Yet another study low carbers should read - Healthy Eating

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Yet another study low carbers should read

andyswarbs profile image
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The Independent: Low-carb diets could increase risk of heart rhythm disorders, research suggests.

independent.co.uk/news/heal...

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TheAwfulToad profile image
TheAwfulToad

I've requested the full text from the authors. However the abstract doesn't even mention low-carb diets, so it's hard to tell if it's relevant or not.

A big red flag for me here is the phrase "restricted cubic splines", which is just a generic curve-fit method; it's a way of drawing a smooth line over scatterplot. You can't just slap a polynomial curve onto something unless you know that the underlying mechanism can be described as such.

Cooper27 profile image
Cooper27Administrator in reply to TheAwfulToad

This is another story on the same article, which gives a bit more detail. Low carb was considered to be <44.8% carb intake.

dailymail.co.uk/health/arti...

TheAwfulToad profile image
TheAwfulToad in reply to Cooper27

>> Researchers then divided the participants into three groups representing low, moderate and high carb intake, reflecting diets in which carbohydrates comprised less than 44.8 percent of daily calories, 44.8 to 52.4 percent of calories, and more than 52.4 percent of calories, respectively.

That confirms my initial impression. 44.8% carbs is still very high carb. That's equivalent to two pasta or rice meals per day.

I get quite tired of these studies that look at everything in terms of % carbs/fat/protein. There is very little information contained in that simplistic measurement. I find the ones looking at specific foods (or combinations of foods) far more relevant to real life - eg., "Mediterranean diet" vs. SAD diet.

Cooper27 profile image
Cooper27Administrator in reply to TheAwfulToad

Yes, the DM article bugged me, because it tried to say this tells us keto is dangerous. Keto is around 10% carbs? I'm not sure.

This study definitely can't tell us anything about keto...

andyswarbs profile image
andyswarbs in reply to TheAwfulToad

Love it!!! Tad said, "44.8% carbs is still very high carb." So much made me laugh. But I know where you are coming from.

TheAwfulToad profile image
TheAwfulToad in reply to andyswarbs

As Cooper27 said, 'keto' would be sub-10% (it's usually defined as <25g carbs/day). However 'low-carb' is not the same thing as 'keto'. Maintenance LCHF is usually in the 50-100g/day range (ie., about 15% carbs). Anything above 150g/day is usually considered non-LCHF.

Cooper27 profile image
Cooper27Administrator in reply to andyswarbs

I was meaning that the article concludes keto is bad, but I don't think you can conclude that from the study - there's a big spectrum of diets between the 10% to 44.8% carb intake groups.

The recommendation is that carbs should make up 45-65% of your carb intake, so I wonder why the "high" groups wasn't considered as >65%, given low was considered anything below that range.

Penel profile image
Penel in reply to TheAwfulToad

Doesn’t seem to have been published yet!

dietdoctor.com/inaccurate-n...

andyswarbs profile image
andyswarbs in reply to Penel

We can only await its publication, then the reviews showing the pros and cons.

Cooper27 profile image
Cooper27Administrator

It's an interesting interpretation, but I've always been told to be wary of blanket studies like this - they provide a checklist asking you to consider how many portions of X,y and z you've consumed per week over the last few years, and rely on good memory, honesty and often lump foods together unfairly. Our diets do substantially evolve with time - you're testament to that yourself.

I personally followed a very carb heavy diet 10 years ago, with a bit too much alcohol, pizza, pasta, bread and sugar (student living!) and I still have a moderate-high carb intake (under their definitions), except now my carbs are from potatoes, wholegrain rice and other starchy vegetables. In studies like this, my carb intake could be linked to an increased risk of autoimmune disease, but you and I would both know that my autoimmune disease was probably caused by the diet of 10 years ago, and not my diet today.

Sorry, that is a long explanation!

Cooper27 profile image
Cooper27Administrator in reply to Cooper27

Actually having read through the article more closely, it does also say high carb intake is almost as bad, so I suppose that negates most of my above comment!

TheAwfulToad profile image
TheAwfulToad in reply to Cooper27

It sounds very similar to the much-touted Harvard study from a few months back, which asserted a U-shaped risk curve for carbs, with the ''valley" at 55%. They also did a cubic spline curve fit without any theoretical justification (they just figured a cubic curve looked nice!).

Alisongold profile image
Alisongold

Thank you for this link.

It is hard to tell if this article is simply bad reporting or bad science. The data collection method seemed rather unreliable as a means of allocating people to the narrow band of those with a moderate carbohydrate diet. The extremely low or high participants were not isolated, these might have provided some more useful results.

Causative factors for the AF then included speculation regarding what carbohydrate reductions people had made, had they cut out fruit and vegetables or eaten more red meat or saturated fats. Wasn’t this data was needed to make any causative correlation at all.

Surely the original research cannot have been so poor, please let me know if anyone finds the original article, I am sure the fast food high carb outlets will be pleased to see this publicity.

TheAwfulToad profile image
TheAwfulToad in reply to Alisongold

>> Surely the original research cannot have been so poor

The press do tend to get the wrong end of the stick, but it probably was. I think it was Zoe Harcombe who suggested that about 90% of nutrition studies are of such poor quality as to be worthless.

I've read a lot of them, and I agree. Many of them are absolutely dire.

I do hope they send me a copy of the paper, but so far I've only had one response to such requests (out of maybe a dozen). And that wasn't a nutrition paper.

andyswarbs profile image
andyswarbs in reply to TheAwfulToad

TAD, how do you judge when a nutrition study is NOT dire?

TheAwfulToad profile image
TheAwfulToad in reply to andyswarbs

The same way you judge any study.

1) Does the methodology actually measure what the experimenters think they're measuring?

2) Have they provided evidence that it does?

3) Have they used statistical tools correctly?

4) Do their results support their conclusions?

Item (4) is usually where most nutrition studies fall down. There are loads of them that either:

(a) Show "no effect", but the authors go right ahead and state that the results support their pet theory regardless.

(b) Use some dubious proxy measurement for a real-world outcome (cholesterol vs. heart disease is the classic one) but assume in their conclusion that there is 1:1 correspondence between the proxy and the target variable.

andyswarbs profile image
andyswarbs in reply to TheAwfulToad

Of course another way to judge a study is whether it is relevant. For example you recently posted two studies about vegetarian diets in your diabetes thread as if conclusions from vegetarian studies automatically applied to vegans. E ven if that were the case would those same studies ever say anything relevant to a whole food plant based diet?

A vegan diet could be beer, oreos and chips. Not exactly healthy. However a varied whole food plant based diet has been shown to reverse a lot of chronic diseases. I think there's active research on alzheimers.

Unfortunately population studies on WFPB diets are rare because it is a niche. But it is coming out of that niche and they will appear.

Cooper27 profile image
Cooper27Administrator in reply to andyswarbs

I've been thinking a lot about this issue recently - it's really the big problem with a lot of food research - it's hard to pin down the variables. You're completely right to be frustrated if wfpb and vegans are banded together, and the study isn't controlled to factor for someone eating a diet of chips, Oreos and pepsi. Or that the study doesn't control for other factors like smoking, exercise, pollution levels etc.

TheAwfulToad profile image
TheAwfulToad in reply to andyswarbs

>> Of course another way to judge a study is whether it is relevant.

It doesn't matter how relevant it is if it doesn't show what the experimenters think it shows.

>> For example you recently posted two studies about vegetarian diets in your diabetes thread as if conclusions from vegetarian studies automatically applied to vegans.

You would think there might be some overlap, no? If there isn't, that's a pretty counterintuitive result, and you need to have a good solid reason why things should pan out that way.

A vegan diet could be beer, oreos and chips. Not exactly healthy. However a varied whole food plant based diet has been shown to reverse a lot of chronic diseases.

I understand what you're saying, and I've leveled the same complaint at many nutrition studies. My main frustration is the way nutritionists describe everything as carbs/fat/protein, as if humans normally subsist on little bowls of desiccated macronutrients. This is why I say most studies aren't measuring what they think they're measuring.

Unfortunately population studies on WFPB diets are rare because it is a niche.

That's true.

The closest alternative are actually the low-carb studies. I know this fact annoys you no end, but low-carb diets are almost always WFPB. They just happen to include meat and dairy.

amykp profile image
amykp

And if I read the original article correctly, it was based on asking participants to recall what they ate in the 1980's. Yes, really! I can barely remember what I ate last week!

me2019 profile image
me2019

Carbs - simple (high GI - potentially lead to diabetes and all sorts of other things including affecting brain chemistry); complex (low GI - energy released slowly and really good)

So....veg and legumes (sprouted, fermented and soaked for 48 hours then cooked) terrific!!!

So be a little skeptic all about extreme diets of any sorts...perhaps.

:)

Penel profile image
Penel

The NHS has endorsed a low-carb diet as a valid dietary option.

diabetes.co.uk/news/2019/ma...

AF seems to be associated with electrolyte imbalance. If you get the diet wrong it’s not going to do you any good.

andyswarbs profile image
andyswarbs in reply to Penel

Are you saying if you get a low-carb diet wrong it will not work - or are you saying that only low-carb can work?

Penel profile image
Penel in reply to andyswarbs

If you get a low carb diet wrong it will not work. And it doesn’t suit everyone.

The full report of the original study has not been published yet. It’s very poor of them to give out partial information, it gives sensational headlines with no way of checking information.

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