Tag Archive for: carbs

More Carbs? Better Choices

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Have you decided whether the extra years you may get by eating too many or too few carbohydrates are worth the effort? How about if you don’t have to make that choice at all? What if you could eat more or fewer carbs and not have to worry about it? Here are the other significant results of the study we’ve looked at this week.

When the researchers considered what people would eat to replace carbohydrates if they chose a low-carb diet, they assumed it would be animal protein such as beef, pork, lamb, and cheese as well as chicken with and without the skin. Likewise when they considered the extra carbs if people ate over 60% carbohydrates, they assumed people would choose more refined carbohydrates. They concluded correctly the additional refined carbs would contribute to metabolic disorders such as type 2 diabetes. They suggested that, based on other studies, if a low-carbohydrate diet used plant-based sources of protein, fats, and oils, there was no increase in mortality on a low-carb diet.

I’ll take it a step further and it’s something you’ve heard before: eat better. It doesn’t matter whether you want to eat a high-carbohydrate or a low-carbohydrate diet. That’s your choice. You just have to eat your vegetables and fruits first, and I’m not talking about just peas, corn, and bananas; there are hundreds of other choices to explore. You can increase the carbs in your diet without hurting your health as long as you make the right choices. Lead with vegetables and you’ll get the fiber and phytonutrients your body needs.

High carb or low carb, it all comes down to eating better. The key to living longer? Eat less. Eat better. Move more.

What are you prepared to do today?

Dr. Chet

 

Reference: http://dx.doi.org/10.1016/ S2468-2667(18)30135-X.

 

Too Many Carbs vs. Too Few

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Yesterday I talked about a Lancet study that says too many carbs are bad and can kill you—but so can too few carbs. The logical question to ask is: what timeline are we talking about? Is it 10 years or 20 years or more? Based on the results of the study, let’s compare the extremes of carbohydrate intake with the mean intake of carbohydrate for a 50-year-old person.

If you ate fewer than 30% of your calories from carbohydrates, you might live up to 29 more years compared to the 33 years a person might live if they ate 50–55% from carbohydrates, so 79 vs. 83. What are four potential years worth to you? They’re only potential years because these are just hazard ratios; it could be as little as 2.5 years or as much as 5.5 years.

On the other hand, if you ate more than 65% of your calories from carbohydrates, you might live another 32 years compared to  33 years for someone who ate 50-55% from carbohydrates. At 82, do you care about one more year?

Only you can decide what those years are worth to you, and to compound the issue, we don’t know what our health will be like when we’re that age. But there may be a way to put the odds in your favor whether you want to eat more or less food high in carbohydrate. I’ll tell you about that tomorrow.

What are you prepared to do today?

Dr. Chet

 

Reference: http://dx.doi.org/10.1016/ S2468-2667(18)30135-X.

 

Huh?

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That’s exactly what I thought when I looked at my health news feed pictured above. Carbohydrates will kill you—maybe. Too many are bad. Too few are bad. It’s all referencing the same study published in Lancet Public Health. What the heck is going on? You’ve heard that beauty is in the eye of the beholder? Evidently, so are provocative headlines.

Researchers examined the mortality rate of participants in the Atherosclerosis Risk in Communities (ARIC) study. The subjects had been followed for 25 years. At the beginning of the study and periodically afterwards, they completed an abbreviated Food Frequency Questionnaire using food models to estimate serving sizes. Foods were analyzed using the Harvard food database to estimate protein, fat, and carbohydrates as well as sources of fats and protein.

What did they find? Just what the headlines said: too many or too few carbohydrates are related to an increase in death. As always, the details are found in the data. We’ll take a look in tomorrow’s Memo.

What are you prepared to do today?

Dr. Chet

 

Reference: http://dx.doi.org/10.1016/ S2468-2667(18)30135-X.

 

The Bottom Line on Veggies and Carbs

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Go ahead and finish your oatmeal and drink your protein-kale smoothie—you do need those veggies. Meanwhile I’ll put the PURE study in perspective.

