EPTNutrition is a necessary part of the human condition and very important in maintenance of proper health and weight. I assume that if you are reading this topic you are likely interested in (1) eating healthy, (2) reducing your weight, and/or (3) gaining weight usually muscle mass. Many people have concerns with all three of these.
With that said, there are a lot of misconceptions and myths in the industry about what constitutes eating healthy. Additionally, gaining or losing weight can be a problematic area for many people to even start approaching.
It is my recommendation that you first read this article on the relationship between diet and exercise because it clears up many of the myths that you may have heard about specific effects of nutrition and exercise and their effects.
The topics in this thread are as follows:
Weight loss
Weight gain
Protein
Resources
Supplementation
The myths and facts about saturated fats and cholesterol, lipid panels, and the lipid hypothesis
-------------------------------------------------------
Weight loss
There are two main approaches to weight loss: (1) calories in < calories out and (2) quality of foods. I will discuss both, but I prefer the second
1. Kcals in < kcals out. Yes, you've all heard of the law of thermodynamics. Calories in vs. calories out is a simple thermodynamic equation which generally works about 90% of the time in weight loss.
There are documented instances of where people can lose weight and improve their health on diets that are calorically restricted but demonstratably unhealthy (e.g. google twinkie diet).
If you are going to use this approach you will need to do two things. First, is chart your food intake for the week (using a food calculator like fitday), and see if you gain or lose any weight. Divide by the number of days to get your approximate calories burned per week,
Second, you want to eat in a caloric deficit of approximately 500 +/- 200 calories. If you are already not eating a lot, you do not want to go below about 1500 calories for men and 1300 calories for women unless you are obese because the body will enter starvation mode.
The reasoning for a slower form of weight loss is that f you deprive the body of nutrients, it will slow down thyroid hormone production which regulates metabolic rate as well as other metabolic factors. Additionally, putting extraordinary amounts of stress on your body raises cortisol production, which will tend to maintain visceral abdominal fat and upper back fat rather than burn it off.
Starvation experiments do show that you will continue to lose weight, but it's at the expense of your body's health.
2. Quality of foods. The quality of foods approach is focused on eliminating caloric dense foods with little nutritional value and replacing them with calorically sparse foods with high nutritional value.
For example, a quality of foods approach would focus on eliminating all junk foods and drinks -- juices, sodas, sports drinks, chips, cookies, donuts, candies, etc. -- and replace them with nutrient rich foods such as fruits, vegetables, meat, birds, fish, eggs, etc. which also have considerably more nutrients than the former.
Basically, the rule is to eliminate processed foods and replace them with real foods.
This is my preferred approach because of a couple of key reasons. First, you can eat 'til you're full. Satiety is a big reason why we eat, and people don't like to be hungry. Since we are eating less calorically dense foods, we can eat 'til we are full and still lose weight. Second, we are getting more nutrients and thus improving our health.
Eating processed foods with excessive carbohydrates tends to lead to the "skinny-fat" look that people want to avoid.
A. Exercise for weight loss.
There are many myths surrounding exercise for weight loss. Here is a general exercise hierarchy chart (assuming you did not read the link above).
I. Lifting heavy weights or bodyweight strength training
II. Intervals/circuit training
III. Light weights = cardio
IV. Specific exercises for the body part (e.g. abs exercises for losing abdominal fat).
Lifting weights and/or strength training, especially as someone new to exercise provides a stimulus for improving body composition which is gaining muscle mass. The stimulus for muscle mass, especially in a caloric deficit, pulls a lot of energy from the fat mass which improves both body composition and reduces the amount of fat in the body. This is why high intensity exercise such as weight lifting, intervals, and circuit training are superior to light weights and cardio.
This is also a carryover from the training thread, but it also addresses this topic.
Why not cardio? Why not lots of reps for toning?
+ Show Spoiler +
Good questions.
If you skipped over the link in the beginning read it now:
>> First, a quick reminder or lesson on how exercise and nutrition affect each other. READ THIS SERIOUSLY... I keep linking it because it tells you about how the body works.
Cardio
Cardio at its heart is a very weak at best at stimulating fat loss. For newer people to exercise, especially those looking to burn fat, cardio is very ineffective. You'll burn maybe 200-300 kcals per mile of exercise at best. Compare this to 3600 kcals in 1 lbs of fat we see at best you'll have to be running 12-18 miles just to burn one pound of fat. As a beginner even a couple miles is daunting, and people are expected to do at least this much for 1 lbs of fat?
This is why losing weight is done in the kitchen. There's a lot of pervasive myths in the fitness industry but when they say that "abs are made in the kitchen" that is actually true.
Weight training provides a stimulus for building muscle. Muscle is very hard to build because it requires lots of calories to actually build the muscle. If diet is strictly controlled, the body derives its energy from burning your fat mass to build the muscle. So in effect, you can "build muscle" and "lose fat" at the same time. (The caveat is that there is diminishing returns the leaner you get).
Therefore, for newer people looking to lose fat it is advisable to lift heavy weights and make sure your nutrition is in order. Weights are superior over cardio (which is about 15-20% of the equation), and nutrition makes up the rest (which is about 80-85% of the equation) in losing weight.
Don't get me wrong, cardio can be used effectively in some populations. However, for the average person looking to lose fat and/or gain muscle this is not one of them.
Light weights and high repetitions for toning
Toning is bullshit. What does it mean anyway to look more toned or defined?
Light weights high repetitions for toning is a huge myth that is pervasive in the fitness industry.
When you boil it down to the facts, "toning" just means you want to lose fat (to see your muscles) and/or make your muscles bigger. So basically when you say you want to "tone" you want to gain muscle and/or lose fat.
1. High repetitions works endurance. It does not put on muscle mass. Strike one.
2. High repetitions does not burn much fat. Just like cardio doesn't. Strike two.
3. There is no such thing as spot reduction. That is to say that doing endless amounts of situps does not make your abs more defined.
You have to put sufficient stress on a muscle to get it to grow. That is much easier done with heavy weights in the 5-8 repetition range (which, incidentally, is about the best repetition range for hypertrophy).
