95 replies to this topic

[DukeNukem]

To me, this is stunning. Just stunning. Makes me doubt MR's past work now.

Not to say that MR's thoughts are exempt from criticism. They are certainly open for it. However if you're going to do it can you at least try to support your view with something other than pop sci books and blogs and your gut feeling that your version of paleo dieting must be optimal for human longevity (despite the fact that if you really were a paleo man eating a paleo diet you would very likely be dead by now and spend much of the short life you did have starving, eating rotten food and otherwise doing lots of things that you would never do). Do you have any evidence for your repeated claims that utilizing your diet and exercise routine one can expect to live to be over 100 despite there being no evidence for such a claim... anywhere? Would you care to address how you think the meta analysis MR references is flawed and provide alternative evidence? (if you want to debate on that level blogs really don't cut it).

Not to be overly critical. Your recommendations for the most part are admittedly much better than most western diets, and probably better than my own current diet. Your advocation for grass fed vs grain fed meat is warranted. But your stoic support of your beliefs, any evidence to the contrary that might exist be damned attitude, is not very scientific.

Address contrary evidence. Don't dismiss it.

I quite often link to studies, or I refer to blogs where the blog's author both uses a study and explains its results and implications.

I also tell people repeatedly that their best guide is their own health (including blood tests and body fat tests). And I've challenged anyone to compare their results to mine. In other words, I willing to put up or shut, in terms of actual results (keep in mind, I'm 48.6 -- but I'm guessing I'm healthier and more fit than most people participating in Imminst).

BTW, on April's blog I posted a lot of links (in the comments section, all which include studies). I'll re-post the links below. MR nor April addressed my post -- although perhaps the blog post that started this topic was meant to address my comment.

http://wholehealthso...pidemic_19.html

http://wholehealthso...art-diseas.html

http://wholehealthso...rt-disease.html

http://wholehealthso...erosis-ldl.html

http://wholehealthso...rosis-diet.html

http://www.paleonu.c...s-and-oils.html

http://nephropal.blo...troduction.html

http://heartscanblog...ga-3-ratio.html

http://drbganimalpha...t-diets-in.html

My main points always revolve around these keys:

o Fructose is unhealthy.
o Grains (especially gluten grains) are unhealthy.
o Processed oils (especially those with greater than 12% PUFAs) are unhealthy.
o Saturated fat is healthy.
o Naturally fed meats (red or otherwise) are healthy.
o Fruits should be eaten in strict moderation, due to fructose content (and never drink fruit juice of any kind).

That's pretty much my best recommendations for a diet. I happen to eat a high-fat, low-carb diet, because I find it leads to the best health stats I've ever measured (and I've been taking detailed blood tests for 10 years, often twice or three times a year).

Edited by DukeNukem, 25 January 2010 - 04:44 PM.

[Jay]

And, lastly, I note that even on a horrible western diet, saturated fat isn't bad for you! See here and here.

primary sources. thank you

I've provided you with many resources to help you understand what seems to be some new concepts for you. You've provided nothing. Primary sources. Excuse me?

[DukeNukem]

And, lastly, I note that even on a horrible western diet, saturated fat isn't bad for you! See here and here.

primary sources. thank you

I'm guessing you simply do not keep up with dietary health news. There are literally dozens of studies showing saturated fat has been erroneously vilified. And here's a very recent meta-study that reaches this conclusion:

http://www.ajcn.org/...cn.2009.27725v1

[Jay]

And, lastly, I note that even on a horrible western diet, saturated fat isn't bad for you! See here and here.

primary sources. thank you

I'm guessing you simply do not keep up with dietary health news. There are literally dozens of studies showing saturated fat has been erroneously vilified. And here's a very recent meta-study that reaches this conclusion:

http://www.ajcn.org/...cn.2009.27725v1

I already posted that for him, but he didn't like it because it's not a... primary source. I guess he prefers if we provide links to all the underlying studies discussed in the meta-analysis and then provide a discussion of each -- in other worse, provide a meta analysis. Oh wait.

