New Nutrition Study Changes Nothing

2

Replies

  • deannalfisher
    deannalfisher Posts: 5,601 Member
    Yup - carbs doing me just fine - I'm down 12lbs to my goal, weight stable and focusing on recomp with between 3-400g carbs a day
  • nvmomketo
    nvmomketo Posts: 12,019 Member
    The PURE study in the Lancet is behind a paywall: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32252-3/fulltext
    Findings

    During follow-up, we documented 5796 deaths and 4784 major cardiovascular disease events. Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 [95% CI 1·12–1·46], ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67–0·87], ptrend<0·0001; saturated fat, HR 0·86 [0·76–0·99], ptrend=0·0088; monounsaturated fat: HR 0·81 [0·71–0·92], ptrend<0·0001; and polyunsaturated fat: HR 0·80 [0·71–0·89], ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64–0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality.

    Interpretation

    High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.

    Nothing really new, no, but some of it bears repeating since government and organizations (like ADA or AHA) are so slow to change their guidelines:

    Saturated fat is not dangerous so eat fat. The higher intakes of fat they looked at appears tolead to a longer life although the macro range was limited... Stroke is reduced among those with higher saturated fat intake which makes me wonder if that is part of the reason that SE Asia has such a high stroke rate.

    The healthiest people avoid refined carbs and sugar so for carbs eat veggies, fruit, beans, seeds and whole grains... and whole grains in bread is not eating whole grains. The lower carbohydrate intake appeared to lead to a longer life although their macro range was limited.

    PURE really had nothing to do with weight loss but just concerned the resultant mortality based upon those diets and their nutrition. I'm sure being overweight would affect mortality levels but it has nothing to do with the study unless you assume some foods are more likely to lead to obesity which then can lead to an earlier death.

    Discussing which macros worked best with weight loss is not really relevant to the PURE study. To keep with the theme of the study, we'd need to have everyone declare their macros, stick with it for 10 years, and then check back in to see who is still living. ;)
  • kimny72
    kimny72 Posts: 16,027 Member
    The article was about health, not weight loss, yes. And I'd like to highlight that the first post to mention weight loss was a low carb post, which led to other posters replying that they lost weight just fine eating plenty of carbs.
    rfrenkel77 wrote: »
    Can't believe people who are trying to lose weight still talking about eating 55% carbs. How's that working for everyone? Look around.

    Which I think highlights the point of the article, that there are too many people jumping on bandwagons and insisting there is "one true way" to be healthy that we are just starting to understand and doctors don't want you to know about, and the scientific community is too confused to see the truth. :neutral:
  • GottaBurnEmAll
    GottaBurnEmAll Posts: 7,722 Member
    What overweight people? I'm 5'1" and weigh 119 pounds, my BMI is 22.5, smack dab in the middle of normal range.

    I had been at a lower weight, 116. I want to get down to 110. I went lower carb to try to get those last few pounds off. You know what happened? A bit of back story here. I had low carbed before. For ten years. I wasn't active back then. Doing it now, as a very active person? Big mistake.

    My cravings went through the roof, and I turned into a binge monster.

    Adding carbs, particularly starchy carbs like potatoes and whole grains back into my diet got rid of my cravings and binge problems. I've been able to stick with my planned deficit since doing that.

    Not everyone is insulin resistant or has a need or wants to low carb. Even some people who are insulin resistant can and do successfully lose weight simply by reducing calories. There used to be a poster on these forums who just didn't want to low carb. She had insulin resistance. She successfully lost around 80 pounds, IIRC, without every giving up any foods she loved.

    Regardless, this is off topic for the purposes of the study.

    The results are being misinterpreted by some of you low carbers.

    If being poor and having a subsistence diet of white rice leading to a high mortality rate inflating the statistics is something you want to hang your hats on, have at it. I don't think those findings are something that prove much of anything, personally.
  • timtam163
    timtam163 Posts: 509 Member
    yarwell wrote: »
    Whenever people find out someone is trying to lose weight, I've noticed a common question is, "Oh, what diet are you on?"

    As if there has to be a label. A fad. A title. A certain method, maybe involving apple cider vinegar or activated almonds. Something, ANYTHING to avoid the boring, prosaic truths contained in that study, and in the countless other studies that say the same thing. "

    I'm guessing you haven't read the study, as it isn't about weight loss at all.

