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We Win! TIME Magazine Officially Recants ("Eat Butter...Don't Blame Fat"), And Quotes Me
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July 28, 2014
3:00 pm
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pam:

The problem with the "safe starches" hypothesis is that Chad appears to have had high TC on a higher-carb diet...so while there are some people who decrease TC on higher carb, perhaps due to the mechanisms Paul mentioned in his articles, Chad doesn't appear to be one of them.

Also, as a woman, lowering TC does you no benefit, and may well do you harm. See the general formulation of Goodhart's Law: "When a measure becomes a target, it ceases to become a good measure."

However, you are correct that vitamin or mineral deficiencies could well be in play. Unfortunately I have no idea where to start without knowing a great deal more information -- unlike many Internet personalities, who seem to feel free to conclusively diagnose others' medical issues based on a few sentences and the thinnest of suppositions!

JS

July 28, 2014
6:18 pm
pam
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Hi, JS

my TC only jumped really high one winter that it jumped high (due to sub-clinical low thyroid, perhaps also anemia)

so i do believe the number is a concern even as a women, not because it would cause diseases. but because of the pattern jump.

i agree that not everyone responds well to safe starch. but just in case since Chad's activities level is very high

regards,

July 30, 2014
7:27 am
Steve
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brenmitch we appear to be in similar boats.

I've done a lot of experimentation with various diet and exercise approaches, and by far I am most-successful thus far on a high protein, low carb, low fat diet of whole foods. I did less-bad on LCHF than on HCLF or intermittent fasting, but LCLF is best for me at the moment.

Excerpting from my cross-post on the met-flex thread:

"For the past few months, I've been almost-exclusively eating skinless chicken breast and spinach with a bit of salsa and sea salt for flavor and egg shell for calcium.

Depending on the reference, this is about:
65% protein
15% carb
20% fat

I also eat a slice of calf liver once or twice per week, and add protein powder or nonfat plain greek yogurt as "snacks" between meals. These would skew the actual protein % even higher.
...
I've been mostly focusing on weight lifting, and that's helped me get stronger and leaner. "Aerobic" exercises didn't actually seem to have much of an effect for me besides increasing appetite. HIIT primarily seemed to adversely impact my strength and recovery from weight lifting, so I stopped doing that."

I should note that I don't go crazy with protein powder or yogurt. 200-400kCal/day max when I don't get enough chicken breast, or substitute some other lean meat like fish...

July 31, 2014
4:29 am
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Gnoll
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It gets better. New Scientist are also picking up on the research (bit.ly/NSsatfat),

"After decades of health warnings, the idea that steak, cheese and lard are bad for your heart is melting away. The truth is more complex – and delicious

THERE'S a famous scene in Woody Allen's film Sleeper in which two scientists in the year 2173 are discussing the dietary advice of the late 20th century.

"You mean there was no deep fat, no steak or cream pies or hot fudge?" asks one, incredulous. "Those were thought to be unhealthy," replies the other. "Precisely the opposite of what we now know to be true."

We're not quite in Woody Allen territory yet, but steak and cream pies are starting to look a lot less unhealthy than they once did. After 35 years as dietary gospel, the idea that saturated fat is bad for your heart appears to be melting away like a lump of butter in ..."

August 3, 2014
2:33 pm
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pam:

Yes, a major change in TC signals some sort of metabolic change (often weight loss). In your case, though, it's the thyroid/anemia that was the problem, and the TC was merely symptomatic. Mainly I think Chad needs to stop running marathons (don't stop running altogether, just cease with the high mileage) and start lifting weights!

Steve:

HP/LF/LC also means "low-calorie", which means you're losing weight…and you'll pretty much be insulin-sensitive by default if you're losing weight. In general, high-protein works very well for weight loss, since it's the only macro we have an obligate daily requirement for. I'm glad you're seeing success -- and I'll have a lot more to say on this subject after AHS!

Asclepius:

I suspect we'll see an acceleration of the trend now, as more and more people and institutions feel the fear of behind left behind -- and, therefore, very likely forced to share the blame for the millions of dead and unimaginable suffering caused by low-fat, low-cholesterol dogma.

JS

August 3, 2014
9:26 pm
Snackowitz
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Entirely non-serious comment here...

