Are some diets “mass murder”?

[blutoski]

From the department of "No, don't hold back... tell us what you *really* think."

BMJ: [Are some diets “mass murder”?]

Excerpt:

Jean Mayer, one of the “greats” of nutrition science, said in 1965, in the colourful language that has characterised arguments over diet, that prescribing a diet restricted in carbohydrates to the public was “the equivalent of mass murder.”1 Having ploughed my way through five books on diet and some of the key studies to write this article, I’m left with the impression that the same accusation of “mass murder” could be directed at many players in the great diet game. In short, bold policies have been based on fragile science, and the long term results may be terrible.2 3 4 5 6

Blutoskitorial:

It's an editorial by Richard Smith, who was actually editor of the BMJ for years and IMO highly esteemed. I also think he may be regrettably moving into Paul Hellyer and Linus Pauling territory in his sunset years.

 

[jaydeehess]

Mass murder would be hyperbole. However criminal negligence and disregard for safety....

 

[luchog]

Well the "Jeffrey Dahmer Diet" might qualify...

 

[Tatyana]

Did anyone read the rapid responses?

I thought they covered the issues with the editorial quite well.

The BMJ isn't afraid to tackle controversial issues, normally, they are far more scientific about it.

 

[Modified]

It was the mistake of believing "You are what you eat, so of course eating fat makes you fat", without any real evidence. A lot of people still believe that today, and more yet believe that eating cholesterol will raise your cholesterol (it seems to have a small effect, but there aren't any foods with enough cholesterol to matter in any case).

Meanwhile bodybuilders and wrestlers continued to cut carbs to lose fat/weight all through the "high carb diets are good" years. Yes, it was often to an unhealthy degree, but there was never any doubt that it worked.

 

[Tatyana]

It was the mistake of believing "You are what you eat, so of course eating fat makes you fat", without any real evidence. A lot of people still believe that today, and more yet believe that eating cholesterol will raise your cholesterol (it seems to have a small effect, but there aren't any foods with enough cholesterol to matter in any case).

Meanwhile bodybuilders and wrestlers continued to cut carbs to lose fat/weight all through the "high carb diets are good" years. Yes, it was often to an unhealthy degree, but there was never any doubt that it worked.

Not exactly.

There are some people that synthesise too much cholesterol (statins work on lowering cholesterol if this is the case) and some people absorb too much cholesterol (different drugs target these individuals) and it can have a significant effect on their serum cholesterol levels.

The low carb dieting has been dropped by most bodybuilders. Even when people used it for dieting, they would still have refeeds once a week or else take quite massive doses of liothyronine (T3) as carbohydrates are required for the peripheral conversion of T4 to T3.



The suppression of the thyroid hormones due to low carb dieting suppresses metabolic processes, which has a lot of the efforts of dieting grind to a stand still.

Low carbohydrate dieting really isn't very good for athletes of any sort.

There are probably applications for obese individuals, but eliminating an entire food group is basically falling into the same mistake people made with reducing or eliminating fat from the diet.

 

[casebro]

Thanks Tatyana. I googled a bit and see you are correct, for the healthy. But apparently not for those of us who are insulin insensitive. For us, low carbs is better for t4->t3.

Metabolism is tough science. I've been reading up on choline after finding that eggs and liver relieved my myopathy. I have known for years that beef helped me, but had thought it was the carnitine. Nope, it was the choline in the beef. "If you think you understand cellular respiration, you've missed something". Of course, maybe I really need on of the other things that the body turns choline into- folate, methionone, a veritable encyclopedia of complications.

One tidbit I read is that about 20% of us have a gene that means we need 2-3 times the choline. Which lead me to 23andMe, who does gene checks on your spit. $99, and they give a list of how your 970,000 SNPs read. Currently, we only know the effects of a few hundred of them. More to come, in a landslide. But geeze, it means we each probably need our own custom tailored diets.

I wonder when Obamacare will cover geneto-dieticians? Probably better for us than a Clogged Artery Vaccine.

 

[bit_pattern]

I've just been unsuccessfully Googling to find the study but recently (i.e. the last year or two) the results of a longitudinal study into mice being fed a low-carb diet found that while the mice certainly had reduced body weight they also had shorter lives and a poorer quality of life (i.e. more disease etc) than mice kept on a balanced diet.

I tend to think the low-carb obsession is pretty much dangerous woo that people may live to regret following in their later years.

 

[Modified]

The low carb dieting has been dropped by most bodybuilders. Even when people used it for dieting, they would still have refeeds once a week or else take quite massive doses of liothyronine (T3) as carbohydrates are required for the peripheral conversion of T4 to T3.

They are still reducing carbs pre-contest, no?

 

[Modified]

Not exactly.

There are some people that synthesise too much cholesterol (statins work on lowering cholesterol if this is the case) and some people absorb too much cholesterol (different drugs target these individuals) and it can have a significant effect on their serum cholesterol levels.

Interesting. It appears that about 25% of the population are cholesterol-sensitive. It seems like that would be a good thing to know and test for. Also, for most of the rest of the population, dietary cholesterol has a negligible effect on blood cholesterol.

 

[casebro]

Moddy, my reading tells me that the best dietary changes can do is lower cholesterol numbers by 5%.

BUT, the fibrate family of drugs have been shown to lower serum lipids, but NOT to lower end points. Which fact is one more datum that makes me doubt the whole cholesterol-> heart disease "science". I suspect a major confounding between fats and umm, and um......

