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Best predictor of heart disease

Most doctors will look at a blood test and focus on the “Total Cholesterol” number as a potential risk factor for heart disease. But a Harvard study shows that the more important numbers on your lipid profile are Triglycerides and HDL — specifically, the ratio of Trigs to HDL. Ideally, you want this ratio to be 2 or lower. Anything under 3.5 is considered good, however.

For example, if your Triglycerides are 100 and your HDL is 50, simply divide 100/50 for a ratio of 2. This is where you want to be.

The Harvard study linked above showed that those with the highest ratio of Triglycerides to HDL had 16 times the risk of heart attack as those with the lower ratio. A diet high in carbohydrate is known to elevate triglycerides.

Macronutrients & Obesity: 1971-2000

From DietDoctor.com — a look at the change of macronutrient composition in our diet from 1971 to 2000. As we transitioned to the recommended low fat approach our carbohydrate intake increased dramatically. It had to, because there are only three macronutrients: carbs, protein, and fat. If you restrict fat you will by default consume more carbohydrate-rich foods.

The LCHF approach flips this to reduce carbs (sugars, starches, grains) and increase the fat content. The typical result of this is healthy weight loss as well as improvements in several metabolic markers like HDL, triglycerides, blood pressure, and insulin sensitivity.

macros-1971-2000

Another look at macronutrients and associated effects from this study.

macros-1971-2008

A Guide to Dietary Fat

Olive OilDietary fat has been vilified for decades, but we now know that eating fat is not what makes us fat, and for many people a low carb / high fat (LCHF) diet is very effective for weight loss, T2 diabetes, improved HDL and triglyceride levels, blood pressure, and other metabolic health markers.

But which fats? Saturated, monounsaturated, polyunsaturated, trans fats — what do these categories mean, which ones are the most beneficial, and what are some good healthy fat sources? Which ones are stable at high temperatures and work well for cooking? What kinds of harmful fats should we avoid?

The tweet below from DietDoctor.com’s Andreas Eenfeldt alerted me to a great resource on fat at Michael Joseph’s Nutrition Advance website. See the article here to gain a better understanding of it and how best to incorporate it into a healthy diet.

Also see the graphic in an earlier post, Fats & oils.

Lipitor

Lipitor is a cholesterol-lowering drug in the family of pharmaceuticals known as statins. Statin drugs are grossly over-prescribed, provide marginal benefit for a small subset of patients, and come with serious side effects.

Here is a screen shot from a Lipitor ad, note the last sentence:

LIPITOR has not been shown to prevent heart disease or heart attacks.

Lipitor

No doubt Pfizer’s lawyers required the marketing team to disclose the uncomfortable truth about Lipitor: it does not do what people think it does. They have spent millions in development and marketing of this drug and still have to post this disclaimer. So why would anyone risk the side effects?

Here is another screen shot I took today from the Lipitor website. Sounds lovely.

Lipitor

Eggs

Couple tweets from cardiovascular research scientist and fellow egg fan Dr James DiNicolantonio.

More about the health benefits of eggs at the Authority Nutrition website.

US & UK dietary guidelines ‘should not have been introduced’

Evidence from randomized controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983.

Another recognition of something we already know: the ‘low-fat’ dietary guidelines issued in the U.S. and the U.K. were not based on reliable nutritional science.

National dietary advice on fat consumption issued to millions of US and UK citizens in 1977 and 1983, to cut coronary heart disease incidence, lacked any solid trial evidence to back it up, and “should not have been introduced,” concludes research published in the online journal Open Heart.

Research article on the meta-analysis is published at the British Medical Journal’s Open Heart website.

Abstract

Objectives
National dietary guidelines were introduced in 1977 and 1983, by the US and UK governments, respectively, with the ambition of reducing coronary heart disease (CHD) by reducing fat intake. To date, no analysis of the evidence base for these recommendations has been undertaken. The present study examines the evidence from randomised controlled trials (RCTs) available to the US and UK regulatory committees at their respective points of implementation.

Methods
A systematic review and meta-analysis were undertaken of RCTs, published prior to 1983, which examined the relationship between dietary fat, serum cholesterol and the development of CHD.

Results
2467 males participated in six dietary trials: five secondary prevention studies and one including healthy participants. There were 370 deaths from all-cause mortality in the intervention and control groups. The risk ratio (RR) from meta-analysis was 0.996 (95% CI 0.865 to 1.147). There were 207 and 216 deaths from CHD in the intervention and control groups, respectively. The RR was 0.989 (95% CI 0.784 to 1.247). There were no differences in all-cause mortality and non-significant differences in CHD mortality, resulting from the dietary interventions. The reductions in mean serum cholesterol levels were significantly higher in the intervention groups; this did not result in significant differences in CHD or all-cause mortality. Government dietary fat recommendations were untested in any trial prior to being introduced.

Conclusions
Dietary recommendations were introduced for 220 million US and 56 million UK citizens by 1983, in the absence of supporting evidence from RCTs.

Fats & oils

Nice resource from cardiovascular research scientist Dr James DiNicolantonio.

Source: his tweet.

Fats & oils

Another good one from Dr D.

Fats

Breakfast: Eggs & pico de gallo

This morning’s low carb breakfast: four eggs fried in butter, topped with pico de gallo (tomatoes, onions, cilantro, jalapeño peppers). Eggs are so great.

Eggs & pico de gallo

LCHF Story: Linda

This is one of many LCHF success stories on the DietDoctor.com website.

Linda Vikström was 40 years old when she started LCHF in 2012, and by August 2014 she cut her weight in half, going from 309 pounds to 154 pounds. Her husband dropped 88 pounds. See the rest of her story here.

A couple of excerpts from the article:

I started eating LCHF in March/April 2012, and have lost 154 lbs. (70 kg) and my husband 88 lbs. (40 kg). The weight loss took 18 months, and we have kept the weight off since then without any effort, and we feel great and we don’t need to go hungry. I got my life back, and have so much energy and am able to be active with my children in a completely different way than I could be before.

I remember when in my job as an assistant nurse, I had to take a lady in her 80’s out for a walk; an alert and healthy lady for her age, but she had poor vision, so my job was to join her so she wouldn’t risk falling. When I walked with her, she was the one who had to adapt her pace to mine as I couldn’t keep up with her. I was in my 30’s and she in her 80’s. Not even then did my warning bells sound.

Linda Vikström

LCHF Story: Neil

Neil lives in England. The NHS (National Health Service, UK’s health care system) failed him with the old dietary guidelines, just like many U.S. docs are doing with their patients.

You can read Neil’s story below, here’s a summary.

  • Losing weight in 2013 on a “healthy low fat diet”
  • Despite the weight loss he discovered he was T1 diabetic, learned he would likely die early from a coronary event
  • Doctors said he should further reduce consumption of fat, dairy, meat, etc — and eat more starches/carbs
  • Started taking insulin (and statins for cholesterol), weight started coming back, muscle aches
  • Following the NHS diet, he was eating 120-200 grams of carbs and injecting up to 40 units of insulin per day
  • Started researching online, found the work of DietDoctor.com, Zoe Harcombe, Ivor Cummins, Trudi Deakin, Tim Noakes, Dr Richard Bernstein — realized he should not be eating what was recommended
  • Cut the carbs from his diet, started eating about 70% fat, stopped taking statins, muscle aches gone, glucose numbers stabilizing
  • Lost 145 lbs, no longer needs insulin, has lots more energy, healthy BMI of 23.5