Hi Suebee
Suebee wrote:Thank you very much Jeff for all the effort you are putting into this issue for us.
Your Welcome.
Lets separate and deal with each issue as an independent issue and not mix differing issues with differing solutions.
Suebee wrote: I see your point--a few nuts, like walnuts, ok; going overboard, no. .
Correct. I posted the actual numbers from the studies and from the FDA. The recommendations from all the leading national health organizations is around 1 to 1.5 oz per day.
The problem for most people is that they can not eat just one. And, the are so easy to overeat on. All national recommendations include this caution in regard to the potential to overeat on them.
Suebee wrote: Saying you need them with every green thing to absorb nutrients (like Dr. F says)--No!
Correct. We discussed this. Yes, you can show an increase in absorption but it is not necessary or required for absorption. And we do not have any evidence that this increased absorption is needed, or is good or improves health outcomes. As I showed in the other thread, if we just eat more of the original food in an amount equal to the same amount of calories that adding the fat would have added, instead of adding the fat, we will get a much much higher overall nutrient density.
More importantly, lets identify the real problem. The real problem in America is not that people who are eating very healthy diets are not absorbing enough nutrients. Do you know of any data showing that? I don't.
The main problem in American is that most peoples diets are low in nutrients and/or are nutrient density because they do not consume enough unrefined unprocessed foods like fruits, beans and vegetables. Their diets are mostly processed refined junk foods and animal foods. Eating more whole plant foods, fresh fruit and veggies and less processed refined junk food, is the solution. Not adding fat to vegetables.
Suebee wrote:But he also slams low-fat opponents like Dr. McDougall, Dr. Esselstyn, Dr. Ornish, saying those diets are too low in fat, that they can lead to heart arrhythmias (which he claims nuts and seeds protect against),
A low level of essential fats (not total fat) can lead to heart arrhythmias, heart disease and sudden death, but the cure for that is not a high fat diet, or adding fat that does not have the essential fats. As I showed, most all nuts and seeds are actually very low in essential fats. So, if the problem is essential fats, you do nothing to fix it by adding foods that are high fat or low fat, if they do not have essential fats. In fact, higher fat diets (though probably typical American higher fat diets) are a risk factor for heart arrhythmias. If you go the American Heart Association website and look up heart arrhythmias, the recommended advice is a "low fat" diet. This is the same with all other national health organizations.
It is true that Dr Ornish did add in fish oil to his program. He recommends around 2-4 grams a day which is actually over what was used in the studies and over the national recommendations, which is 1 gram. However, if you take the 10% Ornish diet and add in 4 grams of fish oil, the diet is still around 10% fat, no more than 11%. So, yes, Dr Ornish realized a potential problem (lack of essential fats) and fixed it with the appropriate solution (adding in essential fats). Doing it though, through fish oil is not necessary as in the Lyon Heart trial they did it with the addition of plant based omega 3s.
But Dr Ornish isn't recommending a high fat diet now for his reversal diet, he just recommended adding in a few grams of essential fats.
Over 100,000 people have gone through the Pritikin Program and they have published the results in over 120 articles in the leading medical journals. Their diet for most of the original studies for the first 15-20 years and over 75 of those studies was below 10%. There was no increased risk or occurrence of arrhythmia's, heart disease or sudden death. Just the opposite. They have slightly modified their guidelines and the diet is now < 15% fat. However, the do not use any avocados, nuts, seeds, or oils. They do allow 3 small servings of fish a week for those who want it. The original program served only one 3 oz serving a week.
The Tarahumara & Pima Indians in Mexico, the long lived Okinawans, and the traditional Hawaiian diets are all under 12% fat, some under 10% fat, and have been well studied with many published articles. They are all considered cardio-protective and heart disease is virtually unknown amongst these populations
Now, IMHO, the reason Dr Ornish may have seen this problem in some of those following the Ornish diet, but not in these native populations, is not because the recommended diet was lacking but because many people who followed his diet (and other low fat diets) did so by focusing on all those low fat foods that were highly processed and refined packaged low fat high carb foods and food products and not whole plant foods. The native populations had no refined processed foods, and had to eat mostly whole natural plant foods. In fact, 90% of the calories in the Tarahumara diet comes from just beans and corn.
If the problem is lack of fat, then fix it with added fat. But that is not the problem.
If the problem is lack of essential fat, then fix it with added essential fat. But just adding fat, without essential fats, does not solve this. And, you do not have to add lots of fat to add essential fats.
So, how does adding high fat nuts, that are low in essential fats, fix an essential fat problem?
Suebee wrote:that weight loss without these can lead to gallbladder attacks, etc.
