New major study: a low-carb diet yet again best for both weight and health markers!

Midsection Of Woman Smiling While Adjusting Weight Scale

Is it harmful to eat a low-carbohydrate diet for weight loss? Or is it even HEALTHIER than the current low-fat dietary advice?

A major new study published today further fuels the debate and has already made major headlines. In the study 148 people were told to eat either a low-carb diet (under 40 g of carbs per day) or a low-fat diet, for one year.

The results are similar to those in previous studies. Once again, those on a low-carb diet lost significantly more weight, in this case three times more:

Skärmavbild-2014-09-02-kl.-08.01.14-800x261

Dashed line = the low-carb group

Those who ate a low-carbohydrate diet also lost more fat mass.

What will upset people the most is that the low-carb group also got better cholesterol levels than those in the low-fat group! As usual, they got more of the good HDL cholesterol, lower triglycerides and an improved cholesterol profile (total/HDL). As if this wasn’t enough, the fat eaters in the low-carb group received a significantly lower risk assessment for heart disease according to the 10-year Framingham risk score!

In addition, the low-carb group got significantly less inflammation in the body (measured as CRP).

Finally, conspiracy theorists don’t get any support that “the meat industry” is behind all studies showing that low-carb diets work best. This study was funded by American tax dollars (through the National Institutes of Health). None of the authors have any financial ties to the industry.

Even before this study the results were nearly unanimous that a low-carb diet provides a better weight and better health markers than today’s low-fat advice:

Swedish Expert Committee: A Low-Carb Diet Most Effective for Weight Loss

After today’s study the truth becomes even clearer. It becomes even harder (and more embarrassing) for people to stick their heads in the sand.

When are people with weight problems going to receive scientifically sound dietary advice from most health care professionals? Hopefully soon.

The study

Annals of Internal Medicine: Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial

Big headlines:

TIME: For Weight Loss, Low-Carb Diet Beats Low-Fat
New York Times: A Call for a Low-Carb Diet
Reuters: Low-carb diets may beat low-fat options for weight loss, heart health
Washington Post: Low carb diets more than low fat ones may help protect against heart disease
USNews: Low-Carb Beats Low-Fat for Weight Loss, Heart Health: Study

Try it yourself

A low-carb diet for beginners

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135 comments

  1. Galina L.
    Then, probably, eating every day within 8 - 6 hours eating window 3 meals a day without snacks between meals would be less slimming for a very lean person even though it would allow still experience benefits of IF , however such regiment will produce fat loss for many people anyway, at least at the beginning.
    In my case attempting to practice intermittent fasting before switching on a LC diet was out of question because I was too hungry between meals. Now my appetite is normalized, and from my point of view the ability to fast is a very important benefit of a diet which fits definitions of LCHF. I am not naturally thin. According to my field observations, naturally thin people usually have easier time skipping meals because their sense of hunger is much weaker, so their choice of a diet to start IF becomes less important, which is convenient when you try to give general directions to another person you have no power/desire to micromanage like you would yourself, and it allows to worry less about the amount of fats or carbs. I am not discussing things like supplementing K2 because other people covered it.
  2. murray
    "Since the biggest cause of death in the USA and a good part of the rest of the world is from coronary artery disease, I would wish that some part of the HFLC community would conduct a study looking at outcomes for those who have existing heart disease so that their might be some information on outcomes from those who follow a high fat diet."

    What good would such a study do? You would just dismiss it as a study conducted by the HFLC community, and therefore biased.

    You even dismiss the evidence of Dr. William Davis's clinic on the basis it is reported in a book by someone who consults with nutritional supplement manufacturers. (Incidentally, Dr. Rheaume-Bleue started consulting with supplement makers as a result of her book. So it is in inaccurate to discredit the book because of the consulting. You might as well criticize Weston Price for publishing his discovery of Activator X (vitamin K2) because Rheaume-Bleue consults for supplement makers.)

    "What would you tell someone with a very very common 75% blockage in their LAD artery, who has stable angina? -- Eat more fat, meat, oil, dairy, butter... etc?"

    YES. (So long as it is not trans fat or vegetable or seed oil. And avoid starch and sugar.) The fact you apparently pose this as a rhetorical question begs the question. It is a touchstone.

  3. Matt
    Wade - in coming up with a hypothetical average joe with arterial blockages you've exempted: diabetics, pre-diabetics, people with metabolic syndrome and/or showing signs of insulin resistances. Furthermore, you've now asked what about the guy with a 20 BMI with blockages.

    OK - if cardiologists didn't have patients who were diabetic, pre-diabetic, have metabolic syndrome or insulin resistance and have a low-normal BMI they'd have to shutter their offices for lack of work. You've come up with the extremely instance. Basically, this is the level of heart disease that would have been known pre-industrialization (that is almost none).

    Unfortunately, the average joe with CVD today does have a metabolic disorder responsible for their heart disease. And that metabolic disorder in vast majority of cases is, in all likelihood, the direct result of the recommended western diet high in carbs, low in fat.

    I use to believe the simplistic notion that fat makes you fat or dietary cholesterol leads to cholesterol in the arterial walls. Unfortunately it's a lot more complicated than "you are what you eat." It's "you are what your body does with what you eat."

  4. NS
    Wade,

    Thanks for the essential comments and bringing some sanity into the discussion. I've often wondered myself what advice LCHF/Atkins-pro doctors give to their patients with CVD issues. Maybe they just advise to "up the butter," although that didn't seem to help Seth Roberts at all who was reportedly eating half a stick a day before succumbing to occlusion of the arteries.

    A raw, high vegan, lower carb, moderate fat regimen might be a good place to start. This was the motivation and thinking behind the "eco-Atkins" experiments in Canada; One gets incredible doses of plant-only-found health substances like phytonutrients, bioflavanoids, all of the other unidentified good stuff, etc.. as well as dramatically reducing insulin and glucose levels as the only carb sources are extremely high fiber and low GI without the issues that come from animal foods. In addition, one gets a ton of nitric oxde which dramatically improves blood flow and K2 from the resistant starches and fibers which ferment and lead to BHB and SCFA.

