Comments on new AHA recommendations

Jim Chinnis · medicine forum Guru Joined: 30 Apr 2005 Posts: 1030

There is an interesting report in HeartWire of the remarks of Dr. Eric
Westman, at Duke University on the new AHA recommendatios. You need to
register to read the full article at
http://www.theheart.org/viewArticle.do?primaryKey=715387&nl_id=tho20jun06

An extract follows:

"...they've started making accommodations for the idea that there might be
multiple dietary patterns that are effective and healthy, although they do
restrict these to the time-honored low-saturated fat, DASH-diet-type
examples."

A conspicuous omission, he says, is the low-carbohydrate-diet approach that
has been the focus of a growing number of rigorously conducted clinical
trials over the past five years. "Low-carb diets aren't mentioned at all in
these recommendations, not a whisper," Westman points out. This, despite the
fact most of these studies compared a low-carbohydrate approach with an
AHA-recommended diet.

"Low-carb diets aren't mentioned at all in these recommendations, not a
whisper," Westman points out. This, despite the fact most of these studies
compared a low-carbohydrate approach with an AHA-recommended diet.

I think we just need better science to say that saturated fat is bad.

"It's unfortunate they didn't reference the six or seven randomized trials
of a low-carb diet that showed the triglyceride-lowering and the HDL-raising
effects of the low-carb dietary patterns," he noted. The omission seems
particularly surprising, given the fact that several participants in the
2006 writing group are currently involved in studies examining
low-carbohydrate approaches, he added. "It could be that they're just
waiting for longer-term studies, but you could at least say that over a
six-month period, the HDL-raising effects of low-carb diets look promising.
Certainly if these were the effects of a drug, not a diet, they would be
mentioned that way."

Westman acknowledged that popular enthusiasm for low-carbohydrate diets
appears to have ebbed in the past year but argues this is not so much a
reflection of disappointing study results as it is dwindling support from
celebrities and food-product manufacturers. He points to several positive
studies presented at the American Diabetes Association meeting earlier this
month, one by his own group at Duke. "Low-carb businesses have gone up and
down, but the research has stayed steady, if not increased."

Westman also took issue with the lack of hard outcomes data to support the
recommendations for reducing saturated fat and cholesterol intake. "In all
the other sections, there are data that link the problem and the
recommendations to good data, but this section is particularly weak,"
Westman argued. In the data cited, saturated- and trans-fat intake is linked
to LDL-cholesterol changes, he noted. "Show me a study where these
recommendations [for reducing saturated-fat intake] have led to improved
outcomes: there isn't one.
--
Jim Chinnis Warrenton, Virginia, USA

Juhana Harju · medicine forum Guru Joined: 06 May 2005 Posts: 1056

Jim Chinnis wrote:

: "Show me a study where these recommendations [for reducing
: saturated-fat intake] have led to improved outcomes: there isn't one.

In the Lyon Diet Heart Trial patients were adviced to replace saturated fats
with olive oil, rape seed oil and rape seed oil based margarine. And there
are other studies as well.

--
Juhana

Jim Chinnis · medicine forum Guru Joined: 30 Apr 2005 Posts: 1030

"Juhana Harju" <shantigiriorama@gmail.com> wrote in part:

TC · medicine forum Guru Joined: 02 May 2005 Posts: 1814

Juhana Harju wrote:

David R. Throop · medicine forum beginner Joined: 08 Mar 2006 Posts: 41

In article <1150899450.122616.258370@i40g2000cwc.googlegroups.com>,
TC <tunderbar@hotmail.com> wrote:

TC · medicine forum Guru Joined: 02 May 2005 Posts: 1814

David R. Throop wrote:

Juhana Harju · medicine forum Guru Joined: 06 May 2005 Posts: 1056

David R. Throop wrote:
: In article <1150899450.122616.258370@i40g2000cwc.googlegroups.com>,
: TC <tunderbar@hotmail.com> wrote:
:
:: I think you mean Canola, not rape. They are not the same. Rape is
:: the original plant from which the Canola plant was derived thru
:: selective genetic manipulation.
:
: Mostly right. Canola is a low-erucic-acid cultivar of rape (aka
: Swedish turnip) grown in Canada. There are other low EA rape
: cultivars, grown in Europe and not sold under the name Canola.

The Lyon Diet Heart Trial was a European study and a special rape seed oil
based margarine was used in the study. Canola, on the other hand, is a
Canadian marketing name for LEAR rape seed oil. Also the rape seed oil sold
for food consumption in Europe is low-erucic-acid although it is just called
simply rape seed oil.

