37 replies to this topic

[kismet]

Can someone upload this one here or in the members section? Thank you.

Am J Clin Nutr. 2010 Jan 13. [Epub ahead of print]
Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM.
http://www.ajcn.org/...cn.2009.27725v1

via Stephan's blog

[johnross]

A number of writers have been pointing this out for years. In general doctors don't have time to keep up so they just go along with the standard view, which in this case is heavily influenced by the scamming bastards in big pharma. If you go back and look up all the studies that are supposed to support the cholesterol model of cvd you will find that they show no influence on risk by fat content of diet. Some explicitly state this in their conclusions and then ignore this important information.

[oehaut]

Can someone upload this one here or in the members section? Thank you.

Am J Clin Nutr. 2010 Jan 13. [Epub ahead of print]
Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM.
http://www.ajcn.org/...cn.2009.27725v1

via Stephan's blog

Is it legal to attach a paper on the forum (copyright)?? If not I can send it to you via email kismet

Edited by oehaut, 17 January 2010 - 08:36 PM.

[kismet]

@Oehut
I think it's legal grey zone, depending on one's interpretation of "fair use". It's likely better to PM it.

A number of writers have been pointing this out for years. In general doctors don't have time to keep up so they just go along with the standard view, which in this case is heavily influenced by the scamming bastards in big pharma. If you go back and look up all the studies that are supposed to support the cholesterol model of cvd you will find that they show no influence on risk by fat content of diet. Some explicitly state this in their conclusions and then ignore this important information.

This is a study of saturated fat, not cholesterol so I don't see how your first point is related to this thread.

Edited by kismet, 17 January 2010 - 08:45 PM.

[johnross]

Can someone upload this one here or in the members section? Thank you.

Am J Clin Nutr. 2010 Jan 13. [Epub ahead of print]
Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM.
http://www.ajcn.org/...cn.2009.27725v1

via Stephan's blog

Is it legal to attach a paper on the forum (copyright)?? If not I can send it to you via email kismet

The theory put to us by our doctors (at least here in the uk) and "health experts" is that saturated fats lead to increased bad cholesterol measured through the proxy of the lipo proteins which transport the cholesterol around the body. No satisfactory mechanism whereby cholsterol causes damage has been proposed. To say that cholesterol was found in the lesions and therefore caused it, is rather like saying that glue was found in the repair of a broken cup and therefore glue broke the cup.

[eason]

This is a study of saturated fat, not cholesterol so I don't see how your first point is related to this thread.

In case you weren't aware, conventional medical textbooks state that high saturated fat intake is correlated with high cholesterol levels in the blood.

[kismet]

The theory put to us by our doctors (at least here in the uk) and "health experts" is that saturated fats lead to increased bad cholesterol measured through the proxy of the lipo proteins which transport the cholesterol around the body. No satisfactory mechanism whereby cholsterol causes damage has been proposed.

Yes, there has for quite some time. The toxicity of oxidised cholesterol derivatives is well established.

And, yes, increased bad cholesterol, is unequivocally bad, especially if it worsens the total chol/HDL and/or trig/HDL ratios, which are some of the best markers of CVD. This article doesn't challange this well-supported hypothesis in any way. It has been known for quite some time (at least one or two decades) that factors beyond lipid metabolism influence CVD.

And saturated fat indeed has negative health effects independent of lipid metabolism (at least in the short term), especially when compared to monounsaturated fats. Carbohydrates may have negative effects of their own balancing out any benefits. Quite often saturated fat does not worsen the TC/HDL ratio or CHs worsen the trig/HDL ratio, so simplistic models are not enough to describe their impact on health.

...and please never involve the "Big pharma is screwing us" gambit without having strong evidence. I really, really hate this one. It's pretty unfair to the good people working at those companies trying to make the world better. Involve it only *when* it is true.

This is a study of saturated fat, not cholesterol so I don't see how your first point is related to this thread.

In case you weren't aware, conventiona medical textbooks state that high saturated fat intake is correlated with high cholesterol levels in the blood.

Which is true, depending on your baseline ("in case you weren't aware"). It is true especially in comparison to MUFAs.

Edited by kismet, 17 January 2010 - 09:09 PM.

[frederickson]

...and please never involve the "Big pharma is screwing us" gambit without having strong evidence. I really, really hate this one. It's pretty unfair to the good people working at those companies trying to make the world better.

do you actually believe the executives in the pharmaceutical industry give a damn about making the world better?!? i can't give you too much grief, because before i actually began my medical research career i also felt this way... oh, to be so naive once again!

