturated fats from plant sources do not have the same effects as those from animal sources. Is this also true in the case with this gene? Does anyone know?
What a concise, well-written article. One to bookmark, and one that I will take the time to read (and possibly bookmark) every linked study. Dr. Carroll has summarized where we are in nutrition science as succinctly and thoroughly as any article I've read in quite some time. Thank you!
7
What a great piece. It is rare to find rational thought in the form of journalistic prose particularly in the medical arena. I am looking forward to reading about the debunking of the "NPO after midnight" debacle, too.
3
Here's the problem: When you continue to focus on individual elements of the diet (fat, protein, carbs, salt) rather than on overall eating styles, you provide no useful guidance for anyone. As a doctor treating obesity,I can tell you that my patients would get no helpful information from knowing how many added teaspoons of sugar to consume in a day. Who counts all this stuff?
It is likely that our new acceptance of fat, without any specific guidance regarding carbs, could lead to the consumption of the ultimate and atherogenic SAD (standard American diet): a combination of fatty foods (now deemed "healthy", with insulin-stimulating carbohydrate. Much better to give people a choice of particular eating styles. The guidelines do reference the Mediterranean diet and vegetarian diets---but the latter can be problematic when they it is overly reliant on carbs as well.
Once again, primal style diets are ignored. Yet more primal eating plans rely on healthy fats, low carbohydrate consumption (except for fruits and vegetables), and a selection of foods that deliver high quality micronutrients.
We have been using primal variants in my medical obesity practice for years. It seems to me that all we are doing in micro-dissecting our diet into elements is chasing the diet to which we were genetically adapted. While we cannot completely recreate that, why not simply try to get as close as possible? www.refusetoregain.com
It is likely that our new acceptance of fat, without any specific guidance regarding carbs, could lead to the consumption of the ultimate and atherogenic SAD (standard American diet): a combination of fatty foods (now deemed "healthy", with insulin-stimulating carbohydrate. Much better to give people a choice of particular eating styles. The guidelines do reference the Mediterranean diet and vegetarian diets---but the latter can be problematic when they it is overly reliant on carbs as well.
Once again, primal style diets are ignored. Yet more primal eating plans rely on healthy fats, low carbohydrate consumption (except for fruits and vegetables), and a selection of foods that deliver high quality micronutrients.
We have been using primal variants in my medical obesity practice for years. It seems to me that all we are doing in micro-dissecting our diet into elements is chasing the diet to which we were genetically adapted. While we cannot completely recreate that, why not simply try to get as close as possible? www.refusetoregain.com
9
My own highly unscientific but random study began 20 plus years ago when I heard about a super low carbo high protein diet being pushed by supplement manufacturers. I thought it was faddish and suspect, given the source. But then people who went on the diet lost a lot of weight. Since then, the only instances I have ever heard of people really losing weight were with low carb diets. Nothing else ever worked. That's random and unscientific but compelling.
4
Low refined carbs -- that should work. But a diet containing lots of spinach, mushrooms, artichokes, kale, and tomatoes will be "high carb" but would also produce weight loss. Whole-foods and plant-based diets DO succeed in helping a lot of people lose weight.
2
I never fell into the fat is bad fad.
Eggs are great and so is whole fat dairy. I believe the "low fat" hype was a marketing campaign, which made billionaire from these fake foodmakers.
I remember the margarine craze in the 1980's when butter was suppose to be bad. It turns out butter, and whole milk is healthier than the " I can't believe it not butters" stuff.
The fattiest and thickest milks I saw was in Eastern European villages and heart disease was practically non-existent in the population, with many people living well pass 100.
http://desperateloseweight.blogspot.com/2015/01/lose-weight-healthy-way....
Eggs are great and so is whole fat dairy. I believe the "low fat" hype was a marketing campaign, which made billionaire from these fake foodmakers.
I remember the margarine craze in the 1980's when butter was suppose to be bad. It turns out butter, and whole milk is healthier than the " I can't believe it not butters" stuff.
The fattiest and thickest milks I saw was in Eastern European villages and heart disease was practically non-existent in the population, with many people living well pass 100.
http://desperateloseweight.blogspot.com/2015/01/lose-weight-healthy-way....
7
While I agree with most of what you say, I think you're mistaking cause & effect when it comes to the reasons for the hype. The low fat mantra came from "scientists" who had an economic motive to skew statistical models to come out with a bias against fat. (They got more grants that way) The US government accepted that and pushed it hard in its dietary guidelines. Given that hype, of course food companies and marketers followed suit and sold products that conformed to conventional wisdom.
1
The "margarine craze" you refer to, which started well before the 80's, was a blanket recommendation for margarine, not based on the more contemporary products with olive, canola or corn oil. Back then, margarines were filled with saturated fat, trans fats, etc., that *were* worse than butter. The newer margarines, like "I can't believe" and Smart Balance, happen to be very good for you. The problem is that you might want to spread them (or butter) on bread. Uh-oh: triglycerides.
"Back then, margarines were filled with saturated fat, trans fats, etc., that *were* worse than butter. The newer margarines, like "I can't believe" and Smart Balance, happen to be very good for you."
This is incorrect. Margarine, by the rationing of WWII, and the time at which it started to gain popularity, was made by hardening vegetable oils via hydrogenation. (Prior to WWII, some animal fats were included in margarine, but for the context of the "butter vs. margarine" debate, the margarine during the time the medical establishment began recommending it was made from vegetable oil.)
Vegetable oil is, depending upon the particular constituent, a blend of the three fatty acids, but primarily is PUFA, usually greater than 70%. PUFAs are prone to oxidation and when oxidated can damage the endothelium. Oxidation can occur endothermically or exothermically.
The "healthy" spreads you mention? Hardly an improvement.
"I can't believe it's not butter" has as its first four ingredients purified water, soybean oil, palm kernel oil, and palm oil. (Also includes salt, soy lecithin, natural flavors [sic], vinegar, vitamin A palmitate, and beta carotene. Good luck finding an ingredients list on their website, though.) Soybean oil is primarily PUFA (about 60%), and the fact that water is used to harden it means a hydrogenation process is being used. The palm fats use SFAs to help stabilize the new formulation, but the largest constituent fat is PUFA ... [cont.]
This is incorrect. Margarine, by the rationing of WWII, and the time at which it started to gain popularity, was made by hardening vegetable oils via hydrogenation. (Prior to WWII, some animal fats were included in margarine, but for the context of the "butter vs. margarine" debate, the margarine during the time the medical establishment began recommending it was made from vegetable oil.)
Vegetable oil is, depending upon the particular constituent, a blend of the three fatty acids, but primarily is PUFA, usually greater than 70%. PUFAs are prone to oxidation and when oxidated can damage the endothelium. Oxidation can occur endothermically or exothermically.
The "healthy" spreads you mention? Hardly an improvement.
"I can't believe it's not butter" has as its first four ingredients purified water, soybean oil, palm kernel oil, and palm oil. (Also includes salt, soy lecithin, natural flavors [sic], vinegar, vitamin A palmitate, and beta carotene. Good luck finding an ingredients list on their website, though.) Soybean oil is primarily PUFA (about 60%), and the fact that water is used to harden it means a hydrogenation process is being used. The palm fats use SFAs to help stabilize the new formulation, but the largest constituent fat is PUFA ... [cont.]
5
A bit of biochemical support for the reason why 70% of the population are "hyporesponders" - that is, eating 3 eggs per day has minimal impact on their cholesterol.
Our body's metabolic regulation of cholesterol has been exquisitely tuned to maintain an optimal level of cholesterol for our cells. We get cholesterol from our diet, but all nucleated cells can also synthesize cholesterol, and all of this is controlled metabolically. The best analogy is a bathtub - if rate that water enters the tub is the same as the rate that water drains, then the water level will remain level. For most people, this system works well. Their cholesterol levels are maintained within a fairly narrow window that is considered "normal".
However, it is a complex system requiring many moving parts. And with each regulatory step, there is a chance that an individual could have a genetic difference that alters their ability to maintain the proper cholesterol levels. The end result is that cholesterol builds up in the blood. Again, with the tub analogy, the water entering in is faster than the water draining out, leading to a higher than normal tub level.
The evidence of the complexity of this system is found in the fact that 30% of the population are NOT "hyporesponders"; that is, they can not regulate their dietary cholesterol.
Our body's metabolic regulation of cholesterol has been exquisitely tuned to maintain an optimal level of cholesterol for our cells. We get cholesterol from our diet, but all nucleated cells can also synthesize cholesterol, and all of this is controlled metabolically. The best analogy is a bathtub - if rate that water enters the tub is the same as the rate that water drains, then the water level will remain level. For most people, this system works well. Their cholesterol levels are maintained within a fairly narrow window that is considered "normal".
However, it is a complex system requiring many moving parts. And with each regulatory step, there is a chance that an individual could have a genetic difference that alters their ability to maintain the proper cholesterol levels. The end result is that cholesterol builds up in the blood. Again, with the tub analogy, the water entering in is faster than the water draining out, leading to a higher than normal tub level.
The evidence of the complexity of this system is found in the fact that 30% of the population are NOT "hyporesponders"; that is, they can not regulate their dietary cholesterol.
6
Nicely written and well-summarized. Also worth noting that amongst those randomized controlled trials, with human subjects, are several studies that support high(er) fat, low(er) carb diets. In these studies, people on high(er) fat, low(er) carb diets had more weight loss, improved blood lipids, and better control of blood sugar compared to people on low fat or "standard" dietary recommendations.
5
Then why does the ADA still recommend a diet heavy on "healthy whole grains" to patients diagnosed with pre-diabetes? Sure it's better than white bread, just like low-tar cigarettes are better than regular cigarettes. But I never hear the medical establishment recommending low-tar cigarettes.
Could it be that the ADA, which is funded by the big drug companies, is more concerned with maintaining its existence by managing diabetes rather than stopping diabetes in its tracks? No Type 2 diabetes means no ADA and no ADA high-paid executives (Type 1 diabetes is a small percentage of diabetes). Follow the money.
If you are diagnosed with Type 2 diabetes, eat zero grains (pasta, bread, rice, cereal) and zero refined sugar. Do not listen to the ADA.
Could it be that the ADA, which is funded by the big drug companies, is more concerned with maintaining its existence by managing diabetes rather than stopping diabetes in its tracks? No Type 2 diabetes means no ADA and no ADA high-paid executives (Type 1 diabetes is a small percentage of diabetes). Follow the money.
If you are diagnosed with Type 2 diabetes, eat zero grains (pasta, bread, rice, cereal) and zero refined sugar. Do not listen to the ADA.
23
In your opinion does that include oatmeal - supposedly particularly benign?
"In your opinion does that include oatmeal - supposedly particularly benign?"
I would think that depends. Most Americans eating oatmeal eat flavored instant oatmeal, which is full of added sugars. Additionally, the more processed it is, the lower the soluble fiber content.
