The China StudyTag Archives

The diabetes, heart disease, and the lipid hypothesis

It boggles my mind that high-carbohydrate diets are recommended to diabetics even though the carbohydrates will increase their insulin needs. The recommendations come out of a faulty belief in the lipid hypothesis. The intent is to prevent the heart disease that often accompanies diabetes. Those on the lipid hypothesis bandwagon like to cite Ancel Keys, but his study fell apart when confounding factors such as accuracy of the reporting of cause of death country to country were looked at. High- carbohydrate diets do lower cholesterol. I can even attest to that from my own experience with the vegan diet. But more recent studies are showing that there is no clear relationship between cholesterol and heart disease. T. Colin Campbell could not find one in his extensive study of the Chinese, and he very much would have liked to since it would have supported his assertion that a vegan diet is healthier. Never mind that the vegans were dying of infectious diseases and malnutrition at a higher rate.

Have you noticed that guidelines relating to cholesterol have been changing? It used to be that they told us that all cholesterol was bad. Then they told us that HDL was a good cholesterol and needed to be high and LDL was the bad cholesterol. Now they’re telling us that not all LDL is bad. It’s only the small dense LDL that’s bad. Such a change over the years! By the way, a high-carbohydrate diet increases the harmful small dense LDL. Some studies do show that heart disease improves when cholesterol is lowered by cholesterol drugs. But there may be another effect at work. The American Heart Association published a study showing that statins decrease inflammation, and this effect may actually be the beneficial action of the drugs.

With the lipid hypothesis falling apart, the rationale for recommending a low-fat/high-carbohydrate diet to diabetics falls by the wayside, or at least it should. Doctors who have suggested anything else have lost their jobs even though their results have proved their recommendations to be valid. So there’s a disincentive in the industry for jumping off the high-carbohydrate bandwagon even if it might actually be wrong. Many doctors are frustrated by the lack of improvement in their diabetic patients, but they’re also afraid to stray from the standard recommendations. A high-carbohydrate diet increases the need for insulin, which is a dangerous situation for a diabetic. Plus, as mentioned, it increases the worst kind of cholesterol. It’s far better to pursue a diet that decreases the need for insulin, I think.

Triglycerides have been shown to be more strongly linked to heart disease than cholesterol is. A high-carbohydrate diet increases triglycerides, too. If you are trying to prevent heart disease and diabetes, a closer look is definitely warranted. The standard protocol may not be the best one.

The positive correlation of wheat to heart disease proved to be interesting. Wheat has a correlation of 0.67 with heart disease—which is the strongest association between any food and heart disease found in the China Study. This is of particular concern given that the recommended high-carbohydrate diet often contains a lot of wheat. I picked the correlation out of a table from a post on animal protein, but apparently I was not the only one to notice. The blogger, Denise Minger, did an entire post on that correlation elsewhere in the blog. She took the data from China Study II and attempted to determine if the wheat/heart disease correlation was confounded by any other factors. With every combination she tried, the wheat/heart disease correlation held up. T. Colin Campbell, an author of China Study II, wrote a paper on the link back in 1996. The theory is that the correlation has something to do with the insulin index of wheat compared to rice. The insulin index of the rice is quite low compared to its glycemic index while the insulin index of wheat is high. In other words, wheat stimulates a higher output of insulin than rice does. I took a look at a chart listing the insulin scores of foods compared with their glucose scores. Rice did indeed have an insulin score much lower than its glucose score, both for brown rice and for white rice, which made it rather unique among carbohydrate sources on the list.

Denise Minger looked through the literature to see if there were any research studies relating to wheat and heart disease. Apparently, there were very few. It isn’t something researchers are looking at. Most wheat related research looked at things like whole grain vs. processed grain. She did find an old rabbit study that looked at wheat germ vs. various oils and atherosclerosis and a human study that looked at wheat bran vs. flaxseed and insulin sensitivity and C-reactive protein. In both studies, the wheat group fared worst. The wheat connection is definitely something that deserves a closer look. Hopefully, other scientists picked up on it and will do some studies.

It would not surprise me if the link held up under closer scrutiny. Gluten, a protein in wheat, has already been found to cause problems in relation to other disorders. I am at present trying to get my daughter to try a gluten free diet to see if it will help improve her neuropathy. The doctors think now that the neuropathy is a rare autoimmune reaction related to her cancer. Supposedly, gluten-free diets have improved neuropathy. Gluten-free diets have been shown to help other autoimmune disorders as well.

References:
T. Colin Campbell. The China Study: The Most Comprehensive Study of Nutrition Ever Conducted And the Startling Implications for Diet, Weight Loss, And Long-term Health. BenBella Books (May 11, 2006).
Denise Minger. “Forks Over Knives”: Is the Science Legit? (A Review and Critique), Raw Food SOS.
Denise Minger. The Truth About Ancel Keys: We’ve All Got It Wrong, Raw Food SOS.
Denise Minger. The China Study: My Response to Campbell, Raw Food SOS.
Denise Minger. Heart Disease and the China Study, Post #1.5, Raw Food SOS.
David J. Lefer, PhD. Statins as Potent Antiinflammatory Drugs, Circulation 2002; 106: 2041-2042, American Heart Association.

