STOP EVERYTHING - Dr. Oz changed his mind again

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Go_Mizzou99
Go_Mizzou99 Posts: 2,628 Member
edited February 21 in Food and Nutrition
Headline: Everything You Know About Fat Is Wrong

Article follows (http://news.yahoo.com/everything-know-fat-wrong-094500070--politics.html):

You can’t blame patients for being skeptical. After years of advocating low fat diets, Dr. Oz recently declared that eating saturated fat might not actually be all that bad. And the month before that, the press hyped a new study that indicated there’s no good evidence that saturated fats cause heart disease. The American Heart Association, on the other hand, continues to promote low-fat diets. So what should physicians tell patients now?

Most practicing doctors are poorly equipped to make sense of it all. (Even the doctors on the 2013 cholesterol guideline committee hired other people to read the literature for them.) What should doctors advise—stick with low fat or start cooking with lard?

In the new book, The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet, science writer Nina Teicholz implies that we should do the latter. Like many people, Teicholz herself was once a disciple of low fat diets—but after she took an assignment writing restaurant reviews, she found herself losing weight on a diet of heavy creams and fatty meats. Her curiosity was piqued, and she began a nearly decade-long critical review of the research on dietary fat. Her conclusion? Eating saturated fat can be the key to developing a healthy and lean body.

However, in order not to over-consume calories, eating more fat implies eating less carbohydrates. Indeed, these low-carb-high-fat (LCHF) diets are back in vogue with the rise of the Paleo movement—partly because people are beginning to question if increased carb intake has caused soaring obesity rates. Besides, for weight loss, low-fat diets yield only modest results and for some people don’t work at all.

That was the case for Dr. Peter Attia, who was featured on Dr. Oz’s show. Attia is a former Johns Hopkins surgeon who followed a low-fat diet and worked out several hours a day, but he was still overweight. Eventually, he developed metabolic syndrome—a condition that presages diabetes and heart disease. But he was able to lose the excess pounds and reverse his metabolic syndrome by dropping simple carbs and, in the process, eating more fat.

Dr. Attia’s story belies the popular misconception that the obese are simply lazy and gluttonous or too dumb and undisciplined to stick to a diet. Just maybe, what’s really making people fat are their hormones—in this case insulin, which, in susceptible people, spikes too high after a carbohydrate meal and locks energy into fat tissue.

This hypothesis was the work of pre-WW2 German and Austrian researchers and came of age in the U.S. in the 1950s. It was given mainstream respectability in 2002 by science writer Gary Taubes in the New York Times article, “What If It’s All Been a Big Fat Lie?” Taubes went on to write two books on the topic. While for many people Taubes’ work has helped reframe the thinking about why we get fat, some influential academicians remain unconvinced.

But many practicing physicians are prescribing LCHF diets anyway—simply because they’re so effective. In fact, Dr. Rakesh Patel, a family practitioner in Arizona, has seen enormous improvements in very sick patients. “These patients are honestly trying to make a go of it with low fat,” Patel told The Daily Beast. “But they come back after their third, fourth, or fifth [cardiac] stent—and I put them on a [LCHF] diet and they get better. A cardiologist sent me a patient recently, and after three months she’s down 25 pounds, her cholesterol is normal, and her LDL-particles are down by 1,000 [with the change in diet alone]. Her energy is good, she feels great.”

Dr. Patel has been prescribing LCHF diets for the last four years and, like other doctors around the country, he’s had some astonishing results. He’s even been able to demonstrate reversal of atherosclerotic plaque. When asked why he’s comfortable prescribing a high fat diet to cardiac patients when the AHA still promotes low-fat diets, Patel says he believes the science is actually on his side.

“For 80% of people with cardiovascular disease, it’s a glycemic (sugar) issue. That’s been shown over and over again in the literature. Even back in 1999 with the DECODE study in the Lancet,” he says. “It’s the carbohydrate that’s the elephant in the room.”

But for the over-worked, guideline-driven doc-in-a-box, low-carb diets still have a daunting public relations battle to overcome. Vocal opponents to LCHF diets insist the diet simply makes you sick, akin to using chemotherapy or amphetamines to shed pounds. Using the diet will, according to low-fat diet doctor Dean Ornish, “mortgage your health.”

Dr. Ornish became famous in the 1990s for showing reversal of coronary artery disease using a very low fat, near vegetarian diet. Since then, other doctors, like Caldwell Esselstyn MD, have used no-added-fat vegan diets even more effectively to reverse atherosclerotic plaque. It may seem difficult for the two approaches to live comfortably together.

But Dr. Patel doesn’t see it that way. “Those diets are also low carbohydrate diets—it doesn’t really matter if you fill the background with plants or with fat. There’s more than one way to skin a cat,” Patel says. “But I like low-carb/[high-fat] because in my experience, I’ve found it easier for patients to stay compliant.”

The two approaches have a couple of other things in common. Proponents both disagree with the American Heart Association dietary recommendations for 25-35% of daily calories as fat (7% as saturated fat)—too high for one camp, too low for the other. And proponents of both are equally dismissive of each other. “I find it ironic,” Dr. Patel says, “that people on each side are more than willing to support their beliefs with clinical anecdotes, but attack the other side for doing the same.”

This has been a theme in nutrition policy since the beginning. Both sides have an almost religious certainty they are right, and both feel they are fighting for patients’ health. “Nutrition science is a blood sport,” Nina Teicholz concluded after nearly a decade observing how science gets done. “When the science is weak, it's all about the politics. That’s been the theme of my book.” And many people agree: with nutrition science, it’s been hard to get to the truth.

“This is not the kind of thing you can dial in from doing a big study,” says Dr. Patel. “You have this heterogeneous population and one diet may not be ideal for another patient. This is where personalized medicine comes in—doctors have to get comfortable dealing with that.”

To be sure, the “truth” may be that a low-carb/high-fat diet is not the answer for every patient. But saturated fats appear to have been decriminalized. With Dr. Oz’s reversal—and the hard work of many patients and physicians—conventional doctors have something else to offer patients who are failing conventional treatment. If history is any guide, doctors and patients can’t afford to wait for the science to get better. It may never be good enough.

TL/DR summary: Dr. Oz changed his mind and now the whole world should listen.

Replies

  • The_Enginerd
    The_Enginerd Posts: 3,982 Member
    Even a broken clock is right twice a day.
  • marissanik
    marissanik Posts: 344 Member
    Is Dr.Oz relevant?
  • Forty6and2
    Forty6and2 Posts: 2,492 Member
    The only thing Dr.Oz is good for is passing time while I'm on the elliptical and trying to ignore my gym creeper. It's entertainment, period. Real Housewives of (whatever) is also just entertainment, as is Honey Boo Boo, and Transformers. I wouldn't bet on any "facts" I "learn" from any of these shows.
  • Go_Mizzou99
    Go_Mizzou99 Posts: 2,628 Member
    Is Dr.Oz relevant?

    Good question...the answer is "Only with he agrees with me" :wink:
  • AlabasterVerve
    AlabasterVerve Posts: 3,171 Member
    Even a broken clock is right twice a day.
    ^This. LCHF has been a life changer for me. Articles like this and the one in the WSJ the other day make me happy. They also help reassure my diabetic mother (who almost eats more carbs in a day than I do in an entire week because "the doctor said") that my diet isn't killing me. Change can't come soon enough -- hopefully it'll happen before my mom kills herself listening to her doctor.

    WSJ Article:
    http://online.wsj.com/news/articles/SB10001424052702303678404579533760760481486?mod=trending_now_1
  • Jestinia
    Jestinia Posts: 1,153 Member
    It's not that it's bad to change your mind when new evidence presents itself, but what took him so long? The evidence isn't all that new.

    "Dr. Attia’s story belies the popular misconception that the obese are simply lazy and gluttonous or too dumb and undisciplined to stick to a diet. Just maybe, what’s really making people fat are their hormones—in this case insulin, which, in susceptible people, spikes too high after a carbohydrate meal and locks energy into fat tissue." I think I should steal this quote for the carb and sugar thread. It sounds like a medical condition to me!
  • albertabeefy
    albertabeefy Posts: 1,169 Member
    It's not that it's bad to change your mind when new evidence presents itself, but what took him so long? The evidence isn't all that new.
    Almost every physician that has done a reversal on dietary fat has taken decades to come to that decision. It's grilled into you in medical school - especially so for those that choose to undertake a fellowship in cardiology - fat, especially saturated, is "artery-clogging" ...

    Most physicians still accept the lipid and diet-heart hypotheses as factual, even though they've not-only never been proven, but mountains of evidence is against them. And they're still taught as absolutes in medical schools today.

    Oz received his MD in 1986, at the height of cholesterol/fat condemnation. Only in the past few years has the evidence supporting fats (including saturated) in the diet become overly-compelling. It's no surprise it took him this long to reverse his position.
  • la_te_ra_lus
    la_te_ra_lus Posts: 243 Member
    snake oil salesman at his finest...
  • KseRz
    KseRz Posts: 980 Member
    I stopped wiping for this? *penguin walks back to the bathroom*
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