Stunning: Saturated Fat and the European Paradox

Wow. This is mindblowing.

Have you heard about the French Paradox? French people traditionally eat a lot of saturated fat, like butter – yet they generally have less heart disease than other populations. A lot of brainpower has been wasted to explain this – do perhaps the red wine protect them?

It’s not a paradox.

Of course, modern science quite clearly shows no connection between saturated fat and heart disease. That’s no secret anymore. But now it gets even more interesting:

I was just shown the diagram above, recently published in the journal Nutrition. It’s based on WHO and FAO statistics over the average intake of saturated fat in 41 European countries in 1998 (the latest available data), and the age-adjusted risk of dying from heart disease. I added some explanations.

More saturated fat, less heart disease

It’s a stunner. The French paradox is actually a French-Swiss-Icelandic-Swedish-German-Austrian-etc.-paradox!

  1. France eats the most saturated fat and has the lowest rate of heart disease deaths in all of Europe.
  2. Switzerland eats second-most saturated fat and has the second-lowest mortality.
  3. The countries eating more saturated fat have less heart disease, period.

Less saturated fat, more heart disease

And the countries eating less saturated fat? Like Georgia, Moldavia, Azerbaijan etc.? Well, they seem to have the highest mortality from heart disease in Europe.

It’s a Pan-European paradox now.

No need to hold the butter?

What does it mean?

Correlations between populations, like these, are known as ecological data. It doesn’t really prove anything. In other words, the diagram above does not prove that saturated fat protects you from heart disease. There are obviously many other differences between these populations, not just the intake of saturated fat.

But a diagram like this can more or less disprove a theory. It’s hard to imagine how saturated fat could be a major cause of heart disease, when European populations stuffing themselves with it are so much healthier, without exception.

Can this possibly be a weird coincidence? Can saturated fat still possibly be bad? What do you say?

PS

When I recently interviewed professor Loren Cordain about our hunter-gatherer ancestors, his guess was that they on average got about 15 percent of their calories from saturated fat.

If that’s true it means that our genes should be well adapted to eating about 15 percent saturated fat. That’s more than twice as much as the maximum in the obsolete fat-phobic advice from the USDA and others. But about as much as the healthiest populations in Europe today. Coincidence?

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168 Comments

  1. Jeff
    JAUS,

    lipid-theory is a rare theory in medicine, it's one those theories that every single lipidologist in every single place on earth agree upon, with this I mean they are on board with "the lower the LDL, the better". The controversy is just in the lay books. I know all the arguments of Ravnskov and I think even talented elementary school kid could refute every single claim of him with the help of google.

    Atherosclerosis can be induced in a great variety of animal species including vegetarian and carnivore species (e.g. insects, birds, cats, dogs, non-human primates etc.) by raising serum cholesterol high enough and maintaining it long enough. Atherosclerosis can also be reversed by lowering TC enough and maintaining it long enough. The lipid deposits and foam cells disappeared but some fibrous tissue remained. Some species, such as the dog and rat, do not get elevated TC from a diet high in saturated fat and cholesterol. But when a way was found to elevate their TC they also developed atherosclerosis. This is so consistent no matter which species is tested that it appears to be a scientific law that elevated LDL can cause atherosclerosis. This can't be explained away by stress, inflammation or some infectious agent.

    Here's the paper on Okinawa, they ate 85% carbohydrate, 6% fat. Meat was eating very seldom, traditionally. The caloric intake has been 10% less from that of the Japanese.

    Implications from and for food cultures for cardiovascular disease: longevity.
    http://www.ncbi.nlm.nih.gov/pubmed/11710359?dopt=Abstract

  2. BA
    @ Jeff,

    It's impossible to really treat the generalization made about animal species in the above within a single comment post, but that generalization is horribly misguided.

    Raising serum LDL or total cholesterol within any animal species is not something that you can control for adequately with any possible experimental protocol, because the mechanism for increasing it will always have some relationship to some other physiologic effect. There is no reliable way to know in any of the experiments of this nature whether those confounding physiologic effects were causative in the atherosclerosis developing or whether it was in fact the LDL ceteris parabis.

    In practice we know that changes in LDL particle number, size, or total cholesterol quantity are homeostatic effects of some shift in the equilibrium of the organism. Cholesterol production is tightly controlled by the liver in animal species, and there is never any situation where LDL rises just for the sake of LDL rising. In order to understand what a change in LDL metrics indicates in a real physiological situation, we have to understand the underlying mechanics that prompted the physiology to upregulate cholesterol.

    Incidentally, we now know a lot more about these mechanics now, which is why what you refer to as the "lipid-theory" is woefully obsolete.

  3. Laura
    Having to agree that association does not make causation however the graph is screaming for attention and certainly is VERY Difficult to explain in the light of the Ancel Keys fat is bad and really if anything should make everybody pause and think. The graph brings together at the low risk end nations with very different eating traditions (although there is a certain degree of food massification now...I had a GErman friend who thought pasta was invented by teh GErmans because of heinz pasta hoops....dear o dear!).
    One important question:
    HOw do they obtain reliable sat fat consumption data? Don't tell me I fear they used those orribly designed questionnaires that do no make qualitative distinctions?
    The problem is that when the research on red meat being bad for us was published one of my and others strongest rejections of the conclusions reached was that it was also based on those rubbish questionnairs and I think it was this site that gave you the link to the actual questionnaires used and showed you how bad they were at distnguishing between people who ate processed and non processed meat.
    It seems therefore unfair to accept this as causal and theory shattering if it is based on the same doggy data gathering tools!

