Tuesday, August 19, 2008

AGE RAGE and ALE: VLDL degradation and Krauss

When you are waiting for a paradigm shift, you look at the old school dinosaurs with incredulity. One such dinosaur is Krauss. Who is Krauss? Well, you know that time worn phase of Churchill's:


"Man will occasionally stumble over the truth, but most of the time he will pick himself up and continue on"


That man is not really Krauss. Krauss is more like a little kitten, just beginning to use a litter tray and making such a mess trying to bury the truth that it doesn't manage to cover it effectively... The smell is pretty much a give away and someone has to empty the litter tray anyway.

This is Krauss burying the unsavoury truth about low carbohydrate diets as best he can, taken from the abstract.


"Moreover, beneficial lipid changes resulting from a reduced carbohydrate intake were not significant after weight loss"


The kitten's litter tray had to be emptied by Feinman and Volek, who know the truth when they smell it. You can read the full text here but this is the summary:


"Although some effort is required to disentangle the data and interpretation, the recent publication from Krauss et al. [1] should be recognized as a breakthrough. Their findings, presented in Figures 1-5, make it clear that the salutary effects of CR [carbohydrate restriction] on dyslipidemia do not require weight loss, a benefit that is not a feature of strategies based on fat reduction. As such, Krauss et al. [1] provides one of the strongest arguments to date for CR as a fundamental approach to diet, especially for treating atherogenic dyslipidemia"


Don't you just love that first phrase! So that's Krauss, just an introduction. Bearing in mind that all of these people live within the lipid hypothesis.

Why focus on Krauss? Well he wrote this commentary on the paper teasing apart the mechanism of the fasting triglyceride lowering effect of fish oils.


Here is the title of his commentary:


Hold the antioxidants and improve plasma lipids?


It never ceases to amaze me how someone who knows so much about the detail of VLDL production can be so stupid. The first thing is that back in the 1990s the original fish oil work showed that adding vitamin E actually increased the hypolipidaemic effect of fish oils. Maybe Krauss doesn't read old stuff from the wilds of scandinavia. Giving vitamin E by mouth is not remotely the same as dropping some vitamin E or desferroxamine on to cultured liver cells in a petri dish. Ancient practical work makes that crystal clear.

The other bizarre lack of perception is that it is BECAUSE saturated fats are not prone to peroxidation that they don't drop VLDL counts. He actually says this. For goodness sake. The man knows so much. He almost understands, but never quite. Saturated fats don't drop VLDLs, specifically because there is no need for the body to panic about saturated fat based VLDLs entering the blood stream. They don't peroxidise. Maybe Krauss has never heard of Kitava, unless he sees it as a potential market for mass stain medication...Sugar coated VLDLs may be another matter, whatever their lipid content.

And then of course you have to ask whether lowering triglycerides with fish oil does any good at all. The answer to that seems to depend on which study you cite. In some they help, in some they don't. But Krauss can't see beyond a lab number.

Peter

12 comments:

  1. have you heard of Ray Peat?
    this guy is very interesting and extremely knowledgeable

    he suggest a worrying trend in the recent rush to lionise fish oil

    we know about the cancer promoting properties of polyunsaturated oils from seeds, but what about the polyunsaturates from fish oils

    these are apparently much MORE unstable and oxidizable (did i just say that?) than sunflower oil for example.

    i would like your take on his arguments if you would???

    http://raypeat.com/articles/articles/fishoil.shtml

    markus

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  2. Hi Markus,

    I find Ray Peat unreadable, a pity because he's possibly correct on a lot of things. He should supply more convincing references, easily accessible, and I might finish his articles. He has posted on this very phenomenon but with three refs (not the MDA one I found). Two were abstracts and one full text. I couldn't see how any of them supported his argument, so gave up on him. He may well have been correct, especially when you look at the roll of MDA in dropping VLDLs, but hey, we all have to be convinced. I wasn't when I read his refs. You tend to give up at that point, well, I do!

    Peter

    PS why don't the innuit die like flies from cancer with omega 3 PUFA intake at over 15 grams per day?

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  3. Regarding the Inuit and cancer.... My gut feeling (bad pun) is with the [Otto] "Warburg effect" that tumor cells generate energy by glycolysis, burning off glucose (evidenced by a pet scan lighting up where the tumors are).

    Incipient tumors restricted of glucose can't get enough of it to fuel mitosis. The lowered insulin levels of a low carb/high fat diet limit the tissue growth, and thankfully it appears the cancer is not adapted to lipolysis. Caloric restriction, involves lowered insulin, and so would be like LC.

    So the way I see it, oversimplified, is PUFAs increase the likelyhood of cell damage, but the damaged cells may require glucose and insulin to develop into a cancer. That doesn't mean I want to play chicken with fate, deliberately increasing my carcinogen [PUFA] intake!!

    Of course then there's the omega-6 eicosanoids some of which promote "cell propagation" among other things (inflammation, platelet aggregation, etc).

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  4. I wonder if Krauss is under a lot of pressure to maintain his funding sources and professional associations happy (he has a close relationship with the American Heart Association).

    His research clearly supports LC and high fat eating as a way to improve lipid parameters, but the people who fund him are saturophobes. So perhaps he walks the thin line?

    Kudos to another great post, by the way.

