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US government to withdraw longstanding warnings about cholesterol (2015)

washingtonpost.com

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Re: US government to withdraw longstanding warnings about cholesterol (2015)

#231

Post by pessimizer »

evidence_first wrote: post #220
brianwawok wrote: post #217

Earlier quoted context omitted.

It's about equal to doctors telling me to eat low sat fat and low cholesterol in 2016. The difference is doctors went to school for this and still are wrong.

Except it's not. The reason we have these publications is that medicine is continually reevaluating its recommendations. Your statement is about as unreasonable as saying 'we don't need computers since sometimes computers stop working'. Also, if you've ever spoken to a doctor about this, few would disagree that nutrition is an area where we still need more research. Finally, ask yourself: in the absence of evidence,…

> The reason we have these publications is that medicine is continually reevaluating its recommendations.

The problem with nutrition is that for a very long period of time it wasn't, at all. It was citing ancient half-assed studies and anecdotes, never bothering to reassess or confirm them, and recommendations for low-salt and low-cholesterol are remnants of that time. I have no doubt that since a lot of that stuff has been called out, there will be money available for scientists to improve our understanding in the near future. My only irritation is that there are massive financial interests in maintaining the common wisdom, and that as a consequence, good findings will be ignored or suppressed.

As it is, the latest findings on salt and cholesterol are still not general knowledge, and the old common wisdom (as exemplified by popular science articles sparked by industry press releases, advice from primary care doctors) is nearly as dominant as it was before. A large part of that is that there's not been a lot of new advice to replace the old bad advice, leaving a hole, but the fact that statins and "diet" food are such a huge category creates a very dominant voice. That the loudest advocates for new findings come from faddish diets whose rationales reek of crank is also depressing.

> Finally, ask yourself: in the absence of evidence, is a diet that avoids fats/cholesterol (which, a priori, are associated with heart vessel disease[1]) such a silly idea?

We don't need science if we are just going to rely on easy, intuitive explanations of everything. Anybody can decide that eating fat makes you fat and fills your arteries with fat; you don't need any particular expertise for that.

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#232

Post by LeifCarrotson »

baron816 wrote: post #134
djsumdog wrote: post #128

Earlier quoted context omitted.

I agree with you. This article also mentions they're focusing on fats/saturated fats; which is also a terrible focus. The real danger is not fat, even saturated/trans-fats, but starches and sugar. The increase in these types of carbohydrates in products like baby formula is actually leading to obesity in infants! Excess sugar can stress arteries and damage them. Cholesterol is carried to these artier by lipids (LDLs…

It's also a myth that runners need a high carb diet. I was a competitive distance runner for many years with a high carb diet and I'm confident that my performance suffered because of it. You're cells become much more efficient at using energy as you train, so you really don't need to eat that many calories at all. I was running 80+ miles per week, with a not above average calorie intake (for Americans), and my weigh…

The point of improving your running economy is not simply to reduce your ml O2/kg body mass/km and kcal/kg/km. That efficiency is nice, but the volume of oxygen you can inhale per minute doesn't change with your diet. A competitive distance runner would use increased efficiency not to reduce their dietary intake, but to increase their speed while maintaining a high-calorie diet.

It doesn't make sense that your cells could become more efficient to the degree that you "don't need to eat that many calories at all". Typical efficiency values are on the order of 1-1.5 kcal/kg/km, so your 80 mpw represents at least 1200 calories per day above baseline. Furthermore, this 1200 calories is just while running - after stopping the workout, you'll need to metabolize protein to help your muscles recover from exertion, and rebuild the glycogen stores which are larger in volume as a result of training, and which are more effectively drained as a result of training, and to rebuild the fat stores which you'll use on your long runs.

And yes, I may be biased in this reasoning due to the fact that I can sit here and type this out while munching on this delicious caramel popcorn and not worry about weight gain. There's no denying that it's high-calorie.

