Carbs, Trans Fats, Fatty Foods, Heart Disease - Wrong Again

[FoolKiller]

We need @FoolKiller in here.

Not so fast, fruits and veggies don't appear to be unscathed in all of this.

The AHA recommendations will have to change as a result of this. Their recommendations are not based real science. I don't blame them for not changing the recommendations in the face of uncertainty - at this point who's to say what's right? But what they've been preaching over the last 50 years is unsubstantiated and actually looks to be counter-productive.

In fact, after reading that article, I think the biggest recommendation I have is that no one should listen to the AHA... probably ever.

Or base opinions on the AHA based on what this article says.

-Allow me to place Edward R. Murrow's hat on and go into condescending communications degree mode.-
[Hat on]

Indeed, up until 1999, the AHA was still advising Americans to reach for "soft drinks," and in 2001, the group was still recommending snacks of "gum-drops" and "hard candies made primarily with sugar" to avoid fatty foods.

Lets not judge based on 15-year-old information. Good God, that's purposeful ignorance, and downright unethical journalism. Quoting standards that are over a decade old when they are revised constantly, based on current believed science, failure to fact check on an editorial level, and using it as a condemnation of a large organization. It almost sounds like a hit piece. Fortunately, it spends a single paragraph examining the new study. I mean, if it hadn't waited until the third paragraph to begin the attack on half-century old science and the organization that then believed it, and still uses some of those standards today, I'd think it was definitely a hit piece. But only 27 of its 29 paragraphs are dedicated to finger pointing.

[Hat off]

I am currently looking at the AHA's Heart Check Food Certification program Nutrition Requirements. These are the requirements you must meet if you want to put this logo on your food packaging in a grocery store.

Here are the relevant bits regarding sugar and/or carbs.

• Certifiable grain-based products include breads, biscuits, cereals (ready-to-eat & cooked), crackers, pancakes, French toast, waffles, muffins, sweet quick-type breads, and pastas. All grain-based products must be a good source of dietary fiber (10-19% Daily Value per RACC) and contain 7 g or less Total Sugars per serving if the product is a good source of dietary fiber (10-19% Daily Value per RACC), or 9 g or less Total Sugars per serving If the product is an excellent source of dietary fiber (20% or more Daily Value per RACC). Sugars from pieces of fruit do not count toward the total sugar allowance but amounts and sources must be disclosed.
• Total sugar for yogurt is limited to 20 g or less per standard 6 oz serving.
• Certifiable juices must be 100% juice or 100% juice plus water with no added sugars/sweeteners (this excludes non-nutritive sweeteners), 120 calories or less per 8 fl oz, and a minimum of 10% Daily Value for 3 nutrients for which a Daily Value exists. At least one of these beneficial nutrients must satisfy the 10% Daily Value level requirement.
• No “Heavy Syrup” allowed for canned fruits and vegetables, including potatoes and sweet potatoes.
• Frozen fruit must be 100% fruit with no added sugar.

Only one statement is not in line with current suggestions for a good glycemic diet, which I italicized and underlined. Does this sound like an organization that suggests eating candy and drinking soft drinks?

Let's find out.

Let's search for candy on their own website.

The results?

Looks like the WSJ chose old data for a reason. But wait! Soft drinks! We got them now!

SON OF A BISCUIT!!!



That said, the AHA standards are meant more for people at risk of heart disease and/or stroke. They are also simplified. They suggest poultry and fish because that is much easier than explaining lean vs non-lean cuts of beef. They aren't meant for everyone. I can say this, I can buy Heart Check Certified ham.

They obviously aren't on some kind of anti-red meat campaign.


And this ends my defense of the AHA. They aren't perfect. No one is. But they fund ten times more research than the government and that is why I am trying to raise money for my Heart Walk team.


As for dietary science in general, this article, in what little it discusses the new study, says nothing that I wasn't told by the dietician who works with my transplant team. The best way to maintain a healthy diet is to follow the glycemic index. It accounts for portion control, even in normally considered "healthy" foods. If you watch carbs and have a nutritionally balanced diet you will take in less fats, calories, and cholesterol as well. Fiber and protein are, based on current knowledge, aids in slowing absorption of things like carbs.

Americas food problem isn't what things we eat, so much as it is how much. All things in proportion. Steak won't kill you, but restaurants sell steaks from 6oz to 22oz, and sometimes bigger. A proper serving of steak is 4oz. The same goes for chicken. People love that tall glass of milk or juice. A serving of either is 8 fl oz, or about half of that tall glass.

That's where our problem comes in. A glycemic-index-based diet accounts for that, since it is measuring carbs, fiber, and protein. You get your necessary protein but need more of something else to get your fibers and carbs. To keep a healthy fiber/carb ratio you have to cut back on breads and look at beans or vegetables. It self-regulates, but it is too much like math for our current fast-paced world.



All this said, I haven't seen the new study yet. The article didn't bother to link it. Based on the other parts of the article, I'm not ready to accept the new study says what they say it says. I will have to find it. But would we be surprised? We have bounced back and forth and the saturated fats, trans fats, and cholesterol thing for decades.

Once I get to see the study I will weigh in more.

 

[Danoff]

Lets not judge based on 15-year-old information. Good God, that's purposeful ignorance, and downright unethical journalism. Quoting standards that are over a decade old when they are revised constantly, based on current believed science, failure to fact check on an editorial level, and using it as a condemnation of a large organization.

I think it's perfectly acceptable to criticize their suggestions from ~2000. The whole point is that the recommendation was to prefer sugars over fat, and that's based on what? Nothing. Turns out that it's a harmful suggestion too. Everyone reading this has been pumped full of a steady diet of "fat is bad" for decades - choose grain and fruit over meats. Turns out it was nonsense.

Americas food problem isn't what things we eat, so much as it is how much. All things in proportion. Steak won't kill you, but restaurants sell steaks from 6oz to 22oz, and sometimes bigger. A proper serving of steak is 4oz. The same goes for chicken. People love that tall glass of milk or juice. A serving of either is 8 fl oz, or about half of that tall glass.

