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Posted 8/17/2018 6:27 AM (GMT -5)
A new study was posted in Lancet dealing with the consumption of carbs and mortality. I thought it might be of interest to those folks dealing with diet changes. Here’s what the authors gave as findings:

“Both high and low percentages of carbohydrate diets were associated with increased mortality, with minimal risk observed at 50–55% carbohydrate intake. Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality, suggesting that the source of food notably modifies the association between carbohydrate intake and mortality.“

/www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext
Posted 8/17/2018 8:49 AM (GMT -5)
Look up the ketogenic diet. There is a body of evidence that shows a low carb, high fat diet is good treatment for a number of disease processes and is a healthy diet for many. More doctors are recommending this diet for dietetics, metabolic syndrome, epilepsy, certain brain tumors and weight loss. There is growing evidence that the diet might reduce other cancers.

Andrew
Posted 8/17/2018 10:22 AM (GMT -5)
Interesting. I have found that a low carb diet is the only way I have been able to successfully lose weight. It's not necessarily easy, but I find it mostly do-able. This seems to suggest plant-based protein is better than animal-based, which makes sense.

As a treat for this summer, I've suspended my low carb intake between the 4th of July and Labor Day--we'll have to see how much weight I will have added during this two-month period.
Posted 8/17/2018 10:31 AM (GMT -5)
my wife has been doing the whole 30 diet with some modifications for a year. she just turned 49 and she runs 25 miles a week and has dropped nearly 40 pounds. she has been a runner for years -- has a run club that she started and has run many marathons and even the ironman the year I was diagnosed -- and I've never seen her this fit and energetic.
Posted 8/17/2018 10:42 AM (GMT -5)
BTW I mention whole 30 as an alternative to ketogenic which she does not believe is healthy,
Posted 8/17/2018 1:52 PM (GMT -5)
low carb is what matters most - especially refined sugars and heavily processed foods.
Posted 8/17/2018 3:44 PM (GMT -5)
Its might not be true that low carb is a healthier diet in the long term. The new study posted in The Lancet found that Low carb diet is associated with a lower expected life span with 15.000 people that and 25 years follow up time. Is is an observational study.

If carbohydrates account for about half of the total calorie intake of a middle-aged person, that person will have an expected life span of 83 years, according to researchers estimates. It will be 82 years at a high carbohydrate diet and only 79 years at a low-carb diet.

The Lancet study said...
We found that low carbohydrate dietary patterns favouring animal-derived protein and fat sources were associated with higher mortality.

The Lancet study said...
Long-term effects of a low carbohydrate diet with typically low plant and increased animal protein and fat consumption have been hypothesised to stimulate inflammatory pathways, biological ageing, and oxidative stress.

Posted 8/17/2018 3:45 PM (GMT -5)

InTheShop said...
low carb is what matters most - especially refined sugars and heavily processed foods.

But I think the study says "medium carbs" is best. "“Both high and low percentages of carbohydrate diets were associated with increased mortality, with minimal risk observed at 50–55% carbohydrate intake. ".

But, just another study that does not correlate with my observations. Your statement more closely corresponds with my observations. And I can, without question, find some studies that do seem to match my observations.

I still prophesy that after we are all gone, they will finally confirm what I have long said: it is all about the insulin. Significantly lower the average fasting insulin levels(the very thing that carbs raise a little or a whole lot), and you will significantly improve all manner of health issues, including the poster child for high insulin levels/insulin resistance, type 2 diabetes. As many T2D folks who have sought to lower naturally produced insulin(by dramatically lowering carbs) can attest, I'm sure. In fact, I know a few who have had dramatic reversals simply by drastically cutting net carbs. As opposed to the vast majority(in the pst at least) of type 2 diabetics who instead attempt to treat T2D with either drugs that increase their own insulin, or actually inject insulin. So they treat a disease characterized by high insulin levels by adding more insulin. No wonder so many doctors say "T2D is a progressive disease". IOW, expect it to get worse despite treatment.
Posted 8/17/2018 4:02 PM (GMT -5)
"low carb is what matters most - especially refined sugars and heavily processed foods."

type of carbs matters too. e.g., whole 30 eliminates grains and rice but you can eat potatoes. whole 30 also eliminates all processed food, booze, sugar and fake sugar -- among other things.
Posted 8/17/2018 4:09 PM (GMT -5)
In the research I've done ( See my blog post: /andrewsviewoftheweek.com/2018/06/03/ketogenesis-or-how-to-burn-fat-without-fire/ )

I've found the best way to treat T2D is to drastically reduce carb intake which dramatically reduces insulin levels and in many causes removes the needs for medications. I've seen recommendations from doctors and dietitians that T2D patients should consume 100 to 120 grams of carbs a day and then take lots of medication to counteract those carbs. Makes no sense - if you can't tolerate insulin why eat foods that increase it? Reducing carbs reduces the insulin and reduces the need for the meds.