[eternaltraveler]

And, lastly, I note that even on a horrible western diet, saturated fat isn't bad for you! See here and here.

primary sources. thank you

I'm guessing you simply do not keep up with dietary health news. There are literally dozens of studies showing saturated fat has been erroneously vilified. And here's a very recent meta-study that reaches this conclusion:

http://www.ajcn.org/...cn.2009.27725v1

I already posted that for him, but he didn't like it because it's not a... primary source. I guess he prefers if we provide links to all the underlying studies discussed in the meta-analysis and then provide a discussion of each -- in other worse, provide a meta analysis. Oh wait.

I'll take a peer reviewed meta analysis. I was thanking you for providing it (genuinely). You're right though, its not a primary source, but it's peer reviewed in a respectable journal. Also it's a heck of a lot easier to fact check than what some guy writes on his blog or in his book.

Its a good place to start.

Edited by eternaltraveler, 25 January 2010 - 05:06 PM.

[eternaltraveler]

I'm guessing you simply do not keep up with dietary health news. There are literally dozens of studies showing saturated fat has been erroneously vilified

well. Actually I do.

I don't understand how you could reach that conclusion when I didn't even say anything regarding my opinion of carbs vs SFA vs PUFA vs whatever other than agreeing with you that your recommended diet is better than the average one. I'm simply attempting to encourage a more scientific atmosphere.

In my opinion a good scientific atmosphere is adversarial without being ad hominem.

Fructose is unhealthy.
o Grains (especially gluten grains) are unhealthy.
o Processed oils (especially those with greater than 12% PUFAs) are unhealthy.
o Saturated fat is healthy.
o Naturally fed meats (red or otherwise) are healthy.
o Fruits should be eaten in strict moderation, due to fructose content (and never drink fruit juice of any kind).

I'm not disagreeing with any of this at the moment (or necessarily agreeing).

Edited by eternaltraveler, 25 January 2010 - 05:14 PM.

[kismet]

Jay, Duke...

http://www.ajcn.org/...cn.2009.27725v1

This study looks at SaFa vis a vis all other nutrients*. Conclusions we can draw from it are too unspecific to support your point (MUFA vs PUFA vs SaFa) and not at all, in any way, opposed to Krauss' meta-analysis (or was *another* meta-analaysis published recently? what jakobsen paper are they talking about?)

I'll address the teratiary sources if I get to it (skimmed 'em, most are irrelevant, though).

*at least that's what the abstract implies, I still haven't gotten hold of the darn paper

Edited by kismet, 25 January 2010 - 06:17 PM.

[oehaut]

Jay, Duke...

http://www.ajcn.org/...cn.2009.27725v1

This study looks at SaFa vis a vis all other nutrients*. Conclusions we can draw from it are too unspecific to support your point (MUFA vs PUFA vs SaFa) and not at all, in any way, opposed to Krauss' meta-analysis (or was *another* meta-analaysis published recently? what jakobsen paper are they talking about?)

I'll address the teratiary sources if I get to it (skimmed 'em, most are irrelevant, though).

*at least that's what the abstract implies, I still haven't gotten hold of the darn paper

The Jakobsen paper is most likely this one, that I've pointed out already in the other thread

Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies.

kismet, didn't I PMed you the meta-analysis? Or are you talking about the other Krauss's paper? I should get it today or 2morrow. (with this one too)

I just sumbled upon this

http://www.zuiveleng...Mozaffarian.pdf

It really looks like most people thinks that PUFAs should replace SFAs as a mean to reduce CHD. I wish we could have a study in which, as Jay asked, PUFAs level was already very low (maybe around 2%) and see what would be the consequence of adding PUFAs.

Edited by oehaut, 25 January 2010 - 06:31 PM.

[DukeNukem]

It really looks like most people thinks that PUFAs should replace SFAs as a mean to reduce CHD.

But here's the flaw with these studies: The conclusion is almost always based on the mistaken belief that lowering LDL reduces cardiovascular risk.

There's a rabbit hole full of flawed assumptions that nutritional "science" has borrowed down for 40+ years: High total cholesterol = bad, therefore SFA = bad because it raises total cholesterol (most via raising HDL, but never mind that). Also, LDL = bad, and therefore PUFAs = good because they lower LDL.