I love that restaurants offer steaks twice or three times as big as they need to be. Occasionally I go without eating for the entire rest of the day so that I can enjoy just that. One of the great things about going out to a restaurant and pigging out is that you pretty much don't have to concern yourself with food for the rest of the day. Maybe some people don't realize that they can't wolf down huge portions and then turn around and do it again 4 hours later, but you and I can agree that that's down to personal responsibility more than anything else.

We have bounced back and forth and the saturated fats, trans fats, and cholesterol thing for decades.

We've bounced back and forth on a lot of things - like whether or not eggs are good for you, or how much water you should drink and when. I do not recall ever hearing anything other than saturated fats = evil, trans fats = worst thing going, and cholesterol = evil in my lifetime. Turns out that the ban on trans fats is resulting in even less healthy practices, and the science behind saturated fats and cholesterol being evil is more than a little dubious.

Let's not pretend that we all knew this was coming or that everyone a few weeks ago knew that the hype around the evils of cholesterol and saturated fats as overblown. This is, in my eyes, a massive failure which has likely resulted in thousands of deaths. I'm glad that we're getting to the bottom of it.

 

[Keef]

I'm 5'11" and apparently I'm "normal" as well at 150. Couldn't go wrong with more muscle mass but I can't be bothered to work out, haha. As long as I don't get a skinny-guy beer gut...better go gluten free! @R1600Turbo

 

[KSaiyu]

A good summary of the study here, and the actual conclusion the authors reached:

Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.

The author of the WSJ piece also has a book coming out....

 

[Danoff]

A good summary of the study here, and the actual conclusion the authors reached:

Totally agrees with my reaction (although it takes a less alarmist tone to what I consider to be important news). It also doesn't touch on all of the points in the previous article - and I wish it did because there are some very important ones about cholesterol. Here's the thing, I have done exactly what all of the recommendations were - which is to swap saturated fats for grains. I've already started changing to a more balanced approach.

 

[CodeRedR51]

I'm 5'11" and apparently I'm "normal" as well at 150. Couldn't go wrong with more muscle mass but I can't be bothered to work out, haha. As long as I don't get a skinny-guy beer gut...better go gluten free! @R1600Turbo

Yeah every time I'm like "maybe I should start lifting or something", my next feeling is.... "nah".

 

[TenEightyOne]

There was an odd discussion in another thread about the amount of fat in a Subway sandwich. I don't know how they're sold in the US but in the UK they're seen as a "healthier" kind of fast food.

Looking at the difference between the US/UK versions of the same sandwich (it was a very odd discussion) the US version looks lethal!

 

[KSaiyu]

Totally agrees with my reaction (although it takes a less alarmist tone to what I consider to be important news). It also doesn't touch on all of the points in the previous article - and I wish it did because there are some very important ones about cholesterol. Here's the thing, I have done exactly what all of the recommendations were - which is to swap saturated fats for grains. I've already started changing to a more balanced approach.

Here's his take on the article

One thing I'm surprised no-one mentions is this claim in the WSJ article:

Excessive carbohydrates lead not only to obesity but also, over time, to Type 2 diabetes and, very likely, heart disease.

I believe we (the UK at least) are eating too many carbs, and would love for this to be proven but I'm pretty sure no study has definitively proven this?

 

[Danoff]

Here's his take on the article

Now that's misleading:

Second, neither the Annals paper nor any other recent research on the topic suggests there is health benefit derived from adding butter, meat, or cheese to our diets.

But no, folks- more meat, butter, and cheese will not promote your health. Neither will nonsense- no matter where it’s published.

Yes I'm sure that keeping everything else the same in your diet but adding these things is not helpful. I don't think that was suggested. What is this nonsense? Why is it that whenever someone wants to make a point they pretend that you can or think you can just change the number of calories you intake. People should assume that their readers are consuming, and going to continue to consume, a set number of calories that keep them at a constant weight. If that's too much of an assumption, just mention it somewhere.

 

[KSaiyu]

Yeah, I'm glad he gets called out on it by other professionals in the comments. Who knew nutrition could be so political

 

[eSZee]

I'm around 5'6", maybe a hair under 5'7". According to a BMI chart I am in the correct weight bracket. Where I am is pretty flat, but not really into street biking. I am looking to get a mountain bike though fairly shortly.

The BMI CHART is almost as big of a joke as the GLYCEMIC index in the sense that unless you're already a diabetic , GI means nothing.

As for dietary science in general, this article, in what little it discusses the new study, says nothing that I wasn't told by the dietician who works with my transplant team. The best way to maintain a healthy diet is to follow the glycemic index. It accounts for portion control, even in normally considered "healthy" foods. If you watch carbs and have a nutritionally balanced diet you will take in less fats, calories, and cholesterol as well. Fiber and protein are, based on current knowledge, aids in slowing absorption of things like carbs.

Americas food problem isn't what things we eat, so much as it is how much. All things in proportion. Steak won't kill you, but restaurants sell steaks from 6oz to 22oz, and sometimes bigger. A proper serving of steak is 4oz. The same goes for chicken. People love that tall glass of milk or juice. A serving of either is 8 fl oz, or about half of that tall glass.

That's where our problem comes in. A glycemic-index-based diet accounts for that, since it is measuring carbs, fiber, and protein. You get your necessary protein but need more of something else to get your fibers and carbs. To keep a healthy fiber/carb ratio you have to cut back on breads and look at beans or vegetables. It self-regulates, but it is too much like math for our current fast-paced world.



All this said, I haven't seen the new study yet. The article didn't bother to link it. Based on the other parts of the article, I'm not ready to accept the new study says what they say it says. I will have to find it. But would we be surprised? We have bounced back and forth and the saturated fats, trans fats, and cholesterol thing for decades.

Once I get to see the study I will weigh in more.

15-20% of your carb intake should be fiber. You'll reach that number with no problem even if you're not trying. People tend to overeat with carb rich foods which will result in more than adequate fiber intake which can be as bad if not worse than low fiber intake.

