Saturated Fat, Cholesterol & Carbohydrates all over the World & Updates

Hello again! It’s been a long 5 months since TheFatNurse’s last post! I’ve been finishing up the last semester of my Family Nurse Practitioner Program and getting ready for the Boards. This means I’ve been spending less time focusing on fat related issues and more time diving into other areas of health. As result, I’ve had less time to focus on the blog. I do plan to get back into updating more regularly once the year is over.

However, the past couple of weeks has had several developments that are too note worthy to not mention! Starting in Australia:

ABC has an investigative show called Catalyst in Australia. Last week they aired a controversial report on saturated fat and cholesterol’s weak association with heart disease. This generated the obvious controversy…but the show followed it up with an episode about statins that generated even more controversy!

The basic premise of this episode was the overprescription of statins based off faulty guidelines and research on primary prevention groups (this is important to keep in mind). In addition to the literature on statins and heart disease, the show also covers some of the research process/designs when drug trials are conducted that can lead to flawed conclusions.

The expected controversy even lead the Australian Advisory Committee to urge ABC to pull the episode from airing since they believed it could have lead people to stop taking their medications – leading to death. Today Dr. Kerryn Phelps, a former Australian Medical Association president, added to the controversy by writing:

Screen Shot 2013-11-01 at 12.33.06 PM

Both episodes are worth a look to understand what the discussion is all about as many people are probably going to be confused with all this conflicting advice.

Moving onto Italy:

Apparently Pasta consumption has dropped 23% in the past decade. Why is this?

Worried about its fattening effects, she and her husband eat it no more than a few times a week, favoring couscous, meat and vegetables instead. “Metabolism changes when you approach 40,” she says, “and pasta is out of the question.”

The share of women between 26 and 30 years old who believe pasta is fattening increased 26% from 2008 to 2012, according to a Nielsen survey. And among 26- to 30-year-old men, the number who think pasta makes people fat increased 16%.

Reminds me of this episode of Portlandia:

Now to Britain:

Looks like the amount of saturated fat that will be in Britain will be decreased and taken out of the food supply:

Almost half of the food manufacturing and retail industry has signed up to the Responsibility Deal Saturated Fat Reduction Pledge by agreeing to reduce the amount of saturated fat in our food and change their products to make them healthier.

Cutting the amount of saturated fat we eat by just fifteen per cent could prevent around 2,600 premature deaths every year from conditions such as cardiovascular disease, heart diseaseand stroke.

Check out the link to the story which details what companies are planning to do. Such as:

Nestlé – which will remove 3,800 tonnes of saturated fat from over a billion Kit Kat bars per year by reformulating the recipe

And whatever they end up replacing the saturated fat will make kit kats “healthier?” Sigh…

And in Sweden:

Apparently, “Sweden has become the first Western nation to develop national dietary guidelines that reject the popular low-fat diet dogma in favor of  low-carb high-fat nutrition advice.”

I’ve heard in the past that a huge portion of the population in Sweden follows a Low Carb High Fat diet so this is not too surprising.

We’ll end with China

I’ve covered in the past how asians are often used in popular press to demonstrate how carbohydrates cannot be fattening since Asians are so skinny…despite being healthy and skinny not being the same thing.

Apparently a new study was released last month showing increased carbohydrate consumption being tied to coronary heart disease in the Chinese.

I won’t get into too much about this particular study since it’s observational and relies on questionnaires – which have faults in generating conclusive evidence. However, these study designs were used in the past to demonize dietary fat. So even if this study is not conclusive, it’s worth noting since it produced different results using similar methods in the past. Some notable observations:

These associations were robust and independent of several known CHD risk factors, including socio economic status, centralobesity, smokingstatus, hypertension, and saturated fat intake.

In a Japanese cohort, the average intakes of raw white rice were 170 g/day in women and 180 g/day in men. In that study, white rice intake was found to be inversely associated with death from cardiovascular disease in men but not in women (49). The reasons for the apparent conflicting results between that study and ours are not clear.

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How You Know Things Aren’t Changing

Picture by Glane 23

By now you may have heard that McDonalds is introducing a healthier yolk-less Egg McMuffin. This of course will do nothing in promoting health since dietary cholesterol, as previously mentioned, has very little to do with serum cholesterol. However, while the claims of health from this new McMuffin are likely to be bunk, the fact that this new sandwich was developed tells us a lot about our existing paradigm; mainly that it hasn’t changed.

