Thursday, March 18, 2010

Fat in Vegan Diets: How Low Should You Go?

I’ve been living among stacks of nutrition research papers over the past six months while working on an update to The Dietitian’s Guide to Vegetarian Diets, a textbook for health professionals and dietetics students. The last edition was published in 2004 so my co-authors and I have looked at all of the studies on vegetarian and vegan diets that have been published since then, along with hundreds of other nutrition papers that are pertinent to vegetarianism.


I’ve learned a lot in the process. It’s reinforced my opinions about some aspects of nutrition and forced me to change my mind about others. I finished my last chapter, which focused on fat and carbohydrates and how they affect heart disease, diabetes, and obesity, yesterday.

Twenty years ago, when I first started working in the area of vegan nutrition I was a big proponent of very low-fat diets. At that time, when diets like the Ornish plan were especially popular, it really did look like this was the best approach for lowering cholesterol and controlling weight. Since then, our understanding about the role of fat in the diet has changed a lot and the situation is far more complex than we originally thought. Anyone who is taking a serious and honest look at the research on diet and heart disease has to question the low-fat approach.

One thing we know (more or less for certain) is that replacing saturated fat in the diet with poly- or monounsaturated fat lowers blood cholesterol just as much as removing all fats from the diet. And there is evidence that eating more unsaturated fat is better as far as heart disease is concerned. Low fat diets are associated with a drop in HDL cholesterol, which is the “good” cholesterol. If HDL drops as much as LDL (the bad) cholesterol, there is actually no net gain as far as heart disease is concerned. There are still a lot of questions about how much HDL really matters, but most research suggests that it matters a lot, especially for women.

Reducing all fats in the diet and replacing them with carbohydrates can also boost triglyceride levels. Some studies show that if most of the carbohydrate comes from whole fiber-rich plant foods (as opposed to refined carbs), this doesn’t happen. Other studies show it happens no matter what kind of carbohydrates people eat. 

Very low-fat diets also produce a type of LDL-cholesterol that is very small and dense and more easily incorporated into artery-blocking plaque. Because of these effects on HDL levels, triglycerides, and LDL size, many researchers question whether very low-fat diets are a wise choice for people at risk for heart disease.

Finally, heart disease is not all about cholesterol. There are other diet factors that have nothing to do with blood cholesterol levels but affect the health of the arteries. Some high fat foods—nuts in particular, but also soyfoods—appear to have benefits for heart disease that aren’t related to cholesterol levels. Unfortunately some low-fat vegan diet plans severely limit these foods or even eliminate them altogether.

And while low-fat eating plans have been promoted for weight loss, they tend not to be effective over the long term. Some research shows that including higher fat foods—like nuts or avocado—in meals helps to make reduced-calorie diets more satisfying and actually promotes better long-term weight control.

This isn’t to suggest that vegans should have a free-for-all with fats. In fact, there is good evidence that eating large amounts of fat all at once can raise risk for heart disease. Because of that, some experts recommend consuming no more than 30 grams of fat at one sitting. That could be a problem for the average omnivore or for those who regularly eat at places like fast food restaurants. But for a vegan who is not indulging in tons of baked goods or fatty snacks, it’s not at all. Here is an example of a healthful vegan breakfast that includes some high fat foods and comes in well under the 30 gram limit:

1/2 cup tofu with mushroom and onions scrambled in ½ tbsp soft margarine
1 slice whole wheat toast with 1 tbsp peanut butter
Fresh fruit

Total fat: 20 grams

Or consider this lunch which doesn’t skimp on healthful fats:

1 cup black bean soup topped with ¼ cup cubed avocado
Tossed green salad sprinkled with 1 tbsp sunflower seeds and dressed with vinaigrette containing 2 tsp olive oil
6 ounces raspberry-flavored soy yogurt

Total fat: 22 grams


Some low-fat vegan diets strive for fat intakes that are as low as 10% of calories. But the World Health Organization says that no one should go below a 15% fat diet and that women of childbearing age should consume diets that are at least 20% fat. They suggest that intakes up to 30 or even 35% of calories can be healthful.