One thing I'm surprised no-one mentions is this claim in the WSJ article:



I believe we (the UK at least) are eating too many carbs, and would love for this to be proven but I'm pretty sure no study has definitively proven this?

I mentioned it on the previous page. If you're a healthy and active adult, high carb intake is not an issue. I work out with guys who intake 400-600g of carbs daily.
If you're a sedentary person that will lead to weight gain and possible disorders.

I wish that all these articles/studies had written in BIG BOLD letters that if you're a healthy active person, none of this really applies to you and if you lead a sedentary lifestyle and are overweight, this most likely applies to you.

 

[TenEightyOne]

Thermodynamics is fairly simple to understand too, if you consume more fuel than you burn or excrete then you gon' be fat.

That said, I remember Viz's take was "Eat right, stay fit, die anyway".

 

[eSZee]

Thermodynamics is fairly simple to understand too, if you consume more fuel than you burn or excrete then you gon' be fat.

That said, I remember Viz's take was "Eat right, stay fit, die anyway".

The thermic effect of food, especially protein, also plays a somewhat small role.

But too many people watch Dr. OZ and think they can live the way they do and take this magic pill/herb/root and lose 30lbs in a week. I'll eat cranberries, grapefruit and chocolate on top of what I normally eat and I'll lose weight. If I eat low GI number foods I'll lose weight.

 

[Keef]

There was an odd discussion in another thread about the amount of fat in a Subway sandwich. I don't know how they're sold in the US but in the UK they're seen as a "healthier" kind of fast food.

Looking at the difference between the US/UK versions of the same sandwich (it was a very odd discussion) the US version looks lethal!

As far as I can tell they're using completely different measurement systems for most of the categories. Besides that, fat and saturated far are two different categories here in the States.

Also in the UK chart, "subtract the 9-grain" is pointing directly at Italian bread, not 9-grain. So this chart is pretty much nonsense. They can't even get the labels right or put items in the same column.

 

[FoolKiller]

I think it's perfectly acceptable to criticize their suggestions from ~2000.

But that isn't what they say today, their guidelines are closer to what the new study says, and you didn't limit your criticism to ~2000. I believe the term you used was, "ever."

The whole point is that the recommendation was to prefer sugars over fat, and that's based on what? Nothing. Turns out that it's a harmful suggestion too. Everyone reading this has been pumped full of a steady diet of "fat is bad" for decades - choose grain and fruit over meats. Turns out it was nonsense.

You and I know that science is evolving and what we think we know changes everyday. This is dietary science. It works just like medical science, physics, and marine biology. Is Merck evil for creating an arthritis drug that worked, but it was discovered to increase the risk of heart problems over long periods of use? Should we never take a drug they make...ever? After we killed Numerous pilots in pursuit of the sound barrier should Chuck Yeager have told them to screw off? Should NASA have shut down after repeated failed early rocket launches? Ever is a big gorram word that I doubt you would apply to any other scientific field that is proven to be wrong time after time. Science is progress. Welcome to the new progress. Once this one study becomes verified through multiple studies then this will become the generally accepted truth. And a few decades later we will find it has some flaws, if not outright flawed.

I love that restaurants offer steaks twice or three times as big as they need to be. Occasionally I go without eating for the entire rest of the day so that I can enjoy just that. One of the great things about going out to a restaurant and pigging out is that you pretty much don't have to concern yourself with food for the rest of the day. Maybe some people don't realize that they can't wolf down huge portions and then turn around and do it again 4 hours later, but you and I can agree that that's down to personal responsibility more than anything else.

And I take home leftovers. But don't get me started on restaurants and sodium. That goes beyond just not eating for the rest of the day. That takes up enough for a couple of days.

We've bounced back and forth on a lot of things - like whether or not eggs are good for you, or how much water you should drink and when. I do not recall ever hearing anything other than saturated fats = evil, trans fats = worst thing going, and cholesterol = evil in my lifetime. Turns out that the ban on trans fats is resulting in even less healthy practices, and the science behind saturated fats and cholesterol being evil is more than a little dubious.

Um, eggs is a cholesterol debate. The change the more we understand about how our bodies process cholesterol. We were told to use trans fats originally to get away from saturated fats. Butter became margarine, lard became shortening, and frying with bacon grease became one of a million oils. Then trans fats were found to be so bad that we had to ban them, supposedly.

See, science progressing from not knowing to not knowing.

Let's not pretend that we all knew this was coming or that everyone a few weeks ago knew that the hype around the evils of cholesterol and saturated fats as overblown. This is, in my eyes, a massive failure which has likely resulted in thousands of deaths. I'm glad that we're getting to the bottom of it.

I didn't know it was coming, nor did anyone specifically list this possibility, but I know I was told this in the form of a suggested diet by a dietician over three years ago. And the hospital will refuse to give me more of any type of food that I've eaten a lot of that day already. I've hit carb limits by just trying to eat a lot of fruit because I felt like fruit.

Everyone who uses their brain knows that there is no one special way to eat, no fad diet. There is no free ride in medicine or human health. There is no eat a lot of X to be healthy. Every dietician, not trying to sell a book, has repeatedly said balance and portion control.

 

[Danoff]

But that isn't what they say today, their guidelines are closer to what the new study says, and you didn't limit your criticism to ~2000. I believe the term you used was, "ever."

Yes well they did base decades of guidelines on bunk science. This is not science that was later discovered to be bunk, this was science that should have always been known to be bunk. If an organization is going to tell me what to eat for a few decades based on scientific studies that don't qualify as scientific, I don't think anyone should listen to them ever.

You and I know that science is evolving and what we think we know changes everyday. This is dietary science. It works just like medical science, physics, and marine biology.

In otherwords, entirely based on politics having nothing to do with science. Sounds like climate science to me.

Is Merck evil for creating an arthritis drug that worked, but it was discovered to increase the risk of heart problems over long periods of use?

They would be if they based on that drug on abysmal scientific analysis. I'm not attacking science here, I'm attacking people who claim authority in the name of science who actually don't know what they're talking about.