    If you disregard the woo-woo, there are some interesting things to learn from Gabriel Cousens' experiments. He is apparently now getting government funding for large scale trials. Around the 53:00 mark here, you can see that he gets even better results than Ornish and Esselstyn, in terms of bio-markers but of course there is no information yet on actual outcomes.

    http://www.youtube.com/watch?v=M0hMVbrVjNg

    In addition to reversing type 2 diabetes, which many regimens are able to do these days as long as there is compliance, he has actually had a small but significant number of type 1 diabetes "remissions." This is a medical "impossibilty." Well, apparently not.

    http://www.amazon.com/There-Is-Cure-Diabetes-Program/dp/1556436912

    Lastly, it also might be worth going in the other direction, noting what Kempner and his rice-diet achieved when there was so little information that doctors could use for hypotheses and patients - kidney disease reversal, atherosclerosis and heart faiure reversal, retinopathy reversal, as well as dramatic weight loss.

    https://www.drmcdougall.com/2013/12/31/walter-kempner-md-founder-of-t...

    http://www.ncbi.nlm.nih.gov/pubmed/1200726

    Reply: #58
  5. LindaN
    From: http://www.nytimes.com/2014/09/02/health/low-carb-vs-low-fat-diet.htm... (One of the links given at the end of the above article.

    "The low-fat group included more grains, cereals and starches in their diet." No where was it specified that these foods were restricted to unrefined or without added sugar, HFCS etc.

    "Both groups were encouraged to eat vegetables, and the low-carbohydrate group was told that eating some beans and fresh fruit was fine as well."

    To me this just negates the entire study.

    Reply: #57
  6. Matt
    Linda,

    How do you figure this "negates the entire study?"

  7. erdoke
    First of all, conclusions should be drawn based on the information included in the original paper. Furthermore, I don't see a big difference between whole grain and refined, white bread. The differences in GI and % fibers are very small and that you can easily verify by visiting the huge GI database the University of Sydney maintains.
    On top of this most supermarket "whole grain" breads contain more refined flour than whole grain. Check the ingredients list, the first item is the biggest ingredient and first place is almost always occupied by wheat flour. It's a myth that modern whole grain (containing) products are healthy when these add up to being a big part of the diet.
  8. FrankG
    I think you've got something on the tip of your nose NS... best wipe it off...

    You know this site is about an LCHF way of life.. it is not devoted to the discussion of low-fat "high" veganity or whatever floats your boat... so why not take it elsewhere, eh?

    Most of the folks here are doing well for many years (many of us far in excess of 12 months) with significantly improved health, including all those precious health-markers which MDs rely on to predict CVD risk.

    You think that you can make an impression here by mentioning that dangerous lunatic Cousens? And you have the gall to suggest that we are the insane ones... LOL Yes I sat through that awful "documentary" with the great man looking like a warmed over corpse, in a a crocheted hat... where they use extreme peer-pressure to try and convince a Type 1 Diabetic to stop taking his insulin!

    I've no doubt there are all kinds of blogs where you can swap "raw, high vegan, lower carb, moderate fat regimen" stories to your heart's content. You're barking up the wrong tree here.

    I don't care what you eat. I care about my health and the health of family and loved ones. I'm not pressuring you to change.. please have the respect to acknowledge the same in others.

    As for Wade: he is now acting the "road-weary traveler, just lookin' for answers" and "why oh why won't Dr Eenfeldt respond to his simple reasonable questions..?" how exactly would YOU respond Wade if the opening salvo to you (as in your comment #20) was insulting and sarcastic? Suggesting that you were not objective... that you were biased... that you had not even read the whole study?

    If you want a reasonable discussion, try having some respect and showing some manners.

    Reply: #86
  9. Wade Henderson
    Well, I return today to see many new comments.

    However I don't see anyone providing any study or facts supporting the theory or advice that the millions of Americans who already have some degree of heart disease (millions and millions) would do best by following a Low-carb, high fat diet.

    The DietDoctor, Andreas Eenfeldt, left only one reply, "Sour grapes...." in post #27

    When I followed it up in post #28, with some very basic questions about dietary advice he would give to the millions and millions of people who already have diagnosed coronary artery disease, angina with a 70% or greater blockage, stable angina,, he gave no reply or indication of the diet he would put them on to have the best outcomes.

    He does not or will not indicate he thinks those millions of patients would do best on a high fat diet, to include bacon, butter, and his typical advice.

    Further, when asked for any study showing that his high fat advice would benefit such patients, he offers no study or facts to back up his normal advice as it would relate to those millions and millions of patients.

    I was merely looking for any study or evidence he might have that would offer a counter alternative to the few studies offered up by the likes of Ornish and Esselstyn.
    They may not be perfect, or large, or ideal, but at least they are something.
    Against which, neither the DietDoctor nor anyone here has offered a alternative suggesting that the high fat , low carb diet will halt the progression of, or reverse existing blockages of coronary arteries.

    Apparently in all of his studies, the DietDoctor has come across no studies showing such a beneficial help from a high fat, low carb diet.

    Oh yes, Murry, in post #32, does claim that Dr. William Davis had one case he talked about from his clinic, who had a 95% reversal.
    Such is the magnitude of the evidence. One patient in one clinic, reported by one doctor.

    Surely there is one study out there showing that the benefit for existing heart patients by those who follow the DietDoctor's advice of eating a high fat, low carb diet gives those patients some reversal or even showing it halts the progression of their disease..
    And that subsequent heart related "events" are lessened or greatly reduced.

    Is there no evidence that a high fat, low carb diet can have such a effect?

    If not, why would any of the millions and millions of such patients follow such advice as would seem to be the advice that the DietDoctor would give out.

    I await any mention of this. Any answer. Any citation or link he might provide indicating that a high fat , low carb diet would help.
    Something factual rather than just theory.

    Others are invited to help.

    Again, the millions of patients would be described as follows.
    Age 50 or older, with stable angina, meaning normally a blockage of 70% or greater.

    Is there any study showing a high fat , low carb diet would halt or reverse the normal expected and usual progression of their disease?

    I've read nothing so far. You would think the diet doctor would have something on this subject affecting millions. Something beyond just short term markers. Something indicating improved "outcomes". Less heart attacks or other cardiovascular events, less deaths, less progression to stents or bypasses, In other words, does it actually help or hurt going out 3, 5, and 12 years?

    Replies: #60, #61
  10. FrankG
    Do you suffer from a reading comprehension problem Wade?

    Do you take lack of evidence for safety, as evidence of danger?

    What alternative do you offer that is guaranteed safe, effective and practicable?

    Do you lightly toss aside as meaningless, the albeit anecdotal but mounting evidence (as measured by medical professionals) of those many who have commented here (myself included) attesting to continued improved health markers several years, if not decades into eating LCHF?

    What is the point of those health markers if you ignore them?

    On what basis do you assume this will all go horribly wrong for me, at some, as yet to be determined, future date?

    You want PROOF? Sorry but I won't l know how long I live until it's done :-) Meantime I fully intend to make the most of whatever time I have and as things look now, I can plan to be around for a good long time and be healthy enough to chase my Grandchildren around the garden. That is NOT something I could have said prior to starting LCHF, in fact my future looked short, painful and bleak.