[niner]

...and please never involve the "Big pharma is screwing us" gambit without having strong evidence. I really, really hate this one. It's pretty unfair to the good people working at those companies trying to make the world better.

do you actually believe the executives in the pharmaceutical industry give a damn about making the world better?!? i can't give you too much grief, because before i actually began my medical research career i also felt this way... oh, to be so naive once again!

Well, he said "the good people", so that rules out most of the executives. The scientists working in pharma do care about making the world better. The executives and marketers, on the other hand, care about the money, more or less by definition. It's not black and white.

[Mind]

Just wanted to concur that sharing material in the open forums is a grey area and in the "open forums" we feel the grey tilts more toward the illegal side of copyright law. In the protected forums (leadership & members) we feel it tilts more toward the legal side of copyright law - similar to having a book club/gathering at your house and sharing/discussing literature/papers.

[oehaut]

Just wanted to concur that sharing material in the open forums is a grey area and in the "open forums" we feel the grey tilts more toward the illegal side of copyright law. In the protected forums (leadership & members) we feel it tilts more toward the legal side of copyright law - similar to having a book club/gathering at your house and sharing/discussing literature/papers.

Thanks, Mind, for clarifying this.

[NeverSayDie]

do you actually believe the executives in the pharmaceutical industry give a damn about making the world better?!? i can't give you too much grief, because before i actually began my medical research career i also felt this way... oh, to be so naive once again!

Kismet is just a kid....what 19 years old? That might explain some of that naïveté. Hopefully he'll learn soon enough.

But yes, it certainly would be nice to live in such a world where this global industry was purely altruistic.

The scientists working in pharma do care about making the world better. The executives and marketers, on the other hand, care about the money, more or less by definition.

"The executives and marketers...care about the money."

Which will unfortunately never change as long as it is a profit-driven industry.

And where is the power in such an industry, with research scientists or with the executives?

Edited by NeverSayDie, 18 January 2010 - 03:44 AM.

[Ben]

do you actually believe the executives in the pharmaceutical industry give a damn about making the world better?!? i can't give you too much grief, because before i actually began my medical research career i also felt this way... oh, to be so naive once again!

Kismet is just a kid....what 19 years old? That might explain some of that naïveté. Hopefully he'll learn soon enough.

I'm glad you for one are discussing the main point of this thread, sharing science with us and not getting personal. In no way have you shown yourself to be smug, hypocritical and unintellectual. Thank you.

I agree with Kismet completely and I and niner are not kids. To rabidly make generalisations about an entire industry is idiotic.

[JLL]

Oh jesus christ what is with this thread. Do you really think that profits are the problem here? Would we have any kind of modern medicine if it there weren't profits to be had?

Why don't you use the same argument for any kind of product or service then? Surely our computers today would be much more efficient and user-friendly if the industry hadn't been motivated by profits for the past 50 years. They would have been produced from a purely altruistic standpoint. Only the engineers that are truly devoted to improve mankind's wellbeing would participate in making these computers. The ones that would like to make money doing it, well, they have no place here.

The pharmaceutical industry's number one goal is surely to make money; but to make money, they have to make drugs. And to make people buy the drugs, they have to convince them that their drugs are worth it.

This can be either done by making good drugs that actually work -- in which case the second goal becomes making the world better -- or by making false claims and lobbying governments. The unfortunate thing here is not that profits are involved; it's that the latter option seems to work all to well for the industry.

[Jay]

There are a lot of forces at play that prevent the mainstream from learning the truth about saturated fat. A big first step would be convincing everybody who cares enough to read the studies.


In the meantime, I keep hearing people plug monounsaturated fat and I wonder why they are so enamored with it. I like Stephan's (from wholehealthsourceblog) thesis that proper nutrition involves (i) balancing and limited PUFA consumption, (ii) restricting fructose consumption, and (iii) getting enough fat soluble vitamins. From this persepctive, any epidemiological study that finds mono is superior to SFA or PUFA may simply be measuring the confoudning associations between high mono consumers (weathy and/or europeans people) and people that more closely fit the model of good nutrition. So, what else is there? Rat studies that show insulin resistance on high SFA diets? Should be easy enough to show that in people to? Can anybody point me to a study? And then there is the study that I posted a few weeks ago showing SFA leads to regression of atherscerosis in PEOPLE. Mono didn't do that, only SFA. What's the explanantion? So, why is monounsaturated fat better than saturated fat again?

[oehaut]

There are a lot of forces at play that prevent the mainstream from learning the truth about saturated fat. A big first step would be convincing everybody who cares enough to read the studies.


