14 October 2009

Don't want a heart attack? Eat your fruit with cream.

Supports Chapter 8: Why 'five portions'?

Over the last three months, I have been engaged in bringing my house into the 21st century. Taking out the remnants of a solar heating system that was great in the summer, when I didn't need it - and next to useless in the winter when I did, and replacing that with a high efficiency gas fire and a condensing boiler. All of which involved a lot of knocking down and rebuilding. And I'm not getting any younger! As a consequence, websites and blogging have had to take a back seat and a lot of controversial studies I should have written about have been missed.

But I felt I couldn't let this one go by:

A new Swedish study looking at fruit and veges in heart disease (click here for the full paper in PDF)arrived on my computer this morning. It finds that eating fruit and veg is only of benefit when combined with a high dairy fat intake. Without the dairy fat, not only was there little or no benefit from eating your 5 portions, the fruit and veg actually increased risk of a heart event by 70%!

What it's really saying, of course, is that to reduce the risk of a heart attack, eating fruit and veg are irrelevant, and may actually be harmful, and it's the saturated fat that is beneficial. So much for the UK's Food Standards Agency's advice to use skim milk and other low-fat dairy!

Oh, and by the way, the study found that eating wholemeal bread and fish twice a week were also of no benefit.

Barry

34 comments:

Chainey said...

Hi Barry

Just (re)reading your book Eat Fat Get Thin, so timely to end up on your site again (followed a link) where I haven't been for a while.

As I understand it, the theory behind the fat+fruit thing is that supposedly the fat-soluble vitamins need the fat to be absorbed.

Dr Mike Eades had a post on the subject a while ago here

Daniel said...

Well if you want to get fat this is really a good recipe - Combining high fat and carbohydrate intake.

I gained about 1kg per day with this diet; was eating about 1-2 Kg berries, 600-1000g red meat and a 1000mL cream plus 500g sour cream a day. It's like eating as a bear in the autumn.

Amanda said...

Great paper, thanks Barry!

Anonymous said...

Barry,
Fascinating article.
You said "Without the dairy fat, not only was there little or no benefit from eating your 5 portions, the fruit and veg actually increased risk of a heart event by 70%!"
I admit that I skimmed through the paper rather fast. Can you point to the bit about the 70% increase?
Thanks,
Steve

Anonymous said...

You must be kidding. I have had almost no dairy in 8 years.

I've been on a low fat, high veggie and fruit, with whole grains, fish and chicken now since January 2006 after a triple bypass for less than 7% coronary blood flow. Any saturated fat now gives me severe angina within 4-24 hours. NOTHING ELSE gives me angina.

I can now exercise for an hour or more at almost aby level I care to do.

If I needed saturated fat, I should be dead. When I eat any, I feel like I may die soon.

Absurd study results. Too small a cohort. Was it all Inuits ?

Anonymous said...

You must be kidding. I have had almost no dairy in 8 years.

I've been on a low fat, high veggie and fruit, with whole grains, fish and chicken now since January 2006 after a triple bypass for less than 7% coronary blood flow. Any saturated fat now gives me severe angina within 4-24 hours. NOTHING ELSE gives me angina.

I can now exercise for an hour or more at almost any level I care to do.

If I needed saturated fat, I should be dead. When I eat any, I feel like I may die soon.

Absurd study results. Too small a cohort. Was it all Inuits ?

Anonymous said...

Angina Guy...troll.

Barry Groves said...

Hi Chainey

Certainly, Mike Eades has a point. But only as far as some of the nutrients are concerned. Vits A, D, E and K are all fat soluble and cannot be absorbed without fats. However, as far as fruit is concerned, the main vitamin is C, which is water soluble.

Daniel

How on earth do you manage to eat that amount? I couldn't eat half that in one day. But you are right: eating lots of sugars with any meals will lead to obesity -- and more.

Steve

Look at the odds ratios in the abstract.

"Daily intake of fruit and vegetables was associated with a lower risk of coronary heart disease when combined with a high dairy fat consumption (odds ratio 0.39, 95% CI 0.21-0.73), but not when combined with a low dairy fat consumption (odds ratio 1.70, 95% CI 0.97-2.98).

The first of these I've bolded (high fat) means that the heart disease risk is 39% -- i.e. reduced by 61%; the second (fatless) means that the risk is 1.70 -- i.e. increased by 70%. The CI (confidence interval) is a measure of the range of results in the individuals. In this case (0.97-2.98) someone had a slightly reduced risk (0.97) while someone else had almost 3 times the risk (2.98). The mean of these is the 1.70, or 70% increase.

