Saturday, January 07, 2012

More of the 17% solution

There are various little one-liner papers which I've tripped over in the last few weeks which are probably worth a post although are not related to the main things I'm interested in at the moment.

The first is an isolated oddity. We all remember Dr Axen and the 17% trans fat diet for rats? Followed by the Complete Idiots with their 14.4% solution.

Of course, no one would ever suggest feeding this much trans fat to humans in a weight loss study. Would they? No, surely not. Except I guess it depends on what you have to prove...

How about this study:



Let's do the math. The ketogenic diet provided bulk calories as fat, 100g/d. A scrummy 35 grams were saturated fat, nice. Next comes 34 grams of OK-ish monounsaturated fat. The obligatory 14g/d of disgusting PUFA is included. Now, maths is complex subject.

One plus one is, err, about, I mean, err, somewhere about one and three quarters. About. I think

OK, let's simplify. 35+34+14=100

Wrong. Yea Gods, I always was bad at math. My worst A level grade. Let's try again

100-(35+34+14)= n, where n is the trans fat content of the fat in the ketogenic diet.

Congratulations Dr Sears. You get the Axen Prize for the maximum undeclared trans fat content of an experimental diet used on humans.

Peter

51 comments:

Margaretrc said...

By my calculation, the difference in trans fats between the two groups was only 3 grams--17 as opposed to 14! That's a lot of trans fats for both groups. No wonder the results weren't significantly different. What a sham! Pun intended.

Avishek said...

Ehh. Although I'd like to agree with you, it could be equally possible that there was a typo, except for the fact that 100 and 50 are very nice numbers to use in a study. I don't think we can conclude that the unreported fats are transfats though.. not enough info?

LeonRover said...

Is not the set of Macro Energy Ratios in the NLC Diet that of Barry Sears famous Zone Diet ?

vlprince said...

Well- at least those consuming the magical 40-30-30 diet also received a fair dollop of trans-fats. I'll admit- I'm surprised they could get that much trans-fats into a diet... I was under the impression that even partially hydrogenated soybean oil was only ~10% trans. Makes it hard to imagine how they'd get more than 10% into a diet.

Tonya said...

I read the whole study, and wish they said what exactly they fed them. I found this interesting, "...inflammatory risk...and perceptions of vigor were more adversely affected by the KLC [ketogenic diet] than by the NLC diet." What I wonder is for the ketogenic diet, did they make sure that the participants got adequate salt intake? Sodium is not listed on their nutrient composition chart. A lack of enough salt when you go very low carb can cause you to get dehydrated, and yeah, you'd feel like crap.

Hmm, inflammation... transfats... inflammation... there seems to be a link missing somewhere.

"Patients should know that there is no apparent metabolic advantage with ketosis during dieting."

Does this include epileptics and brain cancer patients? {/snark}

You know, I almost missed the conflict of interest in the fine print at the bottom...

"HH is an employee of Zone Labs Inc. BS is a stockholder and serves on the boards of directors of Zone Labs Inc and Zone Cuisine Inc; he is also on the boards of directors of Zone Café and ZoneNet. None of the other authors had any personal or financial conflict of interest."

I'm sure it's completely coincidental that the results of their study coincide with their Zone Diet.

Tony Mach said...

Does mineral oil count as fat? How about essential oils? The 17% are not necessarily trans fatty acids – but I guess trans fatty acids would be more healthy than the other alternatives… Though, you never know what they feed when they try to prove how unhealthy "fat" is.

Peter said...

Hee hee, at least 17% mineral oil would have prevented death from constipation on the ketogenic diet...

Peter

Peter said...

Totally unrelated aside: One of the ketogenic dieters developed a cardiac arrhythmia in the first week. I doubt that this was trans fat related but I've heard of rhythm problems occasionally in people who have gone very aggressively in to extreme LC eating. It can happen...

Peter

nanook kernell said...
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nanook kernell said...

is there a chance that someone decides to not include exotic fats like MCT into the saturated fat number? like nutritiondata.self.com suggests that coconut fat contains only 86% fat.