    Now you try to convince me that I am wrong :-)

  11. erdoke
    Sorry to disappoint, but there is no real scientific evidence in Ornish's work behind the diet he promotes. Actually, he prescribes so many lifestyle changes on top of the diet that you cannot know what causes any improvements observed. You should remind your researcher friend from your first post above to talk to Ornish about proper design of scientific research...
  12. Wade Henderson
    FrankG and erdoke, posts #60 and #61, thanks again for providing nothing to support the beneficial effects of a high fat , low carb, diet for those millions of individuals who have existing coronary artery disease.

    I do realize that this most recent study was not intended to address that particular subject, but I bring it up in the course of comments.

    Citing the " the albeit anecdotal but mounting evidence " and trashing the Ornish studies as being "without proper design of scientific research", does not take the place of giving me even one published study indicating that the "outcomes" of cardiovascular patients would be improved or even held steady, by following a high fat, low carb, diet.

    If only the DietDoctor would at least tell us what his advice is for patients with existing coronary artery disease. Does he really tell them to eat more butter, meats, eggs and oils?
    I've yet to see him talk about the advice for them. (perhaps he has, since I don't read here every day)

    Replies: #63, #65, #66
  13. murray
    Wade, your request of Dr. Eenfeldt is unreasonable. I will give you the benefit of the doubt as to whether it is malicious, this time. As would be obvious to anyone who has followed this blog or events in Sweden, if Dr. Eenfeldt made a public representation as to that nature, assuredly some low-fat advocating crank would file a complaint with the college of physicians and subject Dr. Eenfeldt to trial by ordeal for a couple of years. Sure this would great show-trial entertainment for vegans and he would surely prevail in the end, but for those of us who saw the adorable pictures of his young children and genuinely meant our best wishes, that would be a terrible ordeal under which to burden his family.
    Reply: #64
  14. Wade Henderson
    Murry, your reply makes no sense at all.

    Dr. Eenfeldt, can't give out general recommendations or dietary advice for millions of individuals with existing coronary artery advice? Not for a specific individual, but for a entire class of people.
    How come dozens of well known doctors do exactly that, with no repercussions?

    He gives out regular advice about which diet to follow. And he gives links to all manner of studies and advice about what to eat.

    How come the subclass of the millions of those with coronary artery disease is somehow a special class which you cannot address with general advice.
    Your explanation is simply absurd as to why he can't do such.

    I wonder how those dozens of other well known doctors find no trouble in doing the same thing.
    Am I to believe that Sweden has some special rules that say you can give out advice to groups X and Y but not to group Z ?

    Replies: #67, #78
  15. erdoke
    I am not a medical doctor, so don't expect me to provide public health recommendations beyond weight loss. I happened to look into some of Ornish's work some time ago, and wanted to share my impression about what he does. Which is actually more complex than signing you up for a raw vegan diet. From a scientific/research point of view (for which I'm a bit more entitled to form an opinion) changing many potentially important parameters at the same time is certainly not a good idea. That was all I wanted to say and it still does not sound "trashing" to me.
    On the other hand it was you who came here and questioned that the great improvements experienced in this and other studies for 12-18 months will not hold on if the intervention lasts longer. Do you really believe that improving on basically all important health markers for extended periods of time has no positive effect on anything else in the body? That's a bit funny stand to take.
  16. FrankG
    If such a study were already out there, one which met your stringent criteria, then I trust you would already know about it, so you are really just playing a game here right?

    The fact that you repeatedly suggest that such a study should be done by proponents of LCHF shows how you have already set it up for failure in your eyes.

    In my view, research ought to be independently funded.. never by those with a vested interest in the outcomes, and the conclusions ought to simply follow the evidence, not be set out ahead of time.

    Consider the difficulty in funding such a trial: given the current climate and consensus on the role of "fat" in CVD. Imagine if during Galileo's Inquisition, another astronomer had approached the Pope asking for funding to look further into these supposed "Moons of Jupiter"? This is the problem with consensus science: it is all about building more consensus, a bigger edifice, rather than dispassionately following where the evidence leads

    What ethics board in their right minds would allow such a study where high fat was fed to patients with existing CVD? After all, we may have made great strides but as you pointed out earlier, it seems that the majority of Cardiologists still demonize dietary fat and cholesterol.

    OK so we finally overcome these obstacles.. and that could take several years, then we have to set up and run the trial, then write up the findings, look for a publisher (who isn't reliant on drug company advertising to stay solvent) willing to publish... which in of itself seems to be a lengthy process of years or months...

    For the study itself of course we need "hard end points" such as deaths from CVD, or not (how do we know they won't drop dead just after the study ends)... so we are looking at 3, 5 10, 12, 15 years follow-up???

    When do you think such a study could even have been proposed? When did LCHF even start to gain even a small amount of serious medical buy-in? How long has this blog been around?

    You're just playing games and you have no-one fooled.

    ---

    You freely admit the Ornish etc... trials are flawed, whilst still promoting them "well at least they are something". Funny how that same thinking does not apply to the study discussed in this blog post. Like I said earlier, "double standards"

  17. Zepp
    Its very easy.. Eenfeldt is a medical doctor.. if he have a patient with coronary artery disease.. he do a thoroughly excamination of that person.

    Its another question whats causing it.. it could be a lot of things.. for instance virus.. calcification, poison.. or even genetics!

    The thing is still.. fat is seldome any problem.. often is high carb/high glucose levels a more probably cause of it.. by a lot of means.

    And both Eenfeldt and Ornish put people of a bad supermarket diet to a more healtyer diet.. mostly by real food!

    If one realy have a corona artery diseas one shall go to a doctor.. and get excamined.. for causes.

    About 90% of those in swedish heart emergensy rooms have elevated glucose levels.

    Half of them are not alredy diagnosed diabetics.

    The rest have impared ability to handle glucose.

  18. Galina L.
    What if cholesterol trails will satisfy someone? Dr. Briffa discussed the topic not long ago .
    http://www.drbriffa.com/2014/08/15/evidence-links-higher-cholesterol-...

    There are more age-related deceases than an artery blockage, Is it possible that one diet regiment helps sugar regulations and Dementia, but is harmful for the Atherosclerosis? Anyway, I think that the advice to follow a raw vegetarian diet on a day by day basis is extreme, terrible and misguided.

  19. Matt
    Wade,

    I agree there is a lack of good studies about your question. In absence of such, I'll operate on the precautionary principle. I know now that fat doesn't make me fat, that dietary cholesterol doesn't increase blood serum cholesterol, and that my HDL, LDL, Triglyceride markers are all improved. I also note that my waist is 9" slimmer (central obesity), that my BP went from 140/90 (controlled) to 115/50 (unmedicated), and my RHR went from ~90 to <50. My BMI dropped 6 points from 30 to below 24 (a 40lb weight loss). On top of it all, my blood sugar levels are now stabilized at near normal levels.

