Exploring the HuffPo: Sugar, Paleo and Plaque

Man does not live by steak-and-eggs alone.  Woman either, from what I can see.   Having consumed plenty of editorial red-meat in recent days, I decided to venture beyond the low-carb blogosphere this weekend to see who else was writing about diet and health.

There was bound to be somebody.

I ended up at the Huffington Post.  All Internet roads seem to lead there.  The HuffPo (as we insiders call it) is the New York Times of the Digital Age, except that apparently the HuffPo doesn’t pay its blog writers.  You have to admit, that’s a helluva business model.  I could see it spreading.

Several HuffPo articles were begging for a response from me.  I love it when articles do that.  Here are three.

Marcelle Pick. Sugar’s Health Effects: Why You Should Look For Life’s Sweetness Elsewhere.  July 5, 2011.

It’s hard to argue with an article telling people to drop sugar from their diets. Marcelle Pick even endorses the Gary Taubes’ piece from the New York Times: Is Sugar Toxic?  Taubes cites the work of Robert Lustig, a leading expert in childhood obesity, who claims that the problem with sugar is “not about the calories.”  Rather, sugar is “a poison by itself.”

Pick, a nurse practitioner and co-founder of the web site Women to Women, focuses on the “relentless cravings” that sugar consumption causes and says that it’s “time we stopped being held hostage by the sugar industry. Our health is on the line.”   All I can say to that is, hurrah!

Pick also discusses the use of alternative sweeteners such as Stevia and Xylitol, which I’ve tried but do not consume on a regular basis. In fact, I’m dubious about trying to have your cake on a low-carb diet.  Pick is clearly not coming from a low-carb perspective.  At one point, she seems to recommend  “natural sweeteners,” such as “maple syrup, molasses, honey, date sugar, rice syrup and barley malt.” She claims these have more nutritional value than white sugar, but warns that they will all raise a person’s blood sugar levels.  So her position on using them is at least cautious.

David Katz. The Paleo Diet: Can We Really Eat Like Our Ancestors Did? July 6, 2011.

Dr. David Katz, M.D., was one of the panel of judges behind the U.S. News & World Report diet rankings that I blogged about a while ago. As you may recall, low-carb diets faired poorly in those rankings, with the Paleo Diet coming in dead-last.  It was clear that the judges were assuming “low-fat” and “balance” were necessary characteristics of any healthy diet.  No evidence was cited for those assumptions — but that’s how it is with assumptions.  Dietary dogma had struck again.

Katz isn’t exactly issuing a mea culpa in the HuffPo, but he is attempting to clarify his views on Paleo eating.  He says he is all for a Paleo approach, as long as it involves “eating foods direct from nature and more plants than animals.”  He spends much time in the article arguing that the modern meat supply is dissimilar to the paleolithic meat supply.  He says a lot less about the modern plant supply being dissimilar to the paleolithic plant supply.  Yet in the stone-age, no one was buying nuts and seeds in bags at a grocery store.  Bread was unknown.  Produce was not produced.  Even with minimal processing, the plant-based foods we buy or grow today are not the same as whatever stone-age version existed; many generations of ambitious horticulturists have seen to that.

All of that would seem to support Katz’s basic premise that eating exactly like paleolithic people is impossible.  In fact, it does.  I also agree with Katz that the best diet is one that features the least processed whole foods a person can acquire.  But where I seriously differ with Katz is on the balance between animal-based and plant-based foods in that diet.  He seems to want as few animal foods as possible — just a bit of lean meat and fish.  He snidely disses the bacon-cheese burger.  It’s fat-phobia all over again.  As in the U.S. News & World Report rankings, no evidence is offered to justify the low-fat bias.  It is simply there, a basic assumption, pervasive and untested. More dietary dogma.

Toward the end of his piece, Katz makes another dubious, unsupported claim, saying that a “population of some 7 billion people cannot eat as much meat as a population in the millions did, without doing the irreparable harm to the planet that is already far advanced.”

I suspect a population of 7 billion can’t do anything without causing harm to the planet, and that includes growing vast fields of food plants.  Cultivation destroys top-soil; animal husbandry helps replace it.  But if Katz is calling for a rational approach to birth-control, I’m with him.

As you might imagine, Katz got many responses from the Paleo community, which are well worth reading.

Dean Ornish. Cholesterol: The Good, the Bad and the Truth. June 3, 2011.

Dr. Dean Ornish, the medical editor of the Huffington Post, could be called the anti-Atkins.  He’d probably take that as a compliment, but I greatly admire the late Dr. Robert Atkins.

Ornish advocates a low-fat vegan-style diet, so it comes as no surprise in this article when he claims that most Americans “eat a diet that’s relatively high in saturated fat, animal protein, and cholesterol–i.e., a lot of ‘garbage.'”