In the meantime, I keep hearing people plug monounsaturated fat and I wonder why they are so enamored with it. I like Stephan's (from wholehealthsourceblog) thesis that proper nutrition involves (i) balancing and limited PUFA consumption, (ii) restricting fructose consumption, and (iii) getting enough fat soluble vitamins. From this persepctive, any epidemiological study that finds mono is superior to SFA or PUFA may simply be measuring the confoudning associations between high mono consumers (weathy and/or europeans people) and people that more closely fit the model of good nutrition. So, what else is there? Rat studies that show insulin resistance on high SFA diets? Should be easy enough to show that in people to? Can anybody point me to a study? And then there is the study that I posted a few weeks ago showing SFA leads to regression of atherscerosis in PEOPLE. Mono didn't do that, only SFA. What's the explanantion? So, why is monounsaturated fat better than saturated fat again?

That's the only (?) study that i'm aware of
Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU Study

AIMS/HYPOTHESIS: The amount and quality of fat in the diet could be of importance for development of insulin resistance and related metabolic disorders. Our aim was to determine whether a change in dietary fat quality alone could alter insulin action in humans. METHODS: The KANWU study included 162 healthy subjects chosen at random to receive a controlled, isoenergetic diet for 3 months containing either a high proportion of saturated (SAFA diet) or monounsaturated (MUFA diet) fatty acids. Within each group there was a second assignment at random to supplements with fish oil (3.6 g n-3 fatty acids/d) or placebo. RESULTS: Insulin sensitivity was significantly impaired on the saturated fatty acid diet (-10%, p = 0.03) but did not change on the monounsaturated fatty acid diet (+2%, NS) (p = 0.05 for difference between diets). Insulin secretion was not affected. The addition of n-3 fatty acids influenced neither insulin sensitivity nor insulin secretion. The favourable effects of substituting a monounsaturated fatty acid diet for a saturated fatty acid diet on insulin sensitivity were only seen at a total fat intake below median (37E%). Here, insulin sensitivity was 12.5% lower and 8.8% higher on the saturated fatty acid diet and monounsaturated fatty acid diet respectively (p = 0.03). Low density lipoprotein cholesterol (LDL) increased on the saturated fatty acid diet (+4.1%, p < 0.01) but decreased on the monounsaturated fatty acid diet (MUFA) (-5.2, p < 0.001), whereas lipoprotein (a) [Lp(a)] increased on a monounsaturated fatty acid diet by 12% (p < 0.001). CONCLUSIONS/INTERPRETATION: A change of the proportions of dietary fatty acids, decreasing saturated fatty acid and increasing monounsaturated fatty acid, improves insulin sensitivity but has no effect on insulin secretion. A beneficial impact of the fat quality on insulin sensitivity is not seen in individuals with a high fat intake (> 37E%).

But there is also this review

Effect of the dietary fat quality on insulin sensitivity

Recent evidence shows that specific fatty acids affect cell metabolism, modifying the balance between fatty acid oxidation and lipogenesis. These effects may have important implications in addressing the present epidemic of nutrition-related chronic disease. Intake of dietary saturated and n-6 PUFA have increased while n-3 fatty acid intake has decreased. Obesity, type 2 diabetes and insulin resistance are highly prevalent, and both are strongly related to disorders of lipid metabolism characterized by an increased plasma and intracellular fatty acid availability. Thus, it has been hypothesized that change in the quality of dietary fat supply is able to modify the degree of insulin sensitivity. Animal studies provide support for this notion. However, there is limited human data either from normal or diabetic subjects. This review aims to analyse human studies that address this question. To this purpose, the experimental design, dietary compliance, insulin-sensitivity method used and confounding variables are discussed in order to identify the role of dietary fat quality as a risk factor for insulin resistance. Most studies (twelve of fifteen) found no effect relating to fat quality on insulin sensitivity. However, multiple study design flaws limit the validity of this conclusion. In contrast, one of the better designed studies found that consumption of a high-saturated-fat diet decreased insulin sensitivity in comparison to a high-monounsaturated-fat diet. We conclude that the role of dietary fat quality on insulin sensitivity in human subjects should be further studied, using experimental designs that address the limitations of existing data sets.

Is there any known downside to MUFAs? Otherwise it just look like they offer the best ratio benefits/downside and should be priorize. Personnally I really don't care anymore about SFAs and they are not a factor in wheter or not I eat something. I don't get that much anyway. And if they ever were that bad, I'm not sure if it would make a difference in the face of the tonz of vegetable I eat everday, the fact that I exercise frequently, eat a maintenance diet, avoid sugar-based diet and have a quite low-body-fat level.

