Lower LDL cholesterol = more heart failure death!

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Another fascinating paper caught by my friends from a vegan forum - and another chunk of the mainstream medical belief system imploding!  

Note (*)

68% more death in the group with LDL < 71mg/dL (1.8 mmol/L) compared with those > 130mg/dL!

New study "Low-Density Lipoprotein Levels in Patients With Acute Heart Failure" by 
Mark R. Kahn et al., 16 Oct 2012,  found strong rising trend towards higher and higher mortality with lower and lower LDL, in every subcategory of the heart disease etiology or statin/lack of statin treatment. For example, for the total mortality (multivariate statistical analysis), relative mortality risk increased monotonically with lowering of the LDL such as illustrated in the following table:

LDL (mg/dL)	Relative Mortality
> 130	1.0
101-130	1.16
71-100	1.25
< 71	1.68

(based on table III in the study)

The study showed a similarly increasing mortality risk with lower LDL, over time, illustrated by the following figures from the paper:

*)  Harvard Medical School building

High carb and low caloric intake from fat and proteins may increase the risk of dementia in elderly!

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The title is a short version of the concluding sentence from a new Mayo Clinic study. The study tracked 937 initially healthy people aged 70-89 for 3.7 years. During this period 200 developed mild cognitive impairment (MCI) or dementia.

Those patients who were in the highest quartile (i.e. a group) of carbohydrate consumption (as percentage of total calories), have had approximately twice the risk of MCI or dementia (1.89 times, confidence interval P for trend =0.004(*)). Those who belonged to the highest quartile of fat consumption had about one-half the risk of developing MCI or dementia (0.56, P for trend = 0.03(**)). Those with the highest protein intake had 21% lower risk.

The fact that fat, especially saturated seems to be beneficial in dementia and other neurological degenerative diseases, has been known for some time, see for example the references in my past posts: this or this

This study however, is probably one of the first, if not the first, to concentrate on all three macronutrients' intake rather than some partial aspects of the diet.

Quote:

A dietary pattern with relatively high caloric intake from carbohydrates and low caloric intake from fat and proteins may increase the risk of MCI or dementia in elderly persons.

Although the full text is pay-walled, a short writeup is posted on the Mayo Clinic website.

Interestingly, a comparison between the highest quartile of total carbohydrates with the highest sugar (see the quote below), shows that the sugar impact was negative but not to the same extent as the total carbohydrate. This may be indicating that some other form of cabohydrate than the sugar alone, may be the most detrimental to the neurological health. Perhaps the total starch [ *** WHEAT?! ***] or just the total glycemic load?

Those who reported the highest carbohydrate intake at the beginning of the study were 1.9 times likelier to develop mild cognitive impairment than those with the lowest intake of carbohydrates. Participants with the highest sugar intake were 1.5 times likelier to experience mild cognitive impairment than those with the lowest levels.

But those whose diets were highest in fat - compared to the lowest - were 42 percent less likely to face cognitive impairment, and those who had the highest intake of protein had a reduced risk of 21 percent.

When total fat and protein intake were taken into account, people with the highest carbohydrate intake were 3.6 times likelier to develop mild cognitive impairment.

"A high carbohydrate intake could be bad for you because carbohydrates impact your glucose and insulin metabolism," Dr. Roberts says. "Sugar fuels the brain - so moderate intake is good. However, high levels of sugar may actually prevent the brain from using the sugar - similar to what we see with type 2 diabetes."

Wiki 

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Notes:
(*) It means that the probability of the result being by chance is 1/250.
(**) Probability of the result being by chance is 1/33.
(***) Added 13/01/2013, inspired by this .

(I am grateful and indebted to the best source of alerts about new interesting nutrition studies - vegan discussion groups!  Oh my oh my...  Thank you drmcdougall.com )
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Diabetes - low caloric diet and exercise did nothing for heart!

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A new report from an 11 years long just cancelled study "Look AHEAD", conducted by Dr. David Nathan (principal investigator) is going to be published.

Five thousand diabetes type 2 patients split in two groups, one (treatment group) underwent a rigorous diet (1200-1800kcal - about one half of general average!) and about three hours a week of exercise regimen, the other (control group) were only offered some general health information.

Results: in spite of 5% weight reduction in the treatment group - no difference in cardiovascular death!

See a write-up in NYT:

"Diabetes Study Ends Early With a Surprising Result" by Gina Kolata, October 19, 2012

Quote:

The study randomly assigned 5,145 overweight or obese people with Type 2 diabetes to either a rigorous diet and exercise regimen or to sessions in which they got general health information. The diet involved 1,200 to 1,500 calories a day for those weighing less than 250 pounds and 1,500 to 1,800 calories a day for those weighing more. The exercise program was at least 175 minutes a week of moderate exercise.

But 11 years after the study began, researchers concluded it was futile to continue — the two groups had nearly identical rates of heart attacks, strokes and cardiovascular deaths.

My take on it?

I find it absolutely pathetic but also surprising! Only 5% weight reduction! Same rate of heart disease and stroke after after 11 years of consuming about half the calories of average American adult?!  How is that possible, unless...


     - half of the calories they threw out were in things like animal and dairy fat, fish, yolks and meat, leaving mostly carbs. Carbs - like perhaps those on the picture?

http://en.wikipedia.org/wiki/File:NCI_Visuals_Food_Meal_Breakfast.jpg

More, here are study materials and guidelines for this study ("Look AHEAD" trial):

Look AHEAD Materials

This is hillarious (and oh yes, I was right, breakfast cereals, bread, low fat etc., super "healthy"!):

Healthy Eating

More hillarious:

More About Healthy Eating

Quote from the chapter demolishing the low carb diets:

The Claim [of low carb diets]
You’ll lose weight on the diets because they are low in carbohydrate.

The Truth
You may lose weight on the diets because they contain fewer total calories than most people consume. Most of the diets range from 1000-1800 calories. Also, many cause ketosis. In ketosis, the body breaks down fat stores, producing toxic wastes called ketones. To flush out the ketones, the kidneys pull water from the body. It’s the loss of water, not fat, that results in quick weight loss.

I can't help it, it so so so scientific, it is cracking me up! I need some vegan comments to straighten me up, please please ...
Stan (Heretic)