‘High protein diet as bad for health as smoking’ – 348 news articles UK/ 15,400 news articles worldwide
‘Saturated fat is not bad for health’, says heart expert’ – 67 news articles UK/ 2,640 news articles worldwide
Two very different headlines and both in the news last week. You can guess which of the two dominated conversations in the workplace, on radio and tv, at the supermarket checkout, even between random strangers on the street…. Yes, the ‘eating meat kills you’ line rears its ugly head again.
My first reaction to this headline was to take a look at the original paper, ‘Low Protein Intake Is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population’. You can find it here.
The study combined data from 6,381 US men and women over 50 with ‘mouse and cellular studies’. Data collected from people was based on a 24 hour recollection of what they had eaten. This data showed an average consumption of 1,823 calories, the majority of which came from carbohydrates (51%), then fat (33%) and protein (16%), with most of it (11%) derived from animal protein. That is by any description a high-carbohydrate diet although 1,823 calories seems very low, so I wonder how accurately people reported their eating.
The people were followed up for 18 years and results showed 40% overall mortality (2553 people), 19% cardiovascular disease (CVD) mortality (485 people), 10% cancer mortality (255 people), and about 1% diabetes mortality (26 people). So, data from one day’s eating was extrapolated over an 18 year period to help us understand why people died. One day of eating sure gives us an awful of information, but on we go…
The results of this experiment are written here as follows:
‘Using Cox Proportional Hazard models we found no association between protein consumption and either all cause, CVD, or cancer mortality (Table S2). However, high and moderate protein consumption were positively associated with diabetes – related mortality. One explanation is that diabetes may be more prevalent in these groups, possibly because of a switch to a higher protein, lower fat, and lower carbohydrate intake following a diabetes diagnosis. Finally, high versus low protein consumption was found to be associated with an over ten-fold increase in the risk of diabetes mortality for subjects age 66 and over.
However, the much higher prevalence of subjects with a history of diabetes in the high protein group and the small number of subjects dying of diabetes in the low protein group may account for this, thus emphasizing the need for additional studies to determine the role of protein intake on diabetes incidence and mortality.’
From that, I take that there is NO association between high to moderate protein diets and death by cancer, CVD or all cause. Also, that any rise in diabetes deaths was so small and inconclusive that further studies are needed.
However, finding no overall link between protein consumption and these diseases, the study then goes on to isolate the findings according to age. They are broken down into two groups: 50–65 and those aged 66 or over. The people in the former group had ‘a 74% increase in their relative risk of all-cause mortality’ and were ‘more than four times as likely to die of cancer’ during the following 18 years. How this conclusively proves that moderate to high protein consumption causes cancer and death is a mystery. There could be a myriad of confounding factors and as we know so well, correlation is not causation. Nevertheless, the study finds that ‘high levels of animal proteins promote mortality and that plant-based proteins have a protective effect.’
The study then looked at IGF-1 (insulin-like growth factor), which is a hormone that regulates the effects of the growth hormone (GH) in the body. When we are young, we need this hormone to generate growth in our bones and organs but as we age, cell proliferation also carries with it the risk of genetic mutations that may lead to cancer, so there is an argument that high circulating IGF-1 levels pose a risk. Obviously we want the right amount of IGF-1 at the right time and not levels that are abnormally high. Dairy products have been linked to high IGF-1 levels and calorie restricted diets have been found to lower IGF-1 levels.
Levels of IGF-1 were only available for 2,253 people. Although the study states that for those in the 50-65 bracket on a moderate to high protein diet, the risks of all-cause and cancer mortality were increased further with high levels of IGF-1, it also confusingly states that ‘IGF-1 did not account for the association between protein consumption and mortality’. Next they ran ‘predicted hazard ratios’ on the IGF-1 and protein groups to calculate risks.
The data was then combined with ‘mouse and cellular studies’ to look at the effect of IGF-1 levels.
The mice in the high protein group were fed on Harlan AIN-93G (see contents here – just scroll down the page to find the AIN-93G pdf). The diet was 60% carbohydrates, 7% fat and 18% protein (from casein – a milk protein) and contained corn starch, Maltodextrin, Sucrose, Soybean Oil and Cellulose. The study states that ‘additional diets with contents ranging from 4%-18% kcal from protein were created using either the AIN-93G purified diet or the Soy protein diet (93G, G) as reference standards’.
