Wednesday, August 12, 2009

Cleave and Yudkin on Fats

Drs. T. L. Cleave (1906-1983) and John Yudkin (1910-1995) were two diet-health researchers who believed that refined carbohydrate-- and particularly refined sugar-- are behind many modern health problems. They made their case in the scientific journals, as well as in books aimed at the general public. They were also witheringly dismissive of the idea that animal fats could be behind the coronary heart disease epidemic of the 20th century. I'm going to post a few quotes of theirs that I'm particularly fond of, relating to this. I'll start off with a few oldies but goodies from T. L. Cleave's The Saccharine Disease, page 100:
Those who incriminate animal fats in raising the blood lipids and causing coronary disease would have us stop eating the fats that we have been eating from immemorial time, such as the fat found in meat and in the butter and cream derived from milk, and eat instead a whole lot of new oils, mainly expressed from vegetable seeds, many of which oils are alien to us.
From pages 100-101:
The keeping of flocks of sheep, herds of cattle, and other domestic animals, in order to provide a continuity of meat and milk, started with neolithic man many thousands of years before the Christian era... To these fats we are therefore well adapted, quite apart from man, as a hunter, being well acquainted with the fat of animals in evolutionary times far more remote than the neolithic ones.
From page 101:
Contrast with these ancient fats the new oils, mainly expressed from vegetable seeds. Not only are many of these seeds not a natural food for man (e.g., cotton seed and sunflower seed-- and incidentally the sunflower does not even come from the Old World, as we do in the British isles, but from the New), but also the oils expressed from many of them never existed in any quantity before the invention of the modern hydraulic press or the new solvent procedures, and consequently were scarcely eaten in this country before the introduction of margarine, circa 1916, during the First World War. Evolutionarily these oils make us not so much men as the equivalent of a flock of greenfinches, and the evolutionary incongruity is heightened by the fact that the coronary explosion amongst us, as will be seen later, came in since the introduction of just these oils at the period stated, though in margarine they are often saturated by a stream of hydrogen.
Now for a little John Yudkin. From "Dietary Factors in Arteriosclerosis: Sucrose" (Lipids 13(5):370. 1978):
In principle, it is very doubtful that one can in any way profoundly modify the diet of any species, including Homo sapiens, without introducing some hazard. The consumption of large quantities of PUFA [polyunsaturated fat] has been made possible only by the very recent development of sophisticated techniques of cultivating oilseeds, and extracting and refining vegetable oils. Before such techniques were available, these oils made only a small contribution to our diets, as they still do in the poorer countries. We cannot ignore the evidence that the large amounts widely recommended nowadays as a preventive of CHD can produce undesirable effects, such as increasing the risk of gallstones and possibly of carcinomatous changes in the skin. On the other hand, the reduction of the high amounts of sugar that we now consume is not known to be accompanied by any hazard.
Drs. T. L. Cleave and John Yudkin: making sense since 1936.

74 comments:

theoddbod said...

I am becoming very fond of these old articles and papers.

Bris said...

Seed and legume oils have been a very significant component of Mediterranean, African, Middle Eastern, Indian and Asian diets for thousands of years. Sesame oil (41% n-6) is a staple of the Japanese diet and is the basis of tahini a popular Middle Eastern food.

Freshly cold-pressed seed oils (rich in antioxidants) are probably fairly benign. It is very likely that oxidised heat-treated oils high in polycyclic compounds are the real problem.

L said...

bris

you've mentioned your background involves food science. could you please offer an opinion on the following: degradation of heated so called healthy fats like butter, coconut oil and tallow. estimates for the smoke point vary, but for butter and coconut oil 350F is consistently stated. using an infrared thermometer i measured the temperature of the pan at various points while frying using ghee and/or coconut oil (heat: medium flame). i wasn't frying for long periods, e.g. lightly cooked eggs, medium rare steak. the measured temps were always 395-440 (+,-5). i've brought the issue of heat damaged fat up before on this blog, but no one seems to be concerned because if animal fat/coconut oil is involved only immense goodness is possible . should there be a concern? thanks

Ashu said...

Bris,

What is your opinion on the cause of CHD?

I tend to think that stress and activity levels are far more important than diet.

Bris said...

L:

All "fats" found in food are a complex mixture of various fatty acids, triglycerides and other compounds such as lecithin. Even so called saturated fats such as beef tallow contain a very significant percentage of monounsaturated and polyunsaturated fatty acids.

No oil or fat can be heated to above 100C (boiling point of water) without undergoing some oxidation and other undesirable changes. Even at <4C in a refrigerator butter will become slightly rancid (oxidise) after a few months.

I certainly wouldn't eat fried foods. I also suggest that foods are slow-cooked.

Bris said...

Ashu

I think genetics are critical.

Schizophrenics have much higher rates of heart disease and diabetes and low rates of cancers. It is now believed that they have hundreds of mutations on the Major Histocompatibility Complex (immune system) which protect against cancer but increase the risk of heart disease and diabetes.

Several of my relatives have bipolar disorder and depression. Heart disease and obesity is common on both sides of our family. However cancer deaths have been exceptionally rare for many generations despite many smokers, little exercise and often very poor diets. (I'm the skinny very active exception)

My grossly obese and totally sedentary aunt is 80 with no heart disease or diabetes. My mother died at 67 from a heart attack despite being a healthy weight and eating a very sound diet.

My maternal grandfather died at 99. He ate what he liked, was obese, did no exercise and was very healthy until the last few months of his life.

Diet can't really explain any of the paradoxes such as the Kitivans or Okinawans adequately. People of Northern European origin on similar diets living in the tropics still have high rates of obesity, diabetes and CVD. Living in subtropical Australia I see large numbers of obese unhealthy people who eat diets that are arguably far healthier than the traditional diets on Okinawa or Kitiva.

The Okinawa Centenarian Study researchers now admit that Okinawans live longer and have less heart disease due very largely to genetics.
http://www.okicent.org/study.html

Robert Andrew Brown said...

Bris said

"Seed and legume oils have been a very significant component of Mediterranean, African, Middle Eastern, Indian and Asian diets for thousands of years."

"Very significant"?? in terms of modern vegetable based oil consumption ???

From the figures I have seen veg based fats have increased 4 fold and more over the last 100 years.

Robert Andrew Brown said...