And while a bowl of steel-cut oats with fresh berries in it may be a fine choice, it needs to be examined in context of overall diet: there is likely a healthful range of total daily carbohydrate (which varies by individual depending upon level of activity, etc.). Someone who is over-consuming total carbohydrate is only going to exacerbate insulin resistance issues by eating oatmeal. But oatmeal's soluble fiber is probably a good choice WRT prebiotic foods, if one is eating a sensible CHO total.
I would think that depends. Most Americans eating oatmeal eat flavored instant oatmeal, which is full of added sugars. Additionally, the more processed it is, the lower the soluble fiber content.
And while a bowl of steel-cut oats with fresh berries in it may be a fine choice, it needs to be examined in context of overall diet: there is likely a healthful range of total daily carbohydrate (which varies by individual depending upon level of activity, etc.). Someone who is over-consuming total carbohydrate is only going to exacerbate insulin resistance issues by eating oatmeal. But oatmeal's soluble fiber is probably a good choice WRT prebiotic foods, if one is eating a sensible CHO total.
7
Evolution "designed" us to live long enough to successfully produce the next generation, that's all. This probably meant a life of hunting and gathering, "high all cause mortality" lasting maybe 20 to 30 years at best. Evolution does not look at the future past securing better survival, small increments over millions of years. It could not foresee that the brains "it created" would develop science and technologies with the possibility of lifespans that were "unforeseen." Nor could it predict that the products of R&D would have as much potential for good as for harm. The technological advance is only 10-15,000 years old, hardly enough time for evolution to catch up with "The Great Unforseen,"i.e. hardly enough time for science that creates to also investigate the consequences and interactions of its creations, all the willy-nilly stuff from refined agricultural products to cell phones, internal combustion engines, atomic weapons...and a longer lifespan. Hard to accept that we're really just at the beginning of understanding, that our best understanding is always, and may forever, be imperfect and subject to change frequently in the blink of an evolutionary eye. And I doubt that those in the ancient hunting and gathering world endowed there lifespan with the, uh..."expanded meaning" we give it today, another consequence of having such marvelouly imaginative brains. Be brave in this New World we have created that is eating The Old One we came from.
4
The _average_ life expectancy of hunter-gatherers was low, due to infant/childhood mortality, infectious disease, and trauma/violence. The possible life span of hunter-gatherers was similar to modern humans, and they lived that life span relatively free of the chronic diseases that plague us today.
http://www.anth.ucsb.edu/faculty/gurven/papers/GurvenKaplan2007pdr.pdf
Also, in humans there is an adaptive advantage to having some "elders" around -- knowledge, education, leadership, child care, etc. So selection may have acted to keep some elders around past their child-bearing years.
http://www.anth.ucsb.edu/faculty/gurven/papers/GurvenKaplan2007pdr.pdf
Also, in humans there is an adaptive advantage to having some "elders" around -- knowledge, education, leadership, child care, etc. So selection may have acted to keep some elders around past their child-bearing years.
8
Wrong. The human species began to thrive only when 2 generations became available to care for the young - the parents and grandparents, particularly grandmothers.
2
Isn't it possible that even the randomized trial will fail to tell us what the best diet is? My observation of this issue over many years suggests that diet may be too complicated to be tested accurately by either an epidemiological approach or randomized trials if your goal is to make recommendations for the whole population.
Nor is big necessarily better in trials. In fact it may be worse. People are too diverse to be compared in large studies that lump random people together. The variation between individuals swamps out the signal you are looking for. Hence the endless debates about diet, the value of mammograms, PSA testing etc etc etc. The methodology for large populations just isn't good enough except in cases like smoking where the effect is so huge that it can be seen despite individual variation.
To make matters worse, the science tells us that it is fat COMBINED with sugar that is the real problem. That hasn't even entered into these public debates yet and would make the trials even more daunting.
The randomized trial may be the best method we have. But it may not be good enough to solve a problem of this complexity.
Nor is big necessarily better in trials. In fact it may be worse. People are too diverse to be compared in large studies that lump random people together. The variation between individuals swamps out the signal you are looking for. Hence the endless debates about diet, the value of mammograms, PSA testing etc etc etc. The methodology for large populations just isn't good enough except in cases like smoking where the effect is so huge that it can be seen despite individual variation.
To make matters worse, the science tells us that it is fat COMBINED with sugar that is the real problem. That hasn't even entered into these public debates yet and would make the trials even more daunting.
The randomized trial may be the best method we have. But it may not be good enough to solve a problem of this complexity.
8
I'm a great believer in science, and the scientific method, but I've never taken any advice the government has given about diet seriously. It makes about as much sense as the reasons often given for why the stock market goes up or down. The radio finds some broker from the middle of nowhere and he/she gives a reason, which could be as right or wrong as any other.
For "science" to have pushed one type of food over another, and then to change it's collective mind, has always seemed suspect to me. Seems like lots of government time and money (or job security) has been spent muddying the waters when it was written on the rocks at the bottom all the time: Eat a balanced diet.
For "science" to have pushed one type of food over another, and then to change it's collective mind, has always seemed suspect to me. Seems like lots of government time and money (or job security) has been spent muddying the waters when it was written on the rocks at the bottom all the time: Eat a balanced diet.
6
Agreed with most of this, but the problem is that we now have many competing definitions of a "balanced diet." What's your version of a "balanced diet?"
2
Seems like eating a "diverse" diet might be a more tangible goal than a "balanced" diet and should provide sufficiency in required nutrients. (So long diverse doesn't mean eating everything in sight! You have to have a calorie limit.)
2
'"For decades, they’ve been told what to eat because “science says so.” '
It is probably time to acknowledge that people proclaiming what science says are often interest groups and trade representatives who have a financial stake in the sale of nutritional and pharmaceutical products.
Giving a government imprimatur to such claims is just plain wrong. Government's role should be that of evaluating product claims according to whether they are true or false, proven or unproven. If a product meets safety standards, it is not necessary for government to ban a product simply because it makes claims that cannot be validated. It is also not necessary for government to go silent on the issue of validity.
The worst option is the one we have now: government lets trade group representatives make a bogus, compromise recommendation that appears to give government approval for non-science and false marketing claims, while leaving marketers free to claim that science backs them up.
It is probably time to acknowledge that people proclaiming what science says are often interest groups and trade representatives who have a financial stake in the sale of nutritional and pharmaceutical products.
Giving a government imprimatur to such claims is just plain wrong. Government's role should be that of evaluating product claims according to whether they are true or false, proven or unproven. If a product meets safety standards, it is not necessary for government to ban a product simply because it makes claims that cannot be validated. It is also not necessary for government to go silent on the issue of validity.
The worst option is the one we have now: government lets trade group representatives make a bogus, compromise recommendation that appears to give government approval for non-science and false marketing claims, while leaving marketers free to claim that science backs them up.
12
Love the parade of foods, but it's so distracting trying to read these comments with the parade visible on the left.
Make it stop!
:)
Make it stop!
:)
3
Honeybee, do what I do; just scroll the screen enough for the illustration to disappear.
Your mom died at sixty from a stroke and four of her five brothers, who spent their lives doing hard manual labor on farms, died of heart attacks before age fifty, two in their early forties. No one on your mother's side lived past 65. You, in spite of twenty years of marathon running, had bypass surgery at age 59.
Is it just possible that blanket recommendations about a healthy diet may not apply to everyone?
Is it possible to identify those who react badly to dietary cholesterol and saturated fat? Shouldn't the recommendations be that if family history is bad, genetic screening is in order? We test for breast cancer genes in women with bad family history. If genetic tests don't exist, are there tolerance tests that can be done?
By the way, the marathon runner had some fainting spells during races, so was given treadmill tests. He ran the top off of them. It wasn't until he could barely walk that the right tests were finally ordered. This was a few years ago and heart disease in fit people is better detected now, but it took deaths and near deaths to change the recommendations. Maybe medical practice needs to think more in terms of recommendations for individuals.
Is it just possible that blanket recommendations about a healthy diet may not apply to everyone?
Is it possible to identify those who react badly to dietary cholesterol and saturated fat? Shouldn't the recommendations be that if family history is bad, genetic screening is in order? We test for breast cancer genes in women with bad family history. If genetic tests don't exist, are there tolerance tests that can be done?
By the way, the marathon runner had some fainting spells during races, so was given treadmill tests. He ran the top off of them. It wasn't until he could barely walk that the right tests were finally ordered. This was a few years ago and heart disease in fit people is better detected now, but it took deaths and near deaths to change the recommendations. Maybe medical practice needs to think more in terms of recommendations for individuals.
4
My diet has been closer to what "science says so" since I was diagnosed with type 2 diabetes in August, 2011: Less fat, less sweets and junk food, more vegetables (I used to have them once a week), more whole grains. I'm 20 pounds lighter than I was when I was diagnosed, and I've been taken off many of the prescriptions I was put on, including ones for blood sugar, because of how well I've done with diet and exercise. And my cholesterol has been improved; that is also worsened by diabetes. I'll stick with what has worked so far, even if it doesn't fit the study du jour.
7
Skip the healthy whole grains and you will do even better.
6
In reducing the fat in the diet, you've got to increase the carbs, or caloric intake will drop below a sustainable level. In head-to-head studies comparing high-carb-low-fat vs highish-fat-modest carb diets for diabetics, the modest carb diets always do better. I get that it's working for you, and that's great, but maybe try easing up a little on the restriction of the macronutrient that there is zero evidence of worsening diabetes (or heart disease), and edge down on the one that is unquestionably linked with diabetes. A month later if it's still working, wiggle another notch over. You are likely to be a statistically normal diabetic, who will do better on a diet that keeps carbs in checks and fills out calories with metabolically harmless fats.
4
This article refers to a government committee (Dietary Guidelines Advisory Committee) urging repeal of the guideline that Americans limit their cholesterol intake to 300 milligrams a day. At the same time the committee specially listed plant-based diets as a powerful way to prevent chronic diseases. Science has clearly shown that foods high in dietary cholesterol are strongly linked to obesity, heart disease, diabetes, and cancer.
The report disregarded decades of scientific findings and deferred entirely to a 2013 report by the American Heart Association and American College of Cardiology and one meta-analysis of egg consumption. The meta-analysis found that Americans who eat one egg per day or more are 42 percent more likely to develop type 2 diabetes, which leads to cardiovascular disease.
Another consideration is that across the country, animals used for meat, eggs and dairy are hidden away on factory farms and often face unspeakable cruelty. Visit the Mercy For Animals website for more information.
The report disregarded decades of scientific findings and deferred entirely to a 2013 report by the American Heart Association and American College of Cardiology and one meta-analysis of egg consumption. The meta-analysis found that Americans who eat one egg per day or more are 42 percent more likely to develop type 2 diabetes, which leads to cardiovascular disease.
