The Lancet: Gradual weight loss no better than rapid weight loss for long-term weight control (an Aesop Fable)

 

Key Point

The speed at which weight is lost is no doubt a motivational factor to achieving your goals. Following a very-low-calorie diet (vlcd) in the short term may provide quick results adding a motivational factor for obese people to continue.  

However, the 450-800 kcal/day used in the study is an extreme restriction and basically a starvation diet. This is well below the basal metabolic rate for anybody and it would be very difficult to achieve the nutrient levels required to keep your body fit and healthy on such a low calorie restriction for any length of time.  

It is also a widely known fact that under calorie restriction your body will prefer to metabolize muscle mass as fuel rather than fat. This will in turn lower your basal metabolic rate, making you more susceptible to fat gain when you stop dieting. 

The most valid take away from this article is that the diet regime requires to be different for different people and that professionals should be involved for obese people seeking to lose weight. 

However, the article fails to mention particular issues that may make rapid weight loss on vlcd for obese people with BMI >30kg/m2 more effective. 

The findings may not be valid for the general population who are only overweight with BMI > 25-30 kg/m2. The article fails to make this distinction.
   

In summary, Key Point considers that the authors are taking findings from a very specific study on a very specific group and attempting to make sensational generalizations that debunk and sweep aside common sense. Aesop's fable indeed.

The article also offers no health warning or qualification about the serious health issues that could occur from following a 450-800 kcal/day diet. 

The article is copied below:-

The Lancet Diabetes & Endocrinology: Gradual weight loss no better than rapid weight loss for long-term weight control

The study, led by Joseph Proietto, Sir Edward Dunlop Professor of Medicine at the University of Melbourne and Head of the Weight Control Clinic at Austin Health in Australia, set out to examine whether losing weight at a slow initial rate, as recommended by current guidelines worldwide, results in larger long-term weight reduction and less weight regain than losing weight at a faster initial rate in obese individuals.

The Australian trial included 200 obese adults (BMI 30–45kg/m²) who were randomly assigned to either a 12-week rapid weight loss (RWL) programme on a very-low-calorie diet (450–800 kcal/day) or a 36-week gradual weight-loss (GWL) programme. The GWL programme reduced participants’ energy intake by approximately 500 kcal/day in line with current dietary weight loss guidelines. Participants who lost more than 12.5% of their bodyweight were then placed on a weight maintenance diet for 3 years.

Participants who lost weight faster were more likely to achieve target weight loss: 81% of participants in the RWL group lost ≥12.5% of their bodyweight versus just 50% in the GWL group. The researchers found that the initial rate of weight loss did not affect the amount or rate of weight regain in these patients who entered the subsequent weight maintenance period, as similar amounts of weight were regained after 3 years by participants who had lost weight on either diet programme. Weight regain was around 71% in both groups after 3 years.

According to Katrina Purcell, dietician and the first author on the paper from the University of Melbourne, “Across the world, guidelines recommend gradual weight loss for the treatment of obesity, reflecting the widely held belief that fast weight loss is more quickly regained. However, our results show that achieving a weight loss target of 12.5% is more likely, and drop-out is lower, if losing weight is done quickly.”

The authors suggest a number of possible explanations for their findings. The limited carbohydrate intake of very-low-calorie diets might promote greater satiety, and less food intake by inducing ketosis.

Writing in a linked Comment, Dr Corby Martin and Professor Kishore Gadde from Pennington Biomedical Research Center, Baton Rouge, USA say, “The study…indicates that for weight loss, a slow and steady approach does not win the race, and the myth that rapid weight loss is associated with rapid weight regain is no more true than Aesop’s fable. Clinicians should bear in mind that different weight loss approaches might be suitable for different patients in the management of clinical obesity, and that efforts to curb the speed of initial weight loss might hinder their ultimate weight loss success.


Full bibliographic information:
Katrina Purcell, Priya Sumithran, Luke A Prendergast, Celestine J Bouniu, Elizabeth Delbridge, Joseph Proietto. The effect of rate of weight loss on long-term weight management: a randomised controlled trial. The Lancet Diabetes & Endocrinology, 2014; DOI: 10.1016/S2213-8587(14)70200-1

Eating resistant starch may help reduce red meat-related colorectal cancer risk

Key point

The article below is a great example of the importance of a balanced diet with meat providing the "complete protein" and resistant starch providing the nutrients for the "good bacteria" in our gut to thrive allowing to produce butyrates, which nourish and repair our colon keeping it healthy and cancer free.