Gallbladder attacks can occur as a side effect of very rapid weight loss, very low calorie diets, and long periods without eating, regardless of how one loses weight. But first, very rapid weight loss and very low calorie diets are not a good idea for many reasons, not just the potential risk of gallbladder attacks. Now, this risk happens mostly in women and is a result of increased cholesterol levels in the gallbladder. And if appropriate, there are some medications that can be prescribed short term to minimize this risk.
People who lose a large amount of weight quickly are at greater risk than those who lose weight more slowly. Rapid weight loss may also cause silent gallstones to become symptomatic. Studies have shown that people who lose more than 3 lbs per week may have a greater risk of developing gallstones than those who lose weight at slower rates. While certain people say fat may be an issue, no studies have directly linked a diet's nutrient composition or fat content to the risk of gallstones.. It only takes about 10 grams of fat to cause the gallbladder to contract. A 2000 calorie diet that is 10% fat provides around 23 grams of fat per day. A 1500 calorie diet that is 10% fat provides around 17 grams of fat
High fiber intake and regular exercise also lower your risk
However, this recent study on 120 patients who have lost over 100 pounds,recently came out in the AJCN, which confirms these comments. The average weight loss was around 3# per week (which is over what is typically recommended) for over 44 weeks. And, all showed significant health improvements and were followed up for 5 years. Only 2 people had serious side effects and as far as I could tell from the study, none had gallbladder issues.
James W Anderson, Shannon B Conley, and Amy S Nicholas
One hundred-pound weight losses with an intensive behavioral program: changes in risk factors in 118 patients with long-term follow-up.
Am J Clin Nutr 2007 86: 301-7.
quoting...
Side effects were mild, and only 2 patients had severe or serious adverse events. At an average of 5 y of follow-up, patients were maintaining an average weight loss of 30 kg.
Conclusion: Intensive behavioral intervention can be very effective with minimal risk for certain severely obese persons
In the National Weight Control Registry, over 5000 members have lost on average over 65 pounds can kept it off on average for over 6 years. Some of the them lost over 100 lbs and some of them have kept it off for over 10 years. Most of them followed a low fat diet (under 23%) with 1/3 of them following a diet with less than 20% fat. Gallblader problems was not an issue.
So, the gallbladder issue is more of a very low calorie and/or rapid weight loss issue and is not a common problem. However, it can be easily dealt with if it does occur.
Again, this is not a low fat issue and just adding fat doesn't fix it. Recommending a healthy calorie level and a healthy rate of weight loss from a high fiber diet along with regular exercise is the solution.
There are other issues that i am not discussing in detail today and may at a later date. These include the fact that high fat diets, have been shown to decrease arterial blood flow, increase inflammation and increase clotting factors. High fat diets can also impede athletic performance as those on high fat diets, even after an adaption period, require more effort to achieve similar levels of performance. This is why most all endurance athletes the world over, eat a higher carb, lower fat diet.
So, in summary
1) Research has shown that there may be a benefit in relation to CVD by including around 1.5 oz of nuts per day. While some studies have shown some benefit from using 2-3 oz, I know of no convincing evidence supporting this higher intake or a higher intake than this.
2) Ensuring essential fat intake is important dietary issue regardless of whether you follow a low fat or a high fat diet. Essential fats dramatically reduce your risk of heart arrhythmias, heart disease, and sudden cardiac death.
3) The Adequate Intake set by the National Academy of Sciences is 1.1 grams/day for women and 1.6 grams/day for men. The National Institute of Health recommends 2.2 grams/day. Either way, this amount is easily obtained from a whole food plant based diets than includes green leafy veggies, beans, and other healthy foods. A small amount of English walnuts (~1 oz) or flax seeds (1 -2 TB) can insure adequate intake. Chia, and Hemp seeds are also a good source.
4) Most all nuts/seeds are a very poor source of essential fats. They are nutrient dense, but they are also very calorie dense and if included in ones diet, should be limited to the amounts recommended in point 1.
5) Many studies have documented that several native populations around the world have lived long healthy heart disease free lives on a plant based diet that is less than 12% fat.
6) The only studies documented to reverse heart disease, did so on a diet that was less than 10% fat. As we now know, ensuring adequate essential fats, is also an important consideration in any diet, including a low fat reversal diet.
7) high fat dies can also interfere with blood flow, increase clotting factors and impede athletic performance.
8 ) you are welcome (and encouraged) to disagree with and challenge me. But please post the studies and the details of the studies, so we can all read them and discuss them.
In Health
Jeff Novick, MS, RD
Last edited by JeffN on Wed Mar 19, 2008 7:44 pm, edited 1 time in total.