Another consideration is that across the country, animals used for meat, eggs and dairy are hidden away on factory farms and often face unspeakable cruelty. Visit the Mercy For Animals website for more information.
3
Did you read the same article as the rest of us? Science most assuredly does not show that a diet high in cholesterol, fat, or saturated fat leads to any particular negative health outcomes. Recent large meta-analyses have found no links between either cholesterol or saturated fat consumption and heart disease, and most experimental trials of high(er) fat diets show people gaining better control of blood sugar compared to low fat diets.
11
As usual with these 'studies' there is little or no mention of real or whole food prepared with basic ingredients versus the processed substances found in packaged foods. Salt from a shaker at the table or used when seasoning food made from scratch at home is not at all the same thing as the salt used as preservatives at a factory. Caloric intake from eating a Big Mac is not at all the same as the caloric intake of a homemade dinner made with pork or chicken raised outside of a factory farm regardless of the amounts that comprises either. Until the government gets real about this and other discrepancies not currently documented when yielding these findings, I can't take them very seriously.
7
Diet is important but exercise is more important. However, to really benefit from exercise, it is necessary to burn many more calories per day than a 30 minute run, or a 1 hour walk will burn. It is necessary to have an elevated heart rate for hours per day, 5 to 6 days per week, and to lift heavy weights for a significant part of each day. Moderate exercise isn't effective.
1
You sound convinced and I'm intrigued. Effective for meeting what goal? Based on scientific findings?
1
The evidence for disapproving of some foods whilst pushing others appears to have been every bit as solidly evidence based as that for criminalizing some popular recreational drugs whilst promoting others.
1
At least in the area of nutritional guidance, our public health institutions have squandered every last ounce of their credibility, to the detriment of virtually everyone.
13
Eat what you enjoy, surrounded by loved ones, without guilt or shame. Try new foods, learn to cook. Go out and play. Stop worrying so much and working so hard. That is what kills you.
5
On the whole the lesson remains eat reasonable amounts of real food...
but it's worth mentioning that very few studies of "low ft diets" actually assign genuinely low fat diets, like an Ornish diet... so it's not a surprise when no benefit is found.
but it's worth mentioning that very few studies of "low ft diets" actually assign genuinely low fat diets, like an Ornish diet... so it's not a surprise when no benefit is found.
6
Randomized controlled trial, with human subjects, where the Ornish diet was compared explicitly to Atkins, Zone, and "standard" dietary advice. Atkins wins, in terms of weight loss, blood lipid profiles, and blood sugar regulation.
http://jama.jamanetwork.com/article.aspx?articleid=205916
http://jama.jamanetwork.com/article.aspx?articleid=205916
5
Bottom line is the Medical Establishment knows precious little about nutrition, and does not care to learn it either.
During the last several decades we have been told coffee is bad for you, coffee is good for you; nutritional supplements you should not skip, nutritional supplements only help to enrich your pee.
Fat, saturated fat, trans fat, butter fat, margarine, hydrogenated vegetable oil, all had the same treatment: good, bad, killer, healer.
The current craze is the belief chocolate is a critical nutrient, and the coffee is a life extender !? I invested in a very expensive coffee maker, and I hope they are right, otherwise they are not going to sell me much coffee beans.
During the last several decades we have been told coffee is bad for you, coffee is good for you; nutritional supplements you should not skip, nutritional supplements only help to enrich your pee.
Fat, saturated fat, trans fat, butter fat, margarine, hydrogenated vegetable oil, all had the same treatment: good, bad, killer, healer.
The current craze is the belief chocolate is a critical nutrient, and the coffee is a life extender !? I invested in a very expensive coffee maker, and I hope they are right, otherwise they are not going to sell me much coffee beans.
9
Finally an attempt to inject some science into the voodoo proscriptions of people called nutritionists.
11
Thank you for your hard work and an excellent article. It's news we can use.
10
About salt. Is it possible that many poor americans eating mainly fast food are really eating high salt? Thus the studies that compare low-salt diets with normal salt diets are really relevant to this group.
2
If Dr Carroll has a few facts distorted. Randomized clinical trials ARE the GOLD standard of the epidemiological research process. They are funded based on hypotheses derived from aggregated epidemiological results of other clinical trial or observational data such as those of the Harvard observational studies. Correlation of risk factors and an outcome in a single clinical trial does NOT in and of itself determine causation but may hint at that factor as a potential agent and indicates the need for further investigation.
Though Dr Carroll has hit on in his review the individual dietary components which are in play in chronic disease risk, the missing factors are: 1) Diet does not act alone in causing disease. It is one component of a LIFESTYLE that conveys risk or protection. 2) amount of exercise/activity is repeatedly shown to be an important risk determinant for disease. 3) Factors such as stress/stress management, smoking, alcohol intake, etc are shown to be important factors in disease occurrence. These factors act in unison in lowering disease risk and serve as the 'switches' that will activate or help mitigate our individual hereditary risk milleu.
These dietary recommendations reflect not a 'better' science but an ongoing understanding of scientific investigation.
We should recognize that different recommendations can and should be made to different populations of individuals throughout the lifespan based on their risk profiles.
Wm Scott Pappert DrPH
Though Dr Carroll has hit on in his review the individual dietary components which are in play in chronic disease risk, the missing factors are: 1) Diet does not act alone in causing disease. It is one component of a LIFESTYLE that conveys risk or protection. 2) amount of exercise/activity is repeatedly shown to be an important risk determinant for disease. 3) Factors such as stress/stress management, smoking, alcohol intake, etc are shown to be important factors in disease occurrence. These factors act in unison in lowering disease risk and serve as the 'switches' that will activate or help mitigate our individual hereditary risk milleu.
These dietary recommendations reflect not a 'better' science but an ongoing understanding of scientific investigation.
We should recognize that different recommendations can and should be made to different populations of individuals throughout the lifespan based on their risk profiles.
Wm Scott Pappert DrPH
9
After my mother had her first heart attack the doctor told her she would have to stop eating eggs as part of her new "diet". She told him she was allergic to eggs and had probably not eaten more than a dozen in her entire life. One size fits all rarely does. Gary Taubes' "Good Calories, Bad Calories" still has the most accessible information about diet and science investigations into diet.
16
Why not look at other countries and their nutritional standards? This article is weird.
2
There are all sorts of medical hypotheses about diet and disease. But is there any evidence about diet that does apply to the whole population?
Only a little.
1) Sugar causes tooth decay
2) Deficiencies of vitamins and minerals, protein, essential fats and energy, are harmful
3) Chronic intake of energy well above one's needs is harmful.
All of these things have been known for a very long time.
The rest is medicine, not nutrition, and often dubious medicine at that.
Only a little.
1) Sugar causes tooth decay
2) Deficiencies of vitamins and minerals, protein, essential fats and energy, are harmful
3) Chronic intake of energy well above one's needs is harmful.
All of these things have been known for a very long time.
The rest is medicine, not nutrition, and often dubious medicine at that.
3
Guidelines? Who's living their life by Guidelines? We live our lives by TV Commercials, not guidelines. Turn off the TV and you'll be healthier. The most important health advise - Be very judicious about what you believe.
5
Carbs and protein and fat and salt are all red herrings, so to speak, because they distract us from vegetables.
Vegetables make you feel not only physically better, but by reducing your contribution to the maltreatment and slaughter of animals, veggies make you feel less selfish.
Don't give up anything. Just think of vegetables as the center of your meals. Everything else are side dishes.
Vegetables make you feel not only physically better, but by reducing your contribution to the maltreatment and slaughter of animals, veggies make you feel less selfish.
Don't give up anything. Just think of vegetables as the center of your meals. Everything else are side dishes.
20
Veggies are all well and good, but A) it seems highly probable that veggie consumption, like most other things in life*, will display a U-shaped curve, where too little and too much are both equally harmful, and B) most vegetables are very low in calories, so if you aspire to not waste away to nothing you will need to eat some other foods as well. So: What foods will those be?
* http://www.nytimes.com/2014/08/26/upshot/dash-of-salt-does-no-harm-extre...
* http://www.nytimes.com/2014/08/26/upshot/dash-of-salt-does-no-harm-extre...
6
This article, like most others, says nothing about the mechanisms of heart diseases and stroke and diabetes how diet effects those mechanisms.
Why not write about that?
What does the science about the mechanisms of heart diseases tell us? Blood chemistry? Food metabolism?
Give us something to chew on.
Why not write about that?
What does the science about the mechanisms of heart diseases tell us? Blood chemistry? Food metabolism?
Give us something to chew on.
3
High blood sugars (diabetes or pre-diabetes) significantly increase risk of heart disease. Small, dense LDL particles, again a strong correlation, and these are a guide to how much carbohydrate is in diet. oxLDL particles ditto, but not so much LDL - which is often not affected by normal diet factors anyway. None of these correlations confirms causality, and heart disease starts with injury to vessels, for which smoking, high blood pressure, some types of air pollutants are prime culprits.
A diet high in antioxidants and easy on the carbs would seem to be indicated, but why should dietary guidelines focus on heart disease when there are other ways to die and be ill, and when there are obvious non-dietary causes of heart disease?
The main dietary cause of heart disease is diabetes, diabetes and obesity are more directly related to diet than heart disease, so are probably where medical dietary guidelines should be directed first.
But dietary guidelines for the population should be about NUTRITION not medical or environmental hypotheses.
A diet high in antioxidants and easy on the carbs would seem to be indicated, but why should dietary guidelines focus on heart disease when there are other ways to die and be ill, and when there are obvious non-dietary causes of heart disease?
The main dietary cause of heart disease is diabetes, diabetes and obesity are more directly related to diet than heart disease, so are probably where medical dietary guidelines should be directed first.
But dietary guidelines for the population should be about NUTRITION not medical or environmental hypotheses.
7
We don't know. That's the whole point. The body is still fundamentally a black box. There are only vague theories that rise on initial evidence and fall on further study. But the theory of the moment is eagerly taken as fact by a public that pulls for black and white. We. Dont. Know.
2
Eat (moderately) less. Exercise (modularity) more. Don't worry so much, and live longer, healthier and happier lives.
19
Why no mention of triglyceride levels? I thought a few years back, everyone was suddenly harping on these as a greater danger than LDL cholesterol levels. My doctor says unused triglycerides get deposited along smaller blood vessels vs LDL cholesterol which layers along aortas and larger passageways.
3
Well he did say that "many now believe that excessive carbohydrate consumption may be contributing to the obesity and diabetes epidemics. " To reduce triglycerides, reduce carbs, and add omega-3 fatty acides.
3
Frankly, if you eat a balanced diet, exercise, and take common sense precautions (no tobacco, moderate alcohol), why do you need advice from doctors and policy wonks on nutrition? Are we so dependent on "experts" that we cannot follow common sense? The public bodies that told use "based on science" not to eat butter (margarine is better and translates are double plus good), not to eat egg yokes, not to eat red meat, never to smoke a joint (your mind will be destroyed), etc.