Under the "Don't expect public policy to change", in the second point, you refer to glassy eyed zombies.

Wouldn't it be more appropriate to refer to them as "grassy eyed zombies"? ;)

August 5, 2014
8:06 am
RM Fleming, MD, JD
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Politics, religion and food. These three areas of our lives continue to be run by emotion and not science. After serving on multiple AHA committees and presenting testimony in D.C., nothing has changed. The pendulum has swung back and forth between the extremes of diets high in fat to high in refined carbohydrates to high in fat. People will continue to eat the foods they want. They will continue to lack the necessary exercise required to burn off the excess calories they eat and blame someone else for their obesity and other health related problems. No one has published a study showing high fat or high carbohydrate diets coupled with too many calories will improve your health. The truth is that our chronic health problems are the result of excess! Too many calories, too much salt, too much inactivity, too much ... The result is "Inflammation." After presenting our work on this, everyone and their uncle or aunt (although frankly I cannot blame the women for this) set out to show they had the magic answer for this. The truth is "Inflammation" and our "Immune System" is what keeps us alive. Our bodies respond to insults by attacking the insult (viz. inflammation). We are supposed to be smart enough to get away from what's hurting our body and let it heal. Children pull their hands back from the stove after burning their hands. We quarantine those with Ebola, et cetera. When we don't remove ourselves from the offending cause of harm, the harm continues and our "immune system" continues to react, trying to wall off the harm from the rest of the body. Like a teeter totter with too much weight on both ends, it will eventually break. Too much of these excesses are producing the chronic diseases that are reacking havoc with industrialized nations. While people continue to argue over whether too much fat or too many refined carbohydrates is the problem, inflammation will continue to be the final common denominator; just as we established FIRST decades ago and presented on 20/20 in 2004. Too many calories produces this inflammation. Too much saturated fat produces this inflammation. Too many refined carbohydrates produces this inflammation. Too many calories produces this inflammation. Too little exercise promotes this inflammation. Smoking promotes this inflammation. This inflammation produces heart disease, strokes, high blood pressure, cancer..... Despite this mental masturbation, nothing changes and no one is learning. Smile, point your fingers at those on the other side of the argument. We wonder why the politicians in Washington can't work together. Look in the mirror!

August 5, 2014
9:28 am
Immigrant
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Dr. Fleming,
You may want to check out the article series here on hunger and satiety. Yes, many of us eat too many calories, but the question is why? What is it about those extra calories that doesn't make us feel full? In his other articles, Stanton describes some of the science behind hunger and satiety. Different types and qualities of foods have very different effects on satiety, independent of caloric content, and this knowledge alone moves us past a simple "calories in, calories out" model.

Also, if you have a reference where dietary saturated fat is demonstrated to cause inflammation, I think the readership would be very curious to see that reference.

August 5, 2014
10:14 am
RM Fleming, MD, JD
Guest

Thank you for your thoughtful reply "Pooch."

Here are references for your readers. The field is plagued with limited information including dietary journals, drop out issues, failure to have "quantitative" methods to actually measure disease instead of simply looking at surrogate blood markers of disease. Finally, comparing rest-stress images is the incorrect way for determining ischemic heart disease as we and other have now validated. Rest imaging equals tissue damage while stress images reveal blood flow. To determine blood flow images, one must compare two or more stress images, not a viability and blood flow image. When rest-stress is used, there is a 35% error rate-hardly a method applicable for studying the effects of diets on heart disease or for that matter, the presence of heart disease itself.

Fleming RM. The Clinical Importance of Risk Factor Modification: Looking at Both Myocardial Viability (MV) and Myocardial Perfusion Imaging (MPI) Intern J Angiol 2000;9:55-69.

Fleming, RM. The Effect of High Protein Diets on Coronary Blood Flow. Angiology 2000;51(10):817-826.

Fleming RM. The Effect of High, Moderate and Low Fat Diets On Weight Loss and Cardiovascular Disease Risk Factors. Preventive Cardiology 2002;V(III):110-118. [http://www.medscape.com/viewarticle/438769]

Fleming RM. Caloric intake, not carbohydrate or fat consumption, determines weight loss. Am J Med 2003;114:78.