The idea that we need to avoid all dietary fats, including healthful plant ones, is outdated and perhaps even harmful. But even if eating a very low-fat diet is perfectly safe, there is no evidence that it has any advantages over a diet that includes some fat-rich plant foods. Foods like avocado, nuts and nut butters, olives, tofu, dressings and sauces add interest and variety to vegan diets. As always with diets that take veganism a step beyond what is necessary, very low-fat diets add a layer of restriction that can make vegan diets look limiting and unappealing. 

(Here is some updated information about fat in heart healthy diets)

34 comments:

  1. Thanks for this post, Ginny. It has long seemed to me that veganism attracts people with "absolutist" personalities*, who grab onto some "fact" and will loudly assert it as "true" and shout down anyone who dares question their dogma. It is nice to have people like you and Jack Norris doing an honest and open-minded assessment of reality.

    *This is not to say all vegans are like this -- just that there are plenty, and they tend to be the loudest.

    ReplyDelete
  2. The proponents of very low fat diets seem to refer to people with severe cardiovascular issues, diabetes and high weights.

    Maybe very low fat diets have their place as therapeutic diets and that diets for healthier people would be different?

    ReplyDelete
  3. What about the 20+ year studies by Dr Caldwell B Esselstyn (www.heartattackproof.com) that show he can prevent and even reverse heart disease by following a very low fat vegan diet?

    I tend to stay at about 71% carb/16% protein/13% fat in my diet. Admittedly I lose weight easier if I lower the carbs and raise the protein and fat just a bit, but am I setting myself up for heart disease by doing so? It's hard to know what do do anymore, as there's so much conflicting information out there. By the way, those are good, healthy carbs, not processed carbs.

    ReplyDelete
  4. One fabulous article - I have some people to send this way! :)
    I have seen several clients adopt a vegetarian/vegan diet but make the mistake of over-doing the carbohydrates and restricting fats. And often it comes back to bite them as high triglycerides and weight gain.

    Thanks for a factual and balanced article on an oft-misunderstood topic!

    Georgie Fear RD

    ReplyDelete
  5. Thanks all for these comments. To the best of my knowledge, Dr. Esselstyn has reported on what he has seen in his clinical practice. His findings still provide important evidence but, because they aren't based on randomized and controlled studies, they can't be viewed as conclusive (not that any single study is conclusive; it's just that some are stronger than others).

    The issue I have with these very low-fat approaches is that they give the impression that all fat raises cholesteol levels and contributes to heart disease and that is simply not true. Again, the evidence suggests that replacing saturated fat with plant protein or unsaturated fats can reap the same benefits--and perhaps counter some of the potential negative effects of very high-carb diets. Certainly approaches promoted by Dr. Esselstyn and others are better than those endorsed by the American Heart Association but that doesn't mean that they are the ideal approach. And, Beforewisdom, those who are at high risk for heart disease might also be the ones who are most at risk for some of the problems associated with very high carbohydrate diets (raised triglycerides, low HDL, small dense LDL)--so no, I don't think that very low-fat eating is the best approach for them. It think including some healthful higher-fat foods in diets is probably best for everyone.

    The issue for me as an ethical vegan always comes back to how we can best promote vegan diet while being responsible about nutrition issues. If I thought there were advantages to very low-fat eating, I would have to promote that type of diet even though I know it is hard for most people to follow. Because I have not seen anything to convince me that this is the best way to eat AND because it makes a vegan diet look more difficult and less appealing, I think we do a disservice when we promote very low-fat vegan diets.

    And to be honest, because there are so many legitimate questions about this in the scientific literature, an insistence that low-fat vegan diet is the best way to eat can make us look pretty outdated and out of touch with the current science on this issue. For example, the evidence for coronary protective effects of nuts is very strong--and yet, many of these low-fat diets don't include any nuts!

    ReplyDelete
  6. I'm kind of on the fence on low-fat diets so I'm not really in favor for anything but your article does bring out some questions. The so called "healthy fat" sources you are using as examples are either rich in polyunsaturated fatty acids or omega-6. PUFAs raises plasma concentrations of cholesteryl oleate. Older animal studies and studies on humans shows that cholesteryl oleate predicts arteriosclerotic vascular disease. So I'm seriously wondering why that's considered healthy?
    Omega 6 and inflammation is def intresting but it's far from conclusive if vegetable omega-6 cause it. However, if you have a high omega-6 intake you will most likely not get adequate DHA (and possibly EPA)unless you supplement. Some comments regarding these issues would be great.

