Thursday, February 05, 2009

Saturated fat and the FSA

Well it looks like the doner kebab defamation is just a tiny part of a more concerted attack on saturated fat by the UK Food Standards Agency. After Chris ruined my morning by forwarding this link (thanks Chris! No, seriously, we need to know that stuff like this is happening...) I spent some time browsing the FSA web site. Ugh.

A brief snippet looks like this, on colorectal cancer

"There are thought to be a substantial number of dietary factors, and factors related to the diet, which may modify the risk of colorectal cancer, e.g. diets rich in plant foods are thought to be protective. The mechanisms by which dietary factors can alter the risk, and a clear causal link between diet and the risk of colorectal cancer, are yet to be fully established"

Especially the way they say that there is no "fully established" mechanism or "clear causal link" between such practices as eating plants and colorectal health, there is an assumption being expressed here. Maybe I should email them some of the papers from the WHEL study. Or maybe emigrate. Unfortunately the FSA seems to rule Scotland too, so not much benefit from heading north of the border...

The main up side is that even in the USA it looks to be possible, as Richard shows, to buy good quality food, though it might not be available in every location. I can see us going the same route. Food elitism for the educated. The rest eating what JK describes as slave food.

Peter

37 comments:

Richard Nikoley said...

Thanks for the shout out, Peter.

The sad thing is, as I'm currently reading The Paleo Diet, is that Cordain might actually approve of that campaign, in part.

I've never had a more love/hate relationship with a book.

Stan (Heretic) said...

Hi Peter,
I think emigration may be a viable option! Been there done that, a few times...

8-:)

Josephine said...

Oh my god, "Too many crisps, biscuits, cakes and pastries" and the common thing they pull out of that is saturated fat? I'm pulling my hair out here! Not a single suggestion that the wheat or sugar might be problematic? Guess I better calm down and go eat a bunch of healthy whole grains.

Chris said...

I also sent that Guardian piece to Barry Groves. He has written to the Guradian to put them right regarding saturated fats.

Any other letter writers out there?

Cheers

Chris

Peter said...

Chris, I 'm up for the email to the Grauniad but seem to have run out of time. So what's new....

Hi Richard, ah, a review in the offing there? I'd rather that than slog through the full text myself. I'm mellowing on Cordain a bit as, saturophobic as he seems, he cannot be dumped in the same group as the AHA and ADA diet wise. But not quite the OD!

My big problem is that whenever people substitute mono unsaturates for saturates every surogate marker deteriorates and the intervention studies cited by Barry Groves (don't have the refs to hand) show that this follows through to increased mortality. If he is pro PUFA in general I'm obviously dubious.

Let us know what you think when you're done...

Jospehine, yes apart from those four nasties the rest of the list are health foods! They missed off doner kebabs. Slipping there...

Stan, have to see where the job trail leads. But the UK nanny state is a bit depressing at the moment. Wouldn't be so bad if they weren't so utterly wrong about everything!

Peter

Peter said...

Letter writing, 'tis done

Peter

mathman said...

Peter - Would you mind explaining why replacing saturates w/mono increase mortality? My LDL recently doubled in the past year (80-165)and my first inkling was to replace some saturates with mono ala Cordain/Paleo camp. It is easy to espouse that cholesteral means nothing when your numbers are "normal" but I need a little reassurance that saturates are still my friend.

Stan (Heretic) said...

Hi Peter,

Re: nanny state

OFF TOPIC

I have lived in 4 different nanny states: Poland ("People's Republic of"), W.Germany, Ireland and Canada and found their governments uncaring or unfriendly to their own citizens, and making bad decisions most of the time.

Stan (Heretic) said...

mathman,

Sorry for jumping into your conversation with Peter, but I believe it is very important to ignore high LDL otherwise it may cause a severe psychological trauma. 8-:)

As long as most of your LDL comes in form of large (less dense) particles, sub-population phenotype A, it is a sign of good health. Small LDL (phenotype B) come from overeating of carbohydrtates and is also accompanied by high triglycerides, and that may be a marker (but not the cause of!) that something is wrong with the metabolism. Usually, high LDL phenotype B and high TG are the signs of eating too much carbohydrates.

I have seen one case on a high fat LC diet rising LDL to 500 mg/dl (12mmol/L in European units) for over 2 years and no problems whatsoever (his HDL was also very high: 110mg/dl)! Such cases are not typical but seem to occur among people with some prior chronic diseases. In that case it was diabets type 1 and life long anti-epileptic drugs.

Stan (Heretic)

Ken said...

I have flip-flopped about vitamin D supplementation, My rational for thinking you were right all along is at Vitamin D .

peebix said...

