More evidence

Today an article in Archives of Internal Medicine on the benefits of a low carb diet with a vegetarian twist.

It benefitted blood pressure, apolipoproteins and the ratio between total and ldl cholesterol.

More proof that carbs are not good for us.

I've been looking at articles from as far back as 2000, regarding things like "the metabolic syndrome, LDL particle size, and atheroclerosis: the Atherosclerosis and Insulin Resistance
(AIR) study". This was the first study to show a relationship between having small LDL particle size, metabolic syndrome and thickening of plaques in the arterial walls carotid and femoral arteries. And smaller LDL particles are not good.

Another article from the Arteriosclerosis, Thrombosis and Vascular Biology journal, called "Change in LDL particle size is associated with change in plasma triglyceride concentration", talks about how LDL particle size is inversely related to plasma triglyceride concentrations, so the higher your triglycerides, the smaller the size of your LDL particles. It seems the smaller particles are the ones found in plaque folks.

I'm painting a picture here.

So how to lower your plasma triglycerides? Eat fewer carbs. In Canada the RDA for carbs is about 300 g. On South Beach, I would say you get less than 20g a day during Phase I, probably 50 during phase II and less than 100g during Phase III and the rest of your life, depending on whether you gain weight or not.

Exercise is also good for you. It burns whatever glucose you might have in your system and gets you into fat burning mode. It also increases your fitness level and endurance.

Next post: insulin levels and breast cancer

I didn't know sat fats did anything good...

"The approach of many mainstream investigators in studying the effect of consuming saturated fats has been narrowly focused to produce and evaluate evidence in support of the hypothesis that dietary saturated fat elevates LDL cholesterol and thus the risk of CAD. The evidence is not strong, and overall, dietary intervention by lowering saturated fat intake does not lower the incidence of nonfatal CAD; nor does such dietary intervention lower coronary disease or total mortality." (German and Dillard, Am J or Clin Nutr, 2004)

What?

That was 5 years ago and today on CNN the Crestor add still vilifies sat fats and cholesterol in contributing to CAD.

Anyway, I think changes are starting to happen, perhaps with Pres. Obama's stress on utilizing science.

In any case, we know that sat fats are essential in the body. Heck, we produce them ourselves, especially lactating women feeding their babies.

OK, so some good sat fats:

Butyric acid - may play a role in cancer prevention, is a modulator of the immune response and inflammation, functions as an antitumor agent by inhibiting growth and promotion differentiation and apoptosis (s-that is, cell death).

caproic, caprylic and capric acids - the second two have antiviral activity, monocaprin has antiviral activity against HIV, caprylic acid has antitumor activity in mice.

lauric acid - antiviral and antibacterial functions, kills heliobacter pylorii in the stomach, anticaries and antiplaque agent, has adverse effects on various microorganisms including bacteria, yeast, fungi and enveloped viruses, by disrupting lipid membranes and deactivating them.

myristic acid - associated with CAD but most strongly related to average serum cholesterol concentrations, can also increase HDL levels.

palmitic acid - in normal healthy people with normal cholesterol levels, palmitic acid lowers serum cholesterol, replacement of laurate-myristate with palmitate-oleate has a beneficial effect on an important index of thrombogenesis.

stearic acid - and other acids with less than 12 carbon atoms are thought not to increase cholesterol concentrations. Produces beneficial effects on thrombogenic and athergenic risk factors.

So they are not completely without merit. Next time, the effects of sat fats on cholesterol.

The Skinny on Saturated Fats

Maybe Gary Taubes already said this, but sat fats are not the culprit.

I'm reading an article by J Bruce German and Cora J Dillard, from the American Journal of Clinical Nutrition, 2004;80:550-9, for those who check references.

What the article basically says, is don't throw the baby out with the bathwater. First, what more and more of us know, "high-carbohydrate diets were recognized as contributing to the lipoprotein pattern that charcterizes atherogenic dyslipidemia and hypertriacylglycerolemia."

In short, when the food industry began to remove sat fats from foods, they substituted carbohydrates in many forms. And those carbs not only made us fatter or obese, they changed our blood lipid profile to one which is "atherogenic" or bad for our blood vessels and circulation, and they gave us high triglycerides. Thanks a lot.

More interestingly, the article points out some of the things that saturated fats, or fatty acids, do is not bad, and what's more, some have positive effects on the body. The article states that there is no strong evidence that saturated fat elevates LDL cholesterol and thus the risk of CAD. What has not been studied is the possibility that some of the saturated fats might have positive effects, since mammals have within the mammary gland the means to produce a number of saturated fats, namely butyric, caproic, caprylic, capric, lauric, myristic, palmitic and stearic acids, to ensure the growth and survival of mammalian offspring. Evolution is a funny things, and things seem to have happened for a reason.

The article notes that saturated fats are the preferred fuel for the heart, a source of fuel during energy expenditure.

It concludes that the advice to remove sat fats from the diet has made us all fatter, and has failed to have any effect on the prevalence of diabetes and cardiovascular disease.

