Interesting items from my inbox …
ADA Diet Fails Again
That should have been the headline: ADA Diet Fails Again. But it wasn’t. The headline on MedPageToday was Lifestyle Changes Don’t Protect Diabetic Heart. Here are some quotes:
An intense lifestyle intervention for patients with type 2 diabetes that was focused on diet and exercise failed to protect patients against heart problems, researchers reported here.
Final analysis of the randomized, controlled Look AHEAD trial, which was halted in September for failing to show cardiovascular benefit, revealed no significant differences in a composite of cardiovascular endpoints between those who had the intervention and those who only received advice (1.83 events per 100 person-years versus 1.92, P=0.51), according to Rena Wing, PhD, of Brown University, and colleagues.
Wing said during a press briefing that there are a host of explanations for the lack of benefit, among them the fact that participants in the control group were on more medications, particularly statins, which could have lowered their risk of cardiovascular disease, and they also received good education on their disease and on lifestyle.
Also, Wing and colleagues noted, the weight loss achieved by those in the intense group may not have been sufficient to reduce the risk of cardiovascular disease; or the education received in the control group could have lessened the difference between the two groups.
Hmmm, when researchers more or less trash their own study design after the fact, you know they aren’t happy with the results. If the diet and exercise program had produced a significant drop in heart-attack deaths, I doubt they’d be pointing out potential confounders in the study. I’m surprised they didn’t try to save face by announcing that they found a “suggestion” of a benefit despite no significant differences in the data.
Wing noted that subgroup analyses looking at outcomes by history of cardiovascular disease didn’t turn up any significant findings, but they did show “some suggestion” that the intervention was effective at reducing the risk of cardiovascular disease in patients without a history of heart problems.
I stand corrected.
The MedPageToday article didn’t spell out the “intense” lifestyle intervention, so I had to look it up in the full study. Here it is:
Specific intervention strategies included a calorie goal of 1200 to 1800 kcal per day (with <30% of calories from fat and >15% from protein), the use of meal-replacement products, and at least 175 minutes of moderate-intensity physical activity per week.
A low-fat, low-calorie diet plus a half-hour or so of aerobic exercise per day … in other words, exactly what the ADA, AHA, USDA, your average doctor, and all the other experts recommend.
I think we know why the study was such a disappointment.
No-Carb Breakfast Gives You Fatigue?
An article on the Huffington Post titled 7 Little Habits That Are Making You Tired offered this advice:
It’s a myth that if you eat carbohydrates it can zap your energy later on. In reality, your body needs carbs to produce fuel.
I guess it’s a miracle that I’m able to program computers, write blog posts, produce videos, play 72 holes of disc golf and lift weights without any fuel.
A study in the Journal of the American Dietetic Association found that low-carb dieters experienced greater fatigue and reluctance to exercise than dieters who ate more carbohydrates.
I’ve seen that study. The researchers took people who were living on high-carb diets, put them on zero-carb diets, then tested their energy levels a few days later – before they had time to adapt. Then they concluded that people who don’t eat carbs feel fatigued.
Let’s apply that logic elsewhere. People who quit smoking often feel fatigued and depressed for several weeks. Therefore I can only conclude that non-smokers suffer from fatigue. When you’re wolfing down your energy-producing, high-carb breakfast, don’t forget to enjoy a Marlboro afterwards.
As for a meal high in refined carbs zapping your energy later, let’s look at part of an article about another study on that subject:
New brain studies suggest that carb addiction could be real.
Boston Children’s Hospital researchers who scanned the brains of men after they drank milkshakes containing rapidly digesting, highly processed carbohydrates found the men experienced a surge in blood sugar followed by a sharp and sudden crash four hours later.
That plummet in blood sugar activated a powerful hunger signal and stimulated the brain region considered ground zero for addictive behaviour.
“We showed for the first time that refined carbohydrates can trigger food cravings many hours later, not through psychological mechanisms — a favourite food is just so tasty, you need to keep eating — but through biological effects” on the brain, said lead author Dr. David Ludwig.
A load of simple carbs. Glucose spike. Glucose crash. Hunger. Sounds like my experience with the Fit For Life diet.
Earlier studies have shown that tasty, high-calorie foods can trigger the pleasure centre in the brain, raising the notion of “food addiction.”
Ah yes, the food-reward theory. We overeat foods that taste good – just because they taste good. Keep reading:
But Ludwig said those studies typically compared “grossly different foods,” such as cheesecake versus boiled vegetables.
His team performed functional MRI brain scans — machines that capture the brain at work in real-time — on 12 overweight or obese men aged 18 to 35 after they consumed two liquid test meals that looked and tasted identical, and contained the same amounts of calories and carbohydrates. The only difference was that one shake contained fast-digesting, high-GI carbs, the other slow-digesting carbs.
The shakes looked and tasted identical. The food-reward stimulus should be the same. So what happened?
After the high GI liquid meal, blood sugar surged initially, but then crashed four hours later. The men not only reported greater hunger, their MRI scans also showed intense activation in the nucleus accumbens, the part of the brain involved in reward and craving.
It wasn’t the taste that created the craving. It was the glucose crash.
For the record, I don’t totally dismiss food-reward as a factor in obesity. Food manufacturers have made a lot of foods that spike glucose levels taste really, really good. The hyper-rewarding taste draws people to the foods – but it’s the glucose spike-and-crash that causes people to overeat, not the reward factor. I find bacon highly rewarding, but I never gorge on the stuff.
The Guy From CSPI Strikes Again
In Fat Head, I showed the Guy From CSPI declaring fettuccini alfredo a heart attack on a plate and the Hardee’s Monster Thickburger a heart attack on a bun. I’d wager he’s been anxiously awaiting a chance to expand his heart attack on [something] repertoire. Well, he got his chance last week. Now he’s discovered the Heart Attack on a Hook:
A consumer advocacy group is threatening to sue a seafood chain if it doesn’t stop its use of a trans fatty oil, which has contributed to nutrition stats that lead the group to label one of its menu items the “worst restaurant meal in America.”
The Center for Science in the Public Interest issued a formal complaint to Long John Silver’s this week and put out a press release to the public stating that the fast-food restaurant’s “Big Catch” meal — a fried haddock filet, fried onion rings and fried hush puppies — has 33 grams of trans fats, which it states adds up to two weeks worth of the amount recommended by American Heart Association.
If memory serves, The Guy From CSPI has now identified 30 or 40 different meals as the worst restaurant meal in America. Anyway …
“Long John Silver’s Big Catch meal deserves to be buried 20,000 leagues under the sea,” CSPI executive director Michael Jacobson said in a statement. “This company is taking perfectly healthy fish—and entombing it in a thick crust of batter and partially hydrogenated oil. The result? A heart attack on a hook. Instead of the Big Catch, I’d call it America’s Deadliest Catch.”
CSPI announced that it had contacted Long John Silver’s CEO Mike Kern to say the chain would be sued if the use of partially hydrogenated oil isn’t discontinued.
I agree that trans fats are bad news. Among other nasty effects, they lower HDL quite a bit. So I’m sitting here scratching my head, trying to remember why the heck restaurants started frying foods in hydrogenated soybean oil instead of in good fats that raise HDL, like lard or beef tallow. Wait … it’s coming back to me.
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