I love her presentation!
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| Probably not true! |
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| Who is a bastard who wrote "why"? |
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| Magic rocks! :) |
I highly recommend to listen to her video. She is reviewing some old studies showing therapeutic effects of the very low fat high carbohydrate diets (VLFHC). Low fat means well below 10% preferably about 2%. When I begun my high fat low carb experiment back in 1999, which grew into my ongoing lifestyle nutrition to this day, I was aware that the very low fat natural food diet has been successfully used in halting progression of coronary heart disease and MS. I was familiar about Pritikin and Dr. Swank work. Prior to 1999 I was experimenting with vegetarian nutrition but I found it unpalatable, unless a sufficient amount of fat was added. More than 10%. So for me finding dr. Kwasniewski's Optimal Diet was a "gift from God", or I should say a gift from a friend of mine (Andrew S.)! Kwasniewski's Optimal Diet is high animal fat low carb diet (HFLC). After noticing back then that the VLFHC diets have some therapeutic property, I had many questions (i.e. "question everything"). One of them is about the long term viability and the side effects. Like with every therapy, there may be side effects. Are there side effects of VLFHC diets? How do people do on such nutrition scheme fare in the long term? Longevity issue? Longevity with a robust health or not so well? The same question can also be asked about any other diet, including the HFLC diet.
Unlike most other low carb promoters at that time (1970-ties - 1990-ties), dr. Kwasniewski did acknowledge that a high carbohydrate diet may also be healthy, quoting Japanese rice based diet as an example. He also insisted that, on such a diet (1) fat intake must be limited to abut 10% and (2) a sufficient amount of (lean) protein must be consumed. Insulin sensitivity is very high on such a diet because the intake of fat is very low but the pancreatic insulin secretion is medium. Insulin cannot be too low, due to carbohydrate-based metabolism. Typically it amounts to about 20-30 iu per day, based on my understanding and from reports by t1 diabetics (quoting from memory so verify this before you requote me!)
Dr. Kwasniewski also noticed, based on his patients record, that a particular proportion of macronutrients, consisting of about 35-45% of fat (by calories) and about 45-35% of carbohydrates is particulary unhealthy and makes people prone to developing diabetes and atherosclerotic heart disease. Kwasniewski also noticed that it causes a peculiar form of neuro-degeneration for people in their 40-ties and 50-ties manifesting itself in form character disorder (psychopathy). He called that dietary zone "dangerous middle zone". Pancreatic insulin secretion has to be very high (typically 40-60 iu/day or more) on such a diet in order to overcome the insulin insensitivity induced by the high fat intake.
He also noticed that as soon as you up the total fat intake to above 50% of calories then these pathological effects gradually subside and the diet becomes healthy again, even therapeutically healthy. The widely popular diet he publicized in the 1980-ties, arrived at the macronutrient proportions P:F:C (Protein to Fat to Carbohydrates) in gram per day per 1kg of ideal body weight of 1:3-3.5:0.8 to 1:2-2.5:0.5 . This typically works out at way over 60% (typ about 85%) of fat by calories. Notice that fat has 9kcal/g, glucose 4.5kcal/g and protein 3.5kcal/g (or less if used anabolically). Interestingly, Kwasniewski also found that his patients with coronary heart disease begun reversing and recovering. So his patients with many autoimmune disease such as asthma, rheumatoid arthritis, MS, IBS, and other - also recovered on his diet! Even though the HFLC diet is the exact opposite of the VLFHC diet, it nevertheless produced surprisingly similar (if not greater) therapeutic effects! Notice that the insulin sensitivity (and the effect of fat upon it) becomes irrelevant due to very low intake of carbohydrates. Kwasniewski quoted insulin requirement at this point, to be about 6-10 iu/day. How did he measured it? By observing his type 1 diabetic patients!
What Denise Minger has done, is rediscovering and publicizing that fact that there are 2 dietary zones that have therapeutic properties, not just one diet!
What I would disagree with, is her presumption that the VLFHC diet would:
- "results in healthier gut microbiome long term"
There is not proof or comparison studies done for VLFHC vs HFLC on that, while there is enough reports indicating the long term gut flora deterioration among vegans (I would put refs to Dr. Stanley Bass and Dr. Gian-Cursio reports on Natural Hygienists).