I am really not interested at all in the view of the government or some policy group of so-called experts on what I should eat.
I am really not interested at all in the view of the government or some policy group of so-called experts on what I should eat.
9
The reality about cholesterol is that much of that was known some 40+ years ago when I was taking biochemistry in grad school. Perhaps some of these current "dieticians" might want to go back and take a look at the "ancient literature". Sorry, it might not be available on Google but you might actually have to go to a library and get it out of the original printed journals.
12
That dietary cholesterol does not raise blood cholesterol was an established scientific fact by the mid 60s (was fairly certain by mid 50s). That saturated fat only raises (beneficial) HDL and (harmless) fluffy LDL was established in the mid 90s. So... How long until that fact makes it into the dietary recommendations?
27
I will never forget seeing Linus Pauling when I was a grad student in the eighties. He talked about cholesterol synthesis which uses sugars as precursors and suggested that because of feedback inhibition ingested cholesterol would simply slow the rate of cholesterol production, while overinjesting sugars would drive over production of cholesterol. I have happily eaten eggs, shrimp, etc. since then with no bad results.
9
Call me a cynic or a "gubmint-hater" but this has usually been my approach to nutrition:
1. Read what the government says you should do.
2. Do the exact opposite.
1. Read what the government says you should do.
2. Do the exact opposite.
9
I was pleasantly surprised to see Dr. Carroll as the author of an Upshot article. I've just recently started following his YouTube channel, Healthcare Triage, which is excellent. He really know his stuff and willing to let the research speak for itself (along with nuanced understanding that not all research is equal). I highly recommend seeing his videos and subscribing:
https://www.youtube.com/user/thehealthcaretriage/
https://www.youtube.com/user/thehealthcaretriage/
5
These comments suggest to me how difficult it will be to get people to abandon the bad nutrition advice that we were fed for decades. Anyone interested in their health should read Good Calories, Bad Calories and The Big Fat Surprise. The author of the latter wrote an excellent op ed here a few days ago summarizing the issues:
http://www.nytimes.com/2015/02/21/opinion/when-the-government-tells-you-...
In the meantime, remember that just about everything you've been told is wrong. There's no evidence that meat or eggs or saturated fats per se are bad for you. Too little salt appears to be as harmful as too much salt. Food cholesterol doesn't matter and neither total serum cholesterol nor total LDL mean much; triglycerides, LDL density, and other factors have a better correlation with heart disease risk. Seed oils are bad, particularly hydrogenated oils and polyunsaturated oils used for cooking. Fish oil supplements are useless. Oxidized cholesterol appears on the basis of animal studies to be scary stuff -- avoid anything made with dried milk and soft ice cream. Eschew refined grains, avoid processed meats and processed foods in general. Above all, avoid added sugars and fruit juice. Dairy has no special benefits. Get enough vitamin D. And remember that we still don't know very much -- the real, controlled studies just haven't been done and the epidemiological studies are almost useless. Just eat as your ancestors did and you should be fine.
http://www.nytimes.com/2015/02/21/opinion/when-the-government-tells-you-...
In the meantime, remember that just about everything you've been told is wrong. There's no evidence that meat or eggs or saturated fats per se are bad for you. Too little salt appears to be as harmful as too much salt. Food cholesterol doesn't matter and neither total serum cholesterol nor total LDL mean much; triglycerides, LDL density, and other factors have a better correlation with heart disease risk. Seed oils are bad, particularly hydrogenated oils and polyunsaturated oils used for cooking. Fish oil supplements are useless. Oxidized cholesterol appears on the basis of animal studies to be scary stuff -- avoid anything made with dried milk and soft ice cream. Eschew refined grains, avoid processed meats and processed foods in general. Above all, avoid added sugars and fruit juice. Dairy has no special benefits. Get enough vitamin D. And remember that we still don't know very much -- the real, controlled studies just haven't been done and the epidemiological studies are almost useless. Just eat as your ancestors did and you should be fine.
11
Josh Hill, "In fact, SFAs [saturated fatty acids] are recognized as the single dietary factor that has the greatest negative effect on LDL cholesterol (LDL-C) concentrations...Fatty acids regulate at least 4 families of transcription factors: the peroxisome proliferator activated receptors (PPARs), liver X receptors (LXRs), hepatic nuclear factor-4 (HNF-4), and sterol regulatory element binding proteins (SREBPs) (10). A brief review of the postulated effects of fatty acids in regulating plasma cholesterol follows."
in Mechanisms by which Dietary Fatty Acids Modulate Plasma Lipids http://jn.nutrition.org/content/135/9/2075.full
let me know what you think of this publication.
Here's another more recent one:
Mechanisms of Gene Regulation by Fatty Acids
http://advances.nutrition.org/content/3/2/127.full
in Mechanisms by which Dietary Fatty Acids Modulate Plasma Lipids http://jn.nutrition.org/content/135/9/2075.full
let me know what you think of this publication.
Here's another more recent one:
Mechanisms of Gene Regulation by Fatty Acids
http://advances.nutrition.org/content/3/2/127.full
1
@Dr. J:
SFA consumption raises total and LDL cholesterol, but also raises HDL cholesterol, and shifts LDL towards the less harmful particle distribution (large and fluffy). On balance, SFA consumption improves the blood lipid profile.
Whole foods that are naturally rich in SFAs are also nutrient-dense and quite satiating to the appetite, so consumption is kind of self-limiting. Processed foods with added SFAs are a mess.
Several recent large meta-analyses have failed to find any connection between SFA consumption and heart disease.
Finally, there are numerous populations eating traditional diets rich in SFAs, and these groups are relatively free of chronic disease compared to populations on a "westernized" diet.
SFA consumption raises total and LDL cholesterol, but also raises HDL cholesterol, and shifts LDL towards the less harmful particle distribution (large and fluffy). On balance, SFA consumption improves the blood lipid profile.
Whole foods that are naturally rich in SFAs are also nutrient-dense and quite satiating to the appetite, so consumption is kind of self-limiting. Processed foods with added SFAs are a mess.
Several recent large meta-analyses have failed to find any connection between SFA consumption and heart disease.
Finally, there are numerous populations eating traditional diets rich in SFAs, and these groups are relatively free of chronic disease compared to populations on a "westernized" diet.
4
Dr. J.,
I think The Pooch has done an excellent job of summarizing the most salient arguments against a connection between saturated fat and all-cause mortality. It just doesn't show up in the epidemiological evidence, perhaps because increased saturated fat consumption seems preferentially to increase levels of large fluffy LDL, which is fairly benign, whereas the carbohydrates that people tend to eat in lieu of saturated fat raise triglyceride levels and the more harmful small and medium LDL.
I think The Pooch has done an excellent job of summarizing the most salient arguments against a connection between saturated fat and all-cause mortality. It just doesn't show up in the epidemiological evidence, perhaps because increased saturated fat consumption seems preferentially to increase levels of large fluffy LDL, which is fairly benign, whereas the carbohydrates that people tend to eat in lieu of saturated fat raise triglyceride levels and the more harmful small and medium LDL.
1
I'm glad to see that Dr. Carroll has raised the issue of hyporesponders to dietary cholesterol, an issue that is usually not mentioned in news or discussions. Some 70% of the population do not have their cholesterol blood level raised by eating foods rich in cholesterol, while others may be very sensitive. So most of the folks breakfasting on egg white omelets over the years have been missing out on the joy of eggs. (A simple test to distinguish been hypo- and hyper-responders would be marvelous.) The other thing that troubles me are guidelines about the percentage of your calorie intake that should come from fat. Truly, how many people are able to calculate this? The best bet remains moderation in everything.
6
When I was told my total cholesterol was too high thirty years ago, I went on a strict, no cheating, no-fat diet. After three months, I was tested again. My total cholesterol went up. Since then, I really haven't been so concerned about what I eat and my cholesterol is currently under control, though not because of my diet.
5
"The nice thing about standards is that there are so many to choose from. Furthermore, if you do not like any of them, you can just wait for next year’s model." - Andrew S. Tenenbaum. The same seems to apply to dietary and health care recommendations.
9
My biochemisty professor in medical school pointed out that the dietary cholesterol guidelines were essentially nonsense back in 2005, and had been repeating this mantra for some years before.
Humans are consistently prone to attractive oversimplifications - eat fat, get fat... Eat cholesterol, elevate your cholesterol... right? Not so much.
The body is vastly more nuanced and complex than we would like to believe. For the most part, homeostatic mechanisms swiftly kick in to maintain our biologic equilibrium, largely canceling both potential dietary harms and benefits.
With the exception of certain so-called vitamins and amino acids which cannot be synthesized de novo, and therefore must be consumed in our diet, metabolic pathways are fantastically adept at maintaining us within a narrow band of the biochemical status quo.
There is much money to be made by the food purveyors in convincing us otherwise. Media, government and our own limited intuitions are complicit in these scams. At the end of the day, we should work mostly on developing good dietary habits, following Pollan's simple edict of eating real food, not too much, mostly plants. Add to that getting off our collective duffs and breaking a sweat several times a week, and you're way ahead of the game.
Humans are consistently prone to attractive oversimplifications - eat fat, get fat... Eat cholesterol, elevate your cholesterol... right? Not so much.
The body is vastly more nuanced and complex than we would like to believe. For the most part, homeostatic mechanisms swiftly kick in to maintain our biologic equilibrium, largely canceling both potential dietary harms and benefits.
With the exception of certain so-called vitamins and amino acids which cannot be synthesized de novo, and therefore must be consumed in our diet, metabolic pathways are fantastically adept at maintaining us within a narrow band of the biochemical status quo.
There is much money to be made by the food purveyors in convincing us otherwise. Media, government and our own limited intuitions are complicit in these scams. At the end of the day, we should work mostly on developing good dietary habits, following Pollan's simple edict of eating real food, not too much, mostly plants. Add to that getting off our collective duffs and breaking a sweat several times a week, and you're way ahead of the game.
40
Exactly!! Your prof was and is on target. As I stated in my comment, much of this was known some 40+ years ago. Unfortunately, the need for research money and the "foodie" media just love simplistic approaches to nutrition. As if one single item will either kill you or make you a healthy "God-like warrior".
9
I came to comment the exact same thing as EW, with one addition:
The article mischaracterizes the role of science and scientists in creating the deitary guidelines. It makes the allusion that scientists have agreed with the guidelines for the past 10+ years and are suddenly saying, "well, shucks, science changes and we were wrong, but now we're right. So, do what we say now!" In fact, scientists have not agreed with the guidelines, as evidenced by EW's experience, which mine matches precisely.
Be aware that scientists don't make the guidelines. A bunch of non-scientists do! Give the scientists due credit or the American people will never accept its role in in a healthy society!
