Is It Healthy? What are we Comparing

Is it Healthy?

When we ask the question Is it Healthy?, we need to consider is it healthy compared to what.

Giving up sugar and carbohydrates often results in the following outcomes.

  • Giving up potatoes means giving up potato chips that have been deep fried in oil that has been used to fry food for an extended period of time. You are also giving up the salt and possibly the high-fat, high-salt, high-sugar chili sauce.
  • Giving up high-carbohydrate pasta means giving up the high-fat, high-salt, high-sugar tomato sauce and the cheese that is sprinkled (or slathered) on top.
  • Similarly, giving up pizzas means giving up the high-fat pizza base as well the accompanying tomato sauce and cheese.
  • Giving up bread means giving up the butter or margarine spread and the cheese and ham sandwiches.

It is not the carbohydrates that are causing the problems but what accompanies them.

All studies are comparing something. Some examples are listed below.

  • In the 1950s, a number of researchers studied the relationship of saturated fat to serum cholesterol during the 1950s. J Groen, LW Kinsell, EH Ahrens, A Keys, JM Beveridge and B Bronte-Stewart replaced saturated fats in the diet with polyunsaturated fats. All other components of the diet remained the same and the total fat content of the diet did not change. These researchers compared the results of individual participants before and after a two week intervention period.
  • Epidemiological studies such as the China-Cornell-Oxford Project (The China Study) compared 365 variables in 69 counties in China. 1
  • Random clinical trials ideally compare the results of one intervention (the experimental group) with a control group that had no interventions.
  • In Doctor Moseley’s coconut oil study, three very high fat, unhealthy diets are being compared. The high fat diets varied in the type of fat being consumed – butter, olive oil and coconut oil. The only conclusion that can be made is between the three diets. It does not mean that any of the diets are healthy. 2
Before the start of the trial, the scope of the trial must be defined. For example, are we studying cardiovascular health, diabetic outcomes or blood pressure? What criteria are we using to measure these conditions. Are we measuring total cholesterol, LDL cholesterol, HbA1c (a long-term diabetic indicator), serum insulin, glucose tolerance, systolic and diastolic blood pressure?

Most studies compare the results of intervention groups with each other or with the intervention group with a control group.

Women’s Health Initiative

For example, the Women’s Health Initiative evaluated the effect of a low-fat and high-fruit, vegetable-and-grain diet on the prevention of breast and colorectal cancers, and coronary heart disease in post-menopausal women. The participants followed either their usual eating pattern or a low-fat dietary pattern. The women were randomly assigned to the control group or intervention group. The women self-reported their diets which is an unreliable method of determining what was actually eaten.

According to the study, the intervention consisted of: Intensive behavior modification in group and individual sessions designed to reduce total fat intake to 20% of calories and increase intakes of vegetables/fruits to 5 servings/day and grains to at least 6 servings/day. The comparison group received diet-related education materials. 3

By comparing the control group with the experimental group, the widely-reported conclusion from this study informed readers that:

Over a mean of 8.1 years, a dietary intervention that reduced total fat intake and increased intakes of vegetables, fruits, and grains did not significantly reduce the risk of CHD, stroke, or CVD in postmenopausal women and achieved only modest effects on CVD risk.

However, if you compare the changes made in the two groups, neither made significant changes. At the start of the trial, the average weight was 73 kg. By the end of the study, both groups had gained weight. The women were overweight and unhealthy at the start of the 8 year study and were worse off at the end.

The reason. They women did not change anything. It seems obvious – if you wish to instigate change, you need to change something.

Additional Details

Further details can be found in the following article.
Diet Does Not Affect Breast Cancer?

Dr Mosley’s Coconut Oil, Butter and Olive Oil Study

Dr Michael Mosley (Trust Me, I’m a Doctor) instigated a trial to determine the impact of coconut oil on cardio-vascular health.

94 participants were randomly assigned to one of three groups. They were asked to consume an additional 50g of fat – either coconut oil, butter or olive oil, daily for a period of four weeks. 4

The main measure was the change in total cholesterol.

His conclusion that “coconut oil may be good for you” is simply not valid.

An alternative view is that the three high-fat, unhealthy diets have a similar unhealthy impact on, not only cardio-vascular health, but overall health.

Additional Details

Further details can be found in the following article.
Michael Mosley and Coconut Oil

Footnotes

  1. Campbell, T. C. & Campbell, T. M. (2016) The China Study: Revised and Expanded Edition. Dallas, Texas: BenBella Books.
  2. Khaw, K.-T. et al. (2018) Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women. BMJ Open. 8 (e020167), 15.
  3. 144 Howard, B. V et al. (2006) Low-Fat Dietary Pattern and Risk of Cardiovascular Disease. Journal of American Medical Association. 295 (6), 655– 666
  4. Khaw, K.-T. et al. (2018) Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women. BMJ Open. 8 (e020167), 15.

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