Renaud said...

Also, there is obviously something diferent between the 2 groups if you look at the CRP values.

Jenny said...

Unfortunately for those who wish to believe there is magic in a ketogenic diet, this experiment confirms what other experiments, and practical experience have found: the "advantage" of ketogenic diets only applies to people with damaged glucose metabolisms. For everyone else--and or people with blood sugar problems who normalize blood sugar one way or another it is all about the calories.

The main benefit of the ketogenic diet to dieters with abnormal glucose metabolism is that it eliminates the hunger that makes dieting so difficult. Lowering insulin production can sometimes also result in improved weight loss, for a while, but after time this effect often fades out.

But people with normal glucose metabolisms can lose as well on any diet as they can on LC if they cut down on calories. Since these studies are done with healthy volunteers, they won't find any advantage. Blaming it on the fat % ignores the many other studies that find a similar result.

Sidereal said...

Speaking from anecdotal experience, strict ketosis can lead to unpleasant cardiac events in a minority of susceptible people. I've had a couple of supraventricular tachycardias while eating VLC both requiring hospitalisation, while a friend of mine had an atrial fibrillation after a few months on Atkins induction. We're both otherwise healthy medication-free people in our 20s/30s with no cardiac problems. Electrolyte imbalances combined with increased cortisol, noradrenaline and dopamine spell trouble for some people.

Sure there are people who can tolerate eating only meat and water and may even feel great doing so, but not everyone can do this despite the LC mantra that "there are no essential carbohydrates".

John said...
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Jonty said...

That's hilarious Peter, well spotted!

Morris said...

@Jenny
I tend to agree that ketogenic diets may be most beneficial to those whose glucose tolerance is significantly impaired but unfortunately no studies have been done (that I can find). From a strictly personal experience (normal FBG & weight before) based on a short term experiment (2years), the benefit of LC/HF appears to be (as you say) the ability to eat a much lower calorie intake without discomfort. My BMI has dropped from 23.5 to 21.5 and my energy intake from 39 to 27kCal/kg of body weight. I remain agnostic about the reasons for the health marker improvements I have seen as well as the permanence of the benefits but I am unwilling to risk losing them. I would be very interested in hearing form others (who were not previously obese) about their caloric intake, BMI and changes in health markers, and particularly negative ones (which are seldom mentioned) over time but this does not appear to be of general interest. I find fault finding with studies not at all persuasive. Contrary conclusions or more accurately beliefs are not supported by the errors and repeatedly pointing out erroneous studies does not strengthen the case to the contrary.

Bill said...

Hi Peter, nice catch. I agree there appears to be a mistake, but wouldn't trans fat have been counted as MUFA's (or PUFA's)?

Bill

blogblog said...

A few points:

1. The KLC diet was 35% protein (60% fat, 5% carbohydrate). Nobody can tolerate that much protein for six weeks without adverse effects.

2. A proper ketogenic diet is no more than 20% protein and 75-80% fat.

3. It takes 12-18 months to fully adapt to a ketogenic diet.

4. Whenever I hear the name B.Sears my "BS-meter" starts buzzing loudly.

blogblog said...

@Jenny and Sidereal,
ketosis is a completely normal state metabolic for mammals - even amongst obligate vegetarians such as cattle.

The CNS functions more efficiently on ketone bodies than on glucose.

The primary fuel for the heart is palmitic acid - saturated fat.

All mammals evolved from insectivores. Some mammals stayed as carnivores and some mammals later used bacteria to convert dietary carbohydrates to fat and protein. In the case of humans we went from being insectivores to mostly vegetarian and then back to carnivores.

This study is complete rubbish. a) Nobody is going to eat 35% protein. b) Nobody will adapt to a ketogenic diet in six weeks.

The "problems" with ketogenic diets are primarily due to a lack of electrolytes (particularly potassium and magnesium) and not allowing a long enough adaptation period. Realistically you can't completely switch from a SAD to a VLC diet (unless you are young and healthy) in less than a year.

blogblog said...