I found a lot of studies, science and medical research that shows a reduced carb diet is healthy, likely normal, and does not as many would suggest cause harm.

Currently I've reduced my carb intake and feel better than I have in years.

If you want a good book to read on the subject I recommend, Richard David Feinman, "The World Turned Upside Down: The Second Low-Carbohydrate Revolution" He covers the biochemistry, the studies, and the myths of carbs in the diet.

Andrew
Posted 8/17/2018 4:15 PM (GMT -5)

Gemlin said...
Its might not be true that low carb is a healthier diet in the long term. The new study posted in The Lancet found that Low carb diet is associated with a lower expected life span with 15.000 people that and 25 years follow up time. Is is an observational study.

If carbohydrates account for about half of the total calorie intake of a middle-aged person, that person will have an expected life span of 83 years, according to researchers estimates. It will be 82 years at a high carbohydrate diet and only 79 years at a low-carb diet.

The Lancet study said...
We found that low carbohydrate dietary patterns favouring animal-derived protein and fat sources were associated with higher mortality.

The Lancet study said...
Long-term effects of a low carbohydrate diet with typically low plant and increased animal protein and fat consumption have been hypothesised to stimulate inflammatory pathways, biological ageing, and oxidative stress.

So, as always with these types of studies, is there any sort of unintended( or intended) bias? IOW, how well matched was the health of the folks before they began observing them? Kind of like some folks that take some vitamins or a certain diet because they are worried about some disease they have or seem to be headed for? Is it possible that the low carb group were low carb because they were obese, or pre-diabetic, or all ready type 2 diabetic, and or along with any of that the associated hypertension and heart disease, even cancers? I have not yet waded through the entire article yet, so I'm asking: did they adjust for all of the possible differences in health? Or did the only look at the % of carbs, not considering health reasons why folks took up low carb eating in the first place? Because unless they adjusted, (and surely they must have?), then the low carb group that died a very little bit earlier might consist of a group that was less healthy in several different ways before they started observing them, indeed even before they began low carb dieting. And if that is the case, instead of dying a couple of ears earlier than the best group, without the low carb eating they might have died even sooner.

But, I have not found it yet: does anyone know: did they adjust for all possible factors other than just how many carbs the ate? I do see that the lowest carb group has a higher diabetes rate than the higher carb goups(a bit counter intuitive). But does that mean that the lowest carb group had more diabetes at the start(which might be why the switched to low carb eating in the first place)? Or does that mean they got diabetes later on as a result of low carb eating(highly unlikely, but who knows?). If they had more diabetes at the start, which is why they were lowering carbs, then no wonder they had a slightly higher death rate.

If that is not enough to question, the low carb eaters also had a MUCH higher % of smokers! And I seriously doubt the smoking caused them to become low carb eaters. That right there, if not adjusted for, would give that group a higher death rate. But did they adjust for these factors? If not, the results are meaningless.
Posted 8/17/2018 4:19 PM (GMT -5)

F8 said...
"low carb is what matters most - especially refined sugars and heavily processed foods."

type of carbs matters too. e.g., whole 30 eliminates grains and rice but you can eat potatoes. whole 30 also eliminates all processed food, booze, sugar and fake sugar -- among other things.

In the keto diet you'd eliminate the starchy veggies like potatoes and would add lots of the non-starchy ones.

However, just stopping processed foods, grains, alcohol, and sugar (real or fake) goes miles and miles towards health. That alone is good enough for most people and is so much better than the SAD (standard American Diet) plan.

If you have things like T2D or metabolic syndrome, going further into very low carb is likely needed to regain health.

Andrew
Posted 8/17/2018 4:29 PM (GMT -5)

BillyBob@388 said...


But, I have not found it yet: does anyone know: did they adjust for all possible factors other than just how many carbs the ate? I do see that the lowest carb group has a higher diabetes rate than the higher carb goups(a bit counter intuitive). But does that mean that the lowest carb group had more diabetes at the start(which might be why the switched to low carb eating in the first place)? Or does that mean they got diabetes later on as a result of low carb eating(highly unlikely, but who knows?). If they had more diabetes at the start, which is why they were lowering carbs, then no wonder they had a slightly higher death rate.

In his book, Dr. Feinman, finds flaws in most diet studies. Common problems are relying on participates reporting foods consumed, badly formed experiments, not accounting for all factors that affect the study, creative statistics to manipulate the results, using "intent to treat" methods to create false data, and tons of other issues. Few of the studies are truly randomized or have problems with the control groups.

Honesty, I am skeptical of most diet studies as most don't even pass my common sense BS detector.

