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A low-carb guru weighs in on the dietary guidelines

June 29, 2010 |  5:59 pm

Experts buzzing about the scientific report of the dietary guidelines advisory committee released in mid-June certainly had a qualm here and there about the panel's tentative recommendations. But on the whole, a roundup of expert opinion gathered by The Times' Health section suggested there are some points of consensus about how -- and what -- to eat to get and stay healthy.

Proponents of a very low-carbohydrate diet such as that championed by Dr. Robert Atkins, however, found a lot to be steamed about as they read the report. The panel seemed to diss the low-carb lifestyle and its prospects for helping American adults shed excess weight.

Dr. Stephen Phinney, co-author of "The New Atkins for a New You," predictably took issue with the scientific advisory panel's assertion that "there is some evidence that [diets less than 45% of calories from carbohydrate] may be less safe."

That claim only works, says Dr. Phinney, if one is highly selective in the data one chooses to consider.

"Yes, in some -- but certainly not all -- studies, the Atkins diet raises total and maybe LDL cholesterol levels," Phinney acknowledges. But over the past two decades, thinking on cholesterol has changed. "That might have been worrisome" back when cholesterol was just a blunt instrument, a single number, says Dr. Phinney. "But now we know that the Atkins diet raises HDL (i.e., "good') cholesterol, which helps explain why the total cholesterol can go up without increasing risk."

Add to this what Phinney calls "the excellent evidence that carbohydrate restriction changes LDL cholesterol from the bad 'small dense' form to the lower-risk larger particles" -- a shift that represents a major reduction in risk, says Phinney. "But that is completely missed if one just uses the old way of measuring total LDL cholesterol." Finally, Phinney says, in most studies where it was measured, when people actually follow the Atkins diet, their level of inflammation -- which many believe is a predictor of heart disease risk -- goes down.

 "A great deal of recent data that the Atkins diet may actually be more safe," says Phinney.

Phinney also objected to what he called the "continued demonization of saturated fats by the committee."  He cites a recent journal article that makes the case there is no evidence to support the widespread belief that the consumption of saturated fat negatively affects heart health or overall mortality.

For people who follow the Atkins diet -- even those who eat more dietary saturated fat when they do -- blood levels of saturated fats go down, says Phinney. This apparent paradox, he adds, is due to a combination of the body adapting to a low-carb diet by rapidly burning saturated fats as fuel, plus a sharp reduction in the liver's production of saturated fats from dietary carbohydrates.

The dietary guidelines advisory committee, however, may have discounted evidence for these effects because published studies providing such data are relatively new. 

"Frankly, I agree there might be concerns about combining a heavy intake of saturated fats along with lots of sugar and refined carbohydrate," Phinney says. "This combination (think double bacon cheeseburger plus supersized soda) is a diabolical combination designed to dramatically raise the saturated fat levels in your blood triglycerides.

"But when one removes the refined carbs and sugars, eats the 'foundation vegetables,' moderate protein, and healthy fats as described in our book, blood levels of saturated fats plummet, particularly in people with high risk conditions associated with insulin resistance (such as metabolic syndrome and Type 2 diabetes)."


-- Melissa Healy

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Comments (17)

Thank you for this. Fifteen years of low carbing has left me bloomingly healthy; my doctor agrees. I've seen my triglycerides as low as 39, and my HDL as high as 79. I've completely lost the energy swings that plagued me in my 20s and 30s. I've also lost the nagging hunger that used to make me wonder if I was crazy.

I am neither making this up nor exaggerating in the slightest when I tell you that I have been stopped in the hall at the doctor's office, and had the nurses demand to know the "secret" of my HDL and triglyceride numbers. I'm pretty sure "Three eggs a day, all the red meat I can scarf" was not the answer they were expecting, but it is the truth.

I can vouch for a high fat, moderate protien, very low carb diet. Cured my prediabetes. I've been eating like this for about 3 years now with only good effects. My blood sugar is varies between 85 and 105, even after eating, and I lost 30 lbs too. My insulin level is nice and low too, meaning that I don't use much to keep my blood sugar low. You can have very high insulin levels even with normal blood sugar, which is dangerous.
The guidlines (and most dieticians) advice to get up to 65% of caloric intake from carbs is a recepie for obesity and diabetes, as has been proven since the guidlines forst came out.
Stick to Real Food, nothing processed, including bread/wheat products. Your body will thank you. I know mine did.

I can't believe we are still talking about the Adkin's Diet. It's time to eat plants, people!

There are another couple of angles on the cholesterol story with regard to low-carbohydrate diets. It seems that when your doctor orders a cholesterol profile on you, nine times out of ten the lab employs a formula to determine your LDL, rather than counting it directly. For some reason, the formula includes your triglyceride count--which isn't even a cholesterol number, but never mind.

