Dietary fat's undeserved bad reputation, and treatment of diabetes

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This is based on the paper:

Lawrence GD. Dietary fats and health: Dietary recommendations in the context of scientific evidence. Adv Nutr 2013; 4:294-302.

Quote from the "blasphemous" abstract:

... Over the years, data revealed that dietary saturated fatty acids (SFAs) are not associated with CAD and other adverse health effects or at worst are weakly associated in some analyses when other contributing factors may be overlooked. Several recent analyses indicate that SFAs, particularly in dairy products and coconut oil, can improve health. ... The replacement of saturated fats in the diet with carbohydrates, especially sugars, has resulted in increased obesity and its associated health complications. Well-established mechanisms have been proposed for the adverse health effects of some alternative or replacement nutrients, such as simple carbohydrates and PUFAs. The focus on dietary manipulation of serum cholesterol may be moot in view of numerous other factors that increase the risk of heart disease. The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs, ...

Editorial review in The Heart.Org:

Dietary saturated fat has undeserved bad reputation, says review

Quote:

Dietary saturated fat has undeserved bad reputation, says review
MAY 17, 2013 Steve Stiles

Rockville, MD - "The influence of dietary fats on serum cholesterol has been overstated," concludes a review in an American Society for Nutrition publication that, in its words, "calls for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary [saturated fatty acids] SFAs, for which mechanisms for adverse health effects are lacking" [1].

Indeed, argues the author, Dr Glen D Lawrence (Long Island University, Brooklyn, NY), it is likely other factors, such as oxidized polyunsaturated fatty acids (PUFAs) or preservatives in processed meats, that are also present in high-SFA foods that lead to adverse health effects typically associated with high SFA intake.

"The meager effect that saturated fats have on serum cholesterol levels when modest but adequate amounts of polyunsaturated oils are included in the diet, and the lack of any clear evidence that saturated fats are promoting any of the conditions that can be attributed to PUFA, makes one wonder how saturated fats got such a bad reputation in the health literature," Lawrence writes in the review, published May 1, 2013 in Advances in Nutrition.

The article's case is built on interpretations of research from the biochemistry, epidemiologic, and clinical literature but which, nonetheless, does not reference a tremendous body of research supporting alternative views. Still, Lawrence describes:

* The role of lipid peroxidation in promoting atherogenesis, arguing that its effects are more pronounced on PUFA than on SFAs or monosaturated fatty acids.

* An arguably protective effect of omega-3 PUFAs against proinflammatory effects of omega-6 and other PUFAs.

* Evidence that potentially carcinogenic preservatives in processed meats as well as high-heat cooking methods have influenced perceptions that red meat per se has adverse health effects.

* How "the preparation and cooking methods used for foods that are traditionally classified as saturated-fat foods may be producing substances from PUFAs and carbohydrates in those foods that are promoting disease."

* Studies suggesting positive health effects from dairy fat and tropical oils, both high in SFAs.

* The hazards of diets with increased carbohydrates as a result of being lower in fat, in low-fat diets followed to improve health, especially cardiovascular health.

"The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs," the article concludes. "Consequently, the dietary recommendations to restrict saturated fats in the diet should be revised to reflect differences in handling before consumption. . . . It is time to reevaluate the dietary recommendations that focus on lowering serum cholesterol and to use a more holistic approach to dietary policy."

Interesting comments under the editorial, quotes:

# 5 of 6
May 20, 2013 01:46 (EDT)
Robert Bramel
Good Calories, Bad Calories Showed This in 2006
Good Calories, Bad Calories, written in 2006, is beyond doubt the most thoroughly and carefully researched diet and nutrition book ever written (3000+ references), and the author, Taubes, makes an extremely compelling argument that "dietary fat, whether saturated or not, is not a cause of obesity, heart disease, or any other chronic disease of civilization". Anyone hoping to argue against this position ought to spend the three years I did studying and critiquing many of Taubes' reference works. The evidence is overwhelming. The real culprit is insulin, and not incidentally carbohydrates, especially, but not exclusively, the most easily digestible and refined types because they have the most effect on raising insulin levels. Since that time I have watched carefully for studies in any relevant arena that would argue against the insulin hypothesis -- none found so far.

# 6 of 6
May 20, 2013 02:00 (EDT)
Robert Bramel
Response to D Hackam
"...saturated fat often comes 'bundled' with dietary cholesterol. Second, saturated fat can stimulate hepatic LDLc production."
Although I am a special case with LDL of 520 and TC of 620, switching to a high fat (mostly from meat and dairy) diet in 2006, there was no significant change in serum cholesterol levels. The only change was a predicted shift in the makeup of my LDL. With a high carbohydrate diet I had "mixed AB" particle size, and now my single peak is extraordinarily large (279 Angstrom, with a lab range limit of 285). Whatever the effect, my heart arteries continue to have zero calcification.

I found that link in Peter's post and karl's comments - recommended reading!

See also Treatment of Diabetes and Diabetic Complications With a Ketogenic Diet.

Quote (abstract):

Accumulating evidence suggests that low-carbohydrate, high-fat diets are safe and effective to reduce glycemia in diabetic patients without producing significant cardiovascular risks. Most of these studies have been carried out specifically restricting carbohydrates, which tends to lead to increased protein intake, thus reducing the ketosis. However, diets that limit protein as well as carbohydrates, entailing a composition very high in fat, appear even more effective to reduce glucose and whole-body glucose metabolism in humans. In animal models, low-carbohydrate, high-protein diets do not produce ketosis or reduce glycemia but rather cause obesity. However, limiting both protein and carbohydrates as in a classic ketogenic diet remarkably reduces blood glucose in animal models of type 1 and type 2 diabetes and reverses diabetic nephropathy. ...

Dr.Jan Kwasniewski was right!
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