    However when it comes to sat fat I Am VERY BIASED and I KNOW that (animal) fat is GOOD/ESSENTIAL for us and know that we cannot live without...even if the r/ship on that graph was reversed I would stick with my guns and keep my face happily in the lard jar where it is right now! yumyum. Good luck to the low fat dieters of the world it DOES NOT work it makes you miserable (which in itself says somehting) and it probably damaging you as I type!

  4. Laura
    Michelle #2
    Sorry not very relevant to this thread but I could not ignore your appeal....
    I was a carb addict myself it is very difficult to get out of it. I never smoked but I think it must be akeen to smoke or even drink addiction. I jsut could not imagine my day without carbs I could not see how I could go by a few hours without them both before and after I knew they were bad for me. The way it worked for me was to remove them gradually in layers over several weeks.
    Get rid of all the bread/pasta/grains in one go as this will make you feel already sooooo much better and will motivate you. Keep fruit (fresh and dried)/honey still on and gradually discontinue them. If like me you have monthly cravings do this final step at a time of the month when you are not craving to make it easier for you.
    You may have to do a few cycles of this returning to fruit (even some very dark choc is alloowed) (But NEVER return to grains). It will work. I thought I never get rid of my perceived 'need' for them but I have!
  5. Laura
    For all the misguided vegetarians & vegans (I was one of them) of the world have a look at this...you may change your mind....
    http://epic.iarc.fr/
    largest nutritional study in Europe I was a participant....yes questionnaire based but these were as well designed as they could be for such a large study. THeir findings have been published!
  6. Jeff
    @Laura,

    what did they find? Reading these blogs one can easily get the impression that there does not exist a low-carber who has not been, if not vegan, atleast vegetarian. Interesting, especially when considering that vegeterians make up about 2-3% of the Western population.

    @BA

    Daydreaming is allowed. The expert of LDL particle size and number. Thomas Dayspring:

    "statin intolerant: consider ezetimibe (Zetia) plus colesevelam (Welchol) plus a plantstanol (Benecol) plus aggressive low saturated fat diet. Recent data showed ezetimibe/fenofibrate was also efficacious in patients without the metabolic syndrome".

    http://www.lipidcenter.com/pdf/Lipid_Treatment_Algorithm.pdf

    Margharine, statins and low-saturated fat. Thomas Dayspring has not written a low-carb book, as we can all conclude.

  7. Miroslava
    I live in Russia. So I know Ukraine and Belarus well. Who told you that they have small quantites of sat. fat? Sorry, but that's a huge bulls**t, cause ukrainian borsh and belarus's salo have insane amount of sat fat. This statistics is wrong.
  8. Laura
    Jeff They found that life expectancy general health and cancer incidence show little or NO difference between ominvorous and vegetarians if anything vegetarians had a slightly higher risk of colon cancer....so pretty inconclusive and disappointing since when the research came out I was still a convicend vegan! It is all published in peer review journals...but as usual these risks associations are so unreliable really...

    I agree there is a bias for people who already practice some sort of controlled nutrition to adhere to this or that new or newly discovered nutriotional practice. Many reasons for this I guess:
    1 ) many of us may have been struggling with a weight problem and never quite won the battle as vegs;
    2)many vegs strived to have as natural a diet as possible as close to the one our ancestors had and when you discover this had meat then the appeal is immediate
    3) there is a component of orthorexia (the desire to eat the right food according to set precepts) if you worry aboput food being bad for you and wish to exert a kind of control on what goes inside you even in social settings chances are you are orthorexic and in many cases are following some sort of dietary regime. I for one am orthorexic and proud!
    4) finally it cannot be denied that there must be a component of craving meat and animal fat after years of vegetarianism
    tehre must be other reasons so anybody feel free to add.

    About the animal experiments you mention...oh my word! Most of the conditions under which atherosclerosis is artificially induced in experimental animals are EXTREME to say the least but msot often than not involve feed a certain animal a diet rich in a nutrient they are not evolved to consume. Very often it is a fat of vegetable origin (peanut oil being one of the favourite and very effective atherogens) fed to herbovorous animals. And trust me the same priciple of evolution that applies to human animals according to which we are not adapted to consume grains applies also to all animals. Mice for example the experimental animals par eccellence they are nocturnal rodent evolved to chomp mainly on grains and nuts and fruits but very willing if hungry to nibble on anything. if you feed them on animal fats or dairies or sugar they get all sorts of diseases some of them resembling our problems of obesity, diabetes and CHD.

    I can tell you this it is IMPOSSIBLE to upset your blood lipid profile on a paleo type high fat diet. Actually in a few weeks you will restore it to healthy levels. I had HIGH cholesterol after 14 years of being a STRICT vegan now I am better than textbook and my blood pressure is that of a 25 yr old (112/65) as opposed to 140/80 when vegan!!! I ahve recently had surgery (for something that probably would not have happened if I had followed a paleo principle sooner in my lilfe!!) so I was checked left right and centre and although cautious my GP is very happy with my health!!