“Relatively” is a weasel word here, making the literal statement impossible to contradict since we don’t know what Ornish’s basis of comparison is.  Historically, as I posted earlier, Americans are eating a lot less red meat, eggs and lard than they did 30 years ago, and are eating a lot more grains and caloric sweeteners.  Yet as a people we are more obese than ever, and suffer serious health problems as a result.  By Ornish logic, we should have far less “garbage” in our systems now than we did three decades ago, but neither he nor anyone else is claiming that.

The typical American diet is most accurately described as “high-carbohydrate.”  Yes, many Americans also eat a high-fat diet, but even those who do not eat much fat are eating plenty of carbs.  It’s carbohydrates that are the common denominator — 300 grams a day if you follow the government guides and even more if you pay no special attention to your diet.

Dietary fat is essential to human life; dietary carbohydrates are not.  (Go look it up; I’ll wait til you get back.) So which more closely fits the standard definition of “garbage”?

The “truth” about cholesterol that Ornish wants to communicate is that an increased HDL count (“good” cholesterol, the garbage-collector) is not an indicator of better heart health because it means there is more garbage (LDL, “bad” cholesterol) to be collected.

Thus, according to Ornish, the Atkins diet, which typically raises HDL and LDL in a “wash” of traditional risk factors, is apt to clog your arteries with plaque.  The evidence for this is a study of lab mice reported in The New England Journal of Medicine.

Things get interesting when that NEJM report is examined closely.

The report was written by Dr. Steven R. Smith, published on December 3, 2009, and is 1,109 words long — a third shorter than this blog post.  It is entitled “A Look at the Low Carbohydrate Diet.”  It has a disclaimer noting that Dr. Smith receives consulting fees from Unilever, the global conglomerate that owns many brands of packaged foods.

Dr. Smith is not reporting on his own lab study, but on the work of others, primarily S.Y. Foo and associates.  Unlike Smith’s NEJM report, the Foo report’s full-text is freely available online: Vascular effects of a low-carbohydrate high-protein diet.

So let’s take a look at it.

Note first that the title focuses on a “low-carbohydrate high-protein” (LCHP) diet.  Foo and associates consistently refer to the LCHP diet as “low-carbohydrate high-protein.”  Smith, however, defines the diet in question as “the high-fat, high-protein, low-carbohydrate (HPLC) diet.”  Whether “HP” or “LC” comes first in the acronym is unimportant, but the degree to which the diet can be characterized as “high-fat” and “high-protein” is crucial.

Foo and associates tested three diets:

• Standard Chow (SC): 65% carbohydrate, 15% fat, 20% protein
• Western Diet (WD): 43% carbohydrate, 42% fat, 15% protein
• Low-Carb High-Protein (LCHP): 12% carbohydrate, 43% fat, 45% protein

Milkfat was the primary fat source in all diets.

The researchers claim that the percentages of macro-nutrients on the LCHP diet are the same as those of people on the maintenance phase of a low-carb diet, but that is not true, at least not in my experience.  I’ve been eating 9% carbohydrate, 63% fat, 27% protein, 1% alcohol.  If anything, my fat intake seems to be on the low-side; I’ve seen other low-carbers report 70% fat consumption.  (The alcohol, of course, is optional, but adding a little red wine to the mouse-chow might be a useful variation in a future study.)  Granted, I’m still losing weight, but I don’t see my fat percentage ever dropping below 60%.   Regarding the Atkins diet specifically, it is not a high-protein diet in any phase.

Clearly, the researchers were testing a LCHP (low-carb high-protein) diet, not a LCHF (low-carb high-fat) diet.  That’s what they say.  The only confusion is over their assertion that the LCHP diet is typical for human low-carbers.

So what Foo and associates found was that a high protein diet, possibly in combination with high fat, may cause increased artery plaque in laboratory mice.  That’s a lot different  than the spin put on by both Smith and Ornish.

I eat LCHF.  That’s what I mean by a “low-carb” diet: low-carb, high-fat.

I also get the fat in my diet from a variety of sources, animal and vegetable, and not primarily from milk products.  In short, none of the diets examined by Foo and associates resemble the diet that I eat, anymore than I resemble a mouse.

So the fact that the LCHP mice developed more arterial plaque than the SC mice means nothing to me.  First, they’re mice; second, it was one study; and third, their diet was significantly different from mine.  As the researchers themselves note, “. . . caution is warranted in extrapolating from such animal studies. . . .”

I’ve wander a bit from Ornish’s article.  The point is, Ornish bases his attack on “Atkins-like” diets on a sketchy, second-hand journal report of a single experimental  mouse study of a diet that is not Atkins-like at all.