    ReplyDelete
  7. I would think that both Ornish and Esselstyn independently reversing heart disease through a no-added fat vegan (or in Ornish's case, vegetarian) diet says a lot more than randomized trials.

    Furthermore, adding olive oil is adding pure fat with minimal nutritional value. It's not even a real food.

    I suggest you read Esselstyn's book before suggesting that his research isn't valid.

    It's the added fat that fuels development of plaque.

    We just don't need the added oil and believing that it contributes nuritionally is silly. You can get Omega 3 from healthier (and less artificial) sources.

    ReplyDelete
  8. I'm sticking with Dr. McDougall, Barnard, Esselstyn, and Ornish. I think they're right on the money with their methods and they are effective at reaching the population they speak to: those who need to radically change their diets in order to reverse heart disease, diabetes, or obesity.

    I think it's rather silly to suggest to average American eaters that they should seek out fatty food sources.

    If we're going to give any nutritional advice along with promoting veganism, then we should aim for advice that reaches the average person. Most Americans need to be told to cut back on all fats. And to cut back on calories. And to eat more fruits and veggies. They do not need to be told to go out of their way to try to include "good fats."

    Most people, unless they live under a rock or are crazy, will get enough "good fat" simply by virtue of eating a wide variety of vegan foods.

    ReplyDelete
  9. Elaine, this is not about telling Americans to seek out fatty foods. My point is that there is absolutely no reason to eliminate all fatty foods from a vegan diet. The scientific evidence does not support the need for doing so and, as noted, it may actually have some real health disadvantages. And as vegan advocates, we want to promote a healthy diet that is actually attractive to people. Including some higher-fat foods in meals does that--without any negative effects on health. So why would anyone be opposed to that?

    ReplyDelete
  10. I wish I'd had a copy of this back when I was vegan! People tend to assume all vegans are on a mission, rather than just trying to eat better.

    ReplyDelete
  11. I am a vegan, but I have come to believe that there's a lot of important research that has been compiled by advocates for a more 'paleo-style' diet. I know saying so may get me bumped to the bottom decks of the good ship Vegan, but there are a number of potential insights into the link between diet and health that can be comfortably integrated into a animal-free diet.

    I strongly recommend Whole Health Source because the researcher who posts there is fairly reasonable and appreciates the cruelty and environmental destructiveness of our factory farming system.

    He has well documented that traditional human populations can thrive on a wide variety of diets, from the extraordinarily high-fat diets of the Inuit and Massai to the 70% carbohydrate diet of the Kitavans. Despite the remarkably wide-range of diets we can handle, in all documented transitions from traditional foodstuffs to a more modern/western diet that includes sweeteners and other refined carbohydrates (primarily white flour) the investigated population has had their health markedly decline.

    I don't wish to post a feature-length article documenting all the important evidence, but I'd like to list what I believe to be the most relevant implications for vegans from evidence supporting a more 'paleo-oriented' diet. Much of the relevant science is still unsettled, but here are the hypotheses I believe we should pay attention to:

    Refined carbohydrates, especially sweeteners and white flour, are particularly harmful to health in large quantities.

    Fat from industrial seed oils (polyunsaturated omega-6) is uniquely harmful in high quantity in the human diet, in part because it disrupts our usage of omega-3. We should reduce the usage of these oils and/or replace them with saturated (e.g. coconut/palm kernal oil) or monounsaturated ( e.g. extra-virgin olive/avocado oil) fats.

    [This is absolutely controversial, but there's some pretty significant evidence within the Whole Health Source's posts on dietary fats.]

    Omega-3 polyunsaturated fats have been significant in all traditional diets, and almost certainly lacking in most modern diets. Flax oil's short-chain ALA may not convert well to long-chain DHA and EPA in humans. Vegans may want to consider algae-sourced DHA and EPA supplements.

    Traditional societies relying on grains and legumes for a large portion of their diet soak, sprout and/or ferment them before consumption. These processes all serve to improve the bio-availability of the nutrients and may be important for vegans eating a large portion of their calories from these sources.

    Vitamin K2 has been been under-appreciated for its role in human health and is chronically low in western(ized) populations. It's found in greatest concentration in the parts of animals we rarely eat (organs and bone marrow) and dairy from pasture-raised ruminants (displaced by factory dairies). The research isn't definitive, but I believe this nutrient is worth paying attention to. As with B12, fully vegan sources of K2 supplementation are available.