    The sure recipe as a human to upset your blood lipid profile and get atherosclerosis (just as there are well established laboratory protocols to cause the same in other animals) and assuming you believe in a causal link b/w that and HD is to eat carbs and fats especially vegetable oils together in large quantities everyday think pizza/breads/pastries/cakes/cookies sugars you name it. That works a treat
    Fo me is thanks but no thanks

  9. Yoly
    The only think a vegan diet did for me was a fatty liver and pre-diabetes, so no thanks. Yes high fructose and high carbohydrates is the perfect recipe for a fatty liver.
  10. Yoly
  11. Jeff
    @Laura

    none of the stuff you say makes any sense. If you were a vegan why would you care about the mortality of lacto-ovo-vegeterians who can eat almost an equally as carnivorous diet as DietDoctor (eggs, cream, icecream, butter, etc). I posted the new meta-analysis of vegetarians that came out this month. Check it out.

    1) Do you think your low-carb diet is an improvement to your vegan diet? If so, then why didn't bother to check the mortality rates of low-carbers:

    Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies

    "low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women"

    http://www.ncbi.nlm.nih.gov/pubmed/20820038

    Low carbohydrate-high protein diet and mortality in a cohort of Swedish women.
    http://www.ncbi.nlm.nih.gov/pubmed/17391111

    2) In animal models the diet fed is athrogenic diet, a diet of saturated fat and cholesterol, it's not diet of lectins, wheat or sugar

    3) I don't know about the lipid responses of paleo diet, but Kurt Harris do know:

    “I don’t think any person on the planet needs to have any of their lipoproteins or cholesterol tested ever. I think it’s all worse than useless because, what happens is – and I get these emails all the time – you know, eating Paleo, feeling great, blood pressure decreased, no longer on medication, no longer have diabetes… bench press 250, and then they say, but, but, my total cholesterol is now 290 or 300 …

    My answer to that is, well, you were doing fine until you got your cholesterol measured.”

    –Kurt Harris, MD

    A meta-analysis of 395 metabolic ward experiments concluded that in typical British diets replacing 60% of saturated fats by other fats and avoiding 60% of dietary cholesterol would reduce blood total cholesterol by about 0.8 mmol/l (that is, by 10-15%), with four fifths of this reduction being in low density lipoprotein cholesterol

    Clarke R, Frost C, Collins R, Appleby P, Peto R. Dietary lipids and blood cholesterol: quantitative meta-analysis of metabolic ward studies. BMJ. 1997 Jan 11;314(7074):112-7

  12. Wade Henderson
    I tell you folks, it is so instructive about the nature of humans.

    I go from this site to the nearly pure ultra low fat sites, like the John McDougall forums.

    Each site, equally adamant about the scientific reports, the human history, the populations around the world providing the "real world" evidence, and their own personal anecdotal history of success and failure.

    Each convinced. Each set in stone. Each "filtering" all evidence through their particular view or perception.

    Then we wonder why there are wars in the world, religious conflicts, alernative economic theories.

    Everyone is right and they all have ample evidence to back it up.
    Yes, the internet has certainly brought the truth to the masses.

    Meanwhile, the alerted people just keep getting fatter and fatter, while those who live healthy in various parts of the world pay no attention to the science behind their success.

    The ways in which humans group and think, and group-think, is a wonder to behold.

  13. Jeff,

    There is just as strong a correlation between health and vegetarianism.

    I strongly doubt that. But please share a reference if you have it

    A new meta-analysis is fresh from the print. ...Cardiovascular Disease Mortality and Cancer Incidence in Vegetarians: A Meta-Analysis and Systematic Review
    http://www.ncbi.nlm.nih.gov/pubmed/22677895

    29% less CVD mortality? That's less than the difference between France and Switzerland above, two dots next to each other!

  14. Re: A new meta-analysis is fresh from the print. ...Cardiovascular Disease Mortality and Cancer Incidence in Vegetarians: A Meta-Analysis and Systematic Review
    http://www.ncbi.nlm.nih.gov/pubmed/22677895

    29% less CVD mortality? That's less than the difference between France and Switzerland above, two dots next to each other!

    The conclusion of that meta analysis is ", the overall cancer incidence and mortality from ischemic heart disease were significantly lower, but there were no associations of a vegetarian diet with all-cause mortality and mortality from circulatory and cerebrovascular diseases"
    I've seen a similar trend in other papers.
    It seems a bit misguided to me to struggle to lower cholesterol to the point where CHD is minimized only to increase all cause mortality..
    Ned Kock, Health Correlator, plots it out here Based on this graph, the best range of TC that one can be at is somewhere between 210 ~5.43 where cardiovascular disease mortality is minimized; and 220~5.69, where total mortality is minimized.

  15. Jeff
    Andreas,

    the French paradox is not really a paradox, they just do everything differently including stuff like reporting CVD.

