Low-carb, high-protein diet increases risk of death from all causes

The low-carb fad has had its peak, and although it is declining in popularity, the myth persists that eating lots of meat and little or no ‘carbs’ is a great way to lose weight.

Plenty of studies have established that low-carb diets are moderately effective for weight loss over periods of 6 months to 2 years[1-3], though much of the weight lost initially is typically regained. This may be a better option than the processed food-soda diet many other Americans consume, so of course they are moderately effective – the number of calories consumed decreases as refined carbohydrates are eliminated from the diet. Low-carbohydrate diets cause people to lose some weight but at what cost? The short durations of these studies meant that they could not determine whether the diets are sustainable for long-term health. The current state of the medical literature would suggest that they are not – there is abundant data associating high meat consumption with adverse outcomes: weight gain, cardiovascular disease, cancer, diabetes, and all-cause mortality, just to name a few.[4-10] I have been warning for years that the long-term outcome of meat-based diets would not be favorable.

A long-term observational study of low-carbohydrate diets has finally been published this Tuesday in the Annals of Internal Medicine, and the results are intriguing. This study by researchers from the Harvard School of Public Health is the nail in the coffin of the low-carb, high-protein myth. The article details data from a prospective study in which 130,000 total participants provided information about their eating habits and were followed for a minimum of twenty years – this is true long-term data. At baseline, none of the participants had heart disease, cancer, or diabetes. The researchers classified the participants’ diets according to degree of adherence to the following dietary patterns: overall low-carbohydrate, animal-based low-carbohydrate, and high-vegetable low carbohydrate. They then compared death rates between the highest and lowest adherence groups for each pattern.

The authors’ conclusions: A low-carbohydrate diet rich in animal foods was associated with a 23% increased risk of death from all causes (14% increased risk of death from cardiovascular disease). In contrast, a low-carbohydrate diet rich in vegetables was associated with a 20% decreased risk of death from all causes (23% decreased risk of death from cardiovascular disease).[11]

The low-carb proponents had one thing right: the avoidance of refined carbohydrates – white flour, white rice, white pasta, added sugars, etc. are disease-promoting foods. However, the protein sources emphasized in most low-carb diets are micronutrient-poor animal products rather than micronutrient-packed plant products. The current study suggests that plant sources of protein (for example vegetables, nuts, beans, and seeds) promote longevity, whereas high protein animal foods have the opposite effect. This data supports the essential nutritional concept I illustrate with my health equation: Health = Nutrients / Calories. Micronutrient density determines the quality of one’s diet, and since animal products are deficient in micronutrients, they should be minimized. The authors agree that their results likely reflect the lack of protective fiber, minerals, vitamins, and phytochemicals in animal products. [12]

Many proponents of meat-based diets argue that the refined carbohydrate rather than the meat content of the American diet is to blame for our skyrocketing rates of chronic disease. However, too many studies contradict this opinion – and this study clearly demonstrates that choosing plant foods instead of animal foods, even within the context of minimal refined carbohydrate, promotes longevity.

There really should not be any controversy anymore about the health effects of low-carb, high-protein diets. This study (among others) confirms that the current amount of animal-source foods within the American diet should be reduced, not increased, and that meat-centered diets promote premature death; and that diets based predominantly on whole plant foods are lifespan-enhancing.

The “nutritarian” diet I recommend is unique because it focuses on consuming more of the highest micronutrient containing vegetation, as it reduces animal products to a condiment or minimal role held to less than 10 percent of total calories. Vegetables rule!

References:

1. Foster, G.D., et al., Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Ann Intern Med, 2010. 153(3): p. 147-57.
2. Brinkworth, G.D., et al., Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. Am J Clin Nutr, 2009. 90(1): p. 23-32.
3. Sacks, F.M., et al., Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med, 2009. 360(9): p. 859-73.
4. Sinha, R., et al., Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med, 2009. 169(6): p. 562-71.
5. Vergnaud, A.C., et al., Meat consumption and prospective weight change in participants of the EPIC-PANACEA study. Am J Clin Nutr, 2010. 92(2): p. 398-407.
6. Zheng, W. and S.-A. Lee, Well-Done Meat Intake, Heterocyclic Amine Exposure, and Cancer Risk. Nutrition and Cancer, 2009. 61(4): p. 437-446.
7. Key, T.J., et al., Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr, 1999. 70(3 Suppl): p. 516S-524S.
8. Ashaye, A., J. Gaziano, and L. Djousse, Red meat consumption and risk of heart failure in male physicians. Nutr Metab Cardiovasc Dis, 2010.
9. Snowdon, D.A., R.L. Phillips, and G.E. Fraser, Meat consumption and fatal ischemic heart disease. Prev Med, 1984. 13(5): p. 490-500.
10. Aune, D., G. Ursin, and M.B. Veierod, Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies. Diabetologia, 2009. 52(11): p. 2277-87.
11. Fung TT, v.D.R., Hankinson SE,Stampfer M, Willett WC, Hu FB, Low-Carbohydrate Diets and All-Cause and Cause-Specific Mortality: Two Cohort Studies. Ann Intern Med, 2010. 153(5): p. 289-298.
12. Fiore, K. Low-Carb Diet is Better When Rich in Veggies. 2010 September 7, 2010]; Available from: http://www.medpagetoday.com/PrimaryCare/DietNutrition/22035.