    Alex

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  5. Hi Alex,

    I have "Mistakes were made but not by me" on my Christmas list. I hope Krauss has cognitive dissonance, but maybe I should read the book first. Holding deeply held beliefs and having your research repeatedly destroy them must come hard. If he's really just defending his funding it doesn't make him much of a scientist, or a human being either.

    Peter

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  6. Have you read this review about alcohol&liver disease?

    This is from "Hepatology. 1998 Oct;28(4):901-5; Dietary Fat and Alcoholic Liver Disease"

    "The whole spectrum of alcoholic liver disease, including fatty liver, necrosis, inflammation, and fibrosis, is reproduced in rats fed polyunsaturated triglycerides in the form of fish oil with continuous intragastric administration of ethanol. Such an extent of injury does not occur when the animals are fed saturated fat with the ethanol. In addition, the injury can be reversed after ethanol discontinuation by feeding a saturated, but not an unsaturated, fat diet."

    Quite interesting...

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  7. Hi Westie,

    We'll get on to this in the post on Figure 1 of Krauss' commentary. It's interesting and true. You want to see what it does to glucose homeostasis too.

    Peter

    PS alcohol researchers, some of them, know a great deal about insulin and ketones. The hepatic effects of alcohol are indistinguishable from those of fructose...

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  8. Very interesting, Alex.

    So, about cancer, it's the combination of PUFAs (especially n-6) and glucose.

    That could explain why both Inuit (lack of glucose) and Kitavans (lack of n-6: not so much fat, mostly saturated, they eat tubers, coconut and fish) are/were free of cancer.

    I'm surely oversimplifying here (and possibly going to take the second bad mark by Peter...) , but could they be both partially protected by the high intake of Vitamin D (Kitavans from the sun/fish and Inuit from the fish)?

    Another point is quite interesting: the relationship between iodine and cancer.

    I'm pretty well convinced it requires another post in the future, but... I came across an Italian researcher.

    http://web.tiscali.it/iodio/Documenti/Evolution.pdf
    (Evolution of dietary antioxidants: Role of Iodine)

    http://web.tiscali.it/iodio/index.html

    Back to Kitavans and Inuit.

    Do the Kitavans get all the iodine from their foods? Probably yes as they live on an island and eat fish or products from fields non-intensively farmed.

    Did the Inuit get all the iodine from their foods? Probably yes, before the transition to non-Inuit foods.

    (Am J Clin Nutr. 2005 Mar;81(3):656-63.
    Changes in iodine excretion in 50-69-y-old denizens of an Arctic society in transition and iodine excretion as a biomarker of the frequency of consumption of traditional Inuit foods.
    Andersen S, Hvingel B, Kleinschmidt K, Jorgensen T, Laurberg P.
    Department of Endocrinology and Medicine, Aalborg Hospital, Aarhus University Hospital, Denmark and Surgery, Queen Ingrids Hospital, Nuuk, Greenland.

    CONCLUSIONS: Circumpolar non-Inuit are at risk of iodine deficiency. Departure from the traditional Inuit diet lowers iodine intake, which should be monitored in Arctic societies. Urinary iodine excretion may be a useful biomarker of traditional Inuit food frequency.).

    p.s.:
    Sorry, Peter, for my "having too many irons in the fire" (does it have a sense in English?) and for my always being OFF TOPIC.

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  9. Now Chainey, we're talking post-endoplasmic reticulum presecretory proteolysis here.

    I get the impression you're not taking this seriously. Black mark. There's the chair in the corner, you know where the hat is...

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  10. Chainey,

    The guard in Hogan's Heroes was named Schultz.

    Peter,

    I'll take my place in the corner with Chainey now.

    :-)

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  11. Marco,

    I suspect that foods grown wild in habitable environments will support humans. If not, no one would live there (non habitable...). Once you start farming that's another matter. Farming means plants growing where they might not have grown, year after year... In the high alps (iodine deficiency) I guess there were no settled humans until dairying of the high meadows was developed...

    Peter

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  12. "PS why don't the innuit die like flies from cancer with omega 3 PUFA intake at over 15 grams per day?"

    They do age at an accelerated rate, according to Stefansson. The women were sometimes grandmothers before age 23. They looked as old at 60 as American women at 80. All of these are predictable side effects of the high-PUFA diet they ate. They also had bleeding problems. They would suffer nose-bleeds lasting for days and leaving them debilitated. Also bleeding strokes and hemorrhages.

    I don't look at death from a single cause as being very meaningful. One of the problems with Ancel Keys was that he did. He looked at the death rate from heart disease, but didn't consider that something might lower your heart disease deaths while at the same time increasing death from cancer, suicide, accidents, and so forth. That's exactly what happens when you tell people to cut out the saturated fat and eat lots of PUFA.

    If you don't like Ray Peat's style, try Nutri-Spec. Gary Schenker is as opposed to PUFAs as Ray Peat and he says much the same things, that all PUFAs are toxic, esp omega-3.

    http://www.nutri-spec.net/nl/2005-11.html
    http://www.nutri-spec.net/nl/2005-12.html
    http://www.nutri-spec.net/nl/2006-01.html
    http://www.nutri-spec.net/nl/2006-02.html
    http://www.nutri-spec.net/nl/2006-03.html
    http://www.nutri-spec.net/nl/2006-04.html
    http://www.nutri-spec.net/nl/2006-05.html

    Bruce

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