How can we derive data regarding nutrition when mice are fed food filled with such as corn starch, Maltodextrin, Sucrose, Soybean Oil and Cellulose? How can we isolate protein as the culprit against the background of such a combination of other foodstuffs? What does this tell us about meat consumption when the protein used is casein? How can this tell us that consumption of beef in the context of a healthy, real food diet such as Paleo will give us cancer? I just don’t understand the giant leaps that this research makes. But once all of the confusing data, tenuous links, projections, risk analysis and hazard ratios are combined, we end up with a headline that equates high protein with cancer and ultimately that is what makes the news.
The study was funded by NIH/NIA grants to V.D.L. V.D.L has equity interest in a company called L-Nutra. The company make plant-based ‘anti-aging’ replacement meals that mimic the effect of a calorie restricted/fasting diet for chemotherapy patients or for anyone that wishes to ‘increase healthspan’. It makes sense that the research findings are clearly in favour of a predominantly plant-based diet, with the study stating that ‘… associations were either abolished or attenuated if the proteins were plant derived.’
The possibility of using calorie restriction as a way to treat cancer is certainly interesting. There is some very exciting research taking place by Professor Seyfried at Boston College using ketogenic diets (extremely high fat, moderate protein and very low carbohydrate) in conjunction with calorie restriction to treat cancer – see the Resources page. Calorie restriction may be easier in the context of a ketogenic diet as the body is satisfied with very high levels of fat and low levels of carbohydrates, removing the need to eat frequently. However, calorie restriction is not the crux of the argument put forward by this research. This study was clearly intended to promote a plant-based diet while vilifying protein-based diets. Sadly, those hysterical headlines are what people remember.
In the same week as the above story appeared, I was so pleased to see this article about a paper written for the BMJ journal Open Heart by Dr DiNicolantonio, of Ithica College, New York. Dr DiNicolantonio discusses the vilification of saturated fat and the dangers of high carbohydrates. Read the original paper here. It is an excellent summary of the misleading dietary advice adhered to over the last few decades. Many of the issues that Dr DiNicolantonio discusses are touched upon elsewhere on this site (and on other sites that I have recommended over in Resources) – the unfounded fears over saturated fat, the dangers of a high refined carbohydrate diet, the misinformation regarding cholesterol… So refreshing to see this reaching the news but as I said at the beginning of this post, you can guess which of the two stories generated the most publicity.
© Past Present Paleo 2013. All Rights Reserved.
Great to see the Telegraph reporting earlier this month that the Paleo diet was the most searched-for diet on the internet last year. Tap in ‘Paleo diet’ in Google trends and we also get some exceptionally high rises over the last year.
Things are progressing but unfortunately the Telegraph couldn’t let it go without a warning about all that ‘fat-laden meat at the expense of the whole host of good things (calcium, vitamin D, fibre and antixoxidants among them) which are found in dairy and grains.’
This sort of misinformation is a real shame.
As we know, fat is essential (see here). We should not be afraid of good fats and that includes the saturated fat in meat. In fact, our avoidance of fat (twinned with an abundance of ‘healthy’ carbs) has led us into all sorts of problems and deprived us of an essential nutrient, especially for brain function. Fatty meat was regarded as a prized source of food for our hunter-gatherer ancestors, with the leaner meat less so. If we are eating animals that have been entirely grain fed and factory farmed, we will want to limit the fat intake as this is where many of the toxins are stored, but on the whole fatty meat is good stuff.
Apart from the fact that many Paleo adherents enjoy limited forms of dairy if tolerated (fermented products in particular), the idea that dairy products are essential for adequate calcium intake is contentious. Foods such as oily fish (salmon, sardines, mackerel), nuts (almonds in particular), leafy greens (kale especially), tahini and sea vegetables are all excellent sources of calcium. Then there is the fact that Vitamin D controls the amount of calcium within the bones – see my post on Vitamin D here. It is impossible to make up for deficiencies in this hormone by food alone. Apart from this, the links between calcium and bone health are highly contentious, as are the links between calcium deficiency and osteoporosis.
As for grains, we know that the phytates in grain products inhibit mineral absorption (calcium, Vitamin D) and that upon examination, the bones of our Paleolithic ancestors, pre-agricultural revolution and consequently all those grains) showed remarkable strength.
Lastly, our fibre and anti-oxidants are easily available in leafy vegetables and limited fruit without the need to resort to grain consumption. This is nonsense.
Of additional interest in the article was the fact that the Ketogenic diet was also listed, although describing the process of ketone fuelling as a ‘starvation state’ rather than as a perfectly normal process was somewhat alarming.
Anyway, mustn’t grumble too much – at least it gets the word out for the start of 2014. Happy New Year!
© Past Present Paleo 2013. All Rights Reserved.
It’s not even Christmas and already the New Year diet stories are starting. The Daily Mail’s article published last month warns of the dangers of ‘faddy diets’ and announces that ‘experts’ have drawn up a list of diets to be avoided. Right up there with the ‘Breatharian’ diet (air and sunlight alone) and the ‘Alcorexia’ diet (eat small amounts of food so that you can knock back the drink) is none other than the Gluten-free diet.
The article refers to the press release from the British Dietetics Association, whose experts point out: ‘Whilst important for those with coeliac disease or gluten sensitivity, there is no credible published research showing that a gluten-free diet per se leads to weight loss in those without. Many foods that contain gluten, like breaded products, pastries, cakes and biscuits, are high in calories, so by avoiding them, many lose weight. Many believe, wrongly, they can eat as much as they like of gluten-free substitutes like biscuits, sausages and beer. Gluten-free does not mean calorie free.’
So according to the BDA, going gluten-free encourages calorie-cutting by default, which leads to weight loss. However, as soon as people over-eat gluten-free products like biscuits, sausages and beer, then the weight piles back on. Scratch the surface of a gluten-free diet that has led to weight loss and what you will really find is a calorie-counting regime, they say. Consequently, if you are not coeliac or gluten intolerant, rather than fuss around looking for gluten-free products, don’t worry about eating gluten-containing foods – just count the calories.
I decided to have a look at the BDA website in search of some further advice. The general stance taken by the BDA is firmly rooted in the low fat, high carbohydrate, calorie-obsessed conventional wisdom regarding diet. As Christmas is fast approaching, I decided to check out their recommendationsfor the big day (N.B. Taken down for review 2014).
For breakfast, they advise: ‘Try breakfast cereals, porridge, bread, rolls, English muffins, scones, malt loaf, fruit bread, currant bun and bagels are all good sources of energy that will help kick start your metabolism and they’re all low in fat’ with an additional recommendation to eat wholegrain varieties where possible. For lunch, a portion of healthy Omega-3 smoked salmon is a good choice to start (although they go on to recommend cooking vegetables in pro-inflammatory Omega-6 oils). For the main course, the turkey comes with a warning though. They advise that it is: ‘low in fat and high in protein so tuck in – but don’t eat the skin or you’ll add lots more fat and calories’ (back to that low-fat, calorie counting obsession). They also advise people to: ‘Roast potatoes using pure vegetable oil, olive oil or sunflower oil rather than lard.’ Forget about the goose fat – that’s presumably so bad that it doesn’t even warrant a mention. We are encouraged to fill up on vegetables though: ‘…as long as they are not covered in butter or any other fatty spreads they are all low in calories and fat and contribute to the five portions of fruit and vegetables you need every day.’ Even the gravy doesn’t escape their beady eyes, just in case you should be tempted to sneak a drop of fat in. By the time we get to reading about desert, I am losing the will to live, but they reassuringly announce that Christmas pudding is low in fat. However, there is a veiled threat awaiting: ‘so to keep it this way; serve with low-fat custard or crème fraiche’. In terms of alcohol, it is clear that complete avoidance is preferable: ‘even better, offer to drive and stick to non-alcoholic options all night.’ Goodness, I bet Christmas lunches at the BDA are such fun.
After all that, it is clear that any diet regime that the BDA recommends would need to be very firmly rooted in the low-fat, high carbohydrate, calorie-counting sphere. Even more importantly, a gluten-free diet in the context of a no grain, real food, high fat, low-carbohydrate diet would most certainly not meet with their approval. It is important to look at the way that they are subtly defining a gluten-free diet in order to knock it down. Instead of a healthy natural diet that avoids all grains, they are suggesting that a gluten-free diet involves the consumption of highly processed foods that are manufactured to be gluten-free. A quick look at some gluten-free products brings up a list of ingredients such as:
…potato, tapioca, maize, buckwheat, sugar, golden syrup, glucose syrup, caramelised sugar syrup, maize glucose syrup, margarine, dextrose monohydrate, sunflower oils, emulsifier [mono and diglycerides of vegetable fatty acids], emulsifier (sunflower lecithin), emulsifiers sorbitan monostearate and soya lecithins, colour anthocyanins, corn glucose fructose syrup, stabiliser hydroxypropyl methyl cellulose…
The BDA stress that foods like this are laden with calories, but the real issue is not the calories. It’s the fact that they are highly processed foods with many ingredients that have no place in a healthy diet. The problem is that it is not real food. When we eat real food that sustains us – meat, fat, vegetables, eggs – and that doesn’t leave us craving for more in a couple of hours, we should not be worrying about the fat content. And gluten-free can certainly mean real food.
In addition, the issue is not just wheat. The problem with some gluten-free diets is that some of the foods allowed often contain other grains that have irritating effects on our gut and that can be just as problematic for our digestive systems, causing inflammation and blocking the absorption of vitamins and minerals. Read Chapter 6 of The Paleo Solution by Robb Wolf and you may never eat grains again. Also check out the The Definitive Guide to Grains by Mark Sisson and the Grain Manifesto at Whole9 which has links to some excellent articles on gluten-free foods.
The association of a gluten-free diet with other diets such as the ‘Breatharian’ and ‘Alcorexia’ undermines anyone who has found tremendous relief from eliminating gluten – even though they are not coeliac or diagnosed gluten-intolerant. But as the whole subject of the article is about weight-loss, perhaps they would say that digestive health is a different matter. Perhaps the BDA would also contend that they are arguing against a specific gluten-free diet that contains highly processed foods and not one that is made up of natural, real foods, but they have not made any distinction between the two, and in fact have not even acknowledged that an alternative approach to gluten-free exists.
No doubt the BDA would say that a Paleo diet (by default gluten-free) could only work for weight loss too because it reduces the amount of calories consumed. Everything leads back to low fat, high carbohydrates and calorie-counting. Sian Porter, Chairman of the BDA’s Communications Board states that ‘people will believe almost anything and anyone when it comes to nutrition, food and diet.’ I absolutely agree. Margarine healthier than butter, red meat a killer, eggs dangerous, we’ve heard it all. We have believed and trusted the diet ‘experts’ for far too long and look at the state of the nation’s health.
© Past Present Paleo 2013. All Rights Reserved.
Last month the government launched the ‘Responsibility Deal Saturated Fat Reduction Pledge’ which promises to remove ‘one and a half Olympic size swimming pools of saturated fat’ from the nation’s diet’ (who writes these press releases?). We are told that various food manufacturers and retailers have willingly signed up to the pledge and will aim to reduce the saturated fat content in their products to make them ‘healthier.’
I really don’t know where to begin with this one, as it is all so depressing on so many levels. The press release states that ‘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 disease and stroke.’ Ok, first let’s stop there. This first statement assumes that saturated fat is the cause of such diseases. This is a view that has been increasingly rejected over many years. See for instance the ground-breaking article by Gary Taubes What If It’s All Been a Big Fat Lie? (2002) and pop over to the Resources page for more excellent clips and articles. The demonization of natural saturated fats – meat, coconut oil, butter – is beginning to look at least erroneous and at worst dangerous. Especially in terms of brain health, the reduction in saturated fats and the increase in carbohydrates in the diet over the last few decades could be disastrous.
It then goes on to state that ‘One in six male deaths and one in nine female deaths are from coronary heart disease – this is why it’s critical that we challenge the way we eat and that we all make changes where we can.’ Once again they link worrying heart disease figures back to saturated fats with the implication that cutting such fats will reduce overall deaths by CHD. Where is the conclusive proof of this?
It adds that companies are ‘…leading the way to give their customers healthier products and lower fat alternatives.’ The linking of ‘healthier products’ with ‘low-fat’ implies an inextricable link between the two. Who says that low-fat products are healthier? Where is the proof of this? Butter healthier than margarine? Low-fat (sugary) yoghurt healthier than full-fat Greek? Low-fat coconut milk healthier than full-fat? Just type in ‘low-fat’ on a supermarket shopping site and then look at the lists of ingredients in these foods. Many products have been pumped full of sugars, artificial sweeteners (Saccharin, Aspartame) and flavourings to make them more palatable after the fat has been removed. How can these be healthier than natural, full-fat foods?
Next we have a list of some of the proposed changes that producers and retailers will be making:
- Nestlé – which will remove 3,800 tonnes of saturated fat from over a billion Kit Kat bars per year by reformulating the recipe
- Tesco – which will remove 32 tonnes of saturated fat from products such as breadsticks
- Morrisons – which will be reformulating its spreads range to reduce saturated fat, this will remove approximately 50 tonnes
- Aramark – which will increase the amount of 1% fat milk it supplies across its sites and increase the training it gives to its chefs
- Cricketer Farm – which will help one retailer remove 1.5 tonnes of saturated fat by switching to their half fat cheese
So let’s just re-cap: in order to combat heart disease in the UK, we should be eating low-fat Kit-Kats, low-fat breadsticks, low-fat margarines, and low-fat milk and cheese. Is this for real?
The statement then explains how additional companies will also be joining this initiative by reducing saturated fats, changing ingredients, promoting ‘healthier’ menus and generally helping us to eat the ‘right’ foods: ‘reformulating recipes so they include less fat, and introducing new products with lower fat.’ Isn’t this what they have been doing for the past 40 years? Urging us to eat low-fat foods and lecturing people about what/what not to eat. Take a look around – it hasn’t worked! Something is wrong with the low-fat, high carbohydrate approach and yet they still regurgitate the same old line.
On talking about the commitments, Chair of the Responsibility Deal Food Network, Professor Susan Jebb said: ‘They recognise that too much saturated fat can increase cholesterol levels and cause heart disease and premature deaths which is why it’s fantastic that so many companies have committed to helping people cut down on their consumption.’ Not so fast! There are quite a few people that would disagree with Professor Jebb. One such person is Cardiologist Aseem Malhotra. It was great to see him flying the flag for good fats in the wake of the government’s press release and generally disputing the lipid hypothesis. I missed the debate on Jeremy Vine between Dr Malhotra and an NHS spokesman, but was reliably informed that the NHS man failed to provide a convincing rebuttal to Dr Malhotra’s argument.
In addition, this article in the Daily Mail about the controversy was a refreshing change and manages to quote an excellent trio of Malcolm Kendrick, Robert Lustig and Timothy Noakes.
The Telegraph printed a similar article but just can’t help gravitating back towards a cautionary note, warning viewers to indulge in no more than ‘a wee bit’ of steak. It also unhelpfully lumps together ‘butter, fatty meats and pastries’ when talking about saturated fats and warns that when it comes to bread, our daily allowance of fat permits ‘one slice spread with a thick layer’. Perhaps things might improve if we cut the bread out and didn’t worry about eating the butter, but Tom Sanders, professor of nutrition and dietetics at King’s College, London might disagree, stating that ‘It is sensible to avoid fatty meat dishes, choose reduced-fat milk and eat cheese in moderation. Cream is best kept for special occasions.” That’s me done for then.
I did note that Dr Melhota also called for the following measures to be implemented: “a sugary drinks tax, banning junk food advertising to children, ensuring compulsory nutritional standards in schools and hospitals… “. I’ve got to say this worries me. I doubt that schools and hospitals would be singing from the same hymn sheet as Dr Melhotra regarding saturated fats and rejecting decades of advice from their government funders doesn’t strike me as an option. I would add that it is the government poking its nose into what people eat that caused this mess in the first place, not just in the UK but also in the US (George McGovern’s Dietary Goals for the United States for a start). I also think that a change will come not through taxing or banning foods, nor from governments, authorities or quangos, food manufacturers or indeed any government or industry funded organisation to tackle obesity but instead from the grass roots, from individuals who choose to ignore the conventional advice and go looking for themselves. Unfortunately that takes time, and goodness knows how many people will suffer in the interim.
© Past Present Paleo 2013. All Rights Reserved.
Once again the scare stories are surfacing regarding red meat. Barely a week goes by without a newspaper article urging us to avoid red meat for fear of some terrifying consequence. A recent story comes courtesy of the Daily Mail (UK) which seems to be obsessed with these hysterical food scares. While showing the usual photographic cliches of a man chewing a steak and a woman proudly clutching a salad (although it won’t mitigate the effects of all that dangerous meat), the article triumphantly announces:
‘Eating too much meat ‘raises risk of diabetes’ even if they eat lots of fruit and vegetables too’
At first glance, this could seem worrying. The article states that the study focused on 66,485 women and tracked their health for 14 years. It found that those who ate ‘acid-forming foods’ such as meat, cheese, fish, bread and soft drinks were 56% more likely to develop Type 2 diabetes. At the end of the study, 1,372 women had developed diabetes and diagnoses were particularly common in those with an acidic diet. The volunteers had given details about their diet.
The ‘culprit’ foods mentioned include bread and soft drinks, two foods that that cause potentially huge rises in blood sugar levels. The experiment is based upon volunteers giving information about their diet, presumable recalling what they ate and when; a notoriously inaccurate way to gather information. At the end of the experiment, 1,372 women developed diabetes out of a total of 66,485 which works out to around 2.1% of those monitored.
The original report, which you can find here, states that ‘With respect to specific food groups, a high-PRAL (potential renal acid load) diet included significantly more meat, fish, cheese, bread and soft drinks, particularly artificially sweetened beverages, whereas a diet with a low-PRAL score included more dairy products, fruit, vegetables and coffee (Table 1).’
How can meat be singled out as a potential diabetes risk in the presence of several other foods that cause massive insulin swings? The report states that ‘Although we adjusted for most of the known and potential type 2 diabetes risk factors, residual confounding cannot be ruled out.’
It reports that ‘A Western diet rich in animal products and other acidogenic (acid forming) foods can induce an acid load that is not compensated for by fruit and vegetables; this can cause chronic metabolic acidosis.’ Ok, so if we accept that excessive acidogenic foods could be a problem, how do we tell which foods are the problem – or is it all of them? Meat shares the list of acidogenic foods with, amongst others, white flour, bagels, croissants, popcorn, pasta, pastries and most grain products including refined cereals, carbonated soft drinks, sweetened juices, sweetened yoghurts, artificial sweeteners and many other products that we would (hopefully) steer well clear of. Fish and seafood are on there too. I don’t see the headlines warning us not to eat fish.
The strange thing is, I googled the report and found an earlier article by most of the same authors here. In this report, it quite clearly states that red meat (beef, pork, veal, horse, and sheep) poses no increased risk of diabetes, but ‘a direct association was observed only for processed red meat and type 2 diabetes.’ It also states that ‘…we observed no association between unprocessed red meat and diabetes risk’ and ‘Our results suggest that habitual consumption of processed red meat may be associated with a higher incidence of type 2 diabetes and that consumption of unprocessed red meat may not.’
Again, even here it would be interesting to know how they isolated processed meat (sausage, salami, bacon, and ham) from other foods such as bread, sweet beverages, and other high carbohydrate foods that could increase diabetes risk.
I find all this is pretty confusing but I cannot understand how it gets interpreted by the Daily Mail as effectively saying that meat causes diabetes. Surely we would expect to see high incidences of diabetes in modern hunter-gatherer tribes whose diet is predominantly meat, if it is such a risk? Instead we are seeing increasing numbers of people diagnosed with diabetes in western societies and in particular developing societies that have adopted a ‘westernized’ diet in place of their more traditional foods. Presumably one needs to add increasing levels of stress and a decrease in physical exercise to this too. Check out this report for some global figures and projections:
All in all, I am not convinced that red meat raises the risk of diabetes, any more than I believe that it causes cancer and heart attacks.
A recent article in the Telegraph claimed that we should eat red meat only once a week: ‘Having analysed the diet of some 120,000 people over a 20-year period, researchers suggested that adding just one daily portion of red meat – steak and burgers for example – increased the overall risk of death by 13 per cent.‘ Presumably that’s the risk of getting hit by a bus on that extra trip to the butchers.
© Past Present Paleo 2013. All Rights Reserved.