    Time lag may explain the french paradox
    http://www.bmj.com/content/318/7196/0.7

    @Ted

    Why would you conclude something as silly as that? Ever heard of reverse causation? TC cholesterol measured at the old age doesn't tell much these days. If someone has low-cholesterol at the old in Western cultures it may only conveys bad news, it means some one is on statins, blood pressure medication having cancer, chemotrephy, etc. Low LDL in the context of healthy lifestyle is completely another thing. Unless you control these co-founders you'll get fodder for the cholesterol confusionists.

    The whole myth started when Framingham did not control the co-founders. According to William Castelli, the chief scholar of the study, people should have their cholesterol under 150mg/dl consistently much of their life, that's only treshold where plaque formation cannot take place.

    “Under age 50 years these data suggest that having a very low cholesterol level improves longevity. After age 50 years the association of mortality with cholesterol values is confounded by people whose cholesterol levels are falling–perhaps due to diseases predisposing to death.”

    http://www.ncbi.nlm.nih.gov/pubmed/3560398

    "More dispute has arisen regarding the association of low cholesterol and mortality in elderly persons. For example, in the Honolulu Heart Program low cholesterol was associated with greater mortality risk. Obvious explanations for the association are intervening factors that both increase mortality risk and decrease the cholesterol level. In the nine-year follow-up of the Helsinki Aging Study, mortality risk was associated with both lowered cholesterol synthesis and lowered cholesterol absorption, which reflect terminal decline and lead to lower serum cholesterol levels. These associations are not identified, and the relationship between cholesterol and mortality becomes distorted unless the follow-up is long enough"

    http://content.onlinejacc.org/cgi/content/short/44/5/1002

    Cholesterol measured at middle of your life is one of the best predictors of the quality of your life in later and as well as longevity. Having cholesterol over 200 gives a ticket to the high risk group for sudden cardiadic death.

    Ornish et al. demonstrated in an intervention trial that lowering LDL was associated with increased telomerase activity, which in turn is associated with longevity.
    http://www.ucsf.edu/media/pdf/nobel/blackburn_and_ornish_lancet_2008.pdf

  16. Jeff
    Moreover,

    the meta-analysis I showed was designed to track CVD and Cancer Risk. The found an association of lacto-ovo-vegetarian diet to all-cause mortality (-9%), but it was not statistically significant.

    The meta-analysis should be reviewed with some caution due to the following reasons: it included a study from 1984 on Zen priests who were mostly semi-vegetarian and which used a standardized mortality ratio (comparing all the Zen priests to the greater population rather than comparing the “vegetarians” to non-vegetarians within the same group). The Heidelberg Study results were also included and its control group was semi-vegetarians, which means there were semi-vegetarians in both the “vegetarian” and “non-vegetarian” group in the 2012 meta-analysis; while this is not ideal, it should have biased the results against finding a beneficial effect of a vegetarian diet.

    Moreover, since the study did not try to cauge all-cause-mortality it did neither tried to track the duration of the vegetarian diet either:

    Relationship of carotid intima-media thickness and duration of vegetarian diet in Chinese male vegetarians.

    “A decrease in multiple cardiovascular risk factors such as BMI, blood pressure and lipid profile was associated with vegetarian diet. Moreover, taking a low-calorie, low-protein, or vegetarian diet might have great beneficial effects on IMT through improved lipid profile, and the beneficial effects appeared to be correlated with the duration of vegetarian diet”.

    http://www.ncbi.nlm.nih.gov/pubmed/21929760

  17. @ Jeff
    I'm of an age where having a low cholesterol level is not helpful.
    Association between serum cholesterol and noncardiovascular mortality in older age
    Higher total cholesterol was associated with a lower risk of noncardiovascular mortality in older adults. This association varied across the late-life span and was stronger in older age groups.

    I think rather than get to the position where the use of an acetylcholinesterase inhibitor is required it makes more sense to keep levels of choline reasonable with egg yolk and liver regularly.

  18. Jeff
    @Ted

    LOL. More sillyness :) Here's the thing what the cholesterol confusionists do not understood. Cholesterol and duration. Just because we have an obese diabetic who has had a horrific cholesterol profile most of his/her life ends up dying with low TC cholesterol level does not implicate the end of lipid-theory. It implicates that, despite modern drugs are very effective lowering cholesterol in a matter of weeks, the plaques in the arteries do not dissapear within the weeks. The fact that we have loads of obese diabetics and cancer patients dying with low TC cholesterol doesn't mean you shouldn't aim for a good lipid profile, whether you are under 50 or over 50.

    Just eat a prudent plant-based diet and that will get you far. The aggressive Esselstyn/Onnish regime works well. Do not mind of these ideological stigmas attached to certain diet pattern. Low-dose statins are available over-the-counter in the UK, the are as safe as aspirin, use them for your benefit, atleast for a short term. Statins, aspirin and antibiotics are the best medicines ever produced.