This plays out interestingly when the patient has low triglycerides, which occurs the vast majority of the time with people who eat low-carb. This makes sense if you know what triglycerides are: they're former digestible carbohydrates. Your body takes the excess of those and turns them into fatty acids with the intention of storing them in fat cells. Eat less of the digestible carbohydrate foods, and you make fewer triglycerides.

Unfortunately the end result is that low triglycerides skew the formula for LDL calculation--making LDL look higher than it really is. There is a solution for this, because there is a lab test that will count LDL directly, but you must ask for the test, and you must check to see if your insurance will cover it.

If you want to verify what I'm saying for yourself, do a Google search for the Friedenwald formula or Friedenwald's formula (either will get you results).

The other angle on cholesterol and low-carb diets is that the relative danger of LDL particles depends greatly on their size. It's been shown over and over again that on a low-fat, high-carb diet, many people form LDL particles that are small and dense. If the person switches to a high-fat, lower-carb diet, the particle size can and often does change to something larger and fluffier. You want large and fluffy LDL. That's normal LDL and is an indicator of good metabolic health. As far as researchers can tell, fluffy LDL is way too big to fit into your artery lining and form plaques. Only the tiny LDL particles do that.

Again, there are lab tests that detect, if indirectly, your LDL particle size. Ask your doctor about those too. I just did a little glancing around on Google, and Johns Hopkins says it's not necessary to ask for particle size testing since a doctor knows all they need to know from the regular cholesterol test, but Johns Hopkins also says cholesterol is a fat, which isn't true either. (It's a waxy alcohol.) Get the tests done, both direct LDL count and LDL particle size, and then you can make more intelligent decisions about your health care and dietary approach.

Personally, all I need to know is that I can't utilize minerals or fat-soluble vitamins as efficiently if I'm not eating enough fat, and that fat helps me feel full sooner at a meal than if I cut it out of my diet, and that I feel a lot less crazy and mood-swingy when I'm eating more fat, including saturated (but not trans!). Oh, and I'm losing weight too. But that's just a bonus.

Bang on Doc!

We'll get there eventually.

The biggest barrier is money, and I'm not talking about the fact that 15 or 15 DGAC members are directly funded by Big Sugar. If the DGAC did an about face, there'd be terrible turmoil. Imagine suddenly needing to turn all our corn fields into pig farms and all our wheat fields into pasture and all our soy and canola fields into chicken farms. Just stop and think aboit the cost of converting entire food production and transportation industries into healthy supplies. It ain't gonna happen in our life times.

I find it hard to believe anyone could live off of the gov. guidelines and say with a straight face they feel great and are happy.
I doubt anyone of the people involved in making the guidelines practice what they preach when it comes to eating.

Amelia
Adkins includes plants. I eat lots of veggies and some fruits. Don't ignore our entire evolutionary history though. Vitamins A, E, B12, etc have to come from animals. You can't get them from plants. PETA yes, a valid concern. We need to address it. But we'ved evolved on animal products and they are vital to our health.

Only diet that makes sense: (1) Lower your calorie intake, and (2) get more exercise.

That being said, the easiest thing you can do to lose weight: DON'T eat at night. Kitchen is closed after 7:00 pm. You will lose 1 to 2 lbs. a week by not eating at night. Conversely, you will gain 1 to 2 lbs. a week if you insist on eating at night, and it all turns to fat while you sleep.

Second easiest thing you can do to lose weight: Cut out potatoes and bread. Completely. You will lose another pound or two a week.

My husband has lost 45 lbs. on the South Beach Diet. He is currently about 10 lbs away from his goal, and is maintaining his weight loss. His triglycerides are low and his HDL is high, and his LDL are normal. I don't include the numbers as we are Canadian and use the metric measures. He eats very little carb, perhaps a piece of toast, peanut butter for breakfast. Cottage cheese, veggies, cheeese, for lunch. Salad, meat and veg for supper. Apples for a snack. We eat eggs but not bacon, ham only. He has always taken his coffee and tea black, so not a big sweet eater. I am doing better avoiding sugars but have a serious sweet tooth, which is my downfall. My triglycerides and HDL are in the normal range even while I am obese. I need to burn fat, and the only way is to decrease my carbs, increase my metabolism and eat more plants and lean proteins. I need to eat more like my husband!!! (He won't read this so I'm safe in admitting he is more disciplined than me.) We know a low carb diet works.

Same as Dana Carpender here!

Been on low carb for 8 years now. My cholesterol numbers are great as well and also when asked I say lots of meat and eggs (of course I eat veggies too) and they're mouth drops.

I wish people would realize that fat does not make you fat but excess carbs is what makes you fat.

First of all, it's Atkins, not Adkins. If you're going to criticize a way of eating, at least get the name right.

