Most people here probably don't comply to this diet closely, but many still eat fast food from time to time. Your classic McDonalds meal (a burger made with refined grain bun, a couple of slices of full-fat cheese, red meat patty, and a cup of french fries) hits the Western diet pattern in every item.
As far as your use of the word 'millenia', I thought you were using it in the way someone might say 'eon' or some other very long time period. I will contend that the time frame we're talking about it quite short. You are correct that millenia is 1000 years and I was incorrect in saying that it had not been 'millenia'.
But I'd be glad if we could at least agree about this. An average low-carb/Atkins follower would take that McDonalds meal, throw out the bun, and declare the rest perfectly healthy and advisable nutrition.
I'm not aware of any evidence that the advice is ineffective. Just look at the table a few posts back. But there is good evidence that the advice is simply not followed by the general population.Quote:
There is more to it than this. The advice isn't just boring, it's ineffective. People start debating the merits of various other diets because they see that what they've been told is complete B.S. and so they're investigating what works for others. This is a meaningful conversation.
Of course, if you don't just want a lower risk of CHD, if you want a silver bullet diet that will help you lose 10 lbs/month without counting calories or restraining yourself, "expert advice" may not be enough and it might make sense to explore exotic diets.
But I was speaking of the general public who, from what I have observed, pay less and less attention to what the official agencies are saying and more and more respect and attention to the 'experts' like Atkins and Esselstyn. To the general public, the things like the 'food pyramid' (or whatever they are calling it this year) is just not a relevant part of their lives -- but the advise of their favorite dietary expert is gospel.
And, I find that reasonable -- because a lot of legitimate questions have been raised about the advise coming from the likes of the USDA and NIH that those agencies have neglected to address.
Neither do I share your respect for RCT's over observational studies. Both can be biased, both can be misleading -- and both can shed valuable CORRECT information on a complex topic.
For example: the RCT that "proved" that the Mediterranean diet is superior to a low fat diet has been criticized as biased and improper. Specifically, accusations have surfaced that the people who organized the study had a financial stake in its outcome. And, in addition, it has also been criticized because the 'low fat' diet it used was not really a low fat diet, nor were the people on the low fat leg provided with the anywhere even close to the support that the people in the Mediterranean leg were given. So, even though, as an RCT, it was the 'highest level' of evidence, what did it prove?
... The same story can be told of countless RCT's run by the drug companies... Or even by the NIH -- such as the Nurse's Health Study.
Conversely, Campbell conducted an observational study that shed light on the subject -- but it has been largely ignored by the medical community...
No, I think our agencies need to clean up their act and get with the program or they will become increasingly irrelevant -- and they need to start looking at ALL of the data... You cannot ignore something like Framingham or the China Study because it is not an RCT.
If you were a little more savvy, you would know that the beef was the lowest common denominator of industrialized meat, the cheese was not cheese at all, but chemically altered soy oil and the lettuce/tomato/pickles were probably GMO and loaded with chemicals.
Now, could one eat at McDonald's and maintain a state of ketosis if that were their goal? Yes. Who would put forth the notion that the plague of the Western world was that people are going to McDonald's looking for a balanced, healthy diet and getting bamboozled? I just don't understand your premise. It seems bizarre.
... Is NOTHING sacred anymore that you can't even trust that a McD is a real hambooger????
1) There are folks out there who financially benefit from your and others' confusion. Ignore them. All of them. Ornish, Atkins, Esselstyn, all of them. Ignore them. They are not using the scientific method. Their aim is monetary. Ignore them.
