Fat and Heart Disease Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular

disease (American Journal of Clinical Nutrition, 2010) During 523 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD. The pooled relative risk estimates that compared extreme quantiles of saturated fat intake were 1.07 (95% CI: 0.96, 1.19; P = 0.22) for CHD, 0.81 (95% CI: 0.62, 1.05; P = 0.11) for stroke, and 1.00 (95% CI: 0.89, 1.11; P = 0.95) for CVD. Consideration of age, sex, and study quality did not change the results A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. Criticism Meta-analysis of effect of saturated fat intake on cardiovascular disease: overadjustment obscures true associations (American Journal of Clinical Nutrition, 2010) Adjustment for serum cholesterol concentrations will inevitably bias the estimates of effect of saturated fat intake toward the null hypothesis. Response Reply to P Scarborough et al The calculated relative risk estimates and 95% CIs for saturated fat intake in the subset were 1.13 (0.96, 1.33) for CHD, 0.84 (0.63, 1.10) for stroke, and 1.02 (0.86, 1.19) for total CVD. This secondary analysis suggests that the overall results from the meta-analysis are robust and are not affected by different analytic strategies. They corroborate a recent pooled analysis of 11 American and European cohort studies (n = 344,696 persons) that showed that replacement of saturated fat by carbohydrate was not associated with decreased risk of CHD; on the contrary, such a replacement was associated with a slightly increased risk of CHD Dietary Intakes of Saturated Fat and Cardiovascular Disease: Results from the Multi-Ethnic Study of Atherosclerosis (Circulation, 2012) [from the Background]: Prospective studies have shown generally null associations between overall saturated fat consumption and CVD events. After multivariable adjustment, each 1-g greater intake of meat SF corresponded to 5% higher risk of CVD (HR [CI] per 1-g: 1.05 [1.01 1.10]). In contrast, each 1-g greater intake of dairy SF intake corresponded to 4% lower risk of CVD (HR [CI] per 1-g: 0.96 [0.93 0.99]). Substituting 1% of energy from meat SF with energy from dairy SF was associated with a 14% reduction in CVD risk (HR [CI]: 0.86 [0.780.95]). Saturated fat, carbohydrate, and cardiovascular disease (American Journal of Clinical Nutrition, 2010)

Thus, given the changing landscape of CVD risk factors and the increasing importance of the atherogenic dyslipidemia associated with obesity, insulin resistance, and type 2 diabetes, the relative effect of dietary saturated fat on CVD risk requires reevaluation. This is of particular concern with regard to the implications of further restrictions in total and saturated fat beyond prevailing US dietary guidelines, which call for levels no higher than 10% of total energy, and the recognition that subsets of the population may not benefit, and may even be harmed, by the substitution of high intakes of carbohydrates, especially refined carbohydrates, for fat in the diet. In summary, although substitution of dietary polyunsaturated fat for saturated fat has been shown to lower CVD risk, there are few epidemiologic or clinical trial data to support a benefit of replacing saturated fat with carbohydrate. Furthermore, particularly given the differential effects of dietary saturated fats and carbohydrates on concentrations of larger and smaller LDL particles, respectively, dietary efforts to improve the increasing burden of CVD risk associated with atherogenic dyslipidemia should primarily emphasize the limitation of refined carbohydrate intakes and a reduction in excess adiposity. Dietary saturated fat and fibre and risk of cardiovascular disease and all-cause mortality among type 1 diabetic patients: the EURODIAB Prospective Complications Study (Diabetologia, 2012) During a mean follow-up of 7.3 years, 148 incident cases of fatal and non-fatal CVD and 46 all-cause deaths were documented. No statistically significant association was found between SFA and CVD and all-cause mortality Reduced or modified dietary fat for preventing cardiovascular disease (Cochrane Library, 2011) There are no clear health benefits of replacing saturated fats with starchy foods (reducing the total amount of fat we eat). Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence (Lipids, 2010) Based on consistent evidence from human studies, replacing SFA with polyunsaturated fat modestly lowers coronary heart disease risk, with ~10% risk reduction for a 5% energy substitution; whereas replacing SFA with carbohydrate has no benefit and replacing SFA with monounsaturated fat has uncertain effects. Evidence for the effects of SFA consumption on vascular function, insulin resistance, diabetes, and stroke is mixed, with many studies showing no clear effects, highlighting a need for further investigation of these endpoints. Public health emphasis on reducing SFA consumption without considering the replacement nutrient or, more importantly, the many other food-based risk factors for cardiometabolic disease is unlikely to produce substantial intended benefits. A Systematic Review of the Evidence Supporting a Causal Link Between Dietary Factors and Coronary Heart Disease (Archives of Internal Medicine, 2009)

Insufficient evidence (2 criteria) of association is present for intake of supplementary vitamin E and ascorbic acid (vitamin C); saturated and polyunsaturated fatty acids; total fat; -linolenic acid; meat; eggs; and milk New England Journal of Medicine (A study of over 80,000 women over 20 years) Our findings suggest that diets lower in carbohydrate and higher in protein and fat are not associated with increased risk of coronary heart disease in women. A higher glycemic load was strongly associated with an increased risk of coronary heart disease (relative risk comparing highest and lowest deciles, 1.90; 95% CI, 1.15 to 3.15; P for trend=0.003). Saturated Fat and Cardiometabolic Risk Factors, Coronary Heart Disease, Stroke, and Diabetes: a Fresh Look at the Evidence (Lipids, 2010) Based on consistent evidence from human studies, replacing SFA with polyunsaturated fat modestly lowers coronary heart disease risk, with ~10% risk reduction for a 5% energy substitution; whereas replacing SFA with carbohydrate has no benefit and replacing SFA with monounsaturated fat has uncertain effects. Total Fat Intake Is Associated with Decreased Mortality in Japanese Men but Not in Women (American Society for Nutrition, 2012) A high intake of total fat and PUFA was associated with a decrease in all-cause mortality in men Dietary intake of saturated fat by food source and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis (American Society for Nutrition, 2012) After adjustment for demographics, lifestyle, and dietary confounders, a higher intake of dairy SF was associated with lower CVD risk [HR (95% CI) for +5 g/d and +5% of energy from dairy SF: 0.79 (0.68, 0.92) and 0.62 (0.47, 0.82), respectively]. In contrast, a higher intake of meat SF was associated with greater CVD risk [HR (95% CI) for +5 g/d and a +5% of energy from meat SF: 1.26 (1.02, 1.54) and 1.48 (0.98, 2.23), respectively] Conclusion: Associations of SF with health may depend on foodspecific fatty acids or other nutrient constituents in foods that contain SF, in addition to SF. Systematic review of randomized controlled trials of low-carbohydrate vs. lowfat/low-calorie diets in the management of obesity and its comorbidities, Obesity Reviews (2009) A more recent meta-study of randomized controlled studies (from January 2000 to March 2007) that compared low-carbohydrate diets to low-fat/low-calorie diets found that measurements of weight, HDL cholesterol, triglyceride levels and systolic blood pressure were significantly better in groups that followed low-carbohydrate diets. The authors also found a higher rate of attrition in groups with low-fat diets. They conclude that "Evidence from this systematic review demonstrates that lowcarbohydrate/high-protein diets are more effective at 6 months and are as

effective, if not more, as low-fat diets in reducing weight and cardiovascular disease risk up to 1 year." FAO/WHO Expert Consultation background paper, 2009 The available evidence from cohort and randomized controlled trials is unsatisfactory and unreliable to make judgment about and substantiate the effects of dietary fat on risk of CHD. Dietary intervention to reverse carotid atherosclerosis. (Circulation, 2010) Two-year weight loss diets can induce a significant regression of measurable carotid VWV [vessel wall volume, a measurement of plaque buildup]. The effect is similar in lowfat, Mediterranean, or low-carbohydrate strategies and appears to be mediated mainly by the weight loss-induced decline in blood pressure. Cutting down or changing the fat we eat may reduce our risk of heart disease (Cochrane Summaries, 2012) Recommends interventions based on TYPE of fat, not lowering fat: There are no clear health benefits of replacing saturated fats with starchy foods (reducing the total amount of fat we eat) Low carbohydrate diets improve atherogenic dyslipidemia even in the absence of weight loss. (Nutrition & Metabolism, 2006 June) They clearly confirm that carbohydrate restriction leads to an improvement in atherogenic lipid states in the absence of weight loss or in the presence of higher saturated fat. In distinction, low fat diets seem to require weight loss for effective improvement in atherogenic dyslipidemia. Long term effects of ketogenic diet in obese subjects with high cholesterol level. Mol Cell Biochem. 2006 Jun The body weight and body mass index of both groups decreased significantly (P < 0.0001). The level of total cholesterol, LDL cholesterol, triglycerides and blood glucose level decreased significantly (P < 0.0001), whereas HDL cholesterol increased significantly (P < 0.0001) after the treatment in both groups. This study shows the beneficial effects of ketogenic diet following its long term administration in obese subjects with a high level of total cholesterol. Moreover, this study demonstrates that low carbohydrate diet is safe to use for a longer period of time in obese subjects with a high total cholesterol level and those with normocholesterolemia. Effect of a high saturated fat and no-starch diet on serum lipid subfractions in patients with documented atherosclerotic cardiovascular disease. (Mayo Clinic, 2003) Peter Attias analysis: the authors were startled by the results. The subjects experienced a significant reduction in plasma triglycerides and VLDL triglycerides, without an

increase in LDL-C or LDL-P. In fact, LDL size and HDL size increased and VLDL size decreased all signs of improved insulin resistance. Furthermore, fasting glucose and insulin levels also decreased significantly. The mean HOMA-IR was reduced from 5.6 to 3.6 (normal is 1.0) and TG/HDL-C from 3.3 to 2.0 (normal is considered below 3, but ideal is probably below 1.0) in just 6 weeks. Taken together, these changes, combined with the dramatic change in VLDL size, suggest insulin resistance was dramatically improved while consuming a diet of 50% saturated fat! Dietary saturated fats and their food sources in relation to the risk of coronary heart disease in women (American Journal of Clinical Nutrition, 1999) During 14 y of follow-up, we documented 939 incident cases of major CHD events. In multivariate analyses in which age, smoking, and other covariates were controlled for, intakes of short- to medium-chain saturated fatty acids (4:010:0) were not significantly associated with the risk of CHD. In contrast, intakes of longer-chain saturated fatty acids (12:018:0) were each separately associated with a small increase in risk. The multivariate RR for a 1% energy increase from stearic acid was 1.19 (95% CI: 1.02, 1.37). The ratio of polyunsaturated to saturated fat was strongly and inversely associated with CHD risk (multivariate RR for a comparison of the highest with the lowest deciles: 0.58; 95% CI: 0.41, 0.83; P for trend < 0.0001). Conversely, higher ratios of red meat to poultry and fish consumption and of high-fat to low-fat dairy consumption were associated with significantly greater risk. Reduced or modified dietary fat for preventing cardiovascular disease Cochrane Database Syst Rev., 2001 (Updated 2011) Multiple interventions include lowering blood pressure and cholesterol; 10 wellcontrolled trials and 900,000 patient years of observation The pooled effects suggest multiple risk factor intervention has no effect on mortality. 2011 Update: There were no clear effects of dietary fat changes on total mortality (RR 0.98, 95% CI 0.93 to 1.04, 71,790 participants) or cardiovascular mortality (RR 0.94, 95% CI 0.85 to 1.04, 65,978 participants). (yet their conclusion? Eat less saturated fat) Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women (American Society for Clinical Nutrition, 2004) In postmenopausal women with relatively low total fat intake, a greater saturated fat intake is associated with less progression of coronary atherosclerosis, whereas carbohydrate intake is associated with a greater progression. Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies. Human nutrition unit, University of Sydney Low-GI and/or low-GL diets are independently associated with a reduced risk of certain chronic diseases. In diabetes and heart disease, the protection is comparable with that seen for whole grain and high fiber

intakes. The findings support the hypothesis that higher postprandial glycemia is a universal mechanism for disease progression. Total Fat Intake Is Associated with Decreased Mortality in Japanese Men but Not in Women. over 20,000 people Dietary guidelines generally recommend avoiding a high-fat diet. However, the relationship between fat subtypes and mortality remains unclear especially in a population with a relatively low intake of fatA high intake of total fat and PUFA was associated with a decrease in all-cause mortality in men Effects of dietary coconut oil on the biochemical and anthropometric profiles of women presenting abdominal obesity 12 weeks, randomized women were given equal supplement of coconut oil or soybean oil Group S [soybean oil] presented an increase (P < 0.05) in total cholesterol, LDL and LDL:HDL ratio, whilst HDL diminished (P = 0.03). Such alterations were not observed in group C. It appears that dietetic supplementation with coconut oil does not cause dyslipidemia and seems to promote a reduction in abdominal obesity. Castelli et al, 1997, Circulation: High LDL is a marginal risk factor. Low HDL is a 4-fold better predictor of risk than LDL and only reliable predictor of risk for men or women over 50. Saturated fat raises HDL; carbohydrates lower HDL. Minnesota Coronary Study, Arteriosclerosis 9,000 men and women 269 deaths in low saturated fat, low cholesterol group. 206 deaths in control group. Results go unpublished for 16 years; We were disappointed in the way they turned out, said Frantz. Shekelle, Stamler et al. Western Electric Study- 5,400 employees over 15 years The amount of saturated fatty acids in the diet was not significantly associated with the risk of death from CHD. However, Shekelle in New York Times in 1981: The message of these findings is that it is prudent to decrease the amount of saturated fats and cholesterol in your diet. In 1990, AHA and NHLBI author The Cholesterol Facts, citing this study as one that supported a link between saturated fat/diet and CHD when it did not. Research Committee, 1965, Lancet: A low-fat diet has no place in the treatment of myocardial infarction. Good Calories, Bad Calories: In fact, the Seven Countries Study had been one of the very few studies that had measured sugar consumption in its populations, and sugar indeed turned out to predict heart-disease rates as well as saturated fat did. McGill Study (1994):

Concluded that reducing saturated fat in the diet to 8 percent of all calories would result in an average increase in life expectancy of four days to two months. Testimony in front of George McGovern: For a modern disease to be related to an old-fashioned food is one of the most ludicrous things I have ever heard in my life, said Peter Clave. If anybody tells me that eating fat was the cause of coronary disease, I should look at them in amazement. I believe that decreasing the fat in the diet is not the best way of combating a high blood cholesterolI believe that the high blood cholesterol in itself has nothing whatever to do with heart disease. John Yudkin We dont have the luxury of time to find out the truth before making policy. McGovern report

High Saturated Fat Intake Improves Survival in Genetic Cardiomyopathy Compared to a High Polyunsaturated Fat Diet or a Low Fat Diet (Circulation, 2011) Surprisingly, a high fat diet comprised mainly of saturated fatty acids improves LV function and survival in rat models of heart failure induced by hypertension or myocardial infarction. http://www.askscooby.com/nutrition-39/the-truth-about-saturated-fat/ Similarly, only a handful of case-control studies have ever been done investigating saturated fat and CHD. Of the 9 studies, not a single one is supportive of the assertion that saturated fat causes heart disease9,10,11,12*,13*,14*A15*,A16. The research on prospective cohorts is far more extensive. Since 1963, studies at large have failed dismally to find any appreciable association between saturated fat and CHD. In 31 studies15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,A45 there was no association between saturated fat and CHD. And in 2 studies45,46, an inverse relationship (saturated fat and stroke in the former, and progression of atherosclerosis in the latter) was observed. The role of stress through work, depression and other psychosocial factors in the pathogenesis of CHD has been remarkably well established in the literature60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82. In India, researchers followed over a million people to study the incidence of CHD86. In Northern India, the region of Madras had almost 7 times the CHD mortality of Punjab, located in South India. However those living in Punjab ate almost 18 times more fat, most of which was of animal origin (polyunsaturated fat comprised only 2% of total fat intake). Now consider this graph which plots saturated fat (%cal) against CHD mortality (deaths/100,000/yr) in over 40 countries. There is no definitive trend, although the graph may be suggestive of a weak inverse correlation. As mentioned before, the French are not the only nonconformists, Figure 1 elucidates another 5-10 countries who do not adhere to the conventional wisdom of 'more saturated fat, more CHD'.

Another method of measuring saturated fat intake is through chemical analysis. By examining the fat in our cells, we gain a new and more accurate measure of past consumption. This method is far more reliable than the mere dietary recall through food frequency questionnaires which are notoriously inaccurate. When we consume saturated fat, the amount of certain short-chain saturated fatty acids reflect our intake over a longer time period87,88,89,90,91,92,93. For the diet-heart hypothesis to be true, there should be more short-chain fatty acids (denoting increased saturated fat consumption) in those with CHD. But this is not the case; studies have routinely failed to support this assertion93,94,95,96,97,98. Conventional wisdom would have us believe that those who consume diets higher in saturated fat are more prone to heart disease. We have already investigated the prodigious volumes of evidence clearly contradicting this notion. Following the same conventional wisdom, it is perfectly rational to posit that there should be a clear correlation observable between saturated fat intake and degree of atherosclerosis. But again, there is little evidence to prove this. In 4 post-mortem studies, those who ate paltry amounts of saturated fat were just as atherosclerotic as those who ate ample amounts99,100,101,102. And in 1 study an inverse relationship was seen 103. Only 2 studies found a correlation between increased saturated fat intake and degree of atherosclerosis104,105. In both studies however, those who ate less saturated fat also consumed increased quantities of fish, fruit and vegetables that may have offered protection against and/or may have retarded the progression of atherosclerosis. With acknowledgement to the other 5

studies that showed no correlation, it is reasonable to conclude that the increased intake of fish, fruit and vegetables were the attributable dietary constituents to the limited atherosclerosis the rather than the reduction in saturated fat per se. The Masai have subsisted almost entirely on whole milk (of which the males consume in excess of 3 litres per day), fatty meats (on occasion, consumption of beef can total 5 to 10 pounds in a single sitting) and blood (which is substituted for milk in the dry season) for thousands of years106. Despite the fact that the Masai eat on average 300 grams of animal fat per day (their diet is over 65% saturated fat), researchers found the they had some of the lowest serum cholesterol levels in the world, were outstandingly fit and almost totally free of CHD107 Researchers then sent the aortas of the deceased Masai men to America to be compared with age-matched American men. Pathologists observed a striking absence of advanced arterial plaque in the Masai while it was ubiquitous in the American men108. It would only be expected that one would speculate on the possibility that the Masai population may have some genetic aberration allowing them to maintain such a low serum cholesterol and be protected from CHD. Since this was a reasonable objection, researchers decided to study the Masai population that had moved to the urban metropolis, Nairobi. Here the Masai migrants were exposed to the conventional urban environment; caught in the rush of modern life and leading increasingly sedentary lifestyles. It was found that these people had a 25% higher cholesterol and suffered a greater mortality rate than the tribal Masai, thus nullifying any suggestion of an inherent metabolic aberration110. Akin to the Masai, the Samburu are also tribal people that subsist by and large on whole milk (up to 3.5 gallons daily in the wet season) and partially on meat111,112*. Despite their absolutely stupefying affinity for saturated fat (their diet is over 60% saturated fat), the physical constitution of the Samburu's are analogous to that of athletes. Similar to the Masai, they display a notable absence of CHD113. (From Wikipedia: The Maasai herd goats and sheep, including the Red Maasai sheep, as well as the more prized cattle.[86] Electrocardiogram tests applied to 400 young adult male Maasai found no evidence whatsoever of heart disease, abnormalities or malfunction. Further study with carbon-14 tracers showed that the average cholesterol level was about 50 percent of that of an average American. These findings were ascribed to the amazing fitness of morans, which was evaluated as "Olympic standard".[87]) The Pukapuka and Tokelauans live their simple lives sequestered away in two tiny atolls in the South Pacific. The Pukapuka and Tokelauans obtained 35% and 53% of their diet from fat, respectively; and since nearly all of it was coconut derived, it was largely of the saturate kind. Again researchers found these populations to be remarkably devoid of any cardiovascular disease. Generally all degenerative diseases were mostly unheard of114. When researchers followed the islanders to New Zealand where they were exposed to a multitude of unfavorable lifestyle changes, they found the migrants had lower rates of HDL cholseterol115 increased diastolic and systolic blood pressure116and far higher rates of ailments such as diabetes117and gout118. To prove this was indeed a relationship between environment and health, researchers further found the incidence of these illnesses increased the longer the migrants remained in New Zealand.

http://i.imgur.com/lkNRs.png

http://evilcyber.com/nutrition/is-saturated-fat-bad-for-the-heart/

Cholesterol Dietary cholesterol and coronary artery disease: a systematic review (Current Atherosclerosis Reports (2009) Among more than 80,000 nurses and 43,000 male health professionals, dietary cholesterol was not associated with CHD after adjustment for confounders including energy, polyunsaturated fats, trans-fats, and saturated fats (all factors that are related to cholesterol levels). In a case-control study, egg consumption was not associated with nonfatal myocardial infarction among Italian womenlikewise, other studies did not find an association between eggs and CHD

A prospective study of egg consumption and risk of cardiovascular disease in men and women. Journal of the American Medical Association (1999) 37851 men aged 40 to 75 years at study outset and 80082 women aged 34 to 59 years at study outset, free of cardiovascular disease, diabetes, hypercholesterolemia, or cancer After adjustment for age, smoking, and other potential CHD risk factors, we found no evidence of an overall significant association between egg consumption and risk of CHD or stroke in either men or women

Regular egg consumption does not increase the risk of stroke and cardiovascular diseases. Medical Science Monitor (2007) After adjusting for differences in age, gender, race, serum cholesterol level, body mass index, diabetes mellitus, systolic blood pressure, educational status and cigarette smoking, no significant difference was observed between persons who consumed greater than 6 eggs per week compared to those who consume none or less than 1 egg per week in regards to any stroke (RR, 0.9; 95% confidence interval (CI), 0.7 to 1.1), ischemic stroke (RR, 0.9; 95% CI, 0.7 to 1.1), or coronary artery disease (RR, 1.1; 95% CI, 0.9 to 1.3).

Erythrocyte fatty acids, plasma lipis, and cardiovascular disease in rural China, American Journal of Clinical Nutrition co-authored by T. Colin Campbell, peerreviewed scientific paper finding no correlation between dietary cholesterol and heart disease in the China Study Within China neither plasma total cholesterol nor LDL cholesterol was associated with CVD (cardiovascular disease) The results indicate that geographical differences in CVD mortality within China are caused primarily by factors other than dietary or plasma cholesterol. The consumption of wheat flour and salt (the latter measured by a computed index of salt intake and urinary sodium excretion) was positively correlated with all three diseases [cardiovascular disease, hypertensive heart disease, and stroke. Peter Attia, M.D.:

"Most of the cholesterol we eat is not absorbed and is excreted by our gut (i.e., leaves our body in stool). The reason is it not only has to be de-esterified, but it competes for absorption with the vastly larger amounts of UC supplied by the biliary route...Re-absorption of the cholesterol we synthesize in our body is the dominant source of the cholesterol in our body....Eating cholesterol has very little impact on the cholesterol levels in your body.This is a fact, not my opinion. Canadian Health Guidelines Have No Upper Limit for Dietary Cholesterol NHS of United Kingdom: A target for cholesterol or low-density lipoprotein (LDL) is not recommended for primary prevention of cardiovascular diseasethe National Institute for Health and Clinical Excellence (NICE) does not recommend the use of target levels of cholesterol for people taking statins for primary prevention of cardiovascular disease. Multiple Risk Factor Intervention Trial (MRFIT): 10 year, $115 million study on 12,000 high-risk men, seven year study Tested 362,000 middle-aged American Men and found 12,000 (the top 3 percent) whose cholesterol was so high, more than 290 mg/ml, that they could be considered at imminent risk of having a heart attack. -Good Calories, Bad Calories 7 year mortality: 41.2/1,000 (intervention) 40.4/1,000 (controls) The Multiple Risk Factor Intervention Trial was a randomized primary prevention trial to test the effect of a multifactor intervention program on mortality from coronary heart disease (CHD) in 12,866 high-risk men aged 35 to 57 years. Result: There had been slightly more deaths among those men who had been counseled to quit smoking, eat a cholesterol-lowering diet, and treat their high blood pressure than among those who had been left to their own devices....if we were to stick rigorously to a cholesterol-lowering diet for thirty years - say, from age forty to seventy, at which point high cholesterol is no longer associated with an increased risk of heart disease - we would reduce our risk of dying of a heart attack by 1 percent.-Good Calories, Bad Calories

Framingham Heart Study: Long-term, ongoing cardiology study on the residents of Framingham, Massachussetts: The lack of association between serum cholesterol level and the incidence of sudden death suggests that factors other than the atherosclerotic process may be of importance in this manifestation of coronary heart disease, Thomas Dawber. Comparison between cholesterol of people with over 300 and under 170 finds no association with the amount or type of fat consumed (The Farmingham Heart Study: Diet and Regulation of Serum Cholesterol, 1968) There is considerable range of serum cholesterol within the Framingham Study Group. Something explains this inter-individual variation, but it is not diet (as measured here). William P. Castelli, M.D.: or example, in Framingham, Mass, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person's serum

cholesterol. The opposite of what one saw in the 26 metabolic ward studies, the opposite of what the equations provided by Hegsted et al2 and Keys et al3 The Effects of Low-Carbohydrate versus Conventional Weight Loss Diets in Severely Obese Adults: One-Year Follow-up of a Randomized Trial Despite modest overall weight loss in both diet groups, assignment to the lowcarbohydrate group had a direct and more favorable effect on triglyceride level, HDL cholesterol level, and glycemic control in the smaller subgroup of patients with diabetes. Lipid Research Clinics Coronary Primary Prevention Trial: $150 million, 3800 highrisk men. The only variable in the test - the drug cholestyramine - improved chances only by .2%. UCSF Study Led by Warren Browner: A man who might otherwise die at sixty-five could expect to live an extra month if he avoided saturated fat for his entire adult life.

Inflammation: Comparison of low fat and low carbohydrate diets on circulating fatty acid composition and markers of inflammation. (Lipids, 2008) In summary, a very low carbohydrate diet resulted in profound alterations in fatty acid composition and reduced inflammation compared to a low fat diet. Responses of inflammatory markers to a low-fat, high-carbohydrate diet: effects of energy intake. (American Journal of Nutrition, 2006) During the eucaloric phase, the low-fat, high-carbohydrate diet exerted unfavorable effects on the inflammatory markers. In contrast, the ad libitum low-fat, high-carbohydrate intake caused weight loss and affected inflammatory markers favorably. Thus, the energy content of a low-fat, highcarbohydrate diet determines changes in inflammatory markers.

Aspartame: Aspartame: a safety evaluation based on current use levels, regulations, and toxicological and epidemiological studies. (Crit Rev Toxicol, 2007) Acute, subacute and chronic toxicity studies with aspartame, and its decomposition products, conducted in mice, rats, hamsters and dogs have consistently found no adverse effect of aspartame with doses up to at least 4000 mg/kg bw/day. Critical review of all carcinogenicity studies conducted on aspartame found no credible evidence that aspartame is carcinogenic. The data from the extensive investigations into the possibility of neurotoxic effects of aspartame, in general, do not support the hypothesis that aspartame in the human diet will affect nervous system function, learning or behavior. Epidemiological studies on aspartame include several case-control studies and one wellconducted prospective epidemiological study with a large cohort, in which the consumption of aspartame was measured. The studies provide no evidence to support an association between aspartame and cancer in any tissue. The weight of existing evidence is that aspartame is safe at current levels of consumption as a nonnutritive sweetener. Aspartame: review of safety. (Requl Toxicol Pharmacol, 2002) The safety testing of aspartame has gone well beyond that required to evaluate the safety of a food additive. When all the research on aspartame, including evaluations in both the premarketing and postmarketing periods, is examined as a whole, it is clear that aspartame is safe, and there are no unresolved questions regarding its safety under conditions of intended use. Aspartame: scientific evaluation in the postmarketing period. (Requl Toxicol Pharmacol, 2001) even in amounts many times what people typically consume, aspartame is safe for its intended uses as a sweetener and flavor enhancer. (Non-study) Recent Study on Aspartame and Cancer Critically Flawed For example, a serving of nonfat milk provides about 6 times more phenylalanine and 13 times more aspartic acid compared to an equivalent amount of diet beverage sweetened 100% with aspartame. Likewise, a serving of tomato juice provides about 6 times more methanol compared to an equivalent amount of diet beverage with aspartame.

Eating Meat, Red Meat, and Processed Meat Meat consumption and diet quality and mortality in NHANES III, European Journal of Clinical Nutrition (2013) After multivariable adjustment, neither red and processed meat, nor white meat consumption were consistently associated with all-cause or cause-specific mortality

Meat consumption was not associated with mortality. Pancreatic cancer and exposure to dietary nitrate and nitrite in the NIH-AARP Diet and Health Study, Am J Epidemiol (2011) During approximately 10 years of follow-up between 1995 and 2006, 1,728 incident pancreatic cancer cases were identified. There was no association between total nitrate or nitrite intake and pancreatic cancer in men or women. Epidemiology and Prevention, Circulation (2011) Red meat not associated with higher incidence of CHD/diabetes Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation (2010) Consumption of processed meats, but not red meats, is associated with higher incidence of CHD and diabetes mellitus A review and meta-analysis of red and processed meat consumption and breast cancer. (Nutr Res Rev, 2010) "On the basis of this quantitative assessment, red meat and processed meat intake does not appear to be independently associated with increasing the risk of breast cancer" Processed meat and colorectal cancer: a quantitative review of prospective epidemiologic studies. (European Journal of Cancer Prevention, 2010) currently available epidemiologic evidence is not sufficient to support a clear and unequivocal independent positive association between processed meat consumption and CRC. A review and meta-analysis of prospective studies of red and processed meat intake and prostate cancer. (Nutrition Journal, 2010) In conclusion, the results of this meta-analysis are not supportive of an independent positive association between red or processed meat intake and prostate cancer. Increased Lean Red Meat Intake Does Not Elevate Markers of Oxidative Stress and Inflammation in Humans, American Society for Nutrition (2007) Our results do not support the suggestion that higher red meat intake leads to increased risk of heart disease and type 2 diabetes

Blood Pressure: Low-carbohydrate diet review: shifting the paradigm., Nutrition in Clinical Practice (2011) In short-term and long-term comparison studies, ad libitum and isocaloric therapeutic diets with varying degrees of carbohydrate restriction perform as well as or better than comparable LF diets with regard to weight loss, lipid levels, glucose and insulin response, blood pressure, and other important cardiovascular risk markers in both normal subjects and those with metabolic and other healthrelated disorders. Similarities of Carbohydrate Deficiency and Fasting, Archives of Internal Medicine http://www.webmd.com/diet/news/20100125/low-carb-diet-lowers-bloodpressure Study published in Archives of Internal Medicine: 146 people given ketogenic diet vs. weight loss drug and low fat diet. Results better for ketogenic diet; it lowered blood pressure To Fast or Exercise, American Journal of Clinical Nutrition (1968) Sodium loss during fasting has been found to exceed the sodium loss occurring on a low-sodium diet. Carbohydrate administration was observed promptly to stop the sodium excretion of fasting. Eating carbohydrates prompts the kidneys to hold on to salt, rather than exc rete it. The body then retains extra water to keep the sodium concentration of the blood constantremoving carbohydrates from the diet works, in effect, just like the antihypertensive drugs known as diuretics, which cause the kidneys to excrete sodium, and water along with it.-Good Calories, Bad Calories

The effect of salt usage behavior on sodium intake and excretion among Korean women Nutrition Research and Practice (2012) Blood pressure was significantly higher for the middle-aged. Salted vegetables and salted nuts and potato chips were significantly correlated with young women's high sodium diet, while soy sauce on fried food, kimchi, salted vegetables accounted for middle-aged women's high sodium diet. With these results, we concluded that middle-aged women consumed more carbohydrates, less fat, and more sodium and potassium than young women. See A to Z Trials, 2007

Cancer: Food groups and renal cell carcinoma: A casecontrol study from Italy. International Journal of Cancer (2007) A significant direct trend in risk was found for bread (OR = 1.94 for the highest versus the lowest intake quintile), and a modest excess of risk was observed for pasta and rice (OR = 1.29), and milk and yoghurt (OR = 1.27). Poultry (OR = 0.74), processed meat (OR = 0.64) and vegetables (OR = 0.65) were inversely associated with RCC risk. Associations between Red Meat and Risks for Colon and Rectal Cancer Depend on the Type of Red Meat Consumed. (J. Nutr., 2013 Feb) No associations were found between intake of red meat, processed meat, fish, or poultry and risk for colon cancer or rectal cancer. Substitutions of cleaner meats were not very helpful. Targeting insulin inhibition as a metabolic therapy in advanced cancer: A pilot safety and feasibility dietary trial in 10 patients. Department of Radiology, Albert Einstein College of Medicine (2012) Preliminary data demonstrate that an insulin-inhibiting diet is safe and feasible in selected patients with advanced cancer. The extent of ketosis, but not calorie deficit or weight loss, correlated with stable disease or partial remission. Further study is needed to assess insulin inhibition as complementary to standard cytotoxic and endocrine therapies. http://www.ncbi.nlm.nih.gov/pubmed/21110906 - "On the basis of this quantitative assessment, red meat and processed meat intake does not appear to be independently associated with increasing the risk of breast cancer" Carbohydrate intake, glycemic index, glycemic load, and risk of postmenopausal breast cancer in a prospective study of French women. (American Journal of Clinical Nutrition, 2008) Rapidly absorbed carbohydrates are associated with postmenopausal breast cancer risk among overweight women and women with large waist circumference. Carbohydrates and the Risk of Breast Cancer among Mexican Women Cancer Epidemiol Biomarkers Prevention, 2004 In this population, a high percentage of calories from carbohydrate, but not from fat, was associated with increased breast cancer risk. Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports. (Journal of the American College of Nutrition, 1995) Within 7 days of initiating the ketogenic diet, blood glucose levels declined to low-normal levels and blood ketones were elevated twenty to thirty fold. Results of PET scans indicated a 21.8% average decrease in glucose uptake at the tumor site in

both subjects. One patient exhibited significant clinical improvements in mood and new skill development during the study. She continued the ketogenic diet for an additional twelve months, remaining free of disease progression. Food, Nutrition, and the Prevention of Cancer Report (1997): The assembled experts could find neither convincing nor even probable reason to believe that fat-rich diets increased the risk of cancer. American Cancer Society by 2006: There is little evidence that the total amount of fat consumed increases cancer risk.

Losing weight vs. other ill effects: The diet trials

More resources here: http://www.awlr.org/carb-restricted-diets.html#LowCarbWins

Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. (Obesity Review, 2012) Meta-analysis carried out on data obtained in 1,141 obese patients, showed the LCD to be associated with significant decreases in body weight (-7.04 kg [95% CI 7.20/-6.88]), body mass index (-2.09 kg m(-2) [95% CI -2.15/-2.04]), abdominal circumference (-5.74 cm [95% CI -6.07/-5.41]), systolic blood pressure (-4.81 mm Hg [95% CI -5.33/-4.29]), diastolic blood pressure (-3.10 mm Hg [95% CI -3.45/2.74]), plasma triglycerides (-29.71 mg dL(-1) [95% CI -31.99/-27.44]), fasting plasma glucose (-1.05 mg dL(-1) [95% CI -1.67/-0.44]), glycated haemoglobin (0.21% [95% CI -0.24/-0.18]), plasma insulin (-2.24 micro IU mL(-1) [95% CI -2.65/1.82]) and plasma C-reactive protein, as well as an increase in high-density lipoprotein cholesterol (1.73 mg dL(-1) [95%CI 1.44/2.01]). Low-density lipoprotein cholesterol and creatinine did not change significantly, whereas limited data exist concerning plasma uric acid. LCD was shown to have favourable effects on body weight and major cardiovascular risk factors; however the effects on long-term health are unknown. High-Fat Ketogenic Diet to Control Seizures Is Safe Over Long Term, Johns Hopkins Childrens Center, 2010 Current and former patients treated with the high-fat ketogenic diet to control multiple, daily and severe seizures can be reassured by the news that not only is the diet effective, but it also appears to have no long-lasting side effects, say scientists at Johns Hopkins Childrens Center Systematic review of randomized controlled trials of low-carbohydrate vs. lowfat/low-calorie diets in the management of obesity and its comorbidities. (Obes Rev. 2009 Jan) Systematic review of 12 diet trials. Low carb more effective at 6 months and are as effective, if not more, as low-fat diets in reducing weight and cardiovascular disease risk up to 1 year. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus (Nutrition & Metabolism, 2008) Both interventions led to improvements in hemoglobin A1c, fasting glucose, fasting insulin, and weight loss. The LCKD group had greater improvements in hemoglobin A1c (-1.5% vs. -0.5%, p = 0.03), body weight (-11.1 kg vs. -6.9 kg, p = 0.008), and high density lipoprotein cholesterol (+5.6 mg/dL vs. 0 mg/dL, p < 0.001) compared to the LGID group. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes.

Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet (The New England Journal of Medicine, 2008) Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions. Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity (American Journal of Clinical Nutrition, 2008) An LC [low-carbohydrate, high saturated fat diet] does not impair FMD [flow-mediated dilation]. We observed beneficial effects of both diets on most of the CVD risk factors measured. Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women (JAMA, 2007) At all time points, the statistically significant findings for HDL-C and triglycerides concentrations favored the Atkins group. Changes in LDL-C concentrations at 2 months favored the LEARN and Ornish diets over the Atkins diet; however, these differences diminished and were no longer significant at 6 and 12 months. Weight loss was greater for women in the Atkins diet group compared with the other diet groups at 12 months Long term effects of ketogenic diet in obese subjects with high cholesterol level. (Mol Cell Biochem, 2006) This study shows the beneficial effects of ketogenic diet following its long term administration in obese subjects with a high level of total cholesterol. Moreover, this study demonstrates that low carbohydrate diet is safe to use for a longer period of time in obese subjects with a high total cholesterol level and those with normocholesterolemia. Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. (American Journal of Clinical Nutrition, 2009) Compared with the LF group, the LC group had greater decreases in triglycerides (-0.36 +/- 0.15 mmol/L; 95% CI: -0.67, -0.05 mmol/L; P = 0.011), increases in HDL cholesterol (0.23 +/- 0.09 mmol/L; 95% CI: 0.06, 0.40 mmol/L; P = 0.018) and LDL cholesterol (0.6 +/- 0.2 mmol/L; 95% CI: 0.2, 1.0 mmol/L; P = 0.001), and a greater but nonsignificant increase in apolipoprotein B (0.08 +/- 0.04 g/L; 95% CI: -0.004, 0.171 g/L; P = 0.17). Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. (JAMA, 2005) Each popular diet modestly reduced body weight and several cardiac risk factors at 1 year.

The Role of Energy Expenditure in the Differential Weight Loss in Obese Women on Low-Fat and Low-Carbohydrate Diets (Journal of Endocrinology and Metabolism, 2005) The results of this study confirm those of our prior clinical trial and the work of other investigators, showing that low-carbohydrate diets are effective for loss of weight and body fat over periods of 46 months (5, 6, 7). In the current study, the low-carbohydrate dieters lost over 10% of their body weight, whereas the low-fat dieters lost approximately 7% of their body weight, robust results for a 4-month period. When compared with the HC diet, the HF and HP diets were shown to produce significantly (p<0.01) greater reductions in several parameters, including weight loss (HF 2.8 kg, HF 2.7 kg), waist circumference (HF 3.5 cm, HF 2.7 cm) and triglycerides (HF 0.30 mmol/l, HF 0.22 mmol/l). Effect of ketogenic Mediterranean diet with phytoextracts and low carbohydrates/high-protein meals on weight, cardiovascular risk factors, body composition and diet compliance in Italian council employees. From the Background: There has been increased interest in recent years in very low carbohydrate ketogenic diets (VLCKD) that, even though they are much discussed and often opposed, have undoubtedly been shown to be effective, at least in the short to medium term, as a tool to tackle obesity, hyperlipidemia and some cardiovascular risk factors There were no significant changes in BUN, ALT, AST, GGT and blood creatinine. We detected a significant (p < 0.0001) reduction in BMI (31.45 Kg/m2 to 29.01 Kg/m2), body weight (86.15 kg to 79.43 Kg), percentage of fat mass (41.24% to 34.99%), waist circumference (106.56 cm to 97.10 cm), total cholesterol (204 mg/dl to 181 mg/dl), LDLc (150 mg/dl to 136 mg/dl), triglycerides (119 mg/dl to 93 mg/dl) and blood glucose (96 mg/dl to 91 mg/dl). There was a significant (p < 0.0001) increase in HDLc (46 mg/dl to 52 mg/dl). Low-Carbohydrate Diets Promote a More Favorable Body Composition than LowFat Diets Department of Kinesiology, University of Connecticut High-Fat Ketogenic Diet to Control Seizures Is Safe Over Long Term, Johns Hopkins Childrens Center Despite its temporary side effects, we have always suspected that the ketogenic diet is relatively safe long term, and we now have proof, says senior investigator Eric Kossoff, M.D., a pediatric neurologist and director of the ketogenic diet program at Hopkins Childrens. 21 Separate Trials http://www.ncbi.nlm.nih.gov/pubmed/12761365 The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease

http://www.ncbi.nlm.nih.gov/pubmed/12761364 Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost http://www.ncbi.nlm.nih.gov/pubmed/12640371 The LC diet appears to be an effective method for short-term weight loss in overweight adolescents and does not harm the lipid profile. http://www.ncbi.nlm.nih.gov/pubmed/12679447 Based on these data, a very low carbohydrate diet is more effective than a low fat diet for short-term weight loss and, over 6 months, is not associated with deleterious effects on important cardiovascular risk factors in healthy women http://www.ncbi.nlm.nih.gov/pubmed/15505128 Compared with the NCEP diet, the MLC diet, which is lower in total carbohydrates but higher in complex carbohydrates, protein, and monounsaturated fat, caused significantly greater weight loss over 12 weeks. There were no significant differences between the groups in blood lipid levels, but favorable changes were observed within the MLC diet group. http://www.ncbi.nlm.nih.gov/pubmed/15148063 Compared with a low-fat diet, a low-carbohydrate diet program had better participant retention and greater weight loss. During active weight loss, serum triglyceride levels decreased more and highdensity lipoprotein cholesterol level increased more with the low-carbohydrate diet than with the low-fat diet. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538279/ Individual responses clearly show the majority of men and women experience greater weight and fat loss on a VLCK than a LF diet. http://www.ncbi.nlm.nih.gov/pubmed/16409560 Weight loss was greater in the low-carbohydrate (LC) group (-3.55 +/- 0.63, mean +/- sem) vs. -0.92 +/- 0.40 kg, P = 0.001) and cholesterol : high-density lipoprotein (HDL) ratio improved (-0.48 +/0.11 vs. -0.10 +/- 0.10, P = 0.01) this study points out how well low-carb did for the heartand then says but this was at the expense of an increase in relative saturated fat intake. Okay, but if its healthy http://www.ncbi.nlm.nih.gov/pubmed/17823420 Both dietary patterns significantly reduced body weight and were associated with improvements in mood. http://www.ncbi.nlm.nih.gov/pubmed/17971178 Weight loss was greater (6.9 vs. 2.1 kg, P = 0.003) in the low-carbohydrate group, with no difference in changes in HbA(1c), ketone or lipid levels. http://www.ncbi.nlm.nih.gov/pubmed/18635428 Mediterranean and lowcarbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions. http://www.ncbi.nlm.nih.gov/pubmed/19099589 Dietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes. The diet lower in carbohydrate led to

greater improvements in glycemic control, and more frequent medication reduction/elimination than the low glycemic index diet. www.ncbi.nlm.nih.gov/pubmed/18326593 An LC does not impair FMD [brachial artery flow-mediated dilatation]. We observed beneficial effects of both diets on most of the CVD risk factors measured. http://www.ncbi.nlm.nih.gov/pubmed/18174038 The VLCHF diet produced greater decreases in triacylglycerols (VLCHF -0.64 +/- 0.62 mmol/l, HCLF -0.35 +/- 0.49 mmol/l; p = 0.01) and increases in high-density lipoprotein cholesterol (HDL-C) (VLCHF 0.25 +/- 0.28 mmol/l, HCLF 0.08 +/- 0.17 mmol/l; p = 0.002). http://www.ncbi.nlm.nih.gov/pubmed/19082851 The results support the use of dietary carbohydrate restriction as an effective approach to improve features of MetS and cardiovascular risk. http://www.ncbi.nlm.nih.gov/pubmed/19439458 Compared with the LF group, the LC group had greater decreases in triglycerides (-0.36 +/- 0.15 mmol/L; 95% CI: 0.67, -0.05 mmol/L; P = 0.011), increases in HDL cholesterol (0.23 +/- 0.09 mmol/L; 95% CI: 0.06, 0.40 mmol/L; P = 0.018) and LDL cholesterol (0.6 +/- 0.2 mmol/L; 95% CI: 0.2, 1.0 mmol/L; P = 0.001), and a greater but nonsignificant increase in apolipoprotein B (0.08 +/- 0.04 g/L; 95% CI: -0.004, 0.171 g/L; P = 0.17).

Effect of ketogenic Mediterranean diet with phytoextracts and low carbohydrates/high-protein meals on weight, cardiovascular risk factors, body composition and diet compliance in Italian council employees (University of Padova, 2011) The KEMEPHY diet lead to weight reduction, improvements in cardiovascular risk markers, reduction in waist circumference and showed good compliance. Spanish Ketogenic Mediterranean Diet: a healthy cardiovascular diet for weight loss (Department of Genetic, University of Cordoba 2008) Ketogenic diets are an effective healthy way of losing weight since they promote a nonatherogenic lipid profile, lower blood pressure, and decrease resistance to insulin with an improvement in blood levels of glucose and insulin There was an extremely significant (p < 0.0001) reduction in body weight (108.62 kg--> 94.48 kg), body mass index (36.46 kg/m(2)-->31.76 kg/m(2), systolic blood pressure (125.71 mmHg-->109.05 mmHg), diastolic blood pressure (84.52 mmHg--> 75.24 mmHg), total cholesterol (208.24 mg/dl-->186.62 mg/dl), triacylglicerols (218.67 mg/dl-->113.90 mg/dl) and glucose (109.81 mg/dl--> 93.33 mg/dl). There was a significant (p = 0.0167) reduction in LDLc (114.52 mg/dl-->105.95 mg/dl) and an extremely significant increase in HDLc (50.10 mg/dl-->54.57 mg/dl). The most affected parameter was the triacylglicerols (47.91% of reduction). The SKMD is safe, an effective way of losing weight, promoting non-atherogenic lipid profiles, lowering blood pressure and improving fasting blood glucose levels. Effects of Dietary Composition on Energy Expenditure During Weight-Loss Maintenance, JAMA 2012

Among overweight and obese young adults compared with preweight-loss energy expenditure, isocaloric feeding following 10% to 15% weight loss resulted in decreases in REE [resting energy expenditure] and TEE [total energy expenditure] that were greatest with the low-fat diet, intermediate with the lowglycemic index diet, and least with the very low-carbohydrate diet. (i.e., low-fat diets coincided with a decrease in both resting and total energy expenditure; low-carb diets were better) Foster, New England Journal of Medicine, 2003 63 obese men and women randomized into two diets: conventional low fat/low cal and HFLC. Results:

A to Z Trial, JAMA (2007) Atkins outperforms other three other diets in LDL,Triglycerides, HDL, and blood pressure

Workplace Diet Trial (2008) Red means it was a significant change within the group from their baseline. Green means no significiant. Purple means it was significant across the groups. Hemoglobin A1c, a significant predictor of diabetes, was only significantly reduced within low carb group

Studies Refuting Low-Carb

Weight-loss with low or high carbohydrate diet? (Int J. Obes, 1996) Weight loss was similar between high-carb and low-carb groups. However, conclusion states low-carb group had favorable glucose/insulin ratio and blood triglyceride. Energy intake required to maintain body weight is not affected by wide variation in diet composition. (Am J Clin Nutr. 1992) Even with extreme changes in the fat-carbohydrate ratio (fat energy varied from 0% to 70% of total intake), there was no detectable evidence of significant variation in energy need as a function of percentage fat intake. (only measured 16 people) Effect of high protein vs high carbohydrate intake on insulin sensitivity, body weight, hemoglobin A1c, and blood pressure in patients with type 2 diabetes mellitus. (J Am Diet Assoc. 2005) 12 people. The high fat was still 40% carb.

Refutations of the Infamous China Study: Erythrocyte fatty acids, plasma lipids, and cardiovascular disease in rural China(PDF) (American Journal of Clinical Nutrition, co-authored by T. Colin Campbell himself) Within China neither plasma total cholesterol nor LDL cholesterol was associated with CVD [cardiovascular disease]. The results indicate that geographical differences in CVD mortality within China are caused primarily by factors other than dietary or plasma cholesterol. There were no significant correlations between the various cholesterol fractions and the three mortality rates [coronary heart disease, hypertensive heart disease, and stroke]. In contrast, plasma triglyceride had a significant positive association with CHD and HHD but not with stroke. The consumption of wheat flour and salt (the latter measured by a computed index of salt intake and urinary sodium excretion) was positively correlated with all three diseases [cardiovascular disease, hypertensive heart disease, and stroke]. Reply to T. Colin Campbell (American Journal of Clinical Nutrition, 2000) A survey of 65 counties in rural China, however, did not find a clear association between animal product consumption and risk of heart disease or major cancers Denise Minger rebuttal (blog post) Perhaps more troubling than the distorted facts in The China Study are the details Campbell leaves out. Why does Campbell indict animal foods in cardiovascular disease (correlation of +1 for animal protein and -11 for fish protein), yet fail to mention that wheat flour has a correlation of +67 with heart attacks and coronary heart disease, and plant protein correlates at +25 with these conditions?

Plant protein has a correlation of 0.21 with heart disease (positive) Non-fish animal protein has a correlation of 0.01 with heart disease (neutral) Fish protein has a correlation of -0.11 with heart disease (inverse) Meat intake has a correlation of -0.28 with heart disease (strongly inverse) Fish intake has a correlation of -0.15 with heart disease (inverse) Egg intake has a correlation of -0.13 with heart disease (inverse) Speaking of wheat, why doesnt Campbell also note the astronomical correlations wheat flour has with various diseases: +46 with cervix cancer, +54 with hypertensive heart disease, +47 with stroke, +41 with diseases of the blood and blood-forming organs, and the aforementioned +67 with myocardial infarction and coronary heart

disease? (None of these correlations appear to be tangled with any risk-heightening variables, either.) Why does Campbell overlook the unique Tuoli peoples documented in the China Study, who eat twice as much animal protein as the average American (including two pounds of casein-filled dairy per day)yet dont exhibit higher rates of any diseases Campbell ascribes to animal foods? Why does Campbell point out the relationship between cholesterol and colorectal cancer (+33) but not mention the much higher relationship between sea vegetables and colorectal cancer (+76)? (For any researcher, this alone should be a red flag to look for an underlying variable creating misleading correlations, whichin this casehappens to be schistosomiasis infection.) Why does Campbell fail to mention that plant protein intake correlates positively with many of the Western diseases he blames cholesterol forincluding +19 for colorectal cancers, +12 for cervix cancer, +15 for leukemia, +25 for myocardial infarction and coronary heart disease, +12 for diabetes, +1 for breast cancer, and +10 for stomach cancer? Further reading: The China Study exposed: actual data does not support vegetarian health claims (at HunterGatherer) China Study Problems of Interpretation (at Whole Health Source) Polish a turd and find a diamond? (at PaNu) The China Study: Junk Science and Lies (at Robb Wolf) There is no justification for a plant-only diet (at Conditioning Research) Rest in peace, China Study (at The Healthy Skeptic) "The China Study", Debunked (at Theory to Practice) "The China Study: Fact or Fallacy?" (at Let Them Eat Meat) Destroying China (the Study that Is) (at Aspire Natural Health) The China Study Discredited (at Food Renegade) The Study Everyone Talks About: Part 2: The Ravaging Reviews (at Feasting on Fitness) Debunking The China Study (at Crossfit 1776) The Debunking of the China Study (at TJ's Gym) Thoughts on Friday from the middle of the road! (at A Moderate Life) A Critique Worth Reading (at For His Glory & for Our Good) "T. Colin Campbell's The China Study: Finally, Exhaustively Discredited" (at Crossfit Peachtree) The China Study: Crushed by its Own Data (at The Spark of Reason) China Study and T. Colin Campbell: Someone just made you their vegan bitch (at Paleo-ish) The China Study: Evidence for the Perfect Health Diet (at Perfect Health Diet) The China Study Has No Clothes: Smackdown Of T. Colin Campbell (at Nutrition and Physical Regeneration) The slam-dunking of "The China Study" (at the shmaltz) China Study Shakedown (at Natural Messiah) The China Study Toppled A Tale of the Confirmation Bias (at Lean, Mean, Virile Machine) Slaying of a Hypothesis (at Animal Pharm)

"Epidemiology is Bogus" (at Evolutionary Psychiatry) China Study Unveiled -- Not Supporting Veganism (at Primal Wisdom) China fiction? (at The Heart Scan Blog) The China Study - A Superb Analysis (at Primal Muse) Chipping Away at the China Study (at Liberation Wellness) The China study: Debunked (at Food, flora and felines) Buh-bye, China Study (at The Low-Carb Curmudgeon) China Study Debunked (at The Red Pill) Around the Fitness Horn (at x lyssa) RAW FOOD SOS sobre o China Study (at Canibais e Reis) Die veblffende Biegsamkeit von Fakten: The China Study (at Urgeschmack) Veganbibelns fall (at Kostdoktorn.Se) Weekend Link Love (at Mark's Daily Apple) The China Study (at Kat's Food Blog) Debunking junk science: goodbye china study (at abundant brain & health) China Study Unmasked (at AgingBoomersBlog.com) Denise Minger Refutes the China Study Once and For All (at The WAPF Blog) "The China Study" Considered Harmful (at Metamodern) The China Study vs the China study (at The Blog of Michael R. Eades, M.D.)

http://en.wikipedia.org/wiki/Orexigenic - carbs are appetite stimulants More to research: http://www.dietdoctor.com/science http://www.ncbi.nlm.nih.gov/pubmed/19127177 Funny Anecdotal Stuff http://www.rawstory.com/rs/2013/05/07/105-year-old-woman-says-eating-bacon-every-dayis-her-key-to-long-life/ http://www.youtube.com/watch?v=NqXFrs6quvE&feature=youtu.be&t=7m51s Bacons too lean