    So, you tell me. I have a choice. I can go with what I've observed by making a change from a low-fat high carb data to a high fat/low carb diet with all the markers improved above (as well as complete improvement in a whole host of other medical ailments listed above), or I can hang my hat on a single study of 22 males by Dean Ornish, not controlled for all the other factors including the meditation and yoga they he had them do, and not replicated by anyone else.

    Hmmm. . .this is a tough call.

  20. Cindy C
    Perhaps LCHF works better for me because I may have celiac disease. Most of my obvious sign seem to skin rashes following exposure, although many of my other problems could relate to having it. It can be difficult to prove by tests. Following a gluten free diet is only one answer, after years of damage by gluten, our bodies may or may not totally recover. I have to work on a lot of different things.. I am not sure exactly every thing in this article needs to be followed, but it brings out the problems associated with celiac disease besides just avoiding gluten. I went gluten free first, and then LCHF, working on getting the most nutrients, and less processed the better. I was diagnosed with low blood sugar over 30 years ago. I tried going no sugar, but eating whole grains, vegetables, low/moderate starches, low fat. Never worked that well for me. Grains, and certain legumes will deplete cholesterol, vitamin D, and other nutrients. Some nightshade plants seem to affect pain levels and I may be one of those as well.

    http://online.liebertpub.com/doi/full/10.1089/jmf.2014.0025

    Tooth decay and heart disease seem to go hand in hand. To reduce tooth decay and rickets, carbs were reduced in half. Meat, butter, eggs, cod liver oil were supplied. My recent tests showed D at 77, eating some nuts and some seeds here and there, but eating lots of eggs, moderate meats, meat fat, coconut oil, and vegetables, with adding a small amount of sweet potatoes to see how I would react. I sleep better with adding a few more carbs, but gained a few pounds, or water weight.

    http://healthycdcdiabetes.blogspot.com/2010/12/dr-mellanby-tooth-deca...

    http://orthomolecular.org/resources/omns/v05n03.shtml

    http://allaboutcancersource.blogspot.com/2014/07/dietary-fiber-and-mi...

    Infection and heart disease are at times given association. I do not think antibiotic treatment is a good idea though. Our microbiome is very important. We want it to be balanced.

    http://allaboutcancersource.blogspot.com/2014/07/nutrition-and-infect...

    http://www.schsa.org/PublicHealth/pages/healtharticles/diseaseillness...

    http://www.whale.to/a/mellanby.html

    Despite all those eggs, meat, butter coconut oil, and such, along with some nuts, and vegetables, cod liver oil, plus A from fish liver, C, Bs, for over 5 years, my ratios of HDL, and LDL were good, and my C reactive protein was the lowest on the chart. All my ratios came up as 1/2 risk or low risk. My H A1C was 5.3,and I am 99 lb at 5 feet. It is possible a person can lose weight by going through malnutrition,( and blocking nutrients), which may not be the best for a persons health. I used to be very skinny as a teenager, but I was not healthy. I gained some over 20 years, but still not the best health. I lost 20 lb on LCHF, but it was mostly around my waist, and I gained muscle I had never had before in my life. My social anxiety does better on very high fat, very low carb, low/moderate protein, but the rest of me seems to need a little more carbs, and a little less fat. Some stay on this diet for similar health reasons, to reduce seizures, and migraines.

  21. PhilT

    Why use a diet that cuts fat by only a fraction from 37%, when the low-carb diet cuts its marker massively...about 80% from the norm?

    Seems you swallowed the Katz distortion.

    The low fat group cut their daily average fat intake by 44% and carb intake by 20% at month 3, the low carb group cut carbs by 60% and fats by 17%. All as grams per day.

    A greater carbohydrate restriction is feasible because there are no essential carbohydrates - someone looking to lose weight should just take out 150 grams a day of carbs from their diet as a first step. Nothing to lose.

    Reply: #73
  22. PhilT
    Yes Vicente the "low fat" group at 12 months shows an average increase in % body fat of 0.3% with a 95% confidence interval of -0.5 to +1.1

    I would read this as the weight loss in that group wasn't much different to their starting body composition of 40% fat 60% fat free.

  23. Wade Henderson
    PhilT,

    "The low fat group cut their daily average fat intake by 44% and carb intake by 20% at month 3, "

    I have no idea where you got those figures.
    Did you have access to the full study. No where else do I see reference to such figures.

    On the contrary, at baseline the low fat folks were at 35% and aiming for 30% or below.
    Nothing I've read said anything about where they were at month 3 regarding fat intake.

    If you do the math, going from 35% to 30% is a 14% reduction, not 44%.

    Perhaps you can supply us with the source of your figures. Hopefully you have link to the full study, which I'm sure we'd all like to read. Let us know.

    Reply: #75
  24. Ahmed
    I regularly measure my sugar level before I sleep and when I wake up in the morning. To my suprise when I wake up in the morning it is a little bit higher than the level at when I went to bed.

    For 4 nights before I slept the level were between 106-116. However when I checked in the morning without obviously not eating anthing it is up by 20-25 to 138-145.

    Please I need your help

    Thanks

    Reply: #76
  25. Paul the rat
    Wade Henderson,

    Many of us here, myself included, do not need n=1000, 10 years random control trial to show/convince us that LCHF is good for our health or hearts. (I am sure you know how it is with nutritional studies - you give me enough money, cunning statistician and I will give you results you want.) Many of us here just tried LCHF and it worked for us.

    I started LCHF lifestyle almost 20 years ago, when terms like Paleo diet et cetera did not exist. I started LCHF not because I had weight problems or any other health issues – I did so because I came to understanding that fatty acids and ketones are superior to glucose as energy source - but we went through this notions many times on dietdoctor.com. Twenty years later I proved to MYSELF that I was right, I am in perfect shape and state, I often outperform guys who are 30 years younger than me in my chosen sport. Frankly I do not care (never did) what people ate one year ago , 10, 1000, or 10 million years ago, frankly I do not care anymore what Harvard scientists 'demonstrated' by nutritional RCT - I listen to my body and for my body LCHF is perfect!!.

    LCHF saved my father from bypass surgery. Don’t you read personal stories on this blog? (see the latest posted by Arthur H Hazldine #17 at “The Science of Saturated fat: a big fat surprise” post), do you not believe these stories?

    You seem to resurface time and time again and ask the same question – “is the any studies to show this”? What do you need studies for? Are you scared to try LCHF and see how your body responds to it?, or nagging people with questions for which there ae no current direct answers gives you feeling of superiority?

    If you are genuinely interested in LCHF in regards to you cardiovascular health, why don’t you find a good LCHF medico, start LCHF under her/his supervision and see how you go. Asking dr Eenfeld for internet advice on the specific dietary regime is simply naïve, any health professional knows that one can not treat preexisting conditions via telephone or internet by whatever means.