 

Processed foods, low-carb diets linked to depression

 


Three recent studies document that consumption of processed foods increase odds of depression, and not only that, but those high protein, high fat diets (high in animal products) are also linked with more depression. The diet to protect against depression – that is simple, a high nutrient, plant-based diet outlined in my books, Eat for Health and Eat to Live

In one study, middle-aged subjects were categorized by their dietary patterns based on how much “whole” or “processed” food they consumed. The high processed foods group was characterized by high intake of sweetened desserts, fried food, processed meat, refined grains, and high-fat dairy products. Five years later, the researchers evaluated how many of the subjects had reported depression symptoms.

Subjects who ate the most whole foods had the lowest odds of depression, and those who ate the most processed foods had the highest odds of depression – 60% increased odds compared to those who ate the least amount of processed foods.1

Another study compared the effects of low-fat plant-based diet and low-carbohydrate animal-product-rich diet on mood in overweight women. Although both groups lost similar amounts of weight over one year, measures of mental health and mood only improved in the low-fat group. The low-carb dieters eating more fat and animal products had higher depression scores. The authors also cited previous human studies in which high protein, low-carbohydrate diets have resulted in cognitive impairment.2

A third study measured scores of depression before and after removing meat, poultry, and fish from subjects normally eating a typical American diet. Indicators of depression significantly decreased after removing all the animal products and shifting to a plant-based diet for 2 weeks. 3

Nutrition is crucial for regulating mood – high oxidative stress in the brain and low levels of several micronutrients have also been linked to depression.4  

These studies are a reminder that what we eat affects not only our physical health but our mental health as well. Combine great diet with light therapy, exercise, sufficient Vitamin D and the right fatty acid balance for the brain, and you have my protocol to beat depression

 

References:

1. Akbaraly TN et al. Dietary pattern and depressive symptoms in middle age. Br J Psychiatry. 2009 Nov;195(5):408-13.

2. Brinkworth et al. Long-term Effects of a Very Low-Carbohydrate Diet

and a Low-Fat Diet on Mood and Cognitive Function. Arch Intern Med. 2009;169(20):1873-1880

3. Beezhold BL et al. Preliminary evidence that vegetarian diet improves mood. American Public Health Association 2009 National Meeting, Abstract 206464. 

4. Leung BM, Kaplan BJ. Perinatal depression: prevalence, risks, and the nutrition link--a review of the literature. J Am Diet Assoc. 2009 Sep;109(9):1566-75.

 

Low-Fat Diets Heart Healthier After Weight-Loss

New findings in the Journal of the American Dietetic Association reveal diets low in saturated fat are healthier and help keep LDL, or “bad cholesterol”, in check after someone loses weight. For the study, experts assigned 26 healthy, non-obese diets to one diet, Atkins, South Beach or Ornish, for one month apiece, with the intent of studying biological effects of each diet, specifically cholesterol, blood vessel function and inflammation. Data concluded high-fat diets, like Atkins, raised LDL, but the low-fat, vegetarian Ornish style had the best affect on blood vessel function; Reuters reports.

A low-fat diet, i.e. eating less animal foods and more fruits and veggies, has been proven to not only prevent heart trouble, but reserve it. And just last week, scientists found pomegranates help fight cell inflammation that can lead to heart disease. Also, a previous report observed fad diets, such as high-protein low-carbohydrate, don’t hold up overtime, with dieters gaining back weight after only six months.

High-fat diets, like Atkins, are dangerous. A recent study showed participants eating an Atkins diet plan, consuming 50% saturated fat, performed the worst on blood vessel testing.

