Low-glycemic-load diets: impact on obesity and chronic diseases



M

Matti Narkia

Guest
In the abstract of the review article

Bell SJ, Sears B.
Low-glycemic-load diets: impact on obesity and chronic diseases.
Crit Rev Food Sci Nutr. 2003;43(4):357-77.
PMID: 12940416 [PubMed - in process]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12940416&dopt=Abstract>

Bell et al write:

"Historically, carbohydrates have been thought to play only a minor
role in promoting weight gain and in predicting the risk of
development of chronic disease. Most of the focus had been on
reducing total dietary fat. During the last 20 years, fat intake
decreased, while the number of individuals who were overweight or
developed a chronic conditions have dramatically increased.
Simultaneously, the calories coming from carbohydrate have also
increased. Carbohydrates can be classified by their post-prandial
glycemic effect, called the glycemic index or glycemic load.
Carbohydrates with high glycemic indexes and high glycemic loads
produce substantial increases in blood glucose and insulin levels
after ingestion. Within a few hours after their consumption, blood
sugar levels begin to decline rapidly due to an exaggerated increase
in insulin secretion. A profound state of hunger is created. The
continued intake of high-glycemic load meals is associated with an
increased risk of chronic diseases such as obesity, cardiovascular
disease, and diabetes. In this review, the terms glycemic index and
glycemic load are defined, coupled with an overview of short- and
long-term changes that occur from eating diets of different glycemic
indexes and glycemic loads. Finally, practical strategies for how to
design low-glycemic-load diets consisting primarily of low-glycemic
carbohydrates are provided."

--
Matti Narkia
 
In article <[email protected]>,
Matti Narkia <[email protected]> wrote:

> In the abstract of the review article
>
> Bell SJ, Sears B.
> Low-glycemic-load diets: impact on obesity and chronic diseases.


Matti, I'd like to thank you for all the research posts you've made
lately. I realize it takes quite a bit of time and effort to cull
through all that stuff and you should know that it's greatly
appreciated.

I feel as though I've been blazing my own trail with respect to low
carbing when I hear and read all the mainstream medical literature
saying I should be eating much more carbs than I do. Prior to Feb. of
this year I followed a low-fat diet for practically my entire adult life
(hard as hell to loose any weight unless I went sub-1000 cal/day). My
history was the perfect yo-yo syndrom of weight gain and loss.

In February I turned over a new tree and decided the low-fat route
wasn't working for me (especially the incident with the blockage in my
right coronary artery) and chose to try low-carb. I'm totally sold on
it. My blood work has improved substantially (though I never crossed
into the treatment line); with my 25 lb. weight loss my blood pressure
is generally under115/75. To top it off, I don't feel hungry. I don't
feel like I'm depriving myself. And I do allow a bit of ice cream or
somesuch about once a week. In the back of my little pea brain, I know
that if I allow "normal" (as in medical establishment recommended)
quantities of sugar and hi-carb foods back in my life on any kind of
daily basis I'll be back to the old weight struggle all over again.

Your posts have added quite a bit of support and backing to what I've
experienced the past 8 months. Thank you again.
 
Owen Lowe <[email protected]> wrote in message news:<[email protected]>...
> In article <[email protected]>,
> Matti Narkia <[email protected]> wrote:
>
> > In the abstract of the review article
> >
> > Bell SJ, Sears B.
> > Low-glycemic-load diets: impact on obesity and chronic diseases.
>
>
> Matti, I'd like to thank you for all the research posts you've made
> lately. I realize it takes quite a bit of time and effort to cull
> through all that stuff and you should know that it's greatly
> appreciated.
>
> I feel as though I've been blazing my own trail with respect to low
> carbing when I hear and read all the mainstream medical literature
> saying I should be eating much more carbs than I do. Prior to Feb. of
> this year I followed a low-fat diet for practically my entire adult life
> (hard as hell to loose any weight unless I went sub-1000 cal/day). My
> history was the perfect yo-yo syndrom of weight gain and loss.

Had you ever tried the 2PD approach as described at
http://www.heartmdphd.com/wtloss.asp ?

> In February I turned over a new tree and decided the low-fat route
> wasn't working for me (especially the incident with the blockage in my
> right coronary artery) and chose to try low-carb. I'm totally sold on
> it. My blood work has improved substantially (though I never crossed
> into the treatment line); with my 25 lb. weight loss my blood pressure
> is generally under115/75. To top it off, I don't feel hungry. I don't
> feel like I'm depriving myself. And I do allow a bit of ice cream or
> somesuch about once a week. In the back of my little pea brain, I know
> that if I allow "normal" (as in medical establishment recommended)
> quantities of sugar and hi-carb foods back in my life on any kind of
> daily basis I'll be back to the old weight struggle all over again.

Not if you limit the quantity of food (ie 2PD approach).

> Your posts have added quite a bit of support and backing to what I've
> experienced the past 8 months. Thank you again.

Would suggest you ask your doctor about the concerns regarding
hyperketonemia causing lipid peroxidation. Oxidized LDL likely will
accelerate the atherosclerosis that you already have in your coronary
arteries.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com
 
In article <[email protected]>,
[email protected] (Dr. Andrew B. Chung, MD/PhD) wrote:

> See:
>
> http://tinyurl.com/rz25

Link above is to American Heart Association Statement on High-Protein,
Low-Carbohydrate Diet Study Presented at Scientific Sessions with my
comments thrown between their concerns:

> The study is very small, with only 120 total participants and just 60 on the
> high-fat, low carbohydrate diet.

The AHA seems to have a problem defining whether they are commenting on
a high-protein or a high-fat diet...

> This is a short-term study, following participants for just 6 months. There
> is no evidence provided by this study that the weight loss produced could be
> maintained long term.

Their concerns apply to any diet if the person goes back to eating as
they did prior to changing their habits. This seems to be a no-brainer
to me, but I guess makes sense to them. I got fat, and out of shape on a
low-fat, high-carb diet. If I go back to that eating regime I'm sure I'd
gain once again.

> There is no evidence provided by the study that the diet is effective long
> term in improving health.

Maybe not, but I developed a coronary blockage on the "other" way of
eating. If high protein, low carb does better that's great; if not then
I guess I'm not in much worse shape than prior to the diet change.

> A high intake of saturated fats over time raises great concern about
> increased cardiovascular risk ­ the study did not follow participants long
> enough to evaluate this.

First off, I'm not eating a high level of saturated fat. I eat plenty of
meats and protein in general, but it's all low in sat fat. I'm fairly
certain my intake is half or 3/4 of the 10 g. the medical community
advises. So far my lipid panels have improved. It'd be hard to believe
that improvements would be detrimental. Am I to believe that my health
is worse off now on this diet at 25 pounds lighter, better blood
pressure, better lipid tests than it was 9 months ago leading up to my
blockage?

> This study did not actually compare the Atkins diet with the current AHA
> dietary recommendations.

Nothing to say with this one.

I'm curious about one thing. Whomever is promoting/advising/prescribing
a diet, it seems they believe that their single diet will serve all
people with equal success. Is it not possible that the variability of
humans would lead to a variety of diets that work equally well with
different people?
 
Owen Lowe wrote:

> In article <[email protected]>,
> [email protected] (Dr. Andrew B. Chung, MD/PhD) wrote:
>
> > See:
> >
> > http://tinyurl.com/rz25
>
> Link above is to American Heart Association Statement on High-Protein,
> Low-Carbohydrate Diet Study Presented at Scientific Sessions with my
> comments thrown between their concerns:
>
> > The study is very small, with only 120 total participants and just 60 on the
> > high-fat, low carbohydrate diet.
>
> The AHA seems to have a problem defining whether they are commenting on
> a high-protein or a high-fat diet...
>
> > This is a short-term study, following participants for just 6 months. There
> > is no evidence provided by this study that the weight loss produced could be
> > maintained long term.
>
> Their concerns apply to any diet if the person goes back to eating as
> they did prior to changing their habits. This seems to be a no-brainer
> to me, but I guess makes sense to them. I got fat, and out of shape on a
> low-fat, high-carb diet. If I go back to that eating regime I'm sure I'd
> gain once again.
>
> > There is no evidence provided by the study that the diet is effective long
> > term in improving health.
>
> Maybe not, but I developed a coronary blockage on the "other" way of
> eating.

From your comments, it sounds like you problem was with the amount of food and not
the kinds of food (i.e. you gained weight).

> If high protein, low carb does better that's great; if not then
> I guess I'm not in much worse shape than prior to the diet change.
>

Except for the hyperketonemia (and possible hyperhomocysteinemia).

>
> > A high intake of saturated fats over time raises great concern about
> > increased cardiovascular risk ­ the study did not follow participants long
> > enough to evaluate this.
>
> First off, I'm not eating a high level of saturated fat.

Good for you.

> I eat plenty of
> meats and protein in general, but it's all low in sat fat. I'm fairly
> certain my intake is half or 3/4 of the 10 g. the medical community
> advises. So far my lipid panels have improved. It'd be hard to believe
> that improvements would be detrimental.

Oxidized lipids from hyperketonemia could be. The concern remains that your
lipids are lower because they are being oxidized and deposited into your arteries.

> Am I to believe that my health
> is worse off now on this diet at 25 pounds lighter, better blood
> pressure, better lipid tests than it was 9 months ago leading up to my
> blockage?
>

It is possible. Time will tell.

>
> > This study did not actually compare the Atkins diet with the current AHA
> > dietary recommendations.
>
> Nothing to say with this one.
>
> I'm curious about one thing. Whomever is promoting/advising/prescribing
> a diet, it seems they believe that their single diet will serve all
> people with equal success. Is it not possible that the variability of
> humans would lead to a variety of diets that work equally well with
> different people?

The 2PD approach for weight loss seems to work equally well with different people,
ime.

http://www.heartmdphd.com/wtloss.asp

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/
 
Thu, 23 Oct 2003 13:57:38 -0400 in article
<[email protected]> "Dr. Andrew B. Chung, MD/PhD"
<[email protected]> wrote:

>Owen Lowe wrote:
>
>> If high protein, low carb does better that's great; if not then
>> I guess I'm not in much worse shape than prior to the diet change.
>>
>
>Except for the hyperketonemia (and possible hyperhomocysteinemia).
>
Ketosis in adults can be prevented by a daily carbohydrate intake of about
50 g. Hyperhomocysteinemia can in most cases be prevented by taking folic
acid supplements. Vitamins B6 and B12, and TMG could also be helpful.

--
Matti Narkia
 
On Wed, 22 Oct 2003 22:51:50 -0700, Owen Lowe <[email protected]>
wrote:


> I got fat, and out of shape on a
>low-fat, high-carb diet.

your diet had absolutely nothing to do with your lack of fitness and
you got fat because you overate regardless of the macronutrient
content.

> If I go back to that eating regime I'm sure I'd
>gain once again.

Guaranteed. Overconsumption will do that every time.

>> There is no evidence provided by the study that the diet is effective long
>> term in improving health.
>
>Maybe not, but I developed a coronary blockage on the "other" way of
>eating.

What evidence to you have that your choice of diets (which led to your
obesity thru overeating on it) had anything to do with your blockage?

>I'm curious about one thing. Whomever is promoting/advising/prescribing
>a diet, it seems they believe that their single diet will serve all
>people with equal success.

That has been my experience with the 2PDiet.

> Is it not possible that the variability of
>humans would lead to a variety of diets that work equally well with
>different people?

Don't care. Found the one that already does this.

http://antwrp.gsfc.nasa.gov/apod/ap031018.html
Lift well, Eat less, Walk fast, Live long.
 
Matti Narkia wrote:

> Thu, 23 Oct 2003 13:57:38 -0400 in article
> <[email protected]> "Dr. Andrew B. Chung, MD/PhD"
> <[email protected]> wrote:
>
> >Owen Lowe wrote:
> >
> >> If high protein, low carb does better that's great; if not then
> >> I guess I'm not in much worse shape than prior to the diet change.
> >>
> >
> >Except for the hyperketonemia (and possible hyperhomocysteinemia).
> >
> Ketosis in adults can be prevented by a daily carbohydrate intake of about
> 50 g. Hyperhomocysteinemia can in most cases be prevented by taking folic
> acid supplements. Vitamins B6 and B12, and TMG could also be helpful.

Glad that you are finally acknowledging the concerns.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/
 
Thu, 23 Oct 2003 14:29:41 -0400 in article
<[email protected]> "Dr. Andrew B. Chung, MD/PhD"
<[email protected]> wrote:

>Matti Narkia wrote:
>
>> Thu, 23 Oct 2003 13:57:38 -0400 in article
>> <[email protected]> "Dr. Andrew B. Chung, MD/PhD"
>> <[email protected]> wrote:
>>
>> >Owen Lowe wrote:
>> >
>> >> If high protein, low carb does better that's great; if not then
>> >> I guess I'm not in much worse shape than prior to the diet change.
>> >>
>> >
>> >Except for the hyperketonemia (and possible hyperhomocysteinemia).
>> >
>> Ketosis in adults can be prevented by a daily carbohydrate intake of about
>> 50 g. Hyperhomocysteinemia can in most cases be prevented by taking folic
>> acid supplements. Vitamins B6 and B12, and TMG could also be helpful.
>
>Glad that you are finally acknowledging the concerns.
>
That's not a specific concern for LC diets. IMHO according to some studies
from recent years, it's probably sensible to take some supplements as
precautionary measure regardless of your diet. Folic acid is one of them.


--
Matti Narkia
 
Matti Narkia <[email protected]> wrote in message news:<[email protected]>...
> Thu, 23 Oct 2003 14:29:41 -0400 in article
> <[email protected]> "Dr. Andrew B. Chung, MD/PhD"
> <[email protected]> wrote:
>
> >Matti Narkia wrote:
> >
> >> Thu, 23 Oct 2003 13:57:38 -0400 in article
> >> <[email protected]> "Dr. Andrew B. Chung, MD/PhD"
> >> <[email protected]> wrote:
> >>
> >> >Owen Lowe wrote:
> >> >
> >> >> If high protein, low carb does better that's great; if not then
> >> >> I guess I'm not in much worse shape than prior to the diet change.
> >> >>
> >> >
> >> >Except for the hyperketonemia (and possible hyperhomocysteinemia).
> >> >
> >> Ketosis in adults can be prevented by a daily carbohydrate intake of about
> >> 50 g. Hyperhomocysteinemia can in most cases be prevented by taking folic
> >> acid supplements. Vitamins B6 and B12, and TMG could also be helpful.
> >
> >Glad that you are finally acknowledging the concerns.
> >
> That's not a specific concern for LC diets.

The former is a specific concern of high-fat (and low-carb) diets. The
latter a specific concern of high-protein (also low-carb) diets.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com
 
23 Oct 2003 13:54:34 -0700 in article
<[email protected]> [email protected] (Dr.
Andrew B. Chung, MD/PhD) wrote:

>Matti Narkia <[email protected]> wrote in message news:<[email protected]>...
>> Thu, 23 Oct 2003 14:29:41 -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. Hyperhomocysteinemia can in most cases be prevented by taking folic
>> >> acid supplements. Vitamins B6 and B12, and TMG could also be helpful.
>> >
>> >Glad that you are finally acknowledging the concerns.
>> >
>> That's not a specific concern for LC diets.
>
>The former is a specific concern of high-fat (and low-carb) diets.

The ketosis may occur, if daily carbohydrate intake is below 50 g, quite a
low amount. Whether ketosis in LC diet is a reason for concern is
disputable.

>The latter a specific concern of high-protein (also low-carb) diets.
>
You cannot say that unequivocally. Food items with highest folate contents
are liver products, which are high protein foods. Another very high folate
food is yeast, which also relatively high in protein. Soy powder is also
high in folate (it has more folate than any green vegetables) _and_ _very_
high in protein.

Having said that, folate needs may be higher than generally assumed, at
least for some individuals, so it's good to take precaution, IMHO.


--
Matti Narkia
 
"Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in part:

>> If high protein, low carb does better that's great; if not then
>> I guess I'm not in much worse shape than prior to the diet change.
>>
>
>Except for the hyperketonemia (and possible hyperhomocysteinemia).

I believe all the published studies show a negative association between %
calories from protein and level of homocysteine... But it's possible...
--
Jim Chinnis Warrenton, Virginia, USA
 
"Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in part:

>> I eat plenty of
>> meats and protein in general, but it's all low in sat fat. I'm fairly
>> certain my intake is half or 3/4 of the 10 g. the medical community
>> advises. So far my lipid panels have improved. It'd be hard to believe
>> that improvements would be detrimental.
>
>Oxidized lipids from hyperketonemia could be. The concern remains that your
>lipids are lower because they are being oxidized and deposited into your arteries.

If he's eating plenty of protein, how is hyperketonemia likely?

And are you serious that his "lipids are are lower because they are being
oxidized and deposited into [his] arteries"?! I don't have time now, but if no
one beats me to it, I'll calculate how much deposition that implies (lipid
mass) over time...
--
Jim Chinnis Warrenton, Virginia, USA
 
Jim Chinnis wrote:

> "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in part:
>
> >> I eat plenty of
> >> meats and protein in general, but it's all low in sat fat. I'm fairly
> >> certain my intake is half or 3/4 of the 10 g. the medical community
> >> advises. So far my lipid panels have improved. It'd be hard to believe
> >> that improvements would be detrimental.
> >
> >Oxidized lipids from hyperketonemia could be. The concern remains that your
> >lipids are lower because they are being oxidized and deposited into your arteries.
>
> If he's eating plenty of protein, how is hyperketonemia likely?
>

It is still possible if he is eating lots of fat (albeit unsaturated) and is
hypocaloric (ie burning fat stores).

>
> And are you serious that his "lipids are are lower because they are being
> oxidized and deposited into [his] arteries"?!

They might be.

> I don't have time now, but if no
> one beats me to it, I'll calculate how much deposition that implies (lipid
> mass) over time...

Ever seen a "shaggy" aorta? Lots of cholesterol deposition can occur in the arterial
vasculature. Good luck on the calculation without knowing the rates of production nor
the rates of the other "sinks."

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com
 
In article <[email protected]>,
M_un Shot <[email protected]> wrote:

> >Maybe not, but I developed a coronary blockage on the "other" way of
> >eating.
>
> What evidence to you have that your choice of diets (which led to your
> obesity thru overeating on it) had anything to do with your blockage?

AHA! With your comment in mind, what drives the mainstream notion that
low-carb will lead to people keeling over right and left while a
high-carb diet won't? Studies certainly aren't showing that to be the
case.

> >I'm curious about one thing. Whomever is promoting/advising/prescribing
> >a diet, it seems they believe that their single diet will serve all
> >people with equal success.
>
> That has been my experience with the 2PDiet.

A controlled study group of 1? How long have you been on it? What
happens if next week you decide to eat 2.25 lbs and begin gaining weight
- has the diet failed you? Or perhaps did *you* fail the diet - as is
the case with, I dare say, *all* diet failures.

> > Is it not possible that the variability of
> >humans would lead to a variety of diets that work equally well with
> >different people?
>
> Don't care. Found the one that already does this.

Good for you. I've found one that works for me. Isn't the world a grand
place when we can choose among food options and pick the one that suits
our fitness goal, lifestyle, tastes, budget and satiety?
 
In article <[email protected]>,
"Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote:

> > If he's eating plenty of protein, how is hyperketonemia likely?
> >
>
> It is still possible if he is eating lots of fat (albeit unsaturated) and is
> hypocaloric (ie burning fat stores).

The fat burning would stop however once the desired weight loss was
achieved.
 

>> What evidence to you have that your choice of diets (which led to your
>> obesity thru overeating on it) had anything to do with your blockage?

On Thu, 23 Oct 2003 22:12:01 -0700, Owen Lowe <[email protected]>
wrote:

>AHA! With your comment in mind, what drives the mainstream notion that
>low-carb will lead to people keeling over right and left while a
>high-carb diet won't?

Beats me; I never said that. Again I ask you, without dodging the
question this time, what evidence to you have that your choice of
diets (which led to your obesity thru overeating on it) had anything
to do with your blockage?

>> >I'm curious about one thing. Whomever is promoting/advising/prescribing
>> >a diet, it seems they believe that their single diet will serve all
>> >people with equal success.
>>
>> That has been my experience with the 2PDiet.
>
>A controlled study group of 1?

Incorrect.

> How long have you been on it?

18 months. See how easy it is to answer a question?

>What
>happens if next week you decide to eat 2.25 lbs and begin gaining weight
>- has the diet failed you?

..25 "extra" pounds for one week will not produce any weight gain. Been
there, done that. See how easy it is to answer a question?

>Or perhaps did *you* fail the diet - as is
>the case with, I dare say, *all* diet failures.

I haven't failed the diet, the diet has not failed me. See how easy
it is to answer a question?

>> > Is it not possible that the variability of
>> >humans would lead to a variety of diets that work equally well with
>> >different people?
>>
>> Don't care. Found the one that already does this.
>
>Good for you. I've found one that works for me.

What exactly is that? Length of time, how much sat fats are you
eating, volume by weight, etc.

> Isn't the world a grand
>place when we can choose among food options and pick the one that suits
>our fitness goal, lifestyle, tastes, budget and satiety?

Be certain that you aren't living in a deluded world. See how easy it
is to answer a question?

http://antwrp.gsfc.nasa.gov/apod/ap031021.html
Lift well, Eat less, Walk fast, Live long.
 
Matti Narkia wrote:

> Thu, 23 Oct 2003 14:29:41 -0400 in article
> <[email protected]> "Dr. Andrew B. Chung, MD/PhD"
> <[email protected]> wrote:
>
> >Matti Narkia wrote:
> >
> >> Thu, 23 Oct 2003 13:57:38 -0400 in article
> >> <[email protected]> "Dr. Andrew B. Chung, MD/PhD"
> >> <[email protected]> wrote:
> >>
> >> >Owen Lowe wrote:
> >> >
> >> >> If high protein, low carb does better that's great; if not then
> >> >> I guess I'm not in much worse shape than prior to the diet change.
> >> >>
> >> >
> >> >Except for the hyperketonemia (and possible hyperhomocysteinemia).
> >> >
> >> Ketosis in adults can be prevented by a daily carbohydrate intake of about
> >> 50 g. Hyperhomocysteinemia can in most cases be prevented by taking folic
> >> acid supplements. Vitamins B6 and B12, and TMG could also be helpful.
> >
> >Glad that you are finally acknowledging the concerns.
> >
> That's not a specific concern for LC diets.

Low fat/chol (higher carbs) diet would have neither concern.

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