A Perspective - It's Not About the Calories

kennethmgreen

I am posting this article for people to read and discuss in an adult and civilized manner. If you are coming in to start a dispute or make disparaging comments, please post elsewhere.

There are many of us on this website that feel that the QUALITY of the calories and foods we consume is much more important than the QUANTITY.

Great Health and Weight Loss is NOT as simple as Calories In / Calories Out as everyone tries to say it is.

You might avoid some debate if you worded things a little differently.

I won't argue with your belief that the quality of the calories consumed is more important than the quantity - for being healthy.

The fact is, WEIGHT LOSS and HEALTH are mutually exclusive. People often lump the two ideas together (especially those of us trying to lose weight), but they are two different things.

Some might say it's just semantics. But semantics matter. Blurring the line between weight loss and healthy isn't correct, it isn't scientific, and really, it shouldn't be propagated because it furthers confusion.

If you were to say "Healthy Weight Loss," then you are getting closer. Because that is probably an idea more people can align with.

Weight Loss != Healthy. Consider those with eating disorders. Consider those maintaining. Consider those losing weight by starving themselves.

Word choice is important. Even the article you cited starts to talk about fat storage and how the body processes fat. It's not talking about weight loss by that point. This just underscores the fact that weight and health are mutually exclusive. You can be unhealthy skinny or pretty fit carrying extra weight.

I don't think anyone will argue that it is much healthier to lose weight eating healthy foods. The problem is introducing the idea that "healthy foods" is more important than the number of calories. And you have to ask: "More important for what?" Strictly for weight loss, the answer is no. For optimum health, the answer is yes. But one answer is math, and the other is a value judgment.

bcattoes

Actually, Ancel Keys work suggested that people who eat diets rich in saturate fat had more heart disease (something which as been shown to be true in numerous more recent studies).

So, Ancel Keys showed a correlation? Could saturated fat have just been along for the ride?

I think the tables might be (slowly) turning on the saturated fat causes heart disease thing. Here's one post about it which I have linked to before: http://www.proteinpower.com/drmike/cardiovascular-disease/saturated-fat-and-heart-disease-studies-old-and-new/

Yes, satuated fat may have just been along for the ride. Keys research was just the beginning of fat research, and the only correlation shown was more saturated fat in the diet = greater incidence of heart disease for the majority of those in the study. It was not true of all, but then I don't think I've ever seen a study where anything was true for all. Keys' interpretation of the study was that it suggested a diet high in saturated fat could be a risk factor for heart disease. The correlation between a diet high in saturated fat (especially the kind found in milk products and red meat) and incidence of heart disease has proven true in enough medical studies done since Ancel Keys' research that it is generally recommended to limit those types of saturated fat.

gwenmf

bump

infamousmk

I didn't read any of this. I mean, I skimmed, but really, if you try to throw thousands of words at people whom you want to make an impression, you're going to bore most of us. I'm pretty sure EVERYONE here has a goal of looking good naked, whether that comes from being fit and healthy or just plain thin, and I really think that's the important part to focus on.

kennethmgreen

and I really think that's the important part to focus on.

The naked part?

lockef

The correlation between a diet high in saturated fat (especially the kind found in milk products and red meat) and incidence of heart disease has proven true in enough medical studies done since Ancel Keys' research that it is generally recommended to limit those types of saturated fat.

And there are also studies showing that there is no correlation between saturated fat intake and heart disease. You don't hear much about those in the media though.... hmmmm

infamousmk

and I really think that's the important part to focus on.

The naked part?

Yeah. The naked part is always the most important part of everything. Well, and the saturated fat part, or maybe the carb part, I guess, but like I said, I didn't read the article.

staceyseeger

I didn't read any of this. I mean, I skimmed, but really, if you try to throw thousands of words at people whom you want to make an impression, you're going to bore most of us. I'm pretty sure EVERYONE here has a goal of looking good naked, whether that comes from being fit and healthy or just plain thin, and I really think that's the important part to focus on.

:drinker: :drinker: :drinker: :drinker:

Chastityx

It's simple, whether you are watching your calories or not, get your carbs from veggies and not Little Debbies. Some peolpe stay under their calorie goal, but only eat junk food. That is not going to help you maintain a healthy weight or look good naked in the long run.

Grokette

Actually, Ancel Keys work suggested that people who eat diets rich in saturate fat had more heart disease (something which as been shown to be true in numerous more recent studies).

So, Ancel Keys showed a correlation? Could saturated fat have just been along for the ride?