Maybe they are more of a concern on a SAD diet & usually sedentary people?

[scottl]

The toxicity of oxidised cholesterol derivatives is well established.

Just want to emphasize this.

[Jay]

Wonder what role the polyphenols in olive oil played in that result. There is also this study finding coconut oil is superior to olive oil for weight loss. Here. Of course, there are different types of SFAs, with different effects. In general, one of the reasons I don't eat more olive oil is that it comes with too much PUFA. Also, it's not great for cooking. I have been eating a good bit of macadamia nut butter (to balance out the disproportionate SFAs I get from butter and coconut oil) though.

Edited by Jay, 18 January 2010 - 04:14 PM.

[NeverSayDie]

I'm glad you for one are discussing the main point of this thread

I was responding to frederickson and niner. What, I can't do that?

I'm glad you...are not getting personal.

...you shown yourself to be smug, hypocritical and unintellectual. Thank you.

"smug, hypocritical an unintellectual."

Thank you for those insults. I am certainly glad you didn't go and do what you accused me of by getting personal. That might be a little embarrassing if you had (...almost hypocritical?).

Edited by NeverSayDie, 18 January 2010 - 04:30 PM.

[Jay]

The toxicity of oxidised cholesterol derivatives is well established.

Just want to emphasize this.

Are you talking about consuming oxidized cholesterol? The first negative result that I heard about dietary oxychlesterol came only a few months ago. It prompted me to start boiling eggs rather than frying them. I didn't think the theory was well established.

[Jay]

The toxicity of oxidised cholesterol derivatives is well established.

Just want to emphasize this.

Are you talking about consuming oxidized cholesterol? The first negative result that I heard about dietary oxycholesterol came only a few months ago. It prompted me to start boiling eggs rather than frying them. I didn't think the theory was well established.

Edited by Jay, 18 January 2010 - 04:20 PM.

[oehaut]

The toxicity of oxidised cholesterol derivatives is well established.

Just want to emphasize this.

Yup, I think we should let go the "bad" appelation for the LDL cholesterol since in itself it's a very important molecule. The modification that happens to it is a bad thing. Do we say that macrophage are bad because the participate in the atherosclerosis process? I've never heard someone saying bad macrophages and good macrophages.

Wonder what role the polyphenols in olive oil played in that result.

Can polyphenol have a direct/indirect influence on insulin sensitivity?

[Jay]

Can polyphenol have a direct/indirect influence on insulin sensitivity?

Yes. Though, consumption right after exercise can blunt the benefit of such exercise.

[Mind]

Another Imminst discussion of the meta-analysis.

[randyf]

Jay Wrote:

Rat studies that show insulin resistance on high SFA diets? Should be easy enough to show that in people to? Can anybody point me to a study? And then there is the study that I posted a few weeks ago showing SFA leads to regression of atherscerosis in PEOPLE. Mono didn't do that, only SFA. What's the explanantion? So, why is monounsaturated fat better than saturated fat again?

Here's one:

<H1 class=title>Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU Study.</H1>Vessby B, Unsitupa M, Hermansen K, Riccardi G, Rivellese AA, Tapsell LC, Nälsén C, Berglund L, Louheranta A, Rasmussen BM, Calvert GD, Maffetone A, Pedersen E, Gustafsson IB, Storlien LH; KANWU Study.

Unit for Clinical Nutrition Research, Department of Public Health and Caring Sciences/Geriatrics, University of Uppsala, Uppsala, Sweden.



Comment in:

• Curr Diab Rep. 2002 Feb;2(1):69-70.

AIMS/HYPOTHESIS: The amount and quality of fat in the diet could be of importance for development of insulin resistance and related metabolic disorders. Our aim was to determine whether a change in dietary fat quality alone could alter insulin action in humans. METHODS: The KANWU study included 162 healthy subjects chosen at random to receive a controlled, isoenergetic diet for 3 months containing either a high proportion of saturated (SAFA diet) or monounsaturated (MUFA diet) fatty acids. Within each group there was a second assignment at random to supplements with fish oil (3.6 g n-3 fatty acids/d) or placebo. RESULTS: Insulin sensitivity was significantly impaired on the saturated fatty acid diet (-10%, p = 0.03) but did not change on the monounsaturated fatty acid diet (+2%, NS) (p = 0.05 for difference between diets). Insulin secretion was not affected. The addition of n-3 fatty acids influenced neither insulin sensitivity nor insulin secretion. The favourable effects of substituting a monounsaturated fatty acid diet for a saturated fatty acid diet on insulin sensitivity were only seen at a total fat intake below median (37E%). Here, insulin sensitivity was 12.5% lower and 8.8% higher on the saturated fatty acid diet and monounsaturated fatty acid diet respectively (p = 0.03). Low density lipoprotein cholesterol (LDL) increased on the saturated fatty acid diet (+4.1%, p < 0.01) but decreased on the monounsaturated fatty acid diet (MUFA) (-5.2, p < 0.001), whereas lipoprotein (a) [Lp(a)] increased on a monounsaturated fatty acid diet by 12% (p < 0.001). CONCLUSIONS/INTERPRETATION: A change of the proportions of dietary fatty acids, decreasing saturated fatty acid and increasing monounsaturated fatty acid, improves insulin sensitivity but has no effect on insulin secretion. A beneficial impact of the fat quality on insulin sensitivity is not seen in individuals with a high fat intake (> 37E%).