    The PURE study looks at food consumption (self reported questionnaires) and tries to drag out of the statistics any interaction between the diets of the participants and health outcomes because "The relationship between macronutrients and cardiovascular disease and mortality is controversial"

    The study found that
    Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 [95% CI 1·12–1·46], ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67–0·87], ptrend<0·0001; saturated fat, HR 0·86 [0·76–0·99], ptrend=0·0088; monounsaturated fat: HR 0·81 [0·71–0·92], ptrend<0·0001; and polyunsaturated fat: HR 0·80 [0·71–0·89], ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64–0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality.

    but it is important to note that the range of fat and carbohydrate intake reported was limited - the lowest carbohydrate intake quintile was 46% and the highest fat 35%. In part this is because the study is specifcally trying to avoid being dominated by US / European data and hence has a lot of high carb low fat Asian population data in it. The highest carb quintile is 77% and the lowest fat 11% (all median values).

    So what PURE tells us is that within those ranges of consumption there's a modest trend to see more deaths (from any cause) in people eating 77% carbs compared to 46% and fewer deaths in people eating more fat (which is really just the same thing as if carbs go up fat comes down). The fact that these high carb consumers are in China and the lower carb ones in the USA may of course be an influence on the outcomes.

    It didn't find any indication of fat consumption causing mortality, cardiovascular disease, or stroke - in fact stroke reduced with increasing sat fat consumption in this population but again the high sat fat consumers would be Western.

    I don't see how anyone can recommend a particular diet based on PURE, that is just them restating their own beliefs having been given a platform.

    Yea there are many confounding factors; overall mortality is so broad as to be pretty meaningless. Did they control for socioeconomic status, one of the biggest predictors of mortality (due to healthcare access and malnutrition etc)?

    To the people who designed and carried out the study: CORRELATION IS NOT CAUSATION. For the last time.
  • GottaBurnEmAll
    GottaBurnEmAll Posts: 7,722 Member
    edited September 2017
    timtam163 wrote: »
    yarwell wrote: »
    Whenever people find out someone is trying to lose weight, I've noticed a common question is, "Oh, what diet are you on?"

    As if there has to be a label. A fad. A title. A certain method, maybe involving apple cider vinegar or activated almonds. Something, ANYTHING to avoid the boring, prosaic truths contained in that study, and in the countless other studies that say the same thing. "

    I'm guessing you haven't read the study, as it isn't about weight loss at all.

    The PURE study looks at food consumption (self reported questionnaires) and tries to drag out of the statistics any interaction between the diets of the participants and health outcomes because "The relationship between macronutrients and cardiovascular disease and mortality is controversial"

    The study found that
    Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 [95% CI 1·12–1·46], ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67–0·87], ptrend<0·0001; saturated fat, HR 0·86 [0·76–0·99], ptrend=0·0088; monounsaturated fat: HR 0·81 [0·71–0·92], ptrend<0·0001; and polyunsaturated fat: HR 0·80 [0·71–0·89], ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64–0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality.

    but it is important to note that the range of fat and carbohydrate intake reported was limited - the lowest carbohydrate intake quintile was 46% and the highest fat 35%. In part this is because the study is specifcally trying to avoid being dominated by US / European data and hence has a lot of high carb low fat Asian population data in it. The highest carb quintile is 77% and the lowest fat 11% (all median values).

    So what PURE tells us is that within those ranges of consumption there's a modest trend to see more deaths (from any cause) in people eating 77% carbs compared to 46% and fewer deaths in people eating more fat (which is really just the same thing as if carbs go up fat comes down). The fact that these high carb consumers are in China and the lower carb ones in the USA may of course be an influence on the outcomes.

    It didn't find any indication of fat consumption causing mortality, cardiovascular disease, or stroke - in fact stroke reduced with increasing sat fat consumption in this population but again the high sat fat consumers would be Western.

    I don't see how anyone can recommend a particular diet based on PURE, that is just them restating their own beliefs having been given a platform.

    Yea there are many confounding factors; overall mortality is so broad as to be pretty meaningless. Did they control for socioeconomic status, one of the biggest predictors of mortality (due to healthcare access and malnutrition etc)?

    To the people who designed and carried out the study: CORRELATION IS NOT CAUSATION. For the last time.

    Overall mortality was a lot higher among people who were poor and on high carb diets for subsistence.

    Shocking, I know.

    The statistical aggregation model they used lumped a lot of things together that when you broke down the data was far more... meh. Nothing new to be gleaned. It's not a ringing endorsement for low carb. At all.