November 2011Monthly Archives

Your doctor’s advice may not be so great

While reading Trick And Treat by Barry Groves, I found information about an important study of heart disease interventions done in Finland. This study is important because the intervention group in this study was given the current standard of care for the prevention of heart attacks. One group was given the standard heart disease interventions: blood pressure medications, cholesterol medications, advice about diet and exercise. The other group was given no interventions. The study shows that while risk factors were improved, the number of deaths including from heart disease was actually higher in the intervention group. In other words, the standard interventions ultimately had the reverse effect of what was intended. Something in the standard treatments isn’t right.

From the book:

One [study] that did seem to support the “healthy” recommendations was a Finnish trial involving 1,222 men published in 1985. Men in the intervention group were seen regularly and advised about diet, physical activity and smoking. Those with high blood pressure or high cholesterol levels were treated with drugs. The men in this group did as they were advised and, as a result, the “predicted risks” for CHD were halved during the trial. It was hailed as a great success because: “The program markedly improved risk factor status.” In other words, they succeeded in changing their subjects’ diets, and so on. In December 1991, the results of a 15-year follow-up to that trial were published. During this period the intervention group had continued to be instructed on diet, smoking and exercise and treated for high blood pressure and cholesterol when present. Were they healthier? Did they live longer? The results are show in the table:

Deaths during 15-year follow-up
Intervention group Control group
Total deaths 67 46
Heart disease deaths 34 14

These figures show that not only did those who continued to follow the carefully controlled, cholesterol-lowering diet had more deaths in total, they were also more than twice as likely to die of heart disease as those who didn’t – some success!

Dr Michael Oliver, Professor of Cardiology at Edinburgh University’s Cardiovascular Research Unit, commenting on these results in the British Medical Journal, wrote that:

This runs counter to the recommendations of many national and international advisory bodies which must now take the recent findings from Finland into consideration. Not to do so may be ethically unacceptable. We must now face the fact that the evidence from large, well conducted trials gives little support to hopes that altering the lifestyle of the community at large, when started in middle age, will reduce cardiac deaths or total mortality.

References:
Barry Groves. Trick And Treat – how ‘healthy eating’ is making us ill. 2008.
Barry Groves’ site: http://www.second-opinions.co.uk/
Miettinen TA et al. Multifactorial Primary Prevention of Cardiovascular Diseases in Middle-aged Men, JAMA. 1985;254(15):2097-2102.
Strandberg TE, et al. Long-term Mortality After 5-Year Multifactorial Primary Prevention of Cardiovascular Diseases in Middle-aged Men, JAMA. 1991;266(9):1225-1229.
Oliver MF. Doubts about preventing coronary heart disease. BMJ 1992; 304: 393-4.

Stroke reduction in Japan

Cholesterol and animal fat are actually protective against strokes. That’s why Japan has such a high stroke rate. They don’t eat as much animal fat as we do. But they do eat a fair amount of rice, and that can cause damage from the carbohydrates. After the second world war, the Japanese were influenced to eat more like us with more meat and dairy. Their stroke rate went down by 85%.

One of these Japanese studies showed that the benefit came from the animal fat and cholesterol consumed. Those with the highest intake had the lowest incidence of stroke. Animal protein was not significant—just the fat and cholesterol.

The Okinawans, the Japanese people with the longer lifespans, eat more meat and less rice than other Japanese people, and they’re healthier for it.

References:
Barry Groves. Trick And Treat – how ‘healthy eating’ is making us ill. 2008.
Barry Groves. The Dangers of Low Blood Cholesterol, Second Opinions.
Shimamoto T, et al. Trends for Coronary Heart Disease and Stroke and Their Risk Factors in Japan. Circulation. 1989; 3: 503-15.
Adachi H, Hino A. Trends in nutritional intake and serum cholesterol levels over 40 years in Tanushimaru, Japanese men. J Epidemiol 2005; 15:85-89.
Liu L, et al. Changes in stroke mortality rates for 1950 to 1997. A great slowdown of decline trend in Japan. Stroke 2001; 32:1745.
Iso H, et al. Trends of cardiovascular risk factors and diseases in Japan: implications for primordial prevention. Prev Med 1999; 29: S102-S105.
Sauvaget C, et al. Animal protein, animal fat, and cholesterol intakes and risk of cerebral infarction mortality in the Adult Health Study. Stroke 2004; 35: 1351.
Gillman MW, et al. Inverse association of dietary fat with development of ischemic stroke in men. JAMA 1997; 278: 2145-2150.
Atkins D, et al. Cholesterol reduction and the risk of stroke in men. A meta-analysis of randomized, controlled trials. Ann Int Med 1993; 119: 136-145.
Dyker AG, et al. Influence of cholesterol on survival after stroke: retrospective study. BMJ 1997; 314: 1584.