    Again, these are hypotheses, but I think it's worth evaluating the evidence in support of them to best determine how to adopt a healthy vegan lifestyle.

    ReplyDelete
  12. I get most of my fats from tofu and peanut butter and rarely add oil to anything during cooking (I use non-stick cooking spray). I feel better with only the occasional addition of fat foods, a few servings a day of avacodo or peanut butter, but not much more. I think different things work for different people.

    ReplyDelete
  13. It's great to hear there's a shift in the perception relating to good fats. Not only because I've always enjoyed a high fat vegan diet, around 20-30% calories from fat myself. I have excellent blood-lipid values.

    It's also nice to now have some more reasoning weight against those who masochistically enslave themselves to very restrictive eating patterns, and defend them against the science which tells otherwise.

    Good fats are good for you, what's so complicated about that?

    ReplyDelete
  14. Wow. I had no idea that this was such a can of worms. Like Ava, I take the approach that good fats are good for you (even though the specifics of that tend to change...coconut, anyone?) and, when I had gestational diabetes last year, the importance of fat was made clearer to me. In fact, the dietitian that I saw, who unfortunately wasn't overly familiar with vegans diets, was more concerned that I eat enough fat than the fact that I was vegan, which was contrary to what people told me I was in for. She was right, too. When I was careful about a good mix of healthy fat and protein with the prescribed number of carbs, I felt MUCH better than when I left out the fat. I think, therefore, that I learned a valuable lesson from the GD.

    Since I'm no expert, despite having read a variety of books about diet and nutrition, I appreciate that fact that you've taken the time to discuss the findings of your diligent research, Ginny. I know personally how time consuming research is and how vexing it can be. It's refreshing to have access to sane, grounded, well-researched information.

    ReplyDelete
  15. Crystal - I would suggest you use other nuts aside from peanuts - pecans, almonds, cashews and seeds: sunflower, chia, hemp, sesame.

    Like any diet - a well-rounded food source supplied more the daily nutrients we need as vegans. I use grapeseed and olive oil for sauteeing for soups, using mainly nuts and avocado for fats. Plenty of veggies and fruits and not even daily grains. I don't find many vegans where I live and if I have, I've not found them to be absolutists. Moderation!

    ReplyDelete
  16. I applaud your promotion of vegan diets, which are laudable for their own sake regardless of the macronutrient ratio one chooses to adopt. However, Dean Ornish does have a published controlled study showing that his very low fat diet reverses heart disease.

    Furthermore, the argument that there may be disadvantages to a high-carbohydrate diet makes use of a straw-man tactic. Just as all fats are not equal, neither are all sources of carbohydrate. The Ornish and Esselstyn type diet makes use of unrefined plant foods, not cookies.

    Finally, regardless of any studies about fat metabolism conducted after Ornish published, his diet will not suddenly stop working. No other diet than a very-low fat diet has ever been shown to reverse heart disease.

    ReplyDelete
  17. I also will go with McDougall, Essyltein, Campbell, Jeff Novick and the like. Where is your scientific studies, notes to back up your claims? They have decades of knowlege, training and scienic behind them.

    ReplyDelete
  18. I'd just like to say that I am a low fat raw vegan, following Dr. Douglas Graham's plan. His book is "The 80/10/10 Diet". I, along with many others thrive on this lifestyle. I average around 3000 calories daily, ensuring I am eating enough for my athletic endeavours. We promote large amounts of fresh fruits and vegetables, along with small amount of avocado, nuts, and seeds, usually averaging 30 grams of fat daily.
    This is not to say that our way of eating is the only way, but it certainly is optimal for a great number of individuals.
    Our network is www.30bananasaday.com, if anyone is interested in this way of life. Dr. Douglas Graham also has a website, www.foodnsport.com.
    Eating large amount of fresh produce has helped me eliminate toxins from my body, and keeps me fit and healthy!
    :)

    ReplyDelete
  19. First read Prevent and Reverse Heart Disease by Esselstyn. You can't argue with 25 years of hard data.