- "may do best for ApoE4 carriers"
No proof either, other than high serum cholesterol which does not always translate to a health risk, except for people eating in the dangerous middle zone.
- "may be able to restore and heal glucose tolerance which does not happen on the high fat..."
This is not true based on my personal observation. Initially yes, HFLC diet did not restore my glucose tolerance, it only allowed my body to bypass the issue by not showering my body with the excess carbohydrates. Whenever I tried to eat a little bit more than 50g of carbohydrates in a day, I would inevitably come to regret it! Carb-headache and nausea. Beer was especially bad for me. However, after about 2 years I noticed that I was able to increase that limit and add more than previously and after about 6-7 years I noticed that my carbohydrates tolerance has been totally restored! For example I can now consume a high carb dinner if I have no other choice without any adverse side effects. I don't do it often, but it is nice to know that my metabolism has completely been restored. I suspect it has to do with the mitochondrial regeneration. It takes about 7 years to regrow and renew most of our muscular tissues from our stem cells. I also found it that initially I had to watch not only the total carbohydrates intake, but I also had to limit the overall caloric intake from fat as well. Initially the total limit was about 1800kcal. Believe it or not that is actually perfectly sufficient for an adult leading an active life on the high fat diet, without any problems (I was 43 in 1999 when I begun HFLC and I weigh 64k, 173cm height) It was as if my metabolic channels were impaired for both macronutrients, for carbs as well as for fat, except the metabolism of fat, being more effective, allowed me to live better and have more energy in spite of the limitations. Again, that restriction is no longer applicable and lifted itself after about 7 years.
Stan (Heretic) Bleszynski
21 comments :
So, the idea that having equal amounts of fats and carbs is not good health-wise, this idea is empirically found by Dr K.
But I suppose his sample mostly consisted of sick people. What about healthy people?
For the doubt in the logic stems from the observation that most people do eat in this unhealthy zone--35-45% fat and 35-45% carb. Out of these only some are sick. Most of them continue to be healthy till their 80's are even more. Consider the centenarians. Do their diet, typically reported in media, lies in the extreme zones or in the middle zone. I myself never read or heard about a centenarian who practiced either extreme fat restriction or carb restriction.
So, empirically, while it can be maintained that sick people should practice severe restriction of either fats or carbs, I am not convinced that healthy people need to do so.
Healthy people at 80's? At least here (up north) folks on "normal diet" are medicated before they turn to be 50...
Does China study data support Dr K's idea of special risk associated with F:C ratio near unity?
The China study data of vascular disease mortality vs fat calorie percent shows weak inverse relation. The fat calorie percent range from 5 to 33. No special healthfulness of low F is visible.
Similar weak inverse relation was seen for cancer mortality.
LeenaS,
Life expectancy is in high 70s. Plenty of old people, 70 and above are healthy. Of course, they are unlikely to engage in obviously detrimental things like consume excessive vegetable oil or sugar. But I do not see that the health elderly practice restriction either of fat or carb.
Their F:C ratios are probably around 1.
Gyan:
I did not talk about life expectancy but medication. Weather a medicated person is healthy or not, is an interesting philosophical question.
Non-medicated people above 50 years are exeedingly rare here, in spite of lifespans elongated to more than 80 years.
I am talking about not people on normal diet but a subset of elderly who are non-medicated, for instance non-diabetic. Essentially people with intact metabolism. There must be plenty of them. Not everybody in 70s is diabetic. So, given some elderly non-diabetics, my limited observation is that they do not tend to practice extreme restriction on either fat or carb. Thus, they have retained functional metabolism with F:c=1.
Gyan,
I have been struggling with dr. Kwaśniewski's theory (about the dangerous zone in the middle) ever since I heard. Certainly China Study did not support it. On the other hand the fat intake in China in the 1980 was generally lower than 40% so that particular statistics was not well covered by the study. So the absence of an evidence in this case is not an evidence of absence. Also, the medium fat F=C problem, and the risk, even in Kwaśniewski's private research (*), shows up only for the middle aged people or old. Young people seem to be impervious to that. So it is possible that the effect could be missed in most studies, especially that the risk is spread over a long time.