Anonymous

I have eaten a very high saturated fat diet for most of my life. Double cream in cocoa and coffee, cream on fruit, high fat cheeses and butter as well as the fat on meat and coconut oil for frying.

I haven't had a triple bypass, or needed one, because I have never had any heart problems in my 73 years. And, like Mike Eades, my blood pressure now is that of a 20-year-old: around 110 to 115 systolic over 59-62 diastolic. Go figure, as the Americans say.

Incidentally, almost 2,000 people over 12 years is quite enough to show statistical significance. And, No, ttey weren't all Inuit. The Inuit don't live in Sweden.

Barry

Anonymous said...

Anonymus: So saturated fat gives you instant angina. Go to Biology 101 and find out what your own body fat is made of.

Anonymous said...

Thanks Barry. Yes, the figures are interesting!
As I mentioned in another post, I started a low carb diet over six months ago and the results have been dramatic. LDL, HDL and triglc levels are significantly improved and I have 8 years of blood tests to prove it.

By the way, I'm not really 'Anonymous'. Just I can't remember what my username/password is!

Steve

Matthew said...

Dr. Groves, a question that I haven't found a good answer for: what's the effect of artificial sweeteners as lipogenic substances?

The best I've found is a Canadian report that indicates that artificial sweeteners may cause an insulin reaction, but I would suspect that this would be a zero-sum game. This suspicion is mildly heightened by the fact the study cites that any associated weight gain was due to increased appetite, and thus overeating... which isn't possible in absent of carbohydrate. So would artificial sweeteners cause weight gain? Or could they throw someone out of ketosis?

I have found I'm very sensitive to carbohydrate intake so I want to avoid them if they would compromise my ketogenic state.

Finally, I'm curious if you've ever read "Good Calories, Bad Calories" by Gary Taubes?

Stan (Heretic) said...

Re: Angina Guy...troll.

No he is not a troll! He genuinely seeks some help. I am 90% sure that he is DMW56, see his typical post for example on the webmd.

Thanks Barry for catching that paper! Something is clearly happening in Sweden, probably since their Malmo study a few years ago. Oh, I still think it is slightly untypical to choose the reference point of a dietary study in the mid range so that a variation is between 0.39 risk reduction (-61%) and 1.70 risk increase (+70%). Had they use a more typical data presentation based on the end range, for example the low fat as a base (CVD risk = 1)then the risk would drop to an astoundingly small value of 0.23 (4.4 times!) for the high fat + high vegetable group.

Stan (Heretic)

Chainey said...

I too got the feeling that angina guy wasn't a troll.

I think he's annoyed and frustrated after doing "everything right" and yet still finding something missing (or feeling some lingering doubt).

If our claims were really so fantastic (like someone claiming to walk through walls) he wouldn't even be reading this blog.

I can't imagine any plausible mechanism by which fat (even if it were as bad as most think it is) would cause chest pain. Indigestion maybe, if the body was unused to getting its fat and had adapted (as well as it could) to an all-carb diet.

Since I learned about the gall bladder "seizing up" after long deprivation of fat (see link here) I would never advise a long-term vegetarian to eat any significant amounts of animal fat without devising a "plan" with his doctor to reintroduce them.

Barry Groves said...

Hi Matthew

Here is my take on artificial sweeteners

There is still some debate about the role of the artificial sweeteners. Saccharine, aspartame and others contain no calories so, on the face of it, they appear to be an ideal substitute for those people with a sweet tooth who cannot give up sugar. But it seems it isn't as simple as that.

A great deal has been said in the media about artificial sweeteners hampering weight loss. The suggestion is that the pancreas may start to produce insulin for the purpose of reducing blood glucose levels before those levels are elevated, merely in response to a sweet stimulus -- rather in the way your mouth waters when you smell an appetising meal cooking.

Thus eating a calorie-free sweetener can trigger the production of insulin. And as no glucose enters the bloodstream, glucose already there is removed for storage, blood levels are driven down and the result is hunger and increased food intake.

Clinical studies, however, have found no such effect.

Based on my experience, I favour the idea that artifial sweeteners do have a negative effect.

Whether or not this is correct, eating foods containing artificial or any other kind of sweeteners maintains the taste for over-sweetened foods. I think it is much better to reduce your use of all sweeteners gradually until the natural sweetness of foods tastes right for you. The sweetness to aim for is the natural sweetness found in non-tropical fruit such as strawberries, raspberries, blurberries, etc.