    ReplyDelete
  20. Thanks all for these comments. I'm traveling right now so can't respond quite as extensively as I would like this week. But I will say once again that all fats do not raise blood cholesterol levels and promote plaque formation. Only certain fats do that. So to make a blanket requirement for eliminating all fats from the diet to promote heart health is not in line with the current scientific findings. As good as the very low fat diets might be, they would probably be improved with the addition of some foods with proven heart health benefits like nuts. And by promoting heart healthy diets that include some of these foods, which make meals more appealing and tasty, we could attract more people to veganism, thereby providing health benefits for more people and saving more animals.

    Health professionals don't make recommendations based on a handful of studies. The research on these issues is vast and it is important to look at all of it and see what the majority of the best studies say. It's a mistake to think that a few popular books based on a few studies--some of which were not randomized clinical trials--should form the basis for our recommendations regarding vegan diets. If we're going to be successful in promoting vegan diets, we need to evaluate the research much more critically than that.

    ReplyDelete
  21. I am wondering if you know how many fat grams per day is healthy to shoot for? Based upon a 1,500 calorie diet.

    ReplyDelete
  22. Hi all,
    A few quick responses to the comments that have come up over the past week.

    Regarding monounsaturated fats and diabetes, there is a lot of good research on this and eating more of these fats appears to be beneficial for some people with diabetes, so I appreciate having this pointed out.

    And yes, oil is a food! Granted, partitioned foods lose a lot of their good components, and it’s best to eat primarily whole plant foods. But oils have been a part of cultural diets for hundreds of years. They improve the flavor of other more healthful foods and can enhance some nutrient absorption. Obviously, most of us could stand to consume less oil, not more—but that doesn’t mean that there is anything wrong with having a little bit of oil in your vegan diet. I would agree though, that it is much better to get healthful fats from whole foods like nuts, seeds, olives, and avocado.

    As far as the effects of unsaturated fats on cholesteryl oleate, these are animal studies using very high fat intakes and the results are actually conflicting with some research showing low levels of cholesteryl oleate when unsaturated fat is fed.

    I agree that the relationship of fat intake to DHA levels in vegans is an interesting topic. It is very, very complex, though, with a lot of conflicting recommendations—I’ll try to write more about that in the next few weeks.

    Heidi, no one really knows exactly how much fat is appropriate in a diet, and again, type of fat seems to be more important than amount of fat (up to a point, of course) I’m inclined to suggest something between 20 and 25%. If your calorie intake is low, as yours is, it’s probably wise to aim for the lower end of that range so that there is plenty of room in your meals for other healthful foods. At 1500 calories, you might want to aim for 30 grams of fat per day. It’s not an exact science, though, so a little more or little less on some days is okay.

    Peter, I did point out in my post that the type of carbohydrate consumed is important. However, some of the problems associated with very low-fat diets—which include lowered HDL levels and higher triglycerides—have also been seen in diets that used complex carbohydrates. I’ve responded to some of your comments about the Ornish Program (and no, I don’t think that it has stopped working because of newer data!) in a new post today.

    ReplyDelete
  23. No you're wrong regarding cholesteryl oleate. It's been shown in both animal and human studies. The Uppsala longitudinal showed this most recently but also clinical trials with humans have shown increased levels of cholesteryl oleate.

    ReplyDelete
  24. Hi Ginny,

    One thing I like about you is that you are available to post replies in response to various comments.

    Somewhere you had mentioned that Dr Ornish and Dr Esselstyn did different things and hence we can attribute reversal of heart disease to low fat diet alone. While I agree that they did different things, low fat plant based diet was the common denominator. Esselstyn didn't ask his patients to exercise. He simply went by cholesterol below 150 and low fat plant based diet. Ornish program required exercise, yoga, meditation etc etc. Since low fat diet was common, logic tells me that low fat diet had significant effect compared to other components. If Dr O did A, B and C and Dr E did X,Y and C and both of their patients saw reversal then one can conclude that C had significant effect and may the only component responsible for the reversal. Conversely, even in the worst case one can not say that C was not responsible for the reversal.

    Secondly, you say by adding good fats to low fat diet, one can expect even better results? now what is "better result" than the reversal itself? So If I'm a high risk patient or already had heart disease, why would I fiddle with anything other than what is pr oven to be true?

    Would love to hear your comments.