Eating resistant starch may help reduce red meat-related colorectal cancer risk

Consumption of a type of starch that acts like fiber may help reduce colorectal cancer risk associated with a high red meat diet, according to a study published in Cancer Prevention Research, a journal of the American Association for Cancer Research.

"Red meat and resistant starch have opposite effects on the colorectal cancer-promoting miRNAs, the miR-17-92 cluster," said Karen J. Humphreys, PhD, a research associate at the Flinders Center for Innovation in Cancer at Flinders University in Adelaide, Australia. "This finding supports consumption of resistant starch as a means of reducing the risk associated with a high red meat diet."

"Total meat consumption in the USA, European Union, and the developed world has continued to increase from the 1960s, and in some cases has nearly doubled," added Humphreys.

Unlike most starches, resistant starch escapes digestion in the stomach and small intestine, and passes through to the colon (large bowel) where it has similar properties to fiber, Humphreys explained. Resistant starch is readily fermented by gut microbes to produce beneficial molecules called short-chain fatty acids, such as butyrate, she added.

"Good examples of natural sources of resistant starch include bananas that are still slightly green, cooked and cooled potatoes [such as potato salad], whole grains, beans, chickpeas, and lentils. Scientists have also been working to modify grains such as maize so they contain higher levels of resistant starch," said Humphreys.

After eating 300 g of lean red meat per day for four weeks, study participants had a 30 percent increase in the levels of certain genetic molecules called miR-17-92 in their rectal tissue, and an associated increase in cell proliferation. Consuming 40 g of butyrated resistant starch per day along with red meat for four weeks brought miR-17-92 levels down to baseline levels.

yurielkaim.com

The study involved 23 healthy volunteers, 17 male and six female, ages 50 to 75. Participants either ate the red meat diet or the red meat plus butyrated resistant starch diet for four weeks, and after a four-week washout period switched to the other diet for another four weeks.

The above story is based on materials provided by American Association for Cancer Research. Note: Materials may be edited for content and length.

Journal Reference:
K. J. Humphreys, M. A. Conlon, G. P. Young, D. L. Topping, Y. Hu, J. M. Winter, A. R. Bird, L. Cobiac, N. A. Kennedy, M. Z. Michael, R. K. Le Leu. Dietary Manipulation of Oncogenic MicroRNA Expression in Human Rectal Mucosa: A Randomized Trial. Cancer Prevention Research, 2014; 7 (8): 786 DOI: 10.1158/1940-6207.CAPR-14-0053

Bitter orange fat burners - do they work and are they safe (part 2)

Continued... Bitter orange fat burners - do they work & are they safe pt1

To address this question I will refer to published papers and Government advice on Bitter orange. The papers referred are not presented in any particular order and this post does not purport to be a complete comprehensive listing or review of the studies or their validity.

"A Review of the Human Clinical Studies Involving Citrus aurantium (Bitter Orange) Extract and its Primary Protoalkaloid p-Synephrine" (1) year 2012

Sidney J. Stohs, Harry G. Preuss, and Mohd Shara

The study was a review of previous studies by scientists who have been consultants to Nutratech, Inc a company that markets bitter orange products.

Some of the unpublished research reports reviewed in the study were provided by Nutratech, Inc. So you have to consider whether the authors have some bias in favor of showing Bitter Orange as safe and effective.

Where adverse effects have been reported previously by other studies the authors state these may have been other active ingredients in the formulations that caused the problems.

Quote...."The results involving both published and unpublished clinical studies indicate that p-Synephrine alone or in combination with caffeine does not appear to produce significant adverse cardiovascular effects or pose a risk to human health at doses commonly ingested orally."

Personally, I don't want any "adverse effects" to my cardiovascular system significant or otherwise from a supplement.

The authors assert that it is m-Synephrine (m-s) not p-Synephrine (p-s) that causes adverse effects and that Bitter Orange only contains p-Synephrine. They go on to state that other scientists are commonly mistaken about this.