Second, vegetarianism, which I assume amelia is promoting, is dangerous both personally and environmentally. Personally, a grain-based, high-carb diet has been documented to interfere with mineral absorption (unless grains are soaked and fermented to deactivate phytates), cause inflammation due to lectins, and over-stimulate insulin to clear nutrients from the blood and increase blood fats (triglycerides). Environmentally, large-scale commercial agriculture devastates natural perennial-grass ecosystems (which maintain and build topsoil, sustain all manner of microscopic, small, and large animals without assistance), and kills it all to raise annual grasses/grains. Grains require constant tending, produce slightly addictive exorphins to encourage their consumption, and need massive amounts of fertilizer (and produce attendant toxic runoff) to feed the exploding population that their cultivation makes possible.

Commercial livestock practices are horrible, too, but at least they can be made humane and sustainable, and the animals' fat and flesh were the reasons humans developed big brains in the first place. Their nutrient density allows people to eat less overall, instead of requiring ever-increasing amounts of land for nutrient-diffuse, monocropped plants, whose genomes can now be patented, making corporate serfs of farmers. As Lierre Keith, former vegand and author of "The Vegetarian Myth," points out, in order for humans to live, they have to kill something, and vegetarians sacrifice more life than those who eat sustainably-raised meat.

Amelia, the only vitamin that has to come from animal material is B12. You can find lots of plant sources of vitamin E and A. The little bit of B12 that we require can be found in dairy products, or even soil that plant material is grown in.

I guess I have to speak out for the vegetarians on this one. I haven't eaten meat or fish in 25 years. I eat almost every vegetable there is, complex carbs, no refined sugar and I do eat some dairy. I'll put my blood tests up against Dana's any day.

Keep in mind that a large part of your overall health is the genes you were dealt, and I feel I'm lucky. To tell the general public to eat as much red meat and eggs that they can possible shove down their gullet is not very responsible.

We're omnivores which means we can eat both animal and plant material. If you choose to not eat one of those sources you best be very careful about the rest of your diet. No diet should be out of balance, and the Atkins and the Paleo diet are.

A good healthful diet is really about variety and portion size. Just because I don't eat meat and fish doesn't mean I eat as many fruits and vegetables as I want to. Balance is the key. Calories too. Animal fat is higher in calories than a non-meat diet. That's just a fact. As far as your body using fat for energy because it doesn't have a lot of carbs to work with that's a slippery slope.

I think the new guidelines are great. Americans need to be told to lay off the high calorie foods, which includes meat and saturated fats. We are SUCH an overweight country compared to most others.

I'm not boasting about my diet, I'm doing it to stay healthy and to voice my concerns over the horrible conditions in the factory farming industry. The animals are treated like a commodity instead of like animals who should be raised in a respectful, healthy manner and slaughtered with as little pain as possible. Meat produced in the big business of meat production today is full of all kinds of drugs and pesticides.

I don't know why people who feel they've gotten the go ahead to eat all the meat they want are so nasty when it comes to talking to people who don't eat meat. I'm starting to think it's the hormones found in the majority of meat produced today.

You guys eat what you want and let those of us who find balance and compassion a better way to go.

Finally, let me say I'm shocked the USDA had the guts to suggest the new food pyramid. They're in for a lot of trouble in Washington.

If the Atkins diet theory is correct -- and an unbelievably overwhelming amount of evidence argues that it is -- than the USDA Food Pyramid is probably not only singlehandedly responsible for our obesity epidemic, but, if you follow the logic, it is also probably a serious indirect cause of our current financial crisis.

The Food Pyramid is pure enshrined evil, and those involved in okay-ing these dietary recommendations should be shamed and stripped of their credentials.

Carbohydrates are SUGAR, pure and simple. They should not make up the bulk of our diet.

Sugar is POISON.

Why not tell everyone to eat RAT POISON for dinner?

does anyone really know which carbohydrates are good for you? it sure doesn't sound like it from the posts.

has anyone read the last two paragraphs of this article? because by the sound of most of the comments you guys haven't.

Contrary to what the (witch, apparently) doctors behind the USDA report say, if you eat a very, very low carb diet and plenty of fat and protein (lots of eggs, cheese, meat, bacon, butter-soaked vegetables), you're liable to end up 46 and fat like me! (I weigh less than I did in high school, and I was slim in high school -- and effortlessly, and without hunger.) See photo:

http://www.advicegoddess.com/archives/2010/06/28/la_press_club_a_4.html

As investigative science journalist Gary Taubes wrote in "Good Calories, Bad Calories," the first food pyramid was created by an aide to George McGovern with no science experience. Keep up the good work, USDA!

Regarding the Atkins diet, as Taubes told me when I interviewed him for my syndicated column, "Doctors have been saying Atkins is a quack for so long, they never bothered to check whether he actually got the science right. Unfortunately, he did and they didn't."

lynn, rather than just sniping, why don't you tell us what the posters are doing wrong?



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