    ReplyDelete
  25. Mahesh, no it doesn’t exactly follow that every single common element in the different diets is responsible for the benefits. It’s perfectly realistic to think that both A and X are beneficial so that subjects got good results from either of those things. More importantly, though, the programs had a number of factors in common, some of which are known to be protective and some of which aren’t. Both were low in saturated fat and both caused weight loss. Those are two well-known powerful factors for reducing heart disease risk. Low unsaturated fat intake was also common to both programs but is most likely just an innocent bystander—taking all that credit for something that is really just the result of other dietary changes.

    If someone has reversed their heart disease on the Ornish Program, I wouldn’t expect them to try something else. But a lot of people are never going to try a low-fat vegan diet because the low-fat part of it is too difficult. And since it is unnecessary, why promote it? Especially given that many vegans promote this way of eating for everyone not just those with heart disease!

    ReplyDelete
  26. Ginny, there is lot of contradictions in your posts. It seems you did believe that Ornish diet reversed CVD. Then you say it is unnecessary that means you have to prove first that adding little more fat to low fat diet, you can still reverse CVD. If yes then yes people can add little more fat and still reverse CVD. For those who do not have CVD, may be they will be OK with 20-25% fat.

    You believe most of the benefits came from reduced sat fat and weight loss. Now, low fat plant based diet should give you the lowest sat fat and weight loss as fat is calorie dense.

    What people can or can not do is different animal altogether.

    ReplyDelete
  27. Mahesh, first of all, no—there is no evidence that the Ornish diet reversed heart disease. We know that the Ornish Lifestyle Program—which included a low-fat vegan diet—reversed it. No doubt, diet is a powerful part of the reason for the reversal but this study alone does not prove that and I really don’t think that Dr. Ornish has ever said it does.

    Second, you can’t draw conclusions about the best way to eat based on one or two studies. Nutrition research and knowledge are far more complex than that. (I’m going to blog about that topic in another few days.) So based on an overview of the body of research on diet and heart disease, here is what we know:

    • Polyunsaturated and monounsaturated fats do not raise blood cholesterol. This is pretty much rock solid fact.

    • Saturated fat raises blood cholesterol levels. There is not total consensus about this, but for the most part, we can still recommend with some confidence that people who want to reduce their risk for heart disease or reverse existing heart disease should drastically reduce their saturated fat intake.

    • In overweight people with elevated cholesterol, weight loss will reduce cholesterol levels. Again, this is pretty close to being rock solid fact.

    • Nuts have some rather amazing heart-protective effects. This is a growing area of research but the findings are impressive. There is a very consistent relationship between nut consumption and reduced heart disease.

    Looking at these facts, it doesn’t make any sense to think that avoiding all high-fat foods—including nuts—is necessary to reduce heart disease risk. And it’s really not very likely at all that improved heart health would be due to a lower intake of heart healthy foods like nuts. While we don’t have studies that lasted long enough to show reversal, we do have studies showing that diets including heart-healthy higher-fat foods have advantages over low-fat diets in terms of blood cholesterol levels and type. It’s very hard to imagine that adding moderate amounts of these foods would make things worse and it is very likely that they might make them better.

    Finally, most people do lose weight when they severely restrict fats in their diets, but keeping the weight off is another matter altogether. There are, in fact, plenty of studies showing that including some higher fat foods in the diet is more effective for long-term weight control.

    Again, my intent was not to dissuade people from going on the Ornish diet if they have severe heart disease. It was to point out that some of the widely-held beliefs among vegans about nutrition are simply wrong. And the idea that all high-fat foods are bad for you is one of them.

    ReplyDelete
  28. There you go

    http://www.thedoctorwillseeyounow.com/content/heart/art2027.html

    All these studies have further underlined the importance of diet by showing that high fat food raises their risk of developing coronary heart disease separately from blood cholesterol levels. For example, in one study, a group of people following the American Heart Association dietary guidelines — eating 20% of overall calories as fat — showed no change over time in the progression of their coronary artery disease or in their risk of having a heart attack. When their fat intake was lowered to 10%, their heart disease either stopped or began to regress. Their risk of having a heart attack also went down

    ReplyDelete
  29. Mahesh, I'm not really sure what you're saying here. The article you posted suggested that heart disease reversal could be achieved in response to a comprehensive program that included low-fat diet along with cholesterol-lowering drugs, smoking cessation, and weight loss. It doesn't actually make the case for very low-fat diets at all.