PMID: 11317662 [PubMed - indexed for MEDLINE]

[TheFountain]

any epidemiological study that finds mono is superior to SFA or PUFA may simply be measuring the confoudning associations between high mono consumers (weathy and/or europeans people) and people that more closely fit the model of good nutrition.

Yea but you don't know this. Nobody does. It's like the same ridiculous argument some people put forth about CR that those practicing it live 'generally healthier lives' than those not practicing it, hence the results. No. Do not approach things this way, it is confusing and pointless. Proceed with caution when speaking of dietary choices. If studies find correlation between raised bad cholesterol and lipid transport due to saturated fat consumption, believe it till proven absolutely wrong. Especially where heart health is concerned.

[niner]

any epidemiological study that finds mono is superior to SFA or PUFA may simply be measuring the confoudning associations between high mono consumers (weathy and/or europeans people) and people that more closely fit the model of good nutrition.

Yea but you don't know this. Nobody does. It's like the same ridiculous argument some people put forth about CR that those practicing it live 'generally healthier lives' than those not practicing it, hence the results. No. Do not approach things this way, it is confusing and pointless. Proceed with caution when speaking of dietary choices. If studies find correlation between raised bad cholesterol and lipid transport due to saturated fat consumption, believe it till proven absolutely wrong. Especially where heart health is concerned.

He didn't say "is", he said "may". It's not right to accept a study without question; in fact it's our job to question them. If the study is a good one, the design will be such that confounders are minimized, and the authors will describe possible confounders and how they dealt with them.

[TheFountain]

any epidemiological study that finds mono is superior to SFA or PUFA may simply be measuring the confoudning associations between high mono consumers (weathy and/or europeans people) and people that more closely fit the model of good nutrition.

Yea but you don't know this. Nobody does. It's like the same ridiculous argument some people put forth about CR that those practicing it live 'generally healthier lives' than those not practicing it, hence the results. No. Do not approach things this way, it is confusing and pointless. Proceed with caution when speaking of dietary choices. If studies find correlation between raised bad cholesterol and lipid transport due to saturated fat consumption, believe it till proven absolutely wrong. Especially where heart health is concerned.

He didn't say "is", he said "may". It's not right to accept a study without question; in fact it's our job to question them. If the study is a good one, the design will be such that confounders are minimized, and the authors will describe possible confounders and how they dealt with them.

You're saying this because the study is against your held believe that saturated fat is good for long term consumption. If it was a study proving the opposite would you question its design?

[scottl]

Interesting comment on sat fat by Lyle McDonald:

In one context (e.g. low fruit/vegetable/anti-oxidant intake, high stress, inactivity, high body fat, excessive total energy intake), a high saturated fat intake may be exceedigly harmful. In a different context (e.g. high fruit/vegetable intake, low stress, high activity, low body fat, appropriate energy intake), they may have no effect.

http://www.bodyrecom...ion-part-2.html

[NeverSayDie]

Oh jesus christ what is with this thread. Do you really think that profits are the problem here? Would we have any kind of modern medicine if it there weren't profits to be had?

I know that this response that I am posting is not addressing the original content of the thread, but the question has been raised and I will address it.

We are not just talking about profits here. We are talking about mega profits.

Marcia Angell, M.D., who was the first woman to serve as editor-in-chief of the New Englan Journal of Medicine, wrote that in 2001 that the prominent drug companies listed in the Fortune 500 had an average net profit (after taxes) of 18.5%. Other Fortune 500 companies averaged 3.3%. The only industry that came even close to the pharmaceutical industry was commercial banking, with profits of 13.5%.

In 2002, the top ten drug companies in the Fortune 500 earned $35.9 billion in profits. These profits were larger than all of the other 490 Fortune 500 companies combined.