In fact, LDL = both good and bad (yet, 99% of all doctors never check for both the good and bad LDL, they lump the figures together in a useless total). Also, total cholesterol itself is mostly a meaningless figure (mine is 230, but that because I have such a high HDL). PUFA's lower LDL, but that's not always a good thing, and they raise CR-P, a very bad thing (CR-P is much more associated with CVD than cholesterol).

[oehaut]

It really looks like most people thinks that PUFAs should replace SFAs as a mean to reduce CHD.

But here's the flaw with these studies: The conclusion is almost always based on the mistaken belief that lowering LDL reduces cardiovascular risk.

There's a rabbit hole full of flawed assumptions that nutritional "science" has borrowed down for 40+ years: High total cholesterol = bad, therefore SFA = bad because it raises total cholesterol (most via raising HDL, but never mind that). Also, LDL = bad, and therefore PUFAs = good because they lower LDL.

In fact, LDL = both good and bad (yet, 99% of all doctors never check for both the good and bad LDL, they lump the figures together in a useless total). Also, total cholesterol itself is mostly a meaningless figure (mine is 230, but that because I have such a high HDL). PUFA's lower LDL, but that's not always a good thing, and they raise CR-P, a very bad thing (CR-P is much more associated with CVD than cholesterol).

I know this, but the papers looked at mortality number, not lipid profile, so in any case, PUFAs really lower CHD events.

Also, in the post from MR on SFAs from the April's blog that you posted in this thread, Duke, MR, at the end, presented a meta-analysis that concluded that small, LDL subtype are not giving much more information regarding CHD risk factor. Blue had been making a compelling case agasint this too in another thread on the forum. As long that there is not strong evidence that small LDL subtype really matter, it does not seem to be an argument that hold any value.

[Jay]

I know this, but the papers looked at mortality number, not lipid profile, so in any case, PUFAs really lower CHD events.

And, some papers looked at mortality and found that PUFAs (vis a vis saturated fat) really raise CHD events. See here and here, both discussed at whole health source blog here.

I personally suspect that if n-6 PUFA lowers CVD risk at all, the effect is a freak, resulting from lower LDL in people that already have very oxidized LDL and a quite inflammed vasculature. Why not just start with less oxidized LDL and less inflammed vasculature - by restricting and balancing PUFAs? Another plus, is you get to stop eating disgusting and unnatural oils and can instead eat delicious and natural butter.

Edited by Jay, 25 January 2010 - 10:34 PM.

[kismet]

oehaut, yep, I just didn't read it yet. Could you send me 2. & 3. if you get to it? Then I'll have something to review come late february.
There are three (four) recent papers of interest, most of which I still couldn't read, but to sum them up the general trends they show:

1. Am J Clin Nutr. 2010 Jan 13. [Epub ahead of print]
Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM.
http://www.ajcn.org/...cn.2009.27725v1
The paper you sent me just recently. A comprehensive review of the epidemiology found no risk from SaFa apparently compared to (all) other macro-nutrients.

2. Am J Clin Nutr. 2009 May;89(5):1425-32. Epub 2009 Feb 11.
Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies.
Jakobsen et al.
I confused the authors when I looked back at the thread I started recently. Now that is the Jakobsen paper reviewing prospective epidemiology that MR adressed. They review whether exchanging macro-nutrients for eachother is beneficial -- the question we are interested in (MUFA vs PUFA vs SAFA).
MUFA being neutral in their analysis and CHO detrimental, will obviously dilute the results so the other study is mostly irrelevant to our question (it just shows safa is not the devil; that's not what we care about - we want the *best*!)

3. Saturated fat, carbohydrate, and cardiovascular disease.
Patty W Siri-Tarino, Qi Sun, Frank B Hu and Ronald M Krauss
http://www.ajcn.org/...cn.2008.26285v1
They review the evidence from controlled trials and arrive at a different conclusion than Stephan. I'd like to find out why. According to them PUFA decreases CHD, carbs don't.