The article mischaracterizes the role of science and scientists in creating the deitary guidelines. It makes the allusion that scientists have agreed with the guidelines for the past 10+ years and are suddenly saying, "well, shucks, science changes and we were wrong, but now we're right. So, do what we say now!" In fact, scientists have not agreed with the guidelines, as evidenced by EW's experience, which mine matches precisely.
Be aware that scientists don't make the guidelines. A bunch of non-scientists do! Give the scientists due credit or the American people will never accept its role in in a healthy society!
2
I'm certainly no expert on the topic, but I believe there's a growing body of compelling evidence that carbohydrates, particularly simple carbohydrates, are the most harmful part of our diet. I am trying to significantly reduce my consumption of simple carbohydrates and increase my consumption of foods that are less processed, particularly those with non-saturated fats, e.g. nuts, olive oil, etc. From what I can tell, we would also be well-served to pay attention to the health of the flora in our gut and to consume foods like kimchi that promote gut health while avoiding the use of antibiotics.
14
Carbs vary widely in harmfulness and really, none of them are harmful in their natural foods and in moderate quantity. The fructose in an apple, for example, is not harmful, whereas the frucstose in a soda is, because the apple contains bulky fiber that makes us feel full and keeps us from eating too much of it.
If there's any single useful principle here, it's eat foods that our ancestors ate -- not laboratory creations -- in forms that they ate them, e.g., apples rather than apple juice, corn rather than corn oil, unrefined rather than refined grains, etc. This will practically guarantee that you get the nutrients you need in quantitites that aren't harmful.
If there's any single useful principle here, it's eat foods that our ancestors ate -- not laboratory creations -- in forms that they ate them, e.g., apples rather than apple juice, corn rather than corn oil, unrefined rather than refined grains, etc. This will practically guarantee that you get the nutrients you need in quantitites that aren't harmful.
13
No. The fructose in a soda is no more harmful than the fructose in an apple. The problem is the lack of fiber in a soda. Think about it. If you drink a soda and eat high-fiber crackers with it and end up eating the same amount of fructose and fiber as if you'd eaten an apple there is no difference.
Slogans never work. Burpee bred snap peas several decades ago. Our ancestors did not eat them. There is no reason we shouldn't eat them. When I was a kid we drank lots of koolaid--no soda, but lots of koolaid. I doubt that was much different nutritionally than soda. My grandmother would not recognize tofu or yogurt. A big mac, fries and a soda is "mostly plants," but that does not mean it's nutritious.
You must think.
Slogans never work. Burpee bred snap peas several decades ago. Our ancestors did not eat them. There is no reason we shouldn't eat them. When I was a kid we drank lots of koolaid--no soda, but lots of koolaid. I doubt that was much different nutritionally than soda. My grandmother would not recognize tofu or yogurt. A big mac, fries and a soda is "mostly plants," but that does not mean it's nutritious.
You must think.
3
@Janet:
So we can all just add Metamucil to our sodas, and chug away? Soda and crackers magically become health foods when eaten in combination?
We might also consider that the apple is more than just fructose and fiber, there are other nutrients in there.
So we can all just add Metamucil to our sodas, and chug away? Soda and crackers magically become health foods when eaten in combination?
We might also consider that the apple is more than just fructose and fiber, there are other nutrients in there.
5
The science on dietary fats makes sense to me, based on strictly personal, anecdotal experience. The science on salt, though, I suspect is more complex than we're seeing in the science so far.
Ever since I was in my 30s I've been sensitive to salt in the week or so before menstruation. It would make me very bloated and uncomfortable, so I avoided it at that time. Now, as I approach menopause, salt bothers me far more frequently. It does the same for most of the women I know who are about my age. Furthermore, by avoiding salt I can keep my blood pressure down, so it's not just an issue of discomfort, but of overall health.
This leads me to wonder to what degree salt sensitivity is age and gender dependent, and what the optimal daily ranges are for salt-sensitive people vs. "normal" people in terms of daily intake. And of course, how many of us are there who are salt sensitive? Is it most women over 45? Half of us? Just a few of us? And are there other groups who share that issue?
Scientists? Are you listening? Help?
Ever since I was in my 30s I've been sensitive to salt in the week or so before menstruation. It would make me very bloated and uncomfortable, so I avoided it at that time. Now, as I approach menopause, salt bothers me far more frequently. It does the same for most of the women I know who are about my age. Furthermore, by avoiding salt I can keep my blood pressure down, so it's not just an issue of discomfort, but of overall health.
This leads me to wonder to what degree salt sensitivity is age and gender dependent, and what the optimal daily ranges are for salt-sensitive people vs. "normal" people in terms of daily intake. And of course, how many of us are there who are salt sensitive? Is it most women over 45? Half of us? Just a few of us? And are there other groups who share that issue?
Scientists? Are you listening? Help?
4
There is a simple genetic test to determine whether salt raises your blood pressure or not. The genes that make one salt sensitive are more common in those of African descent. But you can also just experiment, eat some salt and see what happens to your BP.
3
That responds to one part of one question, but not the optimal intake ranges for those who develop salt sensitivity (manifested as uncomfortable bloat) surrounding menstruation, or in mid-life, with or without an increase in blood pressure. Nor does it tell me the prevalence in the population of those who are salt-sensitive either constantly or frequently. So, scientists? Are you listening?
Citizen, absolutely true, because I don't happen to know the answer, indeed, your post was the first time I ever heard of the phenomenon. the figures on percentage who like me experience a rise in blood pressure, typically African Americans, are no doubt available but I've never seen them myself. I'm sure you could find them in a web search.
One day we will find out that Woody Allen was right, smoking is good for you. LOL.
3
"Science says so" should be "Sponsor-bias says so" - nearly all of the "nutritional studies" that these guidelines are based on are sponsored by various commodity groups, growers/farmers/livestock organizations or other industry group - one of the first "crowdsourced" legislative efforts going back many years, though from a corrupt and competing crowd. The only net effect is profitable cognitive dissonance that substitutes one dietary "fact" for the next every few weeks. NIH-backed studies are seldom much better since research awards depend on study groups that draw from the same pool of biased researchers.
Perhaps we should simply put this all up for a cash bid, since the FDA and USDA live in terror of being called on the carpet by a congress that is deep in the pocket of these groups and are unable and unwilling to legislate or communicate in any meaningful fashion.
Perhaps we should simply put this all up for a cash bid, since the FDA and USDA live in terror of being called on the carpet by a congress that is deep in the pocket of these groups and are unable and unwilling to legislate or communicate in any meaningful fashion.
11
This article's photo is rather scary. Can one of the food items be sad instead of downright evil?
2
See this previous New York Times article on "The Grand Prix of Epidemiology." (The results of the study have subsequently been reported in T. C. Campbell's 2005 book "The China Study"):
http://www.nytimes.com/1990/05/08/science/huge-study-of-diet-indicts-fat...
The problem with randomized controlled trials (or one of the many problems, that is) is that researchers must begin by making assumptions about possible cause and effect relationships between isolated food components and selected health effects. The validity of the results of such studies is therefore directly dependent on the validity of the researcher's starting assumptions which, most often, have never been verified themselves, thus setting up the conditions for a sequential chain of dubious studies which, when taken together, present to the public a web of unreliable and often contradictory results. This is probably the reason for the common frustration consumers feel at the fact that each study that comes out seems to contradict everything previously "known" (i.e., believed) on the subject.
http://www.nytimes.com/1990/05/08/science/huge-study-of-diet-indicts-fat...
The problem with randomized controlled trials (or one of the many problems, that is) is that researchers must begin by making assumptions about possible cause and effect relationships between isolated food components and selected health effects. The validity of the results of such studies is therefore directly dependent on the validity of the researcher's starting assumptions which, most often, have never been verified themselves, thus setting up the conditions for a sequential chain of dubious studies which, when taken together, present to the public a web of unreliable and often contradictory results. This is probably the reason for the common frustration consumers feel at the fact that each study that comes out seems to contradict everything previously "known" (i.e., believed) on the subject.
5
So everybody except Campbell makes assumptions before starting their research? He's the only honest researcher in the whole bunch?
A different take on "The China Study:"
http://rawfoodsos.com/2010/07/07/the-china-study-fact-or-fallac/
A different take on "The China Study:"
http://rawfoodsos.com/2010/07/07/the-china-study-fact-or-fallac/
5
The China Study (e.g. China-Cornell-Oxford Project) data are not accurately depicted in the interpretive book "The China Study." It's important to note the distinction between the data and the interpretation. It's difficult to take Campbell seriously when some excellent analysis of his methodology have shown it to be suspect, and given the fact that he began his analysis with a fixed outcome in mind. That is not, strictly speaking, what we would refer to as particularly scientific.
4
The Pooch: thanks for the URL. That blog is eye-opening.
1
Here you have a good part of the reason why so many people don't trust doctors and look elsewhere for advice. I had an elderly friend who had no history of heart disease or high blood pressure whose doctor put him on a no-salt, no egg, no meat diet when he was in his late 80's. He spent the last three years of his life- until he died of pneumonia- avoiding all the things he loved to eat, and missing them all the time. All in service to medical mythology. what a shame.
33
So who are you going to go to, a quack? Doctors don't have access to perfect information -- it doesn't exist -- but you can bet that after years of graduate study they know more about what's good and bad for you than some moron with an anti-vaccine web site, or some snake oil salesmen selling nutritional supplements that turn out to be house plants.
9
Josh, yes, I generally agree with you, I would say only that for many reasons it is very important to be as well-informed a "consumer" of medical care as you possibly can be. It can be very difficult to figure out who to trust and believe, and you will find that doctors do not by any means all agree with each other. This is at least partly because once they are out of school, many of them keep up with new things mostly from drug company and other industry representatives. I myself have access to medical research literature, and I have found many times that the research does not support what most doctors think they know.
6
John, agree completely. it can be a struggle -- nutrition being a prime example. You can picup two books and one will tell you to become a vegan and the other to eat like an eskimo! And yes, doctors can fall behind, particularly in an area like nutrition that isn't really something they specialize in. Nor are credentials sufficient -- there are PhD's and MD's who are quacks, and science writers with BA's who do brilliant research. I do think it helps to have some scientific training so as to understand concepts such as epidemiological vs. clinical studies, the placebo effect, confounding variables, and statistical significance, as well as to understand the process and history of science -- the need for reproducibility, the difference between correlation and causation and between a hypothesis and a well-tested theory, the paradigm shift and how scientists respond to one. Sadly, it seems that most people today are leaving school without that basic knowledge and they would do best just to listen to their doctor, since they're easily taken in by the sciency-sounding claims made by quacks.
1
So now carbs are the sinister food group.
That's not going to last either.
The one constant through almost all of human history was food scarcity, punctuated by occasional food abundance. Feast and famine. So the one true problem we face today, is not to stuff things in our pie hole all the time even though we can. We're still acting, as if after todays feast, the next week will be a tough one. Which it wont be.