Peter,

I am a long-time reader but I'm untrained in biology/medicine and I'm afraid that I'm still struggling with the basics in this debate. Can you say a couple of sentences about why there are such deep fault-lines between mainstream ideas and low-carb ideas, and even ideas within the low-carb community e.g. Dr Davis & Cordain both oppose eating saturated fat. I know about Kuhn's ideas on dominant paradigms, and I know how the food and drug corporations probably corrupt published science in areas that relate to their commerce. Still - what is driving the basic divisions in this debate? Why do very educated people disagree in the fundamentals?

Thanks for any comments,
Paul.

Peter said...

Hi Mathman,

I can see your source of concern but I have to mention here that my calculated LDL is somewhere around 250mg/dl (can't remember the exact figure, but that's the ball park), so I'm not exactly in cardiological Nirvana myself but, well, that's the number.

Barry Groves doesn't reference the study beyond saying it was 1965 in Eat Fat Get Thin but I doubt he is making it up. The one which might be of interest to anyone who gives any credence to the lipid hypothesis is the DELTA study, discussed here. It's worth working through the DELTA study before changing your fat choice.

I have to agree whole heartedly with Stan that cholesterol psychosis is a serious condition. Never mind the psychological trauma, changing your diet to lower calculated LDL will produce physical trauma too...

Peter

Peter said...

Ken,

You are obviously thinking this through. I'd just say that at the present time I think a D3 supplement is appropriate but if someone comes along with a convincing argument that it is unimportant I'm listening...

BTW I re read that Vit D post and it doesn't make clear in any way that we are still awaiting the results of intervention studies. It's clearly not cut and dried yet in the context of the SAD. What will happen in terms of studying D3 the context of LC eating? The answer could be different!

Peter

Peter said...

Hi Paul,

I just don't know. Dr Davis always comes over as thinking, but is an absolute believer in the lipid hypothesis, which I consider untenable. I also feel that an LDL 0f 60mg/dl in the context of Civilisation is a significant all cause mortality risk.

I look on Cordain from the context of a saturophile and he is incomprehensible in places. From the main stream he is far out on a limb, in my direction! I'm off the radar.

So why do people believe what they believe? There are some answers in "Mistakes were made, but not by me" but...

Interestingly Sweden has flipped, from Dr Ravnskov (slightly adapted):

"Annika Dahlqvist is a practising doctor who has been immensely popular in Sweden because her work introducing the low-carb diet. She was accused by the Swedish Dietarians Organisation three years ago for malpractice, but was acquitted last year by the newly appointed Chief ot the Health and Welfare Department. At the same time he sacked the three official experts, who had been chosen for developng the new dietary guidelines for diabetics, because of their financial bonds to the food industry"

Peter

Paul said...

Hi Peter,

Thanks for comments. Your last paragraph needs no elaboration - it's clear that capitalism has bent science to the goal of profit. But what about the field of epidemiology? - is it really so useless (as Taubes seems to think) that it produces no useful conclusions? Alternatively, if epidemiology does have value, why are there such diverse opinions about the data? Why is it hard to say 'saturated fat is good' or 'saturated fat is bad' and back it up with an irrefutable (or at least statistically significant) scientific argument, that all scientists could agree on?

Paul.

Stan (Heretic) said...

Slightly off topic (keywords: VITAMIN D, CANCER), but I thought it may be important. We have discussed vitamin D in the past. The following paragraph:

Quote:

Activated Gc protein has been used in humans at much higher doses without side effect. This Gc macrophage activating factor (Gc-MAF) has been shown to be effective against a variety of cancers including breast, prostate, stomach, liver, lung, uterus, ovary, brain, skin, head/neck cancer, and leukemia.
Although GcMAF is also called Vitamin-D binding protein, the activation of macrophages does not require Vitamin D.


Since presence of dietary vitamin D may enhance Gc-MAF, then conceivably it could also explain (if true) some benefitial anti-cancerous effects of diets rich in fish, animal fat and meat.

The original article by Bill Sardi and Timothy Hubbell is there: "Cancer Cured For Good".

Peter said...

Hi Paul,

Epidemiology is dependent on asking the correct questions. Look at the comment by Merchant et al:

"Previous research has identified ethnic differences in cholesterol and other blood fat levels that couldn't be explained by genes, obesity, lifestyle factors or diet, Merchant and his team note, but these analyses usually looked at dietary fat, not carbohydrate consumption"

If you live in the "fat is bad" paradigm you ignore sucrose, though fat and sucrose consumption usually increase in parallel. Even Ancel Keys noted, as a one liner, that sucrose intake and cardiac risk are associated. He then buried it. We're still suffering the consequences.

Peter

Peter said...