If you thought light weights and high repetitions was going to lose you fat mass you're sorely mistaken. If an hours or two of cardio burns less than a pound of fat mass, how do you think that a 30 minute workout of light weights and high repetitions (which is essentially what cardio is for the legs) is going to burn any significant amount of fat mass?
Therefore, for newer people looking to lose fat it is advisable to lift heavy weights and make sure your nutrition is in order. Weights are superior over cardio (which is about 15-20% of the equation), and nutrition makes up the rest (which is about 80-85% of the equation) in losing weight.
If you skipped over the link in the beginning read it now:
>> First, a quick reminder or lesson on how exercise and nutrition affect each other. READ THIS SERIOUSLY... I keep linking it because it tells you about how the body works.
Cardio
Cardio at its heart is a very weak at best at stimulating fat loss. For newer people to exercise, especially those looking to burn fat, cardio is very ineffective. You'll burn maybe 200-300 kcals per mile of exercise at best. Compare this to 3600 kcals in 1 lbs of fat we see at best you'll have to be running 12-18 miles just to burn one pound of fat. As a beginner even a couple miles is daunting, and people are expected to do at least this much for 1 lbs of fat?
This is why losing weight is done in the kitchen. There's a lot of pervasive myths in the fitness industry but when they say that "abs are made in the kitchen" that is actually true.
Weight training provides a stimulus for building muscle. Muscle is very hard to build because it requires lots of calories to actually build the muscle. If diet is strictly controlled, the body derives its energy from burning your fat mass to build the muscle. So in effect, you can "build muscle" and "lose fat" at the same time. (The caveat is that there is diminishing returns the leaner you get).
Therefore, for newer people looking to lose fat it is advisable to lift heavy weights and make sure your nutrition is in order. Weights are superior over cardio (which is about 15-20% of the equation), and nutrition makes up the rest (which is about 80-85% of the equation) in losing weight.
Don't get me wrong, cardio can be used effectively in some populations. However, for the average person looking to lose fat and/or gain muscle this is not one of them.
Light weights and high repetitions for toning
Toning is bullshit. What does it mean anyway to look more toned or defined?
Light weights high repetitions for toning is a huge myth that is pervasive in the fitness industry.
When you boil it down to the facts, "toning" just means you want to lose fat (to see your muscles) and/or make your muscles bigger. So basically when you say you want to "tone" you want to gain muscle and/or lose fat.
1. High repetitions works endurance. It does not put on muscle mass. Strike one.
2. High repetitions does not burn much fat. Just like cardio doesn't. Strike two.
3. There is no such thing as spot reduction. That is to say that doing endless amounts of situps does not make your abs more defined.
You have to put sufficient stress on a muscle to get it to grow. That is much easier done with heavy weights in the 5-8 repetition range (which, incidentally, is about the best repetition range for hypertrophy).
If you thought light weights and high repetitions was going to lose you fat mass you're sorely mistaken. If an hours or two of cardio burns less than a pound of fat mass, how do you think that a 30 minute workout of light weights and high repetitions (which is essentially what cardio is for the legs) is going to burn any significant amount of fat mass?
Therefore, for newer people looking to lose fat it is advisable to lift heavy weights and make sure your nutrition is in order. Weights are superior over cardio (which is about 15-20% of the equation), and nutrition makes up the rest (which is about 80-85% of the equation) in losing weight.
Finally, "spot reduction" of fat does not occur.** Abs exercises may help increase your abdominal muscle mass if they are difficult enough, but your body does not lose specific abdominal fat. To lose fat your body takes it from all over the body when losing weight. Therefore, abdominal exercises are not very good for losing weight in the abdomen. If you feel like adding them AFTER fixing your nutrition and training feel free though.
**Spot reduction has been shown to occur in very obese populations (>30%+ body fat percentage); however, at lower body fat percentages at where people are trying to see visible abs, glutes, legs, arms, etc. it does not work significantly to warrant performing these types of exercises.
-------------------------------------------------------
Weight Gain
Gaining weight is simple. Eat. A lot.
For gaining weight in the context of muscle there are two things that need to be present.
1. A stimulus, such as lifting weights, to force the body to adapt and add muscle mass.
2. A caloric excess to allow the body the energy to produce muscle mass.
If you are looking to add muscle mass see our recommendations in the training topic.
There are a few myths regarding being overweight/obese and losing fat and gaining muscle. I will dispel these now.
The general rule of thumb is that extra "fat" within the body is an energy source. Therefore, if you a overweight/obese and lifting weights BUT eating in a caloric deficit then your body can call on the fat mass as the extra energy to build muscle. Obviously, as your body composition improves the ability of the body to do this decreases. However, this is one of the extraordinary things that can happen with lifting weights and why it is far superior to cardio or higher repetitions for fat loss. Basically, what I described in the above section on weight loss.
Now, there are two ways to approach gaining weight. One is the "clean" way eating healthy foods and the other is the "dirty" way which can be done by eating anything and everything. These two are referred to as clean and dirty bulking respectively.
Obviously, as your guide in this matter I would prefer that you approach it from the clean way which is to eat massive amounts of real foods (whole milk is especially good). However, if you don't care and just want to get bigger fast food is an easy way to provide lots of calories. It's up to you.
-------------------------------------------------------
Protein
Protein intake for athletes/sports should be at least 1g/lbs or 2g/kg bodyweight. If you are eating higher amounts of protein make sure to drink a lot of water.
Protein for weight loss and weight gain are similar.
You need the protein for building muscle if you are trying to gain weight.
If you are trying to lose weight it seems odd to get the same amount of protein, but it is the truth. Protein is very satiating which makes it harder to overconsume food. Additionally, protein is very thermogenic and used as signalling molecules to help stimulate metabolic processes which are beneficial to losing weight.
The other macronutrients (fat and carbs) matter less. See the section on saturated fats and cholesterol if you are interested in learning more about these two macronutrients.
Generally speaking, however, a macronutrient based diet is a bit extreme. There are good and bad things about specific things in macronutrients, so breaking it down that way is not as good as a eat-real-foods approach.
