Low Carb Diets May Pose High Risks

March 08, 2004, HealthNewsDigest.com

by Jennifer Wider, MD, Society for Women's Health Research

http://magazines.ivillage.com/goodh...qCap=1undefined

(HealthNewsDigest.com)...Low-carbohydrate products have invaded our supermarkets. From cereal and ice-cream to snack food and drinks, Atkins mania is everywhere. The Atkins diet and other low-carbohydrate, high-protein diets promise a thinner waistline in record time, but the public seems to be ignoring evidence that this type of diet may have long-term health consequences. What's more, a menu rich in protein and fat has particular concerns for women.

Topping the list of women's health concerns are heart disease, cancer and osteoporosis. Studies have suggested that long-term use of high-protein diets can increase the risk of all three.

Cardiovascular disease is the leading killer of women in the United States. Among the many risk factors, dietary habits and weight status have frequently been implicated. High-protein diets are, by and large, loaded with dietary cholesterol and saturated fat.

Ongoing research trials are trying to determine the effects of such diets on blood cholesterol levels, but there is clear evidence that meals high in saturated fat increase the risk of heart attack. The greatest body of evidence supports the claim that limiting saturated fat and cholesterol in the diet will lower the risk of coronary heart disease.

Most people are unaware that colorectal cancer is the third most common cancer in women behind lung and breast cancers. In 1997, the American Institute for Cancer Research definitively stated that diets high in red meat were likely factors in the development of colorectal cancer. In addition, high-protein, low-carbohydrate diets are often low in fiber. Dietary fiber has proven to be protective against colorectal cancers, according to the results of numerous studies.

Diet seems to play a role in the development of breast cancer, as well. Many research studies link diets high in saturated fat to an increased risk for breast cancer. Results from the Nurses' Health Study establish a relationship between increased consumption of animal fat and a higher risk of breast cancer.

Today in the United States, roughly 10 million people have osteoporosis and 80 percent of sufferers are women. Studies have shown that the body loses large amounts of calcium when a person is on a high protein, low carbohydrate diet. There is evidence that high-protein diets promote the loss of calcium in the urine, increasing the risk of kidney stones and osteoporosis.

Even the Atkins diet Web site lists the potential dangers, so why is the public so perplexed? There's so much contradictory information in the media, not all accurate, that consumers are totally confused, Keith-Thomas Ayoob, Ed.D., nutrition clinic director at the Rose F. Kennedy Children's Evaluation and Rehabilitation Center and associate professor at the Albert Einstein College of Medicine in Bronx, N.Y., said.

There is some evidence that the Atkins diet yields positive results. Two studies in the New England Journal of Medicine in May 2003 revealed that patients were able to lose more weight on Atkins than on traditional diets and one study even suggested that the diet could improve certain heart disease risk factors.

The weight loss on Atkins is clear, said Randy Seeley, M.D., an associate director of the Obesity Research Center at the University of Cincinnati and a member of the Society for Women's Health Research's Isis Fund Network on Metabolism, an interdisciplinary research network on metabolic disorders.

But there are no long-term studies to provide information about the advantages or disadvantages of the diet in the long run. In the absence of information, Seeley said, it is dangerous to give people advice.

With the number of obese Americans at record numbers, extreme dieting doesn't seem to be paying off.

Overweight isn't caused by carbs or fat, but by excess, Ayoob said. It's a disease of excess and it's cured with balance. Balance in your diet, your activity and your lifestyle. No one diet will fit everyone, but extreme diets are useless in the long run.

It is clear that many people lose weight on Atkins and similar diets. Because no long-term studies have ever defined the risks, there is a need for more research to fully assess the potential health hazards of these diets.

Ok..I have a few things to add though...(Sorry if it's long!)

1)
The best diet to avoid breast cancer is high-fat (animal, not vegetable), low-carbohydrate: "After mutual adjustment of different types of fat, an inverse association with monounsaturated fat and a positive association with polyunsaturated fat were found"
. . . "Saturated fat was not associated with the risk of breast cancer"
. . . "we found no positive association between intake of total fat and risk of invasive breast cancer".
Archives of Internal Medicine
1998; 158: 41-45

2)
The best diet to avoid colon cancer is low-carbohydrate, low cereal fibre (bran): "Many carbohydrates can stimulate epithelial-cell proliferation throughout the gastrointestinal tract."
. . . "Until individual constituents of fibre have been shown to have, at the very least, a non-detrimental effect in prospective human trials, we urge that restraint should be shown in adding fibre supplements to foods, and that unsubstantiated health claims be restricted."
. . . "Specific dietary fibre supplements, embraced as nutriceuticals or functional foods, are an unknown and potentially damaging way to influence modern dietary habits of the general population."
Lancet 1996; 348: 319-20

3)
"Our data do not support the existence of an important protective effect of dietary fiber against colorectal cancer or adenoma."
New England Journal of Medicine 1999;340:169-176, 223-224


4)
"The risk of breast cancer decreased with increasing total fat intake (trend p=0.01) whereas the risk increase with increasing intake of available carbohydrates (trend p=0.002)"
. . . "The findings also suggest a possible risk,
. . . of reliance on a diet largely based on starch."
Lancet 1996; 347: 1351-56

5)
"We found no evidence of a positive association between total dietary fat intake and the risk of breast cancer.
There was no reduction in risk even among women whose energy intake from fat was less than 20 percent of total energy intake. In the context of the Western lifestyle, lowering the total intake of fat in midlife is unlikely to reduce the risk of breast cancer substantially."
New England Journal of Medicine,
1996; 334:356-61

6)
A study looking at colorectal subsites: ascending, transverse, descending, sigmoid and rectum concludes that loose or soft faeces are a significant risk factor for cancer at these sites.
Cancer Causes and Control
1995; 6: 14-22.
NOTE: Bran loosens faeces (BAG)

7)
"Johns Hopkins researchers have found evidence that some cancer cells are such incredible sugar junkies that they'll self-destruct when deprived of glucose, their biological sweet of choice"
. . . "Scientists have long suspected that the cancer cell's heavy reliance on glucose, its main source of strength and vitality, also could be one of its great weaknesses,
and Dang's new results are among the most direct proofs yet of the idea."
Proceedings of the National Academy of Sciences USA,
1998; 95: 1511-1516.


8)
Obese people tend to go on
to suffer type II diabetes (NIDDM) and diabetics are more prone to heart disease. For this reason patients with NIDDM are counselled to eat
a 'healthy' low-fat, high-carb diet. But: the best diet for diabetics to avoid heart disease is high-fat, low-carbohydrate because:
"A very high-fat, low-carbohydrate diet has been shown to have astounding effects in helping type 2 diabetics lose weight and improve their blood lipid profiles. The thing many diabetics coming into the office don't realize is that other forms of carbohydrates will increase their sugar, too. Dieticians will point toward complex carbohydrates ... oatmeal and whole wheat bread, but we have to deliver the message that these are carbohydrates that increase blood sugars, too."
81st Annual Meeting of The
Endocrine Society, 12-15
June 1999, San Diego, California

9)
The best diet for weight loss is high-fat, low-carbohydrate because: Average daily losses on high carbohydrate/low fat diet - 49g (like modern slimming diets) Average daily losses on low carbohydrate/high fat diet - 205g (like recommended)
"The most striking feature of the table is that the losses appear to be inversely proportionate to the carbohydrate content of the food. Where the carbohydrate intake is low the rate of loss in weight is greater and conversely."
Quarterly Journal of Medicine
1932; 1: 331-52


10)
"Reduced fat and calorie intake and frequent use of low-calorie food products have been associated with a paradoxical increase in the prevalence of obesity."
American Journal of Medicine
1997; 102: 259-64.

11)
In general, study has demonstrated that multiple risk factors for coronary heart disease are worsened for diabetics who consume the low-fat, high-carbohydrate diets so often recommended to reduce these risks"
Diabetes Care 1995; 18: 10-16

12)
"The failure of fat people to achieve a goal they seem to want and to want almost above all else must now be admitted for what it is: a failure not of those people but of the methods of treatment that are used."
British Medical Journal
1994; 309: 655-6.

13)
"it seems prudent to avoid
the use of low-fat, high-carbohydrate diets containing moderate amounts of sucrose in patients with non-insulin-dependent diabetes mellitus."
American Journal of Medicine
1987; 82:213-220.

14)
"In this study we compared the effects of variations in dietary fat and carbohydrate (CHO) content on concentrations of triglyceride-rich lipoproteins". . . "The diets contained, as a percentage of total calories, either 60% CHO, 25% fat, and 15% protein, or 40% CHO, 45% fat, and 15% protein." "The 60% CHO diet resulted in higher fasting plasma triglycerides (206 ± 50 vs 113 ± 19 mg/dl, p = 0.03), cholesterol (15 ± 6 vs 6 ± 1 mg/dl,
p = 0.005), triglyceride (56 ± 25 vs
16 ± 3 mg/dl, p = 0.003), and lower HDL cholesterol (39 ± 3 vs 44 ± 3 mg/dl,
p = 0.003) concentrations, without any change in LDL cholesterol concentration." "Given the atherogenic potential of these changes in lipoprotein metabolism, it seems appropriate to question the wisdom of recommending that all Americans should replace dietary saturated fat with CHO."
American Journal of Cardiology
2000; 85: 45-4

15)
"Low-fat, high-carbohydrate diets [15% protein, 60% carb, 25% fat] increase the risk of heart disease in post-menopausal women.".
American Journal of Clinical
Nutrition 1997; 65: 1027-33

16)
"Intake of margarine may predispose to development of CHD in men."
Circulation 1995; 91: 925

17)
"Moreover, recent findings in a US population, among 350,000 MRFIT screenees followed 6 years, bear on this idea (of increased stroke and cerebral haemorrhage risk with lowered cholesterol). In that study, there was a sixfold excess risk of death from cerebral haemorrhage in middle-aged men having total serum cholesterol levels lower than 160 mg/dl and also elevated BP."
Circulation 1989; 79 (3): 718-20.

18)
"Intakes of fat, saturated fat, and monosaturated fat were associated with reduced risk of ischemic stroke in men." "In our data intakes of fat and type of fat were not related to the incidence of the combined outcome of all cardiovascular diseases or to total or cardiovascular mortality."
Journal of the American Medical
Association 1997; 78: 2145-2150

19)
"Medical Research Council survey showed that men eating butter ran half the risk of developing heart disease as those using margarine."
Nutrition Week 1991; 21(12): 2-3

20)
Cholesterol is not a deadly poison, but a substance vital to the cells of all mammals. There are no such things as good or bad cholesterol, but mental stress, physical activity and change of body weight may influence the level of blood cholesterol. A high cholesterol is not dangerous by itself, but may reflect an unhealthy condition, or it may be totally innocent.
Uffe Ravnskov, M.D., Ph.D.

TBoneMitch! Nice!

TBone - long , but VERY good. It's great to see all those articles lined up like that.