We were told to use trans fats originally to get away from saturated fats. Butter became margarine, lard became shortening, and frying with bacon grease became one of a million oils. Then trans fats were found to be so bad that we had to ban them, supposedly.

All of that is one consistent direction...

See, science progressing from not knowing to not knowing.

To knowing what? That we should cook with vegetable oils? Turns out that has been wrong for literally our entire lives.

Everyone who uses their brain knows that there is no one special way to eat, no fad diet. There is no free ride in medicine or human health. There is no eat a lot of X to be healthy. Every dietician, not trying to sell a book, has repeatedly said balance and portion control.

I feel like that's a jab at the original article (because of the "sell a book" comment), which did not advocate the lack of balance or portion control. If anything, the original article is advocating more of a balance than what the AHA and virtually everyone else has been for decades. The original article is advocating that we not treat certain foods as inherently dangerous and replace them with others. I don't see how that is a lack of common sense or "using their brain".

 

[TenEightyOne]

Also in the UK chart, "subtract the 9-grain" is pointing directly at Italian bread, not 9-grain. So this chart is pretty much nonsense. They can't even get the labels right or put items in the same column.

I may have titled the UK bread incorrectly - I'll revisit my figures and check in the interest of fairness. You're right about the columns though, it was a PITA looking at the differences between the US and UK figures (which I omitted and will link after the whiskey wears off). Each table shows particular figures which, one presumes, favour Subway's interests. Either way the food isn't as "healthy" as it's portrayed by Subway although these things depend on one's overall diet and lifestyle. I certainly believe that a McDonalds diet wouldn't differ substantially from a Subway diet.

Back on general topic... is olive oil still healthy? I really like it and it's all I generally cook with. For eggs I add butter to the oil so I can heat it more without it smoking. Butter comes from cows which eat grass, so it's essentially a herb. Fact.

EDIT: And why, WHY, do people eat margarine? Read the contents! Ewwww.

 

[FoolKiller]

Yes well they did base decades of guidelines on bunk science.

Was it know to be bunk science? I'll be honest, I don't know. The article claims it, but there is very little evidence to back up their claims.

This is not science that was later discovered to be bunk, this was science that should have always been known to be bunk. If an organization is going to tell me what to eat for a few decades based on scientific studies that don't qualify as scientific, I don't think anyone should listen to them ever.

Until very recently dietary science has been primarily observational correlation. Person A eats a lot of X. Person B doesn't. Person A gets heart disease. It happens in case after case. Every variable can't be accounted for. Only very recently are we able to get close enough to find direct causation on a chemical level, and that is still fairly new. I mean, we are still trying to get beyond eating a lot of something spikes a certain level in a blood test. We see chemical changes in blood and then see a correlating medical issue. Ultimately, that's all we know.

Here is the main issue with this study, as I understand from the article: It says the problem is not what is the current belief. It does not explain why we had, and have, skyrocketing heart disease rates. Change your diet however you want based on this, but the answer is still not answered. What should have always been known (I still don't see how you get that...always is a long time), if anything, is what is causing heart disease rates to increase. We still don't know. And from my very personal point of view, they have less than a generation to figure it out and fix it. I don't think that means it is time to tar and feather someone who screwed the pooch half a century ago, when we had just learned how DNA is structured.

In otherwords, entirely based on politics having nothing to do with science. Sounds like climate science to me.

Find me a human or Earth science field not tied to politics. Even vaccines are controversial now.

They would be if they based on that drug on abysmal scientific analysis. I'm not attacking science here, I'm attacking people who claim authority in the name of science who actually don't know what they're talking about.

The AHA funds research and makes suggestions based on that research. Their suggestions adjust over time to compensate. The article's author may call them an authority, but the AHA's mission statement and goals are not to tell people what do, but to find ways to help prevent heart disease. They didn't get the saturated fats data and stop doing research on diet. They pushed for more.

Look, you expect them to have always known this stuff, but new realizations about LDL cholesterol were discovered in the 1980's. We didn't understand how water traversed through cell walls until 2003 (AHA funded by the way), and how that affected different diseases, like diabetes.

But here we go: Why would they have encouraged more carbohydrates 50 years ago? Maybe because we didn't understand how personal tight blood glucose control could affect diabetes, as opposed to insulin intervention, until 1993. And that was 2,000 years after the disease was known about. Shouldn't they have always known that? So, 15 years ago the AHA got diet wrong and suggested something that caused more complications. Maybe because it was only 20 years ago that we began to understand it.

All of that is one consistent direction...

How is trans fats being the healthier alternative then being the bane of the nanny state one direction?

Look, I get it that you feel like you've been lied to or whatever, but it isn't like we got one rushed study showing a correlation and everyone jumped. There were multiple studies, and some weren't quick. I mentioned the LDL research because it was actively being researched for over a decade. That's a hell of a hoax. This isn't some guy reading tree rings for a few months and hiding his data.

To knowing what? That we should cook with vegetable oils? Turns out that has been wrong for literally our entire lives.

I think I said not knowing, making the point that we are always going to be wrong to some degree. Physics don't change, but by God our understanding of it has thoroughly debunked past accepted knowledge. If there is one thing we should always know, it's how physics work. To this day we debate eve some of Einstein's stuff after new studies are completed.

I feel like that's a jab at the original article (because of the "sell a book" comment), which did not advocate the lack of balance or portion control.

No, it was simply a qualifier. One search through Amazon for diet books will show plenty of dietitians who say a thousand different things.

If anything, the original article is advocating more of a balance than what the AHA and virtually everyone else has been for decades. The original article is advocating that we not treat certain foods as inherently dangerous and replace them with others. I don't see how that is a lack of common sense or "using their brain".

I wasn't referring to the article. I'm referring to the people who jumped from meat and potatoes to fruit salad and rolls.

Even the healthiest thing you can do to avoid introducing harmful food, eating only iceberg lettuce (it has zero nutritional value), is dangerous.