Stan and Chainey

Good points

Barry

Anonymous said...

Hi Barry
Read this report from Sahlgrenska in Gothenburg about children that drink milk with higher fat has a better BMI than children drinking milk with lesser fat (light).
http://www.forskning.se/pressmeddelanden/pressmeddelanden/barnsomoftadrickerfetmjolkvagermindre.5.51a596771249797ef12800023.html

Barry Groves said...

Thanks Anonymous for that. However, I don't read Scandinavian languages and when I went to the website, it gave me a computer virus. Twice!

Barry

Janne said...

Sorry Barry!
I didn't mean to infect your computer. Try this side insdead. It's University of Gothenburg (Sahlgrenska Academy) site (In english):
http://gupea.ub.gu.se/dspace/handle/2077/20457

Barry Groves said...

Thanks Janne. That's much better

Barry

Miki said...

My take on the fruit+vegetable is that they are inverse surrogate for carbohydrates. Fruits are not that prevalent in the long Swedish winter and so are root vegetables. This leaves legumes (low carb lentils?) and lattice to be considered as high fruit+vegetables and if you eat plenty of them and plenty of fat there is not much room left for carbs...
this way the comparison is really between high fat- low carb and low fat- high carb diets

Addiction said...

Haloween is coming up. My kids are very excited to go trick or treating. Right now the drug world is so crazy so I don't even know if I want to take my kids trick or treating. I heard that people put http://www.drugrehab-texas.org that looks like candy inside of little packeges and give them out to kids. They look just like candy and kids don't know any better so they eat it and they could die.

Addiction said...

Haloween is coming up. My kids are very excited to go trick or treating. Right now the drug world is so crazy so I don't even know if I want to take my kids trick or treating. I heard that people put meth that looks like candy inside of little packeges and give them out to kids. They look just like candy and kids don't know any better so they eat it and they could die.

Anonymous said...

Hi Barry - your book "Trick and Treat" has changed my views considerably. I've adopted a high fat-low carb diet and over 6 months have lost a stone (although people would have said that I didn't really need to lose any). I'm not too strict about it but I'm working on at least three hours between doses of carbohydrate and no more than 30g carbohydrate per meal to a total of around 75g CHO per day. Would you say that that was reasonable? I have been trying to find a graph of insulin rise against CHO dose to check but I can't find it in your book.

Thanks for your thoughts. Caroline

Barry Groves said...

Hi Caroline

That looks fine. There isn't a graph of insulin rise against carb intake as everyone is different in this respect, particularly as far as their degree of insulin resistance is concerned. And, as it is more expensive to test for, most general practitioners wouldn't run a test for insulin either.

Addiction

Putting meth into sweet packets is obviously a nasty practice, which no thinking person could condone. But look on the bright side: if it serves to put a stop to the extortion with menaces practice which is trick or treat, it may, perhaps, turn out to be no bad thing after all. It could help to enhance not only kids' health but also their sense of moral values.

Barry

Anonymous said...

Regarding the Trick or Treat issue of Halloween, it is harmless enough in England, no drugs, no menacing, at least in our area, but the greed aspect worries me. How much nicer if the visiting children had something to offer instead/as well. If they really wanted sweets, they could give a flower in return perhaps. Caroline

Anonymous said...

I have a question for Dr Groves or anyone on here with the knowledge.

When you talk about cream. Is store bought cream homogenized. Is it still good for your health to consume store bought dairy products that have been homogenized. If so, is homo better than skim. Is goats milk better than cows milk, because goat milk fat is naturally smaller and does not need homogenization.
....Shauna

Barry Groves said...

Hi Shauna

I think you are talking about milk. 'Cream' is what is removed (skimmed) from milk to produce skim milk. Cream is, essentially, the milk fat.

As well as being dangerous to drink, skim milk is a waste of money as most the goodness of milk is in what is removed - the cream. Skim milk is mostly water; without the fat a lot of what nutrients there are are not properly absorbed without the fat which cream supplies.

At one time, you could see the cream floating on the top of milk. These days, the fat globules are smashed into tiny particles so that what cream there is on milk, is mixed in with the watery part. That is homogenisation: the mixing of the fat in the cream with the rest of the milk.

If you are buying cream, as opposed to milk, there should be no homogenisation, as there is nothing to mix the cream with.

