Saturday, 28 January 2017

The Old Ivory Tower v Nutritional Knowledge

The "trial" of Dr Tim Noakes, is a front for an attack by the nutrition establishment on the Banting Diet. What is the nutrition establishment? In South Africa, it's represented by Stellenbosch University, the dietitians, nutrition scientists, most doctors, and the government departments that control these professions. But more than that, all of these professional bodies have close ties with industry the provide the money, that pays the salaries of key people.

The Banting Diet is a threat to the sugar industry, bakers, grain producers, bread, biscuit and confectionary manufacturers, it's also threatening to the government. The Banting diet demonstrates that the wages of ordinary people cannot sustain a healthy diet. That food based on corn, and corn and more corn, no matter how you dress it up, is poor quality food and an entirely inadequate diet. A diet lacking in animal fats is cheap, but it isn't a healthy diet. That message is dangerous. Powerful forces want to discredit it.

In South Africa, as the proceedings come to an end, in April, it's the established dietary practice that is really on trial, not Dr Noakes. Fortunately, at least in South Africa, and at least on the narrow point, of weaning small children, "official" recommendations have recently changed, and are in line with current science. On the specific issue of a diet for weaning, the official advice and Dr Noakes agree; Noakes is not guilty, and the official advice gets a pass mark.

However, that result will not serve the interests of the establishment, which needs a clear condemnation of very low carbohydrate diets, Banting Diets, for adults. The Stellenbosch University - Cochrane Collaboration Review: "Low Carbohydrate versus Isoenergetic Balanced Diets for Reducing Weight and Cardiovascular Risk: A systematic Review and Meta-Analysis," provides justification of the current dietary standards in South Africa. The study concludes that a low-carbohydrate diet has no advantages over the standard low-fat diet for weight reduction or cardiovascular risk.

This paper is offered as "proof" that there is no value in the Banting Diet. Banting requires you to significantly reduce your consumption of the cheapest foods available. Banting asks people to live almost entirely on protein and fat. Stellenbosch argues two points further against Banting, they say, "It is plausible that these low CHO diets could be harmful, especially over the longer term." They also state that the diet can't be maintained, and that people will revert back to their old dietary pattern, and put their weight on again.

This "conclusion" isn't in line with my own experience. I read the study, with disbelief. But the problem is in the language, and the definition. Low-carbohydrate for Stellenbosch, is defined as less that 45% of the diet from carbohydrates. The average dietary intake for 14 "low-carbohydrate" studies was 35% carbohydrate, 35% fat and 30% protein. That's very different from the 5% to 10% carbohydrate and 80% to 85% fat, of a genuinely low-carb, high-fat diet.

Converting to grams of carbohydrate: Low-carbohydrate for Stellenbosch, is defined as less that 240gm/d. Studies included had carbohydrate intakes less than 191gm/d. For the 14 studies I could get numbers for, the average is 180gm/d. NONE of the studies used had fat intake above 50% of total energy.

Compare that with what Banting recommends. Benefits begin when carbohydrates are less than 120gm/d, but ketosis is not achieved reliably until intake is as low as 50gm/d and even better at 25gm/d. This means that your fat intake needs to be 70% to 85% of your diet. So while the Stellenbosch University - Cochrane Collaboration Review: is consistent within itself, it does not look at very-low carbohydrate diets at all. The Stellenbosch University - Cochrane Collaboration cannot say that the Banting Diet is the same, or more, or less effective, for weight loss and cardiovascular risk, because they made a deliberate choice not to test that.

The conclusions the Stellenbosch University - Cochrane Collaboration Review makes are actually consistent with very-low-carbohydrate studies done by other people. Studies that were excluded from the Stellenbosch University - Cochrane Collaboration Review (I expect excluded for a reason, they undermine the desired outcome.). For instance this study is revealing; Effects of Step-Wise Increases in Dietary Carbohydrate on Circulating Saturated Fatty Acids and Palmitoleic Acid in Adults with Metabolic Syndrome," by B.M. Volk et al. Very briefly; above 400gm of carbohydrates a day weight gain can be expected, in a broad range down from 346gm/d to 179gm/d weight seems to be stable. At 131gm/d weight loss picked up, at 83gm/d and 47gm/d the rate of weight loss significantly improved.

Stellenbosch University tells us that there is no advantage in a low-carbohydrate diet. BUT the low carbohydrate diet they are referring to, has an average carbohydrate intake of 180gm/d. The study by B.M. Volk et al agrees with that. They show that weight loss began to be significant at 131gm/d, and was much stronger at even lower carbohydrate levels.

We can see here that carbohydrate restriction certainly works, but the best results require a very strong restriction that put the body into ketosis. That's not hard to do, but it is unusual, and it does require good understanding of the science and the dietary method for people to do this successfully. You can't instantly become an expert, it takes time and considerable study to gain the knowledge required.