That's not going to last either.
The one constant through almost all of human history was food scarcity, punctuated by occasional food abundance. Feast and famine. So the one true problem we face today, is not to stuff things in our pie hole all the time even though we can. We're still acting, as if after todays feast, the next week will be a tough one. Which it wont be.
10
No, not carbs per se, but unhealthy carbs (refined sugars and refined grains). eat all the carrots you want.
4
All this sounds suspiciously familiar, like big tobacco's resistance to taking blame for deaths by cancer and heart attacks, and it makes me wonder how much the meat, poultry, and salt industries are influencing recent changes in dietary recommendations. Soon we may be told that Big Macs and pork bellies are actually healthful food choices, and maybe it will do us all good to put on an extra few inches around the waist! Well, here's my thinking: since 1980, when salt and cholesterol became official no-nos, coronary death rates have dropped by about 60% , and cancer death rates have declined by 27% among men and 18% among women. Those figures come from the CDC, and while some of the cause may be from Americans' change in smoking habits, my guess is a significant part also comes from eating less fat and shaking on less salt. I'll take a loaf of whole wheat bread, a glass of wine, and a serving of grilled wild caught salmon beside me in the wilderness. That's paradise for now.
3
There have been a lot of changes since the 1980s that might affect death rates from cancer and heart disease. Smoking rates are down, and we've gotten better at detection and treatment of heart disease and cancer.
Your guess may be that the improvement is due to eating less fat and salt. But, without real data, that's nothing more than one man's guess.
Your guess may be that the improvement is due to eating less fat and salt. But, without real data, that's nothing more than one man's guess.
4
Meat is fine. Coronary deaths appear to have dropped because people stopped smoking and because of better treatment and prevention. You're at sea in the land of correlation rather than causation. In fact, heart disease, obesity, diabetes, and cancer appear on the basis of contemporary scientific observation to have soared in primitive societies when they started eating refined sugars and grains rather than their traditional one. I suggest you read "The Big Fat Surprise" and "Good Calories, Bad Calories" to get a sense of what's really going on.
13
Fred Misurella, I bake my own bread (mostly sourdough whole wheat), and I've learned that bread has lots of salt. Read the nutrition label on your bread; you might be surprised.
Actually, Randomized Clinical Trials prove efficacy. They do not prove causation. Their biggest problem is when they fail to show efficacy, this does not disprove the hypothesis that an association between the relevant facet of nutrition and health is causal. Rather that in the population studies, the conditions used for the trial were not adequate to show an effect. Policy is always enacted in a state of uncertainty. At best the science, epidemiology and trials, can narrow down the uncertainty but not eliminate it.
20
Correct Aron, and a glaring mis-statement by the author. Causation can only be confirmed with a proven mechanism. Given that we have not even identified all of the proteins in mitochondria, let alone understand exactly how mitochondria work, it is clear that any sort of conclusions of causation is not in our near future.
One can appreciate how complex the human system is and how variable the individual responses are, but it is a scientific crime not to acknowledge such and proceed to provide unfounded "advice". In the physical sciences many of these diet "researchers" would be derided and otherwise expelled from the mainstream if such broad and definitive claims were asserted based on EOS or other sub-standard work.
There exists a major problem with scientific standards in this field an example of which was reported by Nina Teicholz in this newspaper this past week:
"Much of the epidemiological data underpinning the government’s dietary advice comes from studies run by Harvard’s school of public health. In 2011, directors of the National Institute of Statistical Sciences analyzed many of Harvard’s most important findings and found that they could not be reproduced in clinical trials."
... well, what a stain but something that is not realized by those poor souls who take advice and direction from this "broken" pseudo-scientific field.
One can appreciate how complex the human system is and how variable the individual responses are, but it is a scientific crime not to acknowledge such and proceed to provide unfounded "advice". In the physical sciences many of these diet "researchers" would be derided and otherwise expelled from the mainstream if such broad and definitive claims were asserted based on EOS or other sub-standard work.
There exists a major problem with scientific standards in this field an example of which was reported by Nina Teicholz in this newspaper this past week:
"Much of the epidemiological data underpinning the government’s dietary advice comes from studies run by Harvard’s school of public health. In 2011, directors of the National Institute of Statistical Sciences analyzed many of Harvard’s most important findings and found that they could not be reproduced in clinical trials."
... well, what a stain but something that is not realized by those poor souls who take advice and direction from this "broken" pseudo-scientific field.
7
@Aron, yes good point. In addition, NEGATIVE trials (if adequate in design and number of subjects/time) can be useful for providing evidence against causal relationships.
Steve Rinsler, MD
Steve Rinsler, MD
There is also a huge genetic component for what people can eat and process properly. Northern Europeans and Pacific Islanders will have vastly different outcomes when forced to eat the same diet. We have adapted over millennia to deal with foods available to our distant forebears, and trying to pretend that one diet type fits all is nonsense.
21
@Jenny,
Yes. There is currently a trial in Israel run by a gastroenterologist from the Weizmann Institute (personalnutrition.org/AboutGuests.aspx) evaluating the variability in responses to a range of common foods and providing individual dietary recommendations.
Steve Rinsler, MD
Yes. There is currently a trial in Israel run by a gastroenterologist from the Weizmann Institute (personalnutrition.org/AboutGuests.aspx) evaluating the variability in responses to a range of common foods and providing individual dietary recommendations.
Steve Rinsler, MD
The new government guidelines imply that, during the past twenty years, eating too little fat has contributed to a wide range of health problems. Media responses to the new guidelines seem to suggest that past guidelines were inadequately based on rigorous research, while the new ones are fortified by more up-to-date scientific evidence. In my opinion, the new guidelines, and the interpretations in the media, oversimplify the nutritional issues involved and advance solutions that are at odds with well-designed studies that contradict the latest recommendations. To deplore past guidelines while praising the new ones can hardly be counted as an advance toward a healthier America.
3
Good article, Professor. The sad fact is that most epidemiological studies are worthless. Many of them are retrospective- always suspect- and the prospective ones are seriously flawed as data is usually self-reported. And, to be honest, the Schools of Public Health are famous for cranking out study after study that never pass the "So what?" test. Publish or perish!
Unfortunately, funding for the more rigorous studies put out by Medical Schools are driven by pharmaceutical companies and government. What we need to see are quality studies that address basic common sense health issues that the pharmaceutical companies or the food industries will never sponsor- and might even actively block.
One is a long-term the necessity of eating three meals a day, and specifically the eating of a meal upon awakening- especially in the light of this era's obesity epidemic. Many parameters- psychological as well as biophysical- need to be evaluated. Pilot studies indicate it not what you eat that causes problems, but rather that the individual feels the need to eat all the time and does so. ("Breakfast:The Least Important Meal of the Day")
Getting away from the field of health, a good study evaluating the Chiropractic "subluxation" theories could be easily performed in three years or less. Why hasn't one been done?
I am no fan of government, but "orphan" studies like these with potentially far-reaching effects should be funded.
Unfortunately, funding for the more rigorous studies put out by Medical Schools are driven by pharmaceutical companies and government. What we need to see are quality studies that address basic common sense health issues that the pharmaceutical companies or the food industries will never sponsor- and might even actively block.
One is a long-term the necessity of eating three meals a day, and specifically the eating of a meal upon awakening- especially in the light of this era's obesity epidemic. Many parameters- psychological as well as biophysical- need to be evaluated. Pilot studies indicate it not what you eat that causes problems, but rather that the individual feels the need to eat all the time and does so. ("Breakfast:The Least Important Meal of the Day")
Getting away from the field of health, a good study evaluating the Chiropractic "subluxation" theories could be easily performed in three years or less. Why hasn't one been done?
I am no fan of government, but "orphan" studies like these with potentially far-reaching effects should be funded.
2
I'm a "practicing biological scientist" and have been for many years. I have this to say. Science is hard. It is no different from solving any kind of puzzle or crime mystery. We use logic and data to make conclusions. We struggle to get better and better data, and not to miss clues. Answers come slowly and sometimes from unexpected sources. It is still the best way for humans to learn about nature. However, it isn't static, infallible, or magical.
28
i am also a "practicing biological scientist" (as well as a physician who doesnt practice). I agree that science is hard. However, good scientists don't overstate their results. The problem is when science intersects with public policy. Even a cursory reading of the nutrition literature indicates that although we know a lot, we don't know nearly enough to give useful advice. So what should scientists do when asked to advise on the optimal diet? How about just tell the truth and admit "we're not really sure"?
17
People! Eat real food. Easy.
13
The problem with all of this is over the period in question, total fat consumption DID NOT drop in the US! The assertion that "we listened, went low fat, and are sicker than ever" is just that -- an assertion without evidence. It is true that as a percentage of calories, carbs have increased (and you'd be hard pressed to find any health advocate that claims processed carbohydrates are a good thing), but when you look at TOTAL grams, fat consumption has not dropped one iota in the last 30-40 years. All we've done is ate about 500 calories more per day, which has come from added sugars, processed grain, and added fats (read processed food).
The problem with all of this (and what the committee rightly addressed this) is looking at single nutrients leads to confusion, we have to look at patterns of eating. And eating REAL, whole food, mostly plants, is the answer, and has been for a long time.
Fat, carbs, and protein are macronutrients. On their own, they are neutral. You have to look at the FOOD. Foods cause disease or promote health, not individual nutrients.
The problem with all of this (and what the committee rightly addressed this) is looking at single nutrients leads to confusion, we have to look at patterns of eating. And eating REAL, whole food, mostly plants, is the answer, and has been for a long time.
Fat, carbs, and protein are macronutrients. On their own, they are neutral. You have to look at the FOOD. Foods cause disease or promote health, not individual nutrients.
54
Mostly right -- however, there is no real scientific evidence that eating mostly plants is beneficial. You are falling for the same epidemiological study nonsense that caused these problems in the first place.
9
Actually, there are quite a few studies, not just epidemiological ones, that show a pure vegan, low fat diet has reversed cardiac disease and reduced insulin requirements for those with diabetes. See, for example, Ornish's peer-reviewed studies on dietary intervention producing reversal of heart disease and insulin dependency:
http://www.ornishspectrum.com/wp-content/uploads/Intensive-lifestyle-cha...
http://www.ornishspectrum.com/wp-content/uploads/effectiveness-efficacy-...
http://www.ornishspectrum.com/wp-content/uploads/Intensive-lifestyle-cha...
http://www.ornishspectrum.com/wp-content/uploads/effectiveness-efficacy-...
6
Rather than bogging down this discussion with the reasons that veganism is a terrible idea, I'll just point you to the discussion page from this article from a few months ago, wherein a large number of people did the job very well:
http://well.blogs.nytimes.com/2014/11/24/ask-well-can-athletes-be-vegans/
Note that Ornish's study was tiny, involved a half dozen interventions (not just diet), and that the diet was not vegan.
http://well.blogs.nytimes.com/2014/11/24/ask-well-can-athletes-be-vegans/
Note that Ornish's study was tiny, involved a half dozen interventions (not just diet), and that the diet was not vegan.
