during two weeks in peru we saw very few obese in the native population.

arriving in the miami airport, it was stunning to see obesity everywhere you looked.

i guess everybody in preu must be in on the insulin/hormone secret. and i guess since every year our obesity rates are increasing, we must as a nation be forgetting to do our insulin/hormone management in ever increasing numbers.

Fine. Insulin management is not the only way to lose weight. But it is the most efficient for sedentary industrialized folks. Since we're dealing with Americans - not indegenous peoples who are on a restricted calorie diet, without processed foods, and who likely exercise more in one day than most Americans do in one year - this is, in my opinion, the preferred route to address the national crisis. You are absolutely right though that we, as a nation, are forgetting to do our insulin/hormone management, one scoop of ice cream at a time.

This study seems like it was a collossal waste of time, at least based on the information in the article. Calories in vs. calories out is clearly the source of virtually all weight loss or gain.

Eating the right foods has other benefits from a nutrition and cardiovascular perspective, et. al. Diet and exercise go hand in hand, study it all you want, but that will be your conclusion. Oh yeah, and you'll find that many Americans are lazy and lack self discipline.

So, if you eat less calories than you burn in a day you'll lose weight...if you eat more calories in a day than you burn, you'll gain weight. And if you don't eat enough protein and train with weights while on a calorie deficit you'll also lose muscle mass. This isn't news...this is common sense.

Marbles - how about number vs. "clearly".?

You want the secret to losing weight Factcheckero?

Exercise and diet.

There. That was remarkably hard to deduce.

But see, the problem is there are only about 7 of us posters on here who understand that the results of this study are common sense, and over 150 million people out there who lack this common sense. Unfortunately, that's why studies such as these need to be conducted...

Ruken - your conclusion raises the question "what type of diet?" which is the point of my post. And most Americans will not exercise. Period. So, how do they lose weight without exercise?

Give me two sedentary obese individuals and feed one 2000 calories/day in six meals, consisting of lean protein and fibrous veggies. The other, 2000 calories in ice cream in one meal right before bedtime. No exercise for either. One year later you will have one lean machine and one fatty. Why? Insulin. It is not calories in/calories out. Not all calories are expended as energy or stored. Many are simply excreted. Ask a type 1 diabetic whether they gain or lose weight if they do not manage their disease with the appropriate amount of insulin.

Recommended reading: Good Calories, Bad Calories by Gary Taubes.

Factchecker....not true. I was on a 500-700 cal average per day for 2 years due to medical issues. I could not tolerate solid foods so most of my calories came from liquids. I had to cut out fat almost completely. Instead of losing, I actually gained. It was part of what made diagnosing my condition so difficult, since the majority of people who have it lose weight instead of gain. I couldn't do, and still can't for the most part, fiber of any kind.

I find it amazing that we have so many people who claim that it's so easy that all you have to do is eat less and burn more. If that were the case, do you really think we would have so many fat people in this country? While logically there is truth to eat less/burn more and you will lose weight, but it's a lot more complicated than that.

If people honestly think that your body treats 200 calories consumed from a twinky the same way it treats 200 calories from lean protein, need to spend 3 minutes using Google or go back to basic chemistry to understand how the body processes food on a chemical level.

Our bodies are not designed to deal with the highly processed food that so many of us eat. And what does that due to our bodies? It throws our hormones out of whack, which is why simply saying that eat less than you burn in calories works - because you're assuming that our bodies work efficiently and the way they were designed. But when our bodies or not working efficiently due to the large number of chemicals (i.e., processed foods) we eat, our bodies are not running efficiently, and thus, do not process our foods correctly.

fatcheckero has it right... but it's more than just the hormone insulin that gets disrupted by a diet high in processed foods, nitrates, preservatives, and artificial flavors and sweeteners.

Adam, and what about those who can't eat anything but the highly processed foods? There are approx 5 million (some estimates go as high as 14 million) with my condition, Gastroparesis or paralyzed stomach, or one of the related conditions dealing with gastrointestinal motility. A good number of us can only do the more processed foods if we can tolerate solid food. I spent sooo long eating the few solid foods that I could tolerate: mashed potatoes, white bread, cream of wheat/rice that I won't go near them now. But I still have to watch the fat/fiber content or else I get thrown into a flare up of symptoms. Which means the more processed it is, the better. Add in the fact that many of us are in starvation mode due to the highly restricted calorie intake. You get a perfect setup for weight gain regardless of intake or exercise.

Wow, I was actually expecting some insight in reading this article but this study is actually one of the most ridiculous things I've ever read. It's like telling someone "yeah you'll get in shape if you exercise, whether it's an hour or two, as long as you keep doing it."

Seriously, what rational person wouldn't already know this?

You are sure????? I've been one of those "crazy" low carbers for 6+ years, and the only reason it's tough to adhere to is all of the food pushers out there. I have NEVER counted calories, and while I exercise some, i am not religious about it. I eat high fat/high protein, and have maintained 50lb weight loss for over 5 years. Before low carb, I tried like heck to excercise my way out of a bad diet, running like a nut, lifting weights, bicycling - ugh. Much easier to tell everyone to back off and let me eat the way I want.

I have lost 30 lbs in six months on a carb-regulated diet. Everything else in my life has pretty much remained the same, I eat more calories per day than I used to. The calories in/ calories out model is BS. There are many other factors to consider as fatcheckroo pointed out. The rest of you can debate all you want, when I put on my 33 in waist "skinny jeans" (6 months ago I was struggling into 38 in) the evidence to me is clear.

Mark - let me guess. When people you know asked "wow- how did you do that"? And then you told them, they all then criticized you. That's what happenend to me. Nothing like a chubby weight watchers person telling you your diet is "unhealthy". My maintained weight loss (I'm in my 40's) has been 50lbs - it'll be 7 years of low carb this September for me.

As long as your diet is not causing any other issues like hypertension, or high cholesterol then tell people it p!ss off when they critique your method.

But keep in mind, weight loss is not the end all be all, you could be doing damage to other bodily systems.

I agree with you Sluve. Exercise has to be an addiction, or at least a compulsion.

The trick is to stick with it when body parts start to hurt more with age and wear and tear.

I also agree. I am by no means "addicted" to exercise, but I work out five times a week to ward off the high blood pressure and heart disease that runs in my family. I also eat pretty much what I feel like eating, though I eat in moderation and try not to overindulge too often. I have maintained my weight for the past fifteen years, despite having two children during that time. Exercise truly is the key to shedding excess pounds.

I sure wish Jim Fixx were still alive...to give his opinion on your opinion SLUVE.

http://en.wikipedia.org/wiki/Jim_Fixx

He did exactly what you advocate but died of a fulminant heart attack and his autopsy revealed atherosclerosis - 3 of his coronary arteries were mostly blocked by fatty materials such as cholesterol.

TheMom, I believe he would fit into our "chronic cardio" athlete. Exercise is good, but also puts stress on the body. Too much and you're looking at additional inflammation in the body. Including in the arteries. Obsession is not good, no matter what it's for.

And flyingfarm, it's a seriously bad idea to push through exercise if you're hurting in places. It's a sign to stop, or risk injury. Slow down and work on strengthening problem areas and reducing inflammation gently rather than ignore it, especially when you're older.

I'm not saying you shouldn't exercise, but there really is a point when it's too much, and it doesn't give you a pass to just eat whatever you want. Just because you're "fit" doesn't mean it isn't doing damage.

Demon - actually , could ANYONE admit that maybe, just maybe, he was eating wrong? Nah - couldn't be. We'll just call it a "paradox" and maybe say he should have drunk wine or something.

But that's what I'm sort of saying, in a round-about way. Tons of exercise doesn't give you a free pass on your diet. And if you're eating poorly and putting a ton of extra stress on your body expecting to make up for it, your asking for a bad cholesterol profile and lots of damage to the arteries.

Therefore, eating better and allowing yourself to take it down a small notch on the exercise is probably going to be better for you. And there's no reason it has to be a drag or that you need to be "addicted" to it. I think many adults these days have forgotten that "play" is exercise too and not just for kids. Find a sport you like or gather up some friends, and you won't find yourself running the same boring course day in and day out.

And it just came out recently that one of the doctors that said red wine was good for you falsified his data. I'm not quite saying it isn't, there's been research since, but it proves that people will lie to get famous and it hurts the people that believe it. It's best to keep up with new data and even then take it with a grain of salt. Studies are starting to trend towards the idea that we're been wrong about how saturated fat and sugars effect our bodies too.

http://www.msnbc.msn.com/id/45959905/ns/health-health_care/t/heart-researcher-falsified-red-wine-study-officials-say/

Exercise is good, but also puts stress on the body. Too much and you're looking at additional inflammation in the body. Including in the arteries.

Demon,

Exercise causing inflammation in the arteries? Are you serious? When did you think this up? Exercise in no way has ever been shown to cause any kind of heart disease. To suggest in anyway that Jim Fixx's heart problems were caused by his training is ridiculous. Jim Fixx had severe coronary arterial disease that was caused by heredity and bad eating habits.

Actually, there's one such article here: http://www.psychologytoday.com/blog/p-nu/201103/cardio-may-cause-heart-disease-part-i

He has a link to the study discussed and explains it in his article.

Simply put, they found an alarming rate of heart issues in runners that supposedly shouldn't have had any.

And Mark here, has some interesting points on it as well : http://www.marksdailyapple.com/the-relationship-between-exercise-and-inflammation-and-what-it-means-for-your-workouts/#axzz1kycG5ZRu

I'm not saying all exercise is bad. Reasonable amounts of it do cause inflammation, but if the body is allowed time to recover from that stress it is essentially what makes you stronger. But if you're constantly running mile after mile every single day, your body can't recover and you hit a constant state of inflammation that involves the entire body. That inflammation damages tissue, muscles, and blood vessels. Coupled with the typical very high carb diet of an athlete causing dense LDL and oxidation, yes, heart disease can be a problem.

Demon,

OK, thanks for the link, an interesting article. My comments are these.

1) Even the author admits the 12% increase in LGE (heart tissue damage) is not "statistically significant by the general standards of biomedical publishing.

2) Not addressed are a plethora of other benefits to running (or cardio) such as lowered heart rates, lowered blood pressures, and reduction in heart muscle wall thickness.

3) Even if I accept the fact that Jim Fixx's over training contributed in some way to his heart problems, I still say he died mostly due to his hereditary predisposition to heart disease (there is family history there) and terrible eating habits. I have always felt that the Jim Fixx thing was a lesson to NOT assume cardio exercise will protect against heart disease in the face of everything else.

4) I tend to agree with the author on the marathoning thing. I am an avid runner and think marathoning is insane. A long "race" for me is 5K. But I train for them, including track workouts, and enjoy good, sensible, but intense training. The 26 mile stuff is for the birds and on that maybe we all are in agreement.

Thanks for the info.

Do you understand what CHOLESTEROL acutally IS? It is a building block of every cell in your body. It is used for cellular repair, and recycled by your liver. When more is needed, the liver makes more. VERY LITTLE is ever from the cholesterol in food. The only "harmful" cholesterol is LDL that has an extremely small particle size that is the kind that can "stick" in your arteries causing inflammation. Large particle LDL bumps right on through your arteries, back to your liver for recycling. Standard testing does NOT distinguish between the two - a VAP test is an extra test that will give this data, and it must be asked for. Saturated fat, in the absence of excess carbohydrate, has been demonized based on the faulty research of one man, Dr. Ancel Keyes, who threw out data that did not fit his HYPOTHESIS that "fat is bad". This unproven hypothesis became the basis of the original "food pyramid". And in the 30 years since, we have become a nation of overweight diabetics.

Well said, Wasn't Me!. Ancel Keyes' flawed research and the USDA food pyramid are largely responsible for the obesity epidemic, the other culprit being the massive increase in sugar consumption in America, thanks (not!) for putting high fructose corn syrup in everything food corporations.

this is old, but more applicable now than ever

http://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html?pagewanted=all&src=pm

I know tons of people who are not fat and do not eat healthy. They just exercise or do strenuous activity often.

This. A thousand times this. It's not complicated, in fact, it really is that simple. The problem is that simple and easy are two different things.

From personal experience, I'd say that the ratio of calories to exercise are the secret to weight loss; the ratio of fats, proteins, carbs, etc. are the secret to appetite management. (I don't mention vitamins and protein because in the 1st world, it's just about impossible for a healthy person who eats a varied diet to be vitamin or protein deficient.)

Your post is an example of posting true facts and a fallacious conclusion.

Its possible that particular foods make you more or less hungry - potential diet impact.

Its possible that particular foods make you more less likely to burn calories by increasing or decreasing your probability being active, sleeping etc - potential diet impact.

Learn to think.

a fallacious conclusion

Where is my a "fallacious conclusion"?

There is nothing "fallacious" about your post. It is the simple truth.

An iteration of the "duh" comment I was going to post. If you eat less than you burn, you will lose weight. It doesn't matter if all your daily caloric intake comes from fruit, gummy bears, or butter, if you eat fewer calories than you burn off, you will lose weight. End of story.

Regarding Hank's comment -- regardless of eating food that make you "more hungry," if you end up eating more calories, then you gain weight. If you resist eating more calories, you won't. It's not a "fallacious argument" but rather, the fallacy is that somehow a food that makes one "more hungry" directly results in weight gain.

The concluding statement, "learn to think" is the greatest fallacy here -- an ad hominem logical fallacy.

In a sense, weight loss success can certainly be dependent on the type of food you eat. If you eat nothing but chips, gummy bears, and butter but keep it under, say 1400 calories a day, sure you'll lose weight but you'll be hungry and feeling like crap from eating crap. Eating more lean protein, good fats, produce and whole grain carbs keep you feeling alert and satisfied and give your body the right fuel it needs, especially when on an intense exercise program.

MsKat is right. Calories in, calories out isn't all that simple because if you still aren't eating the right foods, you'll fail.

Eat the right diet, and you won't even really notice that you've cut calories. You'll be stay full, healthy, and lose weight at a nice rate (barring any other health issues).

But many people don't eat the right things or allow for too many cheats. Less calories but the wrong diet results in weight loss, yes, but muscle loss and nutritional deficiencies as well. And those nutritional deficiencies often leave those people constantly hungry, because their body's needs have not been satisfied. I can almost guarantee there are loads of people out there who simply don't know what to eat. Even if they manage to lose, they're usually cranky, tired, and sick.

You can't tell someone who isn't very familiar with the needs of their bodies and what's in their food that it's just calories in, calories out. It isn't that simple.

Based on what long term clinical controlled study do you base "calories in/out" hypothesis (not observational data, which can only disprove, not prove)?????

What that one poster was saying about "filling" foods, is that foods with high fiber tend to be more filling than other foods.

I agree with you MsKat & Ruken, healthy eating counts but is not required for weight loss.

For optimal health and well being:

calories in = vegetables, fruits, whole grains, nuts, and seeds with some (or none) meat and fish.

oops --> add to above: some (or none) dairy.

To Wasn't Me!:

Based on what long term clinical controlled study do you base "calories in/out" hypothesis (not observational data, which can only disprove, not prove)?????

I don't normally respond to trolls, but in your case I'll make an exception if you can prove that you're not a troll.

Dearie - I'm no troll. Just someone who thinks vegetarians are damaging their bodies and minds due to lack of fat and B12. When I QUIT following the advice you are giving, I ceased being a fat person with GERD, IBS - ya know, all that stuff they push pills for on tv?

It is as simple as calories consumed vs. calories burned. Really, it is. The problem is figuring out a way to keep from consuming so many calories--and that's where your diet comes in. That, and exercise.

Yes, you should eat a balanced diet, but if you somehow have the willpower, you can eat sugars and carbs and still lose weight (not saying that's a healthy diet).

Through all the trends and "gimmicks" and bizarre diets out there, I went with exercise more and consume less calories...and lost 55 lbs...and have kept it off for 7 years (and counting). It's not easy because it's a never-ending battle.

Marozzo, for many it is not that simple. There are those of use who are genetically predisposed to hold on to weight, depending on what part of the world your ancestors are from. I am one who is genetically predisposed.

Plus any medical conditions that slow down metabolism don't help any. My body was in starvation mode for 2 years due to a medical condition that severely limited the amount I could take in. The last time it flared up that bad (round 2001), it took about 3 years to get my body turned back round, so that it didn't hold onto every calorie that came in, and was able to lose the weight I had gained and kept it off for about 3 years before flaring again.

Calories in, calories out simply do not apply to everyone. And to put it the way that some people are responding only serves to make those of us who are heavier feel even worse than we already do because there's no controlling it sometimes.

Calories in, calories out simply do not apply to everyone. And to put it the way that some people are responding only serves to make those of us who are heavier feel even worse than we already do because there's no controlling it sometimes.

Calories in, calories out applies to everyone. The issue for some people is their genetic metabolism is slower and/or they are more sedentary -> therefore burn less calories. They require less calories in, to maintain a stable weight. It may not seem fair that you can't eat as much as your skinnier friends but that's the way it is.

I see people who couldn't "control it" do just that AFTER they have a heart attack.

Actually, I am glad I'm a little heavier right now. If I had lost instead of gained the second time around, I would be around a hundred pounds right now. I look at it as my body's insurance against the next time I flare and can't eat enough to sustain me. So many of my "skinnier friends" are extremely unhealthy.

Sorry, Mick, but you're the reason why we have such an obesity epidemic in this country. It's precisely this nonesense that you preach. 50% of your diet from carbs? Are you insane? Forget your thermodynamics and pick up a textbook on biochemistry. Your argument is logical from a textbook viewpoint, but you're assuming that our bodies are operating in an efficient and optimum manner. The problem is, that they're NOT! That's why you need to study biochemistry to understand how the body processes food. It's not a simple physics equation. Well, it is, but you've left out hundreds of variables in your equation. The body uses hormones to regulate all aspects. When these hormones are not in balance, the body simply does not process the way you would have it (perfectly), so your thermodynamics doesn't work. It's like assuming that you can put diesel in a BMW that requires premium unleaded gasoline and it should get the same gas mileage.

Our bodies are designed to run on premium fuel. What people are putting in their bodies these days is far from premium (highly processed, additives, chemicals, etc), so even if they follow your 50/25/25 plan, the body is not going to perform the way you predict that it will.

NJ - Adams - why is 50% carbs insane? Fruits and vegetables are generally mostly carbs but are also healthy, low calorie, and filling with lots of fiber.

EmilyinIowa-

people getting 50% calories from carbs are not getting them from fruits and veggies. They are getting them from wheat, high fructose corn syrup, sugar, rice, and potatoes in that order. not good

@dman: Although, it's pretty hard to gain weight if all you eat is non-starchy vegetables. I think you could force-feed someone carrots, celery, onions, lettuce, etc., and they'd probably still lose weight. They're rather low on the caloric density. It's actually a good way to lose weight -- eat everything else in moderation, but eat freely on the veggies. You end up feeling fuller, get more fiber and nutrients, and end up eating fewer calories.

If you'd actually start researching and stop spouting out old rigged data you'd find that Saturated Fats are not the enemy. Fat doesn't automatically become fat, and it certainly doesn't float around in your arteries.

The main cause of heart disease is inflammation and a diet that causes dense LDL, which is to say, a diet low in fat and high in carbs. Eating foods that oxidize easily (such as the always rancid vegetable oils, also high in Omega-6) causes your small dense LDL to get stuck in crevasses while it's trying to fix your inflamed arteries and then proceeds to oxidize and become hard and immovable. Your HDL can't clean that up. Interesting that following the diet the "doctors" told us to is making it worse.

The large fluffy type of LDL (higher fat, low carb!) is pretty much harmless though, so overall cholesterol doesn't matter as much. It doesn't get stuck or oxidize and even the overall number might be skewed. If it's a larger particle it may appear as if there is more LDL particles than is really there. And if you manage to get your trig levels way down it can even mess with the calculations they use to predict your cholesterol. But typically doctors won't even give you that much information, because after all, it won't get patients on statins now, will it?

the above post contains some truth mixed in with a lot of misconception

Fat doesn't automatically become fat, and it certainly doesn't float around in your arteries.

Fat certainly does float around in your bloodstream in the form of LDL. Free fatty acids also exist in the blood, usually bound to albumin

The main cause of heart disease is inflammation

While inflammation certainly contributes to heart disease, I disagree that it is the MAIN cause. Otherwise we'd be seeing a lot more rheumatoid arthiritis or lupus patients with heart disease. While those two diseases definetely contribute to heart disease through the above mechanism, the epidemiology doesn't support them as the MAIN cause. As proof, most people who have heart disease do NOT have chronic inflammatory conditions, and vice versa. True, many cardiac patients may have some inflammation from other causes, but their quantitative level of inflammation, measured with CRP or ESR is less, on average, than rheumatoid patients

Eating foods that oxidize easily (such as the always rancid vegetable oils, also high in Omega-6) causes your small dense LDL to get stuck in crevasses

How does eating foods that oxidize cause sdLDL to get stuck in creavasses? I think that remark was pulled from a crevasse...

Large fluffy DLD contains no carbs. Its a lipoprotein. Im not aware that a low carb diet, in case that's what you are referring to, alters your LDL composition

but the main point about large LDL being less harmful is true

And if you manage to get your trig levels way down it can even mess with the calculations they use to predict your cholesterol

And you are backwards on the trig level. Too high causes a problem usually. Not too low, that Im aware of. Although I have to say its rare I see a too low. Not only that, but you can always do a direct LDL measurement, which is a measured value, not a calculated one, to avoid any problems.

But typically doctors won't even give you that much information, because after all, it won't get patients on statins now, will it

Statins have been proven to be beneficial, especially in patients with known CAD. That point isn't even debated by experts

Not to mention that I have nothing to gain by a patient going on a statin. They are generic, cheap, and available for $4 at most pharmacies even without insurance. I checked in the mail today for my statin check, but suprise...not there

dman:

Since non-alcoholic fatty liver disease is commonly associated with insulin resistance, it's probably more likely a result of excessive sugar/carb intake than it is a result of excessive fat intake.

Oh dear, it's you again.

First of all, I know that cholesterol technically counts as a fat (and protein), but the assumption that all digested fat goes directly to the bloodstream is what I have the problem with. The idea that any fat that's solid at room temperature clogs your arteries automatically is something I despise. At this point, it's becoming common knowledge that digested cholesterol contributes very little to the cholesterol in your blood anyway. Your body would prefer to do repairs with saturated fat and protein, but in a low fat diet it'll pump out more cholesterol to make up for it. But eating a higher fat diet doesn't clog them, and in fact gives it more material to do proper repairs.

I still stick by that inflammation is the main cause. Even low levels of constant inflammation will cause damage, and your body responds by pumping out more cholesterol to fix it. Often this is the small LDL because the same diet that causes the inflammation is going to cause the small LDL. There are lots of other factors that may be considered causes of heart disease, but in the end, they all cause horrible inflammation.

This might be of interest to you. He explains things in fairly simple terms, but links to his research sources are throughout the article.

http://www.marksdailyapple.com/how-might-inflammation-cause-heart-disease/

I worded the oxidation issue poorly, I admit. However, the point still stands. Eating highly processed foods and foods that oxidize easily, especially when cooked at high temperatures release far more free radicals than anything else. When they change and oxidize the small LDL (which in its smaller state is very prone to it), it fails to function properly and isn't able to be cleaned up after wedging itself in damaged areas. It then causes more damage and keeps building up until you have a nice wall of plaque.

A low carb diet does effect LDL. One of the main reasons for small LDL is insulin resistance, and a low carb diet tends to fix just that in people who are even pre-diabetic and sometimes even for those with Type II. It at the very least makes it much easier to maintain health.

If you can actually get a doctor to get a VAP test, that's great. I know lots of people who's doctors wouldn't. Since the common calculation used is the Friedewald equation, it's great if your trigs are somewhere between 100 and 400 (god, I hope not anywhere near 400) But under 100 for your trigs and the calculations start to get a little wonky. And I'll mention something else about them, again low-carb is great for controlling it. Diets high in carbs and people with elevated insulin tend to have much higher trig levels.

The fact that statins don't do anything to change the particle size of the LDL is a problem. If you still have inflammation and small LDL, there will still be damage. Simply having less of it isn't going to necessarily help you. The only reason I could see it maybe being helpful is if it's a genetic issue. Most of the time it isn't, it's diet. In someone who has large pattern LDL, low trigs, and a good amount of HDL, and only has an elevated cholesterol total, lowering overall cholesterol is a waste. Statins aren't really going to help much with someone who isn't willing to change their diet and put down the damn Ho-Hos.

You know, Dr. Oz is not always our friend -- I'm sure he's a respected cardiologist, by he's still one of those "Oprah" people... you know, people who are good at selling whatever it is they have to sell and Ms. Oprah is willing to "buy."

In my region today's show was about medical "myths." One of these had to do with what happens with the fat we eat.

(Imagine my surprise to see the "Oz-ish" responses here.)

His one (only) expert discussed the so-called "insulin-myth." The "expert" also talked about everything else posters have brought up here, including how "Fat doesn't automatically become fat."

Key word = "automatically." Know what? Protein doesn't "automatically" become muscle.

The USA is becoming an obese society, looking for a shortcut or pharmaceutical way not to be obese. There is no shortcut or pharmaceutical answer. Even gastric by-pass (the last "Dr. Oz" show...) is not an answer.

Please, PLEASE everyone check out these "facts" for yourself. There's a reason Ms. Oprah is still overweight, and it is not genetics....

And about dairy -- get a REAL allergy test!

The fact that you'd even bring up that load-of-crap Oz, or even attempt to lump me in with him is offensive. Even more, the fact that he opposes Gary Taubes so vehemently bothers me, as I generally regard him with high esteem even if I disagree with some of Taubes' work.

I only said "Fat doesn't automatically become fat." in the same way you said "Protein doesn't automatically become muscle." Because it doesn't, even if people seem convinced otherwise. It pains me to watch someone turn up their nose at a beautiful grass-fed steak just because they're damn sure that little bit of heavenly fat on it will make them gain 30 lbs if they look at it.

No, there is no quick fix, and for some people one way of eating will be better than another. But if we continue on the path of encouraging the dietary recommendations that HAVE NOT been working, then it's going to just be that much harder.

And oh dairy...what I wouldn't do to find a nice full-fat greek yogurt these days...

pleasse expain the process by which it "clogs your arteries" - do you realize that you are parroting the so-called "common wisdom" for which there is no long term clinical study to back that up? Sometimes, when we repeat something over and over, we can all believe it to be true, even when we can't really recall HOW we all came to believe it was true.

Wolf,

Here's the deal. You completely and conveniently ignored my excellent point about inflammatory disease. This completely refutes the heart of your argument. Again, if inflammation was the MAIN cause of heart disease, then many lupus or rheumatoid patients would have very high rates of heart disease.

They don't.

As a corollary, the best treatment for heart disease, under your theory, would be steroids or ibuprofen, which decrease inflammation. In fact, steroids have been shown to be ineffective in coronary disease, and even worsen outcomes by causing.ventricular rupture. And we all have heard about the negative effects of Vioxx on coronary disease, which is a powerful non-steroidal anti-inflammatory

Game, set, match

wasn't me

Open a biology textbook to page 1 and start reading. I don't have time to explain basic physiology to you. It is your job to explain why you don't believe the prevailing theory that 99% of reputable scientists believe

I have read countless textbooks, read both biased and nonbiased studies, and treated patients as a cardiologist for years.

What is your resume like to challenge the world's opinion?

A bit pompous of you, really

Read the first damn sentence here:

"People with lupus are more likely to have clogged arteries that can lead to heart attack and stroke at a younger age, likely due to the inflammation from lupus."

http://lupus.webmd.com/news/20031217/lupus-patients-risk-early-heart-disease

And here:

"According to the American College of Rheumatology, rheumatoid arthritis almost doubles the risk of having a heart attack within the first 10 years of getting an RA diagnosis."

http://www.webmd.com/rheumatoid-arthritis/guide/heart-disease-rheumatoid-arthritis

While I disagree with much of the nutritional conventional wisdom on WebMD, it's generally a well referenced and researched website for information for a ton of other things.

At this point if you'd read some newer published studies, there's beginning to be a large backing for much of what I've just said. Those old textbooks won't include those, and for some reason you won't budge in the face of newer information. Stubborn, really.

Shut up before you hurt yourself. I'd never let you be my doctor.

d-man, there's another BIG factor in NAFLD...heredity. 5 people, not including me, in my family have it. 3 of them were exercising regularly and eating well when they were diagnosed. I was diagnosed by accident after a flare up of my underlying condition. Seeing this, there's such a strong presence in the family that even if I cut out all fat (not healthy by the way) I would still have gotten it.

Again, it is NOT as simple as calories in, calories out. Genetics play a large role in weight loss/gain, as well as things like NAFLD.

eric, how is it that virtually everything you write on every board to which you post consists of nothing but your "excellent points?" To use your own phrase, a bit pompous of you, really.

demon,

trust me, I know of increased rates of coronary disease in lupus. But it is NOT THE MAIN CAUSE! I can't make that any simpler for you. I specifically worded my responses with that in mind. Pay attention, because your reading comprehension skills are seriously in question:

then many lupus or rheumatoid patients would have very high rates of heart disease.

I have now BOLDED the pertinent parts for you. Increased risk does NOT equal main cause

Here's another place where I SPECIFICALLY addressed that (#13.3)

While inflammation certainly contributes to heart disease...

Next time, try READING my posts before taking on a superior tone, or risk embarrassing yourself again. I have no problem pointing it out for you

Again, if your point was true that coronary disease is ALL about inflammation, then why aren't anti-inflammatories the mainstay of treatment? Why, in fact, do they cause harm? Are you scared to answer this question? You have now ignored it twice. Your argument falls apart unless you can answer it

Try it

P.S. I would fire you as a patient very quickly, as would most doctors. Patient noncompliance because of an undeserved, stuck up attitude does not sit well with many physicians, FYI

And I took an oath not to harm anyone. I practice medicine according to the established guidelines

The nonsense you spout is in direct violation of those guidelines, and would get your license revoked if in some alternate dimension you were given the privelege of practicing medicine

LTC,

when did I say every post is an excellent point? Nowhere

Maybe they just look better next to yours....

Or maybe they are that good, since you copy my phrases instead of coming up with your own

Do I sense a God complex, Doctor? You are an embarrassment to yourself and the profession.

when did I say every post is an excellent point? Nowhere

Go back and check your posts...

LTC,

you need to go back and read your own posts. God complex?

Do you not have even ONE original thought in your brain? Or do you have to type stereotypical remarks written about doctors countless times over?

Go back and check your posts...

NO. YOU go back and check my posts. YOU made the claim...YOU back it up. Thats the way it works

But I know why your asking me to do it. Because I never said it, and you know it.

Just admit you made a mistake or lied. Or do you have too much of a g-d complex to admit that

We're done. Welcome to the ignore list

demon,

Just to show you what a MAJOR risk factor (like cholesterol) does...

http://www.framinghamheartstudy.org/risk/coronary.html

The framingham study is the largest cohort study studying coronary disease. If you use the calculator, the risk for coronary disease is increased by 14 TIMES with severe dyslipidemia

The risk for lupus wasn't even double

Make sense now?

THATS a major risk factor

Welcome to the ignore list

Oh, well, that's a shame, now, isn't it? And I thought we were getting along splendidly.

I present to you, the very reason those anti-inflammatories like Vioxx can harm more than help:

"In a normal body, the levels of Cox-1 and Cox-2 enzymes are naturally in balance. When you block one but not the other, unexpected things can happen.

It turns out that the Cox-1 enzymes also help make a chemical that encourages blood clotting and tightens the arteries. Normally, these nasty effects are kept in check by another chemical called prostacyclin. But prostacyclin is made, in part, with the help of Cox-2 enzymes -- the enzymes that drugs like Celebrex block.

Blocking only Cox-2 upsets the balance of these enzymes. Levels of prostacyclin go down, the influence of Cox-1 goes unchecked, and your risk of heart attacks and strokes goes up.

This is why Cox-2 inhibitors have been linked to an increased risk of heart attacks and strokes. The dangers were considered so high for the drug Vioxx that it was taken off the market. Bextra, another Cox-2 inhibitor, was also removed from the market partly because of the same risk."

And of course, the original source:

http://arthritis.webmd.com/features/pain-relief-how-nsaids-work

Those anti-inflammatories mess with a system that ideally shouldn't be messed with, and ends up making it worse. You can't just assume that inflammation in a wrist joint is the same as inflammation in the heart and arteries. Quite frankly, in most cases taking an anti-inflammatory is simply covering up the symptom than the cause. Especially in the case of diet, which this article was supposed to be about, it would be much more beneficial to stop eating the very things that cause inflammation rather than take a risky drug to cover up your bad habits.

You might want to note that aspirin is technically an anti-inflammatory as well, and is constantly used to lower the risk of heart disease, even if it's through the prevention of clots.

And again, why is the cholesterol the problem in the first place? We already know that a bad diet can cause a poor cholesterol profile like the small particle size and not enough HDL, but the body releases it for a reason. To fix damage caused by inflammation, from a bad diet, or perhaps one of the many other things that cause inflammation. Blaming cholesterol is like blaming the firemen instead of the fire.

The fact is, everything that increases heart disease has one thing in common, and that's the inflammation to the heart and arteries caused by all of them. Just because your little manufactured chemical doesn't work the way you want it to in one of the most complex things on this planet, doesn't rule out inflammation as the major issue.

And P.S.

I haven't needed a doctor for anything but a pap smear for years.

Established guidelines my ass. You mean the same guidelines that have slowly allowed us to become a fat and sick country? Yep, because clearly what you guys are doing is working. I'm taking an alternate route because it isn't.

I've had to deal with digestive issues my entire life because not one doctor wanted to try anything different then what the damn guidelines said they should. I've had to watch my mother struggle to lose any weight and fight with her Type II diabetes because they still insist she needs to eat the very things that cause her blood sugar levels to shoot up constantly. NOT ONCE did I EVER have a doctor say a damn thing to me when I gained 60 lbs and went from a BMI of normal to obese in a span in of a couple of years. Always have they treated the symptoms and never the cause. I'm sick of it.

And I'm shocked at what I dug up. It changed my entire life around, and now I have to fight with people like you who still cling to your failing guidelines. I used to do everything the "doctors" wanted me to. I ended up sick and fat and depressed.

The framingham study

Oh, good. An epidemiological study based on self-reporing and food frequency questionnaires. How valuable! Here's a link for anyone who wants a run-down of what the Framingham report actually says...and doesn't say, for that matter:

im not going to quote your whole first paragraph, but I can sum up the rebuttal very briefly:

If inflammation is the main cause of coronary disease, as you claim, shouldn't any effect of COX-1 (which is just blood thickening and artery tightening) be outweighed by its anti-inflammatory effect (which is, after all, the MAIN cause of heart disease)?

Secondly, explain why ibuprofen, which is a nonselective cox inhibitor, does not help heart disease

Thirdly, explain why steriods, which have NO effect on COX enzymes, do not help prevent heart disease.

Fourth, why is cholesterol such a bigger risk factor for heart attacks, rather than inflammation, as I have proven?

You can't. Your argument is proven wrong.

You can't just assume that inflammation in a wrist joint is the same as inflammation in the heart and arteries

Why not? Why should it be different? Plus, YOU assumed it when you posted your stats about rheumatoid arthritis. In fact, it is probably the same, as pt's with lupus have higher rates of heart disease FOR A GIVEN CHOLESTEROL LEVEL. In addition, CRP measured in JUPITOR revealed an increased risk in patients with inflammation even with "normal" cholesterol levels

Again, I agree inflammation plays a role. But to call it a major risk factor, or to say it plays a bigger role in heart disease than cholesterol, despite the massive evidence to the contrary, is ridiculous.

Blaming cholesterol is like blaming the firemen instead of the fire.

Wrong. What is your evidence that cholesterol fixes anything? Why does artificially lowering cholesterol through meds REDUCE the risk of heart attacks (JUPITOR, COURAGE, FRAMINGHAM?)

If cholesterol was the cure, not the problem, then lowering it would make things worse, not better

You mean the same guidelines that have slowly allowed us to become a fat and sick country

Your problem is you have the same mindset as many people in this country. You stuff your face with mcdonalds and cheeseburgers all day long, gain weight, and blame someone else. Your obesity is the proof. Point some of those fingers in the mirror

LTC,

also based on mortality data. Or do you think they lied about dying?

What about objective, measured data collected like blood pressure and lipid levels?

REally? You need me to point these things out to you? You should honestly know better....

Hi, eric.

I never said it...

Never? Here's a line from your post on November 24, 2011 at 1:49 PM EST...

You also ignored my excellent points...

...just before you wished me a happy Thanksgiving as only you can:

I do feel sorry for those that have to spend thanksgiving with you though, please give them my regrets

Such a pleasant fellow with whom to converse.

eric: Try following the link.... www.proteinpower.com/drmike/cardiovascular-disease/framingham-follies

wow, so i called two points excellent in the hundreds I have posted here, and you say:

how is it that virtually everything you write on every board to which you post consists of nothing but your "excellent points

Are you lacking in even the basic skill of counting? I think even a first grader knows that two is less than a hundred, and both are less than "every" which you conveniently left out when you intentionally misquoted me. You have to be kidding me. You can't lie when the proof is saved on the internet. I'll call you out on it every time

Why don't you post what you said right before my thanksgiving post? Because it was mean and nasty and would make you look bad

What do you expect when you are rude to people? A kiss?

LTC, meet the real world. Obviously you two are strangers

Your link got deleted. But I have read the data, and spoken with the current lead investigator. I couldn't care less about your second hand link

eric: I'm certain everyone here can draw his or her own conclusions with regard to personalities and nastiness. Why do you think Demon would have greeted you the way she did...

Oh dear, it's you again.

You have created a reputation on these boards of being nasty, insulting, and downright obnoxious towards anyone whose opinion may differ from your own or who may present facts which, for whatever reason, offend your sensibilities.

And as for this...

I couldn't care less about your second hand link

...it just goes to show that you're not interested in an honest, open discussion. Perhaps those on this board who have accused you of being stubborn and hell-bent on disregarding anything contrary to your long-established ways are correct. Don't forget that the "expert scientists" once insisted the world was flat.

Quite frankly, I'm running out of time to deal with you. I could argue drugs with you all day, and now that I look at it, I have. But I've got work that needs to be done, it wouldn't do to show up to class with no ideas for the logo I'm supposed to be working on. We could fight circles around each other, but I have enough proof. I'm not sick, I'm not fat, and I'm as happy as could be these days. It was so easy once I stopped listening to the advice that wasn't working. Honestly, the fact that you managed to argue so long with a 23 year old in college going for Graphic Design is beyond me. With your credentials it should have been no contest, right?

And yes, that pesky obesity problem. Interesting how college, depression and a thyroid problem does that to a person. And when I finally dug myself out of it I tried everything that was supposed to work. No thanks to the doctors that ignored me, by the way. I spent a long time, cranky, tired and miserable, with maybe only a couple of pound lost a month. And then the binging would set in again and I was back to where I started. I like how you can compare someone who developed an eating disorder to someone who simply doesn't care. I did care. I cared a lot. But I couldn't muster up enough energy at the time to do anything but cry about it. I'm not that person anymore.

I'm calling it a day before you give me a headache. I'm sure I'll see you floating around here anyway. I hope a professional like you didn't just waste a good chunk of his day fighting with a kid, right?

LTC,

I looked back at your previouis posts, and it seems you have your share of people who greet you with equally distasteful comments

As in me. To be honest, I don't really care for you. Sorry.

Built a reputation? Really? With who, you and demon? You have a gift for exaggeration

As for me not caring about your second hand link, don't take it personally. And do not blame me if you do.

I don't care for ANYONE's second hand information. Why would I care what dr mike's interpretation of the data is, when I can read it myself and come to my own conclusion?

Why would you Dr. Mike's judgement for your own? What does that say about you?

out of curiosity, i read your link

What is this guy talking about? Does he even have one coherent point?

I could answer all his questions with one simple fact. Inactivity, diet, fat intake, caloric intake all correlate with LDL cholesterol, not as well with total cholesterol.

We learned that later, and it was published in updates to the framingham trial, if ever bothered to look at them instead of spending his time on the original report from 1970

What is this guy talking about?

Well, I think it's pretty clear. To quote him, "[T]he results of this study were pretty clear. These guys tried as hard as they could to show a correlation between diet and serum cholesterol and between diet and the incidence of coronary heart diseas, but failed. The data conclusively demonstrated no such correlations."

As to your previous post, I must say that I have never had anyone greet me with "Oh dear, it's you again." Do not be sorry about disliking me. I take no offense at that. As for the "second hand link," I really don't take anything you say personally. I don't understand, though, how someone who is the business of "caring" for people can attack others with such venom simply because they may have differing thoughs, opinions, and understandings from your own. (I am not speaking only for myself.) It strikes me as particularly sad. I'm afraid you may be a very unhappy man. Hopefully, I am wrong.

As for the interpretation of the Framingham report, of course you can read it yourself and come to your own conclusions. I just don't think you've done it. I think you've accepted the medical establishment's conclusions on this study, rather than forming your own based on a reading of the report. Otherwise, I think you'd probably see that what Mike Eades has written is accurate.

I'm signing off now. You will likely feel you need to get the last word in and sling a bit more mud. So be it, if it makes you feel good.

there was more vitrol and hate in that post, albeit thinly veiled, then anything I have ever written

Along with you"G-d complex comment" You are quite the hippocrit.

Its about time you left. You really haven't contributed anything of value

Built a reputation? Really? With who, you and demon?

Count me in, as well. I see you around these things every once in a while. While you are exceptionally good at hurling insults, your debating skills often leave something to be desired. (By the way, having read your last post, you may wish to make better use of your spell checker.)

Just to show you what a MAJOR risk factor (like cholesterol) does... [link to Framingham]

What do you make of this? Dr. William Castelli, a former director of the Framingham Heart study: "In Framingham, Mass., the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person's serum cholesterol … We found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least and were the most physically active." Arch Intern Med. 1992 Jul;152(7):1371-2.

Or this? " … between 1994 and 2006 the percentage of men aged 65 to 74 with 'high' cholesterol decreased from 87% to 54% … Despite this, the rate of coronary heart disease for this age group stayed about the same … Other age groups have experienced an increase in the rate of heart disease as the number of people with 'high' cholesterol has decreased." http://www.29billion.com/storage/Healthmatters_JustinSmith_Statins.pdf

also based on mortality data. Or do you think they lied about dying?

What about objective, measured data collected like blood pressure and lipid levels?

The mortality, BP, and lipid data tell us nothing about the effects of the various macronutrients if we don't know what the subjects were eating. As LTC pointed out in an earlier post, self-reporting by study subjects and the use of food frequency questionnaires are not terribly reliable.

Did you actually read the first article? I had to log on to my institutional access to read it...

The title of the commentary is "Concerning the possibility of a nut..."

In framingham, this group you bring up ate more nuts. As people on this discussion have already mentioned, the source of your calories may not matter for weight loss, but is important for heart health. There is something protective about nuts that has been known for quite some time. Although higher in fat and cholesterol than ordinarily would be thought to be healthy, eating a moderate amount of nuts is actually cardio-protective, akin to olive oil.

I do not see any reason to invalidate Framingham based on that observation. Not to mention that much of the article you cite talks about the enormous volume of data that directly links increased cholesterol levels with coronary events

As for your second point, in the elderly, there is a known link between higher cholesterol levels and decreased mortality. Most people attribute this to confounding factors. Meaning, that for example, an 73 year old man dying of lung cancer will have very low cholesterol levels as he literally wastes away. Many degenerative diseases in the elderly follow this pattern.

Its the same thing with weight. Hardly anyone would argue that a BMI of >25 is healthy in most younger people, but actually the elderly who have BMIs in that range tend to live longer. Elderly with BMIs that are low are often suffering from some chronic disease or occult malignancy and are on their way out

The nut example aside, self reported food frequency/diet choices were never of major importance in framingham. Its all about cholesterol levels, blood pressure and mortality. Objective data.

Where are you getting the questionairre stuff from?

by the way, I re-read our earlier exchange regarding flu vaccinations, and I really can't find any direct insult I "threw at you"

Im not saying the tenor of our discussion was in the vein of best friends, but I don't see any huge animosity demonstrated

Don't take my disagreements with your viewpoints personally or as an insult. Or from anyone here for that matter. You'll spend most of your time licking your wounds with that mindset.

If you feel different, or can show any insults I directed towards you, please let me know

I'll respond to your first post later. I must go to work this morning and do not have adequate time to put into a response at the moment. However, as for your second post, must an insult be specifically directed towards me for me to make the observation that among your main tactics in arguing your point are derision, ridicule, and general unpleasantry towards the one with whom you are conversing?

no, but I think the person to whom the alleged insults are directed towards would be in a better position than you to comment on them

Either way, if you can quote any unprovoked insults by me towards anyone I would greatly appreciate it.

Also, if you can show that I insult people more than using logic, I would love to see your proof of that as well. Because from here it seems to be an unsubstantiated comment

In framingham, this group you bring up ate more nuts. As people on this discussion have already mentioned, the source of your calories may not matter for weight loss, but is important for heart health. There is something protective about nuts that has been known for quite some time. Although higher in fat and cholesterol than ordinarily would be thought to be healthy, eating a moderate amount of nuts is actually cardio-protective, akin to olive oil.

Yes, that’s true. As you mention, nuts tend to be relatively high in cholesterol. However, I noticed you seem to have a real concern with cholesterol.

Just to show you what a MAJOR risk factor (like cholesterol) does... [link to Framingham]

Fourth, why is cholesterol such a bigger risk factor for heart attacks, rather than inflammation, as I have proven?

Again, I agree inflammation plays a role. But to call it a major risk factor, or to say it plays a bigger role in heart disease than cholesterol, despite the massive evidence to the contrary, is ridiculous. ... What is your evidence that cholesterol fixes anything? Why does artificially lowering cholesterol through meds REDUCE the risk of heart attacks ... If cholesterol was the cure, not the problem, then lowering it would make things worse, not better

I am simply pointing out that even the study’s former director has stated that saturated fat intake and dietary cholesterol intake do not necessarily correlate with higher serum cholesterol.

I do not see any reason to invalidate Framingham based on that observation. Not to mention that much of the article you cite talks about the enormous volume of data that directly links increased cholesterol levels with coronary events

“Information published by the British Heart Foundation shows that the average cholesterol level for women in the UK is the 12th lowest on a scale of 45 European countries. A similar pattern is found for men in the UK, who are the 15th lowest on the same scale (Allender S, Peto V, Scarborough P, Kaur A & Rayner M (2008a) Coronary Heart Disease Statistics. Chapter 10 blood cholesterol. London: British Heart Foundation). Despite this, the UK has one of the highest rates of coronary events in the world (Allender S, Peto V, Scarborough P, Boxer A & Rayner M (2007) Coronary Heart Disease Statistics. Chapter 2 Morbidity. British Heart Foundation: London).

“When we compare the rate of heart disease with cholesterol levels across Europe, we find that no correlation between the two exists. For example, men in Glasgow have lower cholesterol levels than men in Switzerland, but the rate of heart attacks in Glasgow is more than two-and-a-half times greater. This is by no means an isolated case since there are more examples that contradict the idea cholesterol causes heart disease than prove it. …

“A study published in the Lancet included 5,754 patients from Australia and New Zealand who had already had a heart attack. The average cholesterol level of this group of people was around 5.7 mmol/l (Tonkin AM et al (2000) Effects of pravastatin in 3,260 patients with unstable angina: results from the LIPID Study. Lancet 355 1871–1875). Data from the World Health Organization Global Infobase (2009) shows that around the same time, the average cholesterol level for the general population was between 5.5 mmol/l and 5.8 mmol/l. People who suffered a heart attack had the same average cholesterol level as the general population.

“A study published in the American Journal of Cardiology included 8,500 men with existing heart disease (Rubins HB et al (1995) Distribution of lipids in 8,500 men with coronary artery disease. The American Journal of Cardiology 75 1202–1205). The average cholesterol level for this group of people was around 5.5 mmol/l, which (again, according to the World Health Organization) is around the same or even slightly lower than the average cholesterol level for the general population.” http://www.29billion.com/storage/Healthmatters_JustinSmith_Statins.pdf

It seems clear that there is no direct link of increased cholesterol levels with coronary events.

As for your second point, in the elderly, there is a known link between higher cholesterol levels and decreased mortality. Most people attribute this to confounding factors.

Others have simply admitted that they are unable to explain the results of their studies in the face of long-held beliefs that low serum cholesterol concentrations result in a lower risk for cardiovascular disease. According to some researchers, long-term persistence of low cholesterol concentration actually increases risk of death and the earlier patients start to have lower cholesterol concentrations, the greater the risk of death. (Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study. Lancet. 2001 Aug 4;358(9279):351-5.)

The nut example aside, self reported food frequency/diet choices were never of major importance in framingham. Its all about cholesterol levels, blood pressure and mortality. Objective data.

Have you read The Framingham Study: An Epidemiological Investigation of Cardiovascular Disease, Section 24 (subtitled The Framingham Diet Study: Diet and the Regulation of Serum Cholesterol)? Its main focus is dietary choices as reported on food frequency questionnaires. Moreover, if you go to the selfsame website you cited (http://www.framinghamheartstudy.org) and click on “FHS Bibliography,” you will find that searches for the words “diet” and “nutrition” through the various pages will provide several articles on the topics of diet and nutrition.

Where are you getting the questionairre stuff from?

It is common knowledge (and common sense) that food frequency questionnaires provide highly unreliable data. Can you accurately list for us everything you ate four days ago? Even if one were to keep a food “diary” and record purported intake at each meal, can we be certain that each and every one of those individuals measured the servings of each and every food they consumed at each and every meal…for how many years? Can we be certain that individuals were not too busy around the time of one daily meal – lunch, for example – to record the foods eaten and in what amounts every single day? Anyone who was too busy might forget s/he ate half of an apple or perhaps a tablespoon of peanut butter, so some foods would not be recorded when the individuals completed their food diaries later that day. And what about those individuals who were too embarrassed about what they ate to honestly report their dietary habits? Are we to believe that the subjects recorded every handful of M&Ms they took as they passed by the reception desks at their offices? Questionnaires such as these are simply unreliable.

With regard to your later post…

no, but I think the person to whom the alleged insults are directed towards would be in a better position than you to comment on them

If I see a child being beaten by an adult, am I to walk away simply because it is not I who is being beaten? Or because, as a child, I never experienced such physical abuse at the hand of an adult? If I discover my elderly aunt is being abused financially, am I to turn my back on the situation simply because it is not I who is being robbed? These examples are admittedly much more severe than is your behavior here and my response to it, but the concept is the same.

The simple fact of each human being's existence demands that s/he be treated with civility. I am not a particularly religious person, but there is said to have been a man who lived roughly 2,000 years ago who once said something to the effect of "Inasmuch as you have done this unto one of the least of these my brethren, you have done this unto me." This sentence strikes me as quite apropos to our discussion here. If a person shows respect towards one, he shows respect towards all; however, if he shows disdain towards one, he, likewise, shows disdain towards all.

Either way, if you can quote any unprovoked insults by me towards anyone I would greatly appreciate it.

If you so lack self control that another's opinion or his or her disagreement with statements presented by you provokes you to make deliberately injurious commentary, perhaps you might be well advised to enroll in an anger management course or seek other professional counseling.

Also, if you can show that I insult people more than using logic, I would love to see your proof of that as well. Because from here it seems to be an unsubstantiated comment

I will not engage in a spitting match with you over what percentage of your comments are insults and what percentage you might deem to be logical statements. The fact that anyone would use the tactics of insult and denigration in an attempt to intimidate another into agreement with one's position is, frankly, completely aberrant to the notion of meaningful discourse amongst civilized persons.

Yes, that’s true. As you mention, nuts tend to be relatively high in cholesterol. However, I noticed you seem to have a real concern with cholesterol

SERUM cholesterol levels, not as much in food. Cholesterol levels in the body are affected more by saturated fat than dietary cholesterol. Either way, nutrition is not my main focus or area of interest

Yeah, I read Justin Smith's article. I hate to break it to you, but he's an idiot. The biggest mistake he makes is he uses the words "average" and "normal" interchangeably. They do not mean the same thing.

For example, the average weight in this country has gone up by something like 50lbs over the past few decades. In places like Mississippi the average weight is in the overweight range. But by smith's logic, average=normal

The fact is, in those studies he quotes, the AVERAGE LDL of the patients who suffered heart disease is in fact, elevated, and the average LDL of the population was elevated (around 100)

The LDL of a baby is 35. The real problem is most of us have elevated cholesterol, and that's why heart disease is the #1 killer in the westernized world

The other point that Mr Smith misses is that you can't check cholesterol levels immediately following a heart attack. They are artificially low because LDL is a negative acute phase reactant--that means that during times of stress, the body slows way down on its production. Which makes sense; cholesterol is a long term concern for the body, which needs to be suspended at times when you have more pressing issues (such as almost dying)

It would be like measuring heart rates of people who are being chased by lions and then claiming the average HR of a human is 180. You need to measure things like cholesterol in steady state, not at times of stress

I am simply pointing out that even the study’s former director has stated that saturated fat intake and dietary cholesterol intake do not necessarily correlate with higher serum cholesterol.

No. In fact, in the article, he stated the exact opposite. What you did was selectively quote what he said about people who eat nuts, and then try and paint it like he said that about EVERYONE in the study

The Framingham Diet Study: Diet and the Regulation of Serum Cholesterol)?

Was never a main focus of Framingham

It is common knowledge (and common sense) that food frequency questionnaires provide highly unreliable data

I understand the problem with food recall questionairres. But that was never a major focus of framingham; they relied more on objective findings. Nor was it a major focus of mine in my posts

These examples are admittedly much more severe than is your behavior here

Haha, um, ya think?

I will not engage in a spitting match with you over what percentage of your comments are insults

Well, the fact is YOU made the accusation, but suddenly want to retreat when I press you on evidence. Fishy.

Fine. Why don't we take this thread so you don't have to look very far. It seems this started because LTC first made the accusation. Why don't you take a look at post #13.6

Do I sense a God complex, Doctor? You are an embarrassment to yourself and the profession.

She called me an embarrassment. When did say anything to her to warrant that? And then she has the audacity to accuse me of insults? Or what about Demon in post #13.11?

Shut up before you hurt yourself. I'd never let you be my doctor.

Are comments like those necessary? What did I say to invite such venom?

I'd really, really like to see what you have to say to that

To many (most?) following healthcare stories, you may know I have expressed a lot of issues with eric-2573068. So I ask, bear with me?!

eric, when I first encountered you on NV, you were lecturing, condescending and (in some ways) "smarter-than-thou." (Hope you recognize it?) After a while you started getting over it. Good on you.

However, (look at above reply)... there is s difference between "debate" and "arguing." eric-2573068, when you feel defensive, you go on the offence (i.e. argue -- and it's not pretty.) There’re a lot of "arguers" here, and few debaters.

eric-2573068, question is -- would you rather be an "informed debater" or just the rest of the crowd?

A lot of people want to know what "informed" people or "experts" have to say; they don't, however, want to be attacked for disagreeing with you.

Think about it, OK?

SERUM cholesterol levels, not as much in food.

Ah, okay. You just hadn’t specified until now. Also, the article that is the subject of this thread has to do with diet, so it was easy to assume you were speaking to dietary cholesterol.

Either way, nutrition is not my main focus or area of interest

That’s too bad. Diet and nutrition can be very powerful in healing the body. There are quite a few stories on this thread alone of people who have significantly improved their health as the result of making very specific dietary changes. (You might dismiss these individuals' experiences as anecdotal and not based in scientific reality, but I'm sure the results are very real to those people.)

Yeah, I read Justin Smith's article. I hate to break it to you, but he's an idiot.

I agree that Smith makes at least one error (see below with regard to low LDL immediately following MI) in his article. However, his error does not invalidate the studies he cites. I would not label him an “idiot” for having made a single error.

The biggest mistake he makes is he uses the words "average" and "normal" interchangeably. They do not mean the same thing.

Actually, Smith writes, “The ultimate way to test this idea [that cholesterol is somehow more specific to those who are at high risk for heart disease] would be to look at the cholesterol levels of those who already have heart disease or have had a heart attack – what we find is that these people actually have an average cholesterol level – not high cholesterol at all.” First of all, when Smith writes this, he is discussing a population of subjects within the UK. He has already indicated that “the average cholesterol level for women in the UK is the 12th lowest on a scale of 45 European countries” and the average cholesterol of men in the UK is the 15th lowest on that scale. Therefore, one can deduce that a large proportion of the general population in the UK are likely to have “normal” serum cholesterol levels (since they are the 12th or 15th lowest on a sale of 45 countries), and the subjects in question are likely to have “average” serum cholesterol levels when compared to their peers within the UK. He does not use the words “average” and “normal” interchangeably.

The other point that Mr Smith misses is that you can't check cholesterol levels immediately following a heart attack. They are artificially low because LDL is a negative acute phase reactant--that means that during times of stress, the body slows way down on its production. … It would be like measuring heart rates of people who are being chased by lions and then claiming the average HR of a human is 180. You need to measure things like cholesterol in steady state, not at times of stress

You are correct with regard to Smith’s conclusions about the study entitled Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines, Am Heart J. 2009 Jan;157(1):111-117.e2. Epub 2008 Oct 22. However, in another study he cites (Effects of pravastatin in 3260 patients with unstable angina: Results from the LIPID study, Lancet. 2000 Dec 2;356(9245):1871-5), none of the subjects was immediately status post MI; rather, they were all 3-36 months status post MI. It seems this would have provided plenty of time for the acute phase to resolve and cholesterol levels in these individuals to rise from their artificially low levels resulting from MI (or other cardiac event).

No. In fact, in the article, he stated the exact opposite. What you did was selectively quote what he said about people who eat nuts, and then try and paint it like he said that about EVERYONE in the study

I am afraid you have misread my earlier post. If you go back and look, you will see that I wrote:

I am simply pointing out that even the study’s former director has stated that saturated fat intake and dietary cholesterol intake do not necessarily correlate with higher serum cholesterol.

The inclusion of the phrase "do not necessarily" indicates that some individuals may see different results than others after eating various foods.

The Framingham Diet Study: Diet and the Regulation of Serum Cholesterol)?

Was never a main focus of Framingham

It most certainly was, particularly in the early years of the study. Even the Framingham website states, “The researchers recruited 5,209 men and women between the ages of 30 and 62 from the town of Framingham, Massachusetts, and began the first round of extensive physical examinations and lifestyle interviews that they would later analyze for common patterns related to CVD development.” One's dietary habits factor significantly into his/her lifestyle. Thus, the food frequency questionnaires and the numerous reports of studies regarding diet and nutrition that can be found on the Framingham website.

But if you insist on subscribing to the George W. Bush school of propaganda (“Despite all evidence to the contrary, by all means, repeat your comment incessantly and it will become fact in the minds of those whose ears your words may reach”), then there is probably no purpose in continuing this particular line of our discussion.

Well, the fact is YOU made the accusation, but suddenly want to retreat when I press you on evidence. Fishy.

I will simply repeat that I will not engage in a spitting match with you over this issue.

She called me an embarrassment. When did say anything to her to warrant that? And then she has the audacity to accuse me of insults? Or what about Demon in post #13.11?

(LTC is a woman? How can you tell? Just a thought...)

Shut up before you hurt yourself. I'd never let you be my doctor.

Are comments like those necessary? What did I say to invite such venom?

This is the age-old story of the playground bully whose tactics backfire when he finally meets his match. He runs away crying, all the while proclaiming himself the innocent victim.

(LTC is a woman? How can you tell? Just a thought...)

I'll never tell...

@Boris, where the heck to you come off correcting Eric? You attack my posts every time you run across them.

@LTC, good for you. Keep 'em guessing!

However, his error does not invalidate the studies he cites

Have you read the studies he cites? I have. And yes, not only that error but the bigger one about confusing "average" with normal" also invalidates his points.

one can deduce that a large proportion of the general population in the UK are likely to have “normal” serum cholesterol levels (since they are the 12th or 15th lowest on a sale of 45 countries)

Nope. being the 12th worst is still bad

But if you insist on subscribing to the George W. Bush school of propaganda

I think its the pot calling the kettle black. At any rate, heres the biggest problem. Lets say I accept your findings about these observational studies as 100% correct. I have RANDOMIZED, DOUBLE BLINDED, LONG TERM STUDIES showing the benefits of cholesterol lowering.

Look at JUPITER, ALLHAT-LLT, ASCOT-LLA, Heart Protection Study, MEGA, PROVE-IT, and TNT and others.

They are all randomized PROSPECTIVE studies which are higher forms of evidence than retrospective observational studies

For example, in every study you quote, was there any correction for other heart attack risk factors? Smoking, hypertension, diabetes, diet, etc? IF you told me that someone with a normal cholesterol had a heart attack, but they were a diabetic 2 pack a day smoker that weighed 250 lbs, I wouldn't be suprised

Thats the problem with the data you present

This is the age-old story of the playground bully whose tactics backfire when he finally meets his match. He runs away crying, all the while proclaiming himself the innocent victim.

Now you are just being difficult. Its obvious to anyone that they began the insults, and I responded in kind.

IF you want to close your eyes to the truth just for the sake of being argumentative, thats fine. Seeing as you have to resort to some abstract metaphor instead of the facts presented here I think tells me everything I need to know

LTC just strikes me as feminine by the way.

Just to give more credence to the theory that I in fact, am not a "Geoge W" style of debater, here's something NEW to chew on

Explain to me how, if cholesterol has no effect on heart disease, that people with familial hypercholesterolemia get heart attacks in their 20s and 30s.

http://en.wikipedia.org/wiki/Familial_hypercholesterolemia

eric-2573068,

I'm not here every day. You chose to ignore my, uhh.. advice that you be less "god-like" in your posts. OK.

Imatthebeach "@Boris, where the heck to you come off correcting Eric? You attack my posts every time you run across them."What? Uhh, huh????? I understand about defending a NewsVine "friend," but...???? I mean, really???

The outdated concept that saturated fat causes heart disease is just that, outdated. I guess if you keep parroting the same junk, eventually it becomes fact. One thing is for certain, once scientific facts are established, there is no need to continue conducting studies to support these facts. Do we conduct studies to determine the chemical composition of table salt? No, science tells us it is NaCl.

We see thousands of studies examining saturated fat and its effects on numerous diseases. These studies keep coming because the facts can not be substantiated.

I believe saturated fat has been given a bum rap. If anything, the polyunsaturated fats need to be better examined as causative of adverse health issues. Moreover, the processed and structurally altered triacylglycerols of these sources of fat may be far more problematic than the natural fats they were created to replace.

oxidation=inflammation=disease/accelerated aging

eric-2573068

I don't believe you are a doctor, just sayin'.

http://chriskresser.com/i-have-high-cholesterol-and-i-dont-care

People with familial hypercholesterolemia are very rare and their cholesterol numbers are much higher than the average person suffering from CAD

Blood tests may show:

• High levels of total cholesterol
  • Greater than 300 mg/dL in adults
  • Greater than 250 mg/dL in children
• High LDL levels
  • Greater than 170-200 mg/dL in children
  • Greater than 220 mg/dL in adults
• Normal level triglycerides

http://health.nytimes.com/health/guides/disease/familial-hypercholesterolemia/overview.html

Furthermore,

http://www.theheart.org/article/1342317.do

I really love this one. If you are a cardiologist, you should read this stuff!

lpj,

Your opinion is meaningless, you are nowhere near qualified or have enough information to render an opinion, and I dont care about it a bit...just sayin

You completely missed the point about familial hypercholesterolemia. Try reading it again, slower this time. You can even get an adult to help you if you need it

Just out of curiosity, eric, what are your lipid numbers? How's your heart? What do you eat?

im not sure that it matters, but sure, why not...

I take lipitor 20mg about 3-4x per week...my LDL is in the 60s, my hdL is in the high 40s to 50s, and my total cholesterol I think was something like 125 last I checked

I had a cardiac MRI to help calibrate the machine once, and my EF was fine w/o any congenital abnormalities

I have had a buddy echo my heart once just for kicks and there were no problems

Im a pretty young guy (in my 30s), so it would be very unusual for me to have heart problems. I have somewhat of a family history, but no other risk factors (no smoking, hypertension, dm, etc)

My diet and activity, like most americans, could be better. I try and exercise a couple times a week, but when I get busy with work that often suffers

Last night I had salmon for dinner, but the night before I had a ribeye. My diet isn't perfect--I think the occasional indulgence is ok (i have a pretty compulsive sweet tooth)

But my BMI is 22.8, and I feel great

by the way...don't you feel like the biggest hypocrite on earth after you called me "an embarassment" (unprovoked) and then go on to accuse me of slinging mud

Its honestly shocking to me how some people can be so blind to their own vices. Instead of pointing a finger at me you need to look squarely in the mirror, LTC

by the way...don't you feel like the biggest hypocrite on earth after you called me "an embarassment" (unprovoked) and then go on to accuse me of slinging mud

No, I don't.

you should

Yes - if the results of a study do not support a hypothesis then a new hypothesis is proposed based on the evidence. This is science. What do you object to?

The carbs will kill you. 100 calories in a 8-oz coke, a whopping 230 in a McD's SMALL fries (ever seen a SMALL fries at McD's lately? in the paper sack?)

Just by cutting out those two things, you probably dropped 500-1000 calories a day.

And yea, that is a lot.

Good for you!

Congrats!!

Yes, and ironically, fat (and proteins) can be low in calories.

If you can live on less than 2000 calories a day and walk a mile or two (not as hard as it sounds) you can lose weight.

Going low-fat may be heart-healthy, but it won't cause you to lose weight, unless you do the calorie-in, calorie-out thing.

I saw a bag of Jolly Rancher candies in the store the other day, and it said "No FAT!" on it. Well, duh, it is 100% sugar.

But most folks don't get that.

It is like those "candy vegetarians" in college, who live on vegan pop tarts and sugary cereals and think it is a healthy diet - and not a recipe for diabetes.

A balanced diet is the best bet. All of this and none of that rarely works out well.

It isn't. But since people are responding with "eating fat causes heart disease" and "running forever makes you healthy no matter what you eat", I figured I'd add my own rebuttal.

Fair enough. Everything you said was valid, IMHO.

Sugar turns into fat in *some* people. I love carbohydrates--bread, pasta, potatoes, you name it. And I don't want whole grain carbs; I like refined, white flour noodles and such. And I couldn't make it through the day without my Swiss Cake Rolls for dessert at lunch. But I also exercise regularly and limit my overall caloric intake. And I have maintained my weight for a long time.

Carbohydrates are not necessarily your enemy.

All the carbohydrates you mentioned cause spikes in insulin and then sudden drops. This can be measured by checking the insulin level in your blood 1/2 hour after ingesting these foods. Everyone is different, but carbohydrate for me is best from vegetables - I avoid grain carbohydrates as the constant spiking of blood sugar and then the drop causes me fatigue and anxiety. I exercise about 5 days a week, always aiming for 6 (weights, skiing, running, cycling).

I believe it, because I did the exact same thing. I went with Mark Sisson's Primal Diet, which is just the slightly looser (like his stance on dairy, eat it if you can tolerate it) and maybe easier to understand version. Very accessible for the newcomer. Worked fantastically for me too, didn't need to count calories or spend all day at the gym.

Still have weight to lose, but I'm not struggling with it. Easiest change I ever made with my diet, and I still get to eat steak with butter, onions, mushrooms and a little wheat-free tamari.

Sounds similar to my diet. Mine is based from what I read in Gary Taubes' books "Why We Get Fat and What to Do About It" and "Good Calories, Bad Calories". I still have a bit of fat to lose but for the first time in my adult life I'm actually starting to see some definition in my stomach area, I'd say that at the same weight I was at 28, I'm actually leaner now at 48.

I like dairy too, have light cream in my coffee and eat cheese. I do exercise, but I don't spend a lot of time on it and during the busy holiday season I didn't really have any time for it and my weight was unaffected by the lack of it.

Good to know that I won't be called a "Troll" by you guys! Dr. Atkins originally got me started and Gary Taubes was there 2 years after I was still walking around in the same jeans (No weight gain back, 45 and still a size 10!) going - OK - so THIS is how it works!!! So nice not to have to measure, count calories!!! But still, when people I haven't seen for a while ask me how I did it, they feel compelled to tell me "you'll have a heart attack" eating like that, or some version of that. Sigh......

I had tried Atkins first, but looking back on it now, I wasn't eating enough fat. I only lasted a couple of weeks and felt really horrible. Not to mention my digestion was messed up. Didn't even lose a little bit. Problem I was still eating grains and after ditching them I realized I was probably a little gluten intolerant. Grains cause some bloating issues in me and my gut ends up hating me. I spent my entire childhood with issues and GERD, and not once did any doctor ever mention gluten. I got rid of pretty much everything else and never got better. If only I had known...

I only have Taubes's Good Calories, Bad Calories, but I've got Robb Wolf's Paleo Solution and all of Mark Sisson's books. Sad thing is, I haven't been able to get anyone else to at least read them. Believe me, it's frustrating when my Type II mother won't even try getting rid of her grains or even bits of sweets, juices or soda. The doctors have her convinced that she still needs it, so her insulin is in a constant state of bouncing. For some reason she feels like she can't do anything about it.

@Demon: Too bad about your mother not trying this, Demon, from what I've read eating this way can if not completely reverse Type 2 Diabetes it will at least help to lose some of the weight and reduce/eliminate the need to take insulin. Ironic, isn't it that the medical profession treats it with insulin when having too much of in one's system basically causes Type 2. My mom has a dog that's diabetic and gets insulin shots, after telling her all about what I've learned she wants to read Taubes too and try giving her dog actual meat to eat instead of corn-based dry dogfood

I've gotten my wife to read Taubes and she is having good results as well, plus I've gotten a coworker/friend into Paleo, he's reading The Paleo Solution right now. I'm still in the middle of "Good Calories" and have Mark Sisson's "The Primal Blueprint" to read next.

@Wasn't Me!: I get the same thing from some people I tell about how I lost weight too, about the impending heart attack from eating so much fat. The status quo thinking has people utterly brainwashed that fat is the root of all dietary evil. One guy I work with after explaining to him in much detail how I was so successful still keeps skipping meals and eating junk like Lean Cousines that are mostly pasta and at one point we were both at the same weight (he's approx my height too) and he was wearing 38 inch waist jeans and I was about to graduate down to the 34s I wear now. Low fat and calorie restriction is totally not working for him but he won't try what I've been doing because he's worried about his cholesterol. I'm actually looking forward to my next physical so I can get my numbers on the bloodwork to show them the fat in my diet isn't a problem.

She's not even that far gone that she even needs the shots. She just needs to watch her sugar intake, that's all. But if she's lost any weight since she found out quite a few years ago, I haven't noticed. I'm very sure that if she wouldn't keep feeding herself sugar, she'd find it would stabilize quite a bit. She doesn't get to see me too often, I'm hoping another year of watching my results can get her to at least crack open one of the books.

I don't have plans for a dog or two right now, but after college I'm going to rescue a couple of Pit Bulls or maybe a Malamute or Husky depending where we live at the time. I've been trying to plan out what I think I might be able to afford. Raw prey model would be great, but it's already a little expensive getting myself something decent. Might just have to be a high quality grain free food for a while, with raw as an occasional treat.

While I was never diagnosed pre-diabetic or anything, I noticed it made a big difference when I switched. I used to get really sleepy after every meal, and I'd be lightheaded and cranky before I ever actually got hungry. After a few years, I forgot what a growling stomach felt like because the other symptoms would get to me first. Now it's just constant stable energy, and I feel hungry when I'm supposed to. It's great!