Next time: the sat fats and what they do for us.

Sugar Sugar

Honey, ah sugar sugar,....
You are my candy girl, and you've got me wanting you.


You know the rest.

And it's a sad fact that sugar is the origin of many of our problems, personally and as a society. Not only is obesity a personal problem, it is a societal problem.

Gary Taubes did us a great favour with his research on obesity and its patterns and causes. Were it not for him, we would still be thinking that low fat diets were the Greatest!

While exercise is a must for every human being who can do it, it is more important how you eat. If you exercise at a high rate every day, but eat a high carb diet with lots of saturated fat in it, chances are you will have high triglycerides, low HDL and high LDL. You probably have a bad level of C reactive protein as well, which is an indicator of how much inflammation you have in your body.

More and more, research in places like Harvard and Duke Universities is pointing to inflammatory processes and the size of your LDL particles as good indicators of your risk for cardiac disease. And researchers are realizing that "good fats" are important in lowering some of that risk.

A lot of these risk factors are related to the amount of sugar in your diet. High glucose in the blood throws everything off.

Heck, I would even bet that women with problems with their periods that is blamed on perimenopause and other such things, are probably insulin resistant and if they embarked on a program of walking and taking something like Metformin, their problems would stop as their insulin resistance decreased. It happened to me, but I don't want to generalize to a population. My doctor was absolutely skeptical at first, but no longer. She has studied hormones and now thinks that high blood sugar is the cause for many problems.

Want to change one thing in your diet? Reduce the amount of carbs you ingest. Switch to sugar free pop, eat an egg or egg substitute for breakfast instead of that cereal from a box, and look at the yogourt and fruit that you eat, and think about how many carbs are in them. The fewer carbs, the better.

Eating Wrong

I've been off the wagon a few weeks, and the worst part is, I knew I was doing it the whole time.

I could blame hormones or whatever, but I just lost my focus. We have been cutting down a bit on our calorie and fat intake, and using more plant based foods. My husband has of course lost another five pounds. Now I need to get back on the train, and regain my focus.

We no longer make such a big deal about evening meals. I think evening meals are the downfall of society. We make a big fuss over supper, claiming big hunger after a long day of work. I now suggest that we should fuel our bodies for the day while we are "working hard", if many of us do that anymore. Are there a lot of big fat ditch diggers? I don't think so. I think the problem has been that we have a food worship society that is left over from our agrarian roots, where having food was cause for celebration.

My husband and I often have low fat cottage cheese, hummus with vegetables, a salad of some sort (there are so many interesting recipes that are low carb) and some fruit. we do eat dark chocolate. So dinner has to correspond with what we are planning for the evening. No big roast, potatoes and pie if we have a fairly low key evening. Which most of them are.

I suggest everyone eat a big breakfast, a good size lunch, and reasonable snacks with a small dinner. So much more reasonable for the modern lifestyle. And always, low carb.

They are coming around

Check out Dr. Mehmet Oz on Oprah.com. He is coming around to the low carb way. He and Dr. Michael Roizen recently gave advice on that website on how to lose weight, and included such advice as not eating anything white, including baked potatoes, rice, white flour, sugar.....sound familiar? He talked about eating the right kinds of oils. They caution about the sugar in salad dressings. They talk about the right kinds of snack to carry with you at all times in case you have a craving, and alternatives to snacking (water, sex.....) Also suggested is to eat breakfast, and to limit your choices so that having breakfast becomes easy and automatic. They are still afraid of egg yolks though. Blueberry smoothies were also a suggestion I like.

Exercise suggestions are walking, light dumbells, yoga and breaking into a sweat at least once a week.

Dr. Oz also suggest fidgeting to keep your metabolism working.

All in all, considering the reach of Oprah, this is good news. There was no low fat ranting. He seems to be a convert of sorts. Not sure he would agree with my evaluation, but I can see less daylight between him and the low carb approach than before.

http://www.oprah.com/slideshow/health/weightloss/slideshow1_ss_health_diet/1

How to low carb

Some people have a real hard time figuring out how to lose weight, and when I talk to them about low carb living, they really get confused.

Most of us are nutrition illiterates. I was until I started reading articles like What if its all a big fat lie and the Soft Science of Dietary Fat by Gary Taubes. I also read his book, Good Calories, Bad Calories. What a revelation.

Then I bought a few books on metabolism that would be termed texts. And I got some from the library. I think I understand more about how my body works.

It is the why that most of my friends and colleagues don't get. "Aren't carbs good for you?" and "They are low fat." Well, no and yes. They are low fat. But they make you fat. They make your body store fat.

My kids (all adults) now understand about the few good carbs, all whole grain or super complex carbs which are relatively low GI. I tell them the trick is to eat as few of them as you can manage. Two of them go on South Beach from time to time, with some success.

In Canada, the expected intake of carbs is about 300g per day. Way too much. I try and stay around 50 g, from my breakfast cereal and bits of other things during the day. I know a lot of people who would probably eat 500g of carbs a day because they love a big serving of low fat potatoes or rice with supper.