--
Juhana

Juhana Harju · medicine forum Guru Joined: 06 May 2005 Posts: 1056

Jim Chinnis wrote:
: "Juhana Harju" <shantigiriorama@gmail.com> wrote in part:
:: Jim Chinnis wrote:
::
::: "Show me a study where these recommendations [for reducing
::: saturated-fat intake] have led to improved outcomes: there isn't
::: one.
::
:: In the Lyon Diet Heart Trial patients were adviced to replace
:: saturated fats with olive oil, rape seed oil and rape seed oil based
:: margarine. And there are other studies as well.
:
: Juhana, I believe Dr. Westman meant a decently-designed study that
: enables one to see the effect of the saturated fats. The Lyon study
: is impossible to sort out. One can say that the "Lyon" diet was
: better than the control diet, but not which factors made it so.
:
: Would you be able to argue that the Lyon diet reduced the number of
: heart attacks because of its reduced saturated fat?!

Here we go again. I think that there is compelling evidence against
saturated fats. Just look at these two Harvard reviews:

http://tinyurl.com/7yeh5

http://tinyurl.com/j3yrv

--
Juhana

Susan · medicine forum Guru Joined: 05 May 2005 Posts: 932

x-no-archive: yes

Juhana Harju wrote:

Jim Chinnis · medicine forum Guru Joined: 30 Apr 2005 Posts: 1030

"Juhana Harju" <shantigiriorama@gmail.com> wrote in part:

David R. Throop · medicine forum beginner Joined: 08 Mar 2006 Posts: 41

In article <4ftlelF1jhq1vU1@individual.net>,
Juhana Harju <shantigiriorama@gmail.com> wrote:

Jim Chinnis · medicine forum Guru Joined: 30 Apr 2005 Posts: 1030

throop@cs.utexas.edu (David R. Throop) wrote in part:

David R. Throop · medicine forum beginner Joined: 08 Mar 2006 Posts: 41

In article <im3k929qn239ia4n5efgrlem2nivufh7gp@4ax.com>,
Jim Chinnis <jchinnis@SPAMalum.mit.edu> wrote:

Juhana Harju · medicine forum Guru Joined: 06 May 2005 Posts: 1056

David R. Throop wrote:
: In article <im3k929qn239ia4n5efgrlem2nivufh7gp@4ax.com>,
: Jim Chinnis <jchinnis@SPAMalum.mit.edu> wrote:
:
::: I like that the review [by Hu and Willet] gets specific about
::: various sat fats and doesn't treat them all as equal.
:
:: The AHA recommendations that Dr.Westman thinks need better
:: justification treat them all exactly the same.
:
: I'm with Westman on that.

While I agree that various saturated fats have different effects this is
also an issue of successful communication. From the public health point of
view it is very difficult to get the message through if the message is too
complicated. However, there could be some advanced level of recommendations
for people who are particularly interested in nutritional matters.

--
Juhana

Juhana Harju · medicine forum Guru Joined: 06 May 2005 Posts: 1056

Jim Chinnis wrote:
: "Juhana Harju" <shantigiriorama@gmail.com> wrote in part:
:
:: Jim Chinnis wrote:
::: "Juhana Harju" <shantigiriorama@gmail.com> wrote in part:
:::: Jim Chinnis wrote:
::::
::::: "Show me a study where these recommendations [for reducing
::::: saturated-fat intake] have led to improved outcomes: there isn't
::::: one.
::::
:::: In the Lyon Diet Heart Trial patients were adviced to replace
:::: saturated fats with olive oil, rape seed oil and rape seed oil
:::: based margarine. And there are other studies as well.
:::
::: Juhana, I believe Dr. Westman meant a decently-designed study that
::: enables one to see the effect of the saturated fats. The Lyon study
::: is impossible to sort out. One can say that the "Lyon" diet was
::: better than the control diet, but not which factors made it so.
:::
::: Would you be able to argue that the Lyon diet reduced the number of
::: heart attacks because of its reduced saturated fat?!
::
:: Here we go again. I think that there is compelling evidence against
:: saturated fats. Just look at these two Harvard reviews:
::
:: http://tinyurl.com/7yeh5
::
:: http://tinyurl.com/j3yrv
:
: Well, I have to say that I think Dr. Westman is spot on. But I would
: entertain data from a well-controlled study. I certainly have no
: vested interest in saturated fat. (Except for cocoa butter, I guess.)

I read a couple of reviews Dr. Westman had taken part in and I found those
studies very biased with a strong low-carb agenda. I find the Harvard
approach by Hu and Willett much more balanced - they are looking at issues
open-mindedly without any fixed agenda.

Nutrition is not an exact science as there are too many factors affecting
the outcome. That is one reason I am not looking for water proof evidence
but rather what is the most probable answer.

--
Juhana

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