    A meta-analysis of 108 randomized controlled trials of various lipid modifying interventions found that lowering LDL cholesterol significantly decreased the risk of coronary heart disease and all-cause mortality, whereas modifying HDL provided no benefit after controlling for LDL cholesterol.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645847/pdf/bmj.b92.pdf

    Lowering LDL can halt and even reverse heart disease in humans. In the Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) trial, coronary atherosclerosis was virtually stopped in its tracks when LDL was maintained at 79 mg/dL

    Nissen SE, Tuzcu EM, Schoenhagen P, Brown BG, Ganz P, Vogel RA, Crowe T, Howard G, Cooper CJ, Brodie B, Grines CL, DeMaria AN; REVERSAL Investigators. Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial. JAMA. 2004 Mar 3;291(9):1071-80.

    Two large prospective studies with up to 37 years follow-up found that men with higher serum cholesterol were at greater risk of developing high-grade prostate cancer
    http://www.biomedcentral.com/1471-2407/12/25

    The 40 year follow-up of the Whitehall study found that men with higher serum cholesterol were at greater risk of dying from prostate cancer.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3226949/

    Abstract 3610: Comparative Effects of 3 Popular Diets on Lipids, Endothelial Function and Biomarkers of Atherothrombosis in the Absence of Weight Loss

    "In the absence of weight loss, the high fat Atkins diet is associated with increased LDL-C, reduced endothelial vasoreactivity and increased expression of biomarkers of atherothrombosis. As such, these data suggest that isocaloric conversion to the Atkins diet may negatively impact cardiovascular health.."

    http://circ.ahajournals.org/cgi/content/meeting_abstract/116/16_Meeti...

  19. Simon
    Andreas, dont be like the ones you are blaming in other studies.

    Where is all the other cointires? It seem these are handpicked?

    Those countries with low sat. fat also seem to be "alcoholic" counties. Plot theses against numer of alcoholics in the cointry and that would be the same?

    I know you want theses conclustion. But you must be consequent....

  20. @ Jeff
    I'm afraid the only silly person here is the one who doesn't understand that the major anti-inflammatory antioxidant, antinociceptive, antibiotic Vitamin D depends on having a reasonable cholesterol level to enable optimum 25(OH)D levels via the action of UVB on 7 dehydroCHOLESTEROL near the surface of the skin.
    Higher levels of 25(OH)D also associate not only with longer life, longer telomeres, higher cognitive function but also with higher Testosterone levels.
    I'd rather keep my 25(OH)D high and enjoy the benefits while I can.

    Humans not only evolved with the ability to create Cholecalciferol from dawn to dusk but also the anti-inflammatory antioxidant, antinociceptive, antibiotic iron chelator MELATONIN from dusk to dawn.

    Those peoples that do not live a modern westernised life style, without air pollution that reduces UVB penetration to ground level or light pollution at night, that reduces melatonin secretion, will indeed be better able to survive with lower cholesterol levels but given the choice and the fact I do live in a modern western culture, I'd rather hang on to my brain function and sex life for as long as possible.

  21. Jeff
    @Ted

    Ouh, yes, our bodies needs that wonderfull cholesterol. But, how much is enough? Is there an additional benefit of having higher TC cholesterol than newborn f.ex has? Newborn has an LDL of 40mg/dl. Do the people who've inherited the peculiar polymorphism that gives them ridiculously low LDL (15-20mg/dl) and TC cholesterol suffer from non-functional sex-life and non-optimal brain function? The data does not suggest so. In fact, erectile dysfunction is associated with non-favourable lipid-profile.

  22. Yoly
    Low cholesterol is associated with an increase in death rates in people aged 20 and over

    http://healthydietsandscience.blogspot.com/2012/06/low-cholesterol-is...

    Low cholesterol and Cancer

    http://healthydietsandscience.blogspot.com/search/label/Cholesterol%2...

  23. Simon,
    No, these are all 41 European countries with available statistics. Every single one. It just looks too good to be true, that's what's so stunning.

    Regarding possible confounders: Sure, there are millions. And I do point that out in the post.

  24. Wow! Jeff, I think you're barking up the wrong tree here if you think you're going to convince folks to eat a 'plant based' (read vegan) diet on this wonderful site. Every single vegan I know is either emaciated or over weight, has a number of medical problems and is constantly obsessed with food. Not a single vegan that I know is truly healthy and many of them are depressed most of the time. You couldn't pay me $1,000,000 to eat a plant based diet. No thank you. I eat a diet of fat and meat and have never felt or been healthier. I've gone from a BMI of 30 to 21.5 eating this way and have never felt better in my life. My BP is 105/70. You should read Lierre Keith's book.
    http://www.zoeharcombe.com/2011/08/the-vegetarian-myth-lierre-keith/
    Oh, but that might mess with your fanatic belief in the righteousness of veganism so you'd better not.....
    You eat your way and I'll eat mine. 30 years from now we'll see who's still around to prove which of us is right. I'll be 89 then. Considering that my great grand father, grand father, father and mother ate this way and all lived into their nineties I think I'll take my chances.....
  25. Jeff
    @Cate

    The former chiefeditor of JAMA, current editor of MedPageToday George Lundell, give his thumbs up for McDougalls new book:

    The Diet Book to End All Diet Books

    "The fat you eat, the fat you wear"

    http://www.medpagetoday.com/Columns/At-Large/32834

  26. Jeff, it's more like the fat I eat, the fat I lose. My diet is roughly 80% fat, 15% protein and 5% carbs. Where am I wearing that fat I eat when I have a BMI of 21.5 (5'8", weight 140 lbs.)?
    Seriously? When I ate low fat, high carbs I ended up with a BMI of 30.
    In reality it's the carbs you eat, the fat you wear.
  27. Ray
    Don't feed the trolls.
  28. Trolls eat deer and other wild animals but especially love to eat Vegetarians.....,
    Grass fed, free range vegans are their favorite meat.
  29. BA
    This notion that "the fat you eat is the fat you wear" is certifiably insane.