@Morris,

this is my slant on VLC diets.
I'll be 49 years in two months. Most people think I'm in my mid 30s (or even late 20s). I don't have any obvious wrinkles and no hair loss at all. The only real clue to my age is a fair few grey hairs.

I'm healthier than I was 30 years ago but not quite as fit (my resting heart rate was around 45 then).

My BP is ~95/70 with around 3-4g of salt intake a day. If I significantly cut back my sodium intake my BP will quickly become so low (80/60) that I suffer severe postural (othostatic) hypotension.

I also have 15% bodyfat (considered the ideal body fat level for males - low body fat lvels are unhealthy) and a BMI of around 27.

My teeth have zero tartar or scale and no gum disease despite minimal oral hygiene (no flossing, a quick brush each night and I haven't needed a visit to the dentist for a decade). My teeth were quite disgusting on a SAD diet with rampant plaque and lots of cavities.

All this is thanks to a VLC diet.

Paul said...
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Paul said...

blogblog,
What's your diet at the moment?
At BMI 27 with BF 15% you must have lots of muscle to fill your frame right?
How many kcal do you need to keep your BW ?

Paul

Galina L. said...

Sometimes I wonder why mood-altering drags are given right and left while ketosis seems to be suitable only for a very seek people or for a very short intense weight-loss. Based on a personal experience, I can tell that after I started to use ketosis in order to control my migraines, I found it to be a wonderful tool to manege all sort of female's mood and well-being issues associated with PMS and pre-menopause. It significantly widens the possible application pool, unless it may be use as a tool to prove that all females are mentally unstable at least sometimes. On the top of it, since I went on a VLC diet, my autoimmune issues got sorted out and I stopped having seasonal flues and urinary tract infections. Previously, when I lost weight by just eating less, I never had even close results even with more significant weight loss. There is some magical about the ketosis, and I didn't mention an increased mental clarity yet.

David Isaak said...

@Sidereal--

"Speaking from anecdotal experience, strict ketosis can lead to unpleasant cardiac events in a minority of susceptible people...Electrolyte imbalances combined with increased cortisol, noradrenaline and dopamine spell trouble for some people."

Yes indeed, electrolyte imbalances can have adverse effects on the cardiovascular system. But that's true whether you're in ketosis or not. A switch to a low-carb diet usually results in a dump of both water and associated electrolytes, which is why most people advocating LC diets warn that mineral supplements may be needed in the early stages.

But this is true whether the low-carb diet is "ketogenic" or not.

Morris said...

@blogblog
Thanks for your reply, interesting. I would be plump at BMI 27, my BMI dropped from 23.5 to 21.5. I appear fairly muscular for my age but then I am 72 although I look about 10 years younger. As far as I can determine (mostly by inference) the weight loss was mainly in gut bacteria (this is very interesting with observable effects) and (probably) visceral fat around organs. My health markers do not compare to yours but are in the normal range including BG which runs around 4.6-4.9 mm/l. My main point was that possibly for others as well as in my case, the “normal” weight and caloric intake are much lower than usually believed. What is your cal/kg? As far as negative side effects of my LC (about 100gm/day including vegetables ie fibre mostly) these include heart palpitations (first 4 weeks), night cramps in calves ( 16 months later) which are slowly abating and elevated LDL (133%) although improvements in HDL and TGA are much greater.

ItsTheWooo said...

I keep food intake logs daily for several years, and I must say for some reason the subcategories of fat never add up to the total grams.

For example, yesterday I consumed the following:

1608 calories
120 g fat
sat fat 36
pufa 18
mono 55

36 + 18 + 55 = 109. I am quite certain I did not consume 11 grams of transfat.

I ate :
1 ounce of mixed nuts,
half a protein bar (5g fat, 3g sat fat, 2g mono/pufa),
2.5 ounces light cream, 1 cracker, 5 ounces avocado,
3 ounces tomatoes,
1 ounce of cheddar cheese,
.75 ounce pepperoni,
a chicken leg,
2 pieces dark chocolate, and
3 tablespoons amino acid slush.

