Protein, carbohydrates and monounsaturated fats in diet

[Guest guest]

Hi All,

Alternative isocaloric CR diets appear to be of interest. Do saturated fats

benefit

CRers?

The below are excerpts from first a comment earlier this year and then

additional

data from the pdf-available text.

Benefit seems to be a mixed bag for the two diets below.

The paper appears to warrant the details that are presented below.

Arch Intern Med. 2005 May 9;165(9):1071-2.

Comment on:

Arch Intern Med. 2004 Oct 25;164(19):2141-6.

Is a low-carb, low-fat diet optimal?

Westman EC, Yancy WS Jr, Vernon MC. No abstract available

PMID: 15883253

We read with interest the recent article reporting weight and lipid changes

after a

" modified low-carbohydrate (MLC) diet, " which theoretically combines the

benefits of

carbohydrate restriction and saturated fat restriction.1 In several randomized

controlled trials of the ad libitum low-carbohydrate ketogenic diet (LCKD),

which

has no saturated fat restriction, weight loss and elevation in high-density

lipoprotein cholesterol (HDL-C) level are recurring findings.2-7 This is in

contrast

to the lack of elevation in HDL-C levels in the MLC diet (Table). This result is

perhaps not surprising because saturated fat raises HDL-C level more than

unsaturated fats.8 A recent outcome study has found that higher saturated fat

intake

is associated with less progression of coronary atherosclerosis.9 So, the

combination of carbohydrate restriction with saturated fat restriction may make

intuitive, but not scientific, sense.

Table. Comparison of Findings From Low-Carbohydrate vs Low-Fat Diet Trials

-----------------------------------

-----------------------------Low-Fat Low-Carbohydrate

Reference no. Duration, mo---Weight, kg HDL-C, % Weight, kg HDL-C, %

-------------------------------------

2 3 & #8722;4.1 +2 & #8722;9.9 +4

3 6 & #8722;3.9 +8 & #8722;8.5 +13

4 6 & #8722;1.9 & #8722;2 & #8722;5.8 0

5 6 & #8722;5.3 +4 & #8722;9.6 +20

6 6 & #8722;6.5 & #8722;1 & #8722;12.0 +13

7 2.5 & #8722;6.8 & #8722;15 & #8722;7.0 +12

1 3 & #8722;3.4 & #8722;7 & #8722;6.2 & #8722;3

------------------------------------

Abbreviation: HDL-C, high-density lipoprotein cholesterol.

The LCKD still stands as the best dietary method for raising HDL-C levels,

possibly

because of the relatively high saturated fat content. Scientific studies have

not

yet investigated whether saturated fat is harmful under conditions of

carbohydrate

restriction, when fatty acid utilization for fuel is higher and caloric intake

is

relatively lower.

REFERENCES

1. Aude YW, Agatston AS, -Jimenez F, et al. The national cholesterol

education

program diet vs a diet lower in carbohydrates and higher in protein and

monounsaturated fat: a randomized trial. Arch Intern Med. 2004;164:2141-2146.

ABSTRACT/FULL TEXT

2. Sondike SB, Copperman N, son MS. Effects of a low-carbohydrate diet on

weight loss and cardiovascular risk factors in overweight adolescents. J

Pediatr.

2003;142:253-258. CrossRef | ISI | MEDLINE

3. Brehm BJ, Seeley RJ, s SR, D’Alessio DA. A randomized trial comparing a

very low carbohydrate diet and a calorie-restricted low fat diet on body weight

and

cardiovascular risk factors in healthy women. J Clin Endocrinol Metab.

2003;88:1617-1623. ABSTRACT/FULL TEXT

4. Samaha FF, Iqbal N, Seshadri P, et al. A low-carbohydrate as compared with a

low-fat diet in severe obesity. N Engl J Med. 2003;348:2074-2081. ABSTRACT/FULL

TEXT

5. GD, Wyatt HR, Hill JO, et al. A randomized trial of a low-carbohydrate

diet for obesity. N Engl J Med. 2003;348:2082-2090. ABSTRACT/FULL TEXT

6. Yancy WS Jr, Guyton JR, Bakst RP, Westman EC. A randomized, controlled trial

of a

low-carbohydrate, ketogenic diet vs. a low-fat diet for obesity and

hyperlipidemia.

Ann Intern Med. 2004;140:769-777. ABSTRACT/FULL TEXT

7. Meckling KA, O’Sullivan C, Saari D. Comparison of a low-fat diet to a

low-carbohydrate diet on weight loss, body composition, and risk factors for

diabetes and cardiovascular disease in free-living, overweight men and women. J

Clin

Endocrinol Metab. 2004;89:2717-2723. ABSTRACT/FULL TEXT

8. Mensink RP, Katan MB. Effect of dietary fatty acids on serum lipids and

lipoproteins: a meta-analysis of 27 trials. Arterioscler Thromb.

1992;12:911-919.

ABSTRACT

9. Mozaffarian D, Rimm EB, Herrington DM. Dietary fats, carbohydrate, and

progression of coronary atherosclerosis in postmenopausal women. Am J Clin Nutr.

2004;80:1175-1184. ABSTRACT/FULL TEXT

Aude YW, Agatston AS, -Jimenez F, Lieberman EH, Marie Almon, Hansen M,

Rojas G,

Lamas GA, Hennekens CH.

The national cholesterol education program diet vs a diet lower in carbohydrates

and

higher in protein and monounsaturated fat: a randomized trial.

Arch Intern Med. 2004 Oct 25;164(19):2141-6.

