

More Evidence that Refined Carbohydrates, not Fats, Threaten the Heart - cwan
http://www.scientificamerican.com/article.cfm?id=carbs-against-cardio

======
gruseom
The article contains this astonishing statement: the meta-analysis "found no
association between the amount of saturated fat consumed and the risk of heart
disease". No association! Yet this has been public-health, government,
industry dogma for more than a generation. The history of this catastrophe has
barely begun to be written.

~~~
Andys
It usually takes about a generation for bad ideas to pass.

~~~
stretchwithme
It depends on whether government gets behind a bad idea or not. Bureaucracy
doesn't like diversity of thought and tends to reinforce current thinking.
Look at how long its taken for alternative medicine to get blessed.

~~~
demallien
Huh? Bad example. "Alternative medecine" that actually works just becomes
"medecine". The fact that this happens rarely is due to the fact that most
products marketed as alternative medecine are a crock and don't hold up when
tested. If anything, the fact that government allows these things to be
marketed at all is a perfect example of bureaucracy accepting diversity of
thought (when it really shouldn't!)

~~~
Andys
I'd rather the government accept medicines with centuries of empirical
evidence than lab-synthesised chemicals which have been pushed rapidly through
official process using cherry-picked clinical trials and promises of lucrative
paid positions for soon-to-be-ex-FDA officials.

~~~
demallien
Citation needed.

But seriously, as far as I'm aware (and I try to stay current on this topic),
there is no 'medicine' out there with "centuries of empirical evidence" that
isn't already accepted. There _are_ loads of compounds that _claim_ to be
effective, but when tested they are found to be no better than placebo.

Even if a compound is found to be effective, it isn't enough to make a good
medicine. The active ingredient needs to be identified, extracted, and
stabilised in a product that allows doctors to safely control the dose that a
patient receives. Skipping all of that work and just trying to take an
uncontrolled substance is dangerous - you can't tell if the active compound
has broken down, or just isn't present in a particular sample, or conversely,
is present in dangerous amounts. Furthermore, the naturally occurring compound
may have other, undesirable compounds included with it.

Modern medicine aims to control for all of this, and yes, the complexity can
be off-putting compared to the simplicity of "natural" solutions, but there
are good reasons for that complexity existing.

------
patrickgzill
Weston Price was a prominent dentist and nutritional researcher in the 20s and
30s.

He went on a tour around the world, studying isolated groups of people, their
diet (including mineral content) and checking their dental health, using it as
a proxy for resistance to infection and proof that dietary needs are being
met.

From studying groups as diverse as a remote Swiss village, windswept Scottish
fishing town, African tribes, Pacific Islanders, and Inuit, he came to a
series of conclusions which are at least somewhat in agreement with this.

A secondary point was also that poor nutrition of the mother, could be seen in
children due to crowding of the tooth and other maladies.

<http://gutenberg.net.au/ebooks02/0200251h.html>

The book is a little archaic and I am sure that some of the text sounds odd to
modern-day ears, however if you can read past that you can find some
interesting information.

I am aware of the skepticism some have about Weston Price, but recommend at
least skimming his own words rather than reading only choice tidbits presented
by those who disagree with him or would debunk his views as junk science.

~~~
martey
Looking at the websites of the Price-Pottenger Nutrition Foundation
<<http://www.ppnf.org/> > and the Weston A Price Foundation
<<http://www.westonaprice.org/> >, both linked from Price's Wikipedia article,
I am not convinced that those who call his views "junk science" are wrong.

Among their tenets:

* supporting raw whole milk instead of pasteurized milk

* believing that facial structure has an effect on health (and that the nutrition of one's parents affects this)

* campaigning against the fluoridation of public water

~~~
nixme
Yeah, the modern foundations espousing his ideals _do_ promote junk science
like homeopathy. But some of his original research is still interesting.
Consider reading some of Stephan Guyenet's blog posts about that research
(<http://wholehealthsource.blogspot.com/>) (grain of salt implied, like with
any prescriptive nutritional advice).

------
karzeem
Gary Taubes' _Good Calories, Bad Calories_ is a great book that examines the
science behind low-carb diets and attacks low-fat diets as completely lacking
scientific support and being essentially the biggest public health disaster of
the 20th century.