4. Arch Intern Med. 2009 Apr 13;169(7):659-69.
A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Mente et al.
They conclude that SaFa is not detrimental (again this is relative to all other macros) and MUFA beneficial (!), but their pooled sample sizes are smaller than Krauss' and if I had to guess their analysis is likely to be less rigorous. But the study strongly implies that, if anything, SaFa is inferior to MUFA.
However, they correctly note that the mediterranean diet which is based on high MUFA ratios is better supported by clinical evidence than other dietary forms. 

I know this, but the papers looked at mortality number, not lipid profile, so in any case, PUFAs really lower CHD events.

And, some papers looked at mortality and found that PUFAs (vis a vis saturated fat) really raise CHD events. See here and here, both discussed at whole health source blog here.

Yes, and some of those interventional studies found a benefit from PUFA as Stephan also notes in his blogpost. Let's ignore for a moment that Krauss et al. claim that the interventional evidence supports PUFA. (don't start talking about biases; both Stephan and Krauss can be accused of having an agenda ; MR less so)
At best the interventional evidence is mixed (i.e. PUFA vs SaFa seems neutral & many of the interventional studies have been flawed). Now the second best data we have comes from prospective epidemiology, which clearly shows that PUFA decreases CHD compared to SaFa! If we were to use the precautionary principle, I know which fatty acids I'd cut short. We'd just need to answer a few questions:

What about all-cause mortality and long term follow-up?
Is the PUFA oxidation issue really as relevant as their proponents claim?
Now, if the latter is true, why not MUFA? (obviously the question is complicated by Krauss' data showing no benefit from MUFA, which may be due to confounding as the authors apparently hypothesise... but it could be something else too) However, SaFa has no place in your diet no matter what. Either MUFA or PUFA turns out to be superior in prospective studies, biomarkers and in interventional studies it's a wash (now the precautionary principle applies).

I personally suspect that if n-6 PUFA lowers CVD risk at all, the effect is a freak, resulting from lower LDL in people that already have very oxidized LDL and a quite inflammed vasculature. Why not just start with less oxidized LDL and less inflammed vasculature - by restricting and balancing PUFAs? Another plus, is you get to stop eating disgusting and unnatural oils and can instead eat delicious and natural butter.

Appeals to *speculation* and taste don't matter here. Clinical data does, i.e. mostly interventional studies assessing mortality endpoints and prospective epidemiology followed by RCTs assessing risk factors (considerably weaker but still high quality evidence). Two out of three types of evidence now suggest that SaFa is inferior to MUFA/PUFA.

Edited by kismet, 25 January 2010 - 11:20 PM.

[Jay]

Appeals to *speculation* and taste don't matter here. Clinical data does, i.e. mostly interventional studies, prospective epidemiology followed by RCTs assessing risk factors (considerably weaker but still high quality evidence). Two out of three types of evidence now suggest that SaFa is inferior to MUFA/PUFA.

To the contrary, the speculation matters a great deal. Testing the low-PUFA hypothesis, we have the Lyon diet heart study and the "primitive" studies (and some short-term feeding studies) that I am aware of. These studies ALL seem to yield extreme reductions in CVD. Unfortunately, verfying such results today is very difficult because people believe that PUFAs reduce CVD risk. In absence of additional trials, I find that mechanistic plausibility is very important. As for taste, it is a proxy for what is natural. The fact that my body wants me to eat butter and not soybean oil matters to me. It's not like I'm elevating this "taste" evidence over solid results. Indeed, despite trying to prove that SFA causes CVD for 50 years, we have reviews coming out now stating it just ain't so.

Can somebody PM me this study: http://www.ajcn.org/...cn.2008.26285v1?

Edited by Jay, 25 January 2010 - 11:35 PM.

[oehaut]

You might want, kismet, to add this 5th paper to this list

Ann Nutr Metab 2009;55:173-201
Dietary Fat and Coronary Heart Disease: Summary of Evidence from Prospective Cohort and Randomised Controlled Trials
Skeaff, C.M., Miller, J.