-------------------------------------------------------
Resources
Here are some more details on categorical weight loss and practical eating. (I am not addressing bulking because well most people look to the stickies for weight loss).
1. As said before I prefer the high quality foods approach. In terms of protein which helps improve weight loss you should be eating a fist size hunk of meat, fish, birds, or eggs every meal.
2. Eat slowly. The faster you eat the more calories you ingest before you "feel full."
3. Eat 'til you are a full (if on the high quality food approach). If this feels wrong, then eat 'til you are 80% full. If you are on the calories approach then obviously this is more clear cut on calories per meal.
4. Meal frequency matters very little in losing weight. Generally, anything between 3-5 times works well. Alternatively, intermittent fasting works well too.
5. Remember, if your goal is to gain weight you must increase the calories you are eating.
Beyond that, here are some additional resources and details on the why's, the what's, the how's and the when's:
Recommended book on nutrition:
>> The Paleo Solution -- Robb Wolf
A couple quick reads on how to eat healthy:
>> Eat real food is the key to being healthy.
>> Here's something a bit more specific.
Practically, here are two good shopping lists
>> Shopping list 1
>> Shopping list 2
+ How to
>> Quick Start guide
>> Food matrix
Keeping track of your eating habits
>> Logging your food is one of the better ways analyze the quality and quantity of your nutrition.
If you are having a hard time gaining or losing weight in particular, or poor health and looking to eat healthier then doing this is a very good idea. It doesn't matter when you eat so much as what you eat.
Other recommend nutrition sites
>> http://body-improvements.com/resources/eat/
This site above is a very good overview of a lot of topics regarding nutrition.
>> http://www.leangains.com/ >> was a poster in the 2011 TL H&F and you may recognize him from Manifesto's blog
+ Show Spoiler +
http://robbwolf.com
http://wholehealthsource.blogspot.com/
http://www.marksdailyapple.com/
http://whole9life.com/
http://heartscanblog.blogspot.com/
http://coolinginflammation.blogspot.com/
http://freetheanimal.com/
http://www.proteinpower.com/drmike/
http://donmatesz.blogspot.com/
http://drbganimalpharm.blogspot.com/
http://high-fat-nutrition.blogspot.com/
http://diabetesupdate.blogspot.com/
http://ryan-koch.blogspot.com/
http://www.cholesterol-and-health.com/cholesterol-blog.html
>> Another useful user recommend thread
-------------------------------------------------------
Supplementation
Supplements beneficial for overall health -- fish oil, Vitamin D.
Supplements beneficial for mass gain -- creatine, whey & casein, BCAAs, glutamine, carnitine, eating a lot of food, sleeping well. If you are taking protein and creatine remember to drink a lot of water.
Supplements beneficial for losing weight -- proper weight training and eating well; there are no short cuts. Eating right is 80-90% of the equation!!
For eliminating colds and other upper respiratory tract infections such as the flu -- 10,000 - 30,000 IU of Vitamin D. Vitamin C DOES NOT HELP.
For improving sleep:
>> F.lux for computer users
>> More on better sleep
>> [spoiler]~elimination of sounds
~elimination of electronic devices / outlets / plugins near body
~pitch black room
~cool, dry room (60-65 or so degrees is good if possible)
~stay away from artificial light sources (e.g. computer) at least 1 hr before sleep
~eat a meal, preferably with healthy fats and a decent amount of carbs, before sleeping (e.g. NO JUNK FOOD).
~single leg stand to exhaustion with both legs (it actually works really well)
~spine lengthening before sleep (see Esther Gokhale's stuff)
~general exhaustion from physical activity like hiking, pickup games of stuff, lifting, etc.
~Deep breathing exercises
~Deep tissue massage
~magnesium may help (via ZMA or natural calm)
~melatonin helps some people
~phosphatidylserine (anti-cortisol)
~5-HTP (tryptophan deriv)
~L-theonine
~Vitamin D (taken during the day..)
~valerian root
Graphical representation of useful supplements based on studies:
http://www.informationisbeautiful.net/play/snake-oil-supplements/
-------------------------------------------------------
Be forewarned... you are stepping into the science zone.
The myths and facts about saturated fats and cholesterol
First, forget what you have heard about saturated fats and cholesterol. We will look at some of the actual science and biological processes surrounding these to determine whether they are beneficial or harmful.
+ Show Spoiler +
One of the most important analysis of dietary guidelines of the past decades came out last year in Nutritional Journal covering a wide range of topics including saturated fats. This analysis specifically looked at the dietary recommendations for Americans even as the obesity, diabetes, cardiovascular disease, etc. rates continue to rise massively in the US and in most industrialized countries.
Let's go back to the beginning.
There are two main hypotheses to describe the development of cardiovascular disease (among other factors). These are the lipid hypothesis and the chronic endothelial injury hypothesis. Currently, the lipid hypothesis predominates the medical industry; however, as stated in the above analysis of the data there is evidence that may show that it is based, at least partially, on incorrect science.
http://en.wikipedia.org/wiki/Lipid_hypothesis
http://en.wikipedia.org/wiki/Chronic_endothelial_injury_hypothesis
One recent movie, Fat head, looked at exploring the origins of why the lipid hypothesis is supposedly based on faulty science. A bit more on that here:
+ Show Spoiler +
Having looked into the science, I personally do not support the lipid hypothesis and I will detail information later regarding saturated fatty acids and cholesterol later with studies to support why it is likely incorrect.
Let's take a step back.
So what do saturated fats do in the body? What does cholesterol do in the body?
Saturated Fat
There are multiple sources of dietary fatty acids. Lauric acid (12), Myristic acid (14), Palmitic acid (16), and Stearic acid (18) are some of the most common. The only difference between these fatty acids are how many carbons are in the chain length, but as we shall see each of these have different effects on the body.
http://en.wikipedia.org/wiki/Lauric_acid
http://en.wikipedia.org/wiki/Myristic_acid
http://en.wikipedia.org/wiki/Palmitic_acid
http://en.wikipedia.org/wiki/Stearic_acid
Short chain triglycerides I'm going to briefly mention since we have little control over intake of them (as our gut bacteria produces them). However, if you have had issues with digestive problems, food poisoning, and anti-biotics where your gut flora has been decimated it may be a good idea to invest in some good probiotics. In particular, Butyric acid (4 carbon) saturated fatty acid is produced by several gut flora species and has favorable effects on our metabolism and protects against cancer.