Bris said

"The Okinawa Centenarian Study researchers now admit that Okinawans live longer and have less heart disease due very largely to genetics.
http://www.okicent.org/study.html"

Thanks Bris, interesting and useful paper but I think "very largely" is arguably an overstatement.

Paper said

"Does this mean that Okinawan longevity is all genetic? Not at all. We believe the Okinawans have both genetic and non-genetic longevity advantages -- the best combination. In fact, we have written extensively that the Okinawan traditional way of life -- the dietary habits, the physical activity, the psychological and social aspects, all play an important role in Okinawan longevity.

While most studies of humans have suggested that about a third of human longevity is due to genetics, this depends on the age, sex, ethnicity and environment of the study population. For example, studies of "model organisms" of aging, such as rodents, who share many of the same genes as humans, have shown that single genes can influence lifespan by 50% or more. On the other hand, studies of lifestyle interventions, such as eating fewer calories (a.k.a. "caloric restriction") have shown that this dietary intervention can also yield increases in lifespan of a similar magnitude (see Willcox DC et al., Caloric restriction and human longevity: what can we learn from the Okinawans? Biogerontology. 2006;7:173-77). The key is to study both genetic and non-genetic (environmental) factors and ultimately "gene-environment" interactions that lead to healthy longevity."

Bris said...

Robert Andrew Brown

From the figures I have seen veg based fats have increased 4 fold and more over the last 100 years.

Only in the industrialised world. It has always been very high in the countries mentioned.

On Crete olive oil consumption was well over 100ml day according to Keys.

Throughout many parts of Asia and the Indian subcontinent foods fried in vegetable oil were eaten every day. The Taiwanese eat fried food for breakfast and have a traditional fried chicken dish similar to KFC.

Ricardo said...

"THE SACHARINE DISEASE: Conditions caused by the Taking of Refined Carbohydrates, such as Sugar and White Flour", T.L.Cleave (1974) - http://www.cybernaut.com.au/optimal_nutrition/information/library/saccharine_disease.pdf

Adolfo David said...

GREECE- Low saturated fats, high oleic acid and omega 3: low CHD

See "Seven Countries Studies" and the case of Cretan diet (the lowest heart disease rate in Europe), high in fats, but mainly olive oil and omega 3.

Mediterranean diet (an example in many senses against CHD) is moderate to high in fats, but in monounsaturated fats from local extra virgin olive oil and Omega 3.

I live in mediterranean Spain and here typical diet has this fats composition, it is moderate to low in saturated fats.

And Dr Barry Sears has NEVER said that saturated fats are the devil. But I go on thinking the very best fats are extra virgin olive oil (with a lot of antioxidant polyphenols) and Omega 3.

Bris said...

Adolpho:

Dr Uffe Ravsnkov has argued very convincingly in the 'The Cholesterol Myths' that their is no association between saturated fat and heart disease. He also argues that the Mediterranean Diet hypothesis is unconvincing because heart attacks are 6x more common in Capri than nearby Crete despite almost identical diets. The Mediterranean "Diet" should really be called the Mediterranean "Lifestyle". The food itself isn't very important - it is the sun, relaxation and physical activity that is healthy.

Bris said...

Adolpho:

The Seven Countries Study is a fraud. Ancel Keys simply ignored all the data from 16 other countries which completely disproved his argument. Keys also claimed to have lost all his original data from Crete when challenged to produce his evidence.

Adolfo David said...
This comment has been removed by the author.
Adolfo David said...

Anyway Bris, i dont take almost saturated fats because I prefer cold-pressed extra virgin olive oil and Omega 3 fatty acids from fish and purified supplements. I think nobody can prove that saturated fats are really healthier than my fats choices. Simply its a matter of what is better. Our bodies need cholesterol, yes, but I recommend much higher focus on MUFA and Omega 3 PUFA.

Mediterranean diet has the very big mistake of being based on too cereals and starches. But in general mediterranean diet and japanese diet are probably the nearest to an antiinflamatory nutrition.

Adolfo David said...

And for me its always a concern arachidonic acid content of many foods otherwise rich in saturated fats since arachidonic acid is one of the fathers of inflammation.

I disagree a lot with those who say that egg yolks can be taken so liberally. Omega 6 fatty acids are pro inflammatory because of they increase arachidonic acid production in the body. So, criticizing Omega 6 and vegetable oils and then saying that egg yolks and red meats are perfect (I have read this in some comments here) is a enormous contradiction.

Robert Andrew Brown said...
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Robert Andrew Brown said...

Bris

Intake of vegetable fats in India 1950 and 1960s 3/12% cals per paper below. If main dietary oil is sesame then 40% of their intake is Omega 6. Lets say 2% which quite a low Omega 6 intake. But if Omega 3 intake was negligible they would still have health issues.

Western intake of Omega 6 ranges between 8-25% of cals.


Incidence of coronary mortality amongst railway workers in India comparing northern to southern eg Ghee and milk fats v veg oil, was 15 time higher in the South.


http://www.ajcn.org/cgi/reprint/20/5/462

S L Malhotra paper

How different would stress levels be between two groups doing the same occupation and employer etc ??

OK there may be other factors like curcumin. The southerners ate less sugar, but may have had a very low Omega 3 intake.

I would question using the consumption of vegetable oils in traditional eastern diets as any basis for conclusions about consumption of vegetable oils in the western diet.

Stephan Guyenet said...

Bris,

Olive oil is the predominant oil in the Mediterranean region. It's a fruit oil rather than a seed oil and it's low in omega-6 compared to most industrial seed oils. Similarly, the predominant traditional plant oil in Africa is palm oil, which has a fat composition similar to lard (10% omega-6).

Despite their modest sesame oil intake, the traditional Japanese diet is overall low in omega-6 and high in omega-3. Their omega-6 intake has been rising in the last few decades due to Westernization, yet they still only eat about 5% of calories as omega-6, compared to 7% or more in the US.

Sesame and sunflower oil are the only two omega-6 rich traditional oils I can think of that were widely used an in any appreciable quantity. But I don't envy the cardiovascular health of regions that use sunflower oil as a staple... Ukraine, Russia etc.

Most traditional fats, particularly those used in healthy regions, were low in omega-6: lard, olive, tallow, palm, coconut.

Stephan Guyenet said...

Oh yes, then there are the regions that use safflower oil, in India... some of the highest CHD rates in the world, despite their modest life expectancy.

