It has been very well established that, in populations of people on
true low fat diets, HDL is NOT a risk factor. TC/HDL is more important
than LDL ONLY in populations of people who are NOT on true low fat
diets! These (non-low fat diet populations) are the populations from
which the data on TC/HDL were derived. Populations on low fat diets
with low total cholesterol (< 150) frequently have TC/HDL levels > 5,
yet have essentially zero coronary vascular disease. It's getting late
tonight, but I'll supply peer-reviewed, published reference(s) this
weekend.
I do think that the "Omnivore's" review of the Dansinger paper,
however, was both unfair and misleading. The purpose of the study was
NOT to demonstrate, under rigidly controlled conditions, the
differences between the different diets. The purpose of the study was
stated by the authors, which was to "determine their realistic clinical
effectiveness and sustainability for weight loss and cardiac risk
factor reduction."
Their methods were consistent with this goal. They were trying to see
whether the real world application of any of these diet principles was
likely to have an impact on the obesity epidemic. What they did was
decidedly real world; to have expected more was unrealistic. Study
participants had a one hour, in person meeting on 4 separate occasions.
They were then asked to follow the diet, for the sake of science, as
rigidly as possible for the first two months and, thereafter, to follow
each diet according to their own interest level. This is after they
had been instructed in the rationale of each diet. It is also notable
that the entire group of study participants obviously was comprised of
people with a much higher than usual interest in the concept of
improving body composition and health through dietary improvements. If
this particular group of people could not be sufficiently motivated to
follow a given diet in the real world, following volunteering for the
study, being interviewed and screened, attending 4 separate one hour
instruction and adherence-motivating sessions, and then being asked to
fill out case report forms on their subsequent progress (people in such
studies really do strive to please the clinical investigators, beyond
even their own personal hoped-for benefits), then it is highly unlikely
that broad prescription of one of these 4 diet plans over any of the
others would have any important public health benefit.
So the Dansinger study was a valuable contribution to our understanding
of the problems and challenges which exist and they do show that no
existing diet is clearly superior to the others (from among those
tested) in being the answer to the obesity epidemic. That's all the
study claimed to be, but it actually ended up being quite a lot. The
authors concluded that
"cardiovascular outcomes studies would be appropriate" and that "more
research is also needed to identify practical techniques to match
individuals with the diets best suited to their food preferences,
lifestyle, and medical conditions."
It would be no more defensible for me to claim that low fat diets are
best for everyone than it would for the "Omnivore" (or anyone else) to
claim that low carb diets are best for everyone. Based upon existing
knowledge.
- Larry Weisenthal
Mirek Fídler said:Quoted message said:Firstly, in populations on low fat diets, HDL is not a risk factor.
As
Quoted message said:Quoted message said:Ornish has said, when you aren't eating garbage (LDL-raising
dietary
Quoted message said:Quoted message said:fat), you don't need garbage trucks (HDL). There is a voluminous
This is what Ornish wants to believe. In reality, what really matters
is
Quoted message said:TC/HDL ratio. LDL number alone is much less predictive that this
ratio. You
Quoted message said:can try to google real numbers or graphs. This is reality.
Of course, if your LDL is low, you do not need to have high HDL to
achieve
Quoted message said:good ratio.
Even in face of your logic this also makes sense. Even if you would
eat zero
Quoted message said:saturated fat, your body will still produce LDL and you will still
need
Quoted message said:garbage trucks to clean it, just less of them.
Anyway, that was not the interesting part of article, I do not even
remember
Quoted message said:that lipids were discussed there.
Mirek