Medium chain triglycerides (particular 6-12 carbon fatty acids) of which Lauric acid (12) is an example are extremely beneficial for health. Coconut oil and other coconut products contain a lot of MCTs specifically Lauric acid (66%). MCTs are useful for a variety of reasoning including weight loss -- increases oxidation of fatty acids, increases HDL-cholesterol (e.g. the "good" one), anti-bacterial, anti-oxidant, and is anti-inflammatory.
Most types of animal products have some combination of the long chain triglycerides which include the aforementioned Myristic acid, Palmitic acid, and Stearic acid. Each of these have slightly different effects on the body.
All excess energy in the body is specifically converted into palmitic acid, which will make up the majority of the "triglycerides" that you see in a blood panel. Fructose sugar in particular, is a toxin in the body. When it enters the body through the digestive tract, the liver must convert it into a usable form of energy. The energy form that it is converted into palmitic acid -- a saturated fatty acid.
Cholesterol
Cholesterol is a very, very, very important substance in the body. Cholesterol is in every cell of the body and helps to maintain the fluidity of the cell membranes, and regulation of substances passing through them. Additionally, it is intimately involved in nervous system regulation and makes up a large portion of the myelin sheath that speeds up nerve conduction in the body. Additionally, cholesterol is the backbone on which steroid hormones such as testosterone, estrogen, progesterone, etc. are created, and it is also a precursor to vitamin D as sun is required to photo-convert 7-dehydro-cholesterol into proto-vitamin D. Cholesterol is utilized in the adrenal glands to make cortisol and aldolsterone which help regulate fight-or-flight response, and sodium content in the body. Also, cholesterol is converted in the liver into bile salts which the gallbladder emits to help emulsify fatty acids and absorb many of the fat soluble vitamins -- A, E, D, K -- from dietary sources.
The transport of...
Since cholesterol is a hydrophobic substance, it cannot be transported in the body as it would stick to the vessel walls. Thus, the body creates HDL and LDL which are are lipoproteins (e.g. high density lipoprotein and low density lipoprotein) to transport cholesterol in the blood stream. Lipoproteins are composed of fat and protein. The "fatty" part binds to cholesterol so it can carry it, and the protein portion of it is hydrophilic so it can be dissolved into the blood until it gets to where the body needs it.
HDL carries cholesterol back to the liver, LDL carries cholesterol away from the liver to other tissues.
Lipid panels
So let's talk lipid panels.
When you see LDL and HDL in a blood panel it refers to how much LDL there is, and how much HDL there is.
--------------------
Total cholesterol level -- total cholesterol is technically a misnomer since it is a summation of all of the components of lipids in the blood sample (e.g. what a typical blood stream of someone looks like it). It isn't just total "cholesterol" which would just be a summation of HDL and LDL.
Triglyceride level -- triglycerides represent the amount of fatty acids -- palmitic acid mostly -- that is circulating in your blood stream. Triglycerides are the primary source of energy in the body, especially during aerobic exercise. Glucose is only primarily utilized at anaerobic threshold or above.
HDL cholesterol -- represents the amount of HDL in the body.
LDL cholesterol -- represents the amount of LDL in the body. There's actually lots of different subclasses of LDL proteins which a typical lipid panel won't show. Specifically, oxidized LDL (oLDL) or specifically Apolipoprotein B (or ApoB for short) is extremely strongly correlated with the development of cardiovascular disease. Apo B is sometimes referred to as small, dense LDL.
Therefore, you may have high LDL, but if you have a lot of "fluffier" LDL you are at a relatively low risk for cardiovascular disease. If you have low LDL but a lot of the "small, dense" oLDL / ApoB then you are at high risk for CVD. This is why it is important to get LDL subclasses checked even though most doctor's don't know this.... LDL matters little if you don't know if you have the big, fluffy or the small, dense.
There's actually three other classes of lipoproteins that carry fats in the body. Chylomicrons carry triglycerides from the digestive tract into the body. VLDL (very low density lipoprotein) and IDL (intermediate density lipoprotein) also carry fatty acids, but typically these aren't measured.
--------------------
Why are these supposed to be bad?
HDL, LDL, Cholesterol, triglycerdies, etc are neither "good" or "bad." They are needed in the body for various purposes. Only when they get out of whack does it means something is wrong.
According to the lipid hypothesis, high triglycerides and high LDL and low HDL are supposed to contribute towards heart disease.
Picture of atherosclerotic development
+ Show Spoiler +![[image loading]](http://www.virtualsciencefair.org/2009/hsuj9j2/atherosclerosis.jpg)
The development of atherosclerotic lesions show increased fatty accumulations including cholesterol filtrates at the site of the lesion. Sounds correct, right?
Therefore, if you can prove that if high dietary fat intake -- especially saturated fats -- (1) raises blood lipids and (2) increases rates of atherosclerosis then it would be a cause and effect relationship.
Is it cause and effect? Or is it something else.
The chronic endothelial dysfunction theory better fits the data, especially in conjunction with nutritional studies regarding low carbohydrate versus low fat diets. It's funny but every time I browse the literature, there are only good results from low carbohydrate (which include "high fat" and "high protein") diets as opposed to low fat diets.
For example, this mayoclinic study says:
http://www.mayoclinicproceedings.com/content/78/11/1331.full.pdf
Lipid panels improved on almost every measurable and patients lost weight on a high fat no starch diet. And they had cardiovascular disease. So basically, this diet improved their cardiovascular disease.
Take for example, this non-biased search boolean on low carbohydrate vs. low fat:
http://scholar.google.com/scholar?q=low carbohydrate low fat
The first study suggests:
http://www.nejm.org/doi/full/10.1056/NEJMoa022637
Of course, they ended with the cautioning, but there are many other studies.