There are many misstatements of fact in the Stellenbosch University - Cochrane Collaboration Review, statements of prejudice, I believe, rather than a deliberate misrepresentation of that science. For instance "When foods high on CHO are avoided, and replaced with high protein foods, reliance on animal protein sources becomes necessary." Who can argue with that? It's sentence that makes the same point twice. Once as a proposition and once as the obvious result. The problem is that this statement misrepresents what the Banting Diet says. In Banting, carbohydrate is replaced with fat, particularly with saturated fats, which for too long have been lacking in our diet.

Stellenbosch University and friends, are so lipophobic that the can't imagine a diet 70% or 80% fat. That prejudice appears over and over in their review.

Change Your Thinking, Change your Actions, Change who you are Becoming

If we have weight problems, the cause is faulty information that we believe is good health knowledge. We've all been indoctrinated. The news media, official government and medical sources, your doctor, the shelves in the supermarket, continually give you "information" that misdirects your ability to make good dietary choices.

If you can discover for yourself a more healthy diet, you and probably add 10 or 12 years of healthy life-span, to your life. I believe I've been able to do that. Time will tell.

Your knowledge tree has taken a lifetime to build. Our whole society has been misdirected by a faulty dietary theory, that is usually blamed on localAncel Keys in the USA. Fifty years ago, that eating fat makes you fat, an idea that seemed to be logical enough at the time. The mathematical and physics based principle that calories are calories, and therefore obesity was all about the failure to balance eating and exercise, had and still has, very wide support. These ideas are based on "common sense," not on any scientific knowledge. Sadly common sense, lets us down.

Diets don't work for a very good reason. I can tell you what to eat, and how to eat, in five minutes, but no matter how hard you try, you can't do it. Underneath any new dietary information, is a lifetime of previous learning much of directly conflicting with what you've just been told. After a few days, a week, or a month, the learning of a lifetime comes back to dominate what you do.

To succeed you have to unlearn a lot of stuff that you "know," but is causing you problems. ALL of this "knowledge" you've built up is there for a reason. It's there because you, your family, the community around you, agree with you, that this "knowledge is good." You are confident that you KNOW what a healthy diet is. Almost all of us, would make very similar lists, of good things to eat and bad things to eat. So if we are right, we should all be healthy and obesity should be rare.

But that's not the case. 11% are type 2 diabetic, 36% are overweight, and a further 33% are obese. What we KNOW is letting us down. Yet our minds won't allow us to learn better nutrition facts. When we are told that saturated fat is a good element of our new diet, we rebel. That can't be so, we tell ourselves. Our prior indoctrination forbids us learning what we need to learn, and stops us knowing what a more healthy diet might be like.

You can't clean-out a lifetime of faulty knowledge over-night. You have to slowly identify where that knowledge is and quietly prune it away, so you can replace it with better knowledge. Learning is an ACTIVE process, reading, writing, discussing, doing small practical experiments, keeping records. Slowly proving for yourself what works and what doesn't work. That's the principle behind the Take Out Diet.

If you proceed in a sensible way, step by step, you'll discover for yourself a diet that helps you reduce your weight, and to easily maintain that weight without hunger, or sense of going without the foods you love.

This self discovered diet, is one that you will be able to maintain over a long period. That's possible because in the process of learning you have changed your knowledge, the way you talk about food, and the habitual choices your make when choosing food. You will have demonstrated the success of your ideas in your own better health. You will have changed your the health outlook for your future life.

John Stephen Veitch                     Printable Version Printer of this Essay
The Network Ambassador
localOpen Future Health Limited - local You may comment privately to John S Veitch here:    Or write publicly in the comment box below.

Friday, 27 January 2017

LCHF v LFHC Diets - A Randomized Trial

Title: Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial

Author: Bazzano, Lydia A.; Hu, Tian
Publication: Annals of Internal Medicine
Publisher: The American College of Physicians
Date: Sep 2, 2014 Copyright © 2014, The American College of Physicians

Abstract

Background: Low-carbohydrate diets are popular for weight loss, but their cardiovascular effects have not been well-studied, particularly in diverse populations.

Design: A randomized, parallel-group trial. (ClinicalTrials.gov: NCT00609271)

Participants: 148 men and women without clinical cardiovascular disease and diabetes.

Intervention: A low-carbohydrate diet (<40 g/d) or low-fat diet (<30% of daily energy intake from total fat [<7% saturated fat]). Both groups received dietary counseling at regular intervals throughout the trial.

Measurements: Data on weight, cardiovascular risk factors, and dietary composition were collected at 0, 3, 6, and 12 months.

Results: Sixty participants (82%) in the low-fat group and 59 (79%) in the low-carbohydrate group completed the intervention.