Image credit: Andrew Hux

Fad Diets Fail. So Just Eat Less.

Guess what! Fad diets don’t cut it. A new study in yesterday’s New England Journal of Medicine showed gimmick diets, such as high-protein, low-carb and low-fat, aren’t as good as simply cutting calories. The participants, 811 overweight adults, were randomly assigned a diet and each person was encouraged to cut calories, exercise 90 minutes a week, keep a food diary and meet with a nutrition counselor. At the end of the study, no diet came out ahead, people lost an average of 13 pounds over six months, but all groups gained back their weight after a year; the Associated Press reports.

Quick, let’s break it down. Low-carb is bad, too much cancer and heart disease-promoting saturated fat. Plus, a recent study showed low-carb diets make you dopey. High-protein is equally stupid. According to Dr. Fuhrman these fat or meat-centered diets are unquestionably associated with obesity, not weight-loss. And the low-fat diet, as most Americans know it, is what made us all fat in the first place.

Here’s a better choice—coincidently, it jives with the new study—Dr. Fuhrman’s nutrient-dense diet, i.e. lots of fruits, vegetables, nuts, seeds and beans, makes it easy to maintain a healthy bodyweight, specifically green veggies. Green vegetables are packed with fiber and low in calories, meaning you can eat lots of them, fill your stomach quickly and still lose weight. How’s that for a sale pitch!

Image credit: Runs With Scissors

Study Compares Veggie Diets vs. Low-Carb --UPDATE--

Editor’s Note: This is a guest post from Steven Acocella, MS, DC, DACBN and does NOT necessarily represent the opinions of DiseaseProof or Dr. Fuhrman.

At the Beltsville Human Nutrition Research Center in Maryland and published in the Journal of the American Dietetic Association researchers evaluated the short to medium term weight loss results of popular diets. Popular diets: correlation to health, nutrition, and obesity grouped the most popular diets into categories based upon the prescribed ratios of energy for each macronutrient. If you remember from Nutrition 101, caloric energy comes from only 3 sources, fat, carbohydrate and protein. For example, diets such as The South Beach Diet and The Atkins Diet derive 50% or more calories from fat while Dr. Fuhrman’s Eat to Live derives the majority of energy from natural, unrefined carbohydrate.

The study looked at food intake over a 2 year period and included several hundred participants who followed the various diet styles compliantly. They then analyzed the relationship between a reduction of Body Mass Index (BMI), the diet style and the Healthy Eating Index (HEI).

The Healthy Eating Index scores were highest for the vegetarian or near vegetarian diet style and lowest for the low carbohydrate, high fat diets. Conversely, energy intake was highest for the Low Carbohydrate group, often exceeding the average accepted recommendations of 2000 Kcal/day or men and 1500 Kcal/day for women. This is strange considering these were weight loss eating plans that were followed intently.

The weight loss results were no surprise. The healthiest body mass was seen in the vegetarian group. A direct, proportional relationship was seen with a rise in the percentage of calories derived from fat and BMI. As the percentage of fat calories increased so did those subject’s BMI. Total calories were also directly related to the percentage of dietary fat with the average daily energy intake for the vegetarian or nearly vegetarian group consuming 1450 Kcal/day and the high fat diet group consuming 2200 Kcal/day. Researchers noted the relationship between the Healthy Eating Index verses calorie and fat percentages were inversely related.

Putting all this together, this important study using an excellent group of subjects has made the following observations: diets low in fat have the highest Healthy Eating Index scores and are generally the lowest in total calories. Those subjects on these diets enjoyed the most favorable BMI measurements and other biomarkers of health. Conversely, the high fat, low carbohydrate diet styles have the lowest Healthy Eating Index scores and those that consumed this diet style had poor BMI measurements and other indicators of health.

It is worth mentioning that the authors of this study discuss a review of the literature suggests that weight loss is independent of dietary composition and is solely a result of total calories consumed. They suggest that their findings, although supportive of this confers that successful, healthy weight loss over time is a function of quality as well as quantity.

UPDATE: Dr. Fuhrman had some thoughts on Steven’s post:

My health equation, Health = Nutrition / Calories is almost entirely ignored by the scientific community. If the micronutrient density index of a particular diet was published along with the other characteristics researchers would place less emphasis on the relative macronutrient composition and more on the micronutrient composition. Nevertheless, the long-term health potential of a given diet is based so much more on its micronutrient profile rather than its macronutrient profile.

Image credit: altopower