The second study suggests:
http://jcem.endojournals.org/content/88/4/1617.full?l=5579341
So they are similar.... oh wait, but hey we didn't look at the study's methods.
So the low carbohydrate high fat diet did just as well as a calorie restricted lower fat diet. Why didn't they restrict kcals for the high fat diet too? Wouldn't that make a difference as well?
The third study suggests:
http://www.annals.org/content/140/10/769.short
So higher retention rate with low carbohydrate. Check. Greater weight loss with low carbohydrate. Check. Low carb decreased serum triglycerides more. Check. Low carb diet increases HDL more. Check. Not sure what the minor adverse effects were, but they sure weren't big enough to have the retention rate go down more than the other group.
So I checked to at least 20 of the top results and low carbohydrate is at least equally or more effective than low fat diets (when compared) at both losing weight and on markers of cardiovascular disease risk. Check them out if you don't believe me.
Meta studies such at this one show similar findings.
http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2008.00518.x/full
Honestly, how much data do you need to accumulate to prove that "high fat" diets do not cause cardiovascular disease. Saturated fat, and cholesterol don't cause cardiovascular disease.
So going back to specifically something like eggs which have a bunch of cholesterol and fat in them:
http://www.ncbi.nlm.nih.gov/pubmed/22037012
http://www.ncbi.nlm.nih.gov/pubmed/20683785
http://www.ncbi.nlm.nih.gov/pubmed/18991244
http://www.ncbi.nlm.nih.gov/pubmed/21776466
http://www.ncbi.nlm.nih.gov/pubmed/19369056
http://www.ncbi.nlm.nih.gov/pubmed/21134328
http://www.ncbi.nlm.nih.gov/pubmed/15164336
http://www.ncbi.nlm.nih.gov/pubmed/18991244
http://www.ncbi.nlm.nih.gov/pubmed/18203890
http://www.ncbi.nlm.nih.gov/pubmed/17531457
http://www.ncbi.nlm.nih.gov/pubmed/16340654
The evidence vindicates saturated fats risk on heart disease.
http://wholehealthsource.blogspot.com/2011/01/does-dietary-saturated-fat-increase.html
http://www.ajcn.org/content/early/2010/01/13/ajcn.2009.27725.abstract
http://www.ajcn.org/content/80/5/1175.full.pdf html <-- decreased risk in post menopausal women with increased sat fat intake
http://healthydietsandscience.blogspot.com/2011/03/high-saturated-fat-diet-gives.html
http://www.mayoclinicproceedings.com/content/78/11/1331.full.pdf
etc.
In the same line this is why whole milk is healthier than skim milk:
http://wholehealthsource.blogspot.com/2010/12/dairy-fat-and-diabetes.html
http://www.ncbi.nlm.nih.gov/pubmed/16904009
http://www.ncbi.nlm.nih.gov/pubmed/20372173
http://www.ncbi.nlm.nih.gov/pubmed/17925824
http://www.ncbi.nlm.nih.gov/pubmed/11350992
Another interesting article that was ahead of its time:
http://www.sciencedirect.com/science/article/pii/S0002934396004561
So I hate to beat the drum on things I've already covered but the lipid hypothesis really does not make sense when you look at the literature.
When you find studies that support the role of fats in the development in cardiovascular disease and look at some of the specifics of the diet they ate they usually contain large amounts processed fats such as trans fats (which are notoriously bad for you).
This is to say that NORMAL sources of fats and oils such as animal fats, eggs, milk, butter, etc. are good for you. Industrial processed fats such as margarine, deep fried foods, vegetable oils, etc. in general are bad for you.
So what actually causes cardiovascular disease if it's not saturated fats and cholesterol?
Remember what I said before about lipid profiles?
They indicate something is wrong but they don't indicate what is wrong. The lipid hypothesis takes the incorrect step of saying that the lipids themselves cause the problems.
So that leaves us with the chronic endothelial injury hypothesis.
What likely happens is multifold.
1. Dietary effects of high carbohydrate diets (especially fructose) lead to increases in oxidized LDL. Oxidized LDL can get "stuck" in the endothelial wall which aggravates the tissues. The body sends macrophages to help try to clean up the damage. Inflammation results and the chain reaction continues.
2. Ingestion of large amounts of carbohydrates (especially fructose) lead to increases in advanced glycated end products. Fructose is 9x more likely than glucose to form AGE's by the way.
3. Trans fats.
4. Omega 3 vs Omega 6 fatty acids. Normal ancestral consumption in about 1:1 or 1:2 ratio. Normal consumption now is in 10:1 to 20:1 or higher ratios, especially in fried foods.
5. Dysregulation/dysfunction of the body's systems.
Leptin resistance contibutes to obesity. High carbohydrate/sugar intake contributes to metabolic syndrome and weight gain. All of these contribute to insulin resistance. Insulin resistance starts to contribute to dyslipedemia. You get obese, diabetes, high blood pressure, poor lipid panels. Then you get cancer, stroke, heart attack, etc.
http://en.wikipedia.org/wiki/Fructose#Health_effects
http://en.wikipedia.org/wiki/Non-alcoholic_fatty_liver_disease
http://en.wikipedia.org/wiki/Metabolic_syndrome
If you are obese or have documented cardiovascular disease et al. you should know that some of the disease can be reversed to an extent with a low carbohydrate, ketogenic, or Paleolithic diet.
Videos if you don't like reading:
So in the end I hope that this was helpful and that you learned something about nutrition.
Let's go back to the beginning.
There are two main hypotheses to describe the development of cardiovascular disease (among other factors). These are the lipid hypothesis and the chronic endothelial injury hypothesis. Currently, the lipid hypothesis predominates the medical industry; however, as stated in the above analysis of the data there is evidence that may show that it is based, at least partially, on incorrect science.
http://en.wikipedia.org/wiki/Lipid_hypothesis
http://en.wikipedia.org/wiki/Chronic_endothelial_injury_hypothesis
One recent movie, Fat head, looked at exploring the origins of why the lipid hypothesis is supposedly based on faulty science. A bit more on that here:
+ Show Spoiler +
Having looked into the science, I personally do not support the lipid hypothesis and I will detail information later regarding saturated fatty acids and cholesterol later with studies to support why it is likely incorrect.