~~~
MikeCapone
I recommend it too. The title makes it sound like light pop-science, but he
did _a lot_ more research than I expected, and unlike most people commenting
on diet, he went to the primary sources, and even went back a far as 150 years
to see where the current mainstream view comes from.

------
Gillius
All grains regardless of how wholesome they are have numerous issues with
them.

1\. Glycemic index / load...all starchy carbohydrates raise your blood sugar
quickly and then cause a crash. This includes both white bleached flour as
well as whole grains.

2\. Gluten is the protein found in many grains, wheat being the most common.
Gluten is responsible for SO many of today's problems. Seriously just google
"gluten" paired with any autoimmune disease or other health condition and you
will find loads of information. This is not just for people who are diagnosed
Celiacs but for all.

3\. Lectins are found in all grains and legumes. They are the defense
mechanism for the plant to warn off predators to not eat them. They are toxic.
When we consume them they are considered "anti-nutrients" and bind to various
nutrients in our body such as calcium, magnesium, phosphorus, etc. The more
you eat, the more your body is leached.

4\. Calorie per nutrient, grains are horrible. It is impossible to calculate a
grain based diet to meet all the recommended intakes while staying below the
recommended calories. When you calculate a diet based on lean meats, fruits,
vegetables, seeds, and nuts, it appears you are taking in a multivitamin.

5\. Grains are acidic and the body is meant to run on an alkaline base. If you
end the day leaning towards the acidic side you again start to leach
nutrients, specifically calcium from your body. Replacing grains with fruits
and vegetables gets you back to the alkaline side. The only acidic foods that
should be consumed are grass-fed meats.

The Paleo approach is DEFINITELY the way to go for any person who is trying to
get healthier and recover from chronic diseases your doctors have misdiagnosed
you with. It is seriously amazing the vast number of misdiagnoses that occur
when a holistic nutritional approach isn't considered.

~~~
Kutta
\+ many to what is written above, except the issue with acidity, which is as
of now an excessively dubious hypothesis, see:

[http://www.imminst.org/forum/Acid-base-
hypothesis-t40269.htm...](http://www.imminst.org/forum/Acid-base-
hypothesis-t40269.html)

Also, I shall point out that oat is a glaring exception to the grain rule; it
has NO gluten and lectin, it has a relatively mild impact on blood sugar and
has a lot of fiber, with special mention of beta-glucan, an immunoprotectant,
anti-cancer and blood sugar regulating fiber. However, make sure that it is
plain rolled oats, steel-cut oats or oat bran; Cheerios is not a towering
source of oat.

------
csmeder
Maybe we will start to finally see products in major super markets that are
affordable and don't have tons of refined carbs. Right now it is either really
expensive or really time consuming to eat a variety of food that doesn't have
refined carbs.

~~~
jules
What do you mean by refined carbs? Does it include bread, pasta, potatoes,
etc? Because I don't think those are bad for you because they don't cause
blood sugar levels to rise as quickly as stuff like HFCS and sugar (but I
could be wrong).

~~~
tptacek
What's the evidence that you're thinking of that HFCS is particularly bad for
you? Sugar is bad for you no matter what form it takes.

~~~
dalore
I don't think sugar is bad for you. Excess sugar certainly is, but then excess
anything usually is.

~~~
tptacek
Take the spreadsheet 'carbocation posted, sort it by "glycemic index", skip
past all the nulls, and you have a list from "foods this SciAm article
suggests are unhealthful" to "foods this SciAm article suggests aren't
unhealthful". You'll find sugar, flour, potatoes, and white rice at the top of
the list, and fats and oils near the bottom.

