The findings published January 21, 2020 on JAMA network state “Association of Low-Carbohydrate and Low-Fat Diets With Mortality Among US Adults”. Has this study been debunked or is this truly new material? I can’t see the details at the moment due to the pay wall.
Anything coming out of Harvard is extremely biased towards veganism and not to be taken seriously as any kind of valid science.
I can’t see the details either, but I can see from the information available there wasn’t a significant association found between low carbohydrate diets and higher rates of mortality. It seems like the title is being purposefully misleading.
It sounds to me like the findings are saying that neither a low carb or a low fat diet were found to be associated with increased mortality. Great, okay…then it says, but eating a “healthy” low carb diet or a “healthy” low fat diet were associated with lower total mortality. Aside from this being annoyingly ambiguous, I think we would agree that whatever diet you are on, you should try to eat more whole, “healthy” foods in order to live longer. They did seem to be putting an emphasis on plant protein and unsaturated fat as being healthier, and I would have to see more details of the study to understand what the participants were eating, but overall it doesn’t sound like the study showed any increase in mortality on a low carb diet compared to a low fat diet.
The conclusion says “These findings suggest that the associations of low-carbohydrate and low-fat diets with mortality may depend on the quality and food sources of macronutrients.” That seems to be a rather long way of saying almost nothing.
Anyway, I think the title of the study does not fit the findings and it’s probably not showing us anything new.
Conclusions and Relevance In this study, overall low-carbohydrate-diet and low-fat-diet scores were not associated with total mortality. Unhealthy low-carbohydrate-diet and low-fat-diet scores were associated with higher total mortality, whereas healthy low-carbohydrate-diet and low-fat-diet scores were associated with lower total mortality. These findings suggest that the associations of low-carbohydrate and low-fat diets with mortality may depend on the quality and food sources of macronutrients. …” …More
40 grams of dietary fat (per meal) is usually the norm for a ketogenic diet or 70% of your calories are coming from fat?
Fat has more than twice as many calories per gram or units of energy as carbohydrates and proteins.
If your doing that then you would still be in the low fat range?
The study does not quantify the volume of fat they are talking about?
If we don’t have this information we have no idea what a low and high fat diet is? High fat (unhealthy/saturated?) Low fat (healthy/unsaturated?) Hmmmm?
What is considered low carb? (the study is pay walled)image link
The BBC headline was ” Low-carb diets could shorten life, study suggests ” (Ref 1). In the US, CNN went with “ Low and high carb diets increase risk of early death, study finds ” (Ref 2). There were many similar, irresponsible, headlines worldwide that emanated from a study published in August 2018 in The Lancet Public Health journal (Ref 3). The Sydney Morning Herald warned “ People on low carb diets die younger, says science ” (Ref 4).
Let’s look at the ‘science’…
We need to make a critical point up front: every headline using the words “ low carb ” was wrong. The first sentence of the paper was “Low carbohydrate diets…” This was also wrong. The full paper used the words “ low carbohydrate” 40 times. That was also wrong – 40 times. Low carb diets have not been studied by this paper. Full stop. The average carbohydrate intake of the lowest fifth of people studied was 37%. That’s a high carb diet to anyone who eats a low carb diet. As we will see below, the researchers managed to find just 315 people out of over 15,000 who consumed less than 30% of their diet in the form of carbohydrate. The average carb intake of these 315 people was still over 26%. Not even these people were anywhere near low carb eating. Hence, if you do eat a low carbohydrate diet, don’t worry – this paper has nothing to do with you. …More
I don’t know if this is the same study, but there was a recent one where the “lowest carbohydrate” cohort had an average of 46% of dietary calories as carb. Nobody really considers that low carbohydrate.
Also, this particular abstract explains that this is a retrospective observational study. So it’s almost certainly based on food frequency questionnaires, with all the data scrambling and confusion that implies. (The data is gathered from questions almost as foolish as “How many teaspoons of chicken wings did you eat weekly in March 2019?”)
“Our findings show clearly that the quality rather than the quantity of macronutrients in our diet has an important impact on our health,” said first author Zhilei Shan, a postdoctoral researcher in the Department of Nutrition. “The debate on the health consequences of low-fat or low-carbohydrate diets is largely moot unless the food sources of fats or carbohydrates are clearly defined.”
This is actually looks like progress as far as I can see. It basically says that there is no measurable advantage to eating low-fat vs low-carb. The most important predictor of mortality in either case will be food quality. Does anybody really disagree with that at least in principle?
The trouble will come in definitions of “low carb” and “high quality fat”. Regardless it still means that they’re conceding that eating high quality dietary fat doesn’t appear materially affect mortality. That’s a big shift from the Ancel Keys side of the aisle. Progress!
What hasn’t been discussed, but what’s actually of greatest interest to us here is that for the study’s purposes, “high-quality” fat will probably be defined as canola oil and olive oil, and “low quality” fat will be beef and bacon. High quality carbs will be whole-grains and vegetables, and low quality carbs will be white bread and sugar.
I’m guessing they won’t have bothered to explore the 4 natural permutations from a mortality perspective, because that would actually be useful:
High Quality Fat, Low Quality Carb
High Quality Fat, High Quality Carb
Low Quality Fat, Low Quality Carb
Low Quality Fat, High Quality Carb
If they failed to do so the whole study is useless. It’s this fourth one in the list that’s of greatest interest to me, because that’s where keto/paleo/whole 30 resides. This study is unlikely to shed any light on it.
I’d love to read the article but it seems morally wrong to support it financially…
This says all you need to know: One of the authors is Frank B. Hu. You need not read anymore, as you KNOW there is a plant-based, high carb bias. Just look at this garbage:
a healthy low-carbohydrate diet (lower amounts of low-quality carbohydrates and higher amounts of plant protein and unsaturated fat) and a healthy low-fat diet (lower amounts of saturated fat and higher amounts of high-quality carbohydrates and plant protein) were associated with lower total mortality.
Note how they define “healthy”.
You can cease reading after that.
Oh my, these people are on the right path:
The Scientific Report of the 2015 Dietary Guidelines Advisory Committee was primarily informed by memory-based dietary assessment methods (M-BMs) (eg, interviews and surveys). The reliance on M-BMs to inform dietary policy continues despite decades of unequivocal evidence that M-BM data bear little relation to actual energy and nutrient consumption. Data from M-BMs are defended as valid and valuable despite no empirical support and no examination of the foundational assumptions regarding the validity of human memory and retrospective recall in dietary assessment. We assert that uncritical faith in the validity and value of M-BMs has wasted substantial resources and constitutes the greatest impediment to scientific progress in obesity and nutrition research. Herein, we present evidence that M-BMs are fundamentally and fatally flawed owing to well-established scientific facts and analytic truths. First, the assumption that human memory can provide accurate or precise reproductions of past ingestive behavior is indisputably false. Second, M-BMs require participants to submit to protocols that mimic procedures known to induce false recall. Third, the subjective (ie, not publicly accessible) mental phenomena (ie, memories) from which M-BM data are derived cannot be independently observed, quantified, or falsified; as such, these data are pseudoscientific and inadmissible in scientific research. Fourth, the failure to objectively measure physical activity in analyses renders inferences regarding diet-health relationships equivocal. Given the overwhelming evidence in support of our position, we conclude that M-BM data cannot be used to inform national dietary guidelines and that the continued funding of M-BMs constitutes an unscientific and major misuse of research resources.
I have to totally agree with them. But this would put Harvard out of business.
This just in … eating healthier foods is found to be better for your …
wait for it
cue Big Food propaganda and deep pockets research money
Oh you noticed that little gap, huh?
Looks like FUD and propaganda to me. Damage control to keep the average, low information consumer shopping and buying what the industry wants them to.
@atomicspacebunny I love this snippet you’ve cited…
You’ve offered up the primary joke of this study … Harvard concludes that eating unhealthy food is unhealthy, while eating healthy food is healthy.
For the love of humanity, can’t these folks perform some meaningful research?
When you have that much endowment to burn through, apparently not.
Like the studies that show fewer people die when eating whole grain instead of white flour…
They didn’t include the people who ate neither…
Do you ever get the impression that all these studies are done by slim people? Like those who don’t and maybe never have had a weight problem? Because a low fat diet is just not sustainable. You want to actually kill your appetite? Only works with getting the insulin to stop flowing in our veins by cutting carbs. And then these same doctors recommend stomach bypass surgery. Like they never tell their patients about keto as an alternative before they shove them into the operating room.
Did lots of research 2 years ago and ongoing. Listened to all the most interesting people I could find, pro and con, and just took a stand, to take the low carb whole food approach. No regrets.
On a much deeper level we don’t exclusively burn body fat or dietary fat we burn both sugar and fats together (and I do mean back-to-back) and create thermal radiation or heat (UCP-1-2-3-4-5-6-7) from adipose mitochondrial fusion biogenesis (PGC1a) in brown fat adipocytes (PPARγ); problem is you need to have heat sink attached to it when you activate that part of the adipose tissues mitochondria rather than just producing ketones, the current mind set of keto nutritionists doctors and scientists to date don’t get that except maybe Bikman <== dam he’s smart.
Of course we all know we can induce ketosis by restricting carbohydrates and eating fat and protein…yada…yada…yada! But that is not how it’s supposed to work!
But if you slowly practice bringing down the bodies thermostat you reverse the whole process of when you started getting fat.
This is a complex subject with more dimensions then ever realized which I hope to explore further.
And one other thing when you eat man made vitamins or supplements besides bad carbohydrates (fortified junk food) that’s what’s making you fat (unusually hungry?) and are just as bad as eating lots of sugars, starches. That’s what messes up the process described above!
@atomicspacebunny I always appreciate your thought-provoking (and assumption questioning posts). Makes me think!
But I’m not sure I follow your “that’s not how it’s supposed to work” comment with respect to inducing ketosis by restricting carbohydrates?
Given what we presume to be our evolutionary environment for the past gazillion years, isn’t a carb “restricted” diet - as you note, one that’s heavy on fat and protein - precisely how it’s supposed to work (i.e., human metabolism)?
It is “presumed” that only ketosis is natural and how everything should be and ‘it was like that for ‘millions of years’ or so; that’s what we are being told or led to believe and what the current state of science may be incorrectly telling us, but if it were that simple why can’t one person on this planet explain how it works (too many variables?), not even the best highly trained scientists and medical personnel can understand what’s going on even though we may think they do?
You burn endogenous glucose even if you restrict glucose exogenously, same with endogenous and exogenous dietary fat so surely the three biological pathways if it has survived for ‘millions of years’ is not mistaken or confused? Something we’re eating is causing that biological machinery to malfunction and it is not just sugar or fat, our own fats cells burn sugar and fat together if there is enough mitochondria in them?
What is interesting I have enabled my body to take ice cold showers at around 40° to 30° or bath full of ice cubes at 20° and not be cold at all; without shivering in the slightest which means I’m burning sugar and fat together using my own fat cells. It is strange to feel warm when your in a thermal environment that would kill most people.