Lets just say I eagerly await my next labs, what with all the choline I've been eating.

 

[casebro]

Another statistical exagerration:

I'm at the top 2 percentile of height.

I'm at the top 3 percentile by weight.

So, I'm 50% under weight.

 

[ThunderChunky]

Not exactly.

There are some people that synthesise too much cholesterol (statins work on lowering cholesterol if this is the case) and some people absorb too much cholesterol (different drugs target these individuals) and it can have a significant effect on their serum cholesterol levels.

Not all cholesterol is bad and carbohydrates also influence cholesterol profiles. The "saturated fat causes heart disease hypothesis" has totally unraveled, not because saturated fats don't raise cholesterol levels but because cholesterol levels do not cause heart disease in the way it was once believed.

 

[Modified]

Not all cholesterol is bad and carbohydrates also influence cholesterol profiles. The "saturated fat causes heart disease hypothesis" has totally unraveled, not because saturated fats don't raise cholesterol levels but because cholesterol levels do not cause heart disease in the way it was once believed.

In my reading yesterday, I find that there are multiple forms of LDL, and some are thought to be harmless or nearly so, so even LDL/HDL ratio may not be meaningful in some cases.

 

[Red Baron Farms]

cholesterol levels do not cause heart disease in the way it was once believed.

Love the way you carefully worded that. Correct! Cholesterol levels do not cause heart disease in the way it was once believed. However, it does in new ways never suspected. But it is more like a symptom than a cause.

 

[Nonpareil]

Isn't mass murder sort of the point when it comes to diets?

 

[Tatyana]

They are still reducing carbs pre-contest, no?

If you mean carb depleting then carb loading, yes, that is still popular.

Some people still use ketogenic diets, carb cycling etc, but a lot of the non-enhanced (not using performance enhancing drugs) athletes have stopped using low carb dieting.

 

[blutoski]

Did anyone read the rapid responses?

I thought they covered the issues with the editorial quite well.

The BMJ isn't afraid to tackle controversial issues, normally, they are far more scientific about it.

This is the two-sided coin of the Editorials section in any peer-reviewed publication... the content is intended to be thought-provoking and to give the publication credibility of being fair to 'different ideas' that may have some merit, even if they are not currently demonstrable in the literature.

Unfortunately, I think Dr. Smith has done the Paul Hellyer thing and become enraptured by some nonfiction books by nonexperts because they have a great narrative and claim to have done the science, and he wants to go out (how old is he? could he be 90 now?) with a swan song as the Elder Statesman who championed the underdogs.

Pick up the phone, pull some strings at the publication he edited for decades, get an editorial published. What else could they do?

 

[Tatyana]

Not all cholesterol is bad and carbohydrates also influence cholesterol profiles. The "saturated fat causes heart disease hypothesis" has totally unraveled, not because saturated fats don't raise cholesterol levels but because cholesterol levels do not cause heart disease in the way it was once believed.

Again, not exactly. Like all of human biochemistry, it's complicated.

Lipid biochemistry is complicated, nutrition is complicated, and while it does look like saturated fat from animal muscle doesn't negatively impact the fatty acid profile in the body, the fat from dairy, like butter and eggs, may have more of a damaging effect.

There are some people who will have HDL polymorphisms that will make them almost bullet proof with regard to diet, and others who are going to be plaque forming monsters from birth.

In essence, the study found that people at the extreme ends of the
spectrum - that is, those who ate the most or least saturated fat -
had the same chance of developing heart disease. High consumption of
unsaturated fat seemed to offer no protection.

As well, this whole media storm that 'you can eat all the bacon you want, scientists got it wrong' was started by one opinion piece in the BMJ.

I would have thought that after Wakefield, sceptics would be far more critical of all research.

New Scientist did a nice review on the whole thing, unfortunately, most of it is behind a paywall, but you can get an idea from this editorial commentary on the articles:

http://www.newscientist.com/article/mg22329801.400-fat-and-sugar-diet-of-confusion.html#.VJSGrsgKA


I did find a reprint on a blog, from memory of reading it in the magazine, this does appear to be the same, and where I took the quote from:

http://stirling-westrup-tt.blogspot.co.uk/2014/08/tt-ns-2980-heart-attack-on-plate-truth.html

 

[blutoski]

Again, not exactly. Like all of human biochemistry, it's complicated.

My thought is that it's simultaneously complicated and simple. There is a tendency to drill down into incredible detail, which feels like a distraction from larger scale dietary problems.

There is uncertainty about a lot of things, such as whether saturated, unsaturated fats, dietary cholesterol, w6/w3 ratios, LDL/HDL ratios, inflammatory properties, BMI, blah, blah, blah... but at the end of the day this is micromanagement since 99% of the risk is associated with smoking, drinking, obesity.

I've submitted some examples just for illustration purposes in other posts and here's another: I have a colleague who is rather obsessive about her macro/micro nutrient ratios and bioavailability, and spends considerable time planning for, shopping for, and preparing meals. My personal opinion is that if she just used that hour a day to figure out how to eat less and get some exercise to lose that extra 100lbs, she'd be much healthier, no matter what she was eating. She's not a competitive bodysculptor or professional athlete.

Smoke less, drink less, maintain <25% body fat, get 30mins exercise per day, eat less mostly plants. Everything else is sweating the small stuff; rearranging the deck chairs on the Titanic.