I think the tables might be (slowly) turning on the saturated fat causes heart disease thing. Here's one post about it which I have linked to before: http://www.proteinpower.com/drmike/cardiovascular-disease/saturated-fat-and-heart-disease-studies-old-and-new/

Yes, satuated fat may have just been along for the ride. Keys research was just the beginning of fat research, and the only correlation shown was more saturated fat in the diet = greater incidence of heart disease for the majority of those in the study. It was not true of all, but then I don't think I've ever seen a study where anything was true for all. Keys' interpretation of the study was that it suggested a diet high in saturated fat could be a risk factor for heart disease. The correlation between a diet high in saturated fat (especially the kind found in milk products and red meat) and incidence of heart disease has proven true in enough medical studies done since Ancel Keys' research that it is generally recommended to limit those types of saturated fat.

I would like to point you to read the quote in my signature and then consider the fraud that Ancel Keys committed. One, especially a scientist can not CHERRY PICK data and call it conclusive.


http://www.healthiertalk.com/greatest-scam-medical-history-1385

The Fraud of Ancel Keys Kicks off the Lipid Hypothesis

But the “lipid hypothesis” really gained traction in the 1950s, when physiologist Ancel Keys, Ph.D., published what became known as the Seven Countries Study.

Keys presented a comparison of heart disease mortality and fat intake across seven different countries. His comparison showed a “remarkable relationship.” The countries with the highest fat intake had the highest levels of heart disease. The countries with the lowest fat intake had the lowest levels of heart disease. Those in the middle fell conveniently in between.

At the time, Jacob Yerushalmy, a PhD statistician, at the University of California at Berkeley pointed out that we had data on the amount of fat consumed in 22 countries. So why wasn’t it called the 22 Country Study?

It wasn’t called that, because Ancel Keys started with the conclusion. Then he cherry-picked the countries that matched his pre-conceived notion and threw out the ones that contradicted it. And most of them did! When all 22 countries were analyzed, the “remarkable relationship” remarkably disappeared.

Furthermore, Keys established no causative basis. And he based his conclusions on only two phenomena – dietary fat and heart disease. This did not account for the possibility that something else could have caused the heart disease.

It might seem hard to believe that this flawed and fraudulent study was the genesis of the entire animal-fat-causes-heart-disease movement. Certainly, in the last sixty years, there must be hundreds of controlled studies that prove the link, right?

Not quite… there are NONE!

SoDamnHungry

A lot of healthier foods like fruits and veggies have considerably less calories than candy or cookies. Whole grain bread is higher quality and more calories, but also supposedly fills you up much longer than white bread so you snack less. I think calories are important. I agree that the quality of food is important...but that calories determine a lot.

Acg67

thought we were talking about the energy balance equation here and not the lipid hypothesis...

bcattoes

The correlation between a diet high in saturated fat (especially the kind found in milk products and red meat) and incidence of heart disease has proven true in enough medical studies done since Ancel Keys' research that it is generally recommended to limit those types of saturated fat.

And there are also studies showing that there is no correlation between saturated fat intake and heart disease. You don't hear much about those in the media though.... hmmmm

Depends on the media. Medical and scientific publications generally publish studies of all kinds if they are reviewed and foudn to have merit. There are conflicting results in medical studies for everything. This is why any one study never proves anything. Scientific medical studies suggest things based on the interpretion of researchers and reviewers. This is why it's best to look at medical entities that constantly review current and past studies for trends and discrepancies, rather than someone that "cherry picks" one study to tout as the absolute truth. And any publication that says a study "proved" (or disproved) anything should be discarded, especially if they are trying to sell something along with this great revelation.

bcattoes

Actually, Ancel Keys work suggested that people who eat diets rich in saturate fat had more heart disease (something which as been shown to be true in numerous more recent studies).

So, Ancel Keys showed a correlation? Could saturated fat have just been along for the ride?

I think the tables might be (slowly) turning on the saturated fat causes heart disease thing. Here's one post about it which I have linked to before: http://www.proteinpower.com/drmike/cardiovascular-disease/saturated-fat-and-heart-disease-studies-old-and-new/

Yes, satuated fat may have just been along for the ride. Keys research was just the beginning of fat research, and the only correlation shown was more saturated fat in the diet = greater incidence of heart disease for the majority of those in the study. It was not true of all, but then I don't think I've ever seen a study where anything was true for all. Keys' interpretation of the study was that it suggested a diet high in saturated fat could be a risk factor for heart disease. The correlation between a diet high in saturated fat (especially the kind found in milk products and red meat) and incidence of heart disease has proven true in enough medical studies done since Ancel Keys' research that it is generally recommended to limit those types of saturated fat.

