Low Fat vs. Low Carb

[Julie G]

Anybody see the latest?

Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity
http://www.cell.com/cell-metabolism/ful ... 15)00350-2

Here's Time Magazine's coverage of the study:
http://time.com/3994328/diet-low-carb-low-fat/

Here's Mark Sisson's take:
http://www.marksdailyapple.com/low-fat- ... z3jK46Hcyx

Here's Stephan Guyenet's take:
http://wholehealthsource.blogspot.com/2 ... s-low.html

[ApropoE4]

The take-aways from this (small but very well designed) study are:

1. diet composition only makes a very small difference compared to total caloric intake.

The RC diet led to a loss of −0.529 ± 0.13 kg fat
While the RF diet led to a loss of −0.588 ± 0.14 kg fat

2. people lie and the only way to measure anything in a deterministic manner is to lock them up and control their food supply.

[Gilgamesh]

Hey gang,

A related news item:

https://cosmosmagazine.com/life-science ... lace-table

The longest-lived mice in the best metabolic health – their heart doctors would have been happy with their blood lipid profiles, sugar, and insulin levels – were the ones eating more carbohydrates and less fat and protein. A low ratio of protein to carbs appeared to be key. The shortest-lived mice were either on a low protein, low carb, high fat diet or a high protein, high fat, low-carb diet, similar to the original Atkins diet. The mice on the Atkins-type regime were leaner, but the plumper, higher carb eating mice lived 30% longer.

[...]
The results showed that the free eating, higher carb mice lived as long as those on 40% calorie restriction, and were presumably happier too, even if they were a bit chunkier.

("The ratio of macronutrients, not caloric intake, dictates cardiometabolic health, aging, and longevity in ad libitum-fed mice")

It's a rodent study, but it looks like solid work.

I'm worried about my new high-fat (65-70% by calories) diet.... The authors stress the dangers of too much protein, but too much fat was also a problem. At least I'm not eating a huge amount of protein.

This, and other work I'm currently reviewing, is actually pushing me back towards the view that lower-fat, esp. for APOE-ε4s, might be the best strategy (in general -- though we're all different!), if it can be done without concomitant problems with glucose metabolism. As some here have pointed out, if you have to choose between bad lipids and bad glucose markers, bad glucose markers are probably (again, in general: we're all different) the bigger concern as far as AD risk is concerned.

No problem, one might think! Just choose healthy, low-GI carbs. Well, for a lot of us (like me), that doesn't do it. Any appreciable amount of carbs shoots my post-prandial glucose too high. A couple people in the CR Society eat low-fat and simply exercise after every meal. I've mentioned Dean (the "banana-eater") at the CR Society. He exercises several hours/day, including after every meal, mostly in a way (treadmill or recumbent exercycle and desk, and not very intense, but long) that enables him to work.

I find that very light aerobic exercise (getting my pulse from its post-meal resting rate of ~60 BPM [pre-meal resting rate is ~44] up to the 90s or even 80s -- haven't tested 70s) is enough to knock down glucose, and is so easy it doesn't interfere with work/concentration.

Arg. This is so frustrating! I wish we had more solid answers....

GB

[Silverlining]

Hey G, you know this is my problem as well. I would just prefer getting insulin from my Dr, but until that happens, I need to find alternatives. I'm leaving for vaca soon, but upon my return I plan to experiment with the exercise after carb thing. I have a treadmill so that will be very convenient. I'll post my results.

[Gilgamesh]

Silver, look forward to seeing your results.

Myself, I'm going to chance it and stick with high-fat for another month until I'm back in the U.S., and then (finally!) get them there fancy lipid tests yall have been getting (except it's not possible in Massachusetts without a doc's appointment, right??).

If my lipids/cardio risk markers look OK, I'll stick with high fat. It's easy and better on my gut than low-fat (I'm soaking and, where possible -- like with almonds and sesame seeds -- sprouting all nuts and seeds, so I'm minimizing anti-nutrients).

GB

[Tincup]

A good analysis of the paper http://caloriesproper.com/a-brief-expla ... -carb-war/

The paper is here: http://www.cell.com/cell-metabolism/pdf ... %2900350-2 Look at Table 2 on p 5 of the PDF. The baseline diet was 2740 cal 350 g carb (50.2%), 101 g prot (14.5%), 109 g fat (35.3%). RC was 1918 cal 140 g carb (29%), 101 g prot (20.9%), 108 g fat (50.1%). RF was 1918 cal 352 g carb (71.2%), 105 g prot (21.1%), 17 g fat (7.7%). From my perspective the RF is a very low fat diet, however at 140 g carbs, the RC diet is still pretty carby. Remember Denise Minger said, "interesting things happen at both ends of the spectrum (VLC VLF).https://www.youtube.com/watch?v=KFfK27B_qZY This study is at the end of the spectrum on the LF side, but not the LC side. Walter Kempner MD successfully treated T2 diabetics with a rice and sugar diets in the 1940's (he also reportedly whipped non-compliant patients!). However, it was reported if they even had a tablespoon of fat he'd have to put them back on insulin. My understanding of the biochemistry is that the high carbs made the body call for insulin. Insulin requires fat for its manufacture. When there is almost no fat in the diet (and 7.7% would qualify), the body pulls fat from the fat cells to make the insulin.

[marthaNH]

My blood glucose goes higher than I like after a carby meal, too. I have two strategies for dealing with it, one is just keeping quantities low and always including fiber, protein, and fat, and the other is walking. On days when I really need to concentrate and get a lot of work done, I do short walks (1.3 miles) after meals. The break -- not too long -- seems to help my focus. When I have the leisure, I double that.

My current thinking is following the theory that glucose is a bigger problem for me than lipids, hope that turns out to be the right bet. I can keep glucose low if I focus on it, but going off-program it's way too easy to get one-hour readings in the 150s and higher.

[Harrison]

A couple of points:

Figures 3D, 3E, and 3F in the Cell paper shows that in a completely controlled environment there is a modest advantage in the Low fat diet. After reading, "Good Calories, Bad Calories" one would be led to believe the opposite of the cell paper's findings. However, to ApropoE4's point, total caloric intake is more important than macronutrient balance. Before I knew my E3/4 status, I ate a very Taubes-like diet, but in the end started going down the caloric restriction pathway and found that to be a lot more effective.

As this study is in a completely controlled study environment, it does not deal with cravings, urges, satiety, etc. When I used to eat low fat (South Beach diet), I was hungry all the time. When I switched to high fat, low carb, I was in much better control. One study diet may be better than the other in a lab, but people's real world mileage will vary. If you can eat low fat, high carb with no cravings and keep caloric intake under control, that is great. I cannot.

Regarding George's quote of Denise Minger (I enjoyed her book), "interesting things happen at both ends of the spectrum." This can be translated to Alzheimer's disease, where all sorts of interesting, and sometimes contradicting, things are found:
Mid-life obesity is associated with AD
Late-life underweight is associated with AD and late-life mild-overweight is protective of AD
It's thought the mid-life obesity is liked through T2D. The mechanism by which the late-life underweight works is not clear. My late grandfather was slightly overweight but active. As dementia set in, he became underweight, partly through refusing to eat.

[Julie G]

Expanding on Harrison’s correlations, it’d be helpful to focus on the E4 allele specifically. Thanks to Eric Reiman’s and Richard Casseli’s twenty year observational study with a large E4 dataset, that information is most likely available. They’ve previously published papers suggesting that in descending order: high blood pressure, high blood glucose, high cholesterol, and cigarette smoking (one pack a day for at least one year at ANY time) are correlated with AD especially in E4 carriers in a dose dependent fashion. It’d be interesting to see how other variables like BMI, HDL, TGs, LDL-P (?) correlate for our population. I’ve previously spoken with Dr. Reiman. He acknowledged that he has much of that information, but he hasn’t drawn the correlations yet. I plan to follow-up and ask again. He wanted to wait until after the AAIC.

I agree with ApropoE4, macronutrient ratios probably don’t matter much in healthy people. In unhealthy folks (with metabolic impairment/high blood glucose) they may matter… a lot. It’s interesting to note that in this study, the participants, although obese, are metabolically quite healthy. Some of us may be exceptions (thin with metabolic derangement) and may subsequently do better with higher dietary fat. It’s certainly individualized and dependent on so much more than E4. IMO, it’s all the more reason to let your biomarkers guide your macronutrient ratios. I humbly acknowledge all that we DON’T know.

[Stavia]

here's my 2 cents worth: Stavia's big picture view of Life, The Universe and Everything:

1. we don't know. not enough studies to be dogmatic.
2. for the first time in 15 years I am managing effortlessly and without hunger to keep at a healthy weight eating as I do (fat around 40%, no starchy carbs). and my hba1c is, as you Americans say, stellar.
therefore for me

I am not going to waste energy fretting about 1 when 2 is good.

i.e. 2 trumps 1.

p.s. no offence meant for anyone who does want to go deeply into the details. Its just for me at this stage in my life.