But, if you don't want to listen to the AHA ever, then you better have a DNR on file. No CPR for you. No external defibrillation. No pacemakers. No drug delivering stents. No beta blockers. No MRIs.

Maybe I am being a bit biased because the AHA has had a hand in saving my life at least twice. But if anything, the fact that I am typing this right now is evidence that not listening to the AHA ever is bad advice.

Honestly, if you hadn't said that the most I would have said on the subject is, "Well, duh." And I would have still gone on my yellow journalism rant. That is a horrible article to be in the News section. The news ended after two paragraphs. The rest was commentary. That's just my personal professionalism coming out, kind of like a rocket scientist reacting to a movie attributing a failed Mars mission to the wrong agency. When it's your field you react.

 

[Danoff]

Was it know to be bunk science? I'll be honest, I don't know. The article claims it, but there is very little evidence to back up their claims.

They give very specific examples debunking a cornerstone study that launched us down the wrong path for decades and put the person who was responsible for it in a position to further advance his bunk findings.

Until very recently dietary science has been primarily observational correlation. Person A eats a lot of X. Person B doesn't. Person A gets heart disease. It happens in case after case. Every variable can't be accounted for.

You mean like men vs. women? Because the news about cholesterol for women is an about-face. Turns out it's not a great idea to base recommendations for women on studies involving only men (from one age group, from a small population, during weird religious-based dietary period).

Here is the main issue with this study, as I understand from the article: It says the problem is not what is the current belief. It does not explain why we had, and have, skyrocketing heart disease rates. Change your diet however you want based on this, but the answer is still not answered.

Correct. The new research does not answer the questions, it directly contradicts and exposes what we thought we knew as being wrong.

What should have always been known (I still don't see how you get that...always is a long time), if anything, is what is causing heart disease rates to increase. We still don't know.

I don't see why you're attributing my "should always have been known" comment to this totally unrelated thought.

I don't think that means it is time to tar and feather someone who screwed the pooch half a century ago, when we had just learned how DNA is structured.

I don't see why I can't hold people responsible for not checking their sources.

Look, you expect them to have always known this stuff,

Where are you getting this? I said, quite specifically, that they should always have known that the one study was bunk science. It should never have passed muster - never. Not at any point should anyone have looked at that study and thought "yes, that's a good sample size, and not at all biased when it comes to population selection". Why does this mean somehow that I think that science should always have known everything ever?

I'm going to say it again so that I don't get misunderstood.

The recommendations we've all been listening to and changing our dietary habits to for the past half century turns out to be based on terrible scientific practices. That should have been exposed the moment it was released. We should always have known that this was bad science - because it didn't adhere to good scientific principles. We had to wait 50 years for more studies to come along and have contradictory findings before we realized it.

I honestly have no idea what the answer will be, and I started this thread with that sentiment. But the fact that we've been listening to, and adhering to, guidelines that at best have been a waste of time and energy, and at worst have been actually harmful to thousands of people, when those guidelines were in fact based on junk, that could have been exposed as junk 50 years ago, is absolutely awful. And yes I will hold everyone responsible who has had a bullhorn on this issue.

 

[FoolKiller]

They give very specific examples debunking a cornerstone study that launched us down the wrong path for decades and put the person who was responsible for it in a position to further advance his bunk findings.



You mean like men vs. women? Because the news about cholesterol for women is an about-face. Turns out it's not a great idea to base recommendations for women on studies involving only men (from one age group, from a small population, during weird religious-based dietary period).

OK, so I forgot that bit in the article. Why the direct attack on the AHA when nearly every expert source on diet has followed this as well? Better yet, why not aim your guns at the entire food science and health organizations? They have been producing study after study and debate has only been recent. I mean this study was a review of dozens of studies over a long period of time. Unless they had some kind of bias, I would guess some of the studies they reviewed concluded saturated fats were bad, or we have all ignored the majority of science for one badly flawed one. Which do you think it is?

It seems to me like everyone screwed the pooch. Everyone certainly missed the carbs=bad thing, because that fact wasn't realized until 1993, and after that everyone began revising their recommendations. You seem to be missing the fact that despite the study having not been good science that there was no contradicting study to say their resulting recommendations were dangerous, and once we began seeing disagreeing studies we'd have another that confirmed the belief. Was their suggestion wrong? Supposedly. Should it have been caught? Yes. The entire scientific community missed it. Hindsight and all that. Did they recklessly make a dangerous suggestion despite known facts? No. They made suggestions that were revised when new data was introduced. Hell, we only recently have begun to understand how cholesterol actually works.

Correct. The new research does not answer the questions, it directly contradicts and exposes what we thought we knew as being wrong.

After reviewing decades of studies together. Odd that it was necessary to take that broad view to reach this conclusion. If the first study was bunk shouldn't every non-biased study since have been the opposite? Are we going to accuse every researcher of reaching this conclusion of fraud or negligence?

I don't see why you're attributing my "should always have been known" comment to this totally unrelated thought.

Because that is the real question that should have been looked at. We are basing much of physiology science on correlation rather than causation.

Decades of research that doesn't agree on a specific point does not equate to anything should have always been known. At most, it should have been known to be non-conclusive. But as we learned more about cholesterol and how these foods were processed we thought we understood it. Hell, we created effective drugs based on that understanding. What we do know is the saturated fats increases LDL cholesterol in blood tests. High cholesterol in the blood is often correlated with heart disease.

In this story, which discusses the study with a balanced approach, allowing for comments from dissenting voices and supporters (aka, not a hit piece), it is pointed out that we just now have seen that what we thought the blood tests with higher LDL showed is not what is actually happening.

Where the nutrition experts do agree: Getting a clear picture on how the body handles dietary fats is very complex. For example, studies haven’t demonstrated that the LDL-raising effects of consuming saturated fats leads to more heart attacks and strokes. “Saturated fat in the diet makes LDL particles bigger, but it doesn’t increase the number of LDL particles, which we now think is responsible for the increased heart risk,” Mozaffarian said.