7
Fat and sugar is what everyone needs. The amount you intake is crucial. I've been on the Loaded Gun Diet and I've eaten almost anything, losing weight in the process, and as a reward I'm feeling great now.
Well, not those who are pre-diabetic - we have to keep away from sugars/carbs.
6
"(We are not talking here about recommendations for the total amount of calories you should eat. These recommendations assume you’re eating the proper amount of calories, and seek to govern the proportion of nutrients within them.)"
This is probably the most important line in the whole article. It's too bad it's relegated to a parenthetical. If you're eating an appropriate amount of calories and getting enough basic nutrients, it probably doesn't much matter for most people how their calories break down between protein, fat, and carbs.
This is probably the most important line in the whole article. It's too bad it's relegated to a parenthetical. If you're eating an appropriate amount of calories and getting enough basic nutrients, it probably doesn't much matter for most people how their calories break down between protein, fat, and carbs.
6
That assumes, probably incorrectly, that the macronutrient mix won't interfere with the body's natural regulatory mechanisms. Dr. Ludwig, as an example, will pound the table insisting that sugar and highly processed/easily digested carbs can wreak havoc on the insulin cycle and the signaling of hunger/satiety.
Put another way, the macronutrient mix won't matter IF a person can accurately count their calories even after their body's natural regulatory and signalling mechanisms have failed, but most people have a hard time with that.
Put another way, the macronutrient mix won't matter IF a person can accurately count their calories even after their body's natural regulatory and signalling mechanisms have failed, but most people have a hard time with that.
3
This is not true. There's some evidence from controlled studies that the body partitions fat storage/energy differently depending on the type of nutrient. This hypothesis is still being tested. Furthermore, some foods are more satiating than others and some foods cause craving. It is therefore possible for a diet with sufficient calories to leave someone satiated or constantly hungry, depending on nutritional makeup.
You really have to begin with the assumption that everything you were taught about nutrition is wrong, because so much garbage was spouted by the nutrition establishment and supposedly reputable organizations like the AHA.
You really have to begin with the assumption that everything you were taught about nutrition is wrong, because so much garbage was spouted by the nutrition establishment and supposedly reputable organizations like the AHA.
12
I completely agree. Americans simply eat too many calories, and they don't even know how many they should be eating. I am 5'5 and weigh 132 pound. My calorie allowance is around 1800 per day pre-exercise. If I were to eat 2000 per day I would weigh about 7 lbs.
In addition, every time Americans hear that a food is healthy, they think that means they can eat as much as they want. Now people will over eating steak and chicken and butter.
Everyone should get a calorie counter on their phone and a food scale, and measure their food until they learn portioning, and what foods make the satisfied. I find lots of protein and vegetables, with small treats works great for me.
I still drink wine, and eat desert and cheese but in limited quantities.
In addition, every time Americans hear that a food is healthy, they think that means they can eat as much as they want. Now people will over eating steak and chicken and butter.
Everyone should get a calorie counter on their phone and a food scale, and measure their food until they learn portioning, and what foods make the satisfied. I find lots of protein and vegetables, with small treats works great for me.
I still drink wine, and eat desert and cheese but in limited quantities.
2
All I know is that I feel better when I eat a bit of everything, in moderation.
12
Excellent article . The subject of diet and chronic disease is complicated; it's not suprising that this nuanced article is from an MD with knowledge of epidemiology.
The author reminds us people are hetrogeneous. Whether dietary inteventions to lower fat and/or salt intake are effective in decreasing disease and premature death may differ depending on genetics and whether the advise is for prevention of disease of treatment of already diagnosed cardiovascular disease.
I might also add (MD, MPH in hand) that a distinction must be made between serum cholesterol (well established as a risk factor in heart disease) and dietry cholesterol (never established). If this fact is understood, there has been no shift in scientific statements.
Also remember it is nearly impossible to accuately measure fat and/salt intake in free living peoples and that the effect of fat and/or salt on heart disease may not be evident for decades. So the data is, inherently, fuzzy.
This is in contrast to tobacco; the link of cigarettes and health is firm because we can count the cigarettes/packs smoked and multiply by the years of exposure.
IMHO, it is the superficiality and simplification of press releases that make science look sloppy. Why not have medical releases be written by medics and let's write to those who can read and understand science written in laymen's language. Don't water down the science, but write in simple English.
The author reminds us people are hetrogeneous. Whether dietary inteventions to lower fat and/or salt intake are effective in decreasing disease and premature death may differ depending on genetics and whether the advise is for prevention of disease of treatment of already diagnosed cardiovascular disease.
I might also add (MD, MPH in hand) that a distinction must be made between serum cholesterol (well established as a risk factor in heart disease) and dietry cholesterol (never established). If this fact is understood, there has been no shift in scientific statements.
Also remember it is nearly impossible to accuately measure fat and/salt intake in free living peoples and that the effect of fat and/or salt on heart disease may not be evident for decades. So the data is, inherently, fuzzy.
This is in contrast to tobacco; the link of cigarettes and health is firm because we can count the cigarettes/packs smoked and multiply by the years of exposure.
IMHO, it is the superficiality and simplification of press releases that make science look sloppy. Why not have medical releases be written by medics and let's write to those who can read and understand science written in laymen's language. Don't water down the science, but write in simple English.
51
I read just far enough to see that the author began by talking about saturated fat in the diet and then continued by discussing dietary cholesterol. They are not the same thing. Expecting the cholesterol in an egg to raise your own cholesterol is sort of like rubbing brains on your head to get smarter, isn't it? The saturated fats in the egg are the building blocks for our blood cholesterol-- correct?
2
"The saturated fats in the egg are the building blocks for our blood cholesterol-- correct? "
Well - saturated fats but also simple sugars, and in most people's diets it's the food that breaks down to simple sugars that the liver uses to max out its cholesterol capacity.
Well - saturated fats but also simple sugars, and in most people's diets it's the food that breaks down to simple sugars that the liver uses to max out its cholesterol capacity.
2
Suggest you read "Good Calories, Bad Calories." There was no real science behind these recommendations, or rather, the little science that there was was marginalized. The field of nutrition was in essence given over to quacks.
10
Dr. Atkins was right after all. Too bad he didn't live longer once he was shown to be right.
One of the most shocking revelations of recent years was that the "Food Pyramid" created by the federal government to guide our eating, had absolutely no basis in research or fact. When challenged, the government had to admit this. The whole pyramid base of many portions daily of carbs was unscientifically arrived at.
One of the most shocking revelations of recent years was that the "Food Pyramid" created by the federal government to guide our eating, had absolutely no basis in research or fact. When challenged, the government had to admit this. The whole pyramid base of many portions daily of carbs was unscientifically arrived at.
41
I was just told by my cardiologist that my pre-diabetic A1C levels would plummet if I went on the Atkins diet.
8
Nonsense. There is a plethora of scientific literature showing that increased red meat consumption is associated with a host of poor health outcomes including cancer. Whole grains, fruits, and vegetables are and have always been an important component of a healthful diet.
2
The "meat is bad" studies:
A) really appalling epidemiological studies that fall apart if you look at them too closely (the meat eaters smoke twice as much, for example).
B) short small intervention studies showing that a fat free vegan diet improves a handful of blood values among sick obese people who have been eating a highly refined diet.
"Meat is good" studies:
A) Studies comparing omnivore health freaks with vegetarian and vegan health freaks indicate that health outcomes decline as diets become more restrictive.
B) Studies showing that in traditional cultures, people become smaller and weaker as their diets drop below a threshold level of percent calories from animal food.
C) All other evidence of history, anthropology, and evolution.
You keep believing those 6 week studies. I'll believe my 6 million years of evolution!
A) really appalling epidemiological studies that fall apart if you look at them too closely (the meat eaters smoke twice as much, for example).
B) short small intervention studies showing that a fat free vegan diet improves a handful of blood values among sick obese people who have been eating a highly refined diet.
"Meat is good" studies:
A) Studies comparing omnivore health freaks with vegetarian and vegan health freaks indicate that health outcomes decline as diets become more restrictive.
B) Studies showing that in traditional cultures, people become smaller and weaker as their diets drop below a threshold level of percent calories from animal food.
C) All other evidence of history, anthropology, and evolution.
You keep believing those 6 week studies. I'll believe my 6 million years of evolution!
6
Although we have finally learned the error of our ways regarding fat and cholesterol, we are aggressively making the same mistake when it comes to the diet of infants.
The evidence on which breastfeeding recommendations are based is no better than that on which the cholesterol recommendations were based.
The science is extremely weak, contradictory and plagued by confounding variables. Despite this, we are promoting breastfeeding as every bit as important to good health and long life as limiting dietary cholesterol and fat. Indeed, we are going farther, with government attempts to cajole and shame women who choose to formula feed, and dangerous hospital policies like the Baby Friendly Hospital Initiative which, in direct defiance of everything we know about babies suffocating and falling out of hospital beds, promotes 24 hour rooming in of infants.
Everyone “knows” that breastfeeding makes children smarter, healthier, thinner, less likely to develop the chronic diseases of old age. Except that’s not what the scientific evidence shows. The scientific evidence shows that for full term infants in first world countries, the only health benefits are a minor reduction in incidence of colds and diarrheal illness in the first year of life. That it.
If we learn anything from the fiasco on fat and cholesterol recommendations it should be this:
Our recommendations on breastfeeding should reflect what the scientific evidence actually shows, not what we think we “know.”
The evidence on which breastfeeding recommendations are based is no better than that on which the cholesterol recommendations were based.
The science is extremely weak, contradictory and plagued by confounding variables. Despite this, we are promoting breastfeeding as every bit as important to good health and long life as limiting dietary cholesterol and fat. Indeed, we are going farther, with government attempts to cajole and shame women who choose to formula feed, and dangerous hospital policies like the Baby Friendly Hospital Initiative which, in direct defiance of everything we know about babies suffocating and falling out of hospital beds, promotes 24 hour rooming in of infants.
Everyone “knows” that breastfeeding makes children smarter, healthier, thinner, less likely to develop the chronic diseases of old age. Except that’s not what the scientific evidence shows. The scientific evidence shows that for full term infants in first world countries, the only health benefits are a minor reduction in incidence of colds and diarrheal illness in the first year of life. That it.
If we learn anything from the fiasco on fat and cholesterol recommendations it should be this:
Our recommendations on breastfeeding should reflect what the scientific evidence actually shows, not what we think we “know.”
29
Amen, sister.
2
Mammals (including humans) breast-feed their young. This is a practice that has been refined through natural selection for an awfully long time.
It would take some very convincing evidence to change this default.