(*) Kwaśniewski claims to have done stats on airforce pilots' diet, in the 1960-ties, where he was asked to work as a dietetitian (he is orthopedist by training) and was able to correlate a particular P:F:C diet with the pilots' health risk. He also noticed that hypoxia during the high altitude flying tended to exacerbate the risk. For example he found that large proportion of the pilots are already diabetic (t2) by the time they retire from active duty (>45 years old). Another series of test was done by his son Tomasz, a veterinarian working for a large pig farm (collective farm I presume). He was also able to section the pigs and correlate the degree of arterial calcification with the type of a diet fed to the pigs.
LeenaS,
Re: "Healthy people at 80's? At least here (up north) folks on "normal diet" are medicated before they turn to be 50..."
This is very true, with only few exceptions. It reminds me of our friend who had to admit his mother aged 90-something to a nursing home in Toronto. A nurse asked him "what prescription has you mother used". He said "none!". The nurse didn't believe and repeated the question several times assuming he must be lying or just not remembering. Eventually he had to explain, "you see my mother is French and all her life she cooked and ate a high fat food like most French, that's why she never needed drugs". The nurse gave up... :)
Gyan,
Centenarians constitute about 0.5% of the population and it was quite well proven that they are genetically predisposed towards high insulin sensitivity and thus maintain low insulin level no matter what and how they eat. That makes them impervious to a bad diet.
Stan
Gyan, what are you trying to prove? Medications are not taken only on diabetes, even if that IS a huge epidemic now. Statistics reveal the broad use of medications, if you do not believe your eyes.
We have been on LCHF/Kwasniewski for more than 10 years and on lowcarb almost 20 years, and I can see the difference between us and my kin/colleagues/friends, more and more grievously as time goes by...
Cheers,
LeenaS
Hi Stan,
I found you and your blogg from peters comments years ago. I'm not talking much in English in internet, so mainly just a silent listener, but I like your blogg a lot.
Cheers,
LeenaS
Thanks LeenaS! HFLC is a different kind of magic isn't it? Most people just wouldn't believe me so I stopped telling them. They tend to disbelieve me regarding most other topics too. :) Best regards,
Stan
My diet approximates F=C --- which is quite higher fat among my compatriots --- and thus I have significant personal stake in this question.
This I want to be sure regarding empirical support behind Dr K.
But I find encouraging that going to 50 percent fat moves one out of the danger zone
Gyan,
Kwasniewski claims that when fat increases above 45% the problems (diabetic risk) gradually disappear. He was quoting Spanish, French and Swiss diets (also Italian except during the 1940-ties!) which are around 45-50% fat. It may depend on the protein & carbs intake. A F=C F:C=50%:50% is impossible because P=0. For example P:F:C=1:1:2 (by weight in g/kg/day) translates to about 4:8:8 by calories or 20%:40%:40% (relative by calories normalized to 100%).
Another choice for F=C is 10%:45%:45% (by calories) but then the protein intake would be too low (0.5g/kg/day). You see, once you want to maintain F=C there is very little leeway, you either end up in the risky zone or with no protein.
Then, the way out of this arithmetic is to reduce carbohydrates, that's why I wrote F=35%-45% and C=45-35% to define the dangerous zone. so it stretches between F:C=35%:45% to 45%:35% (and P=20%, by calories)
If we explore the area above the upper end of fat in the dangerous zone (BTW, Kwasniewski refers to that zone often as "pentose zone"). For example we get F:C=50:25% (calorie-wise). If we fix the protein intake to be physiologically appropriate (1g/kg/day) then we may get this:
P:F:C=1:1:1 (g/kg/d) which is 4:8:4 by calories per kg/day, or 25%:50%:25% by relative calories, normalized to 100%.
The P:F:C = 25%:50%:25% by cal was in fact my original diet in 1999!
Because I could not consume the full amount of calories prescribed by Kwasniewski's Optimal Diet! That would require P:F:C=1:(2-3):1 (g/kg/day) or even more fat, for younger people performing heavy physical work.