I would like to point you to read the quote in my signature and then consider the fraud that Ancel Keys committed. One, especially a scientist can not CHERRY PICK data and call it conclusive.


http://www.healthiertalk.com/greatest-scam-medical-history-1385

The Fraud of Ancel Keys Kicks off the Lipid Hypothesis

But the “lipid hypothesis” really gained traction in the 1950s, when physiologist Ancel Keys, Ph.D., published what became known as the Seven Countries Study.

Keys presented a comparison of heart disease mortality and fat intake across seven different countries. His comparison showed a “remarkable relationship.” The countries with the highest fat intake had the highest levels of heart disease. The countries with the lowest fat intake had the lowest levels of heart disease. Those in the middle fell conveniently in between.

At the time, Jacob Yerushalmy, a PhD statistician, at the University of California at Berkeley pointed out that we had data on the amount of fat consumed in 22 countries. So why wasn’t it called the 22 Country Study?

It wasn’t called that, because Ancel Keys started with the conclusion. Then he cherry-picked the countries that matched his pre-conceived notion and threw out the ones that contradicted it. And most of them did! When all 22 countries were analyzed, the “remarkable relationship” remarkably disappeared.

Furthermore, Keys established no causative basis. And he based his conclusions on only two phenomena – dietary fat and heart disease. This did not account for the possibility that something else could have caused the heart disease.

It might seem hard to believe that this flawed and fraudulent study was the genesis of the entire animal-fat-causes-heart-disease movement. Certainly, in the last sixty years, there must be hundreds of controlled studies that prove the link, right?

Not quite… there are NONE!

Perhaps you should read Ancel Keys research or any of the peer reviews of it instead blogs or message boards before forming an opinion. I think you'll find that most of what you just re-posted is simply not true.

questionablemethods

Perhaps you should read Ancel Keys research or any of the peer reviews of it instead blogs or message boards before forming an opinion. I think you'll find that most of what you just re-posted is simply not true.

Presumably if Keys cherry picked data, those data that were left out wouldn't be discussed in his research.

bcattoes

Perhaps you should read Ancel Keys research or any of the peer reviews of it instead blogs or message boards before forming an opinion. I think you'll find that most of what you just re-posted is simply not true.

Presumably if Keys cherry picked data, those data that were left out wouldn't be discussed in his research.

Or perhaps you're reading someone that is cherry picking his research.

http://www.pbs.org/wgbh/pages/frontline/shows/diet/interviews/willett.html
Tell us about Ancel Keys, looking at different countries.

One of the ways that we appreciated that diet and lifestyle might really be important was the work of Ancel Keys, who looked at 14 different populations across Europe and Asia. What he realized was that there were some groups -- for example those living in Crete and some villages in Japan -- where heart disease rates were extremely low, only about one-tenth of those in the United States. And yet we also knew, when people moved from those environments, those lifestyles, and lived in the United States, they developed heart disease rates that were very high, just like everybody else in the United States. So that was powerful information telling us that there was something about the diet and lifestyle, way of life, that was extremely important in determining our risk of heart attacks.

Where did the idea of saturated fat come from?

The idea that saturated fat was a major underlying factor for heart disease did come about largely from the work of Ancel Keys, where he looked at various countries around the world and looked at their heart disease rates, and found that they were strongly correlated with saturated fat in the diet. However, even Keys recognized that it was difficult to point the finger totally at saturated fat, because there were many other aspects of diet and lifestyle that were different among these various population. ...

It was suggested we would do better with more vegetable oils?

Building on the work of Ancel Keys that showed that countries with high saturated fat had high heart disease rates, there were a number of detailed studies looking at, if we fed different types of fat, how would they affect our blood cholesterol? And it was found that saturated fats increased our blood cholesterol, and polyunsaturated fats from liquid vegetable oils reduce our serum cholesterol. And so in the mid-1970s, the predominant dietary advice was to replace saturated fat with polyunsaturated fat.

As it turns out, that advice was probably very good and had additional benefits beyond just those that influence serum cholesterol levels, in that [the] increase in polyunsaturated fat was probably largely responsible for the major reduction in heart disease rates we had during the '70s and early '80s in the United States. In fact, the rates of heart disease death went down by about 50 percent during that time.

The movement to get people to switch the types of fat: isn't this a heroic struggle that we should feel proud of?

