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Olestra:really safe !?

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General fitness, health and nutrition
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11 December 2003
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The Moon's Neig
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  1. Sun, 14 Dec 2003 15:27:13 +0200 in article
    <[email hidden]> Matti Narkia

    Quoted message said:

    Sun, 14 Dec 2003 13:00:39 GMT in article <[email hidden]> "giselle"

    Quoted message said:
    Quoted message said:

    - People from Crete have significantly lower incidence of coronary disease compared to other
    groups.

    Not anymore. Take away the strenuous activity and the edge disappears.


    Not so. See for example

    Trichogenous A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival
    in a Greek population. N Engl J Med. 2003 Jun 26;348(26):2599-608. PMID: 12826634 [PubMed - indexed
    for MEDLINE] <http://content.nejm.org/cgi/content/abstract/348/26/2599>

    where adjustment for the physical-activity was made (as in most of the other studies well). See
    also the studies mentioned above.


    People from Okinawa seem to have a tradition of martial arts, which are highly strenuous exercises.
    Even otherwise their life style seems to be far from sedentary. They also have some genetic
    protection that helps the Okinawans live to extreme ages. For example, Okinawan centenarians have
    HLA (human leukocyte antigen) genetic patterns that place them at lower risk for autoimmune
    diseases. They also apply calorie restriction, eating only until they are about 80% full. All this
    affects longevity in addition of the content of their diet. You seem to ignore the potential effect
    of these factors on Okinawans, and yet name the exercise as the only cause for the health and
    longevity of the Cretans in 50s and 60s This does not seem to be a very scientific approach, IMHO.

    --
    Matti Narkia

  2. Sat, 13 Dec 2003 18:01:38 GMT in article
    <[email hidden]> "giselle"

    Quoted message said:


    Do you think that Okinawan Elders are idiots?

    Do you think that they would be smarter if they ate fewer vegetables and more MUFA? Perhaps then
    their cancer, CHD, and stroke deaths would rise so as to be equivalent to those of the
    Mediterraneans.


    Vegetables, cancer and CHD have been handled earlier. As for MUFA and stroke, see

    He K, Merchant A, Rimm EB, Rosner BA, Stampfer MJ, Willett WC, Ascherio A. Dietary fat intake and
    risk of stroke in male US healthcare professionals: 14 year prospective cohort study. BMJ. 2003 Oct
    4;327(7418):777-82. <http://bmj.bmjjournals.com/cgi/content/full/327/7418/777>

    "... CONCLUSIONS: These findings do not support associations between intake of total fat,
    cholesterol, or specific types of fat and risk of stroke in men."

    --
    Matti Narkia

  3. Sun, 14 Dec 2003 13:00:39 GMT in article
    <[email hidden]> "giselle" <[email hidden]>

    Quoted message said:


    "Matti Narkia" <[email hidden]> wrote

    Quoted message said:

    The author states that Crete has the greatest life expectancy in the Western World. The article
    was written in 2001, when Japan had the greatest life expectancy in the world, but at the time
    the Seven Countries study was started Crete's adherence to the traditional diet was much better
    than today and then Crete had the greatest life expectancy in the world.

    It applies to a population at time in the past, when exercise was a major factor.


    Walking may have helped, but numerous studies of many of have been presented here, show that
    Cretan Mediterranean diet has health and longevity benefits which are independent of physical
    activity level.

    BTW, Okinawans practice martial arts and calorie restriction and have some genetic advantage which
    help to improve longevity. How come you have failed to mentioned this, and yet overemphasize the
    effect of exercise on the Cretan longevity, at the expense of the diet?

    --
    Matti Narkia

  4. giselle schrieb:

    Quoted message said:


    "Matti Narkia" <[email hidden]> wrote

    Quoted message said:


    Unfortunately I cannot take only your word for it. In the absence of any convincing evidence I
    think we just have to agree to disagree.

    Most of the studies you cited, which I had previously read, by the way, emphasized the strenuous
    exercise of the Cretans of the 1950s. Perhaps you might benefit from reading them again.

    Quoted message said:

    That's true also for some of the Cretans as I mentioned. Still, we were discussing the
    _traditional_ Cretan diet of 50s, 60s and earlier for which your comment is irrelevant.

    The comment is most relevant--you must have overlooked the relevant mentions in your own
    citations.

    Quoted message said:

    Evidence? Even if true, it's irrelevant, see above.

    No, it isn't. Westerners who say that they adhere to lower fat diets are usually cheating.

    Quoted message said:

    So? You implied that Cretan traditional diet is only good for Cretans. Research shows otherwise.

    Research shows that the tremendous edge that they had applied only at a time when they were
    exercising strenuously.

    In other populations, there is some benefit from replacing trans and saturated fats with MUFA.
    There are other ways to achieve a more favorable lipid mix--by keeping the melting point below 20C--
    it is not necessary to achieve an intake above 30%, or even 20%. A diet at the lower end would
    allow for more room for fruits, vegetables, and soluble fibers, which would in turn promote the
    greatest improvements in lipid profiles, and colonic health, stroke incidence (which is confounded
    by hypertension, excessive sodium intake, and inadequate fruit and vegetable intake) most types of
    cancers, and overall mortality.

    If you look at the results from the Nurses’ Health Study and the Health Professionals’ Follow-Up
    Study (two of the most extensive prospective cohort studies ever conducted) you might find that the
    importance of fruit and vegetables for health or at least for the avoidance of coronary heart
    disease (CHD) often has been somewhat ... overstated.

    In those studies the participants in the highest quintile of intake of fruits and vegetables had a
    relative risk of 80 % for CHD compared to those in the lowest quintile after adjustment for standard
    cardiovascular risk factors. So they experienced only a modest risk reduction of 20 %.

    (jacn.org229)

    To put this into perspective:

    In the Nurses' Health Study women who ate more than 5 oz of nuts per week had a relative risk of CHD
    of 0,65 compared to those who never ate nuts (after adjustment).

    (bmj.bmjjournals.com1341 - this study has already been cited by
    Matti, so you might already be familiar with the results)

    Also in the Nurses' Health Study the substitution of 5 % of calories from polyunsaturated fat for an
    equivalent amount of carbohydrates was associated with a relative risk of CHD of 0,62.

    (content.nejm.org1491 - Matti also has already cited an article that
    provided this result)

    Results about a special fatty acid (alpha-linolenic acid, ALA) form the Nurses' Health Study: Those
    women in the highest quintile of ALA (1,36
    g/d) had a relative risk of fatal heart disease of 0,55 and of nonfatal heart disease of 0,85 when
    compared to the quintile with the lowest intake (0,71 g/d) after adjustment for other factors.

    So already eating a modest amount of ALA can cut the risk of fatal heart disease almost in half. The
    mediterranean diet is high in ALA, by the way.

    (ajcn.org890
    - tinyurl.comz77e)

    So while eating vegetables is certainly important, it is not the only important issue you want to
    adress when determining a healthy diet. And it is probably not even the most important issue.

    Quoted message said:
    Quoted message said:

    Risk factors (like lipid profiles) are just that. The real tests are morbidity and mortality
    rates, which were astonishing low for Crete in the Seven Countries Study.

    WHO/FAO has a different criterion for evaluating convincing evidence. They look at results from
    more than one study, for example.

    Quoted message said:
    Quoted message said:

    The problem with a lower fat diet is adherence.

    You can say that again. Diet which cannot be followed is not worth much. Also, in some people
    low fat diet converts large LDL particles to smaller, more atherogenic LDL particles.

    If they are eating junk carbohydrates instead. If they are eating fruits and vegetables, this
    doesn't happen.

    Most fruits have a lot of sugar. You don't want to overindulge in them.

    Quoted message said:
    Quoted message said:

    Not necessarily. Extra virgin olive oil has high content of phenolic antioxidants.

    These phenolics have a higher calorie costs and are no more powerful than phenolics in lower-fat
    vegetables.

    You don't have to eat large amount of olive oil to have a moderate to high amount of fat in your
    diet. Nuts for example are also good sources of healthy fats. They are packed with all kinds of
    vitamins, minerals and other health promoting substances.

    Quoted message said:
    Quoted message said:

    Also, research suggests that replacing fat with
    carbohydrates is not necessarily a good idea.

    Some research suggests that maintaining junk carbohydrate while limiting fat is not a good idea
    for some people. NO research suggests that limiting fat and maintaining high fruit, vegetable,
    legume, and whole grain intake is not a good idea.

    You will be hard put to find a study that shows that the substitution of, say, fruit for nuts is
    particulary healthy.

    Quoted message said:
    Quoted message said:

    How do you know what is excess?

    The body's EFA requirement is around 6%. A bit more might be useful for absorption of fat soluble
    micronutrients. Not that I am suggesting anyone adhere to a very low fat diet, except for those
    who wish to reverse blockages without surgery. Normals can do fine in the low 20s.

    Quoted message said:

    Crete has been mentioned several times already. Cretan CHD, cancer and overall mortality rates
    were lower than in any other country in the Seven Countries Study, including Japan.

    When they exercised.

    In former times most people in most countries got the kind of excercise the Cretans got. They didn't
    live as long, though.

    Excercise is certainly important and may have contributed to the longevity of Cretans but it is
    certainly not the only factor.

    Quoted message said:
    Quoted message said:

    Any diet which cannot be followed is idiotic.

    This applies to most weight loss diets, as compliance is usually dismal--at about a 95% failure
    rate in the long term.

    This probably does not include low-carb diets.

    Quoted message said:
    Quoted message said:

    Besides, very-low-fat diets have some negative health effects, see the references and links
    provided earlier.

    I made no mention of very low fat interventions until this post, and only in the context of
    their ability to reduce percent diameter stenosis, which no other dietary intervention has been
    shown to do.

    That is debatable.

    Quoted message said:
    Quoted message said:

    Perhaps you could first mention why I should be interested. Is China known for longevity?

    Chinese peasants die of diseases of poverty, not diseases of affluence.

    So to avoid the diseases of afflucence the amount of food (or rather of calories) is as important as
    the kind of foods eaten. That is why it is of limited use to compare the nutrient composition of the
    diets of poor and affluent countries.

    Thorsten

    --
    "Nothing in biology makes sense, except in the light of evolution"

    (Theodosius Dobzhansky)

  5. "Matti Narkia" <[email hidden]> wrote

    Quoted message said:

    Emphasized? Strenuous?. Cretans used _walk_ about 13 km a day as a part of their daily activities.
    Walking can hardly be described as strenuous exercise. Exercise, even walking is good, but the
    studies I've presented show that the benefits of the diet are independent of the physical activity
    level (although the combined effect could be additive or even synergistic)

    Eight miles a day is nothing to scoff at.

    They also plowed fields, with oxen.

    Quoted message said:

    Your comments about today's Cretan diet which differs from the traditional diet are not relevant
    for traditional diet.

    Quoted message said:
    Quoted message said:

    Evidence? Even if true, it's irrelevant, see above.

    These Mediterraneans don't agree with you-- and they don't think that the seven countries data is
    particularly useful.

    Eur J Clin Nutr. 2002 Sep;56(9):796-809. Links Comment in:
    * Eur J Clin Nutr. 2002 Sep;56(9):928-9; author reply 930-1. The high-fat Greek diet: a
    recipe for all? Ferro-Luzzi A, James WP, Kafatos A. National Institute for Food and
    Nutrition Research, Rome, Italy. [email hidden]

    OBJECTIVE: To examine critically the published results of dietary surveys on the fat content of the
    Greek diet, and to assess its evolution and its relationship to the health of the Greeks. To
    consider the implications of these findings for current views on the nature and health implications
    of the traditional Mediterranean diet and how best to define it for use in modern policy making.

    DESIGN: A systematic review of the literature on food consumption in Greece.

    SETTING: Greece.

    RESULTS: The first fully published data on the fat content of the Greek diet-the Seven Countries Survey-
    **relates only to a small number of adult males in Crete and Corfu; the legitimacy of extrapolating
    these results to the rest of Greece is questioned.** Earlier studies and chemical validation of
    intakes point to a lower fat content of the traditional diet than that inferred for Crete. Nearly
    all later surveys relate only to urban groups in Athens (mostly case-control hospital-based samples)
    and a variety of non-representative Cretan groups. Only two studies are larger and more
    representative, but one uses FAO food balance-sheets to reflect the national diet, and the other
    surveyed school-age children in three out of the 52 Greek counties. Unfortunately recent dietary
    studies have proved unreliable, given the continuing lack of national food composition tables with
    survey methods which proved inaccurate for dietary fat content. A progressive upward trend in total
    and saturated fat intake appears to have occurred with all health indicators in relation to fat
    indicating remarkable increases in adult and childhood obesity with attendant progressive
    deterioration in cardiovascular mortality and its risk factors, ie hypertension and diabetes. These
    data emphasise the need to alter current nutritional advice in Greece, particularly when it focuses
    on the promotion of olive oil and a high-fat diet.

    CONCLUSIONS: The findings reaffirm low-moderate fat policies for optimum health, within which olive
    oil can be an important component of the diet.

    Publication Types:
    * Review
    * Review, Tutorial PMID: 12209368 [PubMed - indexed for MEDLINE]

    I am not ignoring a large body of literature.

    I am interested in what's best, from the standpoint of a slender person with a 0.7 w/h ratio, sub
    150 mg/dl total cholesterol, high HDL, low LDL, normal triglycerol, non-NIDDM, and very low to zero
    risk for CHD population--in short, a very healthy person.

    I am not interested in what happens to obese and sick people when they make mild dietary
    interventions because they don't have the fortitude to make more important changes that have a wider
    scope of benefits.

    Willett tends to dilute the message to make it more acceptable to people who are accustomed to
    eating garbage. His solution is a half-way measure with half-way benefits. He assumes that people
    will not be able to stick with moderately low fat high vegetable fiber diets so he tells them to try
    to make slight improvements over what they are used to, and this is a healthy change, but not the
    healthiest.

    There is absolutely no evidence that a person in the healthy category would benefit more by
    increasing MUFA intake to get to some arbitrary intake of above 30% fat rather than increasing
    fruits and vegetables, provided that their saturated fat intake was limited and their PUFA was
    adequate, but not excessive.

  6. Sun, 14 Dec 2003 20:03:21 +0100 in article <[email hidden]>

    Thorsten Schier said:


    Results about a special fatty acid (alpha-linolenic acid, ALA) form the Nurses' Health Study: Those
    women in the highest quintile of ALA (1,36
    g/d) had a relative risk of fatal heart disease of 0,55 and of nonfatal heart disease of 0,85 when
    compared to the quintile with the lowest intake (0,71 g/d) after adjustment for other factors.

    So already eating a modest amount of ALA can cut the risk of fatal heart disease almost in half.
    The mediterranean diet is high in ALA, by the way.

    (ajcn.org890
    - tinyurl.comz77e)


    Yes, the researchers of the Lyon Heart Diet Study also emphasized the importance of ALA, which
    Cretans got mainly from wild herbs. For the Lyon Heart Diet Study Serge Renaud designed a margarine
    similar in composition to olive oil, but enriched in alpha-linolenic acid. See the following excerpt
    from The Lancet's article

    Serge Renaud: from French paradox to Cretan miracle. Lancet 2000; 355: 48 - 52.
    <http://www.thelancet.com/journal/vol355/iss9197/full/llan.355.9197.news.2419.1>

    "Then, "when I saw the results of the Seven Countries Study in 1980", he recalls, "I thought,
    Cretans must be doing--or eating--something right". Crete had by far the lowest coronary
    mortality of the countries studied. Yet, serum cholesterol concentrations were higher in Crete
    than in other countries with higher coronary mortalities. "Something protects Cretans which does
    not reduce their cholesterol", proposed Renaud.

    Renaud guessed that the difference was alpha-linolenic acid and set up the Lyon Diet Heart Study
    in 1985, a secondary prevention trial. Overall, deaths and cardiovascular events were reduced by
    at least 70%, with the protective effect occurring within 2 months. This study, which was
    published in The Lancet in 1994, was initially rejected by the New England Journal of Medicine
    because the "intervention induced no changes in serum lipids", a fact that left the referees
    "wondering how such a large mortality reduction could have possibly been achieved".

    Renaud's answer is simple. The participants in the Lyon study ate like Cretans: no butter,
    cream, or milk; lots of vegetables, fruit, bread, and cereals; and little meat. For the study,
    Renaud designed a margarine similar in composition to olive oil, but enriched in alpha-linolenic
    acid. Patients ate cheese ("a 9000 year old invention not linked to coronary disease"😉 and, of
    course, drank wine. Other linolenic acid-rich ingredients of the Cretan diet-- walnuts, snails,
    and purslane--were replaced by his margarine. Although linolenic acid's protective effects have
    been corroborated in other studies, Ducimetière warns that "the extraordinary [Lyon] results
    await confirmation". >

    Renaud is now retired but has yet another diet-related hunch: that the Cretan diet will prevent
    arrhythmias, an idea prompted by the reduction in ventricular fibrillation in the Lyon study.
    Summing up his life's work, Renaud says it has made him "wonder about the origins of
    civilisations. It is intriguing that ancient Asian and Mediterranean civilisations used natural
    oils in cooking-- colza and olive--with similar fatty acid compositions". And because of his
    belief in ancient wisdom when it comes to diet and health, Renaud ends his book Le régime santé
    (Odile Jacob, Paris, 1998) with a warning: "Don't look for a pill that replaces [the Cretan
    diet]. There is no such thing."

    References related to the Lyon Heart Diet Study:

    de Lorgeril M, Renaud S, Mamelle N, Salen P, Martin JL, Monjaud I, Guidollet J, Touboul P, Delaye J.
    Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease.
    Lancet. 1994 Jun 11;343(8911):1454-9. Erratum in: Lancet 1995 Mar 18;345(8951):738. PMID: 7911176
    [PubMed - indexed for MEDLINE] <ncbi.nlm.nih.govquery.fcgi
    d&list_uids=7911176&dopt=Abstract>

    Renaud S, de Lorgeril M, Delaye J, Guidollet J, Jacquard F, Mamelle N, Martin JL, Monjaud I, Salen
    P, Toubol P. Cretan Mediterranean diet for prevention of coronary heart disease. Am J Clin Nutr.
    1995 Jun;61(6 Suppl):1360S-1367S. PMID: 7754988 [PubMed - indexed for MEDLINE] <ncbi.nlm-ncbi.nlm-
    .nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7754988&dopt=Abstract>

    de Lorgeril M, Salen P, Martin J-L, Monjaud I, Delaye J, Mamelle N: Mediterranean diet, traditional
    risk factors and the rate of cardiovascular complications after myocardial infarction. Final report
    of the Lyon Diet Heart Study. Circulation 1999, February 16, 99:779-785
    <http://circ.ahajournals.org/cgi/content/full/99/6/779>

    Leaf A. Dietary prevention of coronary heart disease: the Lyon Diet Heart Study. Circulation. 1999
    Feb 16;99(6):733-5. <http://circ.ahajournals.org/cgi/content/full/99/6/733>

    Serge C Renaud and Dominique Lanzmann-Petithory The beneficial effect of alpha-linolenic acid in
    coronary artery disease is not questionable American Journal of Clinical Nutrition, Vol. 76, No. 4,
    903-904, October 2002 ajcn.org903

    --
    Matti Narkia

  7. Sun, 14 Dec 2003 19:15:59 GMT in article
    <[email hidden]> "giselle"

    Quoted message said:


    "Matti Narkia" <[email hidden]> wrote

    Quoted message said:

    Emphasized? Strenuous?. Cretans used _walk_ about 13 km a day as a part of their daily
    activities. Walking can hardly be described as strenuous exercise. Exercise, even walking is
    good, but the studies I've presented show that the benefits of the diet are independent of the
    physical activity level (although the combined effect could be additive or even synergistic)

    Eight miles a day is nothing to scoff at.


    As Torsten already mentioned many rural populations of that time got the same amount of exercise,
    but didn't get the health and longevity benefits enjoyed by Cretans.

    Quoted message said:

    They also plowed fields, with oxen.


    That's a lot of exercise - for oxen.

    Quoted message said:
    Quoted message said:

    Your comments about today's Cretan diet which differs from the traditional diet are not relevant
    for traditional diet.

    Quoted message said:

    > Evidence? Even if true, it's irrelevant, see above.

    These Mediterraneans don't agree with you-- and they don't think that the seven countries data is
    particularly useful.

    Quoted message said:

    Eur J Clin Nutr. 2002 Sep;56(9):796-809. Links Comment in:
    * Eur J Clin Nutr. 2002 Sep;56(9):928-9; author reply 930-1. The high-fat Greek diet: a
    recipe for all? Ferro-Luzzi A, James WP, Kafatos A. National Institute for Food and
    Nutrition Research, Rome, Italy. [email hidden]


    In the field of nutrition there is always someone who disagrees, this time apparently Italians.
    Cannot say much about the article on the basis of the abstract, but one of the main objections seems
    to be that the Cretan diet cannot be extrapolated to the rest of the Greece. From the abstract it's
    not quite sure what they mean with that, but it even from the Seven Countries Study it's rather
    obvious that Cretan diet differed from the diets of other parts of Greece. As for the amount fat
    issue, the supporters of the old dogma (low fat diet) don't give up so easily the unsubstantiated
    information they have learned.

    Quoted message said:

    I am not ignoring a large body of literature.


    Which is largely unsubstantiated.

    Quoted message said:


    Willett tends to dilute the message to make it more acceptable to people who are accustomed to
    eating garbage. His solution is a half-way measure with half-way benefits. He assumes that people
    will not be able to stick with moderately low fat high vegetable fiber diets so he tells them to
    try to make slight improvements over what they are used to, and this is a healthy change, but not
    the healthiest.


    You make a helluva lot unsubstantiated assumptions about Willett. The man is a scientist for god's
    sake, an author in over 500 peer-reviewed publications, and professor of nutrition and medicine at
    Harvard. We have to thank his research team for a large part of our current knowledge of nutrition.

    Quoted message said:

    There is absolutely no evidence that a person in the healthy category would benefit more by
    increasing MUFA intake to get to some arbitrary intake of above 30% fat rather than increasing
    fruits and vegetables, provided that their saturated fat intake was limited and their PUFA was
    adequate, but not excessive.


    There is also absolutely no evidence that there would be any harm of any kind from increasing extra
    virgin olive oil consumption so that the total fat intake is 40%, if the total amount of calories is
    not increased.

    --
    Matti Narkia

  8. "Matti Narkia" <[email hidden]> wrote

    Quoted message said:

    So? What's your point? According to Willett 40% is no worse than 18-30%.

    He's usually very good, but in this case he might be wrong at the upper endpoint. WHO/FAO experts do
    not agree with his assessment entirely. They suggest 15-30%, and further, state that 35% is ok only
    in people of normal weight who take in more than 400 g of non-starchy vegetables per day. They also
    suggest that there is no convincing benefit beyond 20%. I have already stated this and you can see
    their recommendations for yourself.

    Also, Willett tends to fixate on a few studies that are flawed and he tend to mollify what he knows
    so as to make it more palatable to a wider group of people.

    Quoted message said:
    Quoted message said:

    Largely irrelevant when total is less than 150-160 mg/dl.


    Ah, but if it is higher than as it quite often is?

    A very high fiber, high fruit and vegetable, moderately low fat (22% total, including 90 g of nuts)
    intervention would take care of almost all problems (exceptions for the unfortunates with the LDL
    receptor pathologies) within two weeks. I've already cited the paper-- the Jenkins very high fiber
    diet. It was about 5 kg of fruits and vegetables and 90 g of nuts per day and nothing else. It would
    probably work well with small quantities of fish or fish oil as well.

    We know very well what works best. We also know that people generally will fail to do what's best,
    particularly when their taste buds are involved and when they are in an environment that is filled
    with junky temptations.

    Quoted message said:

    Have you heard of calories? The studies, which I've presented, show that in isocaloric diets
    (diets with the same amount of calories, the percentage of calories gotten from fat does not have
    any effect on body fatness. If Chinese peasants are slim, it is because of their low calorie
    (energy) intake, not because of their low fat intake.

    Matti, this is completely incorrect.

    These peasants have 30% higher caloric intakes than people in the USA and yet their body weights
    are lower. I'm surprised that you've ignored these studies. I've cited only two below but there are
    many others.

    Toxicol Sci. 1999 Dec;52(2 Suppl):87-94. Energy balance: interpretation of data from rural China.
    Campbell TC, Chen J. Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853,
    USA. [email hidden]

    Data used for this analysis are pertinent to the issue of energy balance and body-weight
    control. They were obtained, in a comprehensive study of human diet, lifestyle, and disease
    mortality, from 65 counties (130 villages, 6500 adults) of rural China (Chen et al., 1990).
    After adjusting the food intake data to represent a reference male adult involved in the least
    physical activity and representing the same body weight, total calorie intake (40.6 kcal/kg body
    weight) was about 30% higher in China when compared with an average adult American male (30.6
    kcal/kg bw). However, the body mass index for the Chinese male was about 25% lower (20.5 vs.
    25.8 kg bw/m2). Diets in rural China were low in fat
    (14.5% of energy), relatively low in protein (65.8 g/day), and high in fiber (33 g/day),
    representing a diet unusually rich in plant-based foods (e.g., including about 90% of the total
    protein). It is believed that the excess energy intake among the Chinese is mostly attributed to
    their greater physical activity. However, some unknown but significant, and probably difficult
    to measure, amount could be due to increased energy expenditure associated with non-post-
    prandial basal metabolism. This hypothesis is based, in part, on evidence from experimental
    animal data from this and other laboratories showing that laboratory rats fed diets comprised of
    substantially reduced intakes of protein consume more energy, but gain less weight. They also
    exhibit increased thermogenesis, due both to enhanced metabolic body heat and to diet-driven
    physical activity, while sharply reducing blood cholesterol concentrations and tumor
    development.

    Publication Types:
    * Review
    * Review, Tutorial PMID: 10630595 [PubMed - indexed for MEDLINE]

    Am J Cardiol. 1998 Nov 26;82(10B):18T-21T. Diet, lifestyle, and the etiology of coronary artery
    disease: the Cornell China study. Campbell TC, Parpia B, Chen J. Division of Nutritional Sciences,
    Cornell University, Ithaca, New York 14853, USA.

    Investigators collected and analyzed mortality data for >50 diseases, including 7 different
    cancers, from 65 counties and 130 villages in rural mainland China. Blood, urine, food samples,
    and detailed dietary data were collected from 50 adults in each village and analyzed for a
    variety of nutritional, viral, hormonal, and toxic chemical factors. In rural China, fat intake
    was less than half that in the United States, and fiber intake was 3 times higher. Animal
    protein intake was very low, only about 10% of the US intake. Mean serum total cholesterol was
    127 mg/dL in rural China versus 203 mg/dL for adults aged 20-74 years in the United States.
    Coronary artery disease mortality was 16.7-fold greater for US men and 5.6-fold greater for US
    women than for their Chinese counterparts.

    *note--these statistics are superior to most of those that we see from Mediterranean countries

    The combined coronary artery disease mortality rates for both genders in rural China were inversely
    associated with the frequency of intake of green vegetables and plasma erythrocyte monounsaturated
    fatty acids, but positively associated with a combined index of salt intake plus urinary sodium and
    plasma apolipoprotein B. These apolipoproteins, in turn, are positively associated with animal
    protein intake and the frequency of meat intake and inversely associated with plant protein, legume,
    and light-colored vegetable intake. Rates of other diseases were also correlated with dietary
    factors. There was no evidence of a threshold beyond which further benefits did not accrue with
    increasing proportions of plant-based foods in the diet.

    PMID: 9860369 [PubMed - indexed for MEDLINE]

  9. Sun, 14 Dec 2003 19:45:17 GMT in article
    <[email hidden]> "giselle"

    Quoted message said:


    "Matti Narkia" <[email hidden]> wrote

    Quoted message said:

    So? What's your point? According to Willett 40% is no worse than 18-30%.

    He's usually very good, but in this case he might be wrong at the upper endpoint. WHO/FAO experts
    do not agree with his assessment entirely. They suggest 15-30%, and further, state that 35% is ok
    only in people of normal weight who take in more than 400 g of non-starchy vegetables per day. They
    also suggest that there is no convincing benefit beyond 20%. I have already stated this and you can
    see their recommendations for yourself.

    Also, Willett tends to fixate on a few studies that are flawed and he tend to mollify what he knows
    so as to make it more palatable to a wider group of people.


    I must say that have a lot more confidence in Willett than in any WHO/FAO bureaucrats. You are
    accusing Willett of scientific misconduct without a shred of evidence. Not very scientific nor
    ethical from your part.

    Quoted message said:
    Quoted message said:
    Quoted message said:

    Largely irrelevant when total is less than 150-160 mg/dl.


    Ah, but if it is higher than as it quite often is?

    A very high fiber, high fruit and vegetable, moderately low fat (22% total, including 90 g of nuts)
    intervention would take care of almost all problems (exceptions for the unfortunates with the LDL
    receptor pathologies) within two weeks. I've already cited the paper-- the Jenkins very high fiber
    diet. It was about 5 kg of fruits and vegetables and 90 g of nuts per day and nothing else. It
    would probably work well with small quantities of fish or fish oil as well.


    You are assuming a helluva lot here on the basis of one study.

    Quoted message said:

    We know very well what works best. We also know that people generally will fail to do what's best,
    particularly when their taste buds are involved and when they are in an environment that is filled
    with junky temptations.


    Actually we know the main benefits/harms for example about macro nutrients such as carbs, fats, and
    protein, but we don't know yet exactly what would be the ideal proportions, if these can be defined.

    Quoted message said:
    Quoted message said:

    Have you heard of calories? The studies, which I've presented, show that in isocaloric diets
    (diets with the same amount of calories, the percentage of calories gotten from fat does not have
    any effect on body fatness. If Chinese peasants are slim, it is because of their low calorie
    (energy) intake, not because of their low fat intake.

    Matti, this is completely incorrect.

    These peasants have 30% higher caloric intakes than people in the USA and yet their body weights
    are lower. I'm surprised that you've ignored these studies. I've cited only two below but there are
    many others.

    Quoted message said:

    Toxicol Sci. 1999 Dec;52(2 Suppl):87-94. Energy balance: interpretation of data from rural China.
    Campbell TC, Chen J. Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853,
    USA. [email hidden]


    The calorie intake has to equal energy consumption. Their energy consumption is in balance with
    their calorie intake. It is as simple as that. The proportion of the fat in their diet has nothing
    to do with that equation. Your abstracts proves that (physical activity).

    Quoted message said:


    *note--these statistics are superior to most of those that we see from Mediterranean countries


    But not superior to the traditional diet of Crete, and that's what we are talking about, not about
    other Mediterranean countries.

    --
    Matti Narkia

  10. giselle schrieb:

    Quoted message said:


    "Matti Narkia" <[email hidden]> wrote

    Quoted message said:

    So? What's your point? According to Willett 40% is no worse than 18-30%.

    He's usually very good, but in this case he might be wrong at the upper endpoint. WHO/FAO experts
    do not agree with his assessment entirely. They suggest 15-30%, and further, state that 35% is ok
    only in people of normal weight who take in more than 400 g of non-starchy vegetables per day.
    They also suggest that there is no convincing benefit beyond 20%. I have already stated this and
    you can see their recommendations for yourself.

    Also, Willett tends to fixate on a few studies that are flawed and he tend to mollify what he
    knows so as to make it more palatable to a wider group of people.

    Would you please tell us, why you think that studies like the Nurses' Health Study or the Health
    Professionals Follow-Up Study are flawed?

    Quoted message said:
    Quoted message said:
    Quoted message said:

    Largely irrelevant when total is less than 150-160 mg/dl.


    Ah, but if it is higher than as it quite often is?

    A very high fiber, high fruit and vegetable, moderately low fat (22% total, including 90 g of
    nuts) intervention would take care of almost all problems (exceptions for the unfortunates with
    the LDL receptor pathologies) within two weeks. I've already cited the paper-- the Jenkins very
    high fiber diet. It was about 5 kg of fruits and vegetables and 90 g of nuts per day and nothing
    else. It would probably work well with small quantities of fish or fish oil as well.

    These studies only show a reduction in cholesterol, not a reduction in coronary heart disease. While
    cholesterol is one risk factor for heart disease, it is not the only one. In the Lion Diet Heart
    Study, there was a reduction of heart attacks of 70 % in the intervention group, although the
    cholesterol in the intervention group was almost the same as in the control group (this was also
    true for HDL-C, LDL-C and Lipoprotein (a)).

    So Jenkins should conduct a large study like the Lion Diet Heart Study and show that his
    intervention program really reduces the number of heart attacks, instead of merely reducing one or
    two risk factors. That is, if he can find enough people who can stomach his diet for severals years
    (as opposed to for a few week like in the studies you cited) and provided his participants don't die
    of malnutrion (this diet seems to be deficient in protein and vitamin B 12 at least).

    Quoted message said:

    We know very well what works best. We also know that people generally will fail to do what's best,
    particularly when their taste buds are involved and when they are in an environment that is filled
    with junky temptations.

    You think you know what works best. Based on a few studies with about ten or so participants which
    lasted only a few weeks.

    And you think this outweighs the evidence provided by studies with tenthousands of participants
    which lasted years, if not decades and measured hard endpoints of heart disease (that is fatal and
    not-fatal heart attacks) as opposed to merely measuring one or two risk factors.

    Well, I must say that I don't agree.

    Thorsten

    --
    "Nothing in biology makes sense, except in the light of evolution"

    (Theodosius Dobzhansky)

  11. Matti Narkia <[email hidden]> wrote in message news:<[email hidden]>...

    Quoted message said:

    Sun, 14 Dec 2003 00:16:42 GMT in article <[email hidden]> "giselle"

    Quoted message said:

    Also, in their *2003* nutrition report, WHO/FAO suggests that there is "no convincing benefit"
    for fat intakes beyond 20%. You can download the full report here (link is at the bottom of the
    page). who.inten

    Surely the panel of experts contributing to this report are not all idiots. Nor are Wilcox,
    Wilcox, and Suzuki, nor is David Jenkins, who used himself as one of the subjects in his very
    high fiber diet paper, and who is currently seeking contrived ways to get similar benefits from a
    low fat very high fiber diet in a higher fat lower fiber diet (so as to ease compliance).


    Wilcox, Wilcox, and Suzuki are the authors of the book

    The Okinawa Program : How the World's Longest-Lived People Achieve Everlasting Health--And How You
    Can Too <http://www.amazon.com/exec/obidos/ASIN/0609807501/ref=ase_okinawaway/102-9801803-4493735>

    John Granger's review of this book is kind of interesting:

    "I lived in Okinawa for four years and have studied nutrition and worked as a dietary
    counselor for fifteen years. With these credentials, I heartily recommend the Okinawan program
    but I cannot encourage you to buy this book without sharing three big reservations and
    misgivings. First, the Okinawans are almost certainly NOT the longest lived people on the
    earth. The authors came to this conclusion by citing worldwide demographic studies calculating
    the number of people who live to be 100 years old per 100,000 population. Okinawa is at the
    top of this chart - but this does not mean they are the longest lived people on the planet.
    The authors nowhere mention in their book the fact that the Okinawan centarians were in their
    late 40s during the Battle of Okinawa in April, 1945. Civilian casualities in the Typhoon of
    Bombs and Steel are estimated at greater than 50%. So what? The select Okinawans who survived
    this battle and the years of semi starvation consequent to the Battle were naturally stronger
    than those who did not. That a greater *percentage* of these people have survived to 100
    reflects the harrowing of the weak members of that generation as much as their hardihood and
    lifestyle. It should also be noted that before and since the US 'restored' Okinawa to Japanese
    control in 1970 (the Okinawans are racially and culturally alien to the Japanese who are in
    effect an occupying country as they were in the 19th century - no suggestion of this in the
    book either!)there has been a tragic 'brain drain' and exodus from the archipelago; every
    young person of talent flees the country keeping their population artificially low and further
    skewing demographics. There are some really healthy old people on the island; any attempt to
    say there are a disproportionate number of them without factoring battle casualities/natural
    selection and brain drain into the calculations is deceptive at best.

    Two, the authors only mention in an aside that the Okinawan program no longer exists on the
    island except in the memories and lifestyles of the venerable elders there. Okinawans under
    50, the authors report, have "the highest level of obesity in Japan, the worst cardiovascular
    risk factor profile, and the highest risk of premature death"
    (p.49). The people most in need of learning the Okinawan program, sadly, are the Okinawans
    themselves. When we lived there, my wife had to import whole grains, the heart of this
    program, from the States because it was unavailable on the island except in medicinal
    packages; to the Okinawans, wanting to eat *genmai* or brown rice was a sign of ill
    health and only to be eaten at that time. Eating the Okinawan Program way is associated
    with war time austerities and deprevation - and avoided like the plague.

    My third reservation explains this generation gap. The authors spend the entire book talking
    in categories that modern Okinawans understand (the sick ones) but which would be nonsense to
    the old folks we are supposed to emulate. The authors speak the language of chemical nutrition
    and psychospiritual categories that are concepts none of the older Okinawans use in their food
    or lifestyle choices. They are a traditional, that is, theocentric culture whose every
    decision is made in light of their religious/family obligations, from food choices to the
    clothes they wear. Their physics or natural science (a yin yand Taoism) reflects their
    metaphysics. This is nowhere mentioned in the book, though it means that this tropical way of
    life will work for you only if you live in a tropical environment (most of us do nowadays
    because of central heating and AC), understand food qualities rather than nutritional
    component quantities, and live in an Amish like worship community - with karate dojo's! Again,
    as the authors admit, this way of life is lost on the younger Okinawans who are the heaviest
    and sickest population on the pacific rim.

    But, hey, the program the authors recommend is a good one! I have to marvel that they spent 25
    years (really 6! for the data used in the book)on the study of Battle of Okinawa survivors,
    however, when the program they recommend is available in Andrew Weil's books (the authors know
    his integrative medicine well and have only re- packaged it here with a Okinawan face - Weil
    even writes the introduction!) and Dean Ornish's writings. If you need to believe there is a
    Shrangri-La Diet Program, this book is a well packaged program for you. But don't imagine that
    time in Okinawa will be of any help in your recovery; Naha, Koza, and Nago are some of the
    nastiest cities in Japan. If you want paradise or some vestige of the lifestyle described in
    this book, go to the outer islands, of which Miyako is probably the most accessible.

    For help with the food they recommend, buy Macrobiotic cookbooks and go to Macrobiotic cooking
    classes. I give the book such a low rating because of the deceptiveness of its central premise
    (Okinawan longevity), the misrepresentation of Okinawa as it is, and its projection of
    scientism onto the traditional lifestyle and relationships of its old people as the reason for
    their survival. Read Dean Ornish's Love and Survival or anything by Andrew Weil for a more
    honest and applicable way to improve your health. Anything by Michio Kushi and his students
    will bring you closer to Okinawan eating than this book (if you'll have to add bitter melon -
    definitely an acquired taste!)."

    Thanks for the info.

    When I first heard about it (on the news) and then later on Oprah (I didn't watch the whole thing),
    I told myself, what a superficial reporting. I was skeptical about the scientific consciousness
    (nutrition) about their diet by those people.

  12. In article <[email hidden]>, [email hidden] says...

    Quoted message said:


    "Matti Narkia" <[email hidden]> wrote

    Quoted message said:

    Mediterranean Diet: More Than Olive Oil 'Divine Mix' Prevents Death From Cancer, Heart
    Disease <http://my.webmd.com/content/article/67/80070.htm>

    Right--and if you take away the excess MUFA you get something like the diet of the Okinawan
    elders, which is associated with much lower rates of CHD, cancers, mortality of all causes, etc..


    LOL...the Okinawan elders. That clinches my own view of all this. It's a bunch of BS and nutrition
    here is being raised to a mystical art. When are you people going to start reincorporating some
    racist thoughts and get real? Diet is only partially going to explain all this. The larger part is
    going to be the genetic component. Jews start breeding programs a long time ago so that they didn't
    have to deal with as much disease and bad traits. They have a lot of centenarians because of this.
    Plus IQ has also been controlled by their cultural emphasis and positive competitive spirit they've
    always maintained, intellectually.

    Regarding Okinawan elders...can you say "elite"? The elite has better genetics as a rule. When
    trying to correlate diet or physical characteristics with disease, one is not going to learn that
    much looking at the elite. It will just skew all the associations.

    Greeks are the elite by definition. That is where everything emanated from. It will take a long time
    to water down the kind of brilliance and competition that Greek society managed to accomplish and
    which built the constitution of their citizens.

    Yes, as long as people can keep to good diets, they max out their genetics, but really the genetics
    is the real DEFINING point. Want to live to 100? If you are already born to parents who don't reach
    85 or so, then you can forget it. Of course all this will be irrelevant when tissue replacement
    takes off...and the subject will become moot. And you will be able to reach 100 or more.

    So, all these diet studies are going to do is to help narrow down where the good genetics of the
    world are!

    Yes, the subject of diet has plenty of fertile ground left worth talking about...but I wouldn't take
    it *that* seriously.

  13. G'day G'day Matti, Giselle,

    Firstly I'd like to thank you both for such an interesting debate.

    This post not CC'd by email On Sun, 14 Dec 2003 20:03:21 +0100, Thorsten Schier

    Quoted message said:

    If you look at the results from the Nurses’ Health Study and the Health Professionals’ Follow-Up
    Study (two of the most extensive prospective cohort studies ever conducted) you might find that the
    importance of fruit and vegetables for health or at least for the avoidance of coronary heart
    disease (CHD) often has been somewhat ... overstated.

    G'day G'day Thorsten,

    The Nurses’ Health Study and the Health Professionals’ Follow-Up Study do have a well established
    reputation. I have a nagging doubt though that one can so easily dismiss vegetables as important
    in contributing to the health of people in Crete twenty years ago. Put simply the consumption of
    vegetables on Crete had a distinctive characteristic not likely to found in a significant number
    of the US participants in those studies. In Crete the practice was to collect wild vegetables,
    horta. This meant a different range of vegetables formed the mainstay of their diets eg purslane.
    Purslane is high in alpha linolenic acid and glutathione. When it was discovered broccoli
    contained anticancer components eg indole-3-Carbinol (I3C) and dithiolthiones it was suggested
    that plant breeders could use GE or standard breeding techniques to increase their concentrations.
    As I heard it, the plant breeders politely told them that they had spent decades breeding out some
    the phytonutrients to improve taste acceptance. The wild strains of broccoli found around Sicily
    (and presumably Crete) have something like five to twenty times the amounts of these active
    ingredients as the more domesticated strains.

    Quoted message said:

    In those studies the participants in the highest quintile of intake of fruits and vegetables had a
    relative risk of 80 % for CHD compared to those in the lowest quintile after adjustment for
    standard cardiovascular risk factors. So they experienced only a modest risk reduction of 20 %.

    (jacn.org229)

    To put this into perspective:

    In the Nurses' Health Study women who ate more than 5 oz of nuts per week had a relative risk of
    CHD of 0,65 compared to those who never ate nuts (after adjustment).

    (bmj.bmjjournals.com1341 - this study has already been cited by
    Matti, so you might already be familiar with the results)

    In Crete they also ate almonds. There is sometimes a tendency to attribute the dramatic improvement
    from nut consumption to the fatty acid content. Frankly, IMHO, taking that line of reasoning is
    making too much out of too little. You might have some insights into how 20 grams of nuts per day
    made such a large difference in the Nurse's Health Study.

    Quoted message said:

    Also in the Nurses' Health Study the substitution of 5 % of calories from polyunsaturated fat for
    an equivalent amount of carbohydrates was associated with a relative risk of CHD of 0,62.

    (content.nejm.org1491 - Matti also has already cited an article
    that provided this result)

    Results about a special fatty acid (alpha-linolenic acid, ALA) form the Nurses' Health Study: Those
    women in the highest quintile of ALA (1,36
    g/d) had a relative risk of fatal heart disease of 0,55 and of nonfatal heart disease of 0,85 when
    compared to the quintile with the lowest intake (0,71 g/d) after adjustment for other factors.

    So already eating a modest amount of ALA can cut the risk of fatal heart disease almost in half.
    The mediterranean diet is high in ALA, by the way.

    (ajcn.org890
    - tinyurl.comz77e)

    So while eating vegetables is certainly important, it is not the only important issue you want to
    adress when determining a healthy diet. And it is probably not even the most important issue.

    I don't live in Crete as it was twenty years ago, yet I'd like the knowledge of ALL available
    factors that contributed to their health so I have a reasonable shot at engineering a diet and
    lifestyle suited to my needs here in New Zealand. Unfortunately, IMHO, some of the data is drowned
    in the incessant arguments over fat intake percentages.

    I sort of wonder what Matti, Giselle and yourself would come up with if you were locked in a room
    (with internet access naturally) by some benevolent dictator who insisted you come up with the best
    diet you could with 30 to 35% of calories from fat.

    What would meals for just one day look like?

    Best wishes and thank you.

    --
    Quentin Grady ^ ^ / New Zealand, >#,#< [ / \ /\ "... and the blind dog was leading."

    homepages.paradise.net.nzquentin

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