    Also, I'm not recommending a high-fat diet or an American Heart Association diet. I'm recommending a vegan diet (which is extremely different from the AHA diet) that includes some healthful higher-fat foods like nuts. I don't disagree with anything in the article you posted. It just doesn't refute anything I've said here.

    ReplyDelete
  30. Ginny, the link that I posted, author doesn't talk about Ornish Program but specifically talks about diet, fat and cholesterol. So we are not talking about other variables here.

    " ***All these studies*** have further underlined the importance of ***diet**** by showing that high fat food raises their risk of developing coronary heart disease separately from blood cholesterol levels"
    .
    Also when you recommend to add nuts and seeds to low fat diet which may be 10-12%, you can easily increase that percentage to 20 -25% which is a problem.

    I would like to see evidence where in adding nuts and seeds to low fat diet will get atleast the same results as low fat diet if not better.

    Otherwise it is like everyone is trying to tinker with the % CFF. We don't like 10% and we don't like 30%, so let's make it 12%, 15% 17% or 20% should not be the basis for dietary recommendations.

    ReplyDelete
  31. Mahesh, the quote you included actually references studies that did not show benefits of very low fat diets or dangers of moderate fat intake. In fact, most of those studies cited actually used drug therapy. And later in the article, the references to high fat intake are specifically in response to the effects of very high fat meals. I addressed that issue in my post, pointing out that eating a lot of fat at one sitting can raise risk for a coronary event.

    Again, I am not promoting high fat diets! But the fact is that the evidence showing protective effects of nuts and seeds is very impressive. I wrote a little bit about that on the examiner site here.

    And again, if people with severe heart disease want to follow a very low fat vegan diet, I don't have a problem with it. There is nothing in the scientific literature to suggest that having a few nuts and seeds every day would reduce the benefit of that diet, but I won't quibble about that. However, there is a trend among some vegans toward promoting a very low fat diet for everyone as a way to lower disease risk. They suggest that if a lot of fat is bad then so is a little. The evidence suggests otherwise.

    ReplyDelete
  32. Diabetes symptoms can be seen in early & older age. But can be cured. Proper diet has to be maintained to control diabetes.

    ReplyDelete
  33. That a fatty meal or olive oil affects the elasticity of your cardiovascular system is not a theory, it's a measured fact. Occurs for sometimes up to six hours after ingesting.

    You don't need "randomized trials" to prove that measurement. Added oil fuels plaque development which can lead to strokes, and that's probably more significant than a small drop in cholesterol.

    Which snowflake causes the avalanche?

    How can one seriously consider oil a food. How do you grow olive oil?

    Oil is a highly processed non-food.

    Sure, some nuts and seeds are fine, even avocados, if you don't have heart disease symptoms.

    But to claim that oil, or olive oil, is healthy, is a micro-view of a particular result (cholesterol lowered in some cases).

    Heart disease, Altzheimer's, Type II Diabetes, etc., are the macro-view.

    Then there's the issue of what does added oil actually contribute to one's diet nutritionally?

    Essentially nadda... little of anything.

    Just fat. You're ingesting fat. It's not needed. You can get enough from REAL food sources.

    Here's a summary I did awhile back that might be useful as it provides cits and links:

    http://soulveggie.blogs.com/my_weblog/2009/01/15-reasons-to-avoid-vegetable-oils.html

    This constant rationalization for added oil is not helping people get rid of their taste addictions to fat.

    Having been "no added fat vegan" now for two and a half years, I can tell you, in all honestly, I lost my taste for added fat about 14 or so weeks into the experiment.

    As Esselstyn put it, I've "recalibrated" my taste buds.

    As to Esselstyn's studies, he reversed heart disease. Tell me of a dietician or modern nutritionist or doctor who's done the same thing, and that it's been tracked over 20 years. Where are the cries for more studies validating his research?

    Simple. You can make more money with heart surgery, satins, and stents, than urging people to eat healthier.

    Bottom line: oil is not a "natural" or "real" food any more than high fructose syrup is. You don't need it, and the evidence is not there that you do.

    Regards, Mark

    ReplyDelete
  34. Mark, thanks for commenting. But your list does exactly what I talked about in this post. You've picked out a few studies that make your case--along with some questionable resources--and ignored the large body of data on this subject. So your list doesn't prove anything and actually does not reflect current understanding of nutrition and heart disease.

    ReplyDelete