Whether goat's mik is better than cow's is debatable. It certainly will be if it is not homogenised as the homogenisation breaks the fat molecules into such small particles that they can be absorbed into the bloodstream from the gut without being properly digested first. This can lead to allergic reactions. This is one of the reasons I don't use milk at all, and why I would recommend not buying homogenised milk.

Barry

Anonymous said...

Thank you Dr Groves, that clears things up. Lots of the cream I found in grocery stores is mixed with milk, so that is why I was originally wondering if they homogenized the cream. I will just have to look for a better quality of cream. Do you have any concerns about the emulsifiers in cream products being a health concern.
...Shauna

billye said...

Hi Barry,
I am a 77 year old convert to high saturated fat and low carbohydrates. I have even gone so far that I eat only grass fed beef and use full fat heavy cream along with full fat yogurt and butter. All grass fed. obviously, I get it. My latest move has been to give up olive oil and have now substituted MCT oil for salad oil. I am now 100% sat fat. I tell you this, so that you know that I am a complete believer. I carry around your book Trick and Treat like it is my bible. Have now re-read it 4 times. Now to my question. I have a grand daughter who is now 20. She has a rare disease called agenesis of the corpus callosum. At about age 1, her myelin sheath started to deteriorate. Now she has no motor, speech, or communication skills because of her condition and shakiness. She is a great uncomplaining young lady and we believe she understands every thing. I am not looking for a miracle, because of the length of time that has passed, just some improvement. I reread the chapter on MS many times. I know that this condition is not MS, but perhaps it is similar. I don't find many studies relative to this, but, like MS this neurological condition is also considered not curable. The question is, what do you think? Do I start her on low carb and high fat along with high dose vitamin D3, maybe 4000IU (she gets no sun, and I will have her 25 (OH) vitamin D tested) along with high dose fish oil? I am going to have a fight on my hands with her parents, my kids, but I have strong shoulders. Yours hopefully.
Bill Eisenberg

Barry Groves said...

Hi Shauna
As emulsifiers are used to enable water and fat to mix, I can't see a reason for their use in cream. However, there are so many emulsifiers used in foods that, without knowing which ones are in our cream, it's not really possible to comment. Wikipedia on this page, might be able to provide answers.

Hi Bill

I'm sorry to hear about your granddaughter's condition, and more sorry that I have no knowledge about it.

As far as diet is concerned, eating the T&T way may help - it will certainly do no harm. I'm glad you also mentioned vitamin D. That is certainly a vital substance in conditions such as the scleroses - and a vital nutrient that many people today are deficient in.

You seem to have thought of everything I could suggest.

Best wishes

Barry

Anonymous said...

I will tell you what is in the cream I bought at the store today Barry. I'd like to know if it is healthy.

The only cream I can find today was Dairyland cream (old fashioned whipping cream 36% milk fat) This is the heaviest cream I can find.

Ingredients: Cream, milk, cellulose gel, carrageenan, cellulose gum

For the life of me I cannot find a product that is just cream.

I can try and find something healthier at a health food store but I am from a small village so it would really be going out of the way. Being surrounded by farms you think it would be easy to find a wholesome product. All I seem to find at the grocers is poison.

Shauna

Barry Groves said...

Hi Shauna

First, there is nothing listed that will do you any harm.

Most of the added ingredients are there to thicken the cream and make it whippable as most people would probably use it on fruit.

In the UK wee also have this type of whipping cream, but we also have single cream (I think that is your light cream) at 18% fat, and double cream (heavy cream) at 48% fat. These are usually just pasteurised.

B arry

Nathan said...

Hi Barry, thank you for writing Trick or Treat. All of my family have benefited greatly from your knowledge.
Just a question about UK commercially made double cream (Tesco). I consume about 300mls/day most days but i am just concerned about the omega 6 content. Is UK dairy generally corn raised or are they largely pastured?
Also what is your opionion of FAGE Total Greek yoghurt as it is now a staple in our family. thank you very much for all your great work

Barry Groves said...

Hi Nathan

Cattle in the UK are almost always grass fed in the summer and hay or silage fed in the winter (hay is dried grass; silage is fermented grass), although they do get supplements while in for milking.

FAGE classic Greek yoghurt looks to be okay, so long as you aren't eating the low- or no-fat ones or the one with honey.

Barry

Vizzybiz said...

Hi Barry,
I cannot find your book anywhere on the net "Eat Fat Get Thin". Where do I go to order it? Thanks