Actually, I think we should be very proud of the achievements that were made during the 1970s, early 1980s, changing the type of fat in diet. We really made some very major national changes, and it did have some important benefits in reducing heart disease rates.

questionablemethods

Perhaps you should read Ancel Keys research or any of the peer reviews of it instead blogs or message boards before forming an opinion. I think you'll find that most of what you just re-posted is simply not true.

Presumably if Keys cherry picked data, those data that were left out wouldn't be discussed in his research.

Or perhaps you're reading someone that is cherry picking his research.

I didn't say that isn't possible, but you suggested going to Keys's research. And if someone is saying "he had access to more data than he analyzed" how would reading Key's research show me otherwise? I'm just questioning the logic behind your recommendation, not the merit of Ancel Keys or the lipid hypothesis.

dieseljay74

For me it is completely about calories. I eat fairly clean anyway, but regardless of an attempt to cut carbs or keep them moderate... seems not to make a difference for me.
I will say that when reducing carbs too much, I feel considerably weaker at the gym....

bcattoes

Perhaps you should read Ancel Keys research or any of the peer reviews of it instead blogs or message boards before forming an opinion. I think you'll find that most of what you just re-posted is simply not true.

Presumably if Keys cherry picked data, those data that were left out wouldn't be discussed in his research.

Or perhaps you're reading someone that is cherry picking his research.

I didn't say that isn't possible, but you suggested going to Keys's research. And if someone is saying "he had access to more data than he analyzed" how would reading Key's research show me otherwise? I'm just questioning the logic behind your recommendation, not the merit of Ancel Keys or the lipid hypothesis.

Well, first of all you'd know whether or not he actually looked at data from only 7 countries or from all 14, so you'd know who is doing the cherry picking. Or you could read the peer reviews of his work, as I also suggested.

Phil4035

I'm thinking about mashing all the theories together and eating nothing but1800 calories worth of bacon per day... I'm thinking I lose that last 15 pounds by Christmas! Woohoo! lol

Ha ha ha. Good One. I'm sure your Doctor would love the cholesterol level! :noway:

lockef

I'm thinking about mashing all the theories together and eating nothing but1800 calories worth of bacon per day... I'm thinking I lose that last 15 pounds by Christmas! Woohoo! lol

Ha ha ha. Good One. I'm sure your Doctor would love the cholesterol level! :noway:

*facepalm*

HMonsterX

I'm thinking about mashing all the theories together and eating nothing but1800 calories worth of bacon per day... I'm thinking I lose that last 15 pounds by Christmas! Woohoo! lol

Ha ha ha. Good One. I'm sure your Doctor would love the cholesterol level! :noway:

*facepalm*

Here you go.

questionablemethods

Well, first of all you'd know whether or not he actually looked at data from only 7 countries or from all 14, so you'd know who is doing the cherry picking. Or you could read the peer reviews of his work, as I also suggested.

Well, I no longer have easy access to my university library (ironically, the University of Minnesota, home of Dr. Keys) and it doesn't appear to be available online (I looked months ago). However, I have read some of his other studies that I could access online and, I guess I take him at face value when he says he looked at data from 7 countries in his "Seven Countries Study."

Here's a quote from "Food consumption patterns in the 1960s in seven countries" by Kromhout et al. 1989 (Keys is 2nd author).

At the end of the 1950s the Seven Countries Study was designed to investigate relations between diet and cardiovascular diseases (1-3). Sixteen cohorts were selected in Finland, Greece, Italy, Japan, The Netherlands, United States, and Yugoslavia.

But you're saying that peer reviews of his work refute this and show that he actually analyzed other countries in the study? Could you direct me to them? I don't know where Willett got that 14 number he mentions, but maybe you do.

I did recently read this from Dr. Willett and he doesn't seem to mention 14 countries there either. In fact, it is really only in one sentence that the long-suspected villain saturated fat is really even incriminated. He seems to be riiiiight on the verge of saying that even saturated fats are fine (and industrial trans fats are not -- duh). Time will tell. Published in the Journal of the American Dietetic Association.

The Great Fat Debate: Total Fat and Health
Walter C. Willett MD, DrPH

Available online 29 April 2011.

Editor's note: On November 8, 2010, Walter C. Willett, MD, DrPH; Lewis H. Kuller, MD, DrPH; Dariush Mozaffarian, MD, DrPH; and Alice H. Lichtenstein, DSc, participated in “The Great Fat Debate” as part of the Member Showcase at the American Dietetic Association's 93rd Food & Nutrition Conference & Expo in Boston, MA. The following is an edited transcript of Willett's presentation. An audio recording of the entire debate is available atwww.eatright.org/fnce.

