Cardiovascular Disease and Reducing Saturated Fat

[Jinzang]

Cochrane Review has published a new meta-analysis on the relation between saturated fat in the diet and cardiovascular disease. Their results showed that reducing saturated fat reduced cardiovascular disease (CVD) events, but not morality. The abstract said:

"We included 15 randomised controlled trials (RCTs) (16 comparisons, ~59,000 participants), that used a variety of interventions from providing all food to advice on reducing saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of combined cardiovascular events by 21%. Meta-regression suggested that greater reductions in saturated fat resulted in greater reductions in risk of CVD events, explaining most heterogeneity between trials. The number needed to treat for an additional beneficial outcome (NNTB) was 56 in primary prevention trials, so 56 people need to reduce their saturated fat intake for ~four years for one person to avoid experiencing a CVD event. In secondary prevention trials, the NNTB was 32. Subgrouping did not suggest significant differences between replacement of saturated fat calories with polyunsaturated fat or carbohydrate, and data on replacement with monounsaturated fat and protein was very limited. We found little or no effect of reducing saturated fat on all-cause mortality or cardiovascular mortality, both with GRADE moderate-quality evidence. There was little or no effect of reducing saturated fats on non-fatal myocardial infarction or CHD mortality, but effects on total (fatal or non-fatal) myocardial infarction, stroke and CHD events (fatal or non-fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI. There was no evidence of harmful effects of reducing saturated fat intakes.

"The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events."

 

[Guided_by_Voices]

Not a meaningful study. High fat in the context of high carbs is not good so without knowing the rest of the diet and whether the participants are fat burners (unlikely) there is no action to take. Also, we rarely eat saturated fat alone so knowing what it was replaced with is a major factor also. Finally, the effect size should have been much stronger if the brochure impact of saturated fat is correct. Healthy user affect is also at play here. Bottom line is still to keep insulin, inflammation and sugar (carbs) down.

 

[Paul M]

Study probably funded by cerial and biscuit manufacturers. Carbs are pretty much the cause of obesity in the western world.

 

[Jinzang]

What the meta-analysis shows is that people who reduced the amount of saturated fat in their diet also reduced the number of cardiovascular events. It didn't seem to matter whether they replace the saturated fats with polyunsaturated fats or carbohydrates. The latter is the only surprising part of the results to me. There was no improvement in all cause mortality.

Weight reduction comes from consuming fewer calories and and burning more calories. It doesn't matter if it's the keto diet, paleo diet, plant based diet, or Martian diet. Macro percentages make no difference in weight loss as long as calories are held constant. If you have a study which shows the opposite, please post a link to it. But only studies which controlled calorie amounts!

 

[Guided_by_Voices]

Humans are not static systems. In the real world, diets which shift the metabolism to fat burning tend to reduce hunger and maintain metabolic rate, both of which are key to good body composition. The hungry and miserable diet may "work" on paper but it does not work in practice and this has been shown by the studies which compare high-sugar (AKA low fat) diets to fat-burning diets. In the fat-burning diets people naturally eat less and their metabolic rate stays high, hence it is a viable diet unlike those which just restrict calories. Note that none of the recommended low-fat diets have ever been shown to work long-term for major weight loss. The recent Biggest Loser study confirms this but others (E.G. MRFIT) do also.

 

[Jinzang]

I assume youŕe talking about this study when referring to MRFIT. The usual problem with dietary advice is adherence. Anecdotally at least, the keto diet is a difficult diet to adhere to, with the "keto flu" and other unpleasant symptoms. You may do well on it and judge it from your experience, but others do not. No diet is for everyone. Not everyone loses weight on the keto diet if eating "ad lib." I have seen more than one post with the title what to do if you are not losing weight on a keto diet.

"Ad lib" plant based diets have been shown to be successful. The best known study showing this is the Broad Study in New Zealand, which you will find in full at the link.

There is something perverse in considering the consumption of carbohydrates unhealthy. Your body has an elaborate mechanism for handling carbohydrates, from amylase in the saliva all the way to storage of glycogen in the muscles. Why would one want to not use it?

 

[PHW]

Low carb high fat diets are tough for the first couple of weeks, but the subsequent reduction in hunger has to be experienced to be believed - it's incredibly liberating! Many reviews of LCHF do not allow sufficient time for adaptation to take place. What seems to knock people off course is the carbs they are unwilling to give up - usually alcohol.

 

[JohnTaylorHK]

Low carb high fat diets are tough for the first couple of weeks, but the subsequent reduction in hunger has to be experienced to be believed - it's incredibly liberating! Many reviews of LCHF do not allow sufficient time for adaptation to take place. What seems to knock people off course is the carbs they are unwilling to give up - usually alcohol.