The question of whether p-s or m-s Synephrine is addressed in a Technical Report entitled "Exactly which synephrine alkaloids does Citrus aurantium (bitter orange) contain?" link to report

This report acknowledges there was some confusion the composition and tested an over the counter weight loss product containing Bitter Orange. The findings were that the product tested contained both p-s and m-s.
  
Dr Stohs' has produced a youtube video proclaiming the benefits of Bitter Orange for weight loss.  In his video he states that the Canadian Government has relaxed the Guidelines for use of Synephrine, however this is not the case for weight loss or health products, see below quoted advice from Health Canada website as of April 2015.  

Canadian Government Health Website
"Bitter orange (Citrus aurantium) peel is used in traditional Chinese medicine for several conditions, including abdominal pain and constipation, and is used in food to make marmalade, but it is not authorized for the purpose of weight loss. Synephrine has not been approved for use in any health products to date. Health Canada has issued warnings about the potential risks of using Ephedra/ephedrine and bitter orange/synephrine for weight loss, including serious cardiovascular adverse reactions."

Whilst the Canadian Government has issued guidelines for approved medicinal uses the amounts up to 50g/day. 

Safety and efficacy of citrus aurantium for weight loss (2) year 2004

 

S Bent, A Padula, and J Neuhaus.

"The participants receiving the herbal mixture containing citrus aurantium lost an average of 1.4 kg in 6 weeks, dropping from 90.9 to 89.5 kg (a 1.5% change)…... Participants receiving the placebo lost an average of 0.9 kg, dropping from 83.6 to 82.7 kg (a 1.1% change). Participants who were in the no-placebo control group lost an average of 0.4 kg, dropping from 78.1 to 77.7 kg (a 0.5% change)."

 

The authors concluded.."There was no evidence that citrus aurantium is effective for weight loss. Information on safety was extremely limited".

Considering the small weight loss these could be due normal daily fluctuations in our weight.

Acute Myocardial Infarction Associated with Dietary Supplements Containing 1,3-Dimethylamylamine and Citrus aurantium (3) year 2014

Triston B. Smith, MD, Brian A. Staub, MD, [...], and Indu G. Poornima, MBBS

This paper describes a case and provides a cautionary tale about taking Bitter Orange and DMAA.
 

"In September 2012, a 22-year-old white man with no relevant personal or family medical history was transferred to our hospital. He had typical anginal chest pain (Universal Pain Assessment Tool score, 8/10), which had started while he coached basketball one day before admission."

"He did not use tobacco, alcohol, or illicit drugs. However, 3 weeks before presentation, he had begun taking daily oral doses of the dietary supplements...before undertaking physical activity."

Discussion 

".....the acute coronary syndrome was caused by the sympathomimetic supplements that he was ingesting before exercise. ....including caffeine, DMAA, and C. aurantium."

1,3-Dimethylamylamine (DMAA)

"Case reports linking dietary supplements with acute myocardial infarction have emerged in the last few years. In 2011, two United States soldiers (ages, 22 and 32 yr) died after sustaining heart attacks during fitness exercises. 1,3-Dimethylamylamine was found during postmortem toxicologic screening.".

"In February 2012, the U.S. Department of Defense removed all products containing DMAA from stores on military bases." 

"At least one case of cerebral hemorrhage linked to the recreational use of DMAA has been reported."

In March 2012, the New Zealand Health Ministry imposed a complete ban on DMAA.6 In February 2012, The Medicines and Healthcare Products Regulatory Agency of the United Kingdom warned several companies to stop selling products that contained DMAA...."

Citrus aurantium

"The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure lists C. aurantium as a cause of resistant hypertension."

"The structural similarity suggests that C. aurantium would have pharmacologic actions similar to those of ephedrine and would evoke comparable physiologic responses."

"Some authors have postulated that because these formulations were polyherbal and polyalkaloidal, C. aurantium might have been unjustly imputed in the association with adverse events. Others have cited the traditional use of C. aurantium in Chinese medicine as justification of its safety in weight-loss products."

"We think that both of these assumptions should serve as poignant reminders of the ephedra debacle, because these same rationales were the chief arguments to validate ephedra's use."

