
Fat vs. carbs: What’s worse for your health? [pdf] - yarapavan
https://liliec.be/resume/Heath-Food/Fat%20vs%20carbs%20What%20is%20really%20worse%20for%20your%20health.pdf
======
drewg123
I'm almost 50, and my family has a history of heart disease. So a few years
ago, I got serious about getting into better shape. Since then, I've lost
almost 55lbs.

I dropped the first 30 over the course of roughly a year and a half 30 by
doing vigorous cardio exercise (running) and not modifying my diet much at
all. My bloodwork looked far better in terms of cholesterol.

In the last 6 months I've dropped another 25 by switching the cardio from
running to rowing, adding weight training, and cutting most carbs from my
diet. I'm not a fanatic.. I still have a glass or two of red wine every day. I
still eat vegetables and fruit. But I avoid empty carbs as much as possible
(chips, rice, bread, etc).

My experience with this, and what I've heard from friends who have done
similar things, makes me think that the abundance of carbs in the modern diet
is a huge problem.

~~~
saargrin
how much do you typically row?

i feel i cant manage more than 20 min at consistent high effort :(

~~~
drewg123
I do about one hour every other day at an average pace of ~29spm keeping my
heart rate mostly in zones 4 & 5.

No question about it: It is _BORING_ as hell. Much more boring than running. I
just listen to podcasts and am very glad when it is done. The nice thing
compared to running is that, in addition to being a full body workout, there
are no excuses. No "its too hot" or its raining, or snowing, or whatever. The
machine is always in my spare room waiting for me.

------
milesvp
Related anecdote. A buddy of mine was dating a type1 diabetic, and he was
amazed at all the advice she'd been told all her life. Basically that she
should be eating mostly (fastish) carbs, counting them, and estimating how
much insulin to use to keep her blood sugar down, then measure, and maybe use
more insulin, or quickly eat a fast sugar to bring it back up. With type1
diabetes blood sugar control is a fine balance between losing a limb from long
term too high sugar levels, and being literally too stupid to eat from too low
sugar levels, and going into a coma.

He's got a background in signal processing, and control theory, and his first
thought was that it's basically the exact opposite of how he'd manage a
signal. Eating then estimating insulin to bring down sugar levels, was
basically less effecting than taking a known amount of insulin and eating to
bring up sugar levels. The main reason being that too much insulin is really
dangerous, and blood sugar is tricky to measure and it can be really hard to
tell if it's going up or it's going down with pin prick tests, even with
multiple tests, since you may be in the part of the signal that's ringing
after a big delta. He was even more convinced after a little research that fat
and protein and soluble fiber will slow down sugar production, which meant it
was even easier to slow down the rate of sugar change through diet changes,
which would make ringing less of a problem, making measurements easier, and
making smaller doses of more frequent insulin a viable strategy.

It took my friend months to convince his girlfriend to change her diet to
lower her carb intake. But when he did it made a big impact on her overall
health. The biggest change was when she stopped eating sorbet and started
eating full fat ice cream at night to keep her blood sugar high enough to last
until morning. It really helped prevent most of the night time blood sugar
issues she was having to deal with. Her doctor even begrudgingly admitted that
while "she was doing everything wrong", "all her numbers were better than
normal", and she should "probably keep doing what she's doing".

Also fun fact, following my friend's advice really helped me and my wife deal
with her gestational diabetes with both pregnancies. We were getting a lot of
bad advice, and we experimented with lots of foods, and cutting carbs really
helped her keep her blood sugar down. Oddly though, potatoes for her didn't
seem to have effects on her blood sugar that its glycemic index would imply,
preparation didn't seem to matter, she could eat a lot more potatoes than she
should have been able to. I suspect she has some kind of genetic or gut flora
predisposition with regards to potatoes.

~~~
AstralStorm
There was this guy in Poland, an MD, who figured this exact thing in 60s. He
essentially took and modified the damaged liver diet (rich in MCTs mostly) and
have it in a series of trials, lightly controlled, vs a plain lower calorie
diet, to a bunch of people in sanatoriums. He derived the diet from basic
principles and then available dietary tables - being forced into service but
the military he had to learn dietetics.

Extremely sick people who could barely walk. The results were pretty
resounding, so good they made whole Polish Academy of Sciences at the time
recoil and denounce him. He was thought to have committed fraud. They stopped
denouncing him repeatedly only in some 2000s.

This was the more correct grandfather of better known Atkins diet. It has some
uses. One of them is rapid weight loss, the other is diabetes, hepatitis
recovery, a few connective tissue diseases and epilepsy refractory to
treatment. It is driven by explicit testing for ketosis and microelement and
vitamin tables. And the difference is it's an actual process not just one flat
prescription.

------
cyounkins
Many evidence-based practitioners disagree:
[https://nutritionfacts.org/video/the-best-diet-for-
diabetes/](https://nutritionfacts.org/video/the-best-diet-for-diabetes/)
[http://plantpositive.com/blog/2012/3/26/tpns-52-54-the-
best-...](http://plantpositive.com/blog/2012/3/26/tpns-52-54-the-best-low-
carb-research-money-can-buy.html)