Adolfo David said...

Stephan and all, Sesame oil is probably more antiinflamatory than proinflamatory due to its content in sesamin, which blocks Delta 5 Desaturase enzyme like Omega 3 EPA

For example Dr Sears sells extra virgin olive oil and organic sesame oil as antiinflamatory oils.

Adolfo David said...

Also, its interesting that sesame lignans inside sesame oil can reduce oxLDL.

Ricardo said...

Cardiovascular risk depends mainly on the types of fats we eat and not as much on the amount, or perhaps it depends more on the total amount of starches/fructose and sugars we are not eating while we are eating more fats? Epidemiology shows that, whatever the type of fats, higher fat intake is associated with decreased cardiovascular deaths. So I ask, on what concerns cardio risk, isn't Total Fat (gr) the most important variable, and the types of fats only secondary? Also, I believe that, for obese people, who I suppose are more prone to heart disease, changing their hypercaloric high-carb diet into an equally hypercaloric high-fat diet, whatever the fats, is much more beneficial than just manipulating fat types. Here is a graph from my database that I believe supports these ideas -> http://www.canibaisereis.com/download/fatintake-cardiomortality.gif

Adolfo David said...

In your graph, Ricardo, USA has one of lowest CHD ratios!? I cant believe it, so strange data

Ricardo said...

Adolfo: Age-standardized mortality rate for cardiovascular diseases (per 100 000 population). Source: World Health Organization. Download from: http://data.un.org/Data.aspx?d=WHO&f=inID%3AMBD22 Another way to find this data: open http://data.un.org, select Databases > Health: WHO Data > Mortality and burden of disease > Age-standardized mortality rate for cardiovascular diseases (per 100 000 population) > View Data.

Robert Andrew Brown said...

Adolfo David

Thanks for the info on sesamin.

Interesting and a complex mix of effects

P said...

@ Robert Andrew Brown,

Interestingly enough, the south indians consume almost zero wheat. Their diet is based mostly on rice and others beans and pulses.

So that is an interesting twist on the hypothesis of wheat causing CHD.

David said...

Hi Stephen (and Bris), be interested to get your take on this study:

http://www.fasebj.org/cgi/content/abstract/fj.09-139691v1

It was reported in the nytimes, where it was also mentioned that yet unpublished data shows similar effects in humans.

Stephan Guyenet said...

David,

OK, you're the third person to send me the study so I guess I'd better address it. The high-fat diet was 14% linoleic acid by calories, a very high intake by human standards (average in the US is around 7%, already very high by historical standards). Linoleic acid is known to impair cardiac function in rodents:

http://www.ncbi.nlm.nih.gov/pubmed/17023268

The same thing has been shown in pigs. It also impairs brain development in pigs.

Furthermore, when you put rats on a high-fat diet, their caloric intake increases dramatically. High-fat fed rats ate 50% more calories than chow-fed rats. So yes, they got fat and their metabolisms deteriorated. Humans on high-fat diets don't increase their calorie intake.

So I think we can put this in the same pile as all the other "high-fat diet" rodent studies that have no relevance to humans.

Bris said...

North and south Indians are genetically quite different. Northern Indians are of Caucasian origin and southern Indians are Dravidians.

Indians nearly always marry within their own class, caste and region and frequently marry relatives so there has been very little genetic mixing for thousands of years.

Simply comparing diets in north and south India and blaming vegetable oil for CHD is as inappropriate as comparing Iraq and Finland and blaming milk for CHD.

Bris said...

Olive oil is 3.5-21.0% linoleic acid. Many Greeks are probably getting high doses (5-10% of calories) of linoleic acid and should be dying like flies from heart disease. They aren't.

Russians and Ukrainians get very little sun, drink vast quantities of hard liquor and have massive psychosocial stress.

It is utterly ridiculous to blame a single dietary component (linoleic acid) based on crude epidemiology as the cause of CHD.

Anand Srivastava said...

I want to comment on the traditional fats of India. Safflower/Sunflower are not traditional fats at all. They have come with modernization, and because they are much cheaper now than the traditional fats.

The traditional fats in the north (of India) are ghee and mustard oil. In the south there is gingely (sesame) oil and coconut oil.

Sesame oil is not use in any large quantity as far as I know.

I believe that traditionally the type of fat has been determined by the occupation. Farmers would have their own cows and would be consuming butter/ghee predominately. Fishermen would be using coconut oil and fish oil predominately.

People must have gotten into a lot of mustard oil only in the near past, with the advent of cities and jobs that were away from villages. Which made milk fats more expensive to obtain. Mustard oil would have gotten cheaper with better pressing equipment.

I wouldn't say that sesame or mustard oil were used in large quantities traditionally. They are of-course special oils used on special occasions.

I would expect that similar things would be true for the japanese.

Bris said...

David:
rats are short-lived foregut fermenting seed eaters. They are probably one of the least plausible animals models of human nutrition imaginable.

If researchers used cats or dogs - which are far more realistic models - for human dietary studies they would immediately discover that carbohydrates and fibre are very bad for humans and fatty meat is very good.

Stephan Guyenet said...

Bris,

The traditional Greek and Cretan diet is low in LA any way you slice it. Olive oil on average is around 12% LA. Even if they got 1/3 of their calories from it, which I guarantee they weren't, that's 4% LA on average.

The 25% LA figure you quoted is for refined olive oil, which is not part of the traditional Mediterranean diet. EVOO generally hovers around 12%.

You have not yet shown us any convincing data that genetics accounts for regional differences in heart attack mortality. Only weak correlative data and speculation.

Anand,

Thanks for the information.

Bris said...

Stephan:
Oh yes, then there are the regions that use safflower oil, in India... some of the highest CHD rates in the world, despite their modest life expectancy.

I have a lot of Indian friends. I even shared a house with a couple of Indian guys. Indians are frequently very heavy smokers and they tend to have extremely low levels of physical activity. In the case of moderately affluent urban Indians physical activity is essentially non-existent. Fruit and vegetable consumption is low even amongst the relatively affluent and sugary sweets are popular.

The dietary problems of India go far beyond using a bit of safflower oil. The people using this oil are basically the poorest and worst fed people. They would be suffering from a totally inadequate grain and legume based diet with inadequate protein, vitamins, minerals and antioxidants.

Life in India is also ultra-stressful. There is massive poverty and huge amounts of discrimination.