Health assessment of sports and weight loss products containing synephrine and caffeine (4) year 2012

The Federal Institute for Risk Assessment (BfR), Germany

The BfR advise that quantities of synephrine should be limited to levels in conventional foods and no more than 6.7mg per day as supplement. They warn that the adverse from synephrine and other products in supplements reinforce each other.
  
It also considers them dangerous because the adverse effects may be magnified by exercise and that many people targeted are overweight. As a result BfR considered that a number of weight loss products on the market should be classified as unsafe.

Key point summary on bitter orange

• Bitter orange, synephrine has not been established to be effective in promoting weight loss in humans.
• Bitter orange in high doses may be unsafe and cause serious heart problems, there is many cases implicating bitter orange.
• Supplements containing other active ingredients and Bitter Orange have unpredictable interactions with other increasing and reinforcing adverse reactions.

Key point conclusion

It is better to stay away from weight loss supplements containing Bitter Orange. In fact it is better to stay away from any supplement until you have definitive evidence that it is safe.

Often we take bigger risks with our own health than we would that of loved ones. Before taking weight loss supplements consider if you would suggest that your adult child or spouse took supplements. 

Comments and discussion are welcome.

         

Bitter orange fat burners - do they work and are they safe? (part 1)

There are numerous weight loss supplements and pills on the market that claim miraculous results for losing weight often with no or little effort or other dietary changes.  This post looks into the effectiveness and safety of a popular herbal thermogenic fat burner and in particular Bitter Orange.

 

What is a Thermogenic Fat Burner

Thermogenic fat burners are drugs or herbal supplements that are meant to increase our basel metabolic rate such that our bodies burns more energy causing us to shed (or burn) body fat.

Ephedrine is such a substance and occurs naturally in Ephedra Sinica ( or Ma Huang) it now more commonly made synthetically for various medicines.

Ephedrine Recent History and Health Dangers

Ephedrine is combined with caffeine and asprin to create ECA stack. Dietary supplements including ECA were popular in the 1990s and early 2000s for people who wanted to lose weight.

As of 2004 the US Food and Drug Administration had 18,000 reports on Ephedrine's adverse effects on people's health. It has since been banned to be sold as part of dietary supplements. In many other countries is use is strictly controlled. The adverse health effects are serious and some are as follows:-

• Cardiovascular: tachycardia, cardiac arrhythmias, angina pectoris, vasoconstriction with hypertension
• Dermatological: flushing, sweating, acne vulgaris
• Gastrointestinal: nausea
• Genitourinary: decreased urination due to vasoconstriction of renal arteries, difficulty urinating is not uncommon,
• Nervous system: restlessness, confusion, insomnia, delusions, paranoia, hostility, panic, agitation
• Respiratory: dyspnea, pulmonary edema

The linked news paper article Michelle's story tells the story of one 46 year old woman who after taking diet pills containing Ephedrine has developed a heart and lung condition with which she had only had a life expectancy of 10 years left.

Bitter Orange

After the banning of Ephedrine many thermogenic dietary supplements and pill formulations replaced Ephedrine with Bitter Orange. The active ingredient in Bitter Orange is Synephrine.

Fat burners containing Bitter Orange Synephrine are legally sold today April 2015 in many countries both in stores and online as is the case in US and UK.

They are sold in a multitude of different guises. The specific quantities of Bitter Orange and other ingredients vary and if you do intend to buy any of these products you would be well advised to investigate the individual contents in detail and not just follow the advice of the retailers.


There is much controversy about Bitter Orange and its safety for use. The health dangers of Bitter Orange and it's active ingredient Synephrine have been claimed
to be similar to that of Ephedrine. Is that a reasonable conclusion or is it a kick back from the Ephedrine problems.  

What Do the Expert Studies and Professional Scientific and Health Authorities Say about Bitter Orange

Is Bitter Orange safe and Does it Work?

Continued.....Bitter orange fat burners - do they work & are they safe Pt2

Sugar: the bitter truth

Some of the things that Robert Lustig is saying need to be widely understood and only 5.4 million have watched his you tube video so far.