This shines a big light on the correlation vs causation issue. We thought we found causation but were missing details. It is really hard for me to attack groups for supporting an idea that known information appeared to make sense. New facts are changing what many scientists accepted as fact.

I don't see why I can't hold people responsible for not checking their sources.

And then suggest disregarding anything they say, ever? Feel free to ponder on why retired and/or dead people missed something decades ago. The people there today have revised, and continue to revise, their recommendations. Let's not toss aside every recommendation they suggest. That is a dangerous suggestion. Very dangerous in this case, as some of those recommendations are used by EMS daily.

Where are you getting this?

I misunderstood your point. I may blame it on dealing with a strep-infected preschooler at 1:00 AM.

The recommendations we've all been listening to and changing our dietary habits to for the past half century turns out to be based on terrible scientific practices. That should have been exposed the moment it was released. We should always have known that this was bad science - because it didn't adhere to good scientific principles. We had to wait 50 years for more studies to come along and have contradictory findings before we realized it.

Is it possibly because better studies showed similar findings? I know I'd love it if no changes were made until all research found causal evidence, but that's not realistic.

This is a case of study after study showing more of sat. fats = more LDL, and more LDL = more risk for CVD: Thus more sat fats vicariously correlates to a possibility of more risk for CVD. This was confirmed by drugs that reduced LDL helping to reduce CVD. The recommendations were to reduce anything that increased LDL. Directly viewing sat. fats to CVD relationships created a contradiction, but the contradiction couldn't be explained and created a confusion regarding the LDL to CVD link.

Contradictions began gaining steam in the 1980s-1990s. And more study into cholesterol was begun. That was when we really began understanding HDL, LDL, and triglyceride. And it took us until just recently to realize an increase in LDL on a blood test could mean multiple things. Thus, now we are at a crossroads. Adapting to this understanding will take time. The issue is that we must now find a way to easily differentiate big LDL from multiple LDL. I'd guess they are taking a wait and see approach. It is better to make a recommendation that will reduce the risk of a false alarm blood test. Until we can detect the difference any smart doctor will not assume a guy who likes bacon is safe with a high LDL test. That would be dangerous and negligent. At a minimum he has to tell the guy to go on a low saturated and trans fat diet for a year to see what happens. And even then, nothing can be safely assumed after he goes back to his Baconators.

So, here is the thought: Will eating saturated fats give you heart disease or increase your risk? Currently it looks like no. Can eating saturated fats make it hard to detect when you do have increased risk? Everything I'm running across in researching this conversation seems to point to a yes.

And yes I will hold everyone responsible who has had a bullhorn on this issue.

And stick by this statement?

I think the biggest recommendation I have is that no one should listen to the AHA... probably ever.

 

[Danoff]

OK, so I forgot that bit in the article. Why the direct attack on the AHA when nearly every expert source on diet has followed this as well?

Oh I'm happy to attack more if that's what you'd like. The AHA just sticks out as an organization that sets guidelines and claims authority so they're an easy target. I'll gladly take up other punchingbags if that's what you prefer.

I would guess some of the studies they reviewed concluded saturated fats were bad, or we have all ignored the majority of science for one badly flawed one. Which do you think it is?

Conjecture on my part probably won't help this discussion, but I'll do it anyway since you requested it. My guess would be that follow-on studies were influenced by that adoption of the previous (bunk) science, and that it took a long time for a broad enough data set to appear before the one that got the ball rolling was found out to be wrong. It is often said that thinking you know something and being wrong is far worse than simply not knowing.

Did they recklessly make a dangerous suggestion despite known facts? No.

Did we reckelssly head down a path based on science we should always have known was wrong? Yes.

If the first study was bunk shouldn't every non-biased study since have been the opposite? Are we going to accuse every researcher of reaching this conclusion of fraud or negligence?

Fraud is too far.

Decades of research that doesn't agree on a specific point does not equate to anything should have always been known.

Again, that's out of context.

At most, it should have been known to be non-conclusive. But as we learned more about cholesterol and how these foods were processed we thought we understood it. Hell, we created effective drugs based on that understanding. What we do know is the saturated fats increases LDL cholesterol in blood tests. High cholesterol in the blood is often correlated with heart disease.

In this story, which discusses the study with a balanced approach, allowing for comments from dissenting voices and supporters (aka, not a hit piece), it is pointed out that we just now have seen that what we thought the blood tests with higher LDL showed is not what is actually happening.

This shines a big light on the correlation vs causation issue. We thought we found causation but were missing details. It is really hard for me to attack groups for supporting an idea that known information appeared to make sense. New facts are changing what many scientists accepted as fact.

That does help to explain why nobody scratched their head and checked their premises. I suppose it's just human nature to think you have it all figured out and move forward, but in this case that kind of laziness has resulted in decades of misdirection. It's sloppy, but like I said I'm glad we're getting to the bottom of it because it is an important topic.

And then suggest disregarding anything they say, ever? Feel free to ponder on why retired and/or dead people missed something decades ago. The people there today have revised, and continue to revise, their recommendations. Let's not toss aside every recommendation they suggest. That is a dangerous suggestion. Very dangerous in this case, as some of those recommendations are used by EMS daily.

First, we have a lot of noise made about how they know what they're talking about even though they don't.
Then we have years of over-the-top beat-it-into-the-public campaigning based on what turns out to be junk.
Then the data is there, in a mix of studies, and they're not the ones who get on it and spread the word.
Then, when someone else publishes an end to decades of misinformation, they go on defense rather than owning up.

I think at this point they need to rethink what they're actually trying to accomplish, because it doesn't look like "helping people" is in the description. It looks to me like "maintain authority" is the priority. I don't think we should be listening to an organization like that.

I misunderstood your point. I may blame it on dealing with a strep-infected preschooler at 1:00 AM.

Apology accepted.

This is a case of study after study showing more of sat. fats = more LDL, and more LDL = more risk for CVD: Thus more sat fats vicariously correlates to a possibility of more risk for CVD. This was confirmed by drugs that reduced LDL helping to reduce CVD. The recommendations were to reduce anything that increased LDL. Directly viewing sat. fats to CVD relationships created a contradiction, but the contradiction couldn't be explained and created a confusion regarding the LDL to CVD link.