Bris said...

Stephan:

One of my food science classmates was Greek and lived there until he was 12. He came to Australia in 1976. He told me unequivocally that most Greeks didn't use extra-virgin olive oil (even in the 1960s) because it was far too expensive. They either used cheap refined olive oil or more commonly inexpensive blended vegetable oils. My friend described the Greek Diet as described by Keys as an utter fantasy with no relationship to what most Greeks actually ate.

Keys did nothing more than interview 42 middle-aged rural men in Crete about their recent food intake. When other researchers vigorously disputed Keys extremely implausible description of the Cretan Diet he claimed that his original notes had been lost.

You have not yet shown us any convincing data that genetics accounts for regional differences in heart attack mortality. Only weak correlative data and speculation.

You're the one relying totally on speculation and weak correlative data. You are so utterly convinced that all CHD is caused by a few dietary factors that you simply ignore every other factor. Occam's Razor tells us that genetics, vitamin D from sunshine, antioxidant intake, low stress and physical activity are far more plausible explanations for varying CHD levels than any single dietary factor you care to name. The idea that all humans have the same tolerances to certain foods is as wrong as saying all humans can tolerate the same amount of sunshine.

In the words of Einstein 'no amount of facts can prove me right but a single fact can prove me wrong'. I don't have to prove anything at all. I simply have to show that simplistic associations don't constitute proof. The truth is that for just about every plausible dietary explanation of CHD their is a paradox which disproves the hypothesis.

It has been unequivocally proven that Okinawans have a higher rate of mutations which confer longevity. It has also been proven unequivocally that northern Europeans have high rates of genetic susceptibility to CVD, mental illness and diabetes. Only by wilfully ignoring these facts can you sustain your argument that n-6 FA and refined carbohydrates are the primary causative factors for CHD.

Changes such as cars, electric lights and working at night arrived at the same time as cheap sugar and refined vegetable oils so it is basically impossible to determine how important individual risk factors for CHD actually are. Maybe Kitivans don't get heart disease because they don't have electric lights to disrupt their natural sleep cycles or melatonin production.

The reality is that there are almost certainly a vast combination of genetic and environmental factors at play. The evidence is also unequivocal that many people have excellent health and longevity regardless of their lifestyle and others have CHD no matter how they live. Hence the old medical saying: 'choose your parents very carefully'.

.

LeenaS said...

Bris said:
The reality is that there are almost certainly a vast combination of genetic and environmental factors at play. The evidence is also unequivocal that many people have excellent health and longevity regardless of their lifestyle and others have CHD no matter how they live. Hence the old medical saying: 'choose your parents very carefully'.

After suffering 40 years from gene-inherited chronic problems (constant allergies, excemas, & imflammmations starting at 11 months of age)... and after being able to stay free from them for almost a decade, thanks to food and only food, you somehow failed to convince me. And looking at your wordings, maybe you have not fully convinced yourself, either?

Nice job again, Stephan

Regards,
LeenaS

gunther gatherer said...
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gunther gatherer said...

Bris, didn't you yourself say you had crone's disease and you keep it under control by eating a high fat diet? Isn't the fact that you cured what is highly regarded by mainstream medicine as a "genetic" disease by simply changing diet composition a contradiction of your assertion that some people are just genetically hard-wired to get sick and some not?

It seems like you're the one cherry picking data and using it to fit your preconceived notion that some people are just born fitter than others. Stephen at least gives you reliable and reiterated results from long-term studies that you can check and question. All we hear from you is "my friend is Greek, and he says", "it's well known that all Okinawans..." or "I know a lot of Indians and they seem to smoke a lot". What kind of authority does that make you? Your attempts to belittle Stephen's hard work when you've done so little of your own rings quite hollow.


If there were definitive data that we're somehow programmed to have diseases of civilisation from birth, there would be no Whole Health Source blog and no one would be seeing reductions in their symptoms of MS, Crones, IBD, depression, obsesity, and improvements in their lipid profiles. In fact you would still be suffering from Crones because you would be resigned to your "fate" from the outset.

Martin Levac said...

What's the cause of CHD? We've known for a while now.

In Gary Taubes' Good Calories, Bad Calories, page 190:

"[In the 1960s]The carbohydrate is disposed of in three sites--adipose [fat]tissue, liver and arterial wall," Stout wrote. "Obesity is produced. In the liver, triglycerides and cholesterol are synthesized and find their way into the circulation. Lipid synthesis is also stimulated in the arterial wall and is augmented by deposition of [triglycerides and cholesterol]...which in a few decades would reach significant proportions."

In case anybody missed the relevant bit:

"...and arterial wall."

I'm no genius but it looks like we know how to cause CHD: Eat sugar.

Bris said...

Gunther:

I eat a VLC diet because that is what my far-northern European ancestors were eating until very recently. If I was Greek I would eat a Mediterranean Diet instead.

The fact is that many diseases that were once considered to be genetic are know shown not to be. MS is now known to be caused by an Epstein-Barr viral infection. Most people who are infected with EBV never develop MS.

Crohn's is now widely considered to be a bacterial infection caused by Mycobacterium paratuberculosis. Crohn's is the human variant of Johne's Disease which infects sheep and cattle. I almost certainly got Chrohn's from drinking some infected cow's milk decades ago.

Saying that MS and Crohn's are genetic diseases is as silly as saying Leprosy and TB are genetic diseases. They are infections that some people don't fight as well as others.

Infectious diseases can only occur where populations are large enough to provide a pool of host carriers. This is one reason why HGs never have diseases such as MS. MS was first described in the mid 1800s when many people had moved into crowded cities.

It is Stephen who makes claims such as 'Russians eat safflower oil and have a lot of heart disease' ergo safflower oil causes heart disease.

Claims such as 'the first heart attack occurred in 1912' are also nonsense. In fact the first coronary thrombosis was diagnosed in a living patient in 1912. Dr Paul White had never heard of a "heart attack" simply because they weren't called heart attacks when he was a medical student. Australian death certificates from the late 1800s show around 8% died from what we would now call heart attacks

Stephan has a fructose/vegetable oil dietary factor explanation for just about everything and is dismissive of both genetics and other lifestyle factors. If he were to also study research concerning vitamin D levels, exercise physiology, gut microbiology, comparative anatomy of species or auto-immunity he might develop a broader and more nuanced perspective on health issues. Stephan is young and enthusiastic rather than old and cynical so he accepts information on face value. I am a lot older and cynical and rarely believe anything I read in a scientific paper. Peter at Hyperlipid is also very cynical.