And we eat way too much. Those of us who don't dig ditches for a living really need to eat more like birds.

It's an ongoing struggle, for sure, but low carb does work.

Even Harvard guys like low carb

It's refreshing to read and hear that Harvard, Duke and other high quality universities are finally on the low carb track.

Most of the foods that we should eat are low carb. For example, beets, cabbage, swiss chard (I don't like it and my mom tries to get me to eat some fresh from her garden every fall), cinnamon, plums/prunes, pumpkin, sardines, blueberries....

Convenience foods aren't good for us. They are just convenient. We need more biochemistry, nutrition, physiology discussions on the blog sphere, so that people get the facts.

We've only been cultivating grains for about 7000 years, folks. They are not part of our nutritional history long enough that our body knows what to do with them other than to turn them to glucose, which of course is bad news.

Gary Taubes explains it so well

Watched his lecture at Berkeley again.

At the hour point, he cuts to the chase. Fat storage happens because of alpha glycerol phosphate, which is needed to bin fatty acids into triglycerides. AGP (my abbrev.) comes from burning glucose and nore is available to store fat when insulin levels are high. Want to store less fat? Keep insulin levels in the blood low. Take in less glucose.

Yalow and Berson in 1965 say "Insulin is the principal regulator of fat metabolism". Gary talks about how emaciated type I diabetics can be, as they no longer produce their own insulin. They have nothing to drive fat accumulation with. When treated with insulin therapy, Dr. Best (yes, that Dr. Best) describes how they develop adipose deposits in the stomach where the insulin is injected.

My husband and I started the South Beach Diet in late September 08. My husband has lost 25 pounds and his blood profile has improved so much his doctor is ecstatic. My husband's triglycerides are WAY down from where they were. The doctor had recommended South Beach. I have lost 17 pounds. Don't you hate men who always win in the weight loss game? My profile is improving as well. LDL and HDL levels close to normal.

It's the insulin, stupid.

Fat percentages in "optimal" diet still not settled

We know that the amounts of fat and carbs in the optimal healthy diet has not been settled. Dr. Walter Willett of Harvard Department of Nutrition says, "(W)e have found virtually no relationship between the percentage of calories from fat and any important health outcome. But what does seem important is the type of fat and the form of carbohydrate." (Harvard World Health News) He goes on further to explain how the message of substituting unsaturated fat for saturated fats got mixed up with substituting carbohydrates for fats. What's more controversial is when he says that the view that all complex carbs are good is not substantiated by any data, and is inconsistent with historical knowledge that the type of fat is a critical factor.

I personally have gotten fat by eating lots of carbs, thinking they were "OK". My friend lost 60 pounds on a low carb diet and I thought she was crazy. She pointed me to Gary Taubes' book "Good calories, Bad calories" and I learned a bit about endocrinology and have been researching more. I now try to stay away from potatoes, rice, bread, crackers and sugary things. I've had good success and have been able to reduce my metforming dose. I am careful about what kind of fats I eat and stay vigilant with saturated fats. I must admit I eat a lot of eggs.

When you learn more about how your body works, you wonder how you have gotten by all these years. I am looking at endocrinology texts now, and reading sources like medical journals. Of course there is a lot of money to be made (and has been made) from low fat foods. Obesity will cost health systems lots in the future until the message changes from Heart Associations and nutritionists.

Low Carb diets do work folks.

So my husband and I have been following a sort of South Beach diet, somewhere between strict phase 1 and phase 2. He of course has lost 10 lbs to my 7, which is par for the course. I don't eat fish which complicates things. I'd like to but get a scratchy throat which could mean allergies. But we've eaten chicken, beef, ribs etc, cottage cheese, cheese.....just little bread. It can be done. I've been eating carb free jello. I have sugar free coffees.

Most interesting is that my blood sugar (I'm a type2 diabetic) is now hovering between 5 and 7 all the time. My doc reduced my metformin a bit. Nice!!! My ankles aren't swollen as much, and she also reduced one of my heart meds that affect my blood pressure. I went to Pritikin in the spring and they say that losing 5% of your body weight improves your health, so I am closing in on that. I need to do it several times.

I got onto this because one of my acquaintances lost 60 lbs and improved her blood profile while doing it. She pointed me to the book "Good Calories, Bad Calories" by Gary Taubes and the rest is history, in that I am doing lots of research on the idea that carbs and therefore insulin can almost be said to be the root of most of the obesity epidemic.

Of course skinny folks don't have to worry as much except if they eat a high carb diet, of simple and easily digestable carbs. Also high fructose corn syrup is a culprit. But being fat brings its own brand of wonderfulness - high blood sugar, high insulin readings, insulin resistance. Fat doesn't just lie there, it is working all the time and affecting you.

I'll let you know how things go, and how my blood profile changes over the next while. Learning to burn fat and stay away from carbs will be interesting.