Obese 6 month year olds

The story he tells is particularly relevant if you care about your children's health. They are the most in danger from the abuse by the industrialized food toxin producers and marketers. He advises of a current obesity epidemic in 6 month old babies and shows that baby formula is no more than sugar laden milkshake. He warns that adult cravings for sugar are set in infancy.

Atkins and Japan diet same difference

The high carb/low fat diet of Japan and high fat/low carb diet as per Atkins are diametrically opposed, but they both work. People will not be overweight by following either diet, what makes these diets work is that they both exclude added fructose.  In these diets fructose would only be consumed in smaller amounts and as part of whole fruits.

Dr Lustig asserts that fructose is in fact a poison to humans and similar to alcohol. In nature we are protected from the ill effects of fructose by the fibre in fruit, plus the fact that historically fruit was not available all year round.

Obesity rates in US have jumped since the 1960s despite people consuming less fat. The rise in obesity is due to Americans consuming more sugar and in particular from the 1970s increasing amounts of high fructose corn syrup (HFCS).  

Fat Consumption Down, Fat Bodies Up

Dr Lustig considers Ancel Keys' findings were mistaken regarding the correlation between high fat intake and high incidence of heart disease. He states that, the entire nutrition advice and policies in the US are wrong and are based on the erroneous findings of Ancel Keys.

Low Fat High Carb (Sugar) Diet is Causing Heart Disease

Dr Lustig accepts that eating a diet high in fat increases cholesterol, he explains that this is the harmless "LDLa" cholesterol which is large and buoyant and does not cause heart disease. However, eating a diet high in carbohydrates, and in particular sugars, increases the small dense cholesterol "LDLb", which damages the arteries and allows the plaque build up causing heart disease.

A major factor in the American diet leading to the obesity is consumption of excessive fructose contained in HFCS an ingredient in many processed foods, including soft drinks. He points out that fructose is actually toxic to our bodies and causes the following problems. 

• Fructose does not suppress the hunger hormone Ghrelin that stops us feeling hungry so we tend to overeat. 
• Fructose causes us to produce uric acid, which causes high blood pressure and also gout.
• Fructose causes high amounts vLDL (triglycerides) to be released into the blood stream causing obesity, type 2 diabetes and heart disease.  
• Fructose damages the liver and causes non-alcoholic fatty liver disease (NAFLD) and causes liver insulin resistance.
• The impact of fructose on the liver is similar to alcohol and leads to cirrhosis. There are reports of children requiring liver transplants and dying of cirrhosis due to NAFLD.  

By comparison he notes that glucose is the fuel of life and that the metabolism of glucose is not harmful to our liver.

Fructose on other hand is closely related to alcohol and similarly toxic and causes many of the same or similar diseases as alcohol. 

  

From an experiment on medical students eating the same amount of calories in glucose or fructose the amount of vLDL (triglycerides) released from consuming fructose was 20 to 30 times that of glucose.

He claims that the US Department of Agriculture won't do anything about excessive HFCS in our processed foods as this would harm the food producing industry and that food exports are important for the US economy. 

What is resistant starch and why is it good

This short video, 4 minutes long, provides a precise and concise explanation of the importance of including resistant starch in our diet and it's benefits in respect to preventing colon cancer.

Resistant starch has also been shown to reduce blood sugar levels, improve our insulin sensitivity which promotes body fat weight loss. Elevated insulin levels in the blood are the major cause of obesity, metabolic syndrome and type 2 diabetes and heart disease.  Other benefits of incorporating more resistant starch  in our diet include better sleeping patterns and reduced waking through the night.  

A key point is that solely increasing resistant starch (a prebiotic) alone may not initially yield benefits and at first you may need to increase the probiotics or "good bacteria" in your gut so they can digest the resistant starch. 

For many of us remedial action may be required to re-establish the "good bacteria" in our gut which may have been killed by taking antibiotics or poor eating habits. This may be achieved by taking of probiotic supplements, as simply eating more probiotic foods may not be sufficient at the beginning.

Some foods that contain "resistant starch" are:

• Green bananas and plantains
• Cooked then cooled rice
• Whole grains and oats
• Raw or cooked then cooled potatoes
• Corn starch or corn flour
• Potato starch (not to be confused with potato flour) 

Personally, I am not up for eating raw or cold potatoes particularly in the substantial quantities needed to achieve the recommended amount of resistant starch for the benefits to manifest.