Andrew
Posted 8/17/2018 4:32 PM (GMT -5)

Somebody said...
There are limitations to this study that merit consideration. This study represents observational data and is not a clinical trial; however, randomised trials of low carbohydrate diets on mortality are not practical because of the long duration of study required. Another limitation of this study is that diet was only assessed at two time intervals, spanning a 6-year period, and dietary patterns could change during 25 years. However, because participants are able to increase or decrease their consumption of carbohydrates during the course of follow-up, any dietary changes that occur after the described assessments would be expected to attenuate any observed associations. Our conclusions about animal fat and protein might have less generalisability to Asian cultures, which often feature very high carbohydrate consumption but with a primary meat source that is often from fish. In fact, the plant score calculated in the Japanese cohort, NIPPON DATA80,24
included fish as a source of protein as well. Hence, animal scores reported here are composed largely of beef, pork, and fowl, in addition to fish. An additional limitation is that the international data13
about very high carbohydrate intakes, largely derived from China, are, on average, higher than the national data,30
for unclear reasons. However, the advantage of these data is that they include multi-racial and ethnic groups across a spectrum of socioeconomic groups, and they are representative of many high quality cohorts. Given the relatively small number of individuals adhering to low carbohydrate diets with mainly plant-based protein and fat sources of macronutrients, this study could not definitively examine the relative benefits of this diet compared with other dietary patterns. Our study focused on general carbohydrate intake, which represents a heterogeneous group of dietary components. Any number and combination of dietary components could have been considered and adjusted for in this analysis; therefore, some confounders might have been unadjusted for. Ideally, it would be preferable to do an individual-level meta-analysis in a collaborative effort that would have allowed for consistent adjustment for confounders in pooled analysis. Finally, some degree of measurement error is unavoidable for all dietary assessment methods, and the absolute intakes need to be interpreted cautiously.



What I am trying to figure out is: did they adjust for the major confounders of higher diabetes and much higher smoking among the lowest carb group? I can not find where they say they did. Anyone know?
Posted 8/17/2018 4:35 PM (GMT -5)
I can't find where they did that.

Maybe I missed it.
Posted 8/17/2018 4:43 PM (GMT -5)

Somebody said...
Briefly, papers were eligible for inclusion if they were a published full-text report, observational study, or randomised controlled trial with a minimum of 1 year follow-up, reporting relative risks (ie, HRs, risk ratios, or odds ratios with CIs), and adjusted for at least three of the following factors: age, sex, obesity, smoking status, diabetes, hypertension, hypercholesterolaemia, history of cardio-vascular disease, and family history of cardiovascular disease.

OK, though these were probably mostly not RCT, it looks like there was an attempt to adjust for some things. Still, if the difference in projected life span was only 2-3 years(over a 30+ year period) from worst group to best, but the worst(lowest carb ) group had a significantly greater # of diabetics and a much greater % of current smoker and far fewer "never smoker", wouldn't you expect that group to have a higher mortality anyway? By a couple of years when looking out 30+ years? I may be wrong, but I would expect the group with more diabetes and much higher smoking to die at least couple of years sooner even if they all ate the same thing. Does that seem like a wild assumption?
/www.webmd.com/diabetes/news/20101201/diabetes-cuts-years-off-life-span-of-americans#1

Somebody said...


Dec. 1, 2010 -- Diabetes cuts about 8.5 years off the life span of the average 50-year-old compared to a 50-year-old without diabetes, new research indicates.

The study also shows that older adults with diabetes have a lower life expectancy at every age compared to people who do not have the disease. For example, researchers say, the difference at age 60 is 5.4 years;..........................

/www.medicalnewstoday.com/releases/9703.php

Somebody said...
Researchers at 'Action on Smoking and Health' have reported that a 30-year-old smoker can expect to live about 35 more years, whereas a 30-year-old non-smoker can expect to live 53 more years. In addition, the children of a parent or parents who smoke may be at risk from the genetic damage done to the parent before conception (because of their previous smoking), the direct effects to them in the womb, and the passive smoke they are exposed to after they are born.

Source: Smokers urged to weigh the 'facts' during the 'Great American Smoke-Out,' Vital Signs, The Daily Progress, Charlottesville, Virginia, Nov. 14, 1993, written by June Russell, a member of Smoke-Free Charlottesville

The amount of life expectancy lost for each pack of cigarettes smoked is 28 minutes, and the years of life expectancy a typical smoker loses is 25 years.

Source: Dying to Quit," 1998 book by Janet Brigham

Post Edited (BillyBob@388) : 8/17/2018 3:53:44 PM (GMT-6)

Posted 8/17/2018 4:52 PM (GMT -5)
Of course there's last year's study, also in the Lancet, that found something else entirely: Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study This study recruited internationally trying for more socio-economic balance. It found that those who ate a high fat diet had lower all-cause mortality than those who ate the most carbs. I'll leave it to you to read their results but, to pique your interest, I will mention that they found that saturated fat lowers your risk of stroke.