2) Health care professionals (HCPs) are scientists. They are trained in the scientific method. That is hammered into them in medical school, perhaps more than any other single thing. They are the experts. Atkins and Esselstyn are not experts. They claim to be. Good HCPs look at the scientific evidence and make their decisions on what interventions to make based on that. Not that every single HCP is "good" or even pays much attention to the scientific evidence compared to the lobbying efforts of drug company salespeople. But the top folks in the field do, and they are very reliable. AHA recommendations are the gold standard. For your amusement, here is a list of folks who have claimed to be the Messiah:
3) Modern media are more about money than truth. If you want to get at the truth in the health field, read peer reviewed studies on Medline. Unfortunately, people believe what they see and hear on the media, including the "new media." Most of it is garbage. This is the fault of the uneducated public and those who profit from having said public be uneducated, most of whom couldn't give a description of the scientific method if their life depended on it, which it might.
4) Name a legitimate question about diet or statins which is being ignored by the scientific community.
5) Observational studies and RCTs are different. Neither one can stand alone. When an RCT confirms causation for something that was observed as an association in an observational study, then one can have some assurance that it is valid.
6) Stand-alone observational studies which have not been confirmed by other studies or RCTs are rightly viewed with skepticism.
7) RCTs which confirm observational studies are what you look for. Scientists will frequently dispute the findings of other scientists. However for their criticism to take precedence over the study which they criticize, they have to do a study which disproves the first study. In this case that has not been done, so we accept the current findings. That's how it works.
We might take Galileo's famous dropping of objects from the Tower of Pisa as an example. In spite of the critics of the time, so far his experiments have not been found to have a different result when done by others.
8) Yes, you can ignore observational studies which reach conclusions at variance with scientific evidence. I hope, briefly, to look at this more closely. The China study is the actual comprehensive study done by Dr. Campbell. The China Study is the money-making book in which he sought to capitalize on the ignorance of the public by pushing a particular philosophy for which he has no good scientific evidence. The China study found 8000 correlations between diet and CHD. Thus the China study is an observational study comparing one variable to another (univariate correlations) and, as such, essentially meaningless unless confirmed by an RCT. Do you know of any of these correlations found to be causative by an RCT? Do they support Dr. Campbell's hypotheses in The China Study? That's the difference.
Since Dr. Campbell's China study showed only univariate correlations, many people have published analyses of his data which are at variance with Dr. Campbell's analysis. Pretty easy to do, since there's no evidence of causation, only of correlation. Surely we are old enough to remember the cigarettes/lung cancer correlation/causation debate, resolved by science showing causation.
Usually I do agree with most everything you write. But I think you have a bit too much confidence in the integrity of our health care system and its research base.
I suspect that you and I could argue these points till the end of days and not agree. But this thread has already wondered far afield.
But, one thing you said made me chuckle:
" ... AHA recommendations are the gold standard. ..."
If you remember what started this thread, do you really want to stand by that statement? :)
Yes, if my LDL were over 190 I certainly would take a statin. I know several people who've been on statins, some for decades, with no ill effect, still in perfect health. In fact I'm going to discuss statins with a retinologist next week to see if it might help my very early macular degeneration.
And, I did not get my cynicism from internet charlatans, it was from listening to physicians and scientists debate the science and its validity.
The new calculator is an example: As soon as it was released, I tested it against the Framingham calculator (that has been the gold standard for over 10 years) and found that it ran 50-75% high. Both calculators are based on science -- but yet they provide very different answers to the same question. But yet the new one was accepted by the scientific and medical communities... Until a couple days later when 2 researchers came up with same conclusion that I had and, at that point, Leaders in the medical community started to back away from it ask for further review...
Another recent example is the study (I forget the name of it) that "proved that HDL is not beneficial". What they did was to treat patients already on a statin with niacin. Their HDL went up -- but they still died just as fast. Many believed that disproved the HDL hypothesis. Some other, more thoughtful persons realized that raising HDL when LDL is already low does not do much good. So, the trial, although scientific, had a bad design and really did not prove or disprove much of anything.
Both observational trials and RCTs merely supply data. Sometimes the data is good and sometimes it isn't. But even if it is good data, then you have to rely on the interpretation and analysis of the data -- which can also be flawed.