Hi Stan,

Very interesting. We're back to sugar moieties, lectin like receptors and the immune system. One of the molecules my wife works with is a lectin like receptor on NK cells. They seem to be very important in innate immunity...

So do we have a mechanism where high D3, from diet or sunlight, simply raises the level of D in the plasma, which up regulates it's binding protein, which happens (probably by "design") to upregulate the anti cancer activity of the innate immune system?

As has come up in comments with Ken re D3, there appears to be very little potential problem from supplementing, this link certainly suggests potential advantage. I'll keep on with the 10,000 iu for the time being!

Peter

Sue said...

mathman,
have you read Richard's post on calculated LDL cholesterol:

"Are you aware that the LDL cholesterol results you get in your routine blood workup is likely a complete fiction? That's right, and it's because LDL isn't measured, but calculated. Here's the formula, called the Friedewald equation.

Here is the link to read more:
http://www.freetheanimal.com/root/2009/01/what-about-ldl-cholesterol.html

marco said...

Peter,

Re Vit. D, I‘ve read somewhere that 1 mcg/day (40 i.u.) Vitamin D3 raise your 25-hydroxyvitamin D about 1 nmol/l (that is 0.4 mcg/l).

So taking 10000 i.u /day could raise your 25(OH)D about 100 mcg/l (or 100 ng/ml…).

If your “starting level” was 25 ng/ml, after supplementation it would hit 125 ng/ml.

Isn’t it really too much?

Disease prevention could require less than this.

A couple of years ago I obtained these results:

September 5th, 2007 (without any supplements) : 44 ng/ml

May 5th, 2008 (supplementing 2000 i.u./day between September and May) : 66 ng/ml

It's 22 ng/ml more with 2000 i.u. wich fits well into this calculation.

L said...

Peter,

Heavy cream (super market variety) in the U.S. has listed as added ingredients monoglyceride and diglyceride(<1%). Anything wrong with these? I only consume a quart/week.

Thanks

Peter said...

Hi Marco,

Yes it could but the dose response curve would need to be linear. I'll let you know what my level is when I get the value back...

Peter

Peter said...

Hi L,

They look like emulsifying agents to stop the cream settling out (probably allows adulteration with water to protect you from too much saturated fat!).

Bottom line is I don't know but I've seen them described as detergents, so possibly not nice on your gut. The other test is could your granny have manufactured cream containing mono/diglycerides...

Theoretically they are OK as your lipase produces them from triglycerides as part of digestion, but I'm not too keen. Maybe I'll stay in the UK after all...

Peter

mathman said...

Thank you both to Stan and Peter for your comments. Sue, I also ready Richard's blog but this was a direct LDL measurement only done after a "typical" testing earlier in the month.

Stan/Peter-What is the name of the test that differentiates the percentage of small, sticky, artertial clogging lipoproteins? Is it sLDL, vLDL, apoA?

I will continue to eat my saturates but I have one other query - does the fact that most of my animal fats come from grain fed animals effect the fatty acid composition? I eat a lot of fatty meats and wonder am I really getting the dose of saturated fats I hope or am I getting a big helping of poly pig?

mathman said...

Please exuse my further questioning as I am trying not to be too selfish.
I also had elevated liver tests ALT/AST and I am slightly anemic. Anemia seems rediculous since red meat provides me plenty of iron and I don't know anything about the liver enzymes other than they show inflammation. Could either of these be related to a high fat diet? Any comments would be greatly appreciated.

L said...

Peter,

Thanks. I'd like to move to the U.K. but I have a serious chip shop addiction and it's not to the chips. Healthier on this side of the water.

Anna said...

Mathman,

Have you had a EBT coronary artery calcium scan? Even if your insurance doesn't cover it, you might consider paying out of pocket for it. If you don't have any coronary artery plaque (0)score), there's your answer.

Be sure to get the very fast, low radiation dose scan. We could have had a conventional scan done through our HMO's imaging lab at no cost, but it was a slower, higher radiation scan. We paid for the scans at an out of network imaging center instead and had the report forwarded to our doctor (you'll also need a doctor who knows how interpret the scan information). There is a big difference in the scan types, because you'll want to get the scan repeated to monitor plaque growth, regression, or stability (so you don't want excessive radiation exposure).

Peter said...

Hi Mathman,

Small dense LDL is the stuff with small diameter and high density. Dr Davis would have more info on how you differentiate, I think it's by NMR, which certainly gives you the particle sizes, small are "bad".

ApoB particles contain the ApoB protein and this is the hallmark of all LDL particles. The B100 version of the ApoB is on liver secreted particles and the B45 (truncated form of B100) is on chylomicrons secreted from the gut.