Fleming RM. The effect of ephedra and high fat dieting – a cause for concern! A case report. Angiology 2007; 58:102-5.

Nielson C, Fleming RM. Blood glucose and cerebrovascular disease in non-diabetic patients. Angiology 2007;58(5):625-9.

Fleming RM. Chapter 64. The Pathogenesis of Vascular Disease. Textbook of Angiology. John C. Chang Editor, Springer-Verlag New York, NY. 1999, pp. 787-798.

As well as studies showing the methods for determining outcomes of diet are flawed by looking either at serum markers of disease which do not always correlate with disease and improved methodology to actually detecting heart disease-which has been verified by physician-researchers in S. Korea and England.

Fleming RM, Harrington GM, Baqir R, Jay S, Sridevi Challapalli, Avery K, Green J. The Evolution of Nuclear Cardiology takes Us Back to the Beginning to Develop Today’s “New Standard of Care” for Cardiac Imaging: How Quantifying Regional Radioactive Counts at 5 and 60 Minutes Post-Stress Unmasks Hidden Ischemia. Methodist DeBakey Cardiovascular Journal (MDCVJ) 2009;5(3):42-48.

Fleming RM, Harrington GM, Baqir R, Jay S, Challapalli S, Avery K, Green J. Renewed Application of an Old Method Improves Detection of Coronary Ischemia. A Higher Standard of Care. Federal Practitioner 2010;27:22-31.

Fleming RM, Harrington GM. Quantitative measurement of sestamibi distribution to detect hidden ischemia made possible by application of Blumgart’s method. J Nucl Med 2011;52(suppl I):1162.

Fleming RM, Harrington GM, Kearney DS, Tomsho M, Sheils J. Myoview and Sestamibi redistribution, stress once – image twice protocol improves detection of ischemia in addition to improving patient throughput and reducing patient radiation to 3.75 mSv. J Nucl Med 2012 (SNM Annual Meeting Program Book): 115.

Fleming RM, Harrington GM, Baqir R. Heart Disease in Men. Chapter 3. Using Multiple Images Post-Stress to Enhance diagnostic Accuracy of Myocardial Perfusion Imaging: The Clinical Importance of Determining Washin and Washout Indicates a Parabolic Function between Coronary Perfusion (Blood Flow) and Cellular ("Uptake/Release") Function. Alice B. Todd and Margo H. Mosley Editors, Nova Publishers, 2009, pp. 75-100. (https://www.novapublishers.com/catalog/product_info.php?products _id=8409)

Fleming RM, Harrington GM. Chapter 13. Fleming Harrington Redistribution Wash-in Washout (FHRWW): The Platinum Standard for Nuclear Cardiology. Establishing Better Standards of Care in Doppler Echocardiography, Computed Tomography and Nuclear Cardiology. Richard M. Fleming, Editor, Intech Publishing July 2011. ISBN: 978-953-307-366-8.

August 5, 2014
10:00 pm
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Snackowitz:

Either way, they're still after our GRAAAAAAINS.

Dr. Fleming:

You're getting close to the source of problem, but inflammation is still a downstream consequence of the metabolic dysfunction of obesity -- as evidenced by the fact that corticosteroids do not make people slim (they make them fat), and neither do other anti-inflammatory drugs.

Also, certain very specific excesses are much more likely to start the cascade than others.

My time is currently very short due to my upcoming AHS 2014 presentation: I'll give your posts more of the time they deserve next week, when the conference is over.

JS

August 26, 2014
9:03 pm
Jean J. Labelle MD
Guest

Our body is composed of trillions of cells. There are however 250 species of these cells and each have specific dedicated functions in the upkeep of our complex body organism. Muscle, brain,[the brain is 80% fat]immunity {homeland security system] endocrine [hormones] synovial [elbow grease] bone,[supporting the body] cartilage [joint padding] liver, [chemical manufacturing and detoxifying ]pancreas[digesting] epidermal [protecting the body against bacteria, virus, and against drying up]sensory [all six senses] and so many other cells each producing different products and building blocks to sustain this fabulous organism.
Who do we think we are in our great intelligence to decide what foods each of this plethora of cells need? We went from low fat diets and anti cholesterol drugs and caused the great epidemic of diabetes by replacing fat by carbohydrates. The cells cannot go to the supermarket and get food for their specific need. They can only look into the blood and try to find their specific building blocks.So why not eat a balanced moderate diet of foods without preservative and insecticides ["organic"[ etc. Those who do so live well and longer. The Symphony of Aging 2006.