In short, RCTs are one of the TOOLS of science -- but they are not, in themselves, science.
I do not distrust scientific research -- but I have learned to take it as a guide rather than a gospel and to give it the "stink test" and compare it to other research in the same area before I accept it. In fact, one of the first things I do when a new study has been released is to read the physician's comments about it. Very often I hear that it was a flawed study or flawed analysis.
As for the AHA guidelines (both old and new): there are simply too many unanswered questions about those guidelines for me to take it as any more than one group's opinion -- even if it is considered to be the "gold standard".
The same happened with nutrition where those with their own agendas, more funding, and more lobbyists have changed policy that is not to the benefit of everyone's health.
Ancel Keys work was not all bad and he did promote a vegetarian and Mediterranean diet as being optimal but at the same time he drew incorrect correlations between the effects of saturated fats and heart disease and was convinced of these theories.
When he gained more influence these became health policy and fats / cholesterol became the boogeyman when the actual picture was much broader.
This led to the move to us seeing more low fat foods and it has reached a point where finding whole fat foods to be difficult to find, made people eliminate so called "bad" foods like liver and heart from their diet, and got them eating foods that replaced their fats with sugars. And when they did have fats it was processed fats like margarine and vegetable oils which we know are bad for you.
A lower carb diet is more satiating than a higher carb diet and you do not have to reload as often... your feet won't be walking you to the fridge.
Keys never looked hard enough at the role of increased sugar consumption as an issue and it does not matter what form that sugar comes in... carbohydrates cause insulin spikes and when you combine those carbs with any fats it causes metabolic issues and oxidative stress to the body.
Speaking for myself and my wife, we feel immensely better after cutting carbs out of our diet... people with thyroid issues or no thyroid can benefit greatly when their endocrine system is messed up or has to deal with artificial modulation through medications as the insulin response does get messed up.
I am on a lower carb diet that does not include many grains, she aims for a near zero carb diet and this has been benefitting her immensely. We saw our doctor today and he was quite impressed at how good all her lipid numbers were after she said she had been on a high fat / low carb keto diet and she really feels great and looks amazing.
This is just science... eliminate carbs and your body will need to burn fat as fuel, insulin spikes will become non-existant, and blood sugars will normalize. We don't count calories and eat when we are actually hungry which is something people struggle with when they are on a carb loaded roller coaster.
I did not do this because I was obese, diabetic, lacked a thyroid, or because I had high lipid numbers... I had a little weight to lose and went on a keto diet and the extra weight vanished and I realized that I felt better.
My LDL has increased a little but is still within the ideal range and science tells us that it does not matter if you have high cholesterol or low cholesterol... the odds of having a heart attack are tied more to other lifestyle, heredity, and dietary factors.
I wake up with more energy, don't crave carbs, and never bonk unless I overdo those carbs... now a little extra sugar in my diet messes me up and makes me realize what a powerful drug it is. I try and limit those to less than 100 grams a day.
I had a physical exam last week and was told I was freakishly strong... during a 6 week period of intense physiotherapy and conditioning I felt like I had endless energy and whenever I could ramp up the weight (my back limits me from doing some exercises) I could do reps at nearly 100% with almost no fatigue and I gained a lot of muscle very quickly.
My father died of a heart attack at the age of 59... he abused his body on a daily basis for his entire life. He smoked a pack of cigarettes a day, drank a fifth of whiskey, and ate a very unhealthy diet.
His rural siblings are all going to be octogenarians in a few years and are enjoying excellent health save for having bad hips... no-one is diabetic and none of them have heart problems. They also don't drink, don't smoke (or quit smoking before I was born), and eat a lot of food they raise themselves.
My brother is almost 60 and hunts and fishes for his own food and won't buy meat from a store, he gave up drinking and smoking 30 years ago... he can outwork and outrun people half his age and if was so inclined, tear your arms off. This is a guy who has never set foot in a gym and has 18 inch arms he developed from working on rigs and pipelines and from hauling and sometimes running game out of the bush.