    Stop being the internet philosopher, or biochemist (as some try to be in the blog-sphere by cutting and pasting basic biochemistry textbooks without much understanding). You are not making yourself superior or important by asking for something that you know is not there.

    Reply: #88
  26. FrankG
    Do you have a diagnosis of Diabetes Ahmed?

    In any case what you are experiencing is very common. You might look out a Diabetes forum or two, to see how often this is discussed :-)

    It is commonly known as "Dawn Phenomenon" where it seems that: early each morning the liver decides to kick out some glucose (from its stored glycogen).. perhaps as an adaptation to get us ready to start the day.

    With Diabetes, or even as yet-undiagnosed pre-Diabetes, your Glucose:Insulin feedback mechanism is no longer as finely tuned as a "normal" healthy person who keeps the Blood Glucose (BG) level always in the normal range.. we tend to overcompensate in both directions.. often with the BG too high and sometimes with it too low. It is this roller-coaster which feels the worst.

    How are your BGs through the rest of the day, particularly after meals? I tend to focus more on those as, like you, I experience Dawn Phenomenon; so my fasting BGs tend to be my highest of the day... BUT the rest of the day they are much improved and far more stable, thanks to eating LCHF.

    Some tips and tricks to try include: a small snack of peanut butter, or cheese shortly before bed, or even a glass of red wine to keep the liver busy. Some have success with these methods but in the end you cannot control your liver.

    Reply: #77
  27. FrankG
    A follow on comment is that: while family Doctors often seem to focus on fasting BGs. I'd suggest that the post-meal levels are far more important in managing your condition day-to-day and in the long-term.

    By testing around meals (before and at set times afterwards) you may find that your tolerance for carbohydrates varies through the day... food which sends your BG sky-high at breakfast might be better tolerated later in the day.

    From my time on Diabetes forums it seems common that early morning is when many (most?) of us are least tolerant of carbs... exactly when most of "the West" is wolfing down a carb-laden breakfast of cereals, toast, jams, muffins, waffles, orange juice etc...

  28. murray
    Open a text on negligence and medical practice.

    Until there are guidelines that sanction the advice, any physician who prescribes advice contrary to bureaucratic guidelines risks liability. If Dr. Eenfeldt says publicly he has in a specific case prescribed treatment counter to bureaucratic guidelines, he risks some ill-willed person filing a complaint and this may result in an investigation. Further, he is not, to my knowledge, a cardiologist.

    This is a significant problem. Evidently (speaking to physicians) there are plenty of physicians out there who prescribe low-carb, high-fat with success, but they remain silent about it for this very reason--the guidelines are out of sync with science and clinical experience. So there is no valid inference from their silence, other than the system being rigged in favour of the status quo. One might also note there are a lot of vested interests in the status quo. So the long march to open, transparent science and effective treatment of patients within the system proceeds step by step. The step taken by the Swedish physician who endured two years of hell to be vindicated on the science is a big step to ask anyone to take. I keep waiting for someone to attack Dr. William Davis with his Track your Plaque program. None of the patients seem to be complaining about their success. As in the Swedish physician case, it was not her patients who complained, but professional dieticians. Outside vested interests.

  29. Nate
    Glad to see the NIH did this study.

    But I'm frustrated that many of the comments have waded into the weeds with Wade's straw man. Who cares whether a particular doctor gives specific advice to an individual person with their unique problems? Every patient is different and every doctor is different.

    (BTW, I can't access comments 1 thru 51. So, I don't know what was said in the beginning.) To me, one the more interesting conclusions of the NIH study is that the low fat group increased their fat mass or at least didn't lose any significant amount. Because they also lost weight, this means that their weight loss was muscle mass. To me that alone puts a large question mark around low fat diets.

    However, going back to the every patient is different idea, I must point out that Dr. Gardener (sp?) of the A to Z Diet study showed that some people did better on the low fat diet than the low carb. But as with the NIH study, the majority of the A to Z dieters did better with the low carb diet. Also, Dr. Atkins knew that everyone was different and was known to frequently tell people after running some tests that his diet could not help them.

    Another point is that the fat mass gain result may get nutritional experts to re-examine their old physiology test books to see how that could happen. Maybe they will learn that insulin is the fat storage hormone and that gluconeogensis can cause muscle loss due to cellular starvation in a calorie deficient low fat diet. A calorie is a calorie, but one cannot easily determine that in an open system like the human body.

    Reply: #85
  30. murray
    Paul, you rock. For seven years I have endured questioning (do you have back problems?) and mild ridicule for having a stand-up desk. I relied on inferences I made from metabolic science and venerable anecdote. Thomas Jefferson, Winston Churchill, Virginia Woolf ... the list went on. Among the benefits is better writing. The great jurist Oliver Wendell Holmes Jr. (who wrote many US Supreme Court judgments and was known for forceful, succinct writing -- "clear and present danger" "marketplace of ideas" being among his famous turns of phrase) wrote his judgments at his stand-up desk (until he was 90) and once quipped, "Nothing contributes to brevity so much as tired knees."

    About a year or two ago other lawyers in our office started getting them. Now there are more than a dozen. After this study, I expect the number of stand-up desk users in the office will go up even more.

    Reply: #83
  31. murray
    Benefits of a stand-up desk:

    The newly inaugurated President Franklin D. Roosevelt called upon the retired justice Holmes and found him reading Plato in Greek. “Why do you read Plato, Mr. Justice?” “To improve my mind, Mr. President,” replied the 92-year-old Holmes.

  32. Paul the rat
    My grandma taught math in class and in private untill her late 80ties - never sitting.
  33. François
    Well I'm back after a few very busy weeks moving back to Canada... This post and this study sure have fired up a lot of passion.

    I do find fascinating how it is difficult for some people to change their paradigm. People who rely on authority (and there are a few) may have a hard time with the LCHF lifestyle. I've seen in this forum a reference to cardiologists. Is it surprizing they still promote low fat, high carb and statins by the bucketfull? Not really! Cardiologists and other physicians are regulated by professional organizations that make sure we stick to the party line with the risk of a disciplinaty hearing for those who suggest something too different: for example, though the evidence is there that statins have many more side effects than reported by company-funded research, are useless for most people (and have very marginal positive effect on the subset of male high risk patients with many CHD risk factors (tobacco, HBP, metabolic syndrome, high LDL-C (the small dense variety, etc), statins are still extremely strongly promoted by our professional organizations for every patient category. There are even discussions on giving statins to "high risk" kids - which, in my opinion, is totally insane and close to being criminal. Though there is mounting evidence that a low carb approach is the way to go for diabetes treatment, professional organizations funded by the soft drink and fast-food industries still promote a high carb approach. Though a high fat (high quality fat, not high omega-6 or high trans fat), moderate protein and low carb diet improves dramatically all surrogate markers of heart disease (lower LDL-C, higher HDL-C, lower triglycerides, lower C-reactive protein, lower insulin and lower HbA1C, lower blood pressure and lower abdominal fat content), such a diet is still indicated as dangerous for cardiovascular disease by the same professional organizations. Just google "meet the fats" of the American Heart Association web site. Sat(urated) is still equated with TRANS. Poly(unsaturated - omega-3 or 6, who cares?) is all good, so is mono(unsaturated). Sight!