Let's take a step back.
So what do saturated fats do in the body? What does cholesterol do in the body?
Saturated Fat
There are multiple sources of dietary fatty acids. Lauric acid (12), Myristic acid (14), Palmitic acid (16), and Stearic acid (18) are some of the most common. The only difference between these fatty acids are how many carbons are in the chain length, but as we shall see each of these have different effects on the body.
http://en.wikipedia.org/wiki/Lauric_acid
http://en.wikipedia.org/wiki/Myristic_acid
http://en.wikipedia.org/wiki/Palmitic_acid
http://en.wikipedia.org/wiki/Stearic_acid
Short chain triglycerides I'm going to briefly mention since we have little control over intake of them (as our gut bacteria produces them). However, if you have had issues with digestive problems, food poisoning, and anti-biotics where your gut flora has been decimated it may be a good idea to invest in some good probiotics. In particular, Butyric acid (4 carbon) saturated fatty acid is produced by several gut flora species and has favorable effects on our metabolism and protects against cancer.
Medium chain triglycerides (particular 6-12 carbon fatty acids) of which Lauric acid (12) is an example are extremely beneficial for health. Coconut oil and other coconut products contain a lot of MCTs specifically Lauric acid (66%). MCTs are useful for a variety of reasoning including weight loss -- increases oxidation of fatty acids, increases HDL-cholesterol (e.g. the "good" one), anti-bacterial, anti-oxidant, and is anti-inflammatory.
Most types of animal products have some combination of the long chain triglycerides which include the aforementioned Myristic acid, Palmitic acid, and Stearic acid. Each of these have slightly different effects on the body.
All excess energy in the body is specifically converted into palmitic acid, which will make up the majority of the "triglycerides" that you see in a blood panel. Fructose sugar in particular, is a toxin in the body. When it enters the body through the digestive tract, the liver must convert it into a usable form of energy. The energy form that it is converted into palmitic acid -- a saturated fatty acid.
Cholesterol
Cholesterol is a very, very, very important substance in the body. Cholesterol is in every cell of the body and helps to maintain the fluidity of the cell membranes, and regulation of substances passing through them. Additionally, it is intimately involved in nervous system regulation and makes up a large portion of the myelin sheath that speeds up nerve conduction in the body. Additionally, cholesterol is the backbone on which steroid hormones such as testosterone, estrogen, progesterone, etc. are created, and it is also a precursor to vitamin D as sun is required to photo-convert 7-dehydro-cholesterol into proto-vitamin D. Cholesterol is utilized in the adrenal glands to make cortisol and aldolsterone which help regulate fight-or-flight response, and sodium content in the body. Also, cholesterol is converted in the liver into bile salts which the gallbladder emits to help emulsify fatty acids and absorb many of the fat soluble vitamins -- A, E, D, K -- from dietary sources.
The transport of...
Since cholesterol is a hydrophobic substance, it cannot be transported in the body as it would stick to the vessel walls. Thus, the body creates HDL and LDL which are are lipoproteins (e.g. high density lipoprotein and low density lipoprotein) to transport cholesterol in the blood stream. Lipoproteins are composed of fat and protein. The "fatty" part binds to cholesterol so it can carry it, and the protein portion of it is hydrophilic so it can be dissolved into the blood until it gets to where the body needs it.
HDL carries cholesterol back to the liver, LDL carries cholesterol away from the liver to other tissues.
Lipid panels
So let's talk lipid panels.
When you see LDL and HDL in a blood panel it refers to how much LDL there is, and how much HDL there is.
--------------------
Total cholesterol level -- total cholesterol is technically a misnomer since it is a summation of all of the components of lipids in the blood sample (e.g. what a typical blood stream of someone looks like it). It isn't just total "cholesterol" which would just be a summation of HDL and LDL.
Triglyceride level -- triglycerides represent the amount of fatty acids -- palmitic acid mostly -- that is circulating in your blood stream. Triglycerides are the primary source of energy in the body, especially during aerobic exercise. Glucose is only primarily utilized at anaerobic threshold or above.
HDL cholesterol -- represents the amount of HDL in the body.
LDL cholesterol -- represents the amount of LDL in the body. There's actually lots of different subclasses of LDL proteins which a typical lipid panel won't show. Specifically, oxidized LDL (oLDL) or specifically Apolipoprotein B (or ApoB for short) is extremely strongly correlated with the development of cardiovascular disease. Apo B is sometimes referred to as small, dense LDL.
Therefore, you may have high LDL, but if you have a lot of "fluffier" LDL you are at a relatively low risk for cardiovascular disease. If you have low LDL but a lot of the "small, dense" oLDL / ApoB then you are at high risk for CVD. This is why it is important to get LDL subclasses checked even though most doctor's don't know this.... LDL matters little if you don't know if you have the big, fluffy or the small, dense.
There's actually three other classes of lipoproteins that carry fats in the body. Chylomicrons carry triglycerides from the digestive tract into the body. VLDL (very low density lipoprotein) and IDL (intermediate density lipoprotein) also carry fatty acids, but typically these aren't measured.
--------------------
Why are these supposed to be bad?
HDL, LDL, Cholesterol, triglycerdies, etc are neither "good" or "bad." They are needed in the body for various purposes. Only when they get out of whack does it means something is wrong.
According to the lipid hypothesis, high triglycerides and high LDL and low HDL are supposed to contribute towards heart disease.
Picture of atherosclerotic development
+ Show Spoiler +
The development of atherosclerotic lesions show increased fatty accumulations including cholesterol filtrates at the site of the lesion. Sounds correct, right?
Therefore, if you can prove that if high dietary fat intake -- especially saturated fats -- (1) raises blood lipids and (2) increases rates of atherosclerosis then it would be a cause and effect relationship.
Is it cause and effect? Or is it something else.
The chronic endothelial dysfunction theory better fits the data, especially in conjunction with nutritional studies regarding low carbohydrate versus low fat diets. It's funny but every time I browse the literature, there are only good results from low carbohydrate (which include "high fat" and "high protein") diets as opposed to low fat diets.
For example, this mayoclinic study says:
http://www.mayoclinicproceedings.com/content/78/11/1331.full.pdf
Effect of a High Saturated Fat and No-Starch Diet on Serum Lipid Subfractions in Patients With Documented Atherosclerotic Cardiovascular Disease
• Results: In patients with atherosclerotic cardiovascular disease, mean ± SD total body weight (TBW) decreased 5.2%±2.5% (P<.001) as did body fat percentage (P=.02). Nuclear magnetic resonance spectroscopic analysis of lipids showed decreases in total triglycerides (P<.001), very low-density lipoprotein (VLDL) triglycerides (P<.001), VLDL size (P<.001), large VLDL concentration (P<.001), and medium VLDL concentration (P<.001). High-density lipoprotein (HDL) and LDL concentrations were unchanged, but HDL size (P=.01) and LDL size (P=.02) increased. Patients with polycystic ovary syndrome lost 14.3%±20.3% of TBW (P=.008) and patients with reactive hypoglycemia lost 19.9%±8.7% of TBW (P<.001) at 24 and 52 weeks, respectively, without adverse effects on serum lipids.
• Results: In patients with atherosclerotic cardiovascular disease, mean ± SD total body weight (TBW) decreased 5.2%±2.5% (P<.001) as did body fat percentage (P=.02). Nuclear magnetic resonance spectroscopic analysis of lipids showed decreases in total triglycerides (P<.001), very low-density lipoprotein (VLDL) triglycerides (P<.001), VLDL size (P<.001), large VLDL concentration (P<.001), and medium VLDL concentration (P<.001). High-density lipoprotein (HDL) and LDL concentrations were unchanged, but HDL size (P=.01) and LDL size (P=.02) increased. Patients with polycystic ovary syndrome lost 14.3%±20.3% of TBW (P=.008) and patients with reactive hypoglycemia lost 19.9%±8.7% of TBW (P<.001) at 24 and 52 weeks, respectively, without adverse effects on serum lipids.
Lipid panels improved on almost every measurable and patients lost weight on a high fat no starch diet. And they had cardiovascular disease. So basically, this diet improved their cardiovascular disease.
Take for example, this non-biased search boolean on low carbohydrate vs. low fat:
http://scholar.google.com/scholar?q=low carbohydrate low fat
The first study suggests:
http://www.nejm.org/doi/full/10.1056/NEJMoa022637
Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost.
This finding should be interpreted with caution, given the small magnitude of overall and between-group differences in weight loss in these markedly obese subjects and the short duration of the study. Future studies evaluating long-term cardiovascular outcomes are needed before a carbohydrate-restricted diet can be endorsed.
This finding should be interpreted with caution, given the small magnitude of overall and between-group differences in weight loss in these markedly obese subjects and the short duration of the study. Future studies evaluating long-term cardiovascular outcomes are needed before a carbohydrate-restricted diet can be endorsed.
Of course, they ended with the cautioning, but there are many other studies.
The second study suggests:
http://jcem.endojournals.org/content/88/4/1617.full?l=5579341
The very low carbohydrate diet group lost more weight (8.5 ± 1.0 vs. 3.9 ± 1.0 kg; P < 0.001) and more body fat (4.8 ± 0.67 vs. 2.0 ± 0.75 kg; P < 0.01) than the low fat diet group. Mean levels of blood pressure, lipids, fasting glucose, and insulin were within normal ranges in both groups at baseline. Although all of these parameters improved over the course of the study, there were no differences observed between the two diet groups at 3 or 6 months. β- Hydroxybutyrate increased significantly in the very low carbohydrate group at 3 months (P = 0.001). Based on these data, a very low carbohydrate diet is more effective than a low fat diet for short-term weight loss and, over 6 months, is not associated with deleterious effects on important cardiovascular risk factors in healthy women.
So they are similar.... oh wait, but hey we didn't look at the study's methods.
Subjects were randomized to 6 months of either an ad libitum very low carbohydrate diet or a calorie-restricted diet with 30% of the calories as fat.
So the low carbohydrate high fat diet did just as well as a calorie restricted lower fat diet. Why didn't they restrict kcals for the high fat diet too? Wouldn't that make a difference as well?
The third study suggests:
http://www.annals.org/content/140/10/769.short
Results: A greater proportion of the low-carbohydrate diet group than the low-fat diet group completed the study (76% vs. 57%; P = 0.02). At 24 weeks, weight loss was greater in the low-carbohydrate diet group than in the low-fat diet group (mean change, −12.9% vs. −6.7%; P < 0.001). Patients in both groups lost substantially more fat mass (change, −9.4 kg with the low-carbohydrate diet vs. −4.8 kg with the low-fat diet) than fat-free mass (change, −3.3 kg vs. −2.4 kg, respectively). Compared with recipients of the low-fat diet, recipients of the low-carbohydrate diet had greater decreases in serum triglyceride levels (change, −0.84 mmol/L vs. −0.31 mmol/L [−74.2 mg/dL vs. −27.9 mg/dL]; P = 0.004) and greater increases in high-density lipoprotein cholesterol levels (0.14 mmol/L vs. −0.04 mmol/L [5.5 mg/dL vs. −1.6 mg/dL]; P < 0.001). Changes in low-density lipoprotein cholesterol level did not differ statistically (0.04 mmol/L [1.6 mg/dL] with the low-carbohydrate diet and −0.19 mmol/L [−7.4 mg/dL] with the low-fat diet; P = 0.2). Minor adverse effects were more frequent in the low-carbohydrate diet group.
So higher retention rate with low carbohydrate. Check. Greater weight loss with low carbohydrate. Check. Low carb decreased serum triglycerides more. Check. Low carb diet increases HDL more. Check. Not sure what the minor adverse effects were, but they sure weren't big enough to have the retention rate go down more than the other group.
So I checked to at least 20 of the top results and low carbohydrate is at least equally or more effective than low fat diets (when compared) at both losing weight and on markers of cardiovascular disease risk. Check them out if you don't believe me.
