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Moderate carbohydrate intake may be best for health, study suggests
kshama2001
Posts: 27,881 Member
in Debate Club
Thoughts?
https://www.sciencedaily.com/releases/2018/08/180817093812.htm
Date: August 17, 2018
Source: The Lancet
Summary:
A new study has found that diets both low and high in carbohydrates were linked with an increase in mortality, while moderate consumers of carbohydrates had the lowest risk of mortality. The study also found that low-carb diets that replace carbohydrates with proteins and fats from plant sources were associated with lower risk of mortality compared to those that replace carbohydrates with proteins and fat from animal sources.
The observational study of more than 15,400 people from the Atherosclerosis Risk in Communities Study (ARIC) in the USA found that diets both low (< 40% energy) and high (>70% energy) in carbohydrates were linked with an increase in mortality, while moderate consumers of carbohydrates (50-55% of energy) had the lowest risk of mortality.
The primary findings, confirmed in a meta-analysis of studies on carbohydrate intake including more than 432,000 people from over 20 countries, also suggest that not all low-carbohydrate diets appear equal -- eating more animal-based proteins and fats from foods like beef, lamb, pork, chicken and cheese instead of carbohydrate was associated with a greater risk of mortality. Alternatively, eating more plant-based proteins and fats from foods such as vegetables, legumes, and nuts was linked to lower mortality.
Read more: https://www.sciencedaily.com/releases/2018/08/180817093812.htm
https://www.sciencedaily.com/releases/2018/08/180817093812.htm
Date: August 17, 2018
Source: The Lancet
Summary:
A new study has found that diets both low and high in carbohydrates were linked with an increase in mortality, while moderate consumers of carbohydrates had the lowest risk of mortality. The study also found that low-carb diets that replace carbohydrates with proteins and fats from plant sources were associated with lower risk of mortality compared to those that replace carbohydrates with proteins and fat from animal sources.
The observational study of more than 15,400 people from the Atherosclerosis Risk in Communities Study (ARIC) in the USA found that diets both low (< 40% energy) and high (>70% energy) in carbohydrates were linked with an increase in mortality, while moderate consumers of carbohydrates (50-55% of energy) had the lowest risk of mortality.
The primary findings, confirmed in a meta-analysis of studies on carbohydrate intake including more than 432,000 people from over 20 countries, also suggest that not all low-carbohydrate diets appear equal -- eating more animal-based proteins and fats from foods like beef, lamb, pork, chicken and cheese instead of carbohydrate was associated with a greater risk of mortality. Alternatively, eating more plant-based proteins and fats from foods such as vegetables, legumes, and nuts was linked to lower mortality.
Read more: https://www.sciencedaily.com/releases/2018/08/180817093812.htm
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Replies
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The thing that occurred to me when I read about this study is that people who are already struggling with obesity and health conditions related to weight (or that they think may be related to weight) are probably more likely to switch to a low carbohydrate diet than people who aren't struggling with weight. Would this possibly skew the numbers for low carbohydrate diet mortality?12
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My initial read of this, after a quick glance through the actual study was that it supported the Blue Zone findings and isn't really anything surprising. Granted, this was a first thing in the morning quick glance, I'll do a deeper dive later on when I have more time.7
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My thought is that the conclusion is a confirmation of what we already knew - "everything in moderation" is best, and that media will, as expected, present is as "both low and high carb diets will kill you".18
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"The highest risk of mortality was observed in participants with the lowest carbohydrate consumption, in both unadjusted and adjusted models." This is interesting.. So is it better to eat high carb than low carb?
The participants' mean BMI was in the overweight range (around 27-28) however their mean energy intake was 1600 cals, this sounds a bit strange to me to be honest.7 -
hippiesaur wrote: »"The highest risk of mortality was observed in participants with the lowest carbohydrate consumption, in both unadjusted and adjusted models." This is interesting.. So is it better to eat high carb than low carb?
The participants' mean BMI was in the overweight range (around 27-28) however their mean energy intake was 1600 cals, this sounds a bit strange to me to be honest.
It looks like the details on calorie intake were based on questionnaires filled out by study participants. We know that people aren't necessarily the greatest at estimating their portion sizes (usually underestimating).10 -
There's reams of critiques written on this study already (just like there were for PURE). It went into my BS box at this point:
And the authors acknowledge that since diets were measured only at the start of the trial and six years later, dietary patterns could have changed over the subsequent 19 years. -BBC News, Low-carb diets could shorten life, study suggests
Do you think? They're generating this "science" based off food frequency questionnaires that we know aren't accurate to begin with and then extrapolating from that bad data 20 years later? It's absolutely ridiculous.
Here's the basis for the FFQ they used: https://regepi.bwh.harvard.edu/health/FFQ/files/80out.pdf13 -
janejellyroll wrote: »hippiesaur wrote: »"The highest risk of mortality was observed in participants with the lowest carbohydrate consumption, in both unadjusted and adjusted models." This is interesting.. So is it better to eat high carb than low carb?
The participants' mean BMI was in the overweight range (around 27-28) however their mean energy intake was 1600 cals, this sounds a bit strange to me to be honest.
It looks like the details on calorie intake were based on questionnaires filled out by study participants. We know that people aren't necessarily the greatest at estimating their portion sizes (usually underestimating).
So how do we know they didn't underestimate their carb intake as well?7 -
My initial thoughts without having much chance to review:
1. Based on questionnaires taken twice - not exactly an accurate food intake measurement.
2. "Low carb" is defined at what many of us would actually consider to be moderate carb.7 -
This is the original source: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext
I keep wanting to read it but just can't get around to it.2 -
janejellyroll wrote: »The thing that occurred to me when I read about this study is that people who are already struggling with obesity and health conditions related to weight (or that they think may be related to weight) are probably more likely to switch to a low carbohydrate diet than people who aren't struggling with weight. Would this possibly skew the numbers for low carbohydrate diet mortality?
That's the diet soda argument. When some studies show that obesity rates are higher among people that drink diet soda, they don't take into account that perhaps obese people are more likely to switch to diet soda.9 -
hippiesaur wrote: »janejellyroll wrote: »hippiesaur wrote: »"The highest risk of mortality was observed in participants with the lowest carbohydrate consumption, in both unadjusted and adjusted models." This is interesting.. So is it better to eat high carb than low carb?
The participants' mean BMI was in the overweight range (around 27-28) however their mean energy intake was 1600 cals, this sounds a bit strange to me to be honest.
It looks like the details on calorie intake were based on questionnaires filled out by study participants. We know that people aren't necessarily the greatest at estimating their portion sizes (usually underestimating).
So how do we know they didn't underestimate their carb intake as well?
That's exactly it -- we don't. They could have over- or underestimated their carbohydrate intake. My intuitive feeling (not based on data) is that in the current carbo-phobic atmosphere the average person would be more likely to underestimate their carbohydrate intake (to make themselves appear more virtuous), but I have no idea if this has been studied and there is anything to bear that out.5 -
janejellyroll wrote: »hippiesaur wrote: »janejellyroll wrote: »hippiesaur wrote: »"The highest risk of mortality was observed in participants with the lowest carbohydrate consumption, in both unadjusted and adjusted models." This is interesting.. So is it better to eat high carb than low carb?
The participants' mean BMI was in the overweight range (around 27-28) however their mean energy intake was 1600 cals, this sounds a bit strange to me to be honest.
It looks like the details on calorie intake were based on questionnaires filled out by study participants. We know that people aren't necessarily the greatest at estimating their portion sizes (usually underestimating).
So how do we know they didn't underestimate their carb intake as well?
That's exactly it -- we don't. They could have over- or underestimated their carbohydrate intake. My intuitive feeling (not based on data) is that in the current carbo-phobic atmosphere the average person would be more likely to underestimate their carbohydrate intake (to make themselves appear more virtuous), but I have no idea if this has been studied and there is anything to bear that out.
I don't think that's the case, though. I'm not defending the study (like I said, haven't read it), but since it started with data from the 80s and 90s, low fat was a more prevalent method for those who wanted to lose weight.5 -
amusedmonkey wrote: »janejellyroll wrote: »hippiesaur wrote: »janejellyroll wrote: »hippiesaur wrote: »"The highest risk of mortality was observed in participants with the lowest carbohydrate consumption, in both unadjusted and adjusted models." This is interesting.. So is it better to eat high carb than low carb?
The participants' mean BMI was in the overweight range (around 27-28) however their mean energy intake was 1600 cals, this sounds a bit strange to me to be honest.
It looks like the details on calorie intake were based on questionnaires filled out by study participants. We know that people aren't necessarily the greatest at estimating their portion sizes (usually underestimating).
So how do we know they didn't underestimate their carb intake as well?
That's exactly it -- we don't. They could have over- or underestimated their carbohydrate intake. My intuitive feeling (not based on data) is that in the current carbo-phobic atmosphere the average person would be more likely to underestimate their carbohydrate intake (to make themselves appear more virtuous), but I have no idea if this has been studied and there is anything to bear that out.
I don't think that's the case, though. I'm not defending the study (like I said, haven't read it), but since it started with data from the 80s and 90s, low fat was a more prevalent method for those who wanted to lose weight.
Oh, I missed that detail. Thank you!1 -
janejellyroll wrote: »The thing that occurred to me when I read about this study is that people who are already struggling with obesity and health conditions related to weight (or that they think may be related to weight) are probably more likely to switch to a low carbohydrate diet than people who aren't struggling with weight. Would this possibly skew the numbers for low carbohydrate diet mortality?
You do have a point but is it just a coincidence that those that faired the best were following a diet which closely matched the diets of those in the blue zones?1 -
I like this paper because it agrees with what I believe
but I think it has to get relegated to the same pile most of these studies do - it's relying on self reported data, quite possibly skewed by the participants memory, inaccurate measuring, and desire to seem like they are doing the right thing.
If nothing else, I think it's a nice pop culture antidote to the keto drum beating. But I'll still fall back on the Blue Zones when defending my carbiness to concerned family and friends
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Lillymoo01 wrote: »janejellyroll wrote: »The thing that occurred to me when I read about this study is that people who are already struggling with obesity and health conditions related to weight (or that they think may be related to weight) are probably more likely to switch to a low carbohydrate diet than people who aren't struggling with weight. Would this possibly skew the numbers for low carbohydrate diet mortality?
You do have a point but is it just a coincidence that those that faired the best were following a diet which closely matched the diets of those in the blue zones?
I happen to think, just as a matter of personal opinion, that data will eventually show that a moderate carbohydrate diet can be an incredibly healthful way to eat (in fact, what we understand of "blue zones" already supports that it is) and that at least some ways of constructing a low carbohydrate diet are potentially harmful. So do I think it's a coincidence? No, I don't. But I also think that my bias towards thinking that obligates me to address the potential issues with this study and acknowledge that we still need a better understanding of how this plays out.
To conclude that a low carbohydrate diet is harmful without acknowledging that at least some of these people in the study may have adopted a low carbohydrate diet because they were already struggling with health issues wouldn't be accurate, IMO.5 -
I like this paper because it agrees with what I believe but I think it has to get relegated to the same pile most of these studies do - it's relying on self reported data, quite possibly skewed by the participants memory, inaccurate measuring, and desire to seem like they are doing the right thing.
If nothing else, I think it's a nice pop culture antidote to the keto drum beating. But I'll still fall back on the Blue Zones when defending my carbiness to concerned family and friends
Yep, I like it because it agrees with my carbiness as well, I just wish I could get myself to read it. More interesting things keep popping up and I keep putting it off. Cliffsnotes would be nice if someone has done more than the skimming and random sampling I did.2 -
I am of the opinion, based on my personal experience only, that a lowish-moderate carb diet works best (for me). As in providing (if you eat the right carbs) good levels of fiber, nutrition and so forth, as measured by blood parameters such as triglycerides and LDL/HDL levels. Both of which markedly improved when I went lowish-carb modified, Paleo plan 6 or 7 years ago. I wonder if this study checked those who ate very low carb for the types of fats and proteins they were making up the balance of their diets with. It's usually the QUALITY of the macronutrients that are factors, I seriously suspect. This is why the Blue Zones work so well. (I'm incorporating some of those foods... bitter melon can be great!) It's going to be a lot more complex than breaking things down to Carb, Fat, Protein. The quality and nature of these three things are paramount.1
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I am of the opinion, based on my personal experience only, that a lowish-moderate carb diet works best (for me). As in providing (if you eat the right carbs) good levels of fiber, nutrition and so forth, as measured by blood parameters such as triglycerides and LDL/HDL levels. I wonder if this study checked those who ate very low carb for the types of fats and proteins they were making up the balance of their diets with. It's often the QUALITY of the macronutrients that are factors, I seriously suspect. This is why the Blue Zones work so well. It's going to be a lot more complex than breaking things down to Carb, Fat, Protein. The quality and nature of these three things are paramount.
I'll go ahead and stop you right there... this study did not include anyone actually eating a low carb diet, much less "very low carb." What the study refers to as "low carb" is actually moderate carb.3
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