    Glasbergen the cartoonist summarized it wonderfully in one of his cartoons: a doctor speaks to his patient: "your weight is coming down, your blood pressure is improving, your cholesterol markers and your sugar are getting better by the day but I tell you, this LCHF diet will kill you in the long run".

    Some physicians have been sued when advising against the party line. I'll quote here my colleague Malcolm Kendrick: "... Dr Annika Dahlqvist, a General Practitioner who had been advising her diabetic patients to eat a low carb high fat diet (LCHF)...

    She was, of course, attacked by the idiots…sorry experts:

    ‘In 2007, the controversy began when two dieticians pointed out to Sweden’s National Board of Health and Welfare that LCHF dietary advice recommended to diabetic patients by general practitioner Dr Annika Dahlqvist was not compatible with either scientific evidence or conventional practice. However, following a report by diabetologist Dr Christian Berne, Dahlqvist was cleared.’

    Cleared of what, exactly? Advising diabetic patients not to eat sugar. The mere fact that anyone could be dragged in front of the authorities for advising this just shows had completely mad the world of dietary advice has become. How entrenched the idiotic anti-fat dogma now is. How utterly divorced from reality and science".

    When we, as physicians, choose to promote a LCHF diet, we have to do so with caution, backed by as much evidence as we can find. A lot can be found in the basic science community, where the Industry does not have as much influence as with human research. For example, I learned there why diabetics have such rampant heart disease: there are insulin receptors on atheromatous plaques, which promotes inflammation and plaque growth.

    As for whether or not there would be reversal of arterial plaques qwith LCHF, it is difficult to know: as pointed up above, some parts of the plaque are fibrosed and likely will not change. But some portions of the plaque are soft. Decreasing circulating insulin will dramatically decrease inflamation and - logically, decrease the plaque(s) size. By how much? I have no clue. Nobody has.

    There are anecdotic reports of symptomatic cardiac patients becoming asymptomatic on a LCHF lifestyle. No double blind, placebo controlled study. Just anecdotes. But we do know - and there are more and more studies to prove it - that all cardiovascular risk factors dramatically improve on such a lifestyle.

    Would I recommend a LCHF diet to a cardiac patient? Yes. I do. Based on the available evidence, that I make available to my patients. Cardiac disease has been linked for thousands of years to a high carb diet. Look up the findings of massive atherosclerosis in Egyptian mummies. Proponents of a vegan lifestyle blamed this on the meat consumption by the elites, but these elites also aŧe lots and lots of carbs, cakes, honey, dates and other fruits. Ancient Egyptians were known by their neighbours as "bread eaters". Egyptian mummies show the evidence of obese and diabetic people. Before fast food and smoking. The Masai and the Inuit thrived on a high fat diet. No cardiovascular disease until the arrival of carbs, introduced by the white man. Hunter-gatherers Indians in North America were healthy as can be. On a SAD diet, they are obese and diabetics. Does meat cause diabetes or heart disease? Highly unlikely.

    In the middle ages, anatomy professors taught anatomy with the dead bodies of people who had been killed by the "justice" of the time, using an old ancient greek textbook. When the body showed something different than the extbook, the body was thrown away. Professional authorities do the same with discording evidence, no matter how strong it is. Orthodoxy must prevail in official circles. Unfortunately.

  34. FrankG
    @Nate "(BTW, I can't access comments 1 thru 51. So, I don't know what was said in the beginning.) "

    The comments are now spread over 2 pages... if you really want to "wade" through them all ( :-P ) try clicking the big blue square with a number 1 in it, at the bottom of this second page of comments.

  35. tony
    "with the great man looking like a warmed over corpse, in a a crocheted hat"

    LMAOROTG! You are too much FrankG! That's the way to tell them veganomaniacs trying to bamboozle us with junk science.

  36. NS
    It was nice to know all that but I did wonder: Was I killing myself? Fortunately I could find out. A few months before my butter discovery, I had gotten a “heart scan” – a tomographic x-ray of my circulatory system. These scans are summarized by an Agatston score, a measure of calcification. Your Agatston score is the best predictor of whether you will have a heart attack in the next few years. After a year of eating a half stick of butter every day, I got a second heart scan. Remarkably, my Agatston score had improved (= less calcification), which is rare. Apparently my risk of a heart attack had gone down.

    http://betabeat.com/2014/04/seth-roberts-final-column-butter-makes-me...

    Roberts died on Saturday, April 26, 2014. He collapsed while hiking near his home in Berkeley, CA. [34] Occlusive coronary artery disease and cardiomegaly contributed to his death. [35]

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

    More regression of coronary atherosclerosis occurred after 5 years than after 1 year in the experimental group. In contrast, in the control group, coronary atherosclerosis continued to progress and more than twice as many cardiac events occurred.

    http://www.ncbi.nlm.nih.gov/pubmed/9863851

    Clinton traces his decision to change back to the morning in February 2010 when he woke up looking pale and feeling tired. His cardiologist quickly brought him into New York-Presbyterian Hospital, where he underwent emergency surgery to insert a pair of stents. One of his veins had given out, a frequent complication following the quadruple-bypass surgery he had undergone in 2004.

    At a subsequent press conference, Clinton recalls, his doctors tried "to reassure the public that I wasn't on the verge of death, and so they said, you know, this is actually fairly normal." Soon after, he received a "blistering" email from Dean Ornish, M.D., the renowned diet and heart disease expert.

    "Yeah, it's normal," wrote Ornish, an old friend, "because fools like you don't eat like you should."

    Prodded into action, Clinton started by rereading Dr. Dean Ornish's Program for Reversing Heart Disease, which urges a strict, low-fat, plant-based regimen, along with two books that were, if possible, even more militantly vegan: Prevent and Reverse Heart Disease, by Caldwell Esselstyn, M.D., and The China Study, by Cornell biochemist T. Colin Campbell, Ph.D. (When I suffered a heart attack in late November 2010, Clinton sent me all three books.)

