Good Fats, Bad Fats

Good Fats, Bad Fats

Every one of our trillions of cells are made of fats and we can’t be alive without fats. Omega 3 fats from fish and tree nuts are healthy and protective, whereas omega 6 fats from vegetable oils and trans fats from hydrogenated oils are bad. The ratio between good fats and bad fats does matter a lot.

The Evidence

Healthy Nuts:

  • Consumption of nuts prevents metabolic syndrome: [O’Neil CE, Keast DR, Nicklas TA, Fulgoni VL. Out-of-hand nut consumption is associated with improved nutrient intake and health risk markers in US children and adults: National Health and Nutrition Examination Survey 1999-2004 Nutrition Research March 2012;32(3 ):185-194. Abstract | O’Neil CE, Keast DR, Nicklas TA, Fulgoni VL. Nut Consumption is Associated with Decreased Health Risk Factors for Cardiovascular Disease and Metabolic Syndrome in U.S. Adults: NHANES 1999–2004. J Am Coll Nutr. December 2011;30(6):502-510 Abstract]
  • Eating nuts may enhance mood. [See]
  • Nuts in Place of carbohydrates Helps Control Blood Sugar and Serum Lipids: Two ounces of nuts daily as a replacement for carbohydrate foods improves both glycemic control and serum lipids in type 2 diabetes.[Jenkins DJA. Nuts as a Replacement for Carbohydrates in the Diabetic Diet. [Diabetes Care August 2011;34(8):1706-1711. Full text]
  • Eating nuts every day helps control Type 2 diabetes and prevent its complications: New research from St. Michael’s Hospital and the University of Toronto has revealed that two ounces of nuts daily as a replacement for carbohydrate foods improved both glycemic control and serum lipids in type 2 diabetes. [Jenkins DJA. Nuts as a Replacement for Carbohydrates in the Diabetic Diet. Diabetes Care June 29, 2011 doi: 10.2337/dc11-0338 Full Text | Report]
  • Almonds may help reduce risk of type 2 diabetes and heart disease: Studyshows that consuming an almond-enriched diet may help improve insulin sensitivity and decrease LDL-cholesterol levels in those with prediabetes. [Michelle Wien et al. Almond Consumption and Cardiovascular Risk Factors in Adults with Prediabetes. Journal of the American College of Nutrition. 2010;29(3):189-197. Abstract | Report]
  • A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study.  Fraser GE et al. Arch Int Med 1992;152(7):1416. [See]
  • Nut Consumption and Decreased Risk of Sudden Cardiac Death in the Physicians’ Health Study.  Albert CM et al. Arch Intern Med. 2002;162:1382-1387. [See]
  • Nut consumption, vegetarian diets, ischemic heart disease risk, and all-cause mortality: evidence from epidemiologic studies. Sabaté J et al. Am J Clin Nutr 1999;70(3):500S-503S. [See]
  • Nuts and their bioactive constituents: effects on serum lipids and other factors that affect disease risk. Kris-Etherton PM et al. Am J Clin Nutr 1999;70(3):504S-511S. [See]

Trans Fats:

  • Consumption of Trans Fatty Acids Is Related to Plasma Biomarkers of Inflammation and Endothelial Dysfunction. Lopez-Garcia E. J. Nutr. 2005;135:562-566. [See]
  • Health effects of trans fatty acids.  Ascherio A, Willett WC. Am J Clin Nutr 1997;66:1006S-1010S. [See]
  • Trans fatty acid isomers in human health and in the food industry.  Valenzuela A, Morgado N. Biol. Res. Santiago 1999;32(4). doi: 10.4067/S0716-97601999000400007. [See]
  • Revealing trans fats. FDA.[See]

Low Carb Advantage

Low Carb Advantage

We, humans, are eating loads of carbohydrates. But, there is increasing evidence to show that low carb and energy restricted diets protect against modern day diseases such as obesity, type 2 diabetes, hypertension etc., Calorie restriction also increases longevity.