Yes, and some of those interventional studies found a benefit from PUFA as Stephan also notes in his blogpost. Let's ignore for a moment that Krauss et al. claim that the interventional evidence supports PUFA. (don't start talking about biases; both Stephan and Krauss can be accused of having an agenda ; MR less so)
At best the interventional evidence is mixed (i.e. PUFA vs SaFa seems neutral & many of the interventional studies have been flawed). Now the second best data we have comes from prospective epidemiology, which clearly shows that PUFA decreases CHD compared to SaFa! If we were to use the precautionary principle, I know which fatty acids I'd cut short. We'd just need to answer a few questions:

What about all-cause mortality and long term follow-up?
Is the PUFA oxidation issue really as relevant as their proponents claim?
Now, if the latter is true, why not MUFA? (obviously the question is complicated by Krauss' data showing no benefit from MUFA, which may be due to confounding as the authors apparently hypothesise... but it could be something else too) However, SaFa has no place in your diet no matter what. Either MUFA or PUFA turns out to be superior in prospective studies, biomarkers and in interventional studies it's a wash (now the precautionary principle applies).

If one is to go with the evidence and a clear reasoning, this is likely the conclusion that must be made (for the moment).

I just can't get around the idea that vegetable oil would be any good for me (esp. because they are highly processed). Since PUFAs could possibly oxydized and cause dommage, and because no downside (AFAIK?) are yet known for MUFAs, and considering that SFAs are not mendatory (maybe if low-HDL?) but do not look harmful by themself (is that it?) it would make sens to favor MUFAs and not bother about SFAs (don't worry about it but don't try to get some on purpose... unless maybe (?) low-HDL and high lp (a))

What PUFAs source are considered in these prospective studies? From grains to oil to fried food? Could there be any important counfonders?

I personally suspect that if n-6 PUFA lowers CVD risk at all, the effect is a freak, resulting from lower LDL in people that already have very oxidized LDL and a quite inflammed vasculature. Why not just start with less oxidized LDL and less inflammed vasculature - by restricting and balancing PUFAs? Another plus, is you get to stop eating disgusting and unnatural oils and can instead eat delicious and natural butter.

Personally, i'm gonna keep my n-6/n-3 low & balanced If anything i'll just add more MUFAs and try to keep my PUFAs relatively low (I think macadiam oil can do this well). I really don't care about SFAs (I don't get much anyway and I train regularly so there's no way they could do harm.. they certainly don't have time to accumulate and cause insulin resistance in my muscle & liver)

[niner]

As for taste, it is a proxy for what is natural. The fact that my body wants me to eat butter and not soybean oil matters to me. It's not like I'm elevating this "taste" evidence over solid results.

I appreciate what you're saying, but my body wants me to eat sugar, so I have to take its desires with a grain of salt...

So we have all this data saying that PUFAs are good when substituted for SFAs, certainly for CHD, and even for all-cause mortality, though maybe not for stroke. But what is the overall health of the cohorts they are looking at? If they are of average health, then they have a pretty significant risk for CHD. Most of us, on the other hand, are presumably in better shape. Frankly, I think I can afford a little bit of added CHD risk if it means significant risk reduction in other areas. In other words, the optimal macronutrient ratios differ, I suspect, depending on the health state of the subjects. For my own diet, I'm inclined to lean modestly toward SFA and away from PUFA on this basis, in apparent contradiction to the studies kismet cites.

[youandme]

Id like to see more here post their bloods showing lipid/trig levels...I believe that only regular blood checks (4x yearly) can help prove what diet is doing what.
..the before and after

The proof is in the pudding ! excuse the pun

[Jay]

I appreciate what you're saying, but my body wants me to eat sugar, so I have to take its desires with a grain of salt...

I hear you. I think there's a difference between foods that are the result of a lot of processing and those that are not, in that the processed foods (like sugar) can trick your body. Anyway, this speculatation was already too much for some people -- and I don't want anybody to puke so I will stop here.

[Jay]

3. Saturated fat, carbohydrate, and cardiovascular disease.
Patty W Siri-Tarino, Qi Sun, Frank B Hu and Ronald M Krauss
http://www.ajcn.org/...cn.2008.26285v1
They review the evidence from controlled trials and arrive at a different conclusion than Stephan. I'd like to find out why. According to them PUFA decreases CHD, carbs don't.