September 3, 2014
1:03 pm
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Dr. Labelle:

"We went from low fat diets and anti cholesterol drugs and caused the great epidemic of diabetes by replacing fat by carbohydrates."

It's truly bizarre that standard treatment for a disease of impaired glucose metabolism is to eat more glucose! It's like telling someone with lung cancer to smoke more cigarettes.

JS

October 5, 2014
3:23 pm
Fmgd
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Have you by any chance watched the last episode of South Park? It deals with this and ends with one of the kids saving the day by putting the age-old food pyramid upside-down.

October 6, 2014
10:11 am
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Fmgd:

No, I haven't -- but upside-down, while not optimal, is indeed far better than right-side up!

JS

October 8, 2014
11:03 pm
Paul K
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Fmgd:
Thanks for mentioning the South Park episode. I just watched it again about an hour ago and almost rolled on the floor. Cartman saved the day and turning the pyramid upside down (the outline turned upside down with the words left in the same rows) probably comes really close to the truth (except for the inclusion of seed oils in the top row of what you should eat most of).

J.
Thanks for all your logical writings, they have helped greatly in my understanding and comprehension of nutritional topics. I have been reading your blog for several years now and keep coming back hoping to find something new.

October 11, 2014
7:21 am
Glen Nagy
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I haven't been able to find your AHS14 talk online. Do you know when your talk is going to be posted? Your talk is the one I really want to see!

October 11, 2014
9:42 am
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Glen:

It's coming very soon. There were some A/V problems (yes, again) that greatly affected the audio track. I've spent quite a bit of time cleaning it up: once I'm done with that, the A/V crew will splice the audio back in and make it available.

I'll let everyone know as soon as it's up!

JS

November 23, 2014
10:54 pm
James
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"It’s truly bizarre that standard treatment for a disease of impaired glucose metabolism is to eat more glucose! It’s like telling someone with lung cancer to smoke more cigarettes.

JS"

Denise minger in her latest presentation believes that high carb diets are superiour when it comes to T2 diabetes reversal. She said that low carb diets only mask the problem through restriction of glucose and weight loss whilst high carb diets can actually heal the disease without weight loss.

November 23, 2014
11:01 pm
James
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Also. I just read one of Mark Sisson's posts's about butter. He seems to be backtracking a bit and advising people that butter is not as innocent and health promoting as he once promoted.

I don't think this TIME magazine article is of great public benefit as it seems to be giving a green light to people who like to hear good news about their preferred dietary habits.

November 25, 2014
11:38 am
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James

I love Denise, but I'm reasonably sure she's a bit behind the curve on this one.

I've been researching this very subject for quite a while. The important and determining factor in all the "high-carb" diabetic interventions I've seen (e.g. the Cuban macrobiotic study) is not their carbohydrate content! They have another common factor which is causing them to work...and given equal amounts of this factor, the lower-carb interventions work even better.

All the puzzle pieces are in my 2013 AHS presentation about metabolic flexibility and the data section of the papers: you're reminding me that I should finish the article and actually publish it!

As far as butter, I've said this, or something like it, many times before:

"...This isn't a high-fat diet! This is a “don't throw away the fat that naturally occurs in food” diet. Note that I don't recommend drinking milk (or any other liquid calories), nor do I recommend dumping butter or coconut oil on things in order to meet some magical macronutrient ratio."

-from my comments to "Eat Like A Predator"

My advice hasn't changed meaningfully in years precisely because I haven't focused on any putative magical properties of a particular "macronutrient" ratio...I've focused on food. Once you start focusing too much on macros you can easily end up with either a pathological fear of butter, or pathological consumption of butter -- when the healthy approach is generally "If it genuinely tastes better with a pat of butter on it, go ahead and add some." Frankly, butter is much like bacon: after the first couple months of "OMG BACON AND BUTTER ON EVERYTHING WOOHOO!!1!!", the desire generally subsides to the level of "condiment".

JS

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