At 12 months, participants on the low-carbohydrate diet had better statistics, than those on the low-fat diet, on the following measures.

Greater decrease in weight (mean difference in change, -3.5 kg [95% CI, -5.6 to -1.4 kg]; P = 0.002).

Bigger decrease in fat mass (mean difference in change, -1.5% [CI, -2.6% to -0.4%]; P = 0.011).

Improved ratio of total–high-density lipoprotein (HDL) cholesterol (mean difference in change, -0.44 [CI, -0.71 to -0.16]; P = 0.002).

Better triglyceride level (mean difference in change, -0.16 mmol/L [-14.1 mg/dL] [CI, -0.31 to -0.01 mmol/L {-27.4 to -0.8 mg/dL}]; P = 0.038).

Greater increases in HDL cholesterol level (mean difference in change, 0.18 mmol/L [7.0 mg/dL] [CI, 0.08 to 0.28 mmol/L {3.0 to 11.0 mg/dL}]; P < 0.001).

Conclusion: The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.

This result does not agree with conclusions of the Stellenbosch University, University of Cape Town and Cochrane Collaboration Review. The reason is easy to see, and completely scientific. According to the Review, there was little or no weight loss advantage in a low-carbohydrate diet, and no advantage in cardiovascular risk factors either. However, the definition of low-carbohydrate used was <191 g/d, with an average energy input of of 35% carbohydrate over 14 studies, which is >135 g/d, perhaps as high as 180 g/d.

Contrast that with the <40g/d specified in the study above, and the difference is crystal clear, low-carbohydrate diets work, but they need to restrict carbohydrate strongly, half measures don't produce good results.

This study from Eric Westman's lab shows the Atkins Diet (or Banting Diet) in the red column, compared with three other less restrictive diets. Here is clear evidence of the much better blood profile from a very-low-carbohydrate diet. There are dozens of studies showing similar things. Studies the Stellenbosch researchers managed to "exclude" from their analysis.

The first three columns are exactly what someone who is overweight or who has diabetes would want. The next four show favourable cholesterol measures, and the last column is a huge improvement in triglyceride levels.

For readers here, the question is, "How do I achieve good results like that?"

The simple answer is by building your dietary knowledge. The place the begin is with the Take Out Diet following the advice of Dr Hugh Butler. He gives you all the science in small doses, and he gives you a practical way to begin. As your knowledge grows, what you can easily achieve will also improve. In a year or so you will probably be Banting, without effort. Right now for most of us, trying to step straight into Banting is a road to frustration and failure. We all have too many wrong ideas in our heads. It takes time to undo that misinformation. There is no shortcut to better knowledge. Dr Butler has the method.

Imagine what you need to remove from your diet, Today and forever: that will improve your health. Take that thing out of your diet. A month later repeat the process. In less than six months, your diet will be much improved; your knowledge will be better, and you might be in a position to seriously think about Banting.

John Stephen Veitch                     Printable Version Printer of this Essay
The Network Ambassador
localOpen Future Health Limited - local You may comment privately to John S Veitch here:
Or please think about this essay, and return to the blog to write a comment.

Wednesday, 25 January 2017

Happy with my Ongoing Learning

I see that the last post in this blog, was on Saturday, 28 May 2016. Lots has happened since then.

For a start the "trial" of Dr Tim Noakes, began in February 2016, and information about those proceedings began slowly to reach me. In particular the videos, from the Noakes Foundation were interesting, but they were also long and confusing. 38 video's to date, about 16 hours, 90 pages of notes in my journal.

I addition I found Dr Jason Fung's many long and complex videos, which are intended to be training material for doctors.

The Big Fat Surprise; Why Butter, Meat and Cheese Belong in a Healthy Diet, a book by Nina Teicholz, is a long read, but it does tell the story in an understandable way, and it's got a good index at the back.

From June until September, I was climbing the learning curve as strongly as possible. In October to December I was consolidating that learning in myself, and in my own daily practice, and rebuilding the web site to reflect that knowledge. In January I've been making the web site more useful to people with small devices, and installing some business tools.

The rebuilt web site offers you four ways to learn about low-carbohydrate dietary practice. Each of those ways gives you access to the basic knowledge. But it's in the interconnection of the knowledge from each area, that the power of the site is revealed.

Those four parts are labeled:
The Nutrition Standards On Trial
The Life Giving Lecture
Nutrition Science
The Banting Diet.

You create your own better health. That starts with improved knowledge. Being aware that you can improve your health, and quietly trying to do that, by making informed choices, and keeping simple records, will work for you in time. You have to make good sense, in your own way, from the health information available.

Here is a simple health test anyone can take, with instant self diagnosis.

John Stephen Veitch
The Network Ambassador
Open Future Limited - You may comment privately to John S Veitch here: