Category Archives: Fat in Diet

LCHF Diet Improves Metabolic Syndrome Even Without Weight Loss

Use the search box to find the recipe for this LCHF avocado chicken soup

“Metabolic syndrome” may be a new term for you. It’s a collection of clinical features that are associated with increased future risk of type 2 diabetes and atherosclerotic complications such as heart attack and stroke. One in six Americans has metabolic syndrome. Diagnosis requires at least three of the following five conditions:

  • high blood pressure (130/85 or higher, or using a high blood pressure medication)
  • low HDL cholesterol:  under 40 mg/dl (1.03 mmol/l) in a man, under 50 mg/dl (1.28 mmol/l) in a women (or either sex taking a cholesterol-lowering drug)
  • triglycerides over 150 mg/dl (1.70 mmol/l) (or taking a cholesterol-lowering drug)
  • abdominal fat:  waist circumference 40 inches (102 cm) or greater in a man, 35 inches (89 cm) or greater in a woman
  • fasting blood glucose over 100 mg/dl (5.55 mmol/l)

One approach to improving the numbers is a low-carb, high-fat (LCHF) diet. Here’s a journal article abstract from JCI Insight:

BACKGROUND. Metabolic syndrome (MetS) is highly correlated with obesity and cardiovascular risk, but the importance of dietary carbohydrate independent of weight loss in MetS treatment remains controversial. Here, we test the theory that dietary carbohydrate intolerance (i.e., the inability to process carbohydrate in a healthy manner) rather than obesity per se is a fundamental feature of MetS.

METHODS. Individuals who were obese with a diagnosis of MetS were fed three 4-week weight-maintenance diets that were low, moderate, and high in carbohydrate. Protein was constant and fat was exchanged isocalorically for carbohydrate across all diets.

RESULTS. Despite maintaining body mass, low-carbohydrate (LC) intake enhanced fat oxidation and was more effective in reversing MetS, especially high triglycerides, low HDL-C, and the small LDL subclass phenotype. Carbohydrate restriction also improved abnormal fatty acid composition, an emerging MetS feature. Despite containing 2.5 times more saturated fat than the high-carbohydrate diet, an LC diet decreased plasma total saturated fat and palmitoleate and increased arachidonate.

CONCLUSION. Consistent with the perspective that MetS is a pathologic state that manifests as dietary carbohydrate intolerance, these results show that compared with eucaloric high-carbohydrate intake, LC/high-fat diets benefit MetS independent of whole-body or fat mass.

TRIAL REGISTRATION. ClinicalTrials.gov Identifier: NCT02918422.

FUNDING. Dairy Management Inc. and the Dutch Dairy Association.

Source: JCI Insight – Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss

Steve Parker, M.D.

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Filed under Causes of Diabetes, coronary heart disease, Fat in Diet, Stroke, Uncategorized

What’s the Optimal Diet for Type 1 Diabetes?

A mess of Bacon Bit Brussels Sprouts: 6 grams of fiber per serve

Dr. Muccioli over at Diabetes Daily posted a brief article on a recent research study. A snippet:

The authors found that a higher intake of fiber was associated with lower average blood glucose values. In contrast, a higher intake of carbohydrate, alcohol, and monounsaturated fat was negatively associated with glycemic control (these patients typically experienced more variability in their blood glucose levels). Finally, the analysis revealed that “substituting proteins for either carbohydrates, fats, or alcohol, or fats for carbohydrates, were all associated with lower variability in the measured blood glucose values.”

Source: Which Dietary Patterns Are Best for Type 1 Diabetes Control? – Diabetes Daily

Eaton and Konner figured the Paleolithic diet provided over 70 g/day of fiber. How much are we in the West eating now? Something like 15–20 grams.

Steve Parker, M.D.

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Filed under Carbohydrate, Fat in Diet, Protein

New Systematic Review Concludes Omega-3 Fatty Acids Have NO EFFECT On Cardiovascular Disease and Longevity

Conquer Diabetes and Prediabetes, Steve Parker MD

Salmon is a rich source of omega-3 fatty acids

That headline is the conclusion of a Cochrane systematic review of the evidence. As you read the summary below, be aware that the main omega-3 fatty acids are alpha-lenolenic acid (ALA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA).

From Cochrane Library:

Increasing EPA and DHA has little or no effect on all‐cause deaths and cardiovascular events (high‐quality evidence) and probably makes little or no difference to cardiovascular death, coronary deaths or events, stroke, or heart irregularities (moderate‐quality evidence, coronary events are illnesses of the arteries which supply the heart). EPA and DHA slightly reduce serum triglycerides and raise HDL (high‐quality evidence).

Eating more ALA (for example, by increasing walnuts or enriched margarine) probably makes little or no difference to all‐cause or cardiovascular deaths or coronary events but probably slightly reduce cardiovascular events, coronary mortality and heart irregularities (moderate/low‐quality evidence). Effects of ALA on stroke are unclear as the evidence was of very low quality.

There is evidence that taking omega‐3 capsules does not reduce heart disease, stroke or death. There is little evidence of effects of eating fish. Although EPA and DHA reduce triglycerides, supplementary omega‐3 fats are probably not useful for preventing or treating heart and circulatory diseases. However, increasing plant‐based ALA may be slightly protective for some heart and circulatory diseases.

Source: Omega‐3 fatty acids for the primary and secondary prevention of cardiovascular disease – Abdelhamid, AS – 2018 | Cochrane Library

These findings are contrary to my views. I’m not sure who’s right. I still aim for cold-water fatty fish consumption twice a week.

Steve Parker M.D.

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Filed under Fat in Diet, Fish, Heart Disease

Dr Maria Muccioli: The Low-Carb Diabetes Revolution (Part I) – Type 1 Diabetes 

Published at Diabetes Daily:

Not long ago, low-carbohydrate diets were considered to be on the fringes of medically-recommended strategies for diabetes control. Long regarded as a “fad diet” and with the health effects often called into question, many patients were routinely discouraged from attempting such an approach. However, in recent years, as more and more research demonstrated the potential benefits of a low-carbohydrate approach for people with diabetes and prediabetes, we have seen a rapid change in the nutritional guidelines and the professional recommendations for patients.

At the 79th American Diabetes Association (ADA) Scientific Sessions, we saw a symposium addressing the changes in the nutrition consensus report for adults with diabetes. Notably, a one-size-fits-all approach is no longer recommended, with experts suggesting now that various eating strategies and macronutrient distributions can work well for patients from a nutritional and glycemic control perspective. Moreover, low-carbohydrate diets were explicitly addressed as a relevant and effective strategy, that is “garnering more attention and support”, as per Dr. William S. Yancy, MD, MHS, who chaired the symposium titled “Providing Options – Using a Low-Carbohydrate or Very Low-Carbohydrate Diet with Adults with Type 1 Diabetes, Type 2 Diabetes or Prediabetes”. In this series, we explore the research and surrounding conversations regarding low-carbohydrate approaches for these distinct patient subgroups.

RTWT!

Source: The Low-Carb Diabetes Revolution (Part I): Type 1 Diabetes (ADA 2019) – Diabetes Daily

low-carb mediterranean diet

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Filed under Carbohydrate, Fat in Diet

Forty Years of Dietary Advice Down the Drain – Buh-Bye!

Dr. Axel Sigurdsson is a cardiologist who focuses his blogging on cardiovascular disease and lipid disorders. I bet he agrees with me that dietary saturated fat is not the malevolent force we were taught in medical school.

From his blog:

“The [PURE study] suggests that placing carbohydrates at the bottom of the food pyramid based on their effect on blood cholesterol was a mistake. In fact, the data show that replacing dietary carbohydrates with different types of fat may improve lipid profile.

In an interview on Medscape, Dr. Mahshid Dehghan, the principal author of the abstract said: “To summarize our findings, the most adverse effect on blood lipids is from carbohydrates; the most benefit is from consumption of monounsaturated fatty acids; and the effect of saturated and polyunsaturated fatty acids are mixed. I believe this is a big message that we can give because we are confusing people with a low-fat diet and all the complications of total fat consumption, and WHO and AHA all suggest 55% to 60% of energy from carbohydrates.”

Today, most experts agree that diets high in saturated fatty acids or refined carbohydrates are not be recommended for the prevention of heart disease. However, it appears that carbohydrates are likely to cause a greater metabolic damage than saturated fatty acids in the rapidly growing population of people with metabolic abnormalities associated with obesity and insulin resistance.”

Source: High Carbohydrate Intake Worse than High Fat for Blood Lipids

PS: A diet naturally high in monounsaturated fat is one you may have heard of: the Mediterranean diet. A low-carb Mediterranean diet is the cornerstone of Conquer Diabetes and Prediabetes.

High MUFA, Low CARB

High MUFA, Low CARB

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Filed under coronary heart disease, Fat in Diet, Mediterranean Diet

Control Blood Sugar With Extra-Virgin Olive Oil

Steve Parker MD, Advanced Mediterranean DIet

Naturally low-glycemic index Caprese salad: mozzarella cheese, tomatoes, basil, extra virgin olive oil

Italian researchers found that extra-virgin olive oil taken with meals helps to reduce blood sugar elevations after meals in type 1 diabetics. This may help explain the lower observed incidence of diabetes seen in those eating a traditional Mediterranean diet, which is rich in olive oil.

Before going further into the weeds, remember that glycemic index refers to how high and quickly a particular food elevates blood sugar. High-glycemic index foods raise blood sugar quicker and higher compared to low-glycemic index foods.

The study at hand is a small one: 18 patients. They were given both high- and low-glycemic meals with varying amounts and types of fat. Meals were either low-fat, high in saturated fat (from butter), or high in monounsaturated fat from olive oil. Meals that were high-glycemic index resulted in lower after-meal glucose levels if the meal had high olive oil content, compared to low-fat and butter-rich meals.

If meals were low in glycemic index, blood sugar levels were about the same whether the diet was low-fat, high in saturated fat, or rich in olive oil.

Action Plan

If you have type 1 diabetes and plan on eating high on the glycemic index scale, reduce your blood sugar excursions by incorporating extra-virgin olive oil into your meals.

Steve Parker, M.D.

Reference: Bozzetto, Luigarda, et al. Extra-virgin olive oil reduces glycemic response to a high-glycemic index meal in patients with type 1 diabetes: a randomized controlled trial. Diabetes Care, online before print, February 9, 2016. doi: 10.2337/dc15-2189

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Filed under Fat in Diet, Glycemic Index and Load

Ghee is making a comeback, at least in India

Also known as clarified butter, ghee is a traditional food in India. I’ve been reading about it for several years but I haven’t tried it yet.

From Times of India:

“Clarified butter remained India’s culinary star for centuries till it was sidelined in the 1980s by vegetable oils because of its high saturated fat. The new oils were aggressively marketed as superior and heart-healthy. Of late, research has shown that saturated fats have no link to obesity, heart disease or early death. In January 2015, the US dietary guidelines declared for the first time that total dietary fat and cholesterol intake are not a concern for healthy people. Now, on the back of some recent studies which maintain that it reduces fat and lower cholesterol, ghee too is making a big comeback in India. It is also making a splash abroad in alternative health circuits.”

Source: Ghee with glee – Times of India

You can make your own ghee. Alton Brown has a recipe, as does Michelle Tam.

If you still think saturated fat is bad, here’s the research proving otherwise.

Steve Parker, M.D.

PS: If you fear saturated fat, rest assured there’s none in my books.

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