I used fitdaypc, which borrows its nutritional info from the USDA.
If they used similarly imperfect nutritional software which does not subcategorize fatty acids correctly it's possible at least some of those "missing" FAs are something other than transfat (either pufa , sat , mono which is not being counted).

blogblog said...

@Paul,

I only east when I'm hungry. My calorie intake varies constantly anywhere between 2000-4000Cal/day. It is very low in summer (very hot and humid where I live) and higher in winter.

Paul said...

blogblog
Thanks for your answer
Are you eating once a day or just when hungry?

paul

blogblog said...

@Paul,

I only eat when I'm hungry. I very rarely eat before about 3-4pm. I tend to then lightly graze from about 3pm until 10pm.

Stan (Heretic) said...

Off-topic:

bye-bye resveratrol

Galina L. said...

@Stan
I new it in my bones all that bs about benefits of a red whine was nothing but nonsense, I hope pushers of a daily aspirin would be caught with pants down too some day.

Stan (Heretic) said...

Yes. What was surprising, that the reaction by the U-of Conn. was so swift and merciless. 60 thousands of report pages against one guy! This is the main "scientist" (or one of) who invented and championed resveratrol. Another of the medical myths truly dead and the main criminal on the run (in India). First "global warming" then this. Hundreds of more scientific myths to go. So much work...

Stan

P.S.
I wonder when is the time for the Cornell Uni to start moving against Dr. T.C.C.? They already have got so much evidence. Any bets?

Steve Olson said...

@Stan (Heretic)

How will they explain away the French Paradox now? Haha.

LeonRover said...

Steve

It's only a French (or Spanish) Paradox to US epidemiologists applying the "lessons" of Framingham.

French (& Spanish) epidemiologists call it the American Paradox.

blogblog said...

@Galina,
a very recent paper has shown that a daily aspirin increases overall mortality by increasing the risks of stroke and bleeding.

Jane said...

French wines are very high in copper and manganese. Scientists think this is very alarming. Actually, if you eat white bread as the French do, they might save your life.

'The study noted the difference in metal contamination across the regions, placing France at the bottom of the league table, with the worst levels, followed by Austria, Spain, Germany and Portugal with increasingly less pollution. The metals that were of most concern were copper and manganese, the scientists said.'

http://www.guardian.co.uk/lifeandstyle/2008/oct/30/wine-foodanddrink

blogblog said...

@Jane,
the levels of coper and manganese in red wine are trivial. You would need to drink two glasses of red wine a day for 20 years to have any increased risk of heavy metal toxicity. Wine drinkers are at far more risk from alcohol than heavy metal toxicity.

blogblog said...
This comment has been removed by the author.
Jane said...

@blogblog

Did you misunderstand my comment? I am not saying the copper and manganese are toxic, I am saying they are protective, and might explain the French Paradox if resveratrol doesn't.

David Isaak said...

"You would need to drink two glasses of red wine a day for 20 years to have any increased risk of heavy metal toxicity."

The term "heavy metal" should be reserved for music. It doesn't have a standard scientific definition, and there is no reliable relationship between metal toxicity and atomic weight.

'This is the main "scientist" (or one of) who invented and championed resveratrol.'

No he isn't. As to Das, research on resveratrol has been a pillar of his career, but it is incorrect to infer that his research is a pillar of reservatrol studies.

There is a lot of conflicting evidence from studies on resveratrol. But dismissing the entire area of research based on fraudulent behavior by Das is like dismissing the entire field of stem-cell research by pointing at Hwang Woo-suk.

"I new it in my bones all that bs about benefits of a red whine was nothing but nonsense..."

As the German proverb has it, "There are more old wine drinkers than old doctors."

But neither resveratrol nor metals need to be invoked. Alcohol alone seems to have cardioprotective effects. See for example:

http://archinte.highwire.org/cgi/content/full/166/19/2145

Myrmecia said...

But they are still focused on what they call "weight loss" (I hope they mean fat loss). But why this obsessive focus on obesity - it's far from the only pathology around.

blogblog said...