Contradictions began gaining steam in the 1980s-1990s. And more study into cholesterol was begun. That was when we really began understanding HDL, LDL, and triglyceride. And it took us until just recently to realize an increase in LDL on a blood test could mean multiple things. Thus, now we are at a crossroads. Adapting to this understanding will take time. The issue is that we must now find a way to easily differentiate big LDL from multiple LDL. I'd guess they are taking a wait and see approach. It is better to make a recommendation that will reduce the risk of a false alarm blood test. Until we can detect the difference any smart doctor will not assume a guy who likes bacon is safe with a high LDL test. That would be dangerous and negligent. At a minimum he has to tell the guy to go on a low saturated and trans fat diet for a year to see what happens. And even then, nothing can be safely assumed after he goes back to his Baconators.

So, here is the thought: Will eating saturated fats give you heart disease or increase your risk? Currently it looks like no. Can eating saturated fats make it hard to detect when you do have increased risk? Everything I'm running across in researching this conversation seems to point to a yes.

So now we're advocating that we all maintain this altered diet that doesn't strike a balance and leads naturally to swapping carbs for saturated fats even though that appears to be counterproductive so that we can make it easier to detect that we have a problem? No way.

And stick by this statement?

I'll take it one step further - the AHA should consider disbanding. I know that sounds like insanity to you, but some other organization will take their place. Maybe some new blood and new thinking is exactly what they need, because I'm seeing self-promoting behavior at this point. At first when organizations rise into a position of prominence, influence and power they often have everyone's best interests in mind. They want to help people, they want to promote welfare, they want to do right by their customers, etc. Eventually, it always seems to end up that they focus on simply keeping the prominence, influence and power. If that weren't the case, why wasn't the AHA on top of this? The data was there. Why aren't they the ones bringing us this information? Isn't in our best interests? Why aren't they admitting that their guidelines need refining, or that they were wrong, or anything other than denial and "stay the course". It doesn't look like medical integrity.

 

[Omnis]

It's irresponsible to say just eat all the bacon and butter you want.

Bottom line: You have to get your blood checked regularly and see what kind of diet works best for you. High apolipoproteins (ApoB) are precursors to atherosclerosis and inflamation. Keeping them low is important.

High carb diets tend to do this better than high fat diets. Exercise is critical, however.

 

[FoolKiller]

Did we reckelssly head down a path based on science we should always have known was wrong? Yes.

So, after a bit of research to backup my own point/thought process I have run across information that is causing me to change my stance.

After reading this page I can't assume that they were working with the only information available at the time. Carbs had been pointed at long before. The site has a bias, being run by an author selling books, but the timeline does not make up facts. I'm sure it leaves some out, but nothing was faked.

Due to the OP article's description of the Keys study as the largest in history at the time, I assumed he was considered to be the top expert in the field at the time. It appears it was heavily disputed at the time. This changes my whole perspective.

Someone screwed up and chose sides in a scientific debate. No clue why.

I think at this point they need to rethink what they're actually trying to accomplish, because it doesn't look like "helping people" is in the description. It looks to me like "maintain authority" is the priority. I don't think we should be listening to an organization like that.

I don't know for sure if it is maintain authority so much as it is human nature to circle the wagons, despite conflicting evidence. I believe the Opinions forums shows this. As for maintaining authority, if that is the case, it can be non-malicious. In other areas they can directly link their efforts to millions of lives saved. Losing face could cause people's trust in those areas to falter as well. A gut reaction to protect the known good without weighing consequences is natural. That doesn't mean it is justified, and this is not an excuse, but a reason for their actions.

So now we're advocating that we all maintain this altered diet that doesn't strike a balance and leads naturally to swapping carbs for saturated fats even though that appears to be counterproductive so that we can make it easier to detect that we have a problem? No way.

Who advocates that? I posted the nutritional guidelines they use for grocery products. Grains were not favored, in fact carbs could only account for 15% of calories, assuming the fiber ratio met a certain level. I'd say the guidelines are striking a fairly balanced diet. I have a couple of their cookbooks and they lean more toward vegetables than anything. In fact, they suggest smashed or roasted cauliflower as opposed to potatoes, and suggest nuts as a snack before anything else.

How do we find out if someone is or isn't at risk of heart disease based on a test that doesn't differentiate between two forms of high LDL? Would you suggest we tell them to eat at their own desire and we just hand them drugs? I'm sure every lazy doctor would applaud that notion. When you're a hammer everything's a nail. That's how we've screwed up mental health science over the last few decades. How do we know that the drugs aren't affecting blood tests by shrinking the LDLs, making them more likely to cause heart issues when combined with more saturated fats?

Until we know more and see exactly how it all interacts we might be choosing between killing people and killing people. We do not know what is the safer option.

I'll take it one step further - the AHA should consider disbanding.

I don't believe that to be an altogether bad idea, but the same effect could be achieved by cleaning house in the top levels. The lower level, local office staff are in it for the right reasons. I've worked with them. Most started as volunteers or interns. They have heart disease, or know someone who does. They aren't the problem. I know the Louisville branch has less than 20 paid employees and everything else is handled by volunteers, like what I am doing now. I'm not ready to **** them down or reject them completely when I know they are funding two projects that have the potential to increase transplant survival rates, and even reduce the organ, tissue, and blood shortage issues that we face.

I also think this is different than not listening to the AHA...ever. That is CPR, heart defibrillation, pacemakers, beta blockers, and nearly a century of other findings that save lives everyday.

 

[Danoff]

I read the article you linked. Very interesting, definitely biased, but also contains a lot of facts as you said.

How do we find out if someone is or isn't at risk of heart disease based on a test that doesn't differentiate between two forms of high LDL?

We get another test, and in the meantime, do not suggest that they take dietary measures that might be counter productive in order to conform to the tests we have. What we tell people they should put in their bodies to stay healthy should be based on our understanding of what promotes health, not what shows up on a test.