PMID: 15505128

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=15505128 & query_hl=22

.... In the NCEP diet the percentages of calories from fat (30%), carbohydrate

(55%),

and protein (15%) were unchanged throughout the trial. Saturated fat comprised

less

than 7% of the total fat intake, and monounsaturated fat between 10% and 15%.

The

diet was tailored to provide approximately 1300 calories for women and 1600

calories

for men.

.... Table 1. Composition of the Study Diet*

----------------------------------------

Component Phase 1 (Weeks 1-2) Phase 2 (Weeks 3-4)Phase 3 (Weeks 5-12)

----------------------------------------

Protein 28 30 33

Carbohydrate 10 27 28

Fat

Saturated 13 8 8

Monounsaturated 17 62 18 43 17 39

Polyunsaturated 32 17 14

-------------------------------------------

*Values are given as daily percentage of caloric intake.

Foods recommended in the MLC diet included those high in protein (ie, lean

meats),

monounsaturated fats (ie, olive, canola, and sunflower oils as well as peanuts,

almonds, pecans, and avocado), and fibers but with a low glycemic index. The

glycemic index is a measure of the level to which a food raises blood glucose

and

elicits an insulin response compared with pure glucose (100%). Therefore, foods

with

a low glycemic index are those that produce a slow and more sustained rise in

blood

glucose, and thus potentially provide a greater sensation of satiety (eg, soy

beans

and peanuts have a glycemic index between 10% and 19%).25 Participants assigned

to

the MLC diet were advised to avoid simple sugars, which have a high glycemic

index,

as well as refined or highly processed foods. All MLC participants were also

encouraged to eat vegetables in unlimited quantities and snack on foods

containing

protein (eg, yogurt) and/or with a low glycemic index (eg, peanuts). Additional

fiber in the form of psyllium (1 teaspoon in a half glass of water before lunch

and

dinner) was also recommended.

The goal of the 3 phases in the MLC diet was to gradually introduce

carbohydrates

into the diet, beginning with more complex carbohydrates (with a lower glycemic

index) and following with foods containing less complex carbohydrates (with a

higher

glycemic index). Because foods with a higher glycemic index may be associated

with a

feeling of early hunger or " craving, " it was expected that this type food would

give

a feedback signal that would help the participants in their future selection of

food. This approach was effective in one of our earlier trials.26

.... Table 3. Randomized Comparisons Between the MLC and NCEP Step 2 Diets Within

and

Between Groups*

---------------------Diet group----

Variable----MLC (n = 22) P NCEP (n = 23) P---- P between diet group

---------------------------------------------

Primary outcome Weight, lb & #8722;13.6±4.0 <.001 & #8722;7.5±4.4 .001 .02

Secondary outcomes

Waist-to-hip ratio & #8722;0.02±3.82 .009 & #8722;0.01±3.47 .20 .27

Lipids, mg/dL

Total cholesterol & #8722;11.9±29.2 .04 & #8722;13.3±17.5 .001 .83

HDL cholesterol & #8722;1.3±9.4 .46 & #8722;3.8±6.3 .006 .27

LDL cholesterol & #8722;3.9±27.4 .48 & #8722;6.4±15.6 .05 .68

Triglycerides & #8722;42.0±101.3 .003 & #8722;15.3±46.2 .20 .12

Total/HDL cholesterol 0.13±0.91 .45 & #8722;0.07±0.59 .60 .36

LDL particle size peak, nm 4.8±6.3 .001 1.2±4.3 .20 .41

Percentage of dense LDL & #8722;6.1±12.4 .02 & #8722;1.4±6.1 .29 .17

-------------------------------------------------

Abbreviations: HDL, high-density lipoprotein; LDL, low-density lipoprotein; MLC,

modified low carbohydrate; NCEP, National Cholesterol Education Program.

SI conversion factors: To convert cholesterol to millimoles per liter, multiply

by

0.0259; triglycerides to millimoles per liter, multiply by 0.0113.

*Values are given as mean±SD unless otherwise indicated.

.... Table 4. Participant Satisfaction Scores Regarding Diet and Diet Counseling*

---------------------------------------------------

Variable-----Diet

-------------MLC (n = 29) NCEP (n = 25)

------------------------------------------------

Satisfaction

Overall satisfaction 4.2±0.9 3.6±1.2

Frequency of hunger 3.8±1.0 3.6±1.1

Satisfaction with taste 4.2±0.9 3.9±1.2

Satisfaction with amount 3.9±0.8 3.7±1.1

Difficulty eating out 3.9±1.2 3.4±1.4

Interference with daily activities 4.2±1.1 3.6±1.3

Difficulty shopping for food 4.2±1.1 4.0±1.1

Difficulty planning and preparing meals 4.1±0.9 3.5±1.3

Diet counseling

Dietitians’ knowledge of obesity 6.4±1.0 6.4±1.0

Dietitians’ knowledge of the diet 6.7±0.7 6.4±0.8

Satisfaction with dietitians’ explanation 6.7±0.7 6.3±1.1

Satisfaction with dietitians’ answers 6.8±0.7 6.7±0.7

Satisfaction with the quality of the written guidelines 6.2±1.3 6.4±0.9

Satisfaction with adaptation of diet to personal taste and habits 6.1±1.2

5.6±1.8

Satisfaction with participation in diet planning 6.2±1.2 5.7±1.6

-------------------------------------------------------

*Scores are given as mean±SD from a scale where 1 is the lowest and 7 the

highest

score. There were no significant differences between the groups.

Al Pater, PhD; email: old542000@...

____________________________________________________

Sports

Rekindle the Rivalries. Sign up for Fantasy Football

http://football.fantasysports.