My body was maxing out at about 1800kcal/day, unable to digest or metabolise more, and my average was about 1500 kcal/day. Mind you although it may sound strange and "magical", I never felt hungry and my energy level was perfect! I was very active professionally and travelled a lot. Much better than before the diet. I was unable to consume any more calories than about 1800 even on pure fat, up until about 7 years into the diet. Starting in 1999, so that happened around 2006. My carbs limit of 0.8g/kg/day that is 50g/day, since I weight 65kg, also lifted itself around that time. I can now eat 100g carbs infrequently without any adverse effects. Before I couldn't! The lesson I learned is that although the metabolic syndrome manifests itself primarily as glucose intolerance, it is really much deeper than that and the metabolism of fats can also be affected and impaired by the same dysfunction (mitochondrial?) that affects glucose. If you try it, do not assume that you would be able to eat (initially) lots of fat! Because of that it was much easier for me to reduce the carbs intake than to increase my fat intake!
Stan
BTW
I simplified calculations out of laziness, the caloric contents of fat is closer to 9kcal/g and its metabolic & athletic impact on the body may even be higher than that rather than just 8, and protein delivers only 3.5kcal/g or less if body uses it for anabolism (tissue building and regeneration).
I often consume carb-heavy meals since low-carb is unknown here (India). But I have probably occult glucose intolerance in the sense of Kraft curves since I feel sleepy afterwards.
That's why I decided to maximize fat intake to the extent possible with conventional diet. But this lands me in the unsafe zone with F:C between 0.8 and 1.2
Maybe one can avoid this unsafe zone by avoiding consuming fat and care in a single meal. My breakfast is generally zero-carb--a little cheese or cream. Lunch is light and I have a high-carb conventional dinner.
I avoid unsaturated fats and sugar. This way I hope to retain metabolic health despite eating in a possibly detrimental macro ratios
Not sure if separating fat and carbs in different meals would help. Also eating high fat in one day and high carb during the next day may cause other problems. It may be hard to switch metabolism frequently between one mode and another. I say "may be" because I don't know for sure. This is a uncharted territory.
As it is, I just got an indian colleague whos is on LCHF - but we are not in India, so I see your point.
Separating fats and carbs might not help that much, since this way the mitochonria cannot specialize on either, and that tends to be a problem. How about alternating with eating and fasting days? This seems to be the traditional way to go on the northern side of Mediterranean. Even a day once a week should clear up quite a bit of unwanted material from the body...
Cheers,
LeenaS
Hi Stan,
Do you think there is something to the fact that low-fat can perhaps cure glucose intolerance as Denise suggests in a year or two, while it took 7 years for your glucose tolerance to repair itself?
Long term low-fat dieters seem to age poorly, and develop issues, but perhaps doing low fat for a few months, improving fasting insulin and glucose tolerance, and then shifting to a lower carb, higher saturated fat diet for maintenance might be useful.
Thanks
Hi Stan,
I'm just wondering: how does this concept coincide with the all the problems with low fat diets on this blog, and all the harms of adding carbs at the expense of saturated fat? Why are the issues not centered on mixed diets?
Thanks so much.
Re: "I'm just wondering: how does this concept coincide with the all the problems with low fat diets on this blog, and all the harms of adding carbs at the expense of saturated fat? Why are the issues not centered on mixed diets?"
Minger noticed that in some cases a short term vegetable based low caloric diet may be helpful. The key word is "short". Back when I was talking to vegans and diabetics on their on-line forums, many reported the same thing, namely that the low-caloric-density vegetable and fruit diets helped them. However none of the people seemed to thrived on such diets in the long term, that is more than 5 years, based on my observation of vegans. Typically they reach a weight loss plateau or something in their body breaks down (typically intestinal, joints and skin, teeth and neurological problems). The only long-term vegan exception I know of, is Neal Pinckney from Hawai, who runs (or ran) a low fat vegan forum since the 1990-ties. That does not apply to those vegetarians who allow some eggs and fish, they can sustain themselves on such diets indefinitely.
Stan, thank you for continuing to post about Dr. Kwasniewski and the Optimal Diet.
Can you say anything about Dr. K's PFC recommendations or other aspects of the Optimal Diet and kidney health/disease?
Thanks very much.
Emma
Hi Emma, you need to consult your medical doctor [disclaimer].
General rules for PFC ratio presented by Dr. Kwasniewski in his Homo Optimus book recommends 1g protein to about 2g of animal fat to 0.5-1g of carbohydrates per 1kg of the ideal body weight per day.
Stan
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