    "I just decided that I was the high-risk person, and I didn't want to fool with this anymore. And I wanted to live to be a grandfather," says Clinton. "So I decided to pick the diet that I thought would maximize my chances of long-term survival."

    http://www.aarp.org/health/healthy-living/info-08-2013/bill-clinton-v...

  37. Andrew
    That does not mean a high carb diet rich in whole plant based foods is unhealthy. Several years ago I went on an all fruit and some veggies nuts and seed diets and lost about 30 pounds! Refined grains, sugar, high fructose corn syrup, fruit juice, dried fruit, and flour are terrible I agree but not all carbs are bad! Thats like comparing coconut oil to vegetable oil and saying they are the same type of fat! If you can find me an obese person who got fat on strawberries and watermelon I'll buy you a gold medal!!! I worked at a diner in Benton, Kentucky for 10 years and it was filled with overweight and obese people everyday scarfing down their greasy eggs sausage and bacon!!
    Not trolling just bringing out an alternative view to the discussion..
    Replies: #89, #90, #96, #97
  38. Galina L.
    here is copy of a comment on the post http://www.dietdoctor.com/monkeys-can-longer-bananas

    "Chupo

    January 16 2:37 2

    Joey b,
    Have a look at this video: http://youtu.be/sTM47y6wziI

    Lots of people get fat on fruit. It's just that they are censored or banned on the sites that promote the diet.

    Andrew Perlot (a low fat raw vegan) did an experiment where he ate low fat raw vegan ad libitum and gained weight. He needs to restrict calories to stay lean.

    http://youtu.be/ShmoS0AnPNA

    Fruit is just not satiating for many people, which causes over-eating and weight-gain.

    Reply: #20"

    Reply: #91
  39. Galina L.
    Here is copy of a comment on the post http://www.dietdoctor.com/monkeys-can-longer-bananas about fruits being fattening. I saw other comments somewhere made by former fruitarians who got fat , who were banned from frutarian forums, but I don't feel like spending my time on finding it.

    "Chupo

    January 16 2:37 2

    Joey b,
    Have a look at this video: http://youtu.be/sTM47y6wziI

    Lots of people get fat on fruit. It's just that they are censored or banned on the sites that promote the diet.

    Andrew Perlot (a low fat raw vegan) did an experiment where he ate low fat raw vegan ad libitum and gained weight. He needs to restrict calories to stay lean.

    http://youtu.be/ShmoS0AnPNA

    Fruit is just not satiating for many people, which causes over-eating and weight-gain.

    Reply: #20"

  40. Caylee
    Short term weight gain is common when you come from a past of calorie restricting it is you're bodies natural way of preparing for the next famine. Many people who adopt the low fat vegan lifestyle gain weight in the beginning I myself gained almost 15 pounds but after about 9 months my body adjusted very well you just have to give it time it can sometimes takes years depending on you're age and how much metabolic damage has been done from you're past way of eating! You cannot find me one person longterm who is heavy on that lifestyle!! So is fruit fattening maybe in the short term possibly but longterm definitely not if it where i'd be obese and i'm only 118 pounds and a 5 foot 7 woman! By the way if you use Andrew Perlot as an example he also talks about how damaging meat dairy and eggs are to you're health and how much better his health is after giving up those foods. I take it you agree with that also!!??
    Reply: #95
  41. François
    It is easy to fall into observational errors. "I worked at a diner in Benton, Kentucky for 10 years and it was filled with overweight and obese people everyday scarfing down their greasy eggs sausage and bacon!!"

    Sure, they ate these eggs and sausage. And tons of it. And lots of "healthy" fruit juice (more sugar than soft drinks), tons of pancakes with syrup and lots of bread. And coffee with loads of sugar. Of course, it is the eggs and bacon that made them fat.

    As for president Clinton, what exactly are his qualifications for being a reference for dietary advice? "I just decided that I was the high-risk person, and I didn't want to fool with this anymore. And I wanted to live to be a grandfather," says Clinton. "So I decided to pick the diet that I thought would maximize my chances of long-term survival." The mere fact that he follows blindly T Colin Campbell's crazy diet advice is enough to discredit him.

    Sure, you can be healthy eating a relatively high carb diet. Some people tolerate it better than others. Usually, they are physically very active. But some others are unable to tolerate significant amounts of fruits. Try a diabetic. While on the contrary, nearly everyone can thrive on a low carb, even ketogenic diet. it was the diet of our ancestors, and we have the same genetic buildup.

    Does it mean no fruit at all? Absolutely not. But to aim for the crazy amounts of carbs recommended in the SAD diet, even so called "healthy carbs" is not a good thing. People who do the LCHF lifestyle are not anti vegetables. Many eat actually much more than people on a standard diet. But we see good sources of fats as a necessary - and delicious - basis to our nutritional needs.

    Before doing LCHF, I followed the conventional advice I gave to my patients. I ended up overweight, suffered from sleep apnea and had high LDL-C. All this has resolved with the LCHF lifestyle. And I'm not hungry. Satiety is important. I'd rather eat two big satisfying meals than six to eight small meals throughout the day so I don't feel hungry. It's my choice. Some people may find being hungry all the time enjoyable. Good for them. Not my cup of tea.

    Reply: #93
  42. NS
    Ornish's (Esselstyn) results, published in the literature, has been the only regimen to date proven to reverse CVD. That is one of the reasons it's covered under health insurance programs, and Medicare. Those corporations are not stupid.

    http://www.pmri.org/certified_programs.html

    Clinton's relevance is in the degree his experience exemplifies Ornish's larger results.

    For patients worried about CVD but more sensitive to carbohydrates, a vegan/vegetarian version of LCHF, which is somewhat akin to Davis' TYP program as well as Cousens' Living Foods program may be appropriate. See my above comments.

    Feasting on butter is not without consequences, as suggested by Seth Roberts' early demise (as well as extremely high LDLps of some other gurus). He was only 61. Why not take into account this "anecdotal evidence" as well?

    "There is an incremental increase in plasma total and low-density lipoprotein cholesterol concentrations with increased intake of saturated or trans fatty acids or with cholesterol at even very low levels in the diet. Therefore, the intakes of each should be minimized while consuming a nutritionally adequate diet. "

    http://www.iom.edu/Activities/Nutrition/SummaryDRIs/~/media/Files/Act...

  43. Murray
    Clinton does not look like a great exemplar to me. A while ago my wife commented, what happened to Clinton, he looks like walking death. Maybe he would have been dead from heart disease on some other dietary regime, but he looks awful. Compare him to Noakes or Phinney, who are of similar age and spry and vibrant. Cate Shanahan notes the neck wattles Dean Ornish has developed on his collagen-deficient diet.