The most efficient way to consume 30 to 40g/day of resistant starch is by adding 3 tablespoons of potato starch to other foods, such as smoothies or yogurts. Potato starch adds 40 calories per 12g consumed and is tasteless. Don't mistakenly buy potato flour.

Sugar is the enemy to weight loss

We all know that excess sugar consumption leads us to put on weight, here Dr Ken Sikaris presentation provides a good explanation of the mechanism.

He focuses on the problems of fructose the sugar found in fruit and which is now being delivered to us on industrial scale through high fructose corn syrup (HFCS) which typically contains 55% fructose and is included in many processed foods. 

The amount fructose we are consuming is very dangerous to our bodies is directly converted to fat, unlike glucose which is used for energy. While we have glucose in our bodies any fructose will be turned to fat.

Table sugar or sucrose is converted in our bodies to glucose and fructose. 

In his presentation he notes that in the past fructose was only available at particular seasons and so we did not consume it all year. In the past when we ate the fruit the fructose was converted to fat stores for the winter months.

He also states that a decline in Vitamin D, mainly obtained from sunlight, triggers our bodies to store fat. For those of us living in locations with 4 seasons and long winters may be using a sun beds is not just about vanity.

   

He notes that by eating whole fruit we are not so likely to overload on fructose as it is difficult to eat a lot of apples plus the fibre regulates the fructose absorption. However, with juicing fruits we are stripping out fibre and consuming too much fructose.

It is worse than just weight gain the stored fat is causing metabolic syndrome, Type 2 diabetes and heart disease.

He also addresses the "high cholesterol" issue and advises that it is not the problem. The problem is the triglycerides or fats floating about in our blood stream caused by excessive sugar consumption and that is what causes heart disease.

It looks like he could follow his own advice and he does admit that he is a sugar addict. 

There is no single paleo diet but we are now eating toxins

There is no single paleo diet. Our ancestors ate what was available at their location. Their climates and seasons were different, so they ate different foods at the different locations and it was unlikely to be what we consider balanced today, or all vegetarian or all meat.

As time changed we evolved and changed our eating and diets from:-

Foraging- picking food and eating. No doubt some mistakes were made with people being poisoned. We were moving from place to place.

Hunting- We gained knowledge and outsmarted other animals and ate them. We boosted our strength and health with our high protein intake. We are still moving from place to place and still foraging. We are true omnivores.

Planting - About 10,000 years ago we growing things in one location, plus foraging and hunting locally.

McDonalds – We are now eating toxins.

 



 

Dr. Jonny Bowden "The Great Cholesterol Myth"

This video presents the alleged fallacies regarding fats, cholesterol, weight loss and heart disease that continue to be perpetrated by our health authorities US government.

Key points are:-

The relationship between cholesterol and heart disease came from experiments on rabbits in the early 1900s in Russia. They fed the rabbits high cholesterol and they developed heart disease. However, what they didn't consider was rabbits are vegetarians and can't process animal foods, dogs may not have the same result. 23:34 in the video.

In the 1950s they started to observe more and more in US people suffering heart disease. A scientist called Ancel Keys then proposed the link between heart disease and high fat diets. He put forward data from 7 countries (USA, Canada, Australia, UK Italy and Japan) that showed increased fat intake the higher incidence of heart disease. 

One problem with Keys' findings was that was a data for 23 countries and he cherry picked the ones that showed the correlation increased fat intake increased heart disease. In countries like Norway, Sweden and Portugal eat as much as fat USA but have heart disease rates 40% that of USA. 25:04 in the video.

He points out that by eating saturated fat cholesterol levels go up. However, he argues that this is not causative of heart disease. He references a number of respected studies and leading scientist who have found increased saturated fat does not cause an increase in heart disease. They state that the nutrition advice promulgated in main stream is contrary to the scientific findings. In fact other studies have shown that increase carbohydrate consumption increases heart disease.