To begin to understand The Great Fat Debate it is useful to go back in time to the famous Seven Countries Study, which described the lack of correlation between total fat in the diet as a percentage of calories and rates of cardiovascular disease. For example, regions with 40% of energy from fat have both the highest rate of coronary heart disease (in Finland) and the lowest rates of coronary heart disease (in Greece). This was a pretty strong suggestion that fat, per se, was not the issue. There were additional studies from around the globe that have examined cancer rates; in general there were strong positive correlations with animal fat or with total fat in the diet.

However, this kind of comparison among different countries is not really conclusive, because the high-risk countries are the affluent, wealthy countries, while the lowest-risk countries are poor, or traditional Asian societies. For this reason, there are so many differences among these countries that you can't really conclude anything about causation. However, for some cancers, the correlation with dietary fat was so strong and seductive that many believed it represented cause and effect. Largely on the basis of that kind of evidence, the main dietary recommendations in this country during the late 1980s, 1990s, and up until fairly recently, focused on reduction of total fat in the diet. I am specifically referring to the 1992 version of the US Food Guide Pyramid, which included the statement “Fats and oils, all types, use sparingly” to underscore this point. Of course, if you're not going to eat fats, then you have to eat something—and even though there was no direct evidence to support such actions, consumers were advised to load up on starch, basically up to 11 servings a day. Potatoes were even included in the vegetable group so the total could be more than 11 servings.

The main nutritional advice—[and] you probably all practiced it like I did as a physician at one time—was to reduce fat in your diet. Even the American Heart Association joined the bandwagon. This was their number one advice for some period of time—use nonfat products. And [consumers] were supposed to try things like angel food cake, and avoid things like devil's food cake. It was good and evil—it was totally crystal clear.

The food industry initially pushed back on this nutritional advice, but then quickly realized that sugar is cheaper than fat, allowing them to manufacture fat-free products and sell them at a premium for a higher price. But were these fat-free products really any better for us?” They were usually the same in calories, but loaded with sugar—even salad dressings became fat-free.

We became concerned about this push for increasing carbohydrate intake in the 1980s. If you refer to the controlled feeding study by Mensink and Katan in the Netherlands, you can see that, trading off calories from olive oil or almost any type of fat versus calories from a carbohydrate, depresses high-density lipoprotein (HDL) cholesterol and increases triglycerides—and that raised some concern, because all else being equal, we know that low HDL cholesterol and high triglycerides are related to higher risk of heart disease, not lower risk of heart disease. But, of course, heart disease etiology is more complicated, and you'd really like to look at clinical end points.

Several large prospective studies have been conducted, including the Nurses' Health Study, in an effort to examine dietary fat and other factors in relation to cardiovascular disease and cancer. For the Nurses' Health Study, dietary data were collected starting in 1980, and dietary assessment was repeated every 4 years while also keeping track of risk of heart disease and other covariates like physical activity and smoking.

When we looked at total fat and coronary heart disease, there was no relationship, and the type of fat has turned out to be what's really important, not the total percentage of calories from fat in the diet. Now, ideally, you'd like to look at this issue in randomized trials. And during the ‘60s, ‘70s, and ‘80s, there was a series of randomized trials of low-fat diets [in an effort] to look at risk of heart disease. If you replaced saturated fat with polyunsaturated fat there was a reduction in risk. (My comment: but other randomized clinical trials from this same time showed no effect or even an advantage over saturated fat -- see the link I posted previously.) But if you replaced total fat or saturated fat with carbohydrate, no reduction in risk [was found].

The biggest study of all in this area was the Women's Health Initiative—a randomized trial among 48,000 women, which continued for an average of approximately 7 years of follow-up. This study showed that there was absolutely no effect on risk of coronary heart disease. The problem with the Women's Health Initiative is that the women actually didn't change their fat intake, because there was no change in HDL cholesterol or triglycerides, so despite this huge investment, [the study] actually didn't test the hypothesis. So, even though there was no difference in risk of heart disease, in reality it was not a very definitive study.

In 1989, the National Academy of Sciences reviewed these findings, and their conclusion was that intake of total fat, independent of the relative content of different types of fatty acids, is not associated with high blood cholesterol levels and coronary heart disease. And a recent review of the findings by the Food and Agricultural Organization, as well as a World Health Organization review, also stated that there was no probable or convincing evidence for significant effects of total dietary fat on coronary heart disease and cancer. I'm just going to mention a little bit of the data on cancer, because breast cancer has been the main concern. We've looked at it in the Nurses' Health Study multiple times. And, again, [there is] no hint of a positive association between total fat in the diet and risk of breast cancer. We've also compiled the data from all the large cohort studies around the world, and putting it all together produces just about the flattest line you'll ever see—no relationship between percentage of calories from fat in the diet and risk of breast cancer.

Some researchers have speculated that total fat in the diet was related to risk of diabetes, but in the large prospective cohort studies that have looked at this, total fat had no association with risk of diabetes, including the Women's Health Initiative study.

One of the last holdouts for the low-fat enthusiasts has been the belief that it's fat in the diet that makes you fat, and somehow, the belief that you can't get fat eating carbohydrate. I grew up in the Midwest and watched people fatten up their cattle. And they definitely fed them carbohydrate—they were even fed whole grains, and cattle did get fat on that. And it's pretty clear that that applies to people as well.

One of the earlier studies that looked carefully at the different levels of fat intake as a percentage of energy was a 1-year feeding study by Knopp and colleagues. In this study, there was about a 2- to 3-kilogram reduction in weight, no matter what the level of fat intake. The conclusion seems to be that if you put a dietitian on somebody's back, they lose 2 to 3 kilograms; the diet seems less important. If you get people to pay attention to what they're eating, [and] get them to back away from the trough a little bit, they'll lose some weight. The fat content doesn't seem to matter. Note that in the Knopp study, that on the low-fat diet there was a very large increase in triglyceride levels, again confirming that if you do go on a diet with a higher percentage of calories from carbohydrate—or a lower percentage of calories from fat—your triglycerides go up.

Some additional randomized trials have examined this issue. A study by Foster [and colleagues] in 2003 showed that, if anything, there was greatest weight reduction over a 1-year period on an Atkins type diet compared to a conventional low-fat diet. In a study done in Boston at Tufts University, people were randomized for 1 year to the Atkins, Zone, Weight Watchers, or Ornish diets. On each one of these diets there was a lot of variability in the degree of weight loss, but overall there was no difference at all among them. A study by Gardiner showed that people on the highest fat diet lost the most weight over a period of 12 months. And most recently, Frank Sacks at Harvard and his colleagues in Louisiana randomized about 800 women to a low-fat diet over a year's period, and there was no difference in weight.

I think the bottom line is pretty clear—multiple randomized trials with equal intensity intervention in each arm provide convincing evidence that the percentage of energy from fat composition has little effect on energy balance, and if anything the literature is showing slight advantages toward the higher-fat diet.

In conclusion, let me reiterate that diets with a lower percentage of energy from fat do not reduce the risk of heart disease, diabetes, cancer, or adiposity. For some people, a reduction in total fat can actually be harmful if healthful fats are preferentially reduced. We should just clean up our dietary guidelines and remove any reference to percentage of energy from fat, and total fat should be removed from Nutrition Facts on the back of packages. People look at fat grams, they think it's important, but in fact, this has been soundly proven to have no real importance.

Walter C. Willett, MD, DrPH, is Fredrick John Stare professor of Epidemiology and Nutrition and chair, Department of Nutrition, Harvard University School of Public Health, Boston, MA.

bcattoes

Well, first of all you'd know whether or not he actually looked at data from only 7 countries or from all 14, so you'd know who is doing the cherry picking. Or you could read the peer reviews of his work, as I also suggested.

Well, I no longer have easy access to my university library (ironically, the University of Minnesota, home of Dr. Keys) and it doesn't appear to be available online (I looked months ago). However, I have read some of his other studies that I could access online and, I guess I take him at face value when he says he looked at data from 7 countries in his "Seven Countries Study."

Here's a quote from "Food consumption patterns in the 1960s in seven countries" by Kromhout et al. 1989 (Keys is 2nd author).

At the end of the 1950s the Seven Countries Study was designed to investigate relations between diet and cardiovascular diseases (1-3). Sixteen cohorts were selected in Finland, Greece, Italy, Japan, The Netherlands, United States, and Yugoslavia.

But you're saying that peer reviews of his work refute this and show that he actually analyzed other countries in the study? Could you direct me to them? I don't know where Willett got that 14 number he mentions, but maybe you do.

I did recently read this from Dr. Willett and he doesn't seem to mention 14 countries there either. In fact, it is really only in one sentence that saturated fat is really even incriminated. He seems to be riiiiight on the verge of saying that even saturated fats are fine. Time will tell. Published in the Journal of the American Dietetic Association.

The Great Fat Debate: Total Fat and Health
Walter C. Willett MD, DrPH

Available online 29 April 2011.

OMG, I love reading Walter Willett!! I hated deleting that even from my response, but I felt the need to shorten it. I don't know where you can get the original study either but I would imagine old journals of medicine would have it, but since the study is more than 30 yo you might only find them on paper. I've never had the pleasure of meeting Dr. Willett but I imagine he got the 14 countries from reviewing the study. I read an article on Keys years ago that described the study but I can't remember where. I do not believe it was on the internet (not sure I even had the internet at the time). If you really want to, I'm sure you can find it. I'm surrpised the NIH doesn't have it, but perhaps it is too old.

questionablemethods

I've never had the pleasure of meeting Dr. Willett but I imagine he got the 14 countries from reviewing the study. I read an article on Keys years ago that described the study but I can't remember where. I do not believe it was on the internet (not sure I even had the internet at the time). If you really want to, I'm sure you can find it. I'm surrpised the NIH doesn't have it, but perhaps it is too old.

If Keys really did analyze and discuss the data for 14 countries in his famous Seven Countries Study then we can at least conclude that he is pretty bad at selecting accurate titles for his research. And also remembering to mention the other seven countries when he talks about research in subsequent publications. :laugh:

I don't necessarily think that Keys should be made into a villain. I'm in research myself and I now how very long and slow the process is and how really, after years and years of research, you might emerge with a tiny glimmer of one answer.... and 20 new questions. I am just glad that my research will probably never be used as the foundation of/key contributor to a nation's dietary guidelines!

bcattoes

I've never had the pleasure of meeting Dr. Willett but I imagine he got the 14 countries from reviewing the study. I read an article on Keys years ago that described the study but I can't remember where. I do not believe it was on the internet (not sure I even had the internet at the time). If you really want to, I'm sure you can find it. I'm surrpised the NIH doesn't have it, but perhaps it is too old.

If Keys really did analyze and discuss the data for 14 countries in his famous Seven Countries Study then we can at least conclude that he is pretty bad at selecting accurate titles for his research. And also remembering to mention the other seven countries when he talks about research in subsequent publications. :laugh:

I don't necessarily think that Keys should be made into a villain. I'm in research myself and I now how very long and slow the process is and how really, after years and years of research, you might emerge with a tiny glimmer of one answer.... and 20 new questions. I am just glad that my research will probably never be used as the foundation of/key contributor to a nation's dietary guidelines!

I'm beginning to wonder if we're talking about 2 different things when it comes to Keys. What I read years ago talked about the countries and how/why some were eliminated. I did a little "Googling" to see if I could find it or something similar and found the article below, which makes me wonder if what I read was actually pre-study research, which seems to be where the criticism comes from.

http://www.sph.umn.edu/epi/history/overview.asp

The study has been criticized for the method in which populations were selected for the study, and the way that the population (ecologic) correlations, with limited numbers of units, were carried out. These days, the configuration of populations for such internal and international comparisons is strengthened by the random selection of greater numbers of units. But the Seven Countries Study was state-of-the-art for its time, and the concept ahead of its time. Ecologic correlations are relatively weak in arriving at causal inference about disease. However, they are crucial indicators of population causes of disease, and of public health preventive strategies, where the epidemiologic evidence is congruent with that from the laboratory and the clinic.

bcattoes

To get back to the OP, or at least the subject line. I believe that without disease, it really is all about the calories. At least that has always proven true for me (I have no diseases, food intollerances or allergies).. Eat less and/or burn more = lose weight.

My problem has always been that when I stop burning more (i.e. stop exercising regularly) I forget to eat less.

questionablemethods

My problem has always been that when I stop burning more (i.e. stop exercising regularly) I forget to eat less.

Yeah, same here.

To get back to the OP, or at least the subject line. I believe that without disease, it really is all about the calories. At least that has always proven true for me (I have no diseases, food intollerances or allergies).. Eat less and/or burn more = lose weight.

I agree but I am also concerned with preventing the diseases that I can prevent. I don't believe that obesity is the cause of diseases of civilization, but a symptom -- for some. For example, both of my grandmothers died of dementia (thought to be Alzheimer's, though brain autopsies weren't performed) and neither of them ever struggled with their weight. So, that is a major concern of mine. When I asked my doctor what I might be able to do now to prevent it, she basically shrugged and said they didn't know, it's likely genetic and that the drugs are getting better.