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#233

Post by pessimizer »

teddyh wrote: post #169
RangerScience wrote: post #89

Earlier quoted context omitted.

Hmm. Could you then disallow any advertising of drug while you're still without FDA endorsement? Like how you're not allowed to advertise cigarettes. I suspect this line of thinking just leads to too many problems, however.

Yes, it’s possible to do this. You may be surprised to hear that the USA is one of only two countries on the entire planet which it’s even legal to advertise drugs. All others outlaw it completely.

Before 1997 it was impractical to advertise them, though. You couldn't mention both the name of the drug and what it was for in an ad without including the entire warning label text. The deregulation was another Clinton thing, and its main beneficiary was the SSRIs.

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#234

Post by teddyh »

comex wrote: post #206
Sacho wrote: post #175

Earlier quoted context omitted.

Indeed, that was surprising to hear, and a quick google search found me many countries in Europe where advertising drugs is legal, within some restrictive framework. Examples: Spain http://uk.practicallaw.com/0-618-5403#a202338 France http://uk.practicallaw.com/2-618-6699 )

Both of those links say that there's a total ban on advertising prescription drugs to consumers, which is more specific than what the parent said but still very broad.

I’m sorry, yes, I should have specified prescription drugs, as that is what I meant. In context, though, this was what was discussed by the grandparent post: “[…] people go to their doctor asking for Rx by name […]”.

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#235

Post by pessimizer »

delecti wrote: post #105
wyager wrote: post #86

Earlier quoted context omitted.

If nutrition science "isn't solved", the government shouldn't be making laws and regulations based on it.

Morality isn't "solved" either, but we still outlaw murder. We can't not try to protect ourselves.

Murder is long solved. We've conclusively determined, with no exceptions, that it is unhealthy for the victim.

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#236

Post by BeetleB »

clarkmoody wrote: post #17

Wouldn't it be nice if there were more government warnings and less restrictions / regulations? Imagine if the FDA, instead of blocking new drugs for 10 years and $1B, it simply withheld its endorsement until satisfied by the clinical trials. Consumers could then take the government's recommendations into consideration when making a decision and drugs could get to market much faster. The history of medical reversals…

>A whole raft of restrictions could be converted to warnings and recommendations, freeing up industry to innovate and consumers to take a little more responsibility for themselves.

When I look at how little regard people have for this when taking supplements, I find it hard to believe they'll take more responsibility for themselves.

Not against all supplements myself, but once I learned how poorly controlled they are - how there is virtually no manufacturer I can trust who is actually giving me what the label claims (so many mg of nutrition per capsule, harmful ingredients not on the labeling, etc) - I pretty much stopped taking all of them. The risks outweigh the benefits.

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#237

Post by teslabox »

PKop wrote: post #226
mjmasn wrote: post #196

Earlier quoted context omitted.

If you're looking to avoid confusion you should refer to them as starches, they are the complex carbs (such as rice, beans, potatoes etc.) that give us energy and should form the largest proportion of any healthy diet. - These starches should preferably be unrefined (yes, quit that white bread, discover the great taste of brown rice) and eaten alongside some green and yellow vegetables to get extra vitamins, minerals…

I won't resort to personal attacks, but I consider this absolutely terrible nutritional advice. The issue here is "excess carbs" are very easy to exceed consuming grains and sugar. Carbs (especially sugar) are what most easily gets converted to adipose fat tissue on the body... unintuitively consuming dietary fat is NOT conducive to increasing body fat. Counter intuitive but true. Consuming a high carb diet, especial…

> Oils, fats, nuts should be primary components of ones diet.

One is not like the others.

Refined vegetable oil is not appropriate for human consumption. Butter and coconut oil are not refined with hexane, or steam deodorized, and are stable at room temperature (and human temperature). Refined vegetable oil can still be used as biodiesel, though.

Small amounts of nuts are okay, but their oils are not exactly stable either.

I'm trying to convince my keto-devoted friend to eat more fruits, to get her metabolism up. She has lost a lot of weight by watching her carb intake. But she's not "well".

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#238

Post by paulryanrogers »

azinman2 wrote: post #73
badsock wrote: post #54

Earlier quoted context omitted.

Just as an example: 9% of the cases of Idiosyncratic Drug-induced Liver Injury is self-harm caused by people taking non-regulated dietary supplements: https://www.ncbi.nlm.nih.gov/pubmed/18955056 You have a theory that the average person will wisely assume the responsibility to vet the health effects of what they consume, but empirical reality disagrees with your theory. Right now people are injuring themselves with…

Don't forget that marketing budgets for pharmaceuticals are also huge. The average person has no chance. The constant bombardment already means people go to their doctor asking for Rx by name even without understanding the medical need or if they're right for it. Now remove regulation... the warnings basically just blur into the background. Already we get so many warnings on prescriptions that they just turn into not…

"Don't forget that marketing budgets for pharmaceuticals are also huge"

Why is it advertising regulated drugs to uninformed consumers is legal?

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#239

Post by yellowgatorade »

mtw wrote: post #219

For those who are curious, the 2015-2020 Dietary Guidelines is available here https://health.gov/dietaryguidelines/2015/resources/2015-202... (PDF) Unfortunately it does not highlight the danger of sugar & processed food. Someone can follows these dietary guidelines and still be able to have a high intake of sugar, HCFS, processed food and all sorts of food chemicals (emulsifiers etc.), all prevalent in the american…

Are there any studies showing that "processed food" is, on its own, dangerous? Or is the inherent danger largely due to the HFCS, sugar, and other items that are usually added in the process?

Re: US government to withdraw longstanding warnings about cholesterol (2015)

#240

Post by pombrand »

For those of you who still believe it's OK or even good to eat a lot of saturated fats, if you look at the studies it's not much of a controversy:" Whether saturated fat is a risk factor for cardiovascular disease (CVD) is a question with numerous controversial views.[1] Although most in the mainstream heart-health, government, and medical communities hold that saturated fat is a risk factor for CVD, some hold contrary beliefs." https://en.wikipedia.org/wiki/Saturated_fat_and_cardiovascul...

Anecdotally, I've read 50% of people who go on Keto see a huge 2-3x increase in triglycerides and LDL-P (Particle count as measured by NMR) - the #1 risk factor for cardiovascular disease. More LDL particles bouncing around in your arteries = bad. People with a condition that makes them break down more LDL have much less artheroscleriosis: http://www.nejm.org/doi/pdf/10.1056/NEJMoa054013 People with a condition that makes them have more LDL particles get more artheroscleriosis: https://en.wikipedia.org/wiki/Familial_hypercholesterolemia Read Peter Attila's exposition that goes in detail (eating cholesterol is fine though): http://eatingacademy.com/nutrition/the-straight-dope-on-chol... Keto could work, but it's a hyper-pro level high-risk diet requiring frequent blood work and still avoiding saturated fats keeping them primarily monounsaturated which makes it very hard to follow. Plus it sucks for weightlifting..

Surprisingly, very low fat diets might be great for you, it might not be the absolute macronutrient composition that matters, but rather the specifics of the nutrients (GI, fiber, other nutrients etc) and your genetic makeup: https://deniseminger.com/2015/10/06/in-defense-of-low-fat-a-... Scary correlations about saturated fats and neurodegenerative disease therein too.

Personally I'm sticking with a "balanced" ~10/45/45 carbs from protein, low GI carb/monounsaturated fat vegan diet - not wanting to risk side effects of any extreme (although I'm having to ensure adequate calcium, K2, D, B12 and DHA and EPA intake - If I didn't find it unethical to eat fish a pescetarian variety would likely be easier/healthier/less gassy). Tip for you vegetarians/vegans: look up low FODMAP foods; foodstuffs low in carbs indigestible in the small intestine which tend to produce more gas.

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