~~~
pmccool
There are some interesting counterexamples; it's possible to make white bread
with a GI of 40 or so. Flour doesn't necessarily mean high GI, nor are
ingredients the sole determinant of GI. There's a paper kicking round where
the authors baked white bread with GIs between 40 and 100 (from memory). The
_only difference was proving time...

~~~
bbatsell
That's because the longer a dough is proofed, the less white flour remains in
its refined state — the yeast has had its way with as many sugar molecules as
it could belch. The flour is still the GI determinant, it's just not refined
white flour anymore.

~~~
pmccool
Longer proving time gave a higher GI. That seems at odds with your
explanation. Have I misunderstood?

~~~
bbatsell
Could you rustle up a link? That makes little to no sense to me.

~~~
pmccool
[http://journals.cambridge.org/action/displayFulltext?type=1&...](http://journals.cambridge.org/action/displayFulltext?type=1&fid=932472&jid=BJN&volumeId=96&issueId=05&aid=932460)

Tables 1 and 2 will give you a quick summary.

~~~
bbatsell
Ah. First of all, those proofing times are not nearly long enough for the
effect I was referring to to come into play. Secondly, each Bread sample is
not at all controlled for its proof time, they are explicitly varying the
volume of each bread (more volume = more proofing time, which is required in
bread-making). Since the entire point of the study is that volume is
correlated with GI, the results make sense.

------
carbocation
Based on the interest generated in the glycemic index by this article, I found
a link to the National Cancer Institute's glycemic index chart for over 4,000
foods.

Link here:
[http://riskfactor.cancer.gov/DHQ/database/gi_values.csfii_94...](http://riskfactor.cancer.gov/DHQ/database/gi_values.csfii_94-96_foodcodes.xls)

Discussion here: <http://news.ycombinator.com/item?id=1333106>

------
daniel-cussen
A few months ago, I thought that sugar was glucose, and therefore good for the
brain. On that basis I would drink two liters of Coke a day for the
brainpower. Then, while on this forum, someone posted a link to
<http://www.youtube.com/watch?v=dBnniua6-oM> (Sugar, the Bitter Truth), which
let me know that sugar is not pure glucose.

I resolved to find glucose, and I eventually did. I had to go to one of the
more industrial neighborhoods in Santiago (I live in Chile) to find it, and
after a few trips there I had myself a 55 lb sack of dextrose mono-hydrate,
which dissolves in water to form pure glucose.

Now I mix it with water for 250 calories of food for thought per glass or put
it in half-liter plastic bottles to drink at school. It's amazing stuff, it's
100% healthy, and it's great for working at hard problems.

~~~
jseifer
Just drink some organic orange juice. It's way better for you.

~~~
euccastro
Better yet, eat the oranges.

------
strooltz
t colin campbell, michael pollan, & Tim Robbins are probably the 3 most
important writers on this topic. while the latter two definitely write more to
stir reaction, prof. campbell basically published his results in the china
study.

basically, all three writers/experts agree that a vegetarian diet consisting
of unprocessed foods is the best (although not foolproof) way to ensure that
you will lead a long and disease free life.

the modern food revolution is only about 60 odd years old at this point -
human evolution cannot keep up with how quickly our food has changed and how
quickly our caloric intake has increased. perhaps in 10,000 years we will be
able to find a way to absorb nutrients from krispy kreme donuts and pizza but
for now its best to stick low on the food chain and as michael pollan say -
"Eat Food, Not Too Much, Mostly Plants".

Anyone looking for sources or more info i recommend the following:

The China Study - T Colin Campbell The Food Revolution (Or Diet For a New
America) - Tim Robbins The Omnivore Dilemma (Michael Pollan) Healthy At 100 -
Tim Robbins

one last note - Diet for a new america was written in 1988!!! This information
has been out there for decades - politics and misinformation has kept it
relatively out of mainstream media and on the sidelines but the statistics and
information is out there for those who take the time to look...