    Paul (the rat) makes the point that for us older guys who want to live better, to mountain bike with our grandchildren rather the just "live to be a grandfather", we learn to listen to our bodies, after refining our sense of hearing by studying the underlying metabolics. This is why I've gone keto. Self-observation and study. There are so many indications of enhanced capacity for self repair that become more important and noticeable with age. A week does not go by I don't hear from some acquaintance in his sixties talking about how aging really, really sucks. Then I go skiing at Whistler with Dr. Wortman (who is in his sixties and has been LCHF for over a decade) and after a full day he blows me away on Peak to Creek, a seven mile continuous run with a one mile vertical drop.

    Given the science behind keto, the indirect evidence (anthropological) and self-observation, it seems lacking in credibility that high fat keto does not also favour maintenance repair of endothelial tissue. The gradient theory of cholesterol causing vascular disease is simply not credible. It seems like saying drinking water causes high blood pressure. Well, yes, in a way, but it is not the relevant cause.

    The problem with anecdotes is that you never know all the facts. Clinton said he is a vegan, but it turns outs he eats salmon and eggs, so he is actually Paleo. Julia child ate loads of butter and she and her husband thrived into their 90s. My great aunt Mae was a butter-eating prairie woman who lived to 103. At a family reunion in a small town where lots of us came from afar, there was a shortage of hotel and house space. Aunt Mae, who was 100 at the time, slept on the bench seat of her pickup truck (at her insistence) so someone else could have a bed.

    So at best, anecdotes can only dispel claims or establish existence proofs. It can show eating butter is not necessarily harmful and there are people who thrive eating loads of butter, but plainly butter is not a cure-all. Many butter eaters do badly. Many other factors come into play. Equally, it is plain not everyone needs to eat butter in order to do well. So this all throws one back into self-observation and study of metabolics. Not everyone is the same. As Nietzsche observed in Twilight of the Idols (the four great errors) vegetarians live longer on a vegetarian diet because their metabolisms require it to Iive longer. The diet is the effect, not the cause. For Nietzsche, and myself it seems, with our metabolisms, that would have been and would be a disaster. Credo experto, for both of us.

    Reply: #99
  44. Galina L.
    Being a frutarian discredits basically anyone's diet advice in my eyes. Self-reporting about getting fat is not a diet advice.
    Animals also get fat eating fruits ( The Paleo Guy) "Endangered orangutans offer a new evolutionary model for early humans" http://thatpaleoguy.com/2011/12/15/what-can-we-learn-about-ourselves-... about monkeys from the Borneo will add to the whole picture. Monkeys there gorged on very sweet local (obviously) fruits when there were plenty of it, like once in 3 - 4 years,got fat, the rest of the time poor beasts survived in chewing bark and leaves."Orangutans prefer ripe, soft, juicy fruits but during the “off-years” on Borneo when nothing else is available, the orangs resort to eating very hard and tough foods. Dominy describes how they rip bark off trees and eat the starchy tissues behind the bark. They will also eat very hard seeds. This far less nutritious diet seems to supply just enough protein to get by."
    I guess a frutarian can suggest without blinking that orangutans would get lean if they get two plentiful years in a row.
  45. Paul the rat
    @ Andrew,
    As I stated on the pages of the dietdoctor.com several times, I do not follow LCHF lifestyle for weight management, I was never overweight. I chose LCHF because it is my private conviction (and I am looking for the solid evidence to the contrary every day - and I truly mean it, in the literature and in my research) that fatty acids, ketone bodies are far superior to glucose as energy source, regulators of metabolism et cetera et cetera - issues, which we covered numerous times on this blog. If 30 bananas a day do you good - good for you, I'll have my lamb liver sautéed in lard and goat cheese instead.

    Front Aging Neurosci. 2014 Jul 16;6:133. doi: 10.3389/fnagi.2014.00133. eCollection 2014.

    Effects of caprylic triglyceride on cognitive performance and cerebral glucose metabolism in mild Alzheimer's disease: a single-case observation.

    Farah BA.
    Author information

    Abstract
    OBJECTIVE:
    To examine the effect of 109 days of caprylic triglyceride (CT) in a 70-year-old male with mild Alzheimer's disease (AD).
    BACKGROUND:
    Cerebral metabolism is limited to glucose under most conditions, and diminished cerebral glucose metabolism is a characteristic feature of AD. Another substrate available for cerebral metabolism is ketone bodies. Ketone bodies (KB) are normally derived from fat stores under conditions of low glucose availability as an alternative energy substrate to glucose. KB can also be produced by oral administration of CT. Prior studies suggest that the alternative energy source of CT may improve cognitive function due to mild to moderate AD, by circumventing the diminished glucose metabolism.
    METHOD:
    The effect of CT was analyzed in a single-case of mild AD with cognitive alterations in an open label study. Study outcomes included the Montreal cognitive assessment (MoCA), mini mental state exam (MMSE), and 18-fluorodeoxyglucose (18F) positron emission tomography (FDG PET) scans.
    RESULTS:
    After 109 days of CT, MoCA scores changed from a baseline value of 24-28, and MMSE scores changed from 23 to 28. No changes were observed on FDG PET scans.
    CONCLUSION:
    The results suggest that, in a case of mild AD, CT may have affected cognitive function, assessed by means of MMSE and MoCA, although glucose uptake and metabolism remained unchanged.

  46. Cindy C
    Starchy types of food for monkeys, and us, are different than very sugary fruits. I have to freeze my blueberries and add a few to a egg type smoothie. Fruits/too much fructose, and I swell up and hurt.

    http://worldnews.nbcnews.com/_news/2014/01/15/22310391-zoo-bans-monke...

  47. NS
    Fair enough. I partially agree with some of your comments but they don't negate mine in any way. Institutions like the IOM and WHO cannot base their policy recommendations on any of our or other anecdotes. They must choose prudently given the weight of all available evidence. You'll note in their pdf link contained above, the minimum RDA for saturated fat is zero. You'll also note that the orginal question from Wade was relating to what specific dietary advice LCHF medical professionals might offer to those already suffering from CVD. We all have to make our own choices at the end of the day based on what we believe is most likely to succeed.
    Replies: #100, #103
  48. FrankG
    "They must choose prudently given the weight of all available evidence."

    Which is exactly why Dr Eenfeldt made this blog post, regarding yet more available evidence demonstrating that not only is LCHF an effective way to manage excess fat mass but that it also does so safely, with improved health markers, even better when compared to a low-fat diet.

    There are many here who demonstrably have already made "our own choices at the end of the day based on what we believe is most likely to succeed." You are free to do the same but don't think for one second that you offering the questionable celebrity of Clinton (the most famous NOT-REALLY-A-vegan), or the dangerous insanity of Cousens, or even a poorly designed "RCT" by Ornish (where far too many variables were changed) will convince anyone here to discount their personal experiences.

    Reply: #101
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