Meta studies such at this one show similar findings.
http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2008.00518.x/full
There are few studies comparing the effects of low-carbohydrate/high-protein diets with low-fat/high-carbohydrate diets for obesity and cardiovascular disease risk. This systematic review focuses on randomized controlled trials of low-carbohydrate diets compared with low-fat/low-calorie diets. Studies conducted in adult populations with mean or median body mass index of ≥28 kg m−2 were included. Thirteen electronic databases were searched and randomized controlled trials from January 2000 to March 2007 were evaluated. Trials were included if they lasted at least 6 months and assessed the weight-loss effects of low-carbohydrate diets against low-fat/low-calorie diets. For each study, data were abstracted and checked by two researchers prior to electronic data entry. The computer program Review Manager 4.2.2 was used for the data analysis. Thirteen articles met the inclusion criteria. There were significant differences between the groups for weight, high-density lipoprotein cholesterol, triacylglycerols and systolic blood pressure, favouring the low-carbohydrate diet. There was a higher attrition rate in the low-fat compared with the low-carbohydrate groups suggesting a patient preference for a low-carbohydrate/high-protein approach as opposed to the Public Health preference of a low-fat/high-carbohydrate diet. Evidence from this systematic review demonstrates that low-carbohydrate/high-protein diets are more effective at 6 months and are as effective, if not more, as low-fat diets in reducing weight and cardiovascular disease risk up to 1 year. More evidence and longer-term studies are needed to assess the long-term cardiovascular benefits from the weight loss achieved using these diets.
Honestly, how much data do you need to accumulate to prove that "high fat" diets do not cause cardiovascular disease. Saturated fat, and cholesterol don't cause cardiovascular disease.
So going back to specifically something like eggs which have a bunch of cholesterol and fat in them:
http://www.ncbi.nlm.nih.gov/pubmed/22037012
http://www.ncbi.nlm.nih.gov/pubmed/20683785
http://www.ncbi.nlm.nih.gov/pubmed/18991244
http://www.ncbi.nlm.nih.gov/pubmed/21776466
http://www.ncbi.nlm.nih.gov/pubmed/19369056
http://www.ncbi.nlm.nih.gov/pubmed/21134328
http://www.ncbi.nlm.nih.gov/pubmed/15164336
http://www.ncbi.nlm.nih.gov/pubmed/18991244
http://www.ncbi.nlm.nih.gov/pubmed/18203890
http://www.ncbi.nlm.nih.gov/pubmed/17531457
http://www.ncbi.nlm.nih.gov/pubmed/16340654
The evidence vindicates saturated fats risk on heart disease.
http://wholehealthsource.blogspot.com/2011/01/does-dietary-saturated-fat-increase.html
http://www.ajcn.org/content/early/2010/01/13/ajcn.2009.27725.abstract
http://www.ajcn.org/content/80/5/1175.full.pdf html <-- decreased risk in post menopausal women with increased sat fat intake
http://healthydietsandscience.blogspot.com/2011/03/high-saturated-fat-diet-gives.html
http://www.mayoclinicproceedings.com/content/78/11/1331.full.pdf
etc.
In the same line this is why whole milk is healthier than skim milk:
http://wholehealthsource.blogspot.com/2010/12/dairy-fat-and-diabetes.html
http://www.ncbi.nlm.nih.gov/pubmed/16904009
http://www.ncbi.nlm.nih.gov/pubmed/20372173
http://www.ncbi.nlm.nih.gov/pubmed/17925824
http://www.ncbi.nlm.nih.gov/pubmed/11350992
Another interesting article that was ahead of its time:
http://www.sciencedirect.com/science/article/pii/S0002934396004561
So I hate to beat the drum on things I've already covered but the lipid hypothesis really does not make sense when you look at the literature.
When you find studies that support the role of fats in the development in cardiovascular disease and look at some of the specifics of the diet they ate they usually contain large amounts processed fats such as trans fats (which are notoriously bad for you).
This is to say that NORMAL sources of fats and oils such as animal fats, eggs, milk, butter, etc. are good for you. Industrial processed fats such as margarine, deep fried foods, vegetable oils, etc. in general are bad for you.
So what actually causes cardiovascular disease if it's not saturated fats and cholesterol?
Remember what I said before about lipid profiles?
They indicate something is wrong but they don't indicate what is wrong. The lipid hypothesis takes the incorrect step of saying that the lipids themselves cause the problems.
So that leaves us with the chronic endothelial injury hypothesis.
What likely happens is multifold.
1. Dietary effects of high carbohydrate diets (especially fructose) lead to increases in oxidized LDL. Oxidized LDL can get "stuck" in the endothelial wall which aggravates the tissues. The body sends macrophages to help try to clean up the damage. Inflammation results and the chain reaction continues.
2. Ingestion of large amounts of carbohydrates (especially fructose) lead to increases in advanced glycated end products. Fructose is 9x more likely than glucose to form AGE's by the way.
3. Trans fats.
4. Omega 3 vs Omega 6 fatty acids. Normal ancestral consumption in about 1:1 or 1:2 ratio. Normal consumption now is in 10:1 to 20:1 or higher ratios, especially in fried foods.
5. Dysregulation/dysfunction of the body's systems.
Leptin resistance contibutes to obesity. High carbohydrate/sugar intake contributes to metabolic syndrome and weight gain. All of these contribute to insulin resistance. Insulin resistance starts to contribute to dyslipedemia. You get obese, diabetes, high blood pressure, poor lipid panels. Then you get cancer, stroke, heart attack, etc.
http://en.wikipedia.org/wiki/Fructose#Health_effects
http://en.wikipedia.org/wiki/Non-alcoholic_fatty_liver_disease
http://en.wikipedia.org/wiki/Metabolic_syndrome
If you are obese or have documented cardiovascular disease et al. you should know that some of the disease can be reversed to an extent with a low carbohydrate, ketogenic, or Paleolithic diet.
Videos if you don't like reading:
So in the end I hope that this was helpful and that you learned something about nutrition.