This is a large study that looks at the economics of food as well as the health benefits. In a separate publication, the analysis of the data focused on the cost of fruit and vegetable intake as a percentage of monthly income. They specifically collected data from low-, middle-, and high-income communities from 18 different countries. Researchers actually went to grocery markets in those countries to collect the cost data. As you might expect, the lower the income, the higher the percentage of monthly revenue spent on vegetables and fruits.

I think that explains part of the reason the second study on vegetable intake and mortality said there was no additional benefit beyond three or four servings per day: if people can’t afford more, it’s wrong to teach them that more is better if it might not be. But that doesn’t justify the headlines because the message that Americans hear is “I don’t have to eat those darn vegetables!”

Yes, you do. Here are the issues with each of the studies.

 

Do Carbs Kill?

In the first study on carbohydrate intake and mortality, researchers used a simple percentage of caloric intake in their analysis. Basically we have a math problem: if someone in a poor country eats 80% of their diet as carbohydrates from root vegetables but they only get 1,000 calories per day that’s a completely different situation from a person who eats 3,000 calories per day but 50% of their calories are from refined carbohydrates and sugars.

As I’ve said many times, while we should eat fewer refined carbohydrates, carbohydrates are not inherently bad; it is the overconsumption that’s the problem. If researchers didn’t analyze the total caloric intake from carbohydrates, protein, and fats, we don’t have the complete answer. The PURE study used a food frequency questionnaire. I’ll leave it at that because I rant too much about the FFQs.

Finally, the researchers simply jumped the gun by recommending that health education should now focus on increasing fat intake while reducing carbohydrates. All types of vegetables and fruits are carbohydrates. Because researchers did not parse out different sources of carbohydrates in their analysis, their recommendations are meaningless.

 

Don’t Bother with More Veggies?

PURE is an observational study; it cannot determine cause and effect. Also it can tell you a lot about a large group of people but nothing about an individual.

The lead researcher actually provided the perspective on vegetables and fruit during an interview: if the research shows that the benefit of eating more plant-based food is a 20% reduction in mortality, and the mortality rate of the population is just 1%, that means the reduction goes from 10 out of 1,000 to 8 out of 1,000. It’s virtually meaningless to an individual.

The researchers hesitated to tell people with very low incomes to spend more on additional servings of plant-based food if there was not a meaningful benefit. But for most of you, the cost of fruit and vegetables is not a hardship, so buy ’em and eat ’em.

 

The Bottom Line

These will not be the last headlines we hear from the PURE study because the data continues to be analyzed. One issue for me is that there’s no data from the U.S. included so the ability to generalize to the U.S. population is very limited. We lead the world in obesity and overweight and our food consumption patterns are different even from other Westernized countries.

One thing remains clear to me: we should all eat more vegetables and fruit and reduce refined carbohydrates. The recommendation never changes: eat less, eat better, move more.

What are you prepared to do today?

Dr. Chet

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References:
1. DOI: http://dx.doi.org/10.1016/S0140-6736(17)32252-3.
2. DOI: http://dx.doi.org/10.1016/S2213-8587(17)30283-8.

 

PURE Headline 1: Do Carbs Kill?

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Never a dull moment when it comes to health news: now they’re asking if you should choose fat rather than carbs.

The research study was called PURE: Prospective Urban Rural Epidemiology, and you’ll be hearing more about it. Over 150,000 people from five continents, 18 countries, and 613 different communities were included in the study. Researchers collected data on demographics, smoking habits, and health questionnaires including a semi-quantitative food frequency questionnaire (FFQ).

In the first paper, researchers examined the relationship between macronutrient intake, specifically fats and carbohydrates, and total mortality including cardiovascular events. Higher fat intake was associated with a decreased risk of total mortality while high carbohydrate intake was associated with a higher risk of mortality. There was no specific relationship between either macronutrient and heart disease.

Should you put down that rice? How about the bread? What about that cabbage and broccoli? Before you decide, let’s check out the second headline grabber on Thursday.

What are you prepared to do today?

Dr. Chet

Insider Update: The next Conference Call will be next Tuesday September 25 at 9 p.m. If you’re not an Insider yet, join now to participate in this information-packed call and get your questions answered.

 

Reference: DOI: http://dx.doi.org/10.1016/S2213-8587(17)30283-8