You are what your body does with what you eat

A newly published study, in the journal Lipids - Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation - found that subjects given a low-carb diet experienced "profound alterations in fatty acid composition and reduced inflammation compared to a low fat diet."

The press release, issued from SUNY Downstate, sums it up completely:

Metabolic syndrome is a condition afflicting one quarter to one third of adult men and women and is an established pre-cursor to diabetes, coronary heart disease, and other serious illnesses. Patients have long been advised to eat a low-fat diet even though carbohydrate restriction has been found to be more effective at reducing specific markers, such as high triglycerides, characteristic of the syndrome. Now, a new study indicates that a diet low in carbohydrates is also more effective than a diet low in fat in reducing saturated fatty acids in the blood and reducing markers of inflammation.

While there have been contradictory and confusing messages directed at health conscious consumers about dietary recommendations, most researchers agree on the need to limit inflammatory agents. In a report published today in the on-line version of the journal Lipids, researchers at the University of Connecticut, SUNY Downstate Medical Center in Brooklyn, and the University of Minnesota show much greater improvement in inflammatory markers in patients with metabolic syndrome on a very low carbohydrate approach compared to a low fat diet.

Lead researcher Jeff S. Volek, PhD, RD, associate professor of kinesiology at the University of Connecticut, describes the study as “adding to the evolving picture of improvement in general health beyond simple weight loss in keeping blood glucose and insulin under control.” The work is part of a larger study (currently under review) showing numerous improvements in blood lipids.

The current work concludes that “lowering total and saturated fat only had a small effect on circulating inflammatory markers whereas reducing carbohydrate led to considerably greater reductions in a number of pro-inflammatory cytokines, chemokines, and adhesion molecules. These data implicate dietary carbohydrate rather than fat as a more significant nutritional factor contributing to inflammatory processes.”

Richard Feinman, PhD, professor of biochemistry at SUNY Downstate Medical Center, adds, “The real importance of diets that lower carbohydrate content is that they are grounded in mechanism: carbohydrates stimulate insulin secretion which biases fat metabolism towards storage rather than oxidation. The inflammation results open a new aspect of the problem. From a practical standpoint, continued demonstrations that carbohydrate restriction is more beneficial than low fat could be good news to those wishing to forestall or manage the diseases associated with metabolic syndrome.”

One of the remarkable effects in the data presented that may have contributed to the results is that despite the three-fold greater saturated fat in the diet for the low carb group, saturated fat in the blood turned out to be higher in the low fat group due to the process known as carbohydrate-induced lipogenesis.

Dr. Volek points out that “this clearly shows the limitations of the idea that ‘you are what you eat.’ Metabolism plays a big role. You are what your body does with what you eat.”

Keeping Our Eyes on the Ball

Today I'd like to interrupt my series on understanding the short and long-term lessons found within the Rules of Induction (Atkins) and provide space for my husband, Dr. Gil Wilshire, MD to share his thoughts in a guest commentary. So, without further ado:

Keeping Our Eyes on the Ball
Gil Wilshire, MD, FACOG

Back in 2006, Regina and I were interviewed and asked about our thoughts on the future of dietary science and policy. We speculated that carbohydrate restricted diets would be an accepted, main-stream concept by the year 2040. I believe we are well on our way to seeing our goal fulfilled well before this arbitrary temporal milestone.

I try to remain constantly vigilant with regard to new scientific information, and it seems that in every month good, new information is published. Recently, Matt Hayes and colleagues (J. Nutr. 137:1944-50, 2007) drilled deeper into out understanding of carbohydrate restriction, metabolic syndrome, and the biochemistry behind satiety. I am pleased to see that our current shared clinical experience of spontaneous caloric control and rapid reversal of metabolic syndrome is now being bolstered by more clinical data. Although the study in question was rather timid with respect to carbohydrate restriction (it was a South Beach-type protocol) I still found the information valuable.

It is another, peer-reviewed paper to the ever-growing pile of scientific evidence supporting our position.

I would also like to add that my ever-growing clinical experience in my new home of Central Missouri continues to be very gratifying. It seems that not a month goes by where something good happens very quickly after a patient begins their new life style (I dislike the thought of "diets"...this implies a temporary change, instead of a whole new way of being). In my obese, "infertile" patients, it is fairly common for women to become pregnant before instituting hormone therapies. Women who appeared destined for the bariatric surgeon are losing huge amounts of weight...and now are making appointments with the plastic surgeons!

I must say, there are many doctors in the surrounding communities who are truly scratching their heads as our mutual patients make healthy progress eating "high fat" diets. Now, after some period of suspicion, I am actually getting requests to learn more about what we do in my office!

Positive results are very persuasive.

Nothing succeeds like success.

Being married to Regina is never boring, and I am privileged to hear all the latest details occurring within the nutritional community every night when I get home from the office. We are a disparate lot in the "low carb" community, with much independent thinking and talented, innovative thought leaders. I suspect that the field of nutrition and metabolism will never be one of lock-step agreement. However, I would like to take this opportunity to reiterate our common goals and to reinforce our shared understanding:

1) Current dietary recommendations that promote low-fat and low cholesterol diets are unscientific, unproven, and fatally flawed; and,
2) The vast majority of modern humans appear to function best when eating nutritionally dense, whole foods that most closely resemble those foods on which we evolved.

I believe it is these principles that unite us all. There will always be bumps in the road, and we must always be prepared for unexpected turbulence. That's life.

Let's keep our eyes on the ball! Slow, steady progress always wins the race.

Good health to us all!

Gil
Mid-Missouri Reproductive Medicine & Surgery