    It's based on some crackpot thermodynamic argument that is completely at odds with everything that is known about the hormonal regulation of fat tissue.

    It's just another way of repackaging the late-20th century fallacy that 9 kcals per gram versus 4 kcals per gram is meaningful to obesity.

  30. Maggan A
    "the fat you eat is the fat you wear"

    Is based on the fact that there is an industri making billions of dollars every year on low fat high carb products.

    And now they target the "red" meat. If they have there way we will soon replace all the meat with cheap produced soyprotein and they will laugh theire way to the bank (with the vegans applauding) when we buy there "scientific" lies.

    As usual - just follow the money. There is not enough money to make on beef and butter :-(

  31. Laura
    Jeff LOL!!!!!
    The paper you quote about increased mortality on low carb diet is actually not even worthy of the SHREDDER!! You know why? they have not checked real LCHF dieters! They have taken two existing study cohorts and based on those dreadful questionnaires extrapolated those that according to a random preset criteria ate less carbs and sub grouped them as low carbers and compared to those that were according to the same criteria as higher carbers and calculate the risk based on mortality/morbidity in the subgroups. Oh my word!!! Cannot say how bad that is!! Almsot all those people are likely to eat grains/sugar/refined starches and rubbish as well no wonder they die a little bit more!!! Bad food combinations are even worst that eliminating a whole food group!
    Here let me quote from the paper itself:

    Our study has limitations. The low-carbohydrate diet scores were not designed to mimic any particular versions of low-carbohydrate diets available in the popular literature. Therefore, the risk estimates do not directly translate to the assessment of benefit or risk associated with the popular versions of the diet.

    The authors should be sued for misinformation and scare mongerning but they put the disclaimer in so their lawyers advised well!!
    And how can you possibly have a LOW CARB vegeterina diet.!!! ALLL plant material is CARBS (unless they only ate avocados and nuts and even they pack in quite a few carbs) honestly!! The authors of that paper really need to go back to basics. !!!
    If you are happy with your diet why do you insist in writing to this blog. You seem so angry and upset by the simple principles of paleo/lchf.
    I am happy and MUCH healthier now and hope to live nad die by the paleo motto: leave well drop dead!
    ourevoire!

    Reply: #128
  32. Laura
    Cate
    I am with you on that...I was a FAT vegan despite being on restricted diet even whilst vegan..now I am slim paleo...
    It is not possible to feel and look this good and being unwell...so face even deeper in the lard jar for me! (home made lard by the way!)
    ANyway Jeff as much as this is an open site WHY DO YOU CARE FOR US? let us die as meat eaters at least we die happy....
  33. @ Laura
    If you found that article by George Lundberg amusing I'm sure you'll find this one even more laughable.
    How to Prevent Obesity -- Stop Eating
    Be aware also that this guy is Editor-at-Large, MedPage Today which probably explains why they publish so much rubbish research and commentary.
  34. Jeff
    George Lundell sits on the board of IOM (American Institute of Medicine). He reported a nice drop of weight, with ultra-high carb diet.

    Low-carbers can always critisize studies, that won't change anything, the trend is more animal foods = more mortality. Eat like a real-low-carber and look like your basic long-term low-carber; Mary Vernon, Loren Cordain, Eric Westman, Robert Lustig, etc. What you have is a fat & diabetic looking fella's.

    According to Atkns co-worker and cardiologist Patric Fratellone, Atkins had 30-40% of his arteries clogged, he was obese and was taking statins and medication for his heart arrhythmia. Atkins suffered already a stroke, which he tried to explain away with myocardial infarction.

  35. Jeff
    Besides,

    George Lundell has it 100% correct;

    Dietary fat affects obesity rate
    http://www.ajcn.org/content/70/4/572.full

    "In all cases, individuals on high-fat, low carbohydrate diets lose weight because they consume fewer calories.”

    “No magic ingredients, strange food combinations or pseudoscientific formulas will alter this metabolic fact”

    Popular Diets: A Scientific Review: A Scientific Review.” Obesity Research 9(2001):1S

    Bravata DM, Sanders L, Huang J, et al. Efficacy and safety of low-carbohydrate diets: a systematic review. JAMA 2003;289:1837-1850

  36. Damn those pesky low carb people. They must have sent their Swedish ninjas into my home to recalibrate my scale, change all the size labels on my clothes from 16 to 8, and exchange my mirrors to fun house mirrors. I shall head to the grocery store and buy 30 bananas and a couple loaves of whole wheat bread as soon as it opens......
    Repeat after me; The sun goes around the earth, the sun goes around the earth....
  37. Quote George Lundberg
    When I did an editorial like this called "How to stop the obese from becoming 'obeser,'" in Medscape on Dec. 17, 2004, it did not solve the problem; the problem just got worse.