It am sure that if 1000 randomly selected Inuit abies were raised on Okinawa or Kitiva many would develop major health problems. I would also suggest that Kitivan and Okinawan babies would not do well if raised as Inuits. The fact is that Okinawans (and also Kitivans) are a genetically distinct isolated population that have genetic adaptations which protect them against CVD.

I mentioned my Greek friend because he lived Greece for many years (he is over there on a holiday now) and is also a expert in food science which makes him a very credible source.

Keys was considered to be a fraudster from the very beginning by many experts. His claims about what the Cretans ate was absolute nonsense and he couldn't show any actual documentary evidence to back his claims. Dr Artemis Simopolous a renowned dietary expert is also from Crete and she has quite a different interpretation of the traditional Cretan Diet to Keys - less olive oil, less bread, more meat and more dairy.

Bris said...

Leena:

After suffering 40 years from gene-inherited chronic problems (constant allergies, excemas, & imflammmations starting at 11 months of age)... and after being able to stay free from them for almost a decade, thanks to food and only food, you somehow failed to convince me. And looking at your wordings, maybe you have not fully convinced yourself, either?

Genes don't cause these conditions. They just make you more susceptible to them. For example you may have never developed any of them if you had been breasttfed for five years, been raised in the tropics or had a hookworm infestation.

When I moved from a temperate to a subtropical climate my health improved immensely without changing my diet. I just had a lot more serum vitamin D.

I'm convinced that even major dietary changes won't prevent heart disease in a lot of people. I consider genetics, stress and exercise to be far more important in that order.

LeenaS said...

Bris:
I'm convinced that even major dietary changes won't prevent heart disease in a lot of people. I consider genetics, stress and exercise to be far more important in that order.

I agree with you on the genes. However, I'm convinced the other way on the diet-excercise issue. And this is based on both scientific research and personal observations.

By now I've seen several times lipid profiles reversed and health recovered due to diet only. And, as for my own "healing", nothing else changed in my environment but the diet. I'm not saying that my way of eating would suit/heal all, but it did the trick for me, in spite of lots of stress, little excercise and insufficient nordic sun. Sorry to hear that you could not find similar cure yourself.

And, when looking down my family line, excercise has not correlated with health or longevity at all. Only food/diet seems to do the trick for us. Then again, my kin is not among the healthiest ones, in spite of normal BMI's and quite "healthy lifestyles".

Maybe food does not matter to the ones with very healthy genes, though?

Robert Andrew Brown said...

Bris said

"Genes don't cause these conditions. They just make you more susceptible to them."

Triggers of these conditions must include dietary factors, that is the reality of the biology. Is that not exactly the territory that this blog looks at.

Yes it is a question of scale - you lean more to genetic influences, Stephan leads more to the influence of diet, but if it was accepted either argument was right we would not be discussing the issue.

"It is Stephen who makes claims such as 'Russians eat safflower oil and have a lot of heart disease' ergo safflower oil causes heart disease."

I do not think it is fair to impute statements to Stephan that he has not made.

"The fact is that Okinawans (and also Kitivans) are a genetically distinct isolated population that have genetic adaptations which protect them against CVD."

I would be fascinated to see papers that support a claim that the freedom of the Okinawans is exclusively genetic, indeed as foods significantly alter gene expression by large factors I struggle with the concept.

I do not think anybody is claiming the Greeks eat the same diets today as they did 40 - 60 years ago, when refined vegetable oils were much rarer than they are today.

Your multi factorial arguments have merit, as does the observation that excess Omega 6 increases inflammation and up down rates the expression of a large array of genes, which must be impacting on body function. The question is how.

The world need young idealistic and enthusiastic and old and cynical. All the great thinker were young once upon a time.

Robert Andrew Brown said...

Bris

If CHD is largely genetic as you claim and diet has little part what factors do you suggest account for changing CHD rates, and what detailed argument do you have that support your claims.

Adolfo David said...

August 2009 journal Dementia & Geriatric Cognitive Disorders

The four-decade study of 9,844 men and women found that having high cholesterol in midlife (240 or higher milligrams per deciliter of blood) increases, by 66 percent, the risk for Alzheimer's disease later in life. Even borderline cholesterol levels (200 - 239 mg/dL) in midlife raised risk for late-life vascular dementia by nearly the same amount: 52 percent

Adolfo David said...
This comment has been removed by the author.
Adolfo David said...

http://www.sciencedaily.com/releases/2009/08/090804071408.htm

any comment appreciated, i suppose you all dont support infinite levels of cholesterol :P

arnoud said...

Adolfo David

it would be interesting to know if it its the mass of the cholesterol that associates with Alzheimer's, or particle count.

Arnoud

Adolfo David said...

Yes Arnoud, total cholesterol is a very poor marker

Kurt G. Harris MD said...

Bris

You said:

"You're the one relying totally on speculation and weak correlative data. "

You made this comment regarding Stephan? I have to say, on top of your serial misquoting of the literature and the lack of internal logic in your own posts, that is really remarkable.

Have you actually read any of this very blog?

I am not just a physician and a blogger, but an avid health blog reader. Whole health source is the most carefully documented and argued of the lot and to claim it contains speculation and weak data just makes you sound completely foolish.

You really should think before typing.

Neither I nor Stephan are claiming there is no such thing as genetic variation, just that the largest fraction of variance in health is dietary. You've presented not single piece of evidence that we are wrong. Only argument by assertion and anecdote. You are really becoming your own straw man.

As far as multiple sclerosis you are once again spreading misinformation.

Stephan Guyenet said...

Bris,

I believe you that modern Greeks eat mostly refined olive oil. My French grandparents in the South of France ate olive oil sparingly because it was expensive. They mostly ate animal fat. I suspect that's true throughout the Mediterranean, contrary to the idea that EVOO is their main fat int he Mediterranean.

Have you seen the cardiovascular statistics for Greece lately? They have a very high heart attack mortality. It's only in specific regions like Crete that it's low. And I don't even know if it's that low in Crete anymore. It was in the 60s and 70s when Keys was there. They also probably ate EVOO rather than refined oils back then.