I don't believe that to be an altogether bad idea, but the same effect could be achieved by cleaning house in the top levels.

It's fair, but at this point they need a big PR campaign to go along with the shakeup, and they need to change their guidelines.

I also think this is different than not listening to the AHA...ever. That is CPR, heart defibrillation, pacemakers, beta blockers, and nearly a century of other findings that save lives everyday.

CPR has undoubtedly saved many lives, but it has also changed soooo much during my lifetime that I can't keep track of it.

I don't know everything the AHA has done that has done good, I'm sure it's a lot. But.... they've screwed the pooch and demonstrated an institutional willingness to ignore. How do you listen to an organization that has done that? Maybe they're right with what they're saying next time, or were right with what they said 10 years ago, they've still demonstrated a lack of credibility. I don't know how an institution recovers from that. Maybe it can be done, but they aren't on that path.

I'm sure they are important to your life. You have every reason to be hoping that they remain intact, and research dollars continue to flow toward the areas where you need them. But you should also know that whether it's the AHA or not, America is 100% committed to understanding why it is dying of heart disease, and the research dollars will continue to flow.

 

[FoolKiller]

We get another test, and in the meantime, do not suggest that they take dietary measures that might be counter productive in order to conform to the tests we have. What we tell people they should put in their bodies to stay healthy should be based on our understanding of what promotes health, not what shows up on a test.

After some talking to some doctors at work, people who properly follow diets like Atkins have a spike, then decrease in cholesterol over time. It is possible to suggest they back off on carbs and try to lose weight (if necessary).

It's fair, but at this point they need a big PR campaign to go along with the shakeup, and they need to change their guidelines.

If I had access to more than just local offices I'd be asking some questions. We had a Heart Walk Committee meeting today, and I walked away feeling good about the work that they do. It could be either the fact that it's the only time I'm sitting in a room with people who understand my life or the fact that after working for state government it feels good to see an efficient operation at work.

If I get to go to the banquet again this year I will be able to talk with local medical directors and AHA executives, so I can ask then.

CPR has undoubtedly saved many lives, but it has also changed soooo much during my lifetime that I can't keep track of it.

Which is why you have to get recertified every 1-2 years.

I don't know everything the AHA has done that has done good, I'm sure it's a lot. But.... they've screwed the pooch and demonstrated an institutional willingness to ignore. How do you listen to an organization that has done that? Maybe they're right with what they're saying next time, or were right with what they said 10 years ago, they've still demonstrated a lack of credibility. I don't know how an institution recovers from that. Maybe it can be done, but they aren't on that path.

Everyone stumbles, makes mistakes, or gets some bad leadership that can create a singleminded approach. Hopefully they can recover. At least they don't still suggest high carb as an alternative. It shows that they are willing to make some change, even if they have trouble letting go of a premise they have followed for decades.

I'm sure they are important to your life. You have every reason to be hoping that they remain intact, and research dollars continue to flow toward the areas where you need them. But you should also know that whether it's the AHA or not, America is 100% committed to understanding why it is dying of heart disease, and the research dollars will continue to flow.

Yet, it's like pulling teeth to get donations for my heart walk team. I'm even setting challenges that result in my being embarrassed in some way.

 

[Omnis]

Hey, look: http://www.huffingtonpost.com/nancy-brown/theres-just-no-doubt-limi_b_5318585.html

 

[Danoff]

Hey, look: http://www.huffingtonpost.com/nancy-brown/theres-just-no-doubt-limi_b_5318585.html

That's sad... it even implies (in multiple ways) that the poorly executed Keys study applies to women - despite there being no women sampled. *facepalm*

 

[Omnis]

I feel like we're all victims to the dumbening down of things to the point where they've confounded everything.

LDL does not cause heart disease. Apolipoprotein B, however, is strongly associated with atherosclerosis-- we know this as a fact. And LDL is usually assocatied with ApoB, but you may have discordant levels between them. That is, even people with very low levels of LDL concentration can still develop plaque and heart disease. You have to get an ApoB particle count by NMR to check for discordance. LabCorp offers one. It's called an LDL-P (P for particle) level, rather than LDL-C (concentration). Testing for LDL-C has been the default and is the cheapest and easiest, but it is meaningless unless you assume concentration is concordant with particle count.

For a given LDL-C, it is best to have as small an LDL-P as possible. This means all the LDL is packaged into only a few carrier proteins. You'll sometimes hear this referred to as "fluffy" cholesterol. This is way better than having all of your cholesterol packaged in tiny bits over tons and tons of lipoprotein particles. The latter condition, without question, mediates cardiovascular disease.

The gist of it is that the small particles can get trapped in the vessel. It's much harder for fluffy particles to get trapped. This trapping initiates an inflammatory cascade. When the called-up cells pass into the lumen to attack the perpetrator, they'll kill it or eat it, and then try to mend the area. That's the start of a plaque and it gets worse since the crap-job those first-responders did also mediates inflammation. So you basically get a bunch of Jeremy Clarksons running onto the scene to fix your car with a hammer, when it really just needed the nail pulled out of its tire. For more, see Dr. Peter Libby: http://www.scientificamerican.com/article/atherosclerosis-the-new-view/

We know that statin drugs lower LDL, but they are of no benefit to people if they lower LDL-C without also lowering LDL-P. If they're concordant, then LDL-P went down with LDL-C. I think it's a person-to-person thing, but that's why you have to test it. I don't know what exactly determines concordance.

 

[Danoff]

Now Gluten is on the chopping block.

http://www.realclearscience.com/blog/2014/05/gluten_sensitivity_may_not_exist.html

Turns out, [sarcasm] I know this is a huge shock to everyone [/sarcasm], that unless you have an auto-immune disease, a recent study indicates that you can't be sensitive to gluten.

Are we sure of the science? No. Does this smell like absolutely 100% the correct answer? Yes.

Read the article for the use of the term "noceboeffect" if nothing else.

 

[Omnis]

Yeah, the only people with legit gluten concerns are those with celiac disease and perhaps eczema.