Reader Comment: Heart Health and Diet
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Nick M writes:
I’ve been interested by your recent posts touching on heart health and diet. I became interested in the topic of diet a few years ago when a prominent South African sports scientist, Tim Noakes, came out strongly in favour of a low carb, high fat diet for general health (and not least heart health). This was a 180 degree shift for Noakes who had been involved in driving the popularity of sports drinks in South Africa some years ago. His position was that having spent a couple of years reviewing the scientific literature he felt that the evidence pointed towards the ‘conventional wisdom’ of the past 60-70 years being wrong (ie pro carb and anti fat, especially saturated fats). Noakes has been vilified by much of the conventional medical establishment, but has stood firm with his position.
I adopted a non-obsessive low carb, high fat diet and have found it has helped me regulate my blood sugar very significantly. But after growing up hearing the high carb, low fat story, I remained slightly concerned about which of the opposing ’truths’ to believe. At a routine visit to a cardiologist a couple of years ago, I made the point that as a layman I have found it hard to know what to believe, but have found success with the low carb, high fat approach. His response was interesting! In essence he said that the science is clear and strongly in support of low carb, high fat. He went on to say that he made a decision some years ago to stop going to cardiology conferences since his experience was that they were peddling a story based on questionable research sponsored in large part by the (processed) food and pharmaceutical industries.
There is obviously lots of literature on all this stuff. The challenge is that much of it is conflicting - hence, my question to the cardiologist. I did read a couple of the more ‘populist’ books on the subject. The one that made the most sense to me overall - despite finding the writing style rather painful - was ’The Primal Blueprint’ by Mark Sisson. The book does lay out the case for low carb, high fat in layman’s terms and it makes suggestions around diet and exercise.
On a loosely related note, the same cardiologist did advocate caution with endurance sport, specifically with high intensity exercise of longer than two hours or so (largely due to the inflammatory response that gets triggered). He referred me to a book written by a cardiologist (and keen cyclist) called ’The Haywire Heart’ (by John Mandrola and Chris Case) which you might be interested in.
WIND: as far as I can tell, the whole cholesterol vs cardiac health thing is one huge scam based on no hard science (hard science shows direct links by varying one factor while holding others fixed). Instead we see mass statistical data correlations masquerading as science. The reason that statins lower reduce heart attack risk modestly has NOT been proven to result from lowering LDL. It is almost certainly an incorrect assumption, the body being far more complex.
That’s right—the reason is NOT known—it’s just a correlation. And there things sit stopped in their tracks as “knowledge” when even the basics remain unknown, such as whether (making up an example) putting 1000 people on a strict Mediterranean diet can not just beat a statin for CVD events, but improve health and avoid all the nasty side effects of statins. The state of this medical pseudo science is pathetic to any objective outside observer.
The only good hard science I have found so far is by a layman—a non-medical person, an engineer like myself, who correctly points out that what passes for science in medicine wouldn’t pass muster in engineering. And directly refutes the accepted link between a high fat diet and LDL cholesterol.
In general, “low carb” makes a lot of sense (30% or less seems about right, less when not active perhaps) and I’d agree with it. I suspect that it will be shown to be harmful over time to aim for 5% or less carbs (Keto diet) as this almost certainly has negative aspects coming from the failure to eat fruits and vegetables and the incorporation of a lot more saturated fat. The body did NOT evolve to subsist that way and there is real risk of nutrient deficiency.
My guess is that much of “low carb” craze (fad) results from the reduction or elimination of excess quantities of poor food choices, e.g., lots of bread/pasta/etc—those largely SUCK and yet such bad choices drive fads/fanatic diets. Throwining the baby out with the bathwater: it makes no sense to stop eating moderate amounts of oranges/strawberries/blueberries/bananas/etc in pursuit of fad diets like Keto—fruits like that are full of nutrition. Ditto for vegetables, especially kohlrabi, cabbage, cauliflower, bell peppers, radishes, carrots, kale, etc.
I’m a believer in moderation, which is to say I enjoy lots of fruits and vegetables (mostly carbs) and See’s candy (mostly nuts but a good amount of carbs) and very limited amounts of bread and sweet potatoes and ric. But zero soft drinks, no fruit juice, very little processed food, no fast food, I rarely eat out, etc.
Athletes and carbs
As an athlete, my favorite competitor is someone on a Keto diet which guarantees poor performance because the multiple energy pathways of the body cannot be used when the required effort rises. You MUST be able to create energy from glucose, and it is literally DANGEROUS if glucose gets low (brain fade). Ride 50 double centuries as I have and learn that fat metabolism is the primary energy source, BUT failure to take in carbs like Tailwind @AMAZON will result in horribly slow and unpleasant day.
Worse, those on a Keto diet are subject to catabolic muscle loss. During a double century for example, the body will eat its own muscle tissue to the tune of 10% to 15% of required energy. That equates to 1/3 to 1/2 POUND of muscle “eaten” as an energy source. Those on a Keto diet might see much higher losses, with the body deprived of adequate carbohydrate stores. Seems like a dumb move to me.
When I complete the Southern Inyo Double Century on March 7, I will burn about 7000 calories. Probably at least another 1000 calories are needed for repair. I will need to take in at least 2000 calories, mostly carbohydrate, from 5 PM to 5 AM before I do the Sunday March 8 double century.
Carbohydrate and 10% to 15% protein together are essential for athletic recovery, for driving the carbs into muscles to be stored as glycogen together with the protein for repair. The Keto diet maniac will NOT recover properly or repair muscle even if doing my paltry baseline 1000 calorie per day ride (7000 calories or 100 MET-hours per week), unless tht pace is kept low.
Tere are times when my athletic recovery cries out for carbs, I go on a binge eating day, which I have found to be effective in losing body fat and dropping weight, believe it or not. Limiting this to one day per week seems about right and highly effective in keeping the body from trying to make itself more and more calorie efficient.
Try riding 60 miles a day for two weeks and see how much cabs matter! An excellent binge day is a bottle of champagne and a half pound of dark chocolate caramel pecan clusters—works wonders and I have had some of my best workouts following that!
High intensity exercise of longer than two hours
See Mayo Clinic: Extreme Physical Activity May Increase Coronary Calcification, But Fitness Still Prevails.