Emerging Evidence

  • Five Lifestyle Changes Can Go a Long Way Toward Cutting the Odds of Type 2 Diabetes: A Population-based prospective cohort study that examined how combinations of lifestyle risk factors relate to the 11-year risk for incident diabetes (National Institutes of Health (NIH)–AARP Diet and Health Study) included 114 996 men and 92 483 women, aged 50 to 71 years in 1995 to 1996, without evidence of heart disease, cancer, or diabetes, with a follow-up survey in 2004 to 2006. Of these, 11 031 men (9.6%) and 6969 women (7.5%) developed new-onset diabetes. Normal weight (maintained a body mass index below 25), nonsmoking, physically active (at least 20 minutes of heart-pounding, sweat-inducing exercise three or more times per week), healthy diet [a diet with lots of fiber, little trans fat, few refined or sugary carbohydrates, and a high ratio of good (polyunsaturated) to bad (saturated) fats] and little to no drinking (two drinks or less a day for men, and one drink or less for women) were associated with least risk of developing diabetes mellitus. [Reis JP et al. Lifestyle Factors and Risk for New-Onset Diabetes. A Population-Based Cohort Study. Ann Int Med. September 6, 2011;155(5):292-299 Full Text |Report]
  • Increasing the ratio of beans to white rice, or limiting the intake of white rice by substituting beans, may lower cardiometabolic risk factors: A new study from Costa Rica, which involved monitoring the diet of almost 2,000 people in an investigation of risk factors for heart disease between 1994 and 2004, has shown that those who regularly traded a helping of white rice for one of beans experienced a 35 per cent reduction in the risk of symptoms that usually lead to diabetes. [Mattei J, Hu FB, Campos H. A higher ratio of beans to white rice is associated with lower cardiometabolic risk factors in Costa Rican adults. Am J Clin Nutr. 2011 Sep;94(3):869-76. Epub 2011 Aug 3. Abstract |Report]
  • Carbohydrate restriction and egg consumption help to alleviate metabolic syndrome [Report]
  • Low Carbohydrate Diet May Reverse Kidney Failure in People With Diabetes: Researchers from Mount Sinai School of Medicine have for the first time determined that a specialized high-fat, low carbohydrate diet may reverse impaired kidney function in people with Type 1 and Type 2 diabetes. [Poplawski MM, Mastaitis JW, Isoda F, Grosjean F, Zheng F, et al. Reversal of Diabetic Nephropathy by a Ketogenic Diet. PLoS ONE 2011;6(4):e18604. doi:10.1371/journal.pone.0018604 Full Text | Older Study | Report | Report]
  • Obstructive Sleep Apnea May Be Improved With Low-Energy Diet: A single-center, prospective, observational follow-up study has found that a very low-energy diet leads to improvements in moderate to severe obstructive sleep apnea in obese men, with benefits maintained at 1 year and proportional to weight loss and baseline severity. [Full text |Report]
  • Type 2 diabetes in newly diagnosed ‘can be reversed’: A small study from Newcastle University, reported in Diabetologia, has found that an extreme eight-week diet of 600 calories a day can reverse Type 2 diabetes in people newly diagnosed with the disease. Although larger studies are needed, these findings are important. [BBC Report]
  • Low-Glycemic-Index Diet Appears to Modulate Alzheimer’s Biomarker: A 4-week diet intervention study has found that healthy cognitively intact older adults who stuck to a low-saturated-fat, low-glycemic-index diet experienced decreases in cerebrospinal fluid (CSF) levels of β-amyloid 42, a biomarker of Alzheimer’s disease risk. [Bayer-Carter JL at al. Diet Intervention and Cerebrospinal Fluid Biomarkers in Amnestic Mild Cognitive Impairment. Arch Neurol. 2011;68(6):743-752. doi:10.1001/archneurol.2011.125 | Report]
  • Mediterranean Diet Cuts Metabolic Syndrome Risk: A meta analysis of the results of 50 studies comprising more than 500,000 people has shown that the Mediterranean diet can reduce the risk of metabolic syndrome. [Abstract from Kastorini CM. The Effect of Mediterranean Diet on Metabolic Syndrome and its Components: A Meta-Analysis of 50 Studies and 534,906 Individuals. J Am Coll Cardiol. 2011;57:1299-1313. doi:10.1016/j.jacc.2010.09.073. | Report]
  • Higher-Protein/Low-GI Diet Best for Maintaining Weight Loss [See Larsen TM et al. Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance.N Engl J Med November 25, 2010; 363:2102-2113 Abstract | Report]
  • Eating whole grains, compared to refined grain products, could lower heart disease risk A large cross sectional study among the Framingham Heart Study participants has shown that increasing whole-grain intake is associated with lower visceral adipose tissue (VAT) in adults, whereas higher intakes of refined grains are associated with higher VAT.[See Abstract AJCNReport]
  • Mediterranean diet protects against type 2 diabetes: [See Full Text Diabetes CareAbstractReport]
  • Low carbohydrate and high monounsaturated fat diets help weight loss and offer metabolic benefits: Brehm BJ,  D’Alessio DA. Weight Loss and Metabolic Benefits With Diets of Varying Fat and Carbohydrate Content: Separating the Wheat From the Chaff Nature Clinical Practice Endocrinology & Metabolism Available at http://www.medscape.com/viewarticle/569321
  • Increasing daily intake of green leafy vegetables could significantly reduce the risk of Type 2 Diabetes: Increasing consumption of green vegetables, and not fruits, helps to reduce the risk of diabetes, a meta analysis finds See Patrice Carter et al. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ 2010;341:c4229 Full Text | Editorial]