McDonalds is one of the most successful companies on the planet and there is no doubt that they must have spent considerable amount of research before the launch of this new McMuffin. Using this new sandwhich as a surrogate, it’s reasonable to conclude that the world still fears dietary cholesterol and believes it is related to heart disease. Not only is dietary cholesterol still feared, but the response online criticizing this move from McDonalds reveals other paradigms still in existence:

McDonald’s says its new Egg White Delight (ugh, even the name seems like a late-in-the-day boardroom compromise) clocks in at 250 calories, according to CNN. But holding the yolk only cuts the calorie count by 50…an original Egg McMuffin has 300 calories. True, without the yolk you’ll skip the cholesterol, but the white cheddar and Canadian bacon will still give you a wake-up call of fat.

And from the CNN Link:

McDonald’s (MCDFortune 500) will release the Egg White Delight, an egg white version of the Egg McMuffin breakfast sandwich, nationwide on April 22, said company spokeswoman Danya Proud.

The new sandwich, which contains bacon and white cheddar on a whole grain English muffin, totals 250 calories, according to Proud. That’s compared to the classic Egg McMuffin, which has 300 calories. She added that egg whites will also be offered on the other breakfast sandwiches sold at McDonald’s.

According to the U.S. Department of Agriculture, an egg yolk contain 5 grams of fat, 2 grams of saturated fat and 213 milligrams of cholesterol, as well as 60 calories, Egg whites, however have no fat or cholesterol, and 15 calories. The USDA recommends that egg yolk consumption should be limited to four yolks per week.

So not only is the paradigm of dietary cholesterol reinforced, but also the paradigm of “a calorie is a calorie” and the paradigm on the horrors of dietary fat. Sad times and a reminder on how far we still are from changing our current knowledge of what really causes heart disease, obesity and diabetes.

Glucose and Cancer

This lecture from the Memorial Sloan-Kettering Cancer Center is over two years old, but the information contained is still relatively unknown. The video is basically a cancer 101 segment in the beginning which progresses into cancer proliferation metabolism; mainly the important role that glucose plays:

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Cancer cells seem to seek a high amount of glucose. So one of the cancer therapies they’ve researched is blocking the cancer’s ability to take up glucose with a drug. In the still above, you can see two cancerous hot spots on the liver (T) that disappear post therapy of the glucose blocking drug. Naturally, this will drive increased interest in the development of pharmaceutical treatments…but what about the other obvious issue here? Oh, they address that as well:

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The answer is carbohydrates since we’re talking so much about glucose metabolism. The lecturer even points out that fat is not cancerous. So if carbohydrates can be cancerous…and fats aren’t…can diet play a role? Perhaps that is why we can see case studies like this:

Of course case studies are just case studies and we’ll need to wait for some randomized clinical trials to really know how well diet can play a role. If you’re interested in more heavy detailed information about the microbio of cancer you may be interested in watching this lecture:

 

Cat Obesity On The Rise…Similar Pathway To Humans?

TheFatNurse just saw this video….WUT

Apparently pet obesity is on the rise with as many as 53% of dogs and 55% of cats being overweight/obese. This increase in weight increases their risk of arthritis, diabetes and cancer…just like HUMANS…

So what does the news report recommend for these overweight pets? Talk to your vet, start an exercise program and choose…A LOW FAT DIET PLAN…WUT…just like HUMANS…The focus of the news story was on an overweight cat being put on a michael phelps exercise regiment and low fat diet plan. The results? SUCCESS, according to the owner, because the cat lost 1 lb… in 6 months. The parallels to the frustration of human obesity are almost an exact match.

Now TheFatNurse is far from an expert on cat physiology…but some vets are suggesting that cats drop the carbohydrates

Diabetes is one of the most common feline endocrine diseases and, while we do  not know all of the causes of this complex disease, we do know that many diabetic cats cease needing insulin or have their insulin needs significantly decrease once their dietary carbohydrate level is lowered to a more species-appropriate level than that found in many commercial foods

WUT…

Feeding a high carbohydrate diet to a diabetic cat is analogous to pouring gasoline on a fire and wondering why you can’t put the fire out.

The so-called “light” diets that are on the market have targeted the fat content as the nutrient to be decreased but, in doing so, the pet food manufacturers have increased the grain fraction (because grains are always cheaper than meat), leading to a higher level of carbohydrates.

cats tend to overeat when free-fed high carb dry food.  The first reason is because the pet food manufacturers do not play fair when manufacturing dry food.  They coat the kibble with extremely enticing animal digests which makes this inferior source of food very palatable to the target animal.

…Carbohydrates do not seem to send the “I’m full and can now stop eating” signal to a cat’s brain like protein and fat do.

The third reason why some cats overeat is boredom.

Wow sounds like they go into the food palatability and hormonal obesity regulation theories of obesity there! This post is merely food for thought because using data from animals for human evidence (even tho early scientist did this by declaring dietary cholesterol leads to heart attacks by feeding cholesterol (an animal product) to rabbits (Herbivores) who then developed heart disease) is not always applicable. Especially so in this case since cats are oligate carnivores while humans are omnivores. Alright enough about cats, TheFatNurse just found it interesting that similar controversies about carbohydrates and chronic disease exists for humans as well as cats.

picture from pandawhale.com

 

Is The Paradigm Shift Starting? Media Updates and Carpal Tunnel

TheFatNurse is Alive and Well despite the lack of updates. Had to take on finals and TheFatNurse is happy to report they never stood a chance! In the meantime, lots of changes occurred since the last update in regards to the media and some new things TheFatNurse learned on carpal tunnel and diabetics.

Doctor Oz…leading the way!? If you’ve followed this blog then you’ll know TheFatNurse is no fan of Dr. Oz who often regurgitates the existing paradigm and has condemned fat as a evil. So you can imagine TheFatNurse’s surprise when Dr. Oz had not ONE but TWO shows that challenged the existing paradigm on diet! Last week Dr. Oz had Dr. Stephen Sinatra & Dr. Jonny Bowden talking about how the current view on cholesterol is all wrong, that there is nothing generally wrong with eating saturated fat, and that cholesterol in general is good for us.

WHOOOA

TheFatNurse’s reaction to this Episode

None of this is new to TheFatNurse…but seeing it on the Dr. Oz show, a huge influential media source, was too surreal! Many days and nights TheFatNurse was laughed at for questioning the existing paradigm…well perhaps no more! The show was progressing nicely until Doctor Oz attempted to use an illustration on how LDL and HDL works…something about a suitcase? Simply put, this best explains how TheFatNurse felt about it:

Let your Guests Explain How it Works!

Kudos to Dr. Oz for bringing up the subject matter, but if you’re interested in how LDL and HDL relate to heart disease check out the For All Ages FatNurse comics on Cholesterol in General and HDL/Triglycerides. However, despite the kudos, TheFatNurse was deeply disturbed by one of Dr. Oz’s comments:

I’m blown away by these side effects you’re reporting. You’re saying there’s data that statin drugs cause diabetes…

For reals? This was big news earlier in the year (February 2012) when the FDA announced they were adding warnings to statins for this very thing. It’s right here on the FDA website if you’re curious. TheFatNurse is just a little shocked Dr. Oz didn’t know that.

People being treated with statins may have an increased risk of raised blood sugar levels and the development of Type 2 diabetes.

However, TheFatNurse was happy to hear Dr. Oz ending the online segment by informing people that sugar is a bigger problem than fats in the diet. What is a bit peculiar is how the online episodes cutoff 1/4 of the show about cholesterol. The part they cutoff is the segment exonerating dietary fats and dietary cholesterol. TheFatNurse was fortunate enough to come across the missing segment tho:

The second Oz show that got TheFatNurse all excited occurred two weeks ago and challenged the paradigm of healthy whole wheat grain. This episode featured Dr. William Davis, a cardiologist, and the author behind Wheat Belly. Again, nothing new if you’ve been following this blog but to see the idea that “healthy whole grain wheat” as unhealthy being discussed so openly on Dr. Oz is just amazing.

Another media boost challenging the dominant paradigm on fat came from CBN news which did a segment on how a ketogenic diet (super low carb & high fat) could help with cancer by “starving” the center cells of glucose.

Although it wasn’t easy, Hatfield stopped eating carbohydrates, which turn into glucose inside your body. Cancer cells love glucose and need it so badly, that if you stop giving it to them, they die.

TheFatNurse hasn’t looked into the medical literature on the subject for clinical trials and what not but this is certainly something worth following up on in the future.

Speaking of blood glucose, TheFatNurse never knew how much more at risk people with impaired blood glucose such as diabetics or people with metabolic syndrome were at developing carpal tunnel syndrome. In this study,

metabolic syndrome was found to be three times more common in patients with CTS and CTS was more severe in patients with metabolic syndrome when compared with those without metabolic syndrome.

To keep it short, what happens is when glucose is elevated and around proteins such as collagen, elastin and fascia in tendons, it goes through something called glycosylation. This basically means that the glucose and proteins combine together. This impairs the function of things such as collagen, elastin and fascia. In nerves, glucose is converted to sorbitol which attracts water. Nerves also have collagen and elastin components. So as you can see in the picture below, when you have all this glycosylation occurring on the median nerve and the surrounding tendons in an enclosed space like the carpal tunnel it’s bad news.

Picture by Wilfredor

TL;DR: Looks like the media may be more friendly and picking up on information that goes against the traditional paradigm than before. Who knows what direction their influence is going to direct things in the future? Also carpal tunnel and hyperglycemia may be closely related.

Whizzkey, Fat Loss Rings, & The Truth about Cholesterol…Becoming Mainstream?

Now that thanksgiving is over and done with, the air is abuzz with commercialism for the rest of the year…so here are some gifts you may find interesting!

Up first is a “fat loss ring” that works by “balancing” the body. Choose where you want to lose fat merely by ring placement! Probably the cheapest weight loss gimmick a person can buy this holiday season!

On the upside, probably the cheapest weight loss gimmick out there (found on Reddit)!

For you whiskey lovers, how about some holiday whiskey from…urine? James Gilpin of Gilpin Family Whisky uses the urine from diabetics to distill his own brand of whisky. From his site:

Large amounts of sugar are excreted on a daily basis by type-two diabetic patients especially amongst the upper end of our aging population. As a result of this diabetic patients toilets often have unusual scale build up in the basin due and rapid mould growths as the sugar put into the system acts as nutrients for mould and bacteria growth. Is it plausible to suggest that we start utilizing our water purification systems in order to harvest the biological resources that our elderly already process in abundance?

These whiskeys actually aren’t for sale, rather James Gilpin uses them as teaching material to try and spread the awareness of diabetes complications. TheFatNurse like!

Speaking of things TheFatNurse likes…check out this new piece on cholesterol from yahoo health!

When it comes to rating your risk for a fatal heart attack, the least important cholesterol number is your level of LDL (bad) cholesterol. In fact, life insurance actuaries don’t even look at LDL levels, because large studies show it’s the worst predictor of heart attack risk.

Wow! This sort of info in a mainstream media source!? Are things changing!?

If you’ve been following TheFatNurse you’ll know that Cholesterol holds a special place in TheFatNurse’s heart (hehehe non-intended pun there). Be sure to check out TheFatNurse’s cholesterol comics if you haven’t seen them yet!

Cholesterol Comic Overview

Triglyceride/HDL comic

New Videos from Dr. Dayspring and…Shaq? Canadian Diabetes Association approves of Juice?

If you have not seen Dr. Dayspring’s new video this week, TheFatNurse highly recommends you take a look below. TheFatNurse has mentioned Dr. Dayspring in the past so his name should be familiar. But if this is your first time hearing his name…he is a diplomate of the American Board of Internal Medicine and the American Board of Clinical Lipidology as well as a fellow of the National Lipid Association while being a professor at the New Jersey School of Medicine and the director of cardiovascular education at the Foundation for Health Improvement and Technology.

The video offers a general overview of cholesterol and heart disease – stuff you will already be familiar with if you have read TheFatNurse’s For All Ages comic series on cholesterol or any of Dayspring’s previous works on Lecturepad. However, the video offers a good layman’s explanation of cholesterol and heart disease. What interested TheFatNurse the most is Dayspring’s point about how hard it is to change medical dogma. After all, it was once considered heresy to wash your hands in the medical community. However, sanitation practices eventually changed…are we currently in the transition of another change with regards to the public’s view of cholesterol and fat? TheFatNurse hopes so!

In other news, TheFatNurse caught a video of Shaq on CNN talking about health. Shaq gives a small sample of what he eats and says he cuts down on the bread, eats an omelette in the morning, salads for lunch and steak or fish for dinner while avoiding soda and candy to keep his weight down (abdominal obesity) in order to reduce the risk for diabetes. Nice job Shaq! TheFatNurse has talked in the past about how focusing on weight shouldn’t be the only factor to be evaluated in diabetes prevention, but it is certainly a good initial step for people to target.

In other news, the latest edition of The Diabetes Communicator, which is associated with the Canadain Diabetes Association, contained some interesting news about Juices. According to the article,

Juice offers a source of a variety of vitamins and minerals and contains phytochemicals that may play a role in the prevention of cardiovascular disease

Sayyyy whhhat? So…you’re telling TheFatNurse…that you can drink juice to prevent heart disease…because somehow…sugar’s role in heart disease…doesn’t matter when it come to juices?

WHAT…TheFatNurse No Like

You can find an excellent rebuttal to this whole thing by Tony NickonChuk, a certified diabetes educator who was, “so horrified in fact that he penned a letter to the Editor-in-Chief of the publication along with the President and CEO of the Canadian Diabetes Association.” Check out his letter here.