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"Low-fat diet could kill you, major study shows"

More from the European Society of Cardiology Congress, in Barcelona, as reported in the Telegraph (UK) [1].

Also, study published in the Lancet today [2].

"The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years"

"We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality."

"During follow-up, we documented 5796 deaths and 4784 major cardiovascular disease events. Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 ... but not with the risk of cardiovascular disease or cardiovascular disease mortality."

"Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 ..; saturated fat, HR 0·86 ..; monounsaturated fat: HR 0·81 ..; and polyunsaturated fat: HR 0·80 ..."

"Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 ..."

"Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality."

"High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings."

-Patrick

[1] telegraph.co.uk/news/2017/0...

[2] thelancet.com/journals/lanc...

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I think we have to thank these so called Scientific Researchers for publishing contradictory and confusing findings from time to time and killing us with their paradoxical stuff.

It is a waste of time reading these research papers by standing on our head not being able to understand all the confusion caused by the pundits involving the diet!

Sisira

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Sisira,

the book "the Big Fat Surprise" explains how Ancel Keys was able to get government funding for his fat theory, & how ultimately, all of the major researchers in the field were Keys' men. You simply couldn't get funding if you had other views.

& the alternative view in the UK, that sugar was the culprit in heart disease, never had a hearing in the U.S. In fact, the sugar industry paid some prominent Keys' guys to do favorable sugar studies.

The polyunsaturated fat industry, which received a tremendous boost from Keys, made sure that critics were silenced. They funded the AHA!

The Keys era is ending.

Here is Nina T:

-Patrick

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My salute to you Patrick for disclosing the truth.

Compared with humans, animals are better off and more fortunate that they can eat what they feel is good for them. They don't have great Scientists, Researchers, Nutritionists and bogus sympathizers funding major projects to tell them what to eat and how to eat!

Sisira

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The single clear voice over the years has been Dr. Myers. He has always advocated a modified Mediterranean Diet. His modifications have been very specific even down to what types of nuts are acceptable and what types are not. Unlike many other diet recommendations, his are aimed specifically at both PCa and heart disease. He has consistently warned about the dangers of low fat & vegetarian diets. His recommendations are consistent with the above study, and the findings presented in the Greger Advanced PCa videos. Hopefully, his retirement will not end his crucial contributions to the literature.

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Winston,

I was with you until the Greger comment. Greger is low-fat. As is Dean Ornish, whom he cites. Ornish aims for 10% fat.

-Patrick

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That's what I get for not looking at the videos again before making the post.

Thank you Patrick!

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As you have rightly said our objective of discussing what is good and what is bad in diet should be focused on mainly prostate cancer and heart heart decease. What Dr.Myers has said in his book "Beating Prostate Cancer : Hormonal Therapy and Diet" is about the adverse consequences of eating red meat, dairy fat, and egg yolks. He says in more than 100 papers in scientific literature that he has read, phytanic acid present in these foods can promote the growth and spread of prostate cancer. On the other hand he favours a Mediterranean diet which is largely with monounsaturated or rich in omega 3 fatty acids coming from olive oil, nuts or small fish in contrast to the American diet rich in saturated fat and omega 6 fats. In addition the Mediterranean diet is rich in anti oxidants. A high fat diet can be justified only in the former case rich in omega3 fats.

Dr.Patrick Walsh in his book "Guide to Surviving Prostate Cancer" says the phytanic acid present in the fat of read meat and dairy products, when metabolized in the body makes a toxic by-product, hydrogen peroxide which can cause mutations in DNA leading to cancer or cancer progression.

Therefore when we make a bold statement to the general public " Low-fat diet could kill you", one may immediately think then, the better option would be to eat all tasty food rich in Fats, without proper discrimination. I think common sense is enough to make the suitable adjustments in our diet and lifestyle to support our primary cancer treatments. These hair-splitting arguments and theories may confuse and mislead the average person.

Sisira

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Sisira. Thank you, you nailed it.

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Hi Sisira,

The message is that low-fat increases mortality versus high-fat. I hate the terms "low" & "high". 40% fat would not be considered "high" by Mediterranean populations. "Low" obviously means low in all of the fat categories that we have been taught to consider as being harmful. But what are the protective fats?