  • Higher Fat at Breakfast May Be Healthier: University of Alabama research reveals that mice fed a meal higher in fat had normal metabolic profiles and in contrast, mice that ate a more carbohydrate-rich diet in the morning and consumed a high-fat meal at the end of the day saw increased weight gain, adiposity, glucose intolerance and other markers of the metabolic syndrome. [MS Bray, J-Y Tsai et al. Time-of-day-dependent dietary fat consumption influences multiple cardiometabolic syndrome parameters in mice. International Journal of Obesity. 30 March 2010.] doi:10.1038/ijo.2010.63 [Abstract] | UAB Report]
  • A Randomized Trial of a Low-Carbohydrate Diet vs Orlistat Plus a Low-Fat Diet for Weight Loss: A new randomized trial comparing a low-carbohydrate diet with a low-fat diet in combination with the weight-loss drug orlistat has found that both strategies produced meaningful weight loss and the low-carb diet in addition produced significant improvements in blood pressure. William S. Yancy Jr, et al., Published in Arch Intern Med. on Jan 25, 2010 [Abstract] | Report]
  • Mediterranean Diet May Have a Protective Role Against Depression: Abstract of Sánchez-Villegas A et al., Arch Gen Psychiatry
  • Mediterranean Diet Might Delay Need for Drugs in Diabetes: Full Text in Esposito K et al., Annals Int Med, 1 Sep, 2009Medscape Article
  • Low-carbohydrate diet has similar effects as low-fat diet in diabetes: Full Text in Davis NJ et al., Diabetes Care, July, 2009
  • Low-Carb and Mediterranean Diets Better than Low-Fat for Weight Loss, Lipid Changes at 2 Years: Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets, offering more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet).
    See Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229-241 Full text Article
  • Caloric Restriction Delays Disease Onset and Mortality in Rhesus Monkeys 
    Abstract in Science, 10 July, 2009BBC NewsScience News
  • Against the grain: Tribals in Maharashtra are happier and healthier with their traditional, natural food: Full Text Article in Down To Earth
  • Diet And Asthma: Mediterranean Diet May Be Protective: See Report | One More Report |Abstract
  • The Mediterranean Diets: What Is So Special about the Diet of Greece? The Scientific Evidence. Simopoulos AP. J. Nutr. 2001;131:3065S-3073S. [See]
  • Paleolithic vs. modern diets – selected pathophysiological implications. Eaton SB, Eaton SB. European Journal of Nutrition 2000;39(2):67-70. [See]
  • A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs. Tommy Jönsson et al. Nutrition & Metabolism 2006;3:39. [See]
  • Biological and Clinical Potential of a Palaeolithic Diet.  Lindeberg S et al. Journal of Nutritional & Environmental Medicine 2003;13(3):149 – 160. [See]
  • Paleolithic nutrition revisited: A twelve-year retrospective on its nature and implications.  Eaton SB. Eur J Clin Nutr 1997;51:207-216. [See]
  • The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic.  Cordain L et al. Eur J Clin Nutr 2002;56(Suppl 1): S42–S52. [See]
  • Evolution, Diet and Health.  Eaton SB, Eaton SB. [See]
  • Against the grain: How agriculture has hijacked civilization.Manning R. North Point Press, New York. 2004
  • Molecular mechanisms linking calorie restriction and longevity. Merry BJ. Int J Biochem Cell Biol. 2002 Nov;34(11):1340-1354. [See]
  • The Retardation of Aging in Mice by Dietary Restriction: Longevity, Cancer, Immunity and Lifetime Energy Intake. Weindruch R et al. J Nutrition 1986;116(4):641-654. [See]
  • A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity. Samaha FF. NEJM 2003;348(21):2074-2081. [See]
  • A Randomized Trial of a Low-Carbohydrate Diet for Obesity. Foster GD. NEJM 348(21):2082-2090. [See] [See Full Text]
  • Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors – A Meta-analysis of Randomized Controlled Trials. Nordmann AJ et al. Arch Intern Med. 2006;166:285-293. [See]
  • Fasting Lipoprotein and Postprandial Triacylglycerol Responses to a Low-Carbohydrate Diet Supplemented with n-3 Fatty Acids. Volek JF et al. J Amer Coll Nutr 2000;19(3):383-391. [See]
  • Comparison of a Low-Fat Diet to a Low-Carbohydrate Diet on Weight Loss, Body Composition, and Risk Factors for Diabetes and Cardiovascular Disease in Free-Living, Overweight Men and Women.  Meckling KA et al. J Clin Endocrin Met 89(6):2717-2723. [See]
  • A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women.  Brehm BJ et al. J Clin Endocrin Met 88(4):1617-1623. [See]
  • Health effects of vegetables and fruit: assessing mechanisms of action in human experimental studies. Lampe JW. Am J Clin Nutr 1999;70(3):475S-490S. [See]
  • Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.  Bazzano LA et al. Am J Clin Nutr 2002;76(1):93-99. [See]
  • Fruit and vegetable intake and risk of cardiovascular disease: the Women’s Health Study.  Liu S et al. Am J Clin Nutr 2000;72(4):922-928. [See]
  • Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? New SA et al. Am J Clin Nutr 2000;71(1):142-151. [See]
  • Rely on internal cues of meal cessation to keep off obesity: Wansink B, Payne CR, Chandon P. Internal and External Cues of Meal Cessation: The French Paradox Redux? Obesity 2007;15:2920-2924. Available at http://www.obesityresearch.org/cgi/content/full/15/12/2920

Modern Diet Fuels Diseases

Modern Diet Fuels Diseases

Our modern diet, comprising mostly of processed cereals, sugars and sweeteners, fried food, fruits and juices, fast food etc., is increasingly being blamed for the so called modern diseases. With increasing exposure to these foods right from early childhood, the modern diseases also seem to be striking the young.

The Evidence

  • Western Diet Promotes Metabolic Syndrome: Yet another study has shown that consumption of Western diet (higher intakes of fast food, meat and poultry, pizza, and snacks) and diet beverage is associated with higher risk of metabolic syndrome when compared with a prudent diet. [Duffey KJ, Steffen LM, Horn LV, Jacobs Jr DR, Popkin BM. Dietary patterns matter: diet beverages and cardiometabolic risks in the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr. April 2012 ajcn.026682. Abstract]
  • White rice and risk of type 2 diabetes: A Meta-analysis of prospective cohort studies has revealed that Asian (Chinese and Japanese) populations had much higher white rice consumption levels than did Western populations and that higher consumption of white rice is associated with a significantly increased risk of type 2 diabetes in Asian populations. [Hu EA, Pan A, Malik V, Sun Q. White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ 2012;344:e2021 doi: 10.1136/bmj.e1454 Full Text |Editorial | Report]
  • Western Style Diets Linked to Kidney Dysfunction: According to a study published in the American Journal of Kidney Diseases, Western diet is associated with a greater likelihood of the development of microalbuminuria (excretion of small amounts of albumin to the urine) and rapid decrease in kidney function, whereas diets similar to the Dietary Approach to Stop Hypertension (DASH) diet may be protective against rapid decline of estimated glomerular filtration rate (eGFR). [Abstract from American Journal of Kidney Diseases February 2011;57(2):245-254 | Report]
  • Processed Food Diet in Early Childhood may Lower IQ: The Avon Longitudinal Study of Parents and Children, which tracks the long term health and wellbeing of around 14,000 children born in 1991 and 1992, has found that a predominantly processed food diet at the age of 3 was associated with a lower IQ at the age of 8.5, whereas a healthy diet was associated with a higher IQ at the age of 8.5. Press Release | Report]
  • Modern day food causes all the ills: The highly processed, calorie-dense, nutrient-depleted diet frequently leads to exaggerated supraphysiological post-prandial spikes in blood glucose and lipids. This post-prandial dysmetabolism induces immediate oxidant stress, which increases in direct proportion to the increases in glucose and triglycerides after a meal. The transient increase in free radicals acutely triggers atherogenic changes including inflammation, endothelial dysfunction, hypercoagulability, and sympathetic hyperactivity. To attenuate the increase in glucose, triglycerides, and inflammation after a meal,  a diet rich in minimally processed, high-fiber, plant-based foods, including vegetables and fruits, whole grains, legumes, and nuts is recommended. Other dietary interventions that can significantly ameliorate postprandial dysmetabolism include intake of lean protein, vinegar, fish oil, tea, and cinnamon. Additional benefits may result from calorie restriction, weight loss and exercise.
    See O’Keefe JH, Gheewala NM, O’Keefe JO. Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health. J Am Coll Cardiol 2008; 51:249-255 Abstract at http://content.onlinejacc.org/cgi/content/abstract/51/3/249 | Anti-Inflammatory” Diet May Improve Postprandial Glucose, Cardiovascular Health
  • Imbalanced diet and inadequate exercise may underlie asthma in children: Metabolic syndrome markers correlate with asthma, new study reveals. [See Report]
  • Metabolic disorders striking the young: Should the stress be on ‘Stress’ or on Food? Many reports emerging from India reveal increasing incidence of metabolic syndrome disorders in young children and many things such as stress at school, sedentary life style, computers, TV, genes and junk food have been blamed. Some have even advised the kids to stop schooling and do yoga for relaxation! Is it not ironical that the so called experts who sought changes in our school education, so as to make it less stressful, now blame the changed methodology for increasing stress? In blaming many things, the strongest reason is bound to be missed: and that reason is the FOOD! See The Young Are Ageing. Outlook Sep 13, 2010 Full Text | Delhi kids suffer from adult ailments! Wonder Woman Sep 8, 2010 [Full Text]
  • Ancient Egyptians Too Had Atherosclerotic Vascular Disease  Abstract of Allam AH et al., JAMA, November 18, 2009;302(19)Medpage Today ReportPhys Org Report
  • Globalization of Food Patterns and Cardiovascular Disease Risk [See] | Globalization and the epidemiology of obesity [See]
  • Dietary Patterns and Risk of Mortality From Cardiovascular Disease, Cancer, and All Causes: See Mediterranean Diet and Incidence of and Mortality From Coronary Heart Disease and Stroke in Women – Circulation, Feb 2009 | A Prospective Cohort of Women; Circulation, 2008;118:230-237 | Dietary Patterns and the Risk of Acute Myocardial Infarction in 52 Countries]
  • Origins and evolution of the Western diet: health implications for the 21st century [See]
  • Canine and Feline Diabetes Mellitus: Nature or Nurture? Rand JS et al. J. Nutr. 2004;134:2072S-2080S [See]
  • Diabetes mellitus in urban and rural communities in Papua New Guinea. Martin FIR et al. Diabetologia. 1980;18(5) [See]
  • Origins and evolution of the Western diet: health implications for the 21st century. Cordain L. Am J Clin Nutr. 2005;81(2):341-354. [See]
  • Putting the wrong fuel in the tank. Burkitt DP, Eaton SB. Nutrition. 1989; 5(3): 189-91. [See]
  • Changes in childhood food consumption patterns: a cause for concern in light of increasing body weights. St-Onge MP, Keller KL, Heymsfield SB. Am J Clin Nutr. 2003;78(6):1068-1073. [See]
  • Fast food restaurant use among adolescents: associations with nutrient intake, food choices and behavioral and psychosocial variables. French SA et al. Int J Obesity. December 2001;25(12):1823-1833. [See]
  • Do We Fatten Our Children at the Television Set? Obesity and Television Viewing in Children and Adolescents. Dietz WH, Gortmaker SL. Pediatrics 1985;75(5):807-812. [See]
  • Epidemic obesity in the United States: are fast foods and television viewing contributing?  Jeffery RW, French SA. Am J Pub Health 1998;88(2):277-280. [See]
  • Imbalanced diet and inadequate exercise may underlie asthma in children: Metabolic syndrome markers correlate with asthma, new study reveals. [See Report]
  • Antibiotic Use May Fuel Modern Day Diseases: Increase in modern day diseases such as obesity, diabetes, allergies and asthma correlate with increasing use of antibiotics, that may be changing the gut milieu. [Blaser M. Antibiotic overuse: Stop the killing of beneficial bacteria. Nature 25 August 2011;476:393–394. Link | Report]