My mom's sister is 83... she can pass for 60 and has never indulged in alcohol or smoking, works on the farm every day, and people half her age cannot keep up with her and if you don't live to be 85 plus in my family there's a problem. My aunt churns butter and won't use margarine, frys and bakes with lard, and sweetens things with the honey she gets from her bees. She eats vegetables she grows and eats chicken, eggs, beef, and pork she raises with her son who helps out.
My mom passed away at 83... it has now been found that the issues that caused her death were medication related and she was an active and busy person until a few weeks before she passed away... she was sharp as a tack too.
Like Carlin said... trust no-one.
I did not believe this whole low fat nonsense when it came out... I had a family around me who enjoyed a pastoral existence and hard work and most people just died from advanced old age.
They did not believe this low fat nonsense either.
I've been to Edmonton a couple times. I even rode bikes one time with a group there. Damn shame I missed you 65'er! There's always next time, I guess.
I'm not going to quote that whole post but
Sixtyfiver, how much carbs did you eat before switching diets?
Tonight I made us a treat... fried chicken livers with black pepper, garlic, a pinch of salt, and hot paprika and we had a side of fermented sauerkraut. Holy good god this was delicious !
We usually eat beef liver and it was notable that when I saw my neurologist last week (back issues and neuropathic pain) the first thing he checked were my B12 levels which were 284pmol/L and he was checking because deficiencies can cause neurological issues... mine were almost double the minimum (150 pmol/L)
Interestingly, the linked study showed that antioxidant supplements decreased the positive effects of statin plus niacin. That's a bit of data worth taking note of.
Of course RCTs are science. They are experiments in the quest to prove or disprove a hypothesis. That's the basis of the scientific method. Experiments which don't prove anything are just as valuable as those which do.
You can of course do anything you want with your health care. You pays your money and you takes your choice. Life is all about choices. Unfortunately, we won't know the result of many of our choices for 20 or 30 years. That's what makes it interesting.
Me, I'm going to keep eating healthy and riding my bike. Weights yesterday, 2 sets of 30. Way to cold to even ride rollers in the shop. Rollers today though, and then going downhill skiing tomorrow, first time this year.
Yes, RCTs are (A PART OF) science -- but they are just one tool of science. And not infallible (as the drug industry would have us believe).
Enjoy your healthy life style -- and the skiing!
The elephant in the room is not cholesterol, fats, carbs or protein.
It's called gluttony. Plain and simple. All the diet recommendations in the world won't be effective when people insist on going back for seconds and thirds, then dessert, and a whole lot of other stuff in between meals.
If people kept their mouths shut more often and moved their legs more, there would be a much reduced need for a host of medications, including statins.
If you stick to more of a fat/protein schedule, you don't get the big blood sugar variations, so you don't get that gnawing hunger. Do you eventually get hungry? Of course, but it is at longer intervals and lower intensities. At least, that's what I've found.
Overeating is a serious problem... the average North American eats more than they need to the tune of 1000 calories a day but there are those who eat properly and still experience weight gain, there are lots of active people who cannot shed pounds until they get off the sugar train.
If you insist that it is merely a matter of carbs in and carbs out then you are well behind the research curves as not all carbs are created equal and even those eating within dietary guidelines are consuming more of them than they should.
I believe someone already posted a link to Sweden's changes in guidelines which now promotes a higher fat / lower carb diet and this was based on some of the most exhaustive research ever done and it forced the medical community in Sweden to admit that they had been wrong.
One of their most interesting findings was that weight loss occurred independent of exercise when a higher fat / low carb diet was adopted and lipid numbers improved.
I'd double dare anyone who wanted to lose weight to try a lower carb diet for 6 weeks where carbs are less than 100 grams per day and where they consumed an adequate number of calories to maintain normal functions.
You can make up the carb deficit in any way you choose as long as you replace the carbs with dietary fats.