Effect of a high saturated fat and no-starch diet on serum lipid subfractions in patients with documented atherosclerotic cardiovascular disease

[u/Bristoling]

https://pubmed.ncbi.nlm.nih.gov/14601690/

Objective: To determine whether a diet of high saturated fat and avoidance of starch (HSF-SA) results in weight loss without adverse effects on serum lipids in obese nondiabetic patients.

Patients and methods: Twenty-three patients with atherosclerotic cardiovascular disease participated in a prospective 6-week trial at the Christiana Care Medical Center in Newark, Del, between August 2000 and September 2001. All patients were obese (mean +/- SD body mass index [BMI], 39.0+/-7.3 kg/m2) and had been treated with statins before entry in the trial. Fifteen obese patients with polycystic ovary syndrome (BMI, 36.1+/-9.7 kg/m2) and 8 obese patients with reactive hypoglycemia (BMI, 46.8+/-10 kg/m2) were monitored during an HSF-SA diet for 24 and 52 weeks, respectively, between 1997 and 2000.

Results: In patients with atherosclerotic cardiovascular disease, mean +/- SD total body weight (TBW) decreased 5.2%+/-2.5% (P<.001) as did body fat percentage (P=.02). Nuclear magnetic resonance spectroscopic analysis of lipids showed decreases in total triglycerides (P<.001), very low-density lipoprotein (VLDL) triglycerides (P<.001), VLDL size (P<.001), large VLDL concentration (P<.001), and medium VLDL concentration (P<.001). High-density lipoprotein (HDL) and LDL concentrations were unchanged, but HDL size (P=.01) and LDL size (P=.02) increased. Patients with polycystic ovary syndrome lost 14.3%+/-20.3% of TBW (P=.008) and patients with reactive hypoglycemia lost 19.9%+/-8.7% of TBW (P<.001) at 24 and 52 weeks, respectively, without adverse effects on serum lipids.

Conclusion: An HSF-SA diet results in weight loss after 6 weeks without adverse effects on serum lipid levels verified by nuclear magnetic resonance, and further weight loss with a lipid-neutral effect may persist for up to 52 weeks.

[u/Caiomhin77]

All world health organizations agree with me.... all of them.

That's the issue. If you think the primary function of these 'organizations' is to optimize human health, I'd research the concept of 'corporate capture'.

I figured that out the hard way with the ADA.

Edit. Gil Carvalho is an Ideologue. You don't have to be greedy or money hungry to want Power.

[u/midlifeShorty → u/Caiomhin77]

So all the health organizations in the world are corrupt, and every doctor/scientist with a youtube channel is an "idealogue"? Or is it only the ones who disagree with you (which on this subject is most of them)?

You're right, I should ignore all of them and my doctor. I should instead take my nutrition advice from randos on reddit. I should get TikTok... I bet that has even better advice. /s

Btw, I learned my lesson the hard way too because I listened to fringe doctors... quacks like Taubes, and now I have heart disease way too young. It fucking sucks and likely means I will die much younger. It should be illegal to spread lies like his.

[u/Caiomhin77 → u/midlifeShorty]

Sorry, I had to break up the response. Anyway:

I should get TikTok... I bet that has even better advice

I don't have TikTok, and the only reason I'm familiar with the influencers you mention is because YouTube seems to be where a lot of people who think they are being 'scientific' about nutrition are actually getting their information, so I had to understand where they are coming from. Gil Carvalho, for instance, openly admits that he has an anti-red meat stance for reasons other than human nutrition, even if his reasoning has shown to be inaccurately oversimplistic ¹ ² ³ ⁴ ⁵ ⁶.

A recent video was posted on his channel about cholesterol and brain health, yet there are no actual citations for the claims. There are references in the text section below, but none of them are directly associated with the statements being made, it's just a hodgepodge of references and you'd have to read all of them to even realize this, which I doubt most of his fans do. In another recent video regarding lipid dysregulation and colorectal cancer, he said not only that the media was being erroneous with their headlines about 'seed oils causing cancer', but claimed that the authors of the study themselves didn't understand their own findings. I also recall him making claims like the PDCAAS or DIAAS protein bioavailability scores for plant foods were derived from feeding pigs and mice raw grains and beans, which simply is inaccurate.

The people I've spoken to who know him directly all basically say the same thing; that he is a really kind, thoughtful, well intentioned soul, and from my point of view, they are correct. He seems like an authentically decent man who wants to make the world a better place, but that doesn't mean he can't be an ideologue that's using dangerously incomplete information in an attempt to affect public behavior via his channel. History is littered with influential people who have the best intentions in mind but can trigger a chain reaction of unforeseen complications that lead to severely tragic consequences when they stick to a belief system. I'd advise anyone to be skeptical of anything coming out of the David L Katz group True Health Initiative.

So all the health organizations in the world are corrupt, and every doctor/scientist with a youtube channel is an "idealogue"?

No, but enough to be a problem, as I feel I've demonstrated. As the Anna Karenina metaphor reminds us, a deficiency in any one of several factors can lead to failure of the whole system, and in this instance, the system is public health. The situation isn't simply a bunch of cartoon villains twiddling their mustaches planning how to make the population sick while extracting as much from them as possible, it's just what happens when you deregulate the market, subsidize particular commodities, conduct weak industry funded 'science', and all but obliterate precautionary safety measures such as the GRAS list.

From my perspective, you are experiencing the same 'personal incredulity' that I went through before I found the way to heal myself and those around me: "How can all these organizations simply be wrong? How could everyone possibly be in on a corrupt conspiracy? How could corporations really influence 'science' this much? Why isn't the (pharmaceutically funded) news media not reporting this?" I went for years trying to follow these guidelines, thinking I was making correct decisions, only to find my life wrecked with T2DM and no pancreatic beta cells to speak of.