Small or large seems to be related to insulin, and personally I think the hyperinsulinaemia is the problem rather than the small dense LDL, but you can't have one without the other so...

Bare in mind I view the whole cholesterol hypothesis as a set of ad hoc patches on ad hoc patches on a piece of bent research from the 1950s, so you're probably asking the wrong person!

Re PUFA, yes, there are plenty of PUFA in pork fat, so if you have liver issues ruminant sources might be better. There is a paper in Nutrition and Metabolism (really must look it up) which shows LC eating increases omega 6s in membranes because they are not being used for inflammatory purposes... Perhaps this is why Kwasniewski doesn't care about lipid PUFA ratios, I don't know on that one. But inflammation is a controlled process.

Anyone with liver issues cannot really do better than long chain saturates as the chylomicrons (ApoB45 labeled particles) completely bypass the liver (they go down the thoracic duct) and can deliver calories to muscle without any hepatic processing.

Obviously fructose is the primary trigger for non alcoholic fatty liver inflammation but alcohol does the job well and there are a host of other triggers for raised liver enzymes.

HTH

Peter

mathman said...

Thank you for your comments. I suspect that my weakness for artificial sweetners/stevia may be troubling my poor liver. Good 'ol sfa completely bypass the liver-that is wonderful. I always hear about the short or medium triglycerides doing this but not the long-chained as well.
Peter- I will make a conscious effort to eat more ruminent fat. Do you watch your PUFA's or do you believe that it doesn't matter when LC?
Anna- I am only 33 so I don't know if I want to irradiate myself just yet. I feel well and I don't want to assume something is wrong because of elevated LDL or liver tests, just hoping to gleen some insight from the experts!

Peter said...

I keep my PUFA low but am not fanatical about it, I eat a lot of pork and even though my chickens lay up to eight eggs a day we need six for me, six for my son and three for my wife. Commercial free range chickens may wander the fields but they certainly are not grass fed! So more omega 6s there for me.

BTW there is another paper in N and M which suggest three eggs a day are a usefully anti inflammatory addition to LC eating. By six a day you are in to diminishing returns. But we like eggs.

Another BTW I assume you are gluten free...

Peter

mathman said...

I am gluten free and I too have a flock of four that lay eggs for my family. I do feed them corn lay mash but I ration it out so it forces them to forage my backyard for a majority of their calories.
Are there certain cuts of pig/chicken that are lower in PUFA's? I thought that eating chicken thighs/legs was better due to a higher fat content, but I may be better served eating small portions of breast adding my own SFA(cream sauce).

Braesikalla said...

Peter,

where did you get the idea that three eggs can reduce inflammatory markers but six can not?
I thought you were referring to this study http://www.nutritionandmetabolism.com/content/5/1/6 . In the context of a LC diet eggs seem to be working fine. Of course, there is this paper http://www.ncbi.nlm.nih.gov/pubmed/15939816? . But the study was run by the "American Heart Association-National Cholesterol Education Program", so we can assume that all partcipants were on a high-carb diet. Four daily eggs on OD could have a totally different response. What do you think?

Peter said...

Hi Braesikalla,

No, that wasn't the study so I'll have a hunt round and see if I can find the one I was thinking of. There were three groups, no eggs, 3/d and 6/d. There was a significant improvement in inflammatory markers in both egg groups but the 6 egg was not a huge amount better than the 3 egg group.

To me personally six is my minimum but I've no idea how much benfit I get from this, or the 12+ on a scrambled eggs for supper day. Anyone eating less than 3 eggs a day is missing out on something...

Peter

Braesikalla said...

Peter,

thanks for your response. It completely fits with my view that eating less than 3 yolks a day is a dangerous habit.

For me personally, it's 6 yolks for breakfast every day. Makes 42 in a week, it's always kind of a shock for my patients (I'm a physical therapist)when I tell them these numbers. But when I explain the rationale behind it, they get very interested and don't consider me a freak anymore. Not at least because I can back up my claims by my physique and robust health.

Peter said...

Hi Braesikalla,

I chased the ref and I was mis remembering it. The effect was on subfractions of lipoprotein particles as posted by G on Animal Pharm.

Only some of the effects were dose limited, others were still improving at 6/d. Yesterday was a 10 yolk day but I was still so full this morning after last night's supper that my eggs had to wait 'til tea time. I'd agree, six egg(yolks)s a day is a reasonable minimum.

Peter

Braesikalla said...

Peter,

thanks for looking up the reference.
I'm thinking about increasing my egg intake to 10/d. Don't want to get a Cholesterol Deficit Syndrome.

Sabine said...

This makes me want to eat another jar of Jersey double cream.