My understanding, based on this article
http://www.slate.com/articles/double_x/doublex/2012/07/daily_beast_and_h...
is that Amy Tuteur has let her medical license lapse over ten years ago. It is misleading that she refers to herself as an MD.
It would take some very convincing evidence to change this default.
My understanding, based on this article
http://www.slate.com/articles/double_x/doublex/2012/07/daily_beast_and_h...
is that Amy Tuteur has let her medical license lapse over ten years ago. It is misleading that she refers to herself as an MD.
17
Food, for infant mammals, is breast milk. "Formula" is not food. Formula is made in a factory. If you think what you "know" is better than 50 million years of evolution then I'm darn glad your weren't our pediatrician.
23
The recommendations for the new guidelines certainly look like a step in the right direction, and the emphasis on "dietary patterns" rather than specific foods and nutrients reflects recent research. Although the US Dietary Guidelines are a popular target for blaming why so many Americans are fat, and sick, many or these criticisms are unfounded, because most Americans weren't following the guidelines. Guidelines have never recommended refined carbohydrates, low fiber grains and cereals, or high sugar items – foods that are widely overconsumed and likely contributors to obesity and chronic disease. For example, in 2010 Americans were far from the guidelines, eating twice as much refined grains, solid fats (mainly from beef fat, butter, and shortening), and sugars, and less than 50% of the fruit or whole grains recommended by the guidelines.
http://www.sheilakealey.com/dietary-guidelines-really-making-us-fat-sick/
http://www.sheilakealey.com/dietary-guidelines-really-making-us-fat-sick/
http://www.sheilakealey.com/dietary-guidelines-really-making-us-fat-sick/
http://www.sheilakealey.com/dietary-guidelines-really-making-us-fat-sick/
4
A large part of the harmful response to the previous guidelines was the industrial food manufacturers' use of them as an excuse for cococting "low-fat" versions of their usual refined carb. cookies, cakes, etc. that were crammed with strange things to substitute for the mouth feel and flavor of the omitted fats. I remember being offered Snackwell cookies as if they were virtuous because low in fat.
Industrially produced American food tends have a lot of added sugar in almost everything - spaghetti sauces, frozen main courses. I don't know why they do this unless it's because subsidies make sugars so cheap, and it disguises the basic tastelessness of hyper-processed, not very good ingredients. I can't help thinking it's the food manufacturers and fast food outlets that do the most harm.
I have to say that my parents' habits were a lot healthier than anything the government has come up with. They really liked vegetables and fruits, grew them or bought from farmers when they could. They used butter, but not much, and liked cheeses but didn't eat a lot, mostly on Triscuits with drinks before dinner, unlike others who had to endure egg white omelettes made with margarine because egg yolks and butter were said to be bad for you. They were not immortal but what they died of (Parkinson's, old age) seems not to have been caused by their diets.
Industrially produced American food tends have a lot of added sugar in almost everything - spaghetti sauces, frozen main courses. I don't know why they do this unless it's because subsidies make sugars so cheap, and it disguises the basic tastelessness of hyper-processed, not very good ingredients. I can't help thinking it's the food manufacturers and fast food outlets that do the most harm.
I have to say that my parents' habits were a lot healthier than anything the government has come up with. They really liked vegetables and fruits, grew them or bought from farmers when they could. They used butter, but not much, and liked cheeses but didn't eat a lot, mostly on Triscuits with drinks before dinner, unlike others who had to endure egg white omelettes made with margarine because egg yolks and butter were said to be bad for you. They were not immortal but what they died of (Parkinson's, old age) seems not to have been caused by their diets.
14
The answer as to why may be very simple. Industrial food producers are out to make money. The cheapest ingredients they can put in food, and not run afoul of the law, are salt and sugar. Sugar as you rightly note is heavily subsidized, which is a fact that ought to make every thinking American of whatever political persuasion livid with rage.
4
You are on the right track, when you say, "Industrially produced American food tends have a lot of added sugar in almost everything - spaghetti sauces, frozen main courses. I don't know why they do this unless it's because subsidies make sugars so cheap, and it disguises the basic tastelessness of hyper-processed, not very good ingredients."
Three main ingredients of American factory made food are, sugar, starch, and salt. Well, you could add the cheap fats such as lard, or corn oil etc.
And those are the ingredients pop up to the surface on any kind of food related illnesses.
And all the above the usual suspects sell for wholesale about a dime to two bits per pound. If you are shipping 100 tons of ready-made slop it makes a big difference in the bottom line to sell ten cents per pound ingredient for let's say for a spaghetti sauce, or canned chili, or any other concoction for reasonably $1 per pound.
That kind of margin does not exist in anything else.
Three main ingredients of American factory made food are, sugar, starch, and salt. Well, you could add the cheap fats such as lard, or corn oil etc.
And those are the ingredients pop up to the surface on any kind of food related illnesses.
And all the above the usual suspects sell for wholesale about a dime to two bits per pound. If you are shipping 100 tons of ready-made slop it makes a big difference in the bottom line to sell ten cents per pound ingredient for let's say for a spaghetti sauce, or canned chili, or any other concoction for reasonably $1 per pound.
That kind of margin does not exist in anything else.
Reading the comments from other columns about the new guidelines, the usual pessimists and detractors were out in force. The anti science brigades were vociferous but it merely speaks to the scientific illiteracy. The vast majority of the public can't or won't read the actual scientific research. The media's "interpretation" of the results of a study usually adds to the confusion. Science is not and never has been static. As new data becomes available, revisions are made. As to diet, the wide variability of each individual's response to changes in diet make generalizations difficult but the dieticians and scientists keep trying. The real killer is likely to be processed foods. The best one can do is to eat real food in moderation and pay attention to your own health.
73
I agree with your comments and would add that both the media and the medical fraternity are not always as knowledgeable as they should be when interpreting statistical results. One of the most famous cases was in the UK where a doctor, meaning well, "found" negative outcomes using a triple vaccine compared with individual ones.
An inadequate knowledge of statistics led to a fall off of children being vaccinated by either method.
An inadequate knowledge of statistics led to a fall off of children being vaccinated by either method.
Tom reports that "The real killer is likely to be processed foods." Which randomized controlled studies support that? Or are we about to be led down another cascade of anecdotal evidence to vilify the food that ordinary folks prefer to eat?
3
Everything you said made sense until the processed foods comment.
There is no scientific foundation for claims like that and it's a textbook case of the naturalistic fallacy.
Processed foods are usually grosser and poorer quality than other foods. However, there is no evidence they specifically cause disease.
There is no scientific foundation for claims like that and it's a textbook case of the naturalistic fallacy.
Processed foods are usually grosser and poorer quality than other foods. However, there is no evidence they specifically cause disease.
1
All of this dietary engineering and nutrient extraction into pills seems counterproductive.
Eating balanced meals of whole foods, including moderate portions of non-antibiotic meat, fish, dairy, unprocessed vegetables, grains and fruits, oils and nuts, is easy and cheap.
It also happens to be how a lot of the BMI<25 countries in the world eat, for a lot less than we spend buying our food in boxes.
Eating balanced meals of whole foods, including moderate portions of non-antibiotic meat, fish, dairy, unprocessed vegetables, grains and fruits, oils and nuts, is easy and cheap.
It also happens to be how a lot of the BMI<25 countries in the world eat, for a lot less than we spend buying our food in boxes.
29
Sure, but lead out most of the oils. Purified oils are not natural foods and there is evidence that they are harmful, much as purified sugars are.
5
Josh, do you have evidence to support your statement that expressed oils are harmful? scientific publications? or do you mean something else by "purified?"
1
Refined vegetable oils show up in the human diet about a decade before the heart disease epidemic exploded. Might be a coincidence, of course, but they don't exactly have a long record of safe use. High in (unstable, easily oxidized, possibly pro-wnflamatory) omega-6 fats, refined using chemicals you don't want to know about. Teicholz Big Fat Lie does an adequate job on the issue, if you want more.
7
We're in an age when certain groups question the objectivity of science on global warming. Here is another example where science can be seen hoisting life-impacting guidelines and stigmas based on anything but fact.
I remember seeing older family members literally look at eggs in fear, and feeling terrible about wanting to have a second egg. As if it was all their fault.
The more we followed science's dictates into high-carbohydrate diets the more obese we as a nation have become.
No wonder some people don't trust vaccines because they think they are being lied to in the name of science. Where is the accountability here?
I remember seeing older family members literally look at eggs in fear, and feeling terrible about wanting to have a second egg. As if it was all their fault.
The more we followed science's dictates into high-carbohydrate diets the more obese we as a nation have become.
No wonder some people don't trust vaccines because they think they are being lied to in the name of science. Where is the accountability here?
14
This wasn't science. It was quackery masquerading as science while the actual scientists, who were warning that this was nonsense all along, were marginalized and ignored, even called crackpots, by the government and the press.
It is sad that it was able to occur, but it is the responsibility of the citizen to distinguish between fields that have been taken over by crackpots and the real scientific research of the kind that has confirmed global warming and that gave us vaccines. Unfortunately, we will now find a lot of ignorant people claiming that warming and vaccines must be scams as well; I've already seen it happening.
It is sad that it was able to occur, but it is the responsibility of the citizen to distinguish between fields that have been taken over by crackpots and the real scientific research of the kind that has confirmed global warming and that gave us vaccines. Unfortunately, we will now find a lot of ignorant people claiming that warming and vaccines must be scams as well; I've already seen it happening.
13
"Since pretty much all calories come from fat, protein or carbohydrates, reducing your consumption of one means that you have to increase your consumption of another."
This is so important. We are always looking for "rules" to follow when it comes to eating because it's easier to be black and white than it is to have to exercise thought and control. That's why there is such a tendency to demonize certain types of food (e.g. carbs, fat, cholesterol, saturated fat,etc.).
Our bodies are pretty good at identifying what they need...we just have to be aware of what our body is telling us. There is a good chart on this page http://bit.ly/Food-Cravings that shows what nutrients our body is really craving when we have a desire to eat ______ (bread, pasta, chocolate, etc.). Once we start to understand what our body is actually looking for, it becomes much easier to feed it properly...then it's not necessary to make blanket statements like, "carbs are bad".
We can just eat again.
This is so important. We are always looking for "rules" to follow when it comes to eating because it's easier to be black and white than it is to have to exercise thought and control. That's why there is such a tendency to demonize certain types of food (e.g. carbs, fat, cholesterol, saturated fat,etc.).
Our bodies are pretty good at identifying what they need...we just have to be aware of what our body is telling us. There is a good chart on this page http://bit.ly/Food-Cravings that shows what nutrients our body is really craving when we have a desire to eat ______ (bread, pasta, chocolate, etc.). Once we start to understand what our body is actually looking for, it becomes much easier to feed it properly...then it's not necessary to make blanket statements like, "carbs are bad".
We can just eat again.
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