Adjusting my diet to avoid potential health issues

It’s important to do the best we can with the plan we’ve invested in. That’s certainly my goal. My big issue with the NutriSystem plan is making sure that my cholesterol level doesn’t tank, and I’m not entirely sure how to do that or even if it can be done. One of my lowest cholesterol readings ever was 125. This was measured following a round of NutriSystem back around 1990, and this also happened to be when I was diagnosed with bipolar disorder. I was suffering with major depression at the time. Somehow, I still managed to function. It’s critical that I don’t let my cholesterol get that low again this time because low cholesterol is a risk factor, and I’ve already seen that my mood dips with my cholesterol readings. My cholesterol readings went down when I was vegan, and I was also beginning to develop depression, so there’s a hint. My intake was very high in fiber while I was vegan, and I know that can lower cholesterol. My guess for this round is that I need to lean my intake toward more fat while, of course, staying in calorie range. I will have blood tests done to make sure that my cholesterol levels stay where they need to be. My mood is good at present at least, so that’s a good sign.

Given the unexpected challenges I have had with my own health, I would advise anyone contemplating making a major dietary change to do so with the assistance of their physician, no matter what your age or how good you think your health is.  At minimum, get a lipid panel done before the change and again a month or two into it.

Choosing dietary fats

Dietary fats are not all the same.  Some can be harmful while others are quite healthy. Some contribute to inflammation, some ease it.  Omega-3 in particular is noted for its anti-inflammatory properties.  I definitely would NOT recommend vegetable oil such as from soy or corn.  It contains too much omega-6 fat, which causes inflammation.  That type of fat will also suppress your immune system and contribute to cancer.  I don’t tend to eat much of those at all, unless I’m eating in a restaurant that prepares the food with vegetable oils.  I don’t use them at home.  Animal fat from pasture-raised meat and dairy, olive oil, and coconut oil don’t contain much omega-6, so they should all be fine.  In fact, these kinds of oils can help the immune system and protect against cancer.  The type of fats you choose will make a difference in weight as well.  Pig farmers tried using coconut oil to fatten their pigs.  It didn’t work.  The pigs stayed lean.  Then they switched to vegetable oil, and the pigs got fat.

An interesting dietary study from 1931

There was an interesting dietary study done in 1931. They conducted a controlled dietary trial using a large variety of diets, ranging from 800 to 2,700 calories. Before they did that, they put all patients on a 1,000 calorie diet of varying types. Here are the stats for the average daily losses for the 1,000 calorie diets:

High-carbohydrate/low-fat – 49 grams
High-carbohydrate/low-protein – 122 grams
Low-carbohydrate/high-protein – 183 grams
Low-carbohydrate/high-fat – 205 grams

In other words, the patients on the low-carbohydrate/high-fat diet lost 4 times what those on the high-carbohydrate/low-fat diet lost. In another commentary on this diet, Barry Groves said that some patients actually gained weight on the high-carbohydrate/low-fat diet.

It was expected that on the 1,700 and 2,700 calorie diets, patients would not lose weight. In fact, all but three did lose weight.

In their conclusion, Lyon and Dunlop said: “The most striking feature … is that the losses appear to be inversely proportionate to the carbohydrate content of the food. Where the carbohydrate intake is low the rate of loss in weight is greater and conversely.”

Barry Groves says in Trick and Treat that the high-fat diet is preferable over the high-protein diet because excess protein creates waste products that stress the organs such as the kidneys. Fat burns cleaner in the body.

References:
Lyon DM, Dunlop DM. The treatment of obesity: a comparison of the effects of diet and of thyroid extract. Quart J Med 1932; 1: 331.
Barry Groves. Trick And Treat – how ‘healthy eating’ is making us ill. 2008.
Barry Groves’ site: http://www.second-opinions.co.uk/

Determining when you’re done with weight loss

At some point in the weight loss process, you’ve got to move into maintenance mode.  Dieting would become a problem if you did not stop and became underweight.  If your significant other thinks you’re thin enough now, I would definitely take that into consideration.  After all, doesn’t what they find desirable count for something?  Also, most people tend to be most critical of themselves.  What you see in the mirror may not be what others are seeing.  This is one of the ways that anorexics go astray.  They see fat in the mirror when in truth they look skeletal.  Such perception actually has a name: body dysmorphic disorder.  If others are telling you that you’re thin enough already and you’ve got a healthy BMI, consider that maybe they’re right.  There’s an article available for calculating ideal weight, if you’d like to check it out.  It’s here.  The last method is a military method that takes into consideration one’s body measurements.