Low-carb article in the Sydney Morning Herald

Discussion in 'Health and medical' started by Matti Narkia, Oct 22, 2003.

  1. Matti Narkia

    Matti Narkia Guest

    In today's (or tomorrow's depending on where you are) Sydney Morning
    Herald there is an article about low-carbohydrate diet:

    The burning question
    The Sydney Morning Herald, October 23, 2003
    http://www.smh.com.au/articles/2003/10/22/1066631499123.html

    It seems mostly to comment about a study already mentioned here,

    Brehm BJ, Seeley RJ, Daniels SR, D'Alessio DA.
    A randomized trial comparing a very low carbohydrate diet and a
    calorie-restricted low fat diet on body weight and cardiovascular risk
    factors in healthy women.
    J Clin Endocrinol Metab. 2003 Apr;88(4):1617-23.
    PMID: 12679447 [PubMed - indexed for MEDLINE]
    <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12679447&dopt=Abstract>

    although there is also some comments about a review article I just
    recently posted in this ng:

    Westman EC, Mavropoulos J, Yancy WS, Volek JS.
    A Review of Low-carbohydrate Ketogenic Diets.
    Curr Atheroscler Rep. 2003 Nov;5(6):476-83.
    PMID: 14525681 [PubMed - in process]
    <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14525681&dopt=Abstract>

    Brehm and Westman have been interviewed, and I found some of their
    comments and some comments about them particularly relevant to the LC
    discussion this ng. Let's take a few citations:

    "According to Brehm, those following Atkins's low-carbohydrate diet
    for four months achieved twice the weight loss of those on a
    conventional calorie-controlled, low-fat diet. Furthermore, the team
    found no evidence of harmful effects from following the diet - at
    least during the study.

    These results are in line with those found in similar small studies
    now starting to emerge. As well as backing the claims made for the
    Atkins diet, these latest results seem to further undermine standard
    nutritional advice about the need to focus on cutting fat and
    calories.

    They are something of an embarrassment to Brehm, whose research is
    funded by the American Heart Association, which has long advocated
    calorie-controlled, low-fat diets.

    As a scientist, Brehm puts unearthing the truth above pleasing her
    paymasters - but it is this that causes most concern. She is having
    problems explaining her findings - and in the increasingly
    vociferous debate over the Atkins diet, that may well land her in
    trouble at next week's meeting.

    The scientific world is becoming increasingly polarised over the
    diet, with researchers such as Brehm being given a tough time over
    their apparent support for what some scientists regard as the
    nutritional equivalent of crystal therapy. At the heart of the
    controversy is the science behind the Atkins diet - first published
    30 years ago - and whether it is really anything more than a
    collection of buzzwords.

    Conventional wisdom dictates that calories are the key to weight
    loss, and so those who lose weight must simply be consuming fewer
    calories than they burn up. Yet, according to Brehm, the obese
    people who lost weight on the Atkins diet ate and burned up
    essentially the same number of calories as those on the standard
    diet. What was very different was the proportion of body fat shed by
    each group, which mirrored their percentage weight loss. On the face
    of it, this backs the central claim of the Atkins diet: that a low-
    carb diet turns the body into a fat-burning machine.

    [...]

    Even more baffling is why there are still such enormous gaps in
    knowledge about how humans respond to diet. The past 20 years have
    seen obesity reach record levels in the developed world. This has
    led scientists to concede that the standard advice on nutrition and
    healthy eating has been an abject failure - yet the Atkins diet is
    still dismissed as a "fad" by the British Dietetic Association, with
    leading nutritionists insisting that there is insufficient
    scientific evidence to give it more credence. This lack of evidence
    has not deterred many in the medical profession from condemning the
    diet out of hand. Last week a poll of British doctors revealed that
    one in four would advise their patients to stay fat rather than try
    the Atkins diet - despite the proven life-threatening effects of
    obesity.

    Such attitudes might suggest that the scientific world is in the
    grip of cognitive dissonance over the Atkins Diet, preferring to
    ignore whatever evidence it does not like. Professor Eric Westman, a
    clinical trials expert at Duke University in North Carolina, and
    author of a study of the evidence for and against the diet, says,
    "It is making people re-examine dogma - and it's not always
    appreciated."

    According to his review, which is due to appear in Current
    Atherosclerosis Reports, studies show that the Atkins diet does
    produce weight loss over six months, and without obvious health
    effects. Contrary to the claims of many nutritionists, there is even
    evidence that it may be healthier than the standard diet: despite
    its promotion of fat and eggs, studies suggest that the diet may
    boost levels of the healthy forms of cholesterol.

    Westman thinks that this unexpected effect may explain a long-
    standing mystery surrounding heart disease. In the late 1980s,
    researchers began investigating the unusually low rates of heart
    attacks and stroke among Eskimo communities in Greenland. Until now,
    the explanation was thought to lie in their diet of oily fish. Yet
    attempts to reduce heart disease using supplements of fish oil
    extracts proved disappointing. Westman says the studies of the
    Atkins diet point to another explanation: that the lo-carb diet
    forced on the Inuit by their environment gives them higher levels of
    healthy forms of cholesterol, which are proven to lower heart
    disease risk.

    Despite this, Westman cautions anyone with a medical condition
    against rushing onto a low-carb diet. "The problem is that it works
    too well," he explains. "The diet can cause insulin levels to drop
    by 50 per cent in one day, so diabetics could find themselves over-
    medicated. It's the same for those with high blood pressure."

    Even so, Westman believes that the results are impressive enough to
    warrant an intensive research effort on the Atkins diet: "We're in a
    period when we will learn a lot."

    It is not a prospect that thrills the entire nutritional science
    community. Westman has been vilified for conducting research with
    financial support from the Atkins Foundation - despite the fact that
    some vocal critics of the diet, such as Dr Susan Jebb, the head of
    nutrition at the UK Medical Research Council, have, in turn,
    received funding from bodies such as the Flour Advisory Bureau.

    Brehm has also run into resistance even over her research funded by
    the American Heart Association.

    "We had a tough time getting our results published - it took 18
    months altogether," she says. "The big journals really couldn't
    handle it. But we're not endorsing the diet: it's just our
    results.""


    But as someone already pointed out in another ng, the best paragraph in
    the article is the last one:

    "Those already embarked on such research suspect that it will take a
    great deal to overcome the visceral response the mere mention of
    Atkins provokes among academics. Says Brehm: "A lot of people just
    want to hold on to what they learned in college.""

    Now _that_ has been seen time after time after time also in LC
    discussions in this ng ;-):



    --
    Matti Narkia
     
    Tags:


  2. Matti Narkia

    Matti Narkia Guest

    Wed, 22 Oct 2003 23:12:40 GMT in article
    <[email protected]> Matti Narkia
    <[email protected]> wrote:

    >In today's (or tomorrow's depending on where you are) Sydney Morning
    >Herald there is an article about low-carbohydrate diet:
    >
    >The burning question
    >The Sydney Morning Herald, October 23, 2003
    >http://www.smh.com.au/articles/2003/10/22/1066631499123.html
    >

    The same article was published in _The Telegraph_ 19.10.2003:

    <http://www.telegraph.co.uk/news/main.jhtml?xml=%2Fnews%2F2003%2F10%2F19%2Fndiet19.xml&secureRefresh=true&_requestid=4432>
    (http://tinyurl.com/s0qg)

    I found also some other Atkins diet related articles from The Telegraph's
    site:

    The woman trying to persuade Britain to swallow the Atkins diet
    16.10.2003
    <http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2003/10/16/natkin16.xml>

    Farming lobby 'pushed for warnings on Atkins diet'
    By Charlotte Edwardes
    05.10.2003
    <http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2003/10/05/watkin05.xml>

    Anti-Atkins nutritionist working for flour millers
    By Tom Peterkin
    18.08.2003
    <http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2003/08/18/natkins18.xml>

    --
    Matti Narkia
     
  3. Matti Narkia wrote:

    > In today's (or tomorrow's depending on where you are) Sydney Morning
    > Herald there is an article about low-carbohydrate diet:
    >
    > The burning question
    > The Sydney Morning Herald, October 23, 2003
    > http://www.smh.com.au/articles/2003/10/22/1066631499123.html
    >
    > It seems mostly to comment about a study already mentioned here,
    >
    > Brehm BJ, Seeley RJ, Daniels SR, D'Alessio DA.
    > A randomized trial comparing a very low carbohydrate diet and a
    > calorie-restricted low fat diet on body weight and cardiovascular risk
    > factors in healthy women.
    > J Clin Endocrinol Metab. 2003 Apr;88(4):1617-23.
    > PMID: 12679447 [PubMed - indexed for MEDLINE]
    > <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12679447&dopt=Abstract>
    >
    > although there is also some comments about a review article I just
    > recently posted in this ng:
    >
    > Westman EC, Mavropoulos J, Yancy WS, Volek JS.
    > A Review of Low-carbohydrate Ketogenic Diets.
    > Curr Atheroscler Rep. 2003 Nov;5(6):476-83.
    > PMID: 14525681 [PubMed - in process]
    > <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14525681&dopt=Abstract>
    >
    > Brehm and Westman have been interviewed, and I found some of their
    > comments and some comments about them particularly relevant to the LC
    > discussion this ng. Let's take a few citations:
    >
    > "According to Brehm, those following Atkins's low-carbohydrate diet
    > for four months achieved twice the weight loss of those on a
    > conventional calorie-controlled, low-fat diet. Furthermore, the team
    > found no evidence of harmful effects from following the diet - at
    > least during the study.
    >


    Only four months.

    >
    > These results are in line with those found in similar small studies
    > now starting to emerge. As well as backing the claims made for the
    > Atkins diet, these latest results seem to further undermine standard
    > nutritional advice about the need to focus on cutting fat and
    > calories.
    >


    The Atkins diet results in the latter so where is the undermining?

    >
    > They are something of an embarrassment to Brehm, whose research is
    > funded by the American Heart Association, which has long advocated
    > calorie-controlled, low-fat diets.
    >


    And still does.

    >
    > As a scientist, Brehm puts unearthing the truth above pleasing her
    > paymasters - but it is this that causes most concern. She is having
    > problems explaining her findings - and in the increasingly
    > vociferous debate over the Atkins diet, that may well land her in
    > trouble at next week's meeting.
    >
    > The scientific world is becoming increasingly polarised over the
    > diet, with researchers such as Brehm being given a tough time over
    > their apparent support for what some scientists regard as the
    > nutritional equivalent of crystal therapy. At the heart of the
    > controversy is the science behind the Atkins diet - first published
    > 30 years ago - and whether it is really anything more than a
    > collection of buzzwords.
    >


    The concern is in long term safety of this *unbalanced* nutritional approach.

    >
    > Conventional wisdom dictates that calories are the key to weight
    > loss, and so those who lose weight must simply be consuming fewer
    > calories than they burn up. Yet, according to Brehm, the obese
    > people who lost weight on the Atkins diet ate and burned up
    > essentially the same number of calories as those on the standard
    > diet. What was very different was the proportion of body fat shed by
    > each group, which mirrored their percentage weight loss. On the face
    > of it, this backs the central claim of the Atkins diet: that a low-
    > carb diet turns the body into a fat-burning machine.


    With hyperketonemia (ketogenic LC dieting, remember?), the body becomes a calorie-peeing machine. The
    ketones spilling into the urine are wasted calories.

    >


    >
    >
    > [...]
    >
    > Even more baffling is why there are still such enormous gaps in
    > knowledge about how humans respond to diet. The past 20 years have
    > seen obesity reach record levels in the developed world. This has
    > led scientists to concede that the standard advice on nutrition and
    > healthy eating has been an abject failure


    Not really. Scurvy and BeriBeri have been cured.

    > - yet the Atkins diet is
    > still dismissed as a "fad" by the British Dietetic Association, with
    > leading nutritionists insisting that there is insufficient
    > scientific evidence to give it more credence. This lack of evidence
    > has not deterred many in the medical profession from condemning the
    > diet out of hand. Last week a poll of British doctors revealed that
    > one in four would advise their patients to stay fat rather than try
    > the Atkins diet - despite the proven life-threatening effects of
    > obesity.


    If those were the only two choices, Atkins or stay obese, I would also recommend the latter. Thankfully,
    there is the AHA diet guidelines dovetailed with the 2PD approach.

    >
    >
    > Such attitudes might suggest that the scientific world is in the
    > grip of cognitive dissonance over the Atkins Diet, preferring to
    > ignore whatever evidence it does not like.


    might suggest.... however, most scientists are actually wary about the hyperketonemia. If hyperketonemia
    were a desirable condition, our bodies would not have glycogen stores (body starch) around to avoid it.

    > Professor Eric Westman, a
    > clinical trials expert at Duke University in North Carolina, and
    > author of a study of the evidence for and against the diet, says,
    > "It is making people re-examine dogma - and it's not always
    > appreciated."
    >
    > According to his review, which is due to appear in Current
    > Atherosclerosis Reports, studies show that the Atkins diet does
    > produce weight loss over six months, and without obvious health
    > effects.


    .... in 6 months.

    > Contrary to the claims of many nutritionists, there is even
    > evidence that it may be healthier than the standard diet: despite
    > its promotion of fat and eggs, studies suggest that the diet may
    > boost levels of the healthy forms of cholesterol.
    >


    not ime.

    >
    > Westman thinks that this unexpected effect may explain a long-
    > standing mystery surrounding heart disease. In the late 1980s,
    > researchers began investigating the unusually low rates of heart
    > attacks and stroke among Eskimo communities in Greenland. Until now,
    > the explanation was thought to lie in their diet of oily fish. Yet
    > attempts to reduce heart disease using supplements of fish oil
    > extracts proved disappointing.


    not ime and not according to the research.

    > Westman says the studies of the
    > Atkins diet point to another explanation: that the lo-carb diet
    > forced on the Inuit by their environment gives them higher levels of
    > healthy forms of cholesterol, which are proven to lower heart
    > disease risk.
    >


    Could be in the genes of the Inuit.

    >
    > Despite this, Westman cautions anyone with a medical condition
    > against rushing onto a low-carb diet. "The problem is that it works
    > too well," he explains. "The diet can cause insulin levels to drop
    > by 50 per cent in one day, so diabetics could find themselves over-
    > medicated. It's the same for those with high blood pressure."
    >


    Would be concerned about the hyperketonemia causing increased lipid peroxidation leading to higher amounts
    of oxidized LDL accelerating atherosclerosis.

    >
    > Even so, Westman believes that the results are impressive enough to
    > warrant an intensive research effort on the Atkins diet: "We're in a
    > period when we will learn a lot."
    >


    Why wasn't this done 30 years ago by Dr. Atkins?

    >
    > It is not a prospect that thrills the entire nutritional science
    > community. Westman has been vilified for conducting research with
    > financial support from the Atkins Foundation - despite the fact that
    > some vocal critics of the diet, such as Dr Susan Jebb, the head of
    > nutrition at the UK Medical Research Council, have, in turn,
    > received funding from bodies such as the Flour Advisory Bureau.
    >
    > Brehm has also run into resistance even over her research funded by
    > the American Heart Association.
    >
    > "We had a tough time getting our results published - it took 18
    > months altogether," she says. "The big journals really couldn't
    > handle it. But we're not endorsing the diet: it's just our
    > results.""
    >
    > But as someone already pointed out in another ng, the best paragraph in
    > the article is the last one:
    >
    > "Those already embarked on such research suspect that it will take a
    > great deal to overcome the visceral response the mere mention of
    > Atkins provokes among academics. Says Brehm: "A lot of people just
    > want to hold on to what they learned in college.""
    >
    > Now _that_ has been seen time after time after time also in LC
    > discussions in this ng ;-):
    >


    All it takes is long term safety data, Matti. Let me know when you find some.

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  4. Matti Narkia

    Matti Narkia Guest

    Thu, 23 Oct 2003 13:08:17 -0400 in article
    <[email protected]> "Dr. Andrew B. Chung, MD/PhD"
    <[email protected]> wrote:

    >Matti Narkia wrote:
    >>
    >> These results are in line with those found in similar small studies
    >> now starting to emerge. As well as backing the claims made for the
    >> Atkins diet, these latest results seem to further undermine standard
    >> nutritional advice about the need to focus on cutting fat and
    >> calories.
    >>

    >
    >The Atkins diet results in the latter so where is the undermining?
    >

    In the former.
    >>
    >>
    >> Conventional wisdom dictates that calories are the key to weight
    >> loss, and so those who lose weight must simply be consuming fewer
    >> calories than they burn up. Yet, according to Brehm, the obese
    >> people who lost weight on the Atkins diet ate and burned up
    >> essentially the same number of calories as those on the standard
    >> diet. What was very different was the proportion of body fat shed by
    >> each group, which mirrored their percentage weight loss. On the face
    >> of it, this backs the central claim of the Atkins diet: that a low-
    >> carb diet turns the body into a fat-burning machine.

    >
    >With hyperketonemia (ketogenic LC dieting, remember?), the body becomes a calorie-peeing machine. The
    >ketones spilling into the urine are wasted calories.
    >

    Ketosis in adults can be prevented by a daily carbohydrate intake of about
    50 g.
    >
    >> - yet the Atkins diet is
    >> still dismissed as a "fad" by the British Dietetic Association, with
    >> leading nutritionists insisting that there is insufficient
    >> scientific evidence to give it more credence. This lack of evidence
    >> has not deterred many in the medical profession from condemning the
    >> diet out of hand. Last week a poll of British doctors revealed that
    >> one in four would advise their patients to stay fat rather than try
    >> the Atkins diet - despite the proven life-threatening effects of
    >> obesity.

    >
    >If those were the only two choices, Atkins or stay obese, I would also recommend the latter.
    >

    It's up to you to decide how you want commit a professional suicide.
    >>
    >>
    >> Such attitudes might suggest that the scientific world is in the
    >> grip of cognitive dissonance over the Atkins Diet, preferring to
    >> ignore whatever evidence it does not like.

    >
    >might suggest.... however, most scientists are actually wary about the hyperketonemia.


    In the context of LC diet? Name two. References?
    >
    >... in 6 months.
    >
    >> Contrary to the claims of many nutritionists, there is even
    >> evidence that it may be healthier than the standard diet: despite
    >> its promotion of fat and eggs, studies suggest that the diet may
    >> boost levels of the healthy forms of cholesterol.

    >
    >not ime.
    >

    It's been show in trials. Trials against your "experience" in LC, hmmm...
    >>
    >> Westman thinks that this unexpected effect may explain a long-
    >> standing mystery surrounding heart disease. In the late 1980s,
    >> researchers began investigating the unusually low rates of heart
    >> attacks and stroke among Eskimo communities in Greenland. Until now,
    >> the explanation was thought to lie in their diet of oily fish. Yet
    >> attempts to reduce heart disease using supplements of fish oil
    >> extracts proved disappointing.

    >
    >not ime and not according to the research.
    >

    Fish and fish oil significantly reduce sudden cardiac deaths by preventing
    arrhythmia. They don't do much to prevent heart attacks. That's been shown
    in trials. What is the research you mention? References?

    >> Westman says the studies of the
    >> Atkins diet point to another explanation: that the lo-carb diet
    >> forced on the Inuit by their environment gives them higher levels of
    >> healthy forms of cholesterol, which are proven to lower heart
    >> disease risk.
    >>

    >Could be in the genes of the Inuit.
    >

    Could be, but that's highly speculative. Westman speculates as well, but his
    speculation is supported by LC diet trials, which have shown LC diet to
    raise HDL.
    >>
    >> Despite this, Westman cautions anyone with a medical condition
    >> against rushing onto a low-carb diet. "The problem is that it works
    >> too well," he explains. "The diet can cause insulin levels to drop
    >> by 50 per cent in one day, so diabetics could find themselves over-
    >> medicated. It's the same for those with high blood pressure."

    >
    >Would be concerned about the hyperketonemia causing increased lipid peroxidation leading to higher amounts
    >of oxidized LDL accelerating atherosclerosis.
    >

    Ketosis in adults can be prevented by a daily carbohydrate intake of about
    50 g.
    >>
    >> Even so, Westman believes that the results are impressive enough to
    >> warrant an intensive research effort on the Atkins diet: "We're in a
    >> period when we will learn a lot."

    >
    >Why wasn't this done 30 years ago by Dr. Atkins?
    >

    You should have asked that from Dr. Atkins when he was still alive. There
    were some LC diet studies already in 70s, I've posted them here, with
    similar results than the newest studies. So it seems that Atkins had
    something to base his diet on.

    --
    Matti Narkia
     
  5. Matti Narkia wrote:

    > Thu, 23 Oct 2003 13:08:17 -0400 in article
    > <[email protected]> "Dr. Andrew B. Chung, MD/PhD"
    > <[email protected]> wrote:
    >
    > >Matti Narkia wrote:
    > >>
    > >> These results are in line with those found in similar small studies
    > >> now starting to emerge. As well as backing the claims made for the
    > >> Atkins diet, these latest results seem to further undermine standard
    > >> nutritional advice about the need to focus on cutting fat and
    > >> calories.
    > >>

    > >
    > >The Atkins diet results in the latter so where is the undermining?
    > >

    > In the former.
    > >>
    > >>
    > >> Conventional wisdom dictates that calories are the key to weight
    > >> loss, and so those who lose weight must simply be consuming fewer
    > >> calories than they burn up. Yet, according to Brehm, the obese
    > >> people who lost weight on the Atkins diet ate and burned up
    > >> essentially the same number of calories as those on the standard
    > >> diet. What was very different was the proportion of body fat shed by
    > >> each group, which mirrored their percentage weight loss. On the face
    > >> of it, this backs the central claim of the Atkins diet: that a low-
    > >> carb diet turns the body into a fat-burning machine.

    > >
    > >With hyperketonemia (ketogenic LC dieting, remember?), the body becomes a calorie-peeing machine. The
    > >ketones spilling into the urine are wasted calories.
    > >

    > Ketosis in adults can be prevented by a daily carbohydrate intake of about
    > 50 g.
    > >
    > >> - yet the Atkins diet is
    > >> still dismissed as a "fad" by the British Dietetic Association, with
    > >> leading nutritionists insisting that there is insufficient
    > >> scientific evidence to give it more credence. This lack of evidence
    > >> has not deterred many in the medical profession from condemning the
    > >> diet out of hand. Last week a poll of British doctors revealed that
    > >> one in four would advise their patients to stay fat rather than try
    > >> the Atkins diet - despite the proven life-threatening effects of
    > >> obesity.

    > >
    > >If those were the only two choices, Atkins or stay obese, I would also recommend the latter.
    > >

    > It's up to you to decide how you want commit a professional suicide.
    > >>
    > >>
    > >> Such attitudes might suggest that the scientific world is in the
    > >> grip of cognitive dissonance over the Atkins Diet, preferring to
    > >> ignore whatever evidence it does not like.

    > >
    > >might suggest.... however, most scientists are actually wary about the hyperketonemia.

    >
    > In the context of LC diet? Name two. References?
    > >
    > >... in 6 months.
    > >
    > >> Contrary to the claims of many nutritionists, there is even
    > >> evidence that it may be healthier than the standard diet: despite
    > >> its promotion of fat and eggs, studies suggest that the diet may
    > >> boost levels of the healthy forms of cholesterol.

    > >
    > >not ime.
    > >

    > It's been show in trials. Trials against your "experience" in LC, hmmm...
    > >>
    > >> Westman thinks that this unexpected effect may explain a long-
    > >> standing mystery surrounding heart disease. In the late 1980s,
    > >> researchers began investigating the unusually low rates of heart
    > >> attacks and stroke among Eskimo communities in Greenland. Until now,
    > >> the explanation was thought to lie in their diet of oily fish. Yet
    > >> attempts to reduce heart disease using supplements of fish oil
    > >> extracts proved disappointing.

    > >
    > >not ime and not according to the research.
    > >

    > Fish and fish oil significantly reduce sudden cardiac deaths by preventing
    > arrhythmia. They don't do much to prevent heart attacks. That's been shown
    > in trials. What is the research you mention? References?
    >
    > >> Westman says the studies of the
    > >> Atkins diet point to another explanation: that the lo-carb diet
    > >> forced on the Inuit by their environment gives them higher levels of
    > >> healthy forms of cholesterol, which are proven to lower heart
    > >> disease risk.
    > >>

    > >Could be in the genes of the Inuit.
    > >

    > Could be, but that's highly speculative. Westman speculates as well, but his
    > speculation is supported by LC diet trials, which have shown LC diet to
    > raise HDL.
    > >>
    > >> Despite this, Westman cautions anyone with a medical condition
    > >> against rushing onto a low-carb diet. "The problem is that it works
    > >> too well," he explains. "The diet can cause insulin levels to drop
    > >> by 50 per cent in one day, so diabetics could find themselves over-
    > >> medicated. It's the same for those with high blood pressure."

    > >
    > >Would be concerned about the hyperketonemia causing increased lipid peroxidation leading to higher amounts
    > >of oxidized LDL accelerating atherosclerosis.
    > >

    > Ketosis in adults can be prevented by a daily carbohydrate intake of about
    > 50 g.


    The accelerated weight loss would be similarly prevented.

    >
    > >>
    > >> Even so, Westman believes that the results are impressive enough to
    > >> warrant an intensive research effort on the Atkins diet: "We're in a
    > >> period when we will learn a lot."

    > >
    > >Why wasn't this done 30 years ago by Dr. Atkins?
    > >

    > You should have asked that from Dr. Atkins when he was still alive.


    You have to wonder about that and his deaths.

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  6. Matti Narkia

    Matti Narkia Guest

    Thu, 23 Oct 2003 14:24:35 -0400 in article <[email protected]>
    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote:

    >Matti Narkia wrote:
    >
    >> Ketosis in adults can be prevented by a daily carbohydrate intake of about
    >> 50 g.

    >
    >The accelerated weight loss would be similarly prevented.
    >

    Not so. Foster et al found that

    "There was no significant relation between weight loss and ketosis at
    any time during the study"

    See

    http://content.nejm.org/cgi/content/full/348/21/2082

    --
    Matti Narkia
     
  7. M_un Shot

    M_un Shot Guest

  8. Matti Narkia wrote:

    > Thu, 23 Oct 2003 14:24:35 -0400 in article <[email protected]>
    > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote:
    >
    > >Matti Narkia wrote:
    > >
    > >> Ketosis in adults can be prevented by a daily carbohydrate intake of about
    > >> 50 g.

    > >
    > >The accelerated weight loss would be similarly prevented.
    > >

    > Not so. Foster et al found that
    >
    > "There was no significant relation between weight loss and ketosis at
    > any time during the study"
    >


    However, closer inspection of the data reveals that less ketosis after 3 months
    was associated with weight regain by 12 months.

    >
    > See
    >
    > http://content.nejm.org/cgi/content/full/348/21/2082
    >


    Yes, please do.

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com
     
  9. Matti Narkia

    Matti Narkia Guest

    Fri, 24 Oct 2003 03:22:45 GMT in article
    <[email protected]> "Dr. Andrew B. Chung,
    MD/PhD" <[email protected]> wrote:

    >Matti Narkia wrote:
    >
    >> Thu, 23 Oct 2003 14:24:35 -0400 in article <[email protected]>
    >> "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote:
    >>
    >> >Matti Narkia wrote:
    >> >
    >> >> Ketosis in adults can be prevented by a daily carbohydrate intake of about
    >> >> 50 g.
    >> >
    >> >The accelerated weight loss would be similarly prevented.
    >> >

    >> Not so. Foster et al found that
    >>
    >> "There was no significant relation between weight loss and ketosis at
    >> any time during the study"
    >>

    >
    >However, closer inspection of the data reveals that less ketosis after 3 months
    >was associated with weight regain by 12 months.
    >

    It shows no such thing. In the Figure 2. of Foster et al the percentage of
    subjects with a positive urinary ketone concentration is constant from the
    20th week to the 52nd week, yet at the same time (from about week 26) the
    weight kept rising, i.e. there is no relation between less ketosis and
    weight gain. Also the authors write:

    "Our data suggest that ketosis was unlikely to be responsible for the
    increased weight loss with the low-carbohydrate diet, since we did not
    find any relation between the presence of urinary ketones and weight
    loss. Furthermore, urinary ketones were not present in most subjects on
    either diet after the first six months."

    If there was no association between urinary ketones and weight loss, why
    would there be an association between less ketosis and weight gain? If there
    were a linear relation on the negative weight loss (= weight gain) side it
    would continue to the positive weight loss side, wouldn't it. Well, it
    doesn't as the quote above and Figure 2 show. Besides, the control group
    regained weight as well after six months. Was that in your opinion also
    because of less ketosis in the control group? I don't think so.

    I think that weight regain in both groups was associated with a slipping
    diet control, i.e. they were consuming more calories. In absolute terms LC
    group regained more, because they did not have calorie restriction even in
    the beginning: they were allowed to consume fat and protein ad libitum. The
    control group did have calorie restriction, but may be that was slightly
    slipping in the end.


    --
    Matti Narkia
     
  10. Susan

    Susan Guest

    x-no-archive: yes

    >Our data suggest that ketosis was unlikely to be responsible for the
    > increased weight loss with the low-carbohydrate diet, since we did not
    > find any relation between the presence of urinary ketones and weight
    > loss.


    Okay, but measurable ketonuria isn't necessary for one to be in ketosis.

    Susan
     
  11. Matti Narkia wrote:

    > Fri, 24 Oct 2003 03:22:45 GMT in article
    > <[email protected]> "Dr. Andrew B. Chung,
    > MD/PhD" <[email protected]> wrote:
    >
    > >Matti Narkia wrote:
    > >
    > >> Thu, 23 Oct 2003 14:24:35 -0400 in article <[email protected]>
    > >> "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote:
    > >>
    > >> >Matti Narkia wrote:
    > >> >
    > >> >> Ketosis in adults can be prevented by a daily carbohydrate intake of about
    > >> >> 50 g.
    > >> >
    > >> >The accelerated weight loss would be similarly prevented.
    > >> >
    > >> Not so. Foster et al found that
    > >>
    > >> "There was no significant relation between weight loss and ketosis at
    > >> any time during the study"
    > >>

    > >
    > >However, closer inspection of the data reveals that less ketosis after 3 months
    > >was associated with weight regain by 12 months.
    > >

    > It shows no such thing.


    Really?

    > In the Figure 2. of Foster et al the percentage of
    > subjects with a positive urinary ketone concentration is constant from the
    > 20th week to the 52nd week,


    Yes, constantly *less* than the previous 20 weeks.

    > yet at the same time (from about week 26) the
    > weight kept rising,


    Yes.

    > i.e. there is no relation between less ketosis and
    > weight gain.


    The relation is *less* hyperketonemia and "weight kept rising."

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  12. Matti Narkia

    Matti Narkia Guest

    24 Oct 2003 15:37:30 GMT in article
    <[email protected]> [email protected]ospam (Susan )
    wrote:

    >x-no-archive: yes
    >
    >>Our data suggest that ketosis was unlikely to be responsible for the
    >> increased weight loss with the low-carbohydrate diet, since we did not
    >> find any relation between the presence of urinary ketones and weight
    >> loss.

    >
    >Okay, but measurable ketonuria isn't necessary for one to be in ketosis.
    >

    If there is no ketonuria, the _potential_ ketosis, if there is any, is not
    likely to be so severe, that it would be a reason for concern, is it?

    --
    Matti Narkia
     
  13. Susan

    Susan Guest

    x-no-archive: yes

    >If there is no ketonuria, the _potential_ ketosis, if there is any, is not
    >likely to be so severe, that it would be a reason for concern, is it?
    >
    >--
    >Matti Narkia


    First, many Atkins induction dieters are in deep ketosis with zero to only
    trace ketones in their urine. This may be because they're burning the ketones
    for fuel efficiently and not overeating dietary fat, from which ketones would
    also show up in urine during very low carb. Heavy water drinking can also
    dilute them to unmeasurable levels.

    The premise that there is no ketosis after three months on 50gms per day is
    bogus.

    Second, I'm of the belief that dietary ketosis is of zero concern. The body
    uses this fuel quite nicely, thanks.

    Susan
     
  14. Matti Narkia

    Matti Narkia Guest

    24 Oct 2003 16:53:44 GMT in article
    <[email protected]> [email protected]ospam (Susan )
    wrote:
    >
    >>If there is no ketonuria, the _potential_ ketosis, if there is any, is not
    >>likely to be so severe, that it would be a reason for concern, is it?

    >
    >First, many Atkins induction dieters are in deep ketosis with zero to only
    >trace ketones in their urine. This may be because they're burning the ketones
    >for fuel efficiently and not overeating dietary fat, from which ketones would
    >also show up in urine during very low carb. Heavy water drinking can also
    >dilute them to unmeasurable levels.
    >

    That's interesting, if true. Surely there must, however, be a correlation
    between the ketosis level and urinary ketosis? Do you have any references
    about the points you made?

    >The premise that there is no ketosis after three months on 50gms per day is
    >bogus.
    >

    However, that's what Westman claims in his correspondence article

    Westman EC.
    Is dietary carbohydrate essential for human nutrition?
    Am J Clin Nutr. 2002 May;75(5):951-3
    http://www.ajcn.org/cgi/content/full/75/5/951-a

    by writing:

    "Data in childhood are unavailable, but ketosis in adults can be
    prevented by a daily CHO intake of about 50 g."

    As for the three months, Foster et al claim in their study

    A Randomized Trial of a Low-Carbohydrate Diet for Obesity
    http://content.nejm.org/cgi/content/full/348/21/2082

    that

    "During the first three months, the percentage of patients who tested
    positive for urinary ketones was significantly greater in the group on
    the low-carbohydrate diet than in the group on the conventional diet
    (Figure 2), but there were no significant differences between the
    groups after three months."

    But then again _you_ claimed that urinary ketones are not reliable indicator
    of ketosis. Would be really interesting to get some references about that.

    >Second, I'm of the belief that dietary ketosis is of zero concern. The body
    >uses this fuel quite nicely, thanks.
    >

    I share your belief, but I haven't had any references yet to prove it. Do
    you happen to have any?

    --
    Matti Narkia
     
  15. Matti Narkia wrote:

    > <snip>Second, I'm of the belief that dietary ketosis is of zero concern. The
    > body
    > >uses this fuel quite nicely, thanks.
    > >

    > I share your belief, but I haven't had any references yet to prove it. Do
    > you happen to have any?


    Don't you believe that the late Dr. Atkins would have produced some references to
    research that squelch safety concerns about hyperketonemia if there were any such
    research?

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  16. Susan

    Susan Guest

    x-no-archive: yes

    >That's interesting, if true. Surely there must, however, be a correlation
    >between the ketosis level and urinary ketosis? Do you have any references
    >about the points you made?


    I don't have references, it's been so many years since I read up on this stuff.
    Others at alt.support.diet.low-carb might.

    It isn't too hard to imagine one burning off ketones for fuel and not having
    significant ketonuria as a result, especially when one is drinking at least two
    quarts or more of water per day, as most low carbers aim to do.


    >But then again _you_ claimed that urinary ketones are not reliable indicator
    >of ketosis. Would be really interesting to get some references about that.


    Perhaps it's in Protein Power by the Eades?

    >I share your belief, but I haven't had any references yet to prove it. Do
    >you happen to have any?
    >
    >--
    >Matti Narkia


    Sorry, I don't have any saved, and I don't feel like it's even an important
    point to cover. To debate Chung? Nuh uh, why bother?

    I'd check Lyle's book for you, but I'm in temp quarters and it's in storage.
    You can find him online (google him up, he's active on usenet) and ask him.
    He's encyclopedic on ketogenics.

    Susan
     
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