Big fat lies

Hanna Sutter from Big Fat Lies in Daily Mail:

«For the past 30 years we’ve been told to eat less and exercise more, to cut back on calories and on saturated fat and, on the whole, we’re doing it.
Our calorific intake between the years 1974 and 2004 decreased by 20 per cent. We are eating about 20 per cent more fruit and vegetables than in the Seventies. 
We are doing approximately 25 per cent more exercise than we were in 1997.
But are our waist lines shrinking? No

Is the british government responsible for the obesity epidemic?

Cancer as a metabolic disease

Is cancer a metabolic disease?
In principle, there are few chronic diseases more easily preventable than cancer.
Seyfried and Shelton 2010

A new and important article in Nutrition and Metabolism makes a case for cancer as predominately a metabolic disease. Research has shown that one of the key features of cancers is an impaired or damaged respiration. In fact, as the authors put it, “Aerobic glycolysis, arising from damaged respiration, is the single most common phenotype found in cancer.” Evidence is reviewed supporting a hypothesis that cancer is a disease of energy metabolism, primarily liked to mitochondrial function.

The hypothesis isn’t new. It was first proposed in the early twentieth century, but was soon displaced with the view of cancer as a genetic disease. Emerging evidence however, questions the genetic origin of cancer and suggests that cancer is primarily a metabolic disease. Damage to cellular respiration may easily precede and underlie the known genome instability associated with tumor development. Once genome instability is established, it increases and furthers respiratory impairment which increases mutation and tumor growth, and we’ve got ourselves a vicious cycle.

The article asks the question “Is it genomic instability or is it impaired energy metabolism that is primarily responsible for the origin of cancer?

The question is of immense importance, as the answer will impact the way we view and treat cancer.

Dietary energy restriction has been used to lower glucose levels, thus reducing growth and progression of several tumor types, like mammary, brain, colon, pancreas, lung, and prostate cancers. Enhanced glycolysis (breakedown of glucose) is required for the rapid growth and survival of many tumor cells, and a treatment targeting cell metabolism will be of great importance.

A shift from glucose to ketone body and fatty acid use would be beneficial because it targets only cancer cells with their reliance on glycolysis, while being benign or even beneficial for normal cells. Not only do cancer cells rely heavily on glucose for fuel, but many do also have abnormalities in the genes and enzymes needed to metabolize ketone bodies for energy.

Despite making a case for a shift in metabolism from glucose to ketone body use, the authors do not make a case for low carbohydrate diets, but rather propose the use of energy restriction to cause a dietary ketosis.
Prostate and gastric cancer are manageable using low carbohydrate ketogenic diets, and these diets are far more efficient and safe for inducing dietary ketosis compared to general energy restriction. Metabolism of ketone bodies for energy can also maintain mitochondrial health and efficiency thus reducing the risk of cancer development.

From the conclusion: 
Two major conclusions emerge from the hypothesis; first that many cancers can regress if energy intake is restricted and, second, that many cancers can be prevented if energy intake is restricted. Consequently, energy restricted diets combined with drugs targeting glucose and glutamine can provide a rational strategy for the longer term management and prevention of most cancers.
Despite beating about the bush when it comes to carbohydrate restriction, this is recommended reading!

It’s your choice

A recent study by Yancy et al shows that going on a low fat calorie restricted diet in combination with the shady orlistat drug results in the same weight loss as a low carbohydrate diet over a 48 week period.
In other words, go on a low fat hunger inducing diet with no scientific merit for long time success and spend your money on drugs. Or, eat what you want when you want as long as you keep carbohydrate intake at a minimum. Oh, and did I mention the low carbohydrate diet results in an overall larger reduction in cardiovascular risk factors?
The study her:
Jimmy More elaborates here:

The tide is turning

Ronald M Krauss, former Senior Advisor to the National Cholesterol Education Program, actively involved with the American Heart Association, former Chairman of the Nutrition Committee, has in collaboration with Siri-Tarino Patty, Sun Qi and B. H. Frank conducted meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Although I have yet to read the entire article the abstract is promising.
Twenty-one studies with 5–23 years of follow-up of 347,747 subjects gave this uplifting conclusion:
“A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.”
I enthusiastically await the response of the nutrition community.
Abstract of article here:

The devil is in the details

Sherlock Holmes is back on the screen. A master of deduction and a firm believer in science, he is showing us the devil is in the details. But even data acquired through vigorous scientific studies need to be exposed to the same meticulous scrutiny worthy of Holmes. For the devil does seem to reside comfortably in the details. 
Recently, a study written by Frank Sacks and colleges was published in renowned New England Journal of Medicine. It examined the effects of four diets differing in macronutrient composition. The study was to a large degree flawed by bad design decisions. The diets were too similar at baseline and ended up looking close to identical. In addition, the researchers chose to do an “intent to treat” analysis witch made it impossible to see the exact effect of following the prescribed diets. Reading Sacks et al we find this, “A smaller group of studies that extended the follow-up to 1 year did not show that low-carbohydrate, high-protein diets were superior to high-carbohydrate, low-fat diets.” The statement is immediately followed by a group of good looking references which supposedly have shown that low carb dieting for one year is no more effective than low fat dieting. But this is not what the referenced articles show us. It is what they try to tell us, but their data tells a different story.  Reading the entire articles, looking closely at the details we find that the statement of Sacks et al is in fact false.
Two of the referenced articles are Foster et al 2003 and Stern et al 2004. Both studies compared a diet low in fat and calories with one low in carbohydrates over one year. Main outcome was (or was supposed to be) weight change.
Foster et al tells us the low carb group lost on average 4.4kg while the low fat group lost 2.5kg. This difference of 1.9kg is not significant and he authors cannot rightly claim that there was a difference. But these numbers also include the subjects in the study who for various reasons didn’t follow their prescribed diet. If we look at the difference between the two groups when we only include those who actually stayed on the diet for a full year the numbers are 7.3kg for the low carb group and 4.5kg for the low fat group. The difference increases to 2.8kg. It might still not be significantly different, but it’s hard to say the diets are the same. In the discussion section Foster et al writes: “The lack of a statistically significant difference between the groups at one year is most likely due to greater weight regain in the low-carbohydrate group and the small sample size.” But weight regain in the low carbohydrate group appeared when carbohydrates were reintroduced to the diet. The underlying conclusion is that decreasing carbohydrates makes you lose weight and increasing carbohydrate intake makes you regain weight.
Similarly, in the study by Stern et al the average weight loss at one year was 5.1kg in the low carb group and 3.1kg in the low fat group. A 2kg difference. The conclusion in their abstract is, “Weight loss was similar between groups… Once again, if only the subjects who completed one year of dieting were examined the low carb group lost on average 7.3kg and the low fat group lost 3.7kg. A 3.6kg difference. Once again the actual effect of following the prescribed diet is covered up by a statistical tool which includes all participants in the study, whether they actually stayed on the diet or not. In addition, Stern et al also reintroduced carbohydrates to the low carb group thus slowing the weight loss and causing weight regain.
The best part of the article from Stern et al is this, “Persons on the low-carbohydrate diet who dropped out lost less weight than those who completed the study (change, -0.2 ± 7.6 kg vs. -7.3 ± 8.3 kg, respectively; mean difference, -7.1 kg [CI, -11.6 kg to -2.8 kg]; P = 0.003).
This tells us that the subjects who followed the low carb diet for one year lost on average 7.3kg while the subjects who didn’t complete the diet, but was still a part of the final analysis lost on average 0.2kg of weight. And it is natural to assume that following a diet gives a different result from not following the diet. But, when looking at the low fat group in the same study we find that, “In contrast, weight loss was not significantly different for those on the conventional diet, whether they dropped out or completed the study (change, -2.2 ± 9.5 kg vs. -3.7 ± 7.7, respectively; mean difference, -1.5 kg [CI, -5.7 kg to 2.7 kg]; P > 0.2).
Translated, the subjects who completed one year of low fat dieting lost on average 3.7kg of weight while the subjects who didn’t follow the diet lost 2.2kg. What this last part implies is that following a low fat diet is no more effective than not following a diet at all.
In conclusion two of the studies wildly cited for not showing a difference between low fat versus low carb diets, actually showed that reducing carbohydrate intake is more effective than reducing fat intake, that decreasing dietary carbohydrates make you lose weight while increasing intake of carbohydrates slows weight loss, and that following a low fat diet is about as effective as not following a diet. The rest of the references in Sacks et al show a similar pattern.
The devil is tapping his hoof to the beat of his fiddle. Salvation is apparently found in the overexcited use of statistical tools, and Sherlock… Sherlock drugged himself silly to get away from all the nonsense.
If you want more details, read this:
and this: