Wednesday, March 19, 2008

My Big Fat Diet - Aim High, Think Big, Score One More!

What happens when you convince a small, remote town to modify their diet to restrict carbohydrate?

You get a study called "My Big Fat Diet," where everyone participating agrees to shun the carbohydrate and dig in and enjoy meat, eggs, cream, real cheese and a variety of non-starchy vegetables.

Dr. Jay Wortman propsed such a study, and after months of ethics reviews and consultations, Wortman and his team of researchers tested the theory that high-calorie Western foods are the root cause of those health problems, not due to the dietary fat content, but the carbohydrate.

As the CBC reported, "[h]e set up a year-long study of the diet in Alert Bay, where 60 people agreed to live on a more traditional aboriginal diet of meat, seafood and non-starch vegetables such as cauliflower.His theory is that sharply reducing the consumption of carbohydrates and sugar will cut deeply into the very high rates of obesity and diabetes in native communities.

People who took part in the study lost significant amounts of weight, Wortman said. They also showed improvements in their cholesterol levels and diabetes control."

The preliminary findings are captured in a poster abstract, available here.

The findings are, in a word, expected.

What Wortman and his team found is what others have found in other studies - those who modify their diet by restricting carbohydrates and eating protein and fat ad libitum lose weight, improve triglycerides and HDL, have no significant findings for LDL or total cholesterol, see improvement in glycemic control with reductions in HbA1c.

In this study's subjects, it is reported that they:
  • Lost 10.1% of body weight
  • Shed 9.7% of their waist circumference
  • Improved their waist-to-hip ratios significantly
  • Triglycerides (TG) declined 19.9%
  • HDL rose 17.4%
  • TG/HDL ratio improved 30.2%
  • TC/HDL ratio improved 11.5%
  • Total Cholesterol (TC) and LDL had no significant change

More importantly, in the initial analysis, those with diabetes were found to have significant improvements in their HbA1c levels - seeing a decline from a mean 7.1% to a mean 6.1%. This is again a study that finds diet alone improves HbA1c significantly while also reducing or eliminating medication!

Now one would think that results like this, and others before it, would inspire those whom remain skeptical to see the value in such a dietary approach; after all, it is helping those with chronic health conditions to lose weight, improve specific risk markers and also reduce medication requirements.

Well, not so fast say the 'experts' sought for comment by the CBC for their article!

"The diet he is advocating has been compared with the high-protein, low-carbohydrate Atkins diet, which has been criticized by the American Society for Nutrition for causing dramatic weight fluctuations, leading to illness.

The Health Canada Aboriginal Food Guide still recommends native people eat rice, bread and pasta."

So, Health Canada Aboriginal Food Guide is going to continue to tell native peoples to keep eating that rice, bread and pasta; despite evidence, from multiple studies now, showing eliminating these foods is benefiicial to health?

But worse still is the message that is now in vogue, that modifying diet to restrict carbohydrate is too hard to do, unsafe anyway, so don't try.

As well, living on a more traditional diet may present challenges for many native communities, said Bernadette Dejonzague, a registered dietitian and a diabetes prevention program co-ordinator. This is because access to food sources such as sockeye salmon may be limited by contamination and transportation issues.

More insulting however, is the insinuation that native peoples are too stupid to modify their diet back to the traditional!

Many people who live in native communities "wouldn't know what to do with a deer or moose, even if they were able to shoot one,'' said Dejonzague, who is a member of the Abenaki First Nation and based in London, Ont.

Let's just forget the fact that native peoples lived off the land for generations prior to the introduction of flour, sugar and refined carbohydrates!

As Canada.com reported, "Starchy food such as flour for bannock, potatoes and pasta were introduced about a century ago and the impact on the aboriginal diet was devastating. Because of our people's low incomes we find it necessary to stretch out food and what better way than to add lots of starches such as bannock and potatoes. The Hudson Bay Company introduced us to bannock and we bought it hook, line and sinker. It found a market for flour at our expense."

At least Canada.com had the guts to be open and honest about the choices one must make, "We need to return to our roots of healthy eating and exercising. Our people in both the urban areas and reserves must examine their eating habits and adjust accordingly.People who have diabetes have two choices: They can treat the symptoms through medication or they can go to the root of the problem and follow a more traditional diet.

So get off the couch and snare a rabbit, set a net, shoot a deer or moose, and when summer comes go out and pick a mess of berries. Walk past the junk food aisle at the supermarket and head to the vegetable section. Our good health depends on what we eat and the Namgis First Nation has thrown out the challenge."

12 comments:

  1. Steve4:07 PM

    " . . . . access to food sources such as sockeye salmon may be limited by contamination and transportation issues."

    So don't follow the program at all, because there's 1% of it that you might not be able to do perfectly. This is the no dairy, no red meat, no fat, no artificial sweeteners, no mercury-tainted fish, it's-just-too-difficult-to-do-it-in-a-healthy-way argument. I love the ignorance of relative risk implicit in these kinds of statements. As if these things will somehow kill me faster than the extra 60 pounds I used to carry around.

    I guess we should always drive to our destinations too, because if we take a plane we might die.

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  2. Regina, if you keep posting articles like this, I may have to re-think everything I learned about nutrition over the last 25 years.

    I don't have time. Please stop.

    -Steve Parker, M.D.
    Author of The Advanced Mediterranean Diet

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  3. Anonymous9:27 PM

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    ReplyDelete
  4. Angelyne7:49 AM

    What gets me about the dietitian comments is how clueless they are. Eating like your ancestors might be difficult because of limited access, I can agree. But instead of *trying* to eat the closest available equivalent foods, let's just give up and eat a carb-heavy diet that is radically different from what your ancestors ate. A diet that has already been shown to be especially detrimental to native people's health. Yes that makes a whole lot of sense to me.

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  5. "The Advanced Mediterranean Diet"

    Well, Me. Parker, you may indeed have to re-think quite a bit when you write (from your web site) stuff like this:

    "The Advanced Diet encourages usage of heart-protective omega-3 polyunsaturated fatty acids in vegetable oils, espcially flaxseed, canola, and soybean oils. These were not significant contributors to the traditional diet. Full-fat versions of dairy products were the norm in the traditional diet. We know now that the saturated fats in them contribute to hardening of the arteries (atherosclerosis), so the Advanced Diet favors the low-fat versions."

    Who is this "we" that "now knows that saturated fats" contribute to hardening of the arteries? Could you cite some valid research that supports this argument?

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  6. Dear charles r, here are a few references that discuss how saturated fats contribute to atherosclerosis (aka hardening of the arteries).

    1. Kush, L.H., et al. Diet and 20-year mortality from coronary heart disease: the Ireland-Bopston Diet Heart Study. New England Journal of Medicine, 1985, 312(13): 811-818.

    2. Differences in coronary mortality can be explained by differences in cholesterol and saturated fat intakes in 40 countries but not in France and Finland. A paradox. Circulation, 1993, 88(6): 2771-2779.

    3. Diet and Coronary Heart Disease. Human Nutrition, Clinical Nutrition, 1982, 36(6): 413-427.

    4. Tell, G.S., et al. Dietary fat intake and carotid artery wall thickness: the Atherosclerosis Risk in Communites (ARIC) Study. American Journal of Epidmiology, 1994, 139(10): 979-989.

    The numerous references cited by the authors of these peer-reviewed scientific journal articles may also be helpful to you. I found these at PubMed.gov.

    I hope this is helpful.

    -Steve Parker, M.D.
    Advanced Mediterranean Diet Blog

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  7. Steve,

    Well I'm sorry but the articles you link to are not particularly convincing or supportive to your argument.

    The first two use words like "weak link," and "may cause," without identifying the mechanisms.

    If I were you, I might take a look at these peer-reviewed articles from the American Journal of Clinical Nutrition. There are many more such articles, but these are good for you to start with:

    Saturated fat prevents coronary artery disease? An American paradox.
    http://www.ajcn.org/cgi/content/full/80/5/1102

    These effects include the paradox that a high-fat, high–saturated fat diet is associated with diminished coronary artery disease progression in women with the metabolic syndrome, a condition that is epidemic in the United States.

    Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women
    http://www.ajcn.org/cgi/content/abstract/80/5/1175?ijkey=e4610ec5427b8118b39ec347e078d34a367efd11&keytype2=tf_ipsecsha

    In postmenopausal women with relatively low total fat intake, a greater saturated fat intake is associated with less progression of coronary atherosclerosis, whereas carbohydrate intake is associated with a greater progression.

    So if you are recommending to women in particular that they reduce or eliminate saturated fat, it seems that you are encouraging a diet that in fact is not particularly helpful in preventing
    atherosclerosis, and may be harmful.

    As the first article points out,

    It is an article of faith that saturated fat raises LDL cholesterol and accelerates coronary artery disease, whereas unsaturated fatty acids have the opposite effect.

    I'm thinking people might be better served by science than faith in this instance.

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  8. Steve Parker10:29 PM

    Thanks for the references, charles r! I will check them out soon. I am not at all opposed to questioning orthodoxy and dogma.

    -Steve

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  9. When I think of Mediterranean food, I think of cheese, sausage, pork, lard, lamb, goat, yogurt, plus non-starchy veggies and fruit, with a tiny bit of starch & sugar perhaps. But most people today think it is heavy on the starch, especially refined starches and sugar, and skimpy on the meat and dairy. Too often folks forget about the veggies, too.

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  10. Anonymous5:08 PM

    "Full-fat versions of dairy products were the norm in the traditional diet."

    And where is the research showing that peoples who have eaten this "traditional diet" for millenia were harmed by the inclusion of full-fat dairy products?

    I thought that vegetable oils were high in Omega-6 fatty acids... of which we get an overabundance these days. There has been much written on the hazards of refined vegetable oils -- simultaneously lowering LDL cholesterol and increasing one's risk of cancer.

    NO ONE before the last century consumed polyunsaturated vegetable oils in any quantity. cf Enig and Fallon's "The Oiling of America."

    I would go with traditional fats -- butter, lard, olive oil -- before becoming a guinea pig in a large untested dietary intervention...

    i.e., the widespread consumption of refined PUFAs.

    But to each their own.

    btw... dairy fat contains CLA (conjugated linoleic acid) and other beneficial nutrients. We may be remembered centuries from now as victims of a nutritional Dark Age -- persuaded to trash our most valuable food stuffs (various fats) and substitute grains & starches (refined or otherwise) instead. Insanity.

    Andrea

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  11. What about pasteurized dairy? That's also a concern.

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  12. Jeroen2:39 PM

    For me it's all hail to meat, fish, vegetables and fruit. There's a BIG yes to Omega 3 in eggs, unbaked nuts and fish. There's a BIG no to bread, pasta, wraps, rice, and vegetable oils, mainly because of unbalanced omega 6-3 values. I've just read Good Calories, Bad Calories, by Gary Taubes, and watched the documentary Fat Head, it's all so clear to me now! I'm going for the 85% paleo lifestyle, whoya

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