That's not really good enough for me. First of all, I think that epigenetics is important to consider. I might have inherited risk factors for Alzheimer's disease, but I might be able to do something about how my genes are expressed. I've increasingly heard Alzheimer's called "type 3 diabetes" (although I've also seen that used for gestational diabetes) because insulin resistance is linked to neurodegeneration. So, my family and I might not get Type 2 diabetes or show other signs right now of insulin resistance (other than a bit of an "apple" body type), maybe insulin resistance is just showing up later in life for us and I could do something now to prevent it -- like limit my carbohydrate intake. I've also seen people say that Celiac disease can mask as Alzheimer's and I've heard figures as high as 90% of Alzheimer's (or what presents as Alzheimer's) have gluten intolerance without any of the classic symptoms of celiac. I'm still trying to research it, so don't quote me on it or anything.

Obviously, trying to prevent every disease known to man is enough to make a person go crazy (oh how deep the rabbit hole goes....). What I do know is that being thin won't necessarily protect me from them.

I don't know how far afield this thread has gotten, but, in short, I do think that calorie quality is vital, especially if excess weight is a symptom. Symptom of what, I don't know -- maybe impaired insulin/leptin sensitivity, maybe micronutrient deficiencies causing your body to cry out for more calories all the time. In any case, I do find that when I concentrate on eating nutrient dense foods, I feel more satiated and stable throughout the day, the calories naturally go down, along with my weight and, I hope, my risk of disease.

tmaksparkie

I am with you 100%. I am a paleo/primal eater and it works. I am not going to say it is for everyone but works for me. I feel much better eating this way and my blood work is perfect(for those that want to know). My doctor has said whatever I am doing keep it up because it works. I have a ton of energy and I do exercise 5-6 times a week at the gym. When I did do clean higher carb diet(carbs normally at 200g a day) I gained weight even though I was under maintenance. And I have a bodybugg so no I do not guess on what I burn. Now I am normally under 100g of carbs and no grains, well I stay away from gluten anyway and eating the same amount of calories I did before and gained weight. So this is the lifestyle for me. Just find what works for you and stick with it.

bcattoes

My problem has always been that when I stop burning more (i.e. stop exercising regularly) I forget to eat less.

Yeah, same here.

To get back to the OP, or at least the subject line. I believe that without disease, it really is all about the calories. At least that has always proven true for me (I have no diseases, food intollerances or allergies).. Eat less and/or burn more = lose weight.

I agree but I am also concerned with preventing the diseases that I can prevent. I don't believe that obesity is the cause of diseases of civilization, but a symptom -- for some. For example, both of my grandmothers died of dementia (thought to be Alzheimer's, though brain autopsies weren't performed) and neither of them ever struggled with their weight. So, that is a major concern of mine. When I asked my doctor what I might be able to do now to prevent it, she basically shrugged and said they didn't know, it's likely genetic and that the drugs are getting better.

That's not really good enough for me. First of all, I think that epigenetics is important to consider. I might have inherited risk factors for Alzheimer's disease, but I might be able to do something about how my genes are expressed. I've increasingly heard Alzheimer's called "type 3 diabetes" (although I've also seen that used for gestational diabetes) because insulin resistance is linked to neurodegeneration. So, my family and I might not get Type 2 diabetes or show other signs right now of insulin resistance (other than a bit of an "apple" body type), maybe insulin resistance is just showing up later in life for us and I could do something now to prevent it -- like limit my carbohydrate intake. I've also seen people say that Celiac disease can mask as Alzheimer's and I've heard figures as high as 90% of Alzheimer's (or what presents as Alzheimer's) have gluten intolerance without any of the classic symptoms of celiac. I'm still trying to research it, so don't quote me on it or anything.

Obviously, trying to prevent every disease known to man is enough to make a person go crazy (oh how deep the rabbit hole goes....). What I do know is that being thin won't necessarily protect me from them.

I don't know how far afield this thread has gotten, but, in short, I do think that calorie quality is vital, especially if excess weight is a symptom. Symptom of what, I don't know -- maybe impaired insulin/leptin sensitivity, maybe micronutrient deficiencies causing your body to cry out for more calories all the time. In any case, I do find that when I concentrate on eating nutrient dense foods, I feel more satiated and stable throughout the day, the calories naturally go down, along with my weight and, I hope, my risk of disease.

Please don't misunderstand my post, I completely agree that food quality is important for health. But not so much for weight loss only. Not without an underlying medical condition.