In the 18-country study, the fats consumed presumably varied widely. "The Prospective Urban Rural Epidemiology (PURE) study is a large-scale epidemiological study that plans to recruit approximately 140,000 individuals residing in >600 communities in 17 low-, middle-, and high-income countries around the world."

With countries ranging from Canada to China, can we make any assumption about "good" fats - other than low fat increased mortality.

Dr. Myers likes the Mediterranean diet. Is olive oil safe? Is oleic acid a good fat?

In my view, we have no proof that oleic acid is beneficial or otherwise. I feel uncomfortable with the oft-reported observation that the ratio oleic:stearic acid increases as cancer becomes more dangerous. Why therefore ingest oleic acid? Both fatty acids are 18 carbons long. Stearic is fully saturated, wheras oleic has a double bond exactly in the middle, making it an omega-9 monounsaturated fatty acid. It is a simple transition & the body contols how much of either it has. Cancer wants more oleic & less stearic (as in beef tallow).

With nuts, however, we don't need to use a lot of added fat to satisfy the 40%.

I have just posted on phytanic acid. Turns out to be a red herring.

I have a couple of posts on eggs. Everyone beats up on them. LOL.

Agreed - dairy is to be avoided.

-Patrick

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Patrick, I have no difficulty in agreeing with what you say. I always appreciate your commitment to research work and your generosity in trying to share your knowledge with others. Research, more often than not has moot points and powder for controversy. With regard to food or any other important matter what we really need is simple advice and explanation that could be digested with average knowledge and common sense. We are not here to outsmart reputed medical professionals such as Dr.Myers or Dr.Walsh and the like. All the same if we have good scientific reasons to differ from their views nothing shall preclude our right to do so. But I have my doubts whether this forum is the proper place to challenge them.

Your good work is very much appreciated and I respect you profusely.

Sisira

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Sisira,

Myers & Walsh expressed opinions based on cell studies. The hypothesis that they assumed to be true was later tested by the 3 human studies I cited. No doubt they would have had little interest in phytanic acid had the papers been available. My aim was not to "outsmart reputed medical professionals", but to present a more up to date picture of phytanic acid - which this time used actual people.

I think when it comes to diet, doctors are in the same boat as patients. Dr. Myers, of course, was a patient too. The Med diet works for him (he must be a 20-year survivor by now), & presumably for his patients. People are stuborn when it comes to dietary beliefs that have no foundation, & he has seen patients following a low-fat diet who do not do well.

But he received a heated response to his views (which he expressed in a vblog post). In the follow-up post, he seemed amused, but he must have been exasperated. He compared dietary beliefs to religious beliefs, implying that it is pointless debating with people who lack an open mind on the subject.

Whenever I post, I hope for a robust continuation, but that rarely happens. I like it when someone comes up with a study that seems to contradict my take on the literature. Gives the brain something to play with. The ultimate aim is to present usable information, not to pursue an agenda.

-Patrick

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I appreciate, this is a healthy and very broad view. Though I have read Myer's book and learned about PCa I have not studied his competence for all times as a medical professional. But lot of people respect him as a good oncologist specializing in treating PCa. I don't have any knowledge in bio-chemistry to go deeper into these arguments but I look at things with sound general knowledge and common sense and see whether anything could be understood clearly for the purpose of practical use.I also don't forget the fact that why I joined this group is because I AM A PROSTATE CANCER PATIENT. My thinking is this is not a forum for scientists.

I offer my unconditional apology if my words offend you.

Thanks for your valuable time.

Sisira

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These very interesting research findings may help shake up some of the more traditional schools of dietary thought. I'm curious to see whether future similar studies will have results that are consistent. I may now be somewhat more justified in the probably higher than average amount of fat I include in my plant-based diet. It is also mostly a whole foods diet, but not entirely so because of the added extracted oils I routinely include. Done well, science very often and rightfully questions our generally accepted intuitive assumptions. Perhaps especially in the field of nutrition science, it pays to constantly assess and modulate one's degree of objectivity. This in part helps prevent falling victim to confirmation bias, which appears to run rampant in some circles. I'm not really good at rating the quality of studies and need to rely more on expert opinion of that. I've not seen much of that for this particular study yet, but from all appearances and the best I can tell, it seems decent.