Kismet, one of the reasons why Stephan might have come to a different conclusion is that he only looked at controlled trials while this study (as best I can tell from the abstract) looked at both controlled trials and epidemiological studies. I've already discussed why I don't think the epidemiology of PUFAs should apply to somebody interested in restricting PUFAs (4%, time of tissue PUFA rollover, etc.), so I think Stephan's approach is superior if the question is whether one should consume vegetable oils at all. If the question is how much more PUFAs to add on top of a standard diet, I think the meta-analysis may have more value.

Also, it seems the meta-analysis made a false statement in the abstract (which is annoying at best)! Consider this quote from the abstract: "Clinical trials that replaced saturated fat with polyunsaturated fat have generally shown a reduction in CVD events, although several studies showed no effects."

This just doesn't sync with Stephan's view of the data: "

• Two trials found that replacing saturated animal fat with polyunsaturated vegetable fat decreased total mortality.
• Two trials found that replacing saturated animal fat with polyunsaturated vegetable fat increased total mortality.
• Eight trials found that reducing saturated fat had no effect on total mortality."

Edited by Jay, 26 January 2010 - 04:00 PM.

[Jay]

Ann Nutr Metab 2009;55:173-201
Dietary Fat and Coronary Heart Disease: Summary of Evidence from Prospective Cohort and Randomised Controlled Trials
Skeaff, C.M., Miller, J.

Oehaut, hard to take seriously any paper that starts with the 7 country study... Moreover, the reduction in death associated with MUFAs had a p value of .356 (which makes sense since the results are all over the place), so I wouldn't put a lot of stock in the conclusions of this study.

Edited by Jay, 26 January 2010 - 04:35 PM.

[mike250]

so what would be or is there an ideal ration between those three: MUFAs, SFAs and PUSFAs

[mike250]

Ann Nutr Metab 2009;55:173-201
Dietary Fat and Coronary Heart Disease: Summary of Evidence from Prospective Cohort and Randomised Controlled Trials
Skeaff, C.M., Miller, J.

Oehaut, hard to take seriously any paper that starts with the 7 country study... Moreover, the reduction in death associated with MUFAs had a p value of .356 (which makes sense since the results are all over the place), so I'd put a lot of stock in the conclusions of this study.

whats wrong with the 7 country study?

[DukeNukem]

Ann Nutr Metab 2009;55:173-201
Dietary Fat and Coronary Heart Disease: Summary of Evidence from Prospective Cohort and Randomised Controlled Trials
Skeaff, C.M., Miller, J.

Oehaut, hard to take seriously any paper that starts with the 7 country study... Moreover, the reduction in death associated with MUFAs had a p value of .356 (which makes sense since the results are all over the place), so I'd put a lot of stock in the conclusions of this study.

whats wrong with the 7 country study?

http://www.ravnskov.nu/myth4.htm

[Jay]

whats wrong with the 7 country study?

http://high-fat-nutr...on-between.html

[oehaut]

Ann Nutr Metab 2009;55:173-201
Dietary Fat and Coronary Heart Disease: Summary of Evidence from Prospective Cohort and Randomised Controlled Trials
Skeaff, C.M., Miller, J.

Oehaut, hard to take seriously any paper that starts with the 7 country study... Moreover, the reduction in death associated with MUFAs had a p value of .356 (which makes sense since the results are all over the place), so I wouldn't put a lot of stock in the conclusions of this study.

Well, as you wish. Still, this review also concluded that SFAs are not related to CHD. That's why I've pointed it out. Also, they seem to report the seven country study only because it's the paper that started the lipid hypohesis - not necesseraly because they believe it's a good paper or whatever.

Their own review concluded that SFAs are not related to CHD so I doubt they give much credit to this very poor study.

[Jay]

Ann Nutr Metab 2009;55:173-201
Dietary Fat and Coronary Heart Disease: Summary of Evidence from Prospective Cohort and Randomised Controlled Trials
Skeaff, C.M., Miller, J.

Oehaut, hard to take seriously any paper that starts with the 7 country study... Moreover, the reduction in death associated with MUFAs had a p value of .356 (which makes sense since the results are all over the place), so I wouldn't put a lot of stock in the conclusions of this study.