    Insanity: doing the same thing over and over again and expecting different results. Albert Einstein

    If we took the brake fluid from vehicles so there were no signals from the brake-pedal to brake and told drivers to just use self-control and will-power to regulate speed, what would be the predictable result?

    Now we know the passage of fat through the digestive tract activates the ileal brake on appetite by up-regulating secretion of satiety hormones cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), peptide YY (PYY) what was the predictable result or removing the brakes for appetite regulation?

    Length and site of the small intestine exposed to fat influences hunger and food intake

    George Lundell may indeed have it 100% right that inflammation is a major factor in heart disease and so it follows restoration of the natural levels of natural anti-inflammatory agents Vitamin D3 (125nmol/l 50ng/ml), magnesium, omega 3 ratio, melatonin) will of course be helpful in reducing metabolic syndrome.
    But the driver of Atherosclerosis is high triglycerides and high trigs are driven by high refined carbohydrate intake
    The LLVLC Show (Episode 585): Lipidologist Dr. Thomas Dayspring Explains The Truth About Cholesterol

  38. Your turn Laura.... :-)
  39. Laura
    Hi Guys I am back Thanks Cate and Ted...Is lauhging academically speaking good?
    I think so...I am starting to be intrigued by Jeff now...who is he trying to convince/save us or himself? Should he not be gracing the pages of the Ornish diet blog?

    I am vastrly impressed by the general knowledge of the bloggers on this site starting of course with Doc (hi there!). This is another interesting aspect of lchf is that many of us reach it like veteran amateur nutritionists after a life long search for health and many are academics...I am ASHAMED sometimes to say that I am a geneticist and yet for 40 b****y years it never occurred to me to ask what did we eat before (all this processed/packaged stuff)? I actually went soooo close but I stopped at the neolithic but I guess it is like little pieces of info falling into place. When I first met my husband he told me that his father had died of celiac disease. I had always seen it as a rarity an anomaly (How can you possibly be intolerant to wheat so wholesome the stuff of life really) but I was intrigued yet I was too addicted to wheat thta I could not conceive a life without it...how wrong.

    As someone correctly points out there are no essential carbohydrates but tehre are essential fatty acids and aminoacids.

    Jeff look give it a try one month and you will be amazed but yet keep the carbs ready at hand so you can stuff a slice of bread or a muffin in your mouth as soon as the month expires...chances are you may not want to anymore. What is it you do not accept? Is it the 'ancestral' bit? some religious people reject it a priory because they do not accept the fact that we are animals with a past a time before a time that extends back millions of years.

    Anyhoo we are not trying to persuade you we can only relate what we know and how we feel on our versions of a lchf.

  40. Laura
    PS
    Jeff lucky you for knowing someone who got it 100% correct..I don't wnybody like that...Yudkin was close (Gary Taubes even closer) but.....
  41. Laura
    Three more things I must get off my chest about the above:

    I am clapping my hands Jeff indeed many people on paleo/lchf do end up eating less but UN-intentionally! although I do not practice calorie counting (useless misleading bla bla done it all before bla did not work made life miserable bla bla) I am quite certain I eat less. MEat and fat ate full of nutrients so you end up eating less but feeling happy/satisfied/nourished (rather than famished, cravey/sad.ratty etc as before on high carbs)

    Your 100% correct link...
    - ecological studies of the type they refer to can be quite misleading. It is very difficult to determine strong causality from population patterns of nutrition. YEs you can say that a certain disease seems to be more common in one country or the other but really you cannot single out the effects of all the countless variables...plus remember that the animal fats we love so much can indeed become harmful in COMBINATION with sugar and carb as the body cannot cope

    - a low fat diet cause weight loss in obese people...quelle surprise!! ANY form of calorie restriction will cause weight loss. I ahve lsot weight many times as a vegan simply by going as low fat as poss (which gave me gall stones joy!) and eating less of everything. Problem is I have ALWAYS invariably put it all back on and felt miserable before during nad after. If you are obese chances are you were scoffing doughnuts and pastries now replace those with fresh fruit or low calorie crackers and you will lose weight but are you healthy? can you keep this regime up ad infinitum? do you have energy for exercise and leaisure?...these are the crucial questions!!

  42. Serum fatty-acid composition and the risk of Alzheimer's disease: a longitudinal population-based study.
    .Results:
    Subjects with a higher proportion of saturated FAs had a decreased risk of AD in crude and multi-adjusted models (hazard ratio for 1-s.d. increase in palmitic acid 0.72; 95% confidence intervals: 0.59-0.89).
    These associations persisted even in the group of approximately 85-year-old survivors.
    n-3 FAs FAs were not associated with decreased risk of AD or dementia.
    Conclusions:
    In contrast to experimental studies, saturated FAs were inversely associated with risk of AD.
    No evidence of a protective effect of n-3 FAs against dementia was found.
  43. Yoly
    Eating Fat Does Not Hurt Cholesterol & It’s Not About Lowering Cholesterol Anyway

    http://thesmarterscienceofslim.com/its-not-about-lowering-cholesterol/

  44. Bill42
    So is there any level of high cholesterol that is deemed risky? And if so risky for what? In the 2008 European Cardiovascular Disease study originally cited way, way back at the start of this thread, Table 9.2 shows the mean age-adjusted total cholesterol for men and women for 2002 (ignoring the "projections" for 2005, 2010). Averaged for all the countries listed, the mean cholesterol for both men and women is about 5.3 mmol/litre, so do all Europeans need statins?
  45. @ Bill42 mean cholesterol for both men and women is about 5.3 mmol/litre, so do all Europeans need statins?
    5.3mmol/l = 205 mg/dl

    That rather depends on whether our intention is to raise or lower All Cause Mortality / CHD incidence/mortality?

