lower fat AND low carb?

[TomE]

Jeff,

Are you acquainted with the dietary philosphy of Ray Kurzweil and Terry Grossman MD, as explained in their book, "Fantastic Voyage"? It appears to be an attempt to combine the best aspects of the "low fat" approach with the best aspects of "low carb." Basically, it advocates getting about 25% of calories from fat (mosty omega 9 and 3), 15-33% of calories from carbs, with as much as one-third of that being fiber. And 42-60% from protein. Ninety percent of the protein is from low fat, low starch vegetable sources.

They say this is ideal for people with diabetes and pre-diabetes, but even people without any risk of diabetes should keep carbs to just 33% of calories (again, with as much as one-third that as fiber).

The only way to make these numbers add up would be get food from the following sources in the following percentages (for the non-diatbetic group on an 1800 calorie per day diet):

15% from olive oil (substitute with raw almonds if you want)
30% from low fat tofu and soy protien products like low carb cereal/pasta/cookies.
35% from low starch vegetables and lower amounts of tomatoes and carrots.
10% from animal products mainly wild alaskan salmon and one serving of lean chicken or turkey per week.
< 10% from fruit and starches. Mainly should be berries and melons, and (perhaps) several small servings of whole grains and beans per week.

Eating more very low starch veggies and less soy would be ok. Ideally one should eat numerous meals/snacks throughout the day to further limit glucose/insulin, and maybe include a starch blocker.

The basic insight in their diet plan is that the *least* healthy state for a person is one where saturated fat - and "bad" cholesterol - is high, blood glucose and insulin levels are also high, and anti-oxidant load is low. That describes what happens on the Standard American Diet. High blood glucose levels, which occur when one eats carbs, results in glycoxidation of blood cholesterol, which is an underappreciated yet well established part of the disease pathway of atherosclerosis.

Their ideal is when blood glucose and insulin levels are consistently very low, "bad" cholesterol is low, and anti-oxidant intake and absorption is very high.

What do you think?

[Quiet Heather]

I read a study that showed the insulin response of different foods, and surprisingly, some protein foods created a bigger insulin response than some carb foods.

Here it is:
http://www.ajcn.org/cgi/reprint/66/5/1264.pdf

I think pcrm.org has some other info on why high protein diets aren't so great for diabetics. Looking forward to hearing Jeff's take on this.

[JeffN]

What do you think?

Hi Tom

I would not recommend it.

As I have said, my position is that there should be some good evidence for anything we do, whether it is a food, a diet, a herb, a medicine, a supplement, a treatment, or anything. We should also be aware of the potential harm and/or side effects.

Good evidence, means peer reviewed published studies in mainstream scientific journals.

Anyone can came out and make virtually any claim they want. The burden of proof is not really on us to disprove everyone of them and all their claims but the real burden of proof is on them to substantiate their products, diets and their claims. And with more than short term unpublished data or anecdotal info. If they get shut down for one diet, they just rearrange a few things and come right back out with a new diet making the same extra-ordinary claims.

in addition, extra-ordinary claims require extra-ordinary proof.

The burden is on them, not me.

I recommend a lower fat, higher carb, higher fiber, adequte protein unrefined unprocessed plant based near vegetarian (or vegan is someones chooses) diet like the McDougall program. If I thought you could do better than that, this forum would be filled with those recommendations. Instead, it is filled with "good evidence" supporting this program.

If you have not read through the forum and many of the threads, I recommend you take some time to do so.

In Health
Jeff

[TomE]

Jeff,

Ok, I'm not in a position to defend the Kurzweil diet. But Joel Furhman has a diet that is higher in fat, higher is protein, and much lower in non-fiber carbs. A defense of this kind of diet as being superior to the low fat vegeterian type was posted by Furhman.

Here's the crux from that article:

"Though the low-fat vegetarian diet did lower LDL cholesterol 16%, it raised triglycerides 18.7% and the LDL/HDL ratio remained unchanged, reflecting minimal overall improvement. The Eat To Live approach differed in that the LDL cholesterol was more significantly lowered without unfavorable impact on HDL or triglycerides, reflecting sizable improvement in cardiac risk factors."

citation:

Jenkins DJ, Kendall CW, Popovich DG, et al. Effect of a very-high-fiber vegetable, fruit and nut diet on serum lipids and colonic function. Metabolism 2001 Apr;50(4):494-503.

Please respond to Furhman's argument.

[JeffN]

I read a study that showed the insulin response of different foods, and surprisingly, some protein foods created a bigger insulin response than some carb foods.

Here it is:
http://www.ajcn.org/cgi/reprint/66/5/1264.pdf

Thanks.

This is the "insulin index" which has shown that although foods high in protein may not raise blood sugar, they do raise insulin levels and sometimes even more than foods high in carbs. Just monitoring blood sugar, and/or making the assumption that if blood sugar goes down, than insulin levels also go down, is wrong.

There are a few studies on a zone type diet with higher protein levels that showed that while blood sugars did go down, insulin levels went up and may lead to longterm damage to beta cells.

Higher protein diets, even those based on vegetable proteins have the "potential" to also increase IGF-1, which may may cause an increase in growth rate of cancers.