And for those of us who are very low-carb, or ketogenic, or paleo, I will point out that all of our diets have a miss-is-as-good-as-a-mile aspect that makes us largely uninterested in incremental changes in the middle of the macro-nutritional balance spectrum. These studies just don't say that much about us.
Posted 8/17/2018 4:58 PM (GMT -5)

PeterDisAbelard. said...
Of course there's last year's study, also in the Lancet, that found something else entirely: Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study This study recruited internationally trying for more socio-economic balance. It found that those who ate a high fat diet had lower all-cause mortality than those who ate the most carbs. I'll leave it to you to read their results but, to pique your interest, I will mention that they found that saturated fat lowers your risk of stroke.

And for those of us who are very low-carb, or ketogenic, or paleo, I will point out that all of our diets have a miss-is-as-good-as-a-mile aspect that makes us largely uninterested in incremental changes in the middle of the macro-nutritional balance spectrum. These studies just don't say that much about us.

Your study is 1 example of many of why I said: "But, just another study that does not correlate with my observations. Your statement more closely corresponds with my observations. And I can, without question, find some studies that do seem to match my observations."
Posted 8/17/2018 5:12 PM (GMT -5)
"However, just stopping processed foods, grains, alcohol, and sugar (real or fake) goes miles and miles towards health. That alone is good enough for most people and is so much better than the SAD (standard American Diet) plan."

yeah I agree. We eat too much junk and too many carbs. on my last physical my cholesterol was higher than ever and the doctor is now talking about meds -- I was at the top of a fat cycle and I wasnt too strict about fasting the night before the blood draw. so I asked for a retest in two months.

in the past six weeks I've dropped almost 15 lbs through weigh***chers. I go there mostly for accountability and I don't count points -- because I know what I can eat and how much. and my diet is low carb, more vegetables and fruits and of course portion control. I've also stepped my gym work up a bit.
Posted 8/17/2018 9:42 PM (GMT -5)
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Posted 8/18/2018 2:24 PM (GMT -5)
For what it’s worth, I’ve found the best diet is 3 square meals a day, with a maximum calorie intake based on weight, height, goal, etc. Combined with weight training and cardio 5x + a week, it’s been the easiest for me, and I’ve tried them all.

I keep my calorie intake to 2,000 calories per day, documented on a phone app., and workout with weights three days a week and cardio the other three.

I also believe this type of diet will lead to the longest life span, as well as overall health today.
Posted 8/18/2018 4:21 PM (GMT -5)
Dewayne...that diet sounds immensely sensible. But for me...it's the wine with dinner (or weekend cocktails) that tends to put me over the 2,000 calories/day. Now clearly, there's an easy way for me to deal with that...
Posted 8/18/2018 4:56 PM (GMT -5)
Interesting thread. I am reading a most intriguing book "intuitive eating", and the base premise is diets are bad and lead to weight gain eventually due to deprivation. If we can listen to our bodies we will find/relearn how to eat healthily. While this book does not address specific disease it is based on studies of the ineffectiveness of long-term health and weight stabilization.

I am an expert at losing weight and gaining it also. I am the best shape of my life and starting to eat based on mindful eating. My energy level is high and I feel good about food. Something to think about.
Posted 8/18/2018 5:41 PM (GMT -5)

Michael_T said...
Dewayne...that diet sounds immensely sensible. But for me...it's the wine with dinner (or weekend cocktails) that tends to put me over the 2,000 calories/day. Now clearly, there's an easy way for me to deal with that...

I hear you. I like beer. One thing I’ve done is replace french fries with green beans, and it’s made up some points.

I try to eat one of the frozen ‘Lean Cuisine’ meals a day, usually for lunch, and I eat the same 400 calorie breakfast every day (steel cut oatmeal, 3/4 piece of ‘Food for Life’ raisin bread - with my Dachsund getting the other 1/4, and 4 oz of orange juice mixed with water).

So, after breakfast and lunch I’m usually around 650 calories, which leaves about 1350 for dinner. I can have a good meal for 1,000 calories and three light beers if I want then, and still be within my calorie count for the day.
Posted 8/18/2018 10:46 PM (GMT -5)
Dennis,

I've never encountered a diet book that didn't totally sell me in the introductory chapter where it talks about why all those other diet books are mistaken. It's the part that comes later, where they try to tell me what I ought to eat, and why I ought to eat it, where they mostly seem to go wrong.

As for listening to my body, I've tried that. It sings to me -- arias on double cheeseburgers and rhapsodies over hot fudge sundaes -- and I've decided that my best shot at managing my weight is to find ways to get it to shut the heck up.
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