He quotes the Lyon Diet Heart Study which compared Mediterranean Diet to the Western Diet and the health outcomes of 605 middle aged men and women who had previously suffered heart attacks. There was significant reduction in deaths and heart problems with those who followed the Mediterranean Diet compared to the Western Diet. 

 extract from LDHS final report

The Mediterranean-style diet used in the Lyon Diet Heart Study included:

• More bread, more root vegetables and green vegetables, more fish.
• Less beef, lamb and pork (replaced with poultry).
• No day without fruit.
• Butter and cream were replaced with margarine high in alpha-linolenic acid.

The Mediterranean diet averaged 30 percent of calories from fat, 8 percent from saturated fat, 13 percent from monounsaturated fat, 5 percent from polyunsaturated fat and 203 mg/day of cholesterol. Compared to the control group, people in the experimental group consumed less Omega-6  and more oleic acid, alpha-linolenic acid and dietary fibre.

People in the control group (Western Style) consumed a diet with about 34 percent of calories from fat, 12 percent from saturated fat, 11 percent from monounsaturated fat, 6 percent polyunsaturated fat and 312 mg/day of cholesterol. This diet is comparable to what is typically consumed in the United States.

Comparison of daily nutrient between control "Western style" diet and experimental Mediterranean diet 

 extract from LDHS final report

 

 

Key differences in the diets appear to be ratio of Omega 6 to Omega 3 which was 18.27:1 for the Western diet and 4.29:1 for the Mediterranean diet in LDHS.

 

Another significant difference is that the amount of cholesterol consumed in Mediterranean diet was some 65% of that in the Western diet. However, blood cholesterol levels between the groups were no different. This would seem to concur with the belief that the body regulates cholesterol production depending on the amount consumed.  

 

Contrary to what Bowden states at 35:00, the Mediterranean Diet followed in the LDHS was lower in overall fat and red meat intake and so doesn't directly support his hypothesis that saturated fats are not causing heart problems. One big take away seems to be to cut back on red meat.

A key finding the Lyon Diet Heart Study was that all cholesterol level measures did not change for either group. However, despite this death rates and heart attacks were still substantially reduced for those on the Mediterranean diet, indicating cholesterol levels are not relevant.  

He states that the only reliable Cholesterol test is called the "Particle Test" and measures LDL A (harmless) and LDL B (killers).  He states that saturated fats only increase LDL A which is harmless. 42:00.

He states the real cause of heart disease is inflammation of the arteries caused by Omega-6 from (vegetable oils and eating grain fed beef) and sugar. Other sources state that inflammation is caused by LDL B cholesterol.  

Our diets contain too much Omega-6 and not enough Omega-3, the ratio in America is 16 to 1. The ratio should be 1 to 1.

What are carbohydrates and are they making us fat?

Carbohydrates are molecules containing carbon, hydrogen and oxygen. They supply us with the fuel-energy that enables us to function.  Proteins and fats are other energy sources. Carbohydrates consumed in excess of our energy needs, are quickly transformed into stored fat within our bodies.

For years there has been debates concerning the optimum diet to achieve weight loss including “low fat high carb diets” and “low carb high fat diets”.

Increasingly there is growing evidence to support that “low carb high protein diets” are more effective than “low fat high carb diets” in the management and control of our weight and stored body fat.

Our Government Health Authorities and many main stream nutritionists are conservative and resistant to change their views in the face of the growing scientific evidence against the previously perceived wisdom to reduce fats and exercise strict calorific control.

Contrary, we need to stop counting calories and eat until we are full. We need to count our carbs and in particular the bad processed carbs, from Ronald Mac etc.. It has been proven many times that by restricting carb intake, not calorie intake, we will lose weight.

The key concern it seems for many of main stream nutritionists is that a “low carb high fat diet” will cause heart disease. However, increasingly the scientific evidence is showing this may be fallacy not based on real scientific evidence and not all fat is bad. The real culprit causing obesity and heart disease is added sugar in our diet and which is pervasive in so many of our processed foods including low fat foods.   

Kris Gunnars, of authoritynutrition.com has undertaken a review of 23 respected gold standard scientific studies which compare “low fat” and “low carb” diets. The chart below is a summary of the results and shows that “low carb” resulted in greater weight loss. 

So what are carbohydrates in terms of food and do we need them?