In Health
Jeff

[JeffN]

But Joel Furhman has a diet that is higher in fat, higher is protein, and much lower in non-fiber carbs. A defense of this kind of diet as being superior to the low fat vegeterian type was posted by Furhman.

Here's the crux from that article:

"Though the low-fat vegetarian diet did lower LDL cholesterol 16%, it raised triglycerides 18.7% and the LDL/HDL ratio remained unchanged, reflecting minimal overall improvement.

The low fat diet used in the study referred to is not the one I recommend that has been documented in dozens of studies to lower TGs, LDL, TC around 25-30%.

The ones referenced in the article that raise triglycerides are using refined carbs that are low in fiber and higher in calorie density. These two articles written by a colleague clearly explain these experiments and why the criticism in not applicable to a McDougall style low fat diet.

http://www.foodandhealth.com/cpecourses/medit.php

http://www.foodandhealth.com/cpecourses/stanford.php

The Eat To Live approach differed in that the LDL cholesterol was more significantly lowered without unfavorable impact on HDL or triglycerides, reflecting sizable improvement in cardiac risk factors."

citation:

Jenkins DJ, Kendall CW, Popovich DG, et al. Effect of a very-high-fiber vegetable, fruit and nut diet on serum lipids and colonic function. Metabolism 2001 Apr;50(4):494-503.

Please respond to Furhman's argument.

The citation above is about an experiment done to recreate a gorilla type diet in humans, It was all raw fruits, veggies and some nuts and seeds. The diet has been used in 2 very short-term studies. It was not and is not the Eat To Live (ETL) diet and studies on the actual ETL diet have failed to produce similar results.

http://www.drmcdougall.com/forums/viewt ... 0&#p282170

On the ETL diet...

- In regard to cholesterol, there was a drop of 196 to 185 in the first 6 months, but no further change over the next 18 months. Same with LDL, it dropped from 122 to 108 but never went lower. And, we see it actually went up from 108 to 118 at 12 months and 18 months and then dropped again to 107 at 24 months. Under 100 is what is recommended for LDL and under 70, is considered ideal. Overall total change in cholesterol went from 196 down to 183 which is a drop of 13 points over 2 years, which is about a 6.6% change. This is a modest benefit at best. The overall drop in LDL was 12%, which is good but as we see, it could be better.

- Triglycerides fell from 154 to 129 (16%) in 6 months but both numbers are considered good as anything under 150 is considered ideal. However, the TG's were trending up as they were higher at 2 years than at 6 months.

On the Gorilla Diet...

The Jenkins gorilla diet was about 30% calories from fat comprised of raw fruits, vegetables and nuts. It lowered total cholesterol about 21% and LDL about 30%. You are welcome to follow such a diet if you would like, but the studies were only on 10 people and they only were on the "gorilla" diet for 2 weeks.

Here are the "2" studies...

http://www.ncbi.nlm.nih.gov/m/pubmed/9160820

http://www.ncbi.nlm.nih.gov/m/pubmed/11288049/

A similar diet was also used for a 12 day experiment, though never published, that the BBC reported on. Cholesterol levels dropped around 20% in 12 days.

http://news.bbc.co.uk/2/hi/uk_news/magazine/6248975.stm

Dr Jenkins found the gorilla diet unrealistic and unsustainable so he created The Portfolio Diet, which is also well studied, which picked out certain components of the gorilla diet that he thought would be most effective. So, he took a typical American diet, cleaned it up somewhat to a healthier version, and added in 4 things that he identified in the gorilla diet as being beneficial 1) focus on foods high in soluble fiber including the use of supplemental soluble fiber (metamucil), 2) supplemental plant sterols (benecol or Cholest-off) 3) vegetarian - so used soy protein sources instead of animal protein 4) 1 oz of nuts a day (almonds as they sponsored the studies).

http://www.ncbi.nlm.nih.gov/m/pubmed/16522904/

http://www.ncbi.nlm.nih.gov/m/pubmed/15699225/

http://www.ncbi.nlm.nih.gov/m/pubmed/25326876/

http://www.ncbi.nlm.nih.gov/m/pubmed/21862744/

The diet lowered LDL and TC around 30%, almost the same as the original gorilla diet. This is very famous and well known and called The Portfolio Diet. Jenkins figured since he couldn't get people to follow the gorilla diet, if they just would eat healthier and add in these 4 things, they can reduce their risks dramatically and virtually the same as the gorilla diet. This is why benecol and metamucil become so popular, We also know that the metamucil alone will lower cholesterol around 7% and the plant sterols will lower it around 10-14% so together that is almost 17-21%. So those 2 alone, with getting rid of all the animal foods, probably accounted for most of the effect. Clean up the American diet somewhat and add in a few known effective supplements and it is an improvement.

The Pritikin Program has documented the "average" drop in almost 5K subjects in total & LDL cholesterol is 23% and they were able to maintain it for over 18 months. Triglycerides also went down 33%. They have replicated this many times on dozens of studies over several decades.

Barnard, R.J. Effects of life style modification on serum lipids. Arch Int Med, 151:1389-1394,1991.

https://pubmed.ncbi.nlm.nih.gov/2064490/

You are welcome to follow The Portfolio Diet as it is healthier than the typical American diet but it is still not as good as the one recommended here. If you read the above linked articles (which are used for Continuing eduction and well referenced), you will see why.

In Health
Jeff