Well, as you wish. Still, this review also concluded that SFAs are not related to CHD. That's why I've pointed it out. Also, they seem to report the seven country study only because it's the paper that started the lipid hypohesis - not necesseraly because they believe it's a good paper or whatever.

Their own review concluded that SFAs are not related to CHD so I doubt they give much credit to this very poor study.

I agree and wasn't being at all dismissive - the paper you posted is an important one to review. Re the 7 country study, I think your interpretation is correct, but to mention that study without taking a critical view is suggestive of biases.

[DukeNukem]

New post on saturated fat and PUFAs, quite relevant:

http://www.proteinpo...es-old-and-new/

[stephen_b]

I would like to see the postprandial triglyceride response relationship to saturated fat discussed a bit more. Is the quick rise in triglycerides (but not fasting triglycerides) seen after eating saturated fat 1) real and 2) of concern? See Dr. Davis blog entry for more discussion.

[oehaut]

Just for the sake of it, I just found this review (for what it worth)

Has the association between saturated fatty acids, serum cholesterol and coronary heart disease been over emphasized?
International Dairy Journal, Volume 19, Issues 6-7, June-July 2009, Pages 345-361
Peter W. Parodi

Despite 50 years of research and public health messages, coronary heart disease is still the major cause of
death in developed countries. This review outlines the elaboration of risk factors for coronary heart
disease with emphasis on total and LDL cholesterol levels and discusses the dynamic and heterogeneous
nature of serum lipoproteins. The role of saturated fatty acids in hypercholesterolemia is examined and it
is concluded that those acids that increase levels concomitantly increase antiatherogenic HDL cholesterol
and decrease proatherogenic lipoprotein[a] and small dense LDL particles such that they could be
atherogenically neutral. Evidence from epidemiological studies does not supply convincing evidence for
an association between saturated fatty acids and coronary heart disease. The surprisingly few randomised
controlled trials that examined isocaloric substitution of saturated fatty acids for vegetablederived
fats mostly fail to show a benefit for reduction in saturated fatty acid intake on coronary heart
disease risk. The contention that the benefits accruing from the potent hypocholesterolemic action of
statin drugs ends the cholesterol controversy is disputed.

I can PM the paper upon request.

Something must be going on lately because just in the 2009 year, to my knowledge, 6 reviews were published in which SFAs was not consider a significant risk for CHD - whereas, up to 2008, the only review of this kind I can think of was the one by Ravnskov.

Edited by oehaut, 26 January 2010 - 11:49 PM.

[e Volution]

I appreciate what you're saying, but my body wants me to eat sugar, so I have to take its desires with a grain of salt...

I hear you. I think there's a difference between foods that are the result of a lot of processing and those that are not, in that the processed foods (like sugar) can trick your body. Anyway, this speculatation was already too much for some people -- and I don't want anybody to puke so I will stop here.

No, please don't stop the speculation! I think the attraction to sugar might have something to do with Supernormal Stimulus. So your underlying point about sugar being processed (not found in nature, honey does not count!) is absolutely spot on. We crave sugar to our own healths detriment and this can be seen as our evolved tastes 'misfiring' because this can actually have negative effects [diabetes] within our reproductive lifetime; absolute proof its an evolutionary discordance. This is in stark contrast to our taste for fats, which when consumed in abundance (transfats aside) do not have a negative impact within our reproductive lifetime (look at the Inuits 80% animal fat diet).

This is an important distinction! You guys are smarter than me, but I think this evolutionary reasoning/speculation needs more deployment in these forums!

[e Volution]

I would like to see the postprandial triglyceride response relationship to saturated fat discussed a bit more. Is the quick rise in triglycerides (but not fasting triglycerides) seen after eating saturated fat 1) real and 2) of concern? See Dr. Davis blog entry for more discussion.

There has been a bit of complaining lately about people [duke] referencing blogs & internet articles, but I think this is a great example of a very important topic being discussed more in-depth on a blog (a Cardiologists blog no less) than on this forum! I think its great and absolutely integral we are prudently analysing and discussing all the data in minute detail-this is how good science is done-but there is something to be said about taking a step back and following this 'community' of bloggers for a view of the bigger picture and where it is going...