I don't ignore factors besides diet. I've said on numerous occasions that I believe exercise is a factor, and vitamin D may be one as well. But to ignore diet is really something. I've presented data on this blog that spans ecological studies, prospective studies, controlled trials, and mechanistic studies in model systems, that all point in the same direction.

The gene theory doesn't have anything close to that. All you can say is, for example, the Okinawans have genes that we think might predispose to longevity and protect from CHD, maybe this explains what we see. It's nothing more than association and speculation.

I believe that diet is the dominant factor. In the Lyon Diet-heart trial, diet alone reduced cardiovascular deaths by 77% and total mortality by 70%. Can you show us a controlled trial of any other lifestyle factor that achieved results like that?

Steve Parker, M.D. said...

Bris got my attention when he wrote that he knows the causes of multiple sclerosis and Crohn's disease. That was news to me. The authors at www.UpToDate.com agree with me that the causes are unknown.

P said...

I always find it funny when people make sweeping statements about India, its people and their eating habits, based on "couple of friends from India". If only everything was so straightforward and simplistic.

I would advise people to ignore everything Bris has said so far about India.

It also makes me question Bris' other assertions.

FYI Bris, many of the so called dravidians also belong to R1a haplogroup ( as are majority of people from north). I could send you links to research papers, but this is not the place.
Also, I would say the people in India get wayyyyyy more activity in than car bound suburban americans.

gunther gatherer said...

Bris,

I think this genetic component to health that has you so religious is actually just dietary variation in different populations that TURN SOME GENES on or off, and so you observe certain expressions in certain populations. Does that sound fair enough?

I have to agree with Robert and Kurt that you are making a lot of assumptions, misreadings and biased correlations with regards to the blog itself, Stephen's research and opinions, and cultural differences between human populations in general.

I also disagree with you about the origins of MS and Crohn's. The Masai drink unpasteurised milk like it's going out of style, and not one case of Crohn's among them. That "well known" bacterial cause is a non-starter.

But I agree with you about proper gut microbiota, parasites, low stress, and other factors being modulators of inflammation. There are many confounders here, but best not to throw out this blog's thoroughly analysed and wonderfully presented research just because you're older and wiser...

Nancy LC said...

Oh good heavens, quoting Keys? That guy was one of the worst things ever for nutrition science. Bald faced manipulation of data to back his premises was his game.

Ross said...

Bris,

You said, "Crohn's is now widely considered to be a bacterial infection caused by Mycobacterium paratuberculosis. Crohn's is the human variant of Johne's Disease which infects sheep and cattle. I almost certainly got Chrohn's from drinking some infected cow's milk decades ago."

This statement is incorrect. A few anti-milk commentators assert that bovine paratuberculosis is the most likely cause of Crohn's disease because many Crohn's sufferers also test positive for paratuberculosis. We need to reconsider the age-old caution about correlations: correlation does not imply causation.

In fact, the causation appears to be reversed. Paratuberculosis bacterium in pasteurized milk is common, not rare. If it could cause Crohn's disease, most of the US would have Crohn's, because it is impossible to drink a substantial quantity of homogenized pasteurized milk without drinking some that contains viable bovine paratuberculosis.

What really appears to be happening is that the Crohn's disease (an auto-immune disorder where the body attacks the intestinal lining) makes a person susceptible to bovine paratuberculosis, so the next time they drink milk, it penetrates the gut and is then detected by various antibody tests.

It is a much more credible theory that leptins in wheat, soy or other grains/legumes caused you to have a perforated gut and provoked an immune response that has progressed all the way to Crohn's disease. Your current low-carb diet should be successful in preventing aggravation and worsening of your condition.

Drs. Cynthia and David said...

Bris, I'm sure everyone reading this blog appreciates someone with an open mind and differing perspective/opinion. However, with all of the comments and criticisms you've made, I suggest you start your own blog to set out your thoughts and observations in greater detail. If it's only half as good as Stephan's, I'm sure we would all enjoy reading it and gaining from your wisdom and insights, as well as providing our own constructive criticism. It's not so easy, though you might find it rewarding. Cynical can be good too.

Thanks for another great post, Stephan. I was hoping for more substantive comments on the subject matter.

Cynthia

darnoconrad said...

I second what Drs. Cynthia and David said. I read the blog to read Stephan.

Stephan, I follow each post you write and admire your work. I hope that with the new donation button you are making a profit because I certainly have from your posts.

David said...

Thanks Stephan and Bris for the comments about the rodent dietary fat/standard chow study... it makes sense that the rodent they used is a poor model for humans, but they claim in the nytimes article that they found similar effects in humans (as yet unpublished data)

Bris said...

The problem with this theory is that Yudkin and Cleave both erroneously assume the humans are perfectly adapted to a meat-based Paleolithic Diet.

Physician S Boyd Eaton and his son anthropologist Stanly B Eaton have always stated that there have always been many different Paleolithic diets from very high carbohydrate tuber-based diets to almost totally meat-based diets according to what foods were available locally. The work of the Eatons is far more intellectually rigorous and authoritative than writers like Cleave, Weston Price and Stefansson.

It is also obvious that some people have few health issues on ultra high-carbohydrate diets (Kitivans) and others with few health issues on a totally meat-based diet (Inuits). The rest of the humanity are somewhere in between.

No mammal (except possibly shrews and lower primates such as lemurs) is ever anything more than adequately adopted to it's diet even after tens of millions of years of evolution. That is because all mammals evolved from frugo-insectivores

Even on their natural diet polar bears get gallstones, house cats invariably get severe scale on their teeth and sheep and cattle get Johne's Disease (bovine Crohn's Disease).

The inconvenient fact is that very closely related wild mammal species can have totally different diets. Gelada baboons eat only grass while all other baboons eat insects and fruit. Pandas are bamboo eating bears and ocelots are partly frugivorous cats. In each of these examples the gut physiology and dentition are virtually identical to closely related species with very different diets.

Bris said...

In fact, the causation appears to be reversed. Paratuberculosis bacterium in pasteurized milk is common, not rare. If it could cause Crohn's disease, most of the US would have Crohn's, because it is impossible to drink a substantial quantity of homogenized pasteurized milk without drinking some that contains viable bovine paratuberculosis.

Not true. Most humans are remarkably resistant to infection by mycoplasmas such as TB, leprosy and Crohn's. Even the spouses and carers of TB patients and lepers rarely developed these diseases. However they frequently developed antibodies.