Looking at the USDA Dietary Guidelines

Today’s reading included a blog post by Denise Minger looking at USDA recommendations. The USDA recommends reducing saturated fat in the diet as well as reducing overall fat content. In their library of supporting documents, only one of the 12 studies cited actually supports these recommendations. The one study that does, a meta-analysis of studies, is later contradicted by a larger meta-analysis that shows no improvements. The first study is apparently confounded by publication bias. To further confound such studies, the USDA presented a pie chart showing where saturated fat in the American diet comes from. Grain-based desserts and pizza provide the largest portions of saturated fat in the American diet. But I just learned from the “Forks over Knives” post that China Study II positively correlates wheat with heart disease death and deaths from all medical causes. In fact, wheat correlates with heart disease better than any other food. Those grain-based desserts and pizza that we’re getting our saturated fat from have a lot of wheat in them. Meanwhile, animal protein and animal fat were negatively correlated in that study, meaning that death rates were lower. That’s an interesting finding from a scientist who promotes a vegan diet. So anything showing that saturated fat is harmful is likely confounded by the junkie carbohydrate and wheat intake that often accompanies the saturated fat. Furthermore, studies supporting increased intake of polyunsaturated vegetable oils are confounded by the overall healthier habits of those consuming those oils. When the data are corrected for these healthy habits, the benefit of the vegetable oils disappears.

By the way, the cited USDA studies and also Dr. Caldwell Esselstyn’s results cited in “Forks over Knives” blog post would support my modifications to the NutriSystem diet for attempting to keep my cholesterol levels healthy. This further increases my optimism that I have made the right modifications. We’ll see when I get the results back from this coming Thursday’s blood draw.

As an interesting aside, the USDA was unable to be conclusive as to whether fruits and vegetables are actually good for you. They say further study is needed. Very interesting indeed! Results from China Study II would support the inclusion of green vegetables, at least, since they are negatively correlated to deaths from all medical causes. Fruit is positively correlated with deaths from heart disease, stroke, and diabetes in that same study, though. Have I not said before that fruit poses problems due to the sugar content? That’s why I decided to eliminate fruit from my modified diet. There are better sources for the micronutrients fruits provide among the vegetables, and I do make sure to include those.

References:
U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans 2010.
Denise Minger. The New USDA Dietary Guidelines: Total Hogwash, and Here’s Why, Raw Food SOS.
Denise Minger. “Forks Over Knives”: Is the Science Legit? (A Review and Critique), Raw Food SOS.

Conflicting advice

I’m currently reading The Schwarzbein Principle: The Truth About Losing Weight, Being Healthy, and Feeling Younger by Diana Schwarzbein, M.D. It seems everybody has a different idea of what constitutes a good diet. In her book, she says that fats and cholesterol are important. She also likes to use hormone replacement therapy to keep estrogen levels up. She told stories about how clients on vegetarian diets had high blood cholesterol levels, and they were helped by adding eggs and meat to their diet. And yet, we’ve got The China Study, a massive epidemiological study, and other studies as well telling us that a plant based diet is superior for health. It’s difficult to know how to reconcile the information. To her credit, Dr. Schwarzbein does have a chapter on The Committed Vegetarian in her book in which she says the following:

Again, I never discourage anyone from eating a vegetarian diet. I discourage eating a bad vegetarian diet of cereals, pasta, breads, and sweets. A good vegetarian diet emphasizes tofu, seeds, legumes, nuts and whole grains, such as barley and quinoa, to get all the protein you need. A good vegetarian diet also provides essential fats from avocados, olives, and oils. You must mix and balance foods to get the needed nutritional balance at every meal. It is more work to eat a good vegetarian diet than it is to eat a meat-based diet, but it can be done.

My guess is that it’s only more work until one establishes the habits of a balanced diet. Then it becomes second nature. Right now, it’s still work for me to figure out how to do this right.

[Edit: This post was recovered from my old Exploring Veganism blog. Veganism ultimately proved to be an inappropriate approach for me.]

Trying out veganism

I’ve been reading The China Study lately. Its main message is that we can control our health outcomes by adopting a mostly vegan diet. According to the authors, studies show that animal proteins cause the so-called Western diseases of cancer, diabetes, and heart disease.

During the animal studies, they noticed that rats fed a plant-based diet were more active than those on a diet including animal protein. They gave the rats metered exercise wheels and found out very quickly that the rats on the plant-based diet were twice as active!

During the last several days, I’ve felt very sluggish. During this time, I ate a lot of dairy and meat, since that sort of thing is encouraged when one follows a low carbohydrate diet. When I read about the vegan rats, it dawned on me that the low carbohydrate high animal protein diet could be the cause of that sluggishness. I decided to give veganism a try to see if I felt better.

Yesterday was my first day on a vegan diet. It’s probably too soon to tell if I’m feeling better. I’m not exactly sure what metric to use for that. Perhaps I could look at how many hours I sleep. Last week, I slept in a lot, often sleeping until 11:00 AM or noon. I used information from Low-cost vegan meal plans.: An article from: Vegetarian Journal as a model for how to plan the meals. I certainly did not lack for protein. According to Diet Pro, I got 82 g of protein, which is more than the 55 g or so that I need. I got 20.5 mg of iron, too, which is plenty, even for a woman. I was surprised that I got 75% of my B12 need as well. I might have gotten more, since I don’t have B12 amounts in my database for some of the foods I ate.

[Edit: This post was recovered from my old Exploring Veganism blog. Veganism ultimately proved to be an inappropriate approach for me.]