Carbs consist of three different groups:-

Starches, which are found in vegetables and grains and are referred to as “complex carbohydrates”. Complex carbs provide the body energy more immediately than consumed fats and protein and are a key fuel for the brain and nervous system.  Complex carbs or starches, unlike sugars are released into the blood stream slowly and so you will not crash and crave bad carbs later in the day.

Sugar on the other hand is a simple carbohydrate and it is released very quickly into the blood stream giving an energy boost. Sugars are naturally occurring in the fruit we eat. They are also added into the numerous processed foods (toxins) that we consume. Added sugar is the major cause of obesity, metabolic syndrome and type 2 diabetes.

Fibre is only found in whole fruit (not in juice), vegetables and whole grains. It promotes a healthy digestive system and is key to preventing gut cancers. There are two types of fibre insoluble and soluble. Soluble fibre reduces the amount of bad cholesterol (LDL) within the blood stream. Porridge in particular contains soluble fibre which soaks up bad cholesterol. Insoluble fibre is not digested but helps your digestive system to move and remain healthy.

Another benefit of eating sufficient fibre, is that it makes us feel fuller longer without being hungry.

Carbohydrates (apart from sugar) provide significant benefits to our health and well-being. So what is the problem?  The first is consumption of too much sugar and in particular added sugar and then refined grains where the fibre and other nutrients have been stripped out. Carbs are good but in moderation and only the complex ones.

How many carbs should we eat?
 

Let us, look at the National Health Service (NHS) in UK "Eat Well Plate" and calculate the amounts of the different types of food it may represent.

 

It is split into 5 segment food groups as follows:

• bread, rice, potatoes, pasta and other starchy foods - 33%
• fruit and vegetables - 33%
• milk and dairy foods - 15%
• meat, fish, eggs, beans and other non-dairy sources of protein - 12%
• foods and drinks high in fat and/or sugar - 8%

 

Typical Foods and Quantities to Follow NHS Eat Well Plate Guidelines  

Observations

In carbs category the energy density varies quite a lot. In aiming for weight loss it may be better to target foods with lower energy density. In this way you will feel fuller by eating a greater volume of food with less calories by weight. Rice and potatoes are better choice than bread and pasta.

If you only ate spinach you would need to eat 3kg to reach the recommended calorific guidelines. This is not realistic: unless you are a gigantic rabbit.

We need a paradigm shift in considering how much vegetables we consume and to increase them substantially. By blending whole vegetables you can increase the quantities of vegetables you consume. 

The quantity of sugar in fruit are high.  If you are aiming for weight loss it is better to increase your green vegetable intake more than your fruit intake. Personally I am careful of fruit sugar (fructose) and 3 pieces of fruit a day is plenty.

Summary of carbohydrate intake by following Eat Well Plate

  









So how much carbohydrate should we eat for weight loss and would the NHS “Eat Well Plate Guidelines” allow us to achieve weight loss?

We can discount fibre as that is mainly passing through and only count the starches and sugar and the total amount of carbs by following the NHS “Eat Well Plate Guideline” is 300g.

This amount of carbs is far in excess of what will allow us to lose weight without restricting calories in other foods and so feeling hungry.

The answer to how many carbs we should eat to lose weight varies from person to person, but the range is much lower than 300g. To lose weight you need chose one.

Greater than 150g carb (half NHS amount). You need be on calorie restriction plus exercises to lose weight. You may feel hungry.

Equal or less than 150g carb intake per day. You need to exercise to lose weight, but can eat more protein and fats. This may be the maintenance range once you have lost weight.

50g to 100g carb. If you increase protein and fat intake you will not feel hungry. Also by eating only complex carbs, such as starch you will have immediate energy. Porridge Oats are recommended. By staying in this range for carbs you will lose weight easily and by eating protein and healthy fats until you feel full and not go hungry. You should undertake light aerobic and some resistance exercise to maintain muscle mass.

50g or less, this is “Atkins” territory. It is effective for fat loss but not sustainable for most people overtime. Plus you will smell of bad decay.   

The gram amounts above only include starch and sugar. Fibre and "resistant starches" may be disregarded in counting carbs. 

When undertaking weight reduction it is key to do it at a sustainable pace and also undertake strength/resistance training to maintain muscle mass. Regular aerobic exercise also reduces blood sugar, helps reverse metabolic syndrome and allows the body to burn fat stores.