~~~
nixme
I _strongly_ disagree with your recommendations for Campbell and Robbins (and
I assume you mean John Robbins, not Tim Robbins). Like most nutritionists,
they do agree on eliminating refined carbohydrates and processed foods from
your diet. But these two specifically argue that saturated fats are unhealthy
and low-fat diets are optimal, the exact _opposite_ of the thesis of the study
and article.

Robbins is a dietary extremist and his books make Quackwatch's list of non-
recommended books that "promote misinformation, espouse unscientific theories,
and/or contain unsubstantiated advice" [1]. The National Council Against
Health Fraud even had a critical blurb towards his television program about
_Diet For a New America_ in their '91 newsletter [2].

While I find Campbell's actual research in the china studies important, the
book infers much more than the studies showed, not to mention a lack of
supporting follow-up studies that control for the most common criticisms
(genetics, rates of exercise, comparisons with mostly meat-eating populations
without diseases of civilization, etc.). I have a real issue with taking
descriptive information from data and turning it into prescriptive advice
before accumulating sound evidence. For a good critique, the always awesome
SkepDoc Harriet Hall posted a review on the Science-Based Medicine blog (which
I highly recommend) [3], although the comments get bogged down about her
linking to a similar criticism by the Weston Price foundation.

Oddly enough, as a lifelong vegetarian myself, I find myself wanting to agree
with these authors and recommending them to others. But it's disheartening
these authors feel the need to fortify their ethical choices with shoddy
scientific inferences. Yes, following their recommendations will almost
certainly lead to better health, but only because those recommendations merely
happen to correlate well with a healthier than average diet, not because their
assumed causations about optimal health are necessarily correct.

However, I do agree with your recommendation for Pollan.

[1]
[http://www.quackwatch.org/04ConsumerEducation/nonrecbooks.ht...](http://www.quackwatch.org/04ConsumerEducation/nonrecbooks.html)

[2] <http://www.ncahf.org/nl/1991/9-10.html>

[3] <http://www.sciencebasedmedicine.org/?p=385>

------
donaldc
_The analysis, overseen by Ronald M. Krauss, director of atherosclerosis
research at the Children’s Hospital Oakland Research Institute, found no
association between the amount of saturated fat consumed and the risk of heart
disease._

Considering that this is the conclusion of the study, the article itself seems
to soft-peddle the implications, stating in multiple places that saturated fat
may be "less bad" than refined carbohydrates. I'm a little mystified as to why
the article itself refuses to conclude that saturated fat is not a cause of
heart disease. The evidence that it plays a role has never been particularly
compelling.

------
blehn
Almost all nutritional research seems inherently flawed to me only because
it's so difficult to control the diets, lifestyles, and (obviously) genes of
the study participants.

 _The China Study_ makes some compelling arguments for avoiding "animal-based"
foods, but of course, there are people like the Inuit, who don't exhibit high
incidence of cancer and heart disease despite eating mostly animal-based
foods.

I try to take all this stuff with a grain of salt, but the idea of "Eat food.
Not too much. Mostly plants." seems most sensible to me. And I'd probably add
to that, "Get some exercise."

~~~
shpxnvz
Due to the lack of carbohydrates in their diet, Inuits apparently process
protein differently than most others, through gluconeogenesis. I can't say
whether that has any substantial impact on their susceptibility to cancer, but
it's not _necessarily_ inconsistent with the "China Study" findings.

------
tumult
I always wondered about this as a kid in school, when they talked about 'the
food pyramid' and that nonsense. It's not like when you eat animal fat, it
slides out of your digestive tract unchanged into your own tissue. It has to
be broken down and digested and turned into something else. At the time, I
remember thinking it would have been like assuming you could eat someone
else's brains and gain their knowledge.

But I was just a kid and they were the grownups, so I didn't say anything and
believed what they were telling me.

(Nothing, literally nothing, I learned in school outside of how to read,
write, and perform simple arithmetic has been correct or useful in my life.)