Robert Andrew Brown said...

Bris said

"The inconvenient fact is that very closely related wild mammal species can have totally different diets. Gelada baboons eat only grass while all other baboons eat insects and fruit. Pandas are bamboo eating bears and ocelots are partly frugivorous cats. In each of these examples the gut physiology and dentition are virtually identical to closely related species with very different diets."

And none of them ate nutrient depleted refined carbohydrates, mineral deficient foods,or had massive Omega 3 6 imbalances.

theoddbod said...

Perhaps someone could answer this question for me:
With all of these comments basically being about genes vs. diet as the main cause for disease (any disease it seems, which is absurd).
What is the actual order of things happening when you consume a certain food type (I realize most metabolic processes are happening constantly)? Food can change genes (turn them on and off, as per gunter), has anyone ever looked at a microarray? Food can also change the populations of microflora in our guts and throughout or body which can have profound health effects. Guess what? Gut bacteria can also influence and change the expression of our own genes. So what is the actual order of things? When we eat a food, what genes get turned on? Is it transporter genes so we can absorb the nutrients and send them where they need to go? or do bacteria get the first crack at it and have the biggest influence?

Nit picking at our own genetic differences is futile when looking at the how many differences there are between people from all over the world. Except when you can find simple mutations that result in metabolic disorders like phenylketonuria or a an inability to make leptin. In these cases a simple dietary change or a injection (of leptin) can fix all of the problems.
Of course there are genetic differences. But the prime example is just looking at what happens to anyone who changes from their traditional diet to a Western diet, boom! Obesity, diabetes, heart disease. People from every background are affected by this diet; our genes just tell us how quickly and to what extent.

Ed said...

Bris,

I'd like to strongly support what Drs. Cynthia and David said. You seem to have the time for a prodigious amount of posts here, I would enjoy if you could put that effort to good use with well formed and documented arguments on your own blog. Please post a link to your blog here and I'll follow the RSS feed.

TedHutchinson said...

Thanks to theoddbod
Diet & insulin resistance: a review & Asian Indian perspective.
As we have previously discussed Indian diets we can see in this paper what happens when their diet changes to one with a high intake of dietary carbohydrate and omega-6 PUFAs, low intake of omega-3 PUFAs and fiber.

While we are arguing about relatively trivial aspects of diet UNILEVER are busy explaining that
Foods with a high fat quality are essential for healthy diets.
and I'm sure you won't be surprised that they think 1.5% transfat may be a useful addition.

It worries me that we may be in danger of distracting perhaps even confusing new readers to Stephan's excellent blog by clouding the main issues with somewhat repetitive discussions. I think we need to focus more intensely on the major dangers.

Ed said...

TedHutchinson,

That abstract is crushingly depressing.

Quote: "High-fat dairy products and fatty meats are examples of foods with low fat quality, whereas vegetable oils (tropical oils such as palm and coconut oil excluded) are products with a generally high fat quality."

Good god. I don't care if some lab-coat-wearing wacko believes this, but people like my mother might be persuaded by the scientific tone and setting.

It is interesting that the degenerative diseases took some time to manifest, so two people with starkly different diets might not see the impact for years. But children nowadays are getting "adult onset" diabetes and heart disease. At some point I have to believe that individuals in our society will look around and see the healthy ones and ask them how they are eating, and learn from them.

My wife isn't quite on board, I'm working on her. I wish I could give her, and the rest of my family, an easy-reading but authoritative book that covered the elegant angle that Stephan has taken on all this.

Measurable body metrics would be very interesting as a sort of unambiguous body benchmark. Some that come to mind would be blood levels of the fat soluble vitamins A, D, E, K, tissue-MUFA, oxLDL. The thyroid hormones, too.

<b>Stan Bleszynski</b> said...

Bris wrote:

rats are short-lived foregut fermenting seed eaters. They are probably one of the least plausible animals models of human nutrition imaginable.

If researchers used cats or dogs - which are far more realistic models - for human dietary studies they would immediately discover that carbohydrates and fibre are very bad for humans and fatty meat is very good.


There may be other factors mucking up their rats study, besides the rats gut. Peter's theory (researcher's brain) is one such but I suspect that the rat's chow is the culprit. 50% of fat means that probably around 40% of the rest was dextrose (sugar) with corn starch with powdered caseine added for protein.

When Dr. Rafalski did similar studies on rats in 1980 using Dr. Kwasniewski's "Optimal Diet" (~80% animal fat), his rats did surprisingly well.

Regarding genetics and other factors, I agree, however if the diets were really of the lesser importance then you would not have had so many self-healing cases of auto-immune disease CVD, diabetes type II and I cures etc. I suspect (=my opinion and my personal experience with the OD but have no proof) that the nutrition is the factor number one, while genetics, exercize, environment, not speaking English (Dr. Kendricks' joke) are only secondary.

Stan

Stephan Guyenet said...

Darnoconrad,

I have made some money from donations. I wouldn't exactly call it a profit though, since I'm blowing it on blog-related books and photocopies, haha. It really has allowed me to buy some great stuff.

David,

I saw that. We'll see what their human study looks like. I can think of several ways in which a poor study design would give a misleading result, for example if they didn't give the subjects several weeks to adapt to the higher level of fat/lower carbs. Citing their own unpublished results is a pretty weak way to support their theory.

mtflight said...

"I think nobody can prove that saturated fats are really healthier than my fats choices. " Adolfo David

Just to stir the waters a little tiny bit...

Dietary polyunsaturated fatty acids and composition of human aortic plaques.

Felton CV, Crook D, Davies MJ, Oliver MF.
Wynn Institute for Metabolic Research, London, UK.

"We compared the fatty-acid composition of aortic plaques with that of post-mortem serum and adipose tissue, in which essential fatty-acid content reflects dietary intake.

"Positive associations were found between serum and plaque omega 6 (r = 0.75) and omega 3 (r = 0.93) polyunsaturated fatty acids, and monounsaturates (r = 0.70), and also between adipose tissue and plaque omega 6 polyunsaturated fatty acids (r = 0.89).
"No associations were found with saturated fatty acids.

"These findings imply a direct influence of dietary polyunsaturated fatty acids on aortic plaque formation and suggest that current trends favouring increased intake of polyunsaturated fatty acids should be reconsidered.
PMID: 7934543


"Dietary eicosapentaenoic acid and docosahexaenoic acid from fish oil. Their incorporation into advanced human atherosclerotic plaques."