~~~
AstralStorm
Careful, this is with picked evidence. Use metastudies - they show effects are
rather low if any once corrected for lifestyle factors...

I was suckered into the Greger's vegan diet for a year with no results, not
even in bloodwork. (Even supplemented.)

Most importantly, we have not really plumbed the depths of ketogenic diets.

(Which is very different from eating a lot of meat - it's a lot of fats and
generally MCT and middle chain saturated are the optimal.)

~~~
cyounkins
Any author or paper can be subject to bias, including meta-analysis.

I understand the discussion is about fats in general, but we have extremely
reliable evidence that saturated fat causes heart disease, the #1 killer of
men and women, our parents and grandparents. I'll quote HackerNews user
cageface because s/he said it so well
([https://news.ycombinator.com/item?id=16566968](https://news.ycombinator.com/item?id=16566968)):

"Literally hundreds of metabolic ward studies (the gold standard in nutrition)
have demonstrated a direct, causal relationship between saturated fat intake
and blood cholesterol levels. And the correlation between high cholesterol
levels and CVD has been known for decades. Don't be fooled by observational
studies which fail to disentangle the highly variable baseline individual
cholesterol levels from the effects of fat in the diet. Here is a review of
395 direct feeding experiments, which are much more appropriate for measuring
the effects of diet:"

[https://www.ncbi.nlm.nih.gov/pubmed/9006469](https://www.ncbi.nlm.nih.gov/pubmed/9006469)

[https://www.ahajournals.org/doi/pdf/10.1161/01.cir.000010366...](https://www.ahajournals.org/doi/pdf/10.1161/01.cir.0000103664.47406.49)

------
m463
> But more recently we discovered that smaller LDL particles cause more
> plaques than large LDLs. And while eating saturated fat raises large LDL
> levels, small LDLs are boosted most by refined carbohydrates.

Will refined foods ever get a bad rap? I suspect they are easy to monetize
because they are efficient to create, store and transport and they can then be
used as off-the-shelf ingredients. They will have commercial interests behind
them, which means marketing slant.

------
stevespang
Polyunsaturated oils = excessive free radicals under storage and heat of
cooking

Saturated fats and the cholesterol of meats = atherosclerosis

Fried anything = acrylonitrile, carcinogenic

Monosaturated oils such as olive oil are the key, not to mention the
beneficial compounds such as oleuropin unique to olive oil. Eat handfuls of
raw walnuts daily. Walnuts actually have higher alpha-linolenic acid (ALA)
than flax seed.

Moderate complex carbs.

Supplement with Bilberry extract, Chokeberry extract and Elderberry extract
for powerful health promoting anthocyanins, teaspoons of each daily.

Just gave up most all forms of refined sugar, lost more weight, feel better.
Swim 5,200 yds. minimum per week. Mildly ripped from swimming.

I am 65 yrs. male and 5'10", 164 lbs., vegetarian since 20 yrs., severe
central sleep apnea (treated), but overall, never felt better in my life.

~~~
AstralStorm
Link between saturated fats and atherosclerosis is tenuous at best.

It is now likely that not all of these days have the effect. Likewise only
certain density lipids are dangerous.

Metabolism is a complex beast.

~~~
cyounkins
As I described above, I have to disagree: The link between saturated fat
intake and blood LDL cholesterol is very well established by hundreds of
controlled-feeding experiments. Here is a meta-analysis of 395 such
experiments:
[https://www.ncbi.nlm.nih.gov/pubmed/9006469](https://www.ncbi.nlm.nih.gov/pubmed/9006469)

Going from LDL cholesterol to atherosclerosis, the plaque that composes the
arterial blockages is largely made of cholesterol-rich lipids. On a higher
level, the use of statins to lower cholesterol is the #1 thing doctors do to
try to reduce a person's risk of heart disease.