Wholeheartedly agree. I would like to add that there is a wide range in what is considered to be a low-carb diet. In my experiments, I have tried levels between zero and 80 grams carb (I'm 128lbs, 12% body fat). I found 80gms or less to have the most beneficial effect on well being and energy levels, and surprisingly 80gms or more of protein seems to be optimal,.making up the remainder with nutritious fats. Zoe Harcombe, in her book "The Obesity Epidemic", correlates weight loss to carbohydrate, not calorie restriction, and, surprisingly, correlates cardiac disease etc with latitude! Yes, where you live in the world, the amount of sunshine is significant. Further reading Kate Rhaume-Bleue's Vitamin K2 and the Calcium Paradox, further reveals the importance of adequate A, D and K2 in reducing osteoporosis and atherosclerosis through osteocalcin activation. Macros are important to get right, but there are other nutritional requirements that are important also. Namaste.

 

[Paul M]

Just look what high carb diets have done to modern society. Those recommendations half a century or so ago to limit fat intake and consume more carbs and fibre have led to mass obesity in the western world, not to mention soaring rates in diabetes. I was forever feeling hungry on a high carb diet and consumed much more than I needed to.

 

[Cataceous]

Just look what high carb diets have done to modern society. ....

It's the refined carbs that have done this. Refined oils are not exactly health food either.

 

[Paul M]

Either way it's the trend towards the high carb low fat diet recommended by so called experts that have led to obesity, a massive rise in diabetes and numerous other ailments.

 

[Vince]

10 Year Zero Carb Carnivore Veteran Loses Weight and Shares Healing Story

In this video, Kelly Hogan talks about all things Carnivore! Kelly has been carnivore for over 10 years! Some of us fear going zero carbohydrate carnivore for long term because of the potential unknowns and dangers to health. Though it may be anecdotal, here’s one of many personal shares that...

www.excelmale.com

 

[Jinzang]

I'm seeing a lot of carbophobia in these comments. There are healthy carbs and unhealthy carbs. Healthy carbs are fruits and unrefined plants. Unhealthy carbs are added sugars and refined flours. If you believe otherwise, please post a link to a journal study (not some doctor's opinion) showing a worse health outcome from a diet rich in fruit or unrefined carbs as opposed to refined carbs. For example, greater obesity, worse blood markers, or higher rates of disease or death

 

[UCFguy01]

Low carb high fat diets are tough for the first couple of weeks, but the subsequent reduction in hunger has to be experienced to be believed - it's incredibly liberating! Many reviews of LCHF do not allow sufficient time for adaptation to take place. What seems to knock people off course is the carbs they are unwilling to give up - usually alcohol.

alcohol is my weakness for sure!!! I try to drink low carb beer as much as possible which does help with the weight gain and bloated feeling. I still eat low'ish carb type diet but the beer is my achilles heal.

 

[JohnTaylorHK]

I'm seeing a lot of carbophobia in these comments. There are healthy carbs and unhealthy carbs. Healthy carbs are fruits and unrefined plants. Unhealthy carbs are added sugars and refined flours. If you believe otherwise, please post a link to a journal study (not some doctor's opinion) showing a worse health outcome from a diet rich in fruit or unrefined carbs as opposed to refined carbs. For example, greater obesity, worse blood markers, or higher rates of disease or death

I agree with what you say. Even foods listed as containing bad fats are actually those rich in simple carbohydrates. I don't like to think of myself as a "carbophobe", I enjoy many different types of carbs up to the limit which I have imposed on myself which gives me the best perceived level of well-being. This is a borderline ketogenic diet, according to The Ketogenic Diet by Lyle McDonald (ch. 6), where he determines "ketogenic" as the ratio of ketogenic macro nutrients to anti-ketogenic macro nutrients being greater than 1. Namaste.

 

[Nelson Vergel]

 

[fifty]

His summary:
Eat salmon
Take niacin to increase HDL (up to 2g/day)
Take ACE inhibitor
Low dose Crestor

 

[Gman86]

All we have to do is try to mimic how our direct ancestors would of eaten for hundreds of thousands of years. Primarily animal meat, animal fat, animal organs, seasonal fruit (which would of been much less sweet than fruit today), and eaten plants only to avoid starvation. Agriculture is too recent in human history, and our bodies have not evolved to be able to process grains efficiently, and it does not do well on them. 99% of our ancestors throughout evolution would have never had a surplus of carbohydrates, like modern man does today. Our ancestors would have eaten a high fat, moderate to high protein, low to very low carb diet. They would of been constantly cycling in and out of ketosis. All we have to do to optimize health is mimic this way of eating. Guided_by_voices is absolutely correct. Almost all chronic diseases/ issues we face can be linked back to insulin resistance, too high of carbohydrates in the diet, frequent insulin spikes, and having high blood sugar levels that take too long to return to a healthy level.

You can still be healthy when consuming a surplus of carbohydrates. You just have to keep protein moderate/ high, and fats lower, and optimize exercise and sleep, to remain insulin sensitive and metabolically healthy. And obv choose your carbohydrates sources wisely, and try to get most of your carbohydrate intake before and after exercising. It is still far off from an optimal diet, and isn’t what the body prefers, but with a little extra work, you can still keep the body in a healthy state, for a long time.

 

[Nelson Vergel]

Well, healthy eating is the foundation. But genetics have a very strong influence. Did you watch the video I just posted?

 

[Paul M]

No heart benefit in adding niacin to statin