"The incorporation of fatty acids from dietary fish oil was measured in obstructive atherosclerotic plaques removed from 11 patients fed fish oil, rich in omega-3 fatty acids, for 6-120 days before a planned arterial endarterectomy. The fatty acids of plasma and atheroma were analyzed with special reference to docosahexaenoic acid (DHA, 22:6) and eicosapentaenoic acid (EPA, 20:5), the principal omega-3 fatty acids of fish oil. The omega-3 fatty acid content increased greatly in plasma from 0.9% of fatty acids to 14.8% in cholesteryl esters, from 3.8% to 22.1% in phospholipids, and from 1.3% to 21.9% in triglycerides. The omega-3 fatty acid content of the atherosclerotic plaques was also greater when compared with that of plaques removed from 18 non-fish oil-fed controls. The omega-3 fatty acid in cholesteryl esters of the plaques was 4.9% in the experimental group versus 1.4% in control plaque, in phospholipids it was 8.8% versus 1.8%, and in triglycerides it was 4.7% versus 0.7% (p less than 0.001 for each lipid class). The two major omega-3 fatty acids (DHA and EPA) behaved differently. Compared with their respective plasma levels, relatively more DHA than EPA was deposited into the plaques. Whereas the increase of omega-3 fatty acids in plasma reached a plateau 3 weeks after initiation of fish oil feeding, a linear increase in plaque omega-3 fatty acids continued with time. As a result of the changes in fatty acid composition, the lipid classes of both plasma and plaque had a higher unsaturation index in the fish oil-fed group.
PMID: 1829632

What does this mean? it could mean that double bonds are unstable and can cross-link, becoming damaged. Saturated fat appears to have a protective effect on PUFA from cross-linking. [1]

1] http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15124014

Rose said...

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Hendrickus Brokking said...

May I suggest that the thyroid/pituitary/hypothalamus might have something to do with CHD ad infinitum? If so, we might come closer to understanding why good health is so much more complicated than simply reducing carbohydrate and eating mackerals and flax seeds, and suet from grass-only, hormone-free, naturally impregnated, free-range, lovingly slaughtered, genetically pure, occasionally petted, cattle. (Some recent truly low-carb studies actually show an increase in reliable biomarkers of inflammation and acute phase reactants in subjects adopting low carbohydrate nutrition, and this even with an emphasis on animal fats.)

Brahmhatt S et al. "Thyroid ultrasound is the best prevalence indicator for assessment of iodine deficiency disorders: a study in rural/tribal schoolchildren from Gujarat (Western India)." European Journal of Endocrinology (2000) 143 37 - 46.

A disturbing study, when one remembers that many low carbohydrate eaters are beset with a variety of very real bodily (i.e., physiological, NOT psychological) complaints, some or many of which are surprisingly not corrected by low-carb nutrition. One of these is a curious inability to lose weight on low-carb fare, in those susceptible to this frustrating condition. Put me on greasy meat alone, and the excess flesh promptly vanishes.; re-introduce traces of certain low-carb plant choices (<20g digestible carb/day), and
weight rebounds to levels no different than if I were eating 150 grams/day.

I suggest anyone very serious about recovering their health - for I think it can be urged we are all sick, some more (malignancies, kidney and liver dernagements) some less so (corrective lenses, caries, allergies, negligible muscle mass in spite of dutiful exercising) - obtain this study in its entirety and reflect carefully on its implications.

Incidentally, I am always obliged to scratch my head, and that rather vigourously, when I see the normal ranges for thyroid function tests, both seral and radiological. Those pitiable Indian children must be awfully ill. Poor children, so naive, unaffected, artless. And without the tracest particle of knowledge whereby they can recover and lead reasonably lengthy and happy lives, in otherwise very difficult conditions of gross poverty and dreadful hygiene.

I often wonder if carbs would be half as harmful if we weren't in the habit of routinely insulting the thyroid. Kempner, MD, fed white rice, fruit (lower in many chemicals quite possibly toxic to the thyroid) and up to 500 grams (!!!!) white sugar per day to heart patients and on this regimen commonly noted markedly improved glucose tolerance after several months, even in diabetics, to say nothing of significant reductions in heart size and hypertension, and stalling of retinopathy.

Oh, well. Science will utterly fail in answering some of these most pressing and basic questions. The reason is, I suspect, we'd be obliged in face of the findings to quit our dearest prejudices - in short, to change, from highest government on down to lowest governed.

Now, if you'll excuse me, I've a pot of super-heated rendered beef fat to strain...the smell of oxidized lipids is truly divine!

Jason said...

Bris: "Not true. Most humans are remarkably resistant to infection by mycoplasmas such as TB, leprosy and Crohn's. Even the spouses and carers of TB patients and lepers rarely developed these diseases. However they frequently developed antibodies."

Right... but the core issue is not the microbe itself... it is your/a body's compromised immunity that is incapable of mounting an innate defense against the pathogen that is the problem. The pathogen is a result of the diseased state. It's the terrain.

trinkwasser said...

Agree with the last statement! Genetics vs environment is not either/or.

Anecdotal: my mother had Crohn's. She told stories of drinking warm milk fresh off the cart when young. I had TB antibodies without ever having the disease. One theory suggests that Crohn was wrong to differentiate between his disease and paratuberculosis infection - the same infectious agent causes different symptoms depending on genetic susceptibility (Ashkenazi Jews are one subgroup with high levels of Crohn's and some other diseases almost certainly for genetic reasons).

Type 2 diabetes has a much higher genetic loading than Type 1. Type 1 may be associated with a trivial viral infection which switches on the autoimmune attack whereas nonsusceptinle people would just get a sniffle and recover. Type 1 is also associated with a cluster of genes which predispose to other autoimmune conditions. Type 1 is also associated with gluten intolerance. Although only about 10% of all diabetes, Type 1 is actually increasing *faster* then Type 2 and the rate of increase varies regionally.

Meanwhile the symptoms of Type 2 can be put effectively into remission by the correct diet.

Many more such examples exist displaying the *interraction* between genetic and environmental factors. Doesn't matter if you carry the genes if no environmental factor causes them to be expressed. However the same environmental insult may then express different genes which you *do* carry instead.