~~~
malkia
Domesticated animals have more fat than wild animals. Maybe wild animals are
better for us, than domesticated.

~~~
Kutta
Not really; pigs in particular have been bred to contain much, much less fat
and more muscle than what is typical in wild boars and ancient pig breeds. The
relatively rare mangalitsa hog is a perfect example of a fatty breed. Although
I note that this preference of lean pigs started only in the 20th century with
the anti-fat craze and the advent of vegetable oil production.

------
whyenot
It's not as simple as avoiding refined carbohydrates. Rice, baked potatoes,
watermellon, dates, and parsnips all have a very high (>90) glycemic index,
while some refined carbohydrates such as whole wheat bread and pasta have
medium to low GI (<70).

~~~
pmccool
Yeah. What's more, the same kind of bread from different makers can have
significantly different GI. The sugar content of fruit (and so, presumably,
its GI) varies with all sorts of things. So I completely agree that it's not
that simple.

------
puredemo
I'm always a little perturbed when I read about "refined carbs" being bad for
you. This is partially because of the "Paleo Diet" folks who rail against any
and all grains (and legumes) all the time.

How refined is too refined exactly? Is whole wheat bread considered refined?
Oatmeal? Granola?

Or are we specifically talking about white flour here?

~~~
weaksauce
Not an expert by any means but I imagine that they are talking about high
fructose corn syrup and bleached white flour.

~~~
tptacek
No, I don't think that's true. Grains in general are troublesome (there are
some worse than others, so that for instance bran won't kill you and flax is
downright good for you [but yech]), but this isn't some fad about how bleached
flour is particularly bad for you. Foods consisting primarily of flour are in
general not going to be particularly healthy.

Here's a link:

[http://www.health.harvard.edu/newsweek/Glycemic_index_and_gl...](http://www.health.harvard.edu/newsweek/Glycemic_index_and_glycemic_load_for_100_foods.htm)

'carbocation posted a link to an Excel spreadsheet of GI listings for lots of
foods, too.

You'll find that the lists aren't simply about demonizing Coca Cola and Wonder
Bread.

------
dkasper
It's hard for me to believe I'm saying this, but if this new study is true
then apparently it's time to revisit the Atkins diet.

------
stretchwithme
If it comes from a factory, factory farm or a lengthy cooking process, the
food is optimized for low cost and nice appearance. It may be disastrous for
you healthwise.

If a food is found in nature and humans evolved with it and like eating it,
its more likely to be good for you if eaten with the sort of variety of foods
you'd find in nature.

The fact that we like it is itself information about how healthy a food is,
provided technology isn't fooling our brains somehow.

~~~
SapphireSun
I too love snickers bars! I pick them from my garden each day.

------
jseifer
I've mentioned Ray Peat's articles before on this site but if you've found
this article interesting, have a look at some of his articles:
<http://raypeat.com/articles/>

------
tjstankus
Barry Sears (of the Zone Diet), among others, has been saying essentially this
for 15+ years. But I think ppl are starting to catch on, e.g., most know that
corn syrup is terrible for you.

------
viggity
How can this be?!?!?! The scientific consensus _was_ overwhelming!!! Al Gore
and Michael Mann tell me I am not to question scientific consensus and to do
so I shall be branded a "denier".

------
hackermom
The problem is the insulin response generated when the various sugary
carbohydrates hit the blood stream; "slow" carbohydrates are nowhere near
being a problem.

~~~
carbocation
What you say is almost certainly true with regards to diabetes risk. However,
the association is less perfect with regards to atherogenesis; in other words,
the glycemic index/heart disease risk may be purely mediated by diabetes.

Nevertheless, this article is a great start; I like that the media is now
starting to pick up on the correct correlation between carbs and
atherosclerosis - and if they also begin to understand and convey the glycemic
index, so much the better. As the studies discussed in this reasonably well-
cited article indicate, carbohydrate load correlates with the atherogenic
lipid profile, whereas saturated fat load does not.

------
c00p3r
By whom this study was funded? The Association of American pork producers, I
guess. =)