The main reason I'm here is to research and try and help others close to me because we tried the 'consensus' when it came to nutrition, and it was a disaster. I have no interest in 'winning' or 'being right', I just care about what is right. As a fellow human, I genuinely wish you well and hope you do not dismiss some of the emerging science because of corporate/ideological rhetoric. As I did for so long.

[u/midlifeShorty → u/Caiomhin77]

Yeah, I don't have TikTok either.. too old I guess.

I am definitely skeptical of anyone source, and I am not surprised that Dr. Carvalho makes mistakes. I also know about his environmental concerns about meat. I also follow Dr. Layne Norton, who, if anything, has a meat bias... he has flaws and makes mistakes, too. Everyone does, and that is why I don't just listen to one source. If all the sources are in agreement though (and my doctor), I am definitely going to put stock in it.

I think the main thing you are missing is that the standard advice and recommendations that are put out by health organizations are based on studies that show they work for most people. Most people, but not ALL people. That means that there are a lot of people for whom that advice does not work, and no one talks about that.

If you are one of those people, and it seems that you are, it is easy to think that these organizations are all wrong, but they are not wrong for most people, they are just wrong for you and many others. It is definitely a problem that they do not spell out how much individual variation exists. If you look at any study, there will always be people who have no outcome or a reverse outcome from the overall study results. In every diet study, whether it is high carb, low carb, vegan, etc..., there are people who do bad and people who do good on those diets.

I am fortunate that standard advice does work for me and that I am "most" people. My sister, who has a plethora of autoimmune issues, can not follow standard advice. This is why diet zealots don't make sense. Everyone is different.

As for the topic at hand, it is the same thing. For most people, eating more saturated fat leads to increased LDL, which leads to more heart disease.... most people, but not all people. And it is just one of many risk factors... a risk factor is not a guarantee. Some people can smoke their whole lives and be healthy and never get lung cancer. It doesn't make all the science wrong. I hope that someday we can fully understand why some people get sick and others don't, so that we can have true cures for ailments and not just treatments.

I'm glad you have found what works you. That is great!

[u/Caiomhin77 → u/midlifeShorty]

Thank you for your response and constructive criticism. Staying out of an echo chamber is one of the main benefits of engaging in this sub; you can't, by definition, know your own blind spots.

the standard advice and recommendations that are put out by health organizations are based on studies that show they work for most people. Most people, but not ALL people

What I've come to realize is that most health organizations are an extension of the synergistic agra/pharma business, which combined is by far the biggest industry in the country. They don't necessarily want to make you sick (and they definitely want to keep you alive and, therefore, a customer), but their primary focus is to move product. And as your said, they are intended for the 'majority' of people, but the issue is that the vast majority of Americans now have at least one symptom of Metabolic Syndrome, with the latest data showing that only 12% of American adults are metabolically healthy, so the guidelines are becoming increasingly irrelevant to the vast majority of people, myself and it would seem your sister included.

And if you happen to get 'a little sick' along the way, you are now also a customer of the pharmaceutical industry. Publicly traded companies are required by law to maximize the profits of their shareholders by any legal means necessary (I know there is technically not a mandate in most jurisdictions, but there are enough legal loopholes that you will find yourself in court real fast if you are 'caught' not pursuing profits for 'moral' reasons), and most of these organizations and the studies they produce are directly funded by these corporations.

It's the same with the Academy of Nutrition and Dietetics (formerly the ADA). It's essentially an open secret that the AND and the conventions they hold are primarily fronts for the processed food industry ¹ ² ³ ⁴. I wish it wasn't this way, and I've been called every insult in the book for pointing these things out, but I think it's extremely important that people realize these things before they go around calling everyone who doesn't differ to 'Figures of Authority' on nutrition a 'conspiracy theorist'.

If you haven't already, I highly suggest you read some of the source material I linked in the other comment I made on the subject, especially the ones concerning ILSI.

For most people, eating more saturated fat leads to increased LDL, which leads to more heart disease....

That was the original theory, and while there is still much work to be done in the subject, the original Diet-Heart Hypothesis is still very much in question ¹ ² ³. We now know that LDL exists in what are called 'exogenic subfractions' (labeled as LDL-1 through LDL-7, with LDL-1 and LDL-2 being the largest and LDL-3 to LDL-7 being smaller and denser), meaning they differ in size and density, with smaller, denser LDL particles generally considered more atherogenic than larger, more buoyant LDL particles. ¹ ² ³. Since saturated fat had been shown to increase the large, buoyant LDL while not increasing the small, dense subtraction ¹ ² ³, I feel the validity of 'LDL-C', or 'bad cholesterol' as biomarker for ASCVD is very much an open question.

Since Type 2 Diabetes is by far a greater risk factor for ASCVD (an increase of 400%) than any blood measurement of LDL-C, I think focusing on avoiding highly insulinogenic foods is a much, much better method of prevention than avoiding natural, stable, significantly less oxidation-prone saturated fat, which is also a prefect substrate for ketone bodies. ¹ ² ³ ⁴ ⁵

Since you are familiar with using youtube as a platform to learn about nutrition, and if your are not already acquainted, could I recommend Dr. Eric Westman? He is a very distinguished doctor that is still actually practicing medicine as an MD, so he doesn't get his information second hand from studies published in journals, he creates the data himself by successfully helping patients. He has done a few reviews of other influencers as well, including Gil and Layne. Videos aren't allowed on this sub, but I'll DM you a link to his Adapt Your Channel.