@David Isaak,
when I was studying biochemistry manganese and copper were considered to be toxic heavy metals. They are toxic because they disrupt metabolic pathways by binding with enzymes.

No experimental evidence exists to support the use of resveratrol in humans. Resveratrol has never shown any benefits in mammal experiments. It has shown benefits in one poor quality study using fish. The rest of the "evidence" is based on isolated cell cultures, yeasts and invertebrates.

Glaxo wasted a billion or so dollars of research money before concluding resveratrol was totally worthless.

NO Antioxidant supplement has ever been shown to offer health benefits in human clinical trials. In fact they are far more likely to be harmful than beneficial.

George Henderson said...

Isn't the metabolic "advantage" actually a form of inefficiency, and therefore something to avoid unless actually necessary?
@ Morris,
I am normal weight and went low-carb and occasionally ketogenic or all-meat to control Hep C symptoms and replication. My viral load has dropped from 400,000 to 26,000 after a year or two, which I believe is directly related to improved lipids. I have increased fitness, better sleep, normal BP and obviously eat less often and have more control over my appetite and choices.
I don't count calories; in fact, I am a calorie skeptic.
a) the body is not a furnace, OXPHOS is not combustion,
b) calorie values for foods are just generalised averages,
c) at home no-one is burning your poohs and wees to see how many calories you excrete (which has to be part of those laboratory experiments).

Low carb reviews frequently state that "weight loss is not necessary for improvements in lipid profile, cardiovascular risk etc".
Actually I was underweight when I started (64 Kg at 5'8") and quickly gained 4kg which I consider an improvement.

gallier2 said...

@George

Prof. Lutz has a section in his book (Life without bread) where he presents several cases of underweight people who manage to normalize their weight with a low-carb change. He speculates that low-carb allows the body to regulate to the "ideal" weight, up or down depending on where you started.

blogblog said...
This comment has been removed by the author.
blogblog said...

@George

I was a mere 60kg at 183cm tall until I was 21. This crept up to around 65kg when I was 25 and to 70kg at about 30. Being skinny definitely wasn't genetic as all my family have quite muscular physiques.

I now weigh about 80kg on a VLC diet. But have I deliberately been as heavy as 88kg on a VLC diet. I suspect I could get to over 100kg on a 4000-5000Cal/day VLC diet combined with some serious weight training.

The whole metabolic advantage or unpalability argument regarding low carb simply doesn't stack up when you consider than many people gain (considerable) weight on a "boring" low carbohydrate diet.

I have noticed that I feel much warmer on a VLC diet than a SAD. I never get cold hands and feet and can comfortably wear very little clothing in quite cool weather.

Paul said...

blogblog
Are you eating high fat (like 80% kcal) regardless of your kcal intake or modify it based on kcal. I mean lower kcal lower % fat, higher kcal higher % of fat

Paul

viji said...

Great information. Sometimes fat is also considered to be based on saturated and unsaturated.
Pure Acai

Wout Mertens said...

@Morris:
- The cramps and palpitations sound like magnesium deficiency. Consider supplementing it (I supplement 200mg/day myself for the same problems and it really made a difference. I started with 400mg/day).

- Furthermore, if adding carbs makes you feel better, add carbs. Do not count vegetables as carbs, you're not digesting them but your gut is and it converts them to short-chain fats. In healthy people eating 50 carb g/day at minimum is probably desirable.

@blogblog:
- I can assure you that many French drink two glasses of red wine per day. So do Belgians :) So you're saying that gives us toxic levels of copper and manganese?
- Many people report the same kind of improvements with LCHF diets (including me, with LC being <150g carb), so maybe the Very is only needed for some people.

Shameer Mulji said...

@blogblog

your posts are definitely interesting. Just out of curiosity, what do you typically eat on a daily basis? How does one manage to eat up to 80% fat on a VLC diet?

I'm asking because I'm fairly new to this.

Thanks.

Shameer Mulji said...

@blogblog

your posts are definitely interesting. How does one manage to eat up to 80% fat on a VLC diet? What do you typically eat on a daily basis?

I'm asking because I'm relatively new to this.

Thanks.