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I’m afraid Ms. T’s little Ted Talk raised more questions than were answered:

1That researchers cherry-pick their data and many approach their subjects with preconceived ideas.

2That just because the Japanese die from other cancers, the fact remains they have a very low incidence of breast and prostate cancer. Why not drill down into the traditional Japanese diet for possible explanations why they have fewer cases of breast and prostate cancer, instead of glibly citing that they have many other forms of cancer?

3That just because there is little or no evidence of heart disease among the meat-milk-blood drinking and eating Masai , we just can’t conclude that theirs is a healthier diet: could one explanation be that these “warriors” killed themselves off before they could get any slow developing diseases?

4Ms T’s Ted Talk lamely ends (at least the part we see) with the conclusion that perhaps the reputation of saturated fat has somehow been rehabilitated. Not really.

5Regarding the research and publishing of Dr. Robert Atkins, the late Dr. Nicholas Gonzalez, yes, the very one who treated cancer with pancreatic hormones, in a interview recalls the following anecdote: Dr. Gonzalez was a friend of Dr. Atkins and often visited the doctor where they often talked about diet and other health matters. Dr. Gonzalez was, therefore, friendly with the Atkins research staff, especially the head researcher. One day, according to Dr. G, he received a telephone call from Dr. A’s head researcher who invited Dr. G to lunch. During the lunch, the researcher appeared glum and depressed. When asked the reason for this apparent dispondency, the researcher answered that the research he had been working on for years had not paned-out and would Dr. G care to hire him for his office. Puzzled, Dr. G inquired about the nature of this research that hadn’t been successful. The researcher replied that Dr. A had been working on curing cancer through diet, his “Atkins Diet,” but all attempts do so had failed. At the conclusion of the interview, Dr. G points out to the interviewer that Dr. Atkins was perhaps one of the world’s most knowledgeable metabolic specialists at the time: if he couldn’t find a connection between cancer and diet no one could (not even his “heirs” the Ketogenic-Paleolithic Diet advocates). Dr. G's final remark to the interviewer is that in his experience treating cancer patients (he began in 1987), there was no one size fits all diet. Some individuals thrived on a predominately meat diet , others on a plant-based diet and still others on a diet that combined both.

Finally, speaking of “cherry-picking,” I invite you to read the following abstract, " Integr Cancer Ther. 2006 Sep;5(3):206-13."

Potential attenuation of disease progression in recurrent prostate cancer with plant-based diet and stress reduction.

Saxe GA1, Major JM, Nguyen JY, Freeman KM, Downs TM, Salem CE.

Author information

1

Department of Family and Preventive Medicine, Moores UCSD Cancer Center, University of California, San Diego, La Jolla, California 92093-0901, USA. gsaxe@ucsd.edu

Abstract

A rising level of prostate-specific antigen (PSA), after primary surgery or radiation therapy, is the hallmark of recurrent prostate cancer and is often the earliest sign of extraprostatic spread in patients who are otherwise asymptomatic. While hormonal therapy may slightly extend survival in a minority of patients, it is not curative and produces side effects including hot flashes, decreased libido, and loss of bone mass. Alternatively, dietary modification may offer an important tool for clinical management. Epidemiologic studies have associated the Western diet not only with prostate cancer incidence but also with a greater risk of disease progression after treatment. Conversely, many elements of plant-based diets have been associated with reduced risk of progression. However, dietary modification can be stressful and difficult to implement. We therefore conducted a 6-month pilot clinical trial to investigate whether adoption of a plant-based diet, reinforced by stress management training, could attenuate the rate of further PSA rise. Urologists at the University of California, San Diego, and San Diego Veterans Affairs Medical Centers recruited 14 patients with recurrent prostate cancer. A pre-post design was employed in which each patient served as his own control. Rates of PSA rise were ascertained for each patient for the following periods: from the time of posttreatment recurrence up to the start of the study (prestudy) and from the time immediately preceding the intervention (baseline) to the end of the intervention (0-6 months). There was a significant decrease in the rate of PSA rise from prestudy to 0 to 6 months (P < .01). Four of 10 evaluable patients experienced an absolute reduction in their PSA levels over the entire 6-month study. Nine of 10 had a reduction in their rates of PSA rise and an improvement of their PSA doubling times. Median PSA doubling time increased from 11.9 months (prestudy) to 112.3 months (intervention). These results provide preliminary evidence that adoption of a plant-based diet, in combination with stress reduction, may attenuate disease progression and have therapeutic potential for clinical management of recurrent prostate cancer.

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Kuanyin,

[1] Not sure what the "question" is. Do you doubt bias in academia? Critics of Ancel Keys have been locked out of the system since the 1950's. Less so now. Limiting a search from 1956 - 1976, say, how many sugar/CVD studies occurred in the U.S. - as opposed to fat/CVD studies? In this period, the sugar hypothesis was pursued in the UK by Yudkin - not in the U.S. The Keys men actively set out to trash the competing sugar theory. And even took money from the sugar industry.

[2] You wrote: "That just because the Japanese die from other cancers, the fact remains they have a very low incidence of breast and prostate cancer. Why not drill down into the traditional Japanese diet for possible explanations ..."

Researchers have done just that, but to what end?

First, let us not dismiss the other cancer rates in Japan. You mention diet, so let's look at stomach cancer. You have to admit that food & drink have to be the suspects. In Japan, the rate is 29.9 per 100,000 [1]. In Korea, it is 41.8/100,000. Both have low rates of PCa. The rate in the U.S. is 7.3/100,000 [2].

Nina made a good point, I feel.

Why not drill down anyway. What do Japanese men not eat? Not much sugar. A vending machine is more likely to give you soup than soda.

They eat a lot of fish, including fish that Americans don't eat - the fatty varieties. Don't assume they are on a 10% Ornish regime.

""The death rate from coronary heart disease in Japan has always been puzzlingly low," said Akira Sekikawa, M.D., Ph.D, an assistant professor of epidemiology at the University of Pittsburgh, PA, and an adjunct associate professor at Shiga University of Medical Science, Otsu, Japan. "Our study suggests that the very low rates of coronary heart disease among Japanese living in Japan may be due to their lifelong high consumption of fish."

"Japanese people eat about 3 ounces of fish daily, on average, while typical Americans eat fish perhaps twice a week. Nutritional studies show that the intake of omega-3 fatty acids from fish averages 1.3 grams per day in Japan, as compared to 0.2 grams per day in the United States." [3]

Japanese obesity rates are very low, whereas U.S. rates are at an all time high. I contend that a high-carb diet leads to high insulin levels, elevated triglycerides & excess fat accumulation. Particularly dangerous for PCa.

"Only 3.6 percent of Japanese have a body mass index (BMI) over 30, which is the international standard for obesity, whereas 32.0 percent of Americans do." [4]

[3] Forget about the health problems of the Masai. That man's high saturated fat diet didn't translate to obesity, whereas the high carb diet of the fat lady did. Was she healthier for eating the Ornish way?

[4] I gather you are saying that the Atkins diet has no effect on cancer? I'm not promoting Atkins for PCa, & Nina wasn't promoting it for cancer in general. The subject was CVD.

...

I have already written about the Saxe study (actually, both of them). This was the best that Greger could do? Three ancient studies, & two of them 10-man short-term studies by Saxe.

-Patrick

[1] wcrf.org/int/cancer-facts-f...

[2] seer.cancer.gov/statfacts/h...

[3] sciencedaily.com/releases/2...

[4] ideas.repec.org/p/ags/umrfw...

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Hello Kuanyin,

I am not a specialist in any science. But I am a strong rationalist. On this subject of what Diet can do for prostate cancer, the explanation you have provided in your above reply is excellent. I believe, for many it has a very useful and simple take home advice. There may be few other specialists who want to challenge the simple facts. I like all what you have said and that is my way too.

Thanks for your time and detailed explanation.

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First of all, regarding Dr. Gregor: there is no doubt that he is a “flaming vegan” so it stands to reason that he is on the hunt for research material that supports his position. Secondly, he really doesn’t say much about a high carbohydrate diet except to stick to fruits and vegetables with a low glycemic load. Thirdly, his position on grains seems to be that it’s all right to eat them (although he has been down on brown rice lately because of the arsenic issue) as long as they are un-refined.

As far as the Maasai are concerned, the study cited below seems to say that that their diet is the result of Natural Selection. That they have a particular genetic make-up that offers protection against all that fat, blood and meat they are consuming. This seems to be true in our population, as well, but to a lesser degree. There are individuals who can eat a high fat diet—meat, cheese, you name it—but do not suffer the consequences. I think there is a genetic explanation as well. So, if people want to self-select themselves and their progeny for the sake of the total gene pool by eating a high fat diet, it’s their choice.

As for the Japanese diet, the fact remains that Japanese men and women coming to our country and eating the great American diet do suffer from a higher incidence of breast and prostate cancer. They have a higher incidence of gastric cancer due probably to the genetic constitution of the host (the Japanese), the genotype of the infecting organism (H pylori) and the environment. They also eat a lot of smoked, salted and pickled food. Last, but not least. are the tons of heterocyclic amines generated by their beloved hibachi grills. The top causes of death in Japan is influenza and pneumonia followed by stroke (smoking?) and lung cancer (which fits in with the smoking hypothesis) and one could add air pollution. Whatever protection fish in their diet contributes to their overall health is rendered by a PUFA! Not a saturated fat. There diet is still primarily low in saturated fat and they don’t have a high incidence of diseases (colorectal cancer and heart heart disease) associated with this fat.

My objection to Ms. T’s Ted Talk is a bit peevish: I think she is a “carpetbagger”: a reporter, with little prior qualification in health or nutrition, reporting on something that has been available for all to know for many years, i.e., “the great polyunsaturated fat conspiracy.” I think she has partaken of too much of the Kool-Aid and presented a slightly skewed report.

Finally, I find it a bit curious that you warn about partaking of milk products but not the proginator of these products. Let’s face it, at our age few people are going to make any major changes in their diets. I certainly will keep my intake of saturated fat low (with the exception of avocados and coconut milk, although coconut milk seems to be under attack by Dr. Gregor, lately), as well as reduce my consumption of bread which I continue to eat.

Lactase Persistence and Lipid Pathway Selection in the Maasaihttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0044751

Abstract

The Maasai are a pastoral people in Kenya and Tanzania, whose traditional diet of milk, blood and meat is rich in lactose, fat and cholesterol. In spite of this, they have low levels of blood cholesterol, and seldom suffer from gallstones or cardiac diseases. Field studies in the 1970s suggested that the Maasai have a genetic adaptation for cholesterol homeostasis. Analysis of HapMap 3 data using Fixation Index (Fst) and two metrics of haplotype diversity: the integrated Haplotype Score (iHS) and the Cross Population Extended Haplotype Homozygosity (XP-EHH), identified genomic regions and single nucleotide polymorphisms (SNPs) as strong candidates for recent selection for lactase persistence and cholesterol regulation in 143–156 founder individuals from the Maasai population in Kinyawa, Kenya (MKK). The non-synonmous SNP with the highest genome-wide Fst was the TC polymorphism at rs2241883 in Fatty Acid Binding Protein 1(FABP1), known to reduce low density lipoprotein and tri-glyceride levels in Europeans. The strongest signal identified by all three metrics was a 1.7 Mb region on Chr2q21. This region contains the genes LCT (Lactase) and MCM6 (Minichromosome Maintenance Complex Component) involved in lactase persistence, and the gene Rab3GAP1(Rab3 GTPase-activating Protein Catalytic Subunit), which contains polymorphisms associated with total cholesterol levels in a genome-wide association study of >100,000 individuals of European ancestry. Sanger sequencing of DNA from six MKK samples showed that the GC-14010 polymorphism in the MCM6 gene, known to be associated with lactase persistence in Africans, is segregating in MKK at high frequency (∼58%). The Cytochrome P450 Family 3 Subfamily A (CYP3A) cluster of genes, involved in cholesterol metabolism, was identified by Fst and iHS as candidate loci under selection. Overall, our study identified several specific genomic regions under selection in the Maasai which contain polymorphisms in genes associated with lactase persistence and cholesterol regulation.

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