Sugar - Fat

[pjoshea13]

New study below [1]. Today's NY Times front-page story - [2].

The article is good, as far as it goes, but is misses some background.

So many bad things about dietary advice in the U.S. over the past 60 years can be traced back to Ancel Keys. [3]

I was amused to read in the 2nd paragraph of his Wiki page:

"The journalist Nina Teicholz, who directly disputes Keys’ theories in her book The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet (2014), writes that "...if there is a Great Man theory of history...whereby strong personalities steer events using their own personal charisma, in the history of nutrition Ancel Keys was, by far, the Greatest Man"." [3]

The Teicholz book [4] is an extraordinary work of scholarship as well as an enjoyable read. Keys would have hated his Wiki page.

Briefly, Keys had researched diet & cardiovascular disease in post-WWII Europe & come to the conclusion that cholesterol causes CVD. Which translated to animal meat causing heart disease. He published his flawed, but influential, "Seven Countries Study" at a time when there was concern in the U.S. about heart attacks. Why the concern? In 1955, President Eisenhower, age 64, suffered a heart attack while playing golf.

Keys appeared in Washington DC &, largely due to his personality, was responsible for the government setting aside a lot of money for research. Never mind that Ike had a four-pack-a-day habit, cholesterol must be to blame.

The money, of course, went to followers of Keys. It became a poor career move for a researcher to want to explore alternative theories. With few exceptions, cholesterol studies continued to be published for decades by followers of Keys & those who dared not question his dogma.

Two of Keys' men, mentioned in the new study, were Dr. Frederick J. Stare & D. Mark Hegsted:

"Dr. Frederick Stare (1910–2002) was the founder and first head of the Department of Nutrition at Harvard University’s School of Public Health. A lifelong fighter against the health food industry and the organic food movement, Dr. Stare often served as a government witness against natural-foods advocates, testifying that such proponents were alarmists and frauds. Over the course of his career, Dr. Stare procured massive amounts of funding for Harvard and his own research from food-manufacturing giants such as Coca-Cola, General Foods, and the National Soft Drinks Association." [5]

"David Mark Hegsted (March 25, 1914 – June 16, 2009) was an American nutritionist who studied the connections between food consumption and heart disease. His work included studies that showed that consumption of saturated fats led to increases in harmful cholesterol, leading to the development of dietary guidelines intended to help Americans achieve better health through improved food choices. After his death, researchers uncovered his connections to research funded by the sugar industry in which Hegsted played down connections between sugar consumption and heart disease, focusing on saturated fats as the culprit." [6]

An important figure in the saga was John Yudkin, who, safely in London, had no reason to fear Keys' influence:

"John Yudkin FRSC (8 August 1910 – 12 July 1995) was a British physiologist and nutritionist, and the founding Professor of the Department of Nutrition at Queen Elizabeth College, London." [7]

Yudkin was warning of sugar's role in CVD from the mid-1950's.

From the new paper:

"Early warning signals of the coronary heart disease (CHD) risk of sugar (sucrose) emerged in the 1950s. We examined Sugar Research Foundation (SRF) internal documents, historical reports, and statements relevant to early debates about the dietary causes of CHD and assembled findings chronologically into a narrative case study. The SRF sponsored its first CHD research project in 1965, a literature review published in the New England Journal of Medicine, which singled out fat and cholesterol as the dietary causes of CHD and downplayed evidence that sucrose consumption was also a risk factor. The SRF set the review’s objective, contributed articles for inclusion, and received drafts. The SRF’s funding and role was not disclosed. Together with other recent analyses of sugar industry documents, our findings suggest the industry sponsored a research program in the 1960s and 1970s that successfully cast doubt about the hazards of sucrose while promoting fat as the dietary culprit in CHD."

"In 1965, the SRF asked Fredrick Stare, chair of the Harvard University School of Public Health Nutrition Department to join its SAB as an ad hoc member. Stare was an expert in dietary causes of CHD and had been consulted by the NAS, National Heart Institute, and AHA, as well as by food companies and trade groups. Stare’s industry-favorable positions and financial ties would not be widely questioned until the 1970s."

"On July 1, 1965, the SRF’s Hickson visited D. Mark Hegsted, a faculty member of Stare’s department, after publication of articles in Annals of Internal Medicine in June 196526- 29 linking sucrose to CHD. The first 2 articles reported results from an epidemiological study suggesting that blood glucose levels were a better predictor of atherosclerosis than serum cholesterol level or hypertension. The third (p210) demonstrated that sucrose, more than starches, aggravated carbohydrate-induced hypertriglyceridemia and hypothesized that “perhaps fructose, a constituent of sucrose but not of starch, [was] the agent mainly responsible.” An accompanying editorial (p1330) argued that these findings corroborated Yudkin’s research and that if elevated serum triglyceride levels were a CHD risk factor, then “sucrose must be atherogenic.”

"On July 11, 1965, the New York Herald Tribune ran a full-page article on the Annals articles stating that new research “threatened to tie the whole business [of diet and heart disease] in a knot.” It explained that, while sugar’s association with atherosclerosis was once thought to be theoretical and supported by limited studies, the new research strengthened the case that sugar increased the risk of heart attacks."

"On July 13, 1965, 2 days after the Tribune article, the SRF’s executive committee approved Project 226, a literature review on “Carbohydrates and Cholesterol Metabolism” by Hegsted and Robert McGandy, overseen by Stare. The SRF initially offered $500 ($3800 in 2016 dollars) to Hegsted and $1000 ($7500 in 2016 dollars) to McGandy, “half to be paid when you start work on the project, and the remainder when you inform me that the article has been accepted for publication.” Eventually, the SRF would pay them $6500 ($48 900 in 2016 dollars) for “a review article of the several papers which find some special metabolic peril in sucrose and, in particular, fructose.”"

& so on.

I think it quite reasonable for the men to be paid for the article, although it might have been prudent to disclose that fact in the small print. Much has been made of the payments since the new paper came out, but these men were committed to the Keys cholesterol dogma. Stare might have written the article gratis. I don't believe that the payments show corruption.

But what it does show, & Nina Teicholz makes this very clear in her book, is how Keys & his men sacrificed intellectual honesty to defend his theories.

Stamler, who co-authored papers with Keys & Stare was interviewed by Teicholz:

"And Yudkin!" Stamler nearly bellowed to me. ... "I was part of shooting him down!"

Decades later, it is still very personal.

"Walter Willett, M.D., Dr.P.H. ... is an American physician and nutrition researcher. Currently, Willett is the Fredrick John Stare Professor of Epidemiology and Nutrition and the chair of the department of nutrition at Harvard School of Public Health. He is also a professor of medicine at Harvard Medical School." [8]

"Willett, who is one of the most frequently quoted academic sources on nutrition in the news media, appears to have crossed a Rubicon when he denounced Katherine Flegal, an epidemiologist at the US National Center for Health Statistics, for publishing a study that showed people who were overweight (but not obese) lived longer than those deemed normal weight. “This study is really a pile of rubbish, and no one should waste their time reading it,” he told National Public Radio." [9]

What does all this have to do with PCa?

I keep hearing views on diet, from men with PCa, that seem to parrot the party line as laid down by Keys in the 1950's. It's a line that has flourished because opponents in academia have been starved of funds. Earlier this year, my wife was advised by a doctor to stay away from red meat & animal fat. Doctor's don't learn much about nutrition in medical school, but you don't need to be a doctor to have been indoctrinated.

Dramatic changes in smoking habits have had a profound effect on U.S. cardiovascular disease in the past fifty years. If Keys were still alive, he might argue that he was responsible for the changes in CVD rates. But one thing is clear, the pre-PSA era PCa rate steadily increased during the Keys era. As men began to eat less red meat, the PCa incidence rate did not drop. & the rate of increase did not falter.

Conventional dietary advice is tainted. & the more the U.S. food pyramid is tweaked, the worse things become.

-Patrick

[1] archinte.jamanetwork.com/ar...

[2] nytimes.com/2016/09/13/well...

[3] en.wikipedia.org/wiki/Ancel...

[4] amazon.com/Big-Fat-Surprise...

[5] seleneriverpress.com/histor...

[6] en.wikipedia.org/wiki/D._Ma...

[7] en.wikipedia.org/wiki/John_...

[8] en.wikipedia.org/wiki/Walte...

[9] forbes.com/sites/trevorbutt...

[BigRich]

Patrick,

I didn't eat red meat for five years, previous to that I ate approximately 80 oz. a week. Then, I thought this disease has taken many things away from me, and eating is a pleasure. Now, I eat once every two weeks, red meat, a steak, lamb chops or pork chops, lean cuts of meat, well trimed of fat.

You have to enjoy life.

Rich

[pjoshea13 in reply to BigRich]

Rich,

You wrote "well trimed of fat". That's the kind of thinking that Ancel Keys instilled into Americans.

There has recently been a rejection of that thinking by some restaurant chefs. Fat = flavor.

There is a place in Maine called "Duckfat" famous for their "classic Belgian fries made with local Maine potatoes fried in duck fat".

duckfat.com

The pork industry really screwed up when pigs became lean ("the other white meat"). Who wants to eat meat that has to be soaked in a marinade to give it flavor?

Enjoy your next steak - look for the marbling! LOL

-Patrick

[BigRich in reply to pjoshea13]

Patrick,

You are right, fat tastes good.

Rich

[adlerman]

Health advice in this country is upside down. It's like having dropouts teaching high school classes. Doctors get little to no nutrition education. Nutritionists-many of them- parrot the government ignorance. Linus Pauling- the only scientist to win TWO Nobel prizes- devoted his life to Vitamin C and was reportedly taking up to 14 grams of it a day himself. His claims were dismissed based on faulty replications of his research- money really does talk in this country. A professor at Harvard in the 70's- Dr. Jean Meyer took money from the sugar industry to publish papers claiming sugar is OK. Our country is sadly lacking in people with morals and ethics.

[GAdrummer]

Any unbalanced diet leads to some sort of nutritional deficiency which causes trouble at some point. My husband was on a clinical trial with VT-464 that caused a brain fog so bad that he was dropped from the trial. "Metabolic encephalopathy" the doctors called it. He was so mentally disfunctional that he stopped eating meat (and a lot of other things and lost 20 pounds in one month). After one month without the drug, he was not recovering the way other men had. A neurologist ran tests and discovered a vitamin B12 deficiency. A little pill twice a day has made a big change in him, and he is almost back to his old self.

[Hidden in reply to GAdrummer]

As I understand it, stomach acid breaks down meat protein to generate B12. As a GERD sufferer taking an acid reducer drug I was at risk of a B12 deficiency which can cause brain problems, some irreversible. Of course the doctor who prescribed the acid reducer med (back before it was over-the-counter) failed to alert me to that effect. The packaging for omeprazole doesn't mention anything about the B12 deficiency issue.

[GAdrummer in reply to Hidden]

And the fact that my husband was trying to protect his bones by eating a bunch of anti-acid tablets a day for their calcium content apparently set himself up for the worst possible "chemo brain". The last day he was on the drug he bombed the standard neuro exam and for the first time realized that he couldn't function. As a college professor, he was totally mortified - a terrible sight.

Let this be a warning to men facing the possibility of "chemo brain" with cancer treatments.

[pjoshea13 in reply to GAdrummer]

My understanding of vitamin B12 deficiency is that it takes a long time to become apparent. A healthy omnivore who converts to veganism without considering B12 needs, will not get into trouble for at least 3 years.

The body is very efficient at recycling B12 from bile acids in the gut.

Which makes me think that your husband's B12 status might not have been good for some time. The reason I bring this up, is that there is another digestive problem that must be considered.

Parietal cells in the stomach secrete intrinsic factor. This facilitates B12 uptake in the small intestine. Intrinsic factor levels can reduce with age. For that reason, many use a sublingual B12 supplement. The supplement is allowed to dissolve in the mouth, & some is absorbed before the rest is swallowed. It's also a good option when there is concern about stomach acid levels.

Some men, over time, produce suboptimal levels of stomach acid. Food might be insufficiently digested to release the B12. PPIs such as Prilosec might reduce acid secretion too far.

(Anti-acid pills wouldn't normally be taken so as to interfere with digestion, but the stomach normally acts quickly to restore the correct pH.)

Wikipedia:

"The total amount of vitamin B12 stored in body is about 2–5 mg in adults. Around 50% of this is stored in the liver. Approximately 0.1% of this is lost per day by secretions into the gut, as not all these secretions are reabsorbed. Bile is the main form of B12 excretion; most of the B12 secreted in the bile is recycled via enterohepatic circulation. Excess B12 beyond the blood's binding capacity is typically excreted in urine. Owing to the extremely efficient enterohepatic circulation of B12, the liver can store 3 to 5 years’ worth of vitamin B12;[86] therefore, nutritional deficiency of this vitamin is rare. How fast B12 levels change depends on the balance between how much B12 is obtained from the diet, how much is secreted and how much is absorbed. B12 deficiency may arise in a year if initial stores are low and genetic factors unfavourable, or may not appear for decades."

en.wikipedia.org/wiki/Vitam...

-Patrick

[GAdrummer in reply to pjoshea13]

So I guess that at 78 he is "over time" and the VT-464 put him way over the edge. The difference between him in the beginning of May before VT-464 and by the end of July when he was taken off the drug was truly frightening.

[rowboattom in reply to Hidden]

Thanks WSQPeddie I will be sure to add B12 , I use omeprazole

[2548oo]

The countries with the lowest prostate cancer rates are India and China [ probably pre Mc donalds ] their diets seem to be rice, legumes, vegetables a little meat, herbs and spices.

Dairy doesn't seem to be part of the diet. You can't beat a good curry.