    Ned Kock Health Correlator has a useful graph here chart showing the best range of TC that one can be at is somewhere between 210, where cardiovascular disease mortality is minimized; and 220, where total mortality is minimized.

    So what do we think will happen if we all take statins to get TC below 205 mg/dl/ 5.3ng/ml?
    Will CHD/All Cause Mortality increase or decrease?

    It's a bit like asking the question What is the The lowest-mortality BMI: What is its relationship with fat-free mass?
    The answer from many health professionals may not be best for patients survival.

  46. Jeff
    @Bil42

    yes, "all" Europeans and Americans need statins. A healthy range for TC cholesterol is below 3,88mmol/l, it's only treshold where plaque formation cannot take place. I am just reading Daniel Steinbergs Cholesterol Wars book and it nicely illustrates how some physicians have a mental barrier accepting that a whole populatio can be "abnormal", he had very interesting examples.

    I posted the most fresh statin meta-analysis, which confirms this very well. Dietdoctor didn't really understand it, and was confused over the 1 to 1000 example. Just to give an example, In Finland in the 1960s, in a ten year time frame, ou of 1000 men 70 men was died because of fatal heart attack.

  47. Jeff
    Ted,

    I already responded to your "Ned Kock says this" -argument. It's all rubbish, in the sense that most Western people have their TC cholesterol confounded with cancers and other illnesses. Many of of those on statin medication have already suffered a stroke. Since this is all explained to you by now, I wonder why you even bother to spread this BS anymore. It seems that it's all ideological to you.

    From the Framingham:

    "Under age 50 years these data suggest that having a very low cholesterol level improves longevity. After age 50 years the association of mortality with cholesterol values is confounded by people whose cholesterol levels are falling–perhaps due to diseases predisposing to death.”

    http://www.ncbi.nlm.nih.gov/pubmed/3560398

    Here's the study I referred to, and no, it's n ot funded by the statin merchants:

    The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials

    "In individuals with 5-year risk of major vascular events lower than 10%, each 1 mmol/L reduction in LDL cholesterol produced an absolute reduction in major vascular events of about 11 per 1000 over 5 years. This benefit greatly exceeds any known hazards of statin therapy. Under present guidelines, such individuals would not typically be regarded as suitable for LDL-lowering statin therapy. The present report suggests, therefore, that these guidelines might need to be reconsidered".

  48. @ Jeff
    I agree with your point that
    some physicians have a mental barrier accepting that a whole population can be "abnormal"
    my understanding is that prior to the development of statin drugs humans survived reasonably well.

    Modern lifestyles and the foods available to us have changed significantly over the last 50yrs and so it's increasingly the case that our level of Vitamin D, magnesium, omega 3 relative to omega 6 and melatonin are now all generally less than ideal.

    It is reasonable to wonder if Statins are simply analogues of Vitamin D in which case rather than use an expensive drug with many side effects it may be more sense to correct vitamin D status?

    If when we Compare mechanism and functional effects of magnesium and statin pharmaceuticals we see that Mg acts as a statin is it not more sense to correct the underlying deficiency situation rather than use expensive drugs that cause massive side effects?
    If we know that most elderly depressed diabetics are seriously magnesium deficient should our priority be to correct the actual magnesium deficiency or a hypothetical statin deficiency?

    As we know that many of the benefits of statins arise from the anti-inflammatory actions of those drugs does it not make sense to improve the natural balance of anti inflammatory omega 3 relative to pro inflammatory omega 6 dietary intakes?

    We also know that as people age their ability to create vitamin D decreases as does their ability to create MELATONIN.
    Each of the potential anti-inflammatory, immunomodulatory, antioxidant and endothelial protection effects that have been attributed to statins are also provided by melatonin.
    If we are aware of the Protective Role of Melatonin against Amyloid-β involvement in AD should we not first correct the natural melatonin deficiency which arises from ageing and not getting sufficient outdoor bright light exposure?

  49. Bill42
    Jeff,

    > yes, "all" Europeans and Americans need statins.

    What utter nonsense.

    > A healthy range for TC cholesterol is below 3,88mmol/l, it's only treshold
    > where plaque formation cannot take place.

    Perhaps you'd like to explain why plaques form in the first place, and also why approximately half of all CVD occurs in people who do not have "high" TC levels?

  50. > yes, "all" Europeans and Americans need statins.

    What utter nonsense.

    But VERY profitable!

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