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Cholesterol is not an important risk factor for heart disease and current dietary recommendations do more harm than good, by Tim Noakes

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A talk by Tim Noakes.
Original slides available here: http://www.health.uct.ac.za/centenary/past_events/centenary_debate/

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Cholesterol is not an important risk factor for heart disease and current dietary recommendations do more harm than good, by Tim Noakes

  1. 1. @ProfTimNoakes Slides available on www.health.uct.ac.zaProfessor TD Noakes OMS, MBChB, MD, DSc, PhD (hc), FACSM, (hon) FFSEM (UK) Discovery Health Professor of Exercise and Sports Science MRC/UCT Research Unit for Exercise Science and Sports Medicine, University of Cape Town and Sports Science Institute of South Africa
  2. 2. Economic Within 5 years of The presence of A high fat dietconsiderations the widespread the genetic reversesdrove the adoption adoption of these predisposing allknownof the current guidelines rates of condition, coronary riskdietary guidelines diabetes and carbohydrate- factors in personswithout proper obesity increased resistance, with carbohydrate-scientific explosively. explains why large resistanceevaluation or numbers of whereas a highproof. persons in carbohydrate diet predisposed worsens those populations factors. become obese and diabetic when exposed to a high carbohydrate diet.
  3. 3. TODAY 2.5 - 3.5 MILLION YEARS AGOOmnivore Vegetarian Homo sapiens Australopithecus Africanus
  4. 4. This change For 3.5 million yearsoccurred as humans we have done very became the best well without beingmid-day persistence told what we should hunters in the eat animal kingdom
  5. 5. TRIBE / COUNTRY HEIGHT (cm) Cheyenne 176.7 Arapaho 174.3 Crow 173.6 Sioux 172.8 Blackfeet 172.0 Australia 172.0 Canada 171.0 United States 171.0 Norway 169.0 United Kingdom 166.0 Russia 165.0 Italy 161.0 PLAINS INDIANS HUNTING BUFFALO BEFORE THE ARRIVAL OF THE WHITE MANSteckel RH, Prince JM. Tallest in the world: Native Americans of theGreat Plains in the nineteenth century. Am Econ Rev 2001; 91: 287-294.
  6. 6. MODERN PLAINS INDIANS HUNTING THE WHITE MAN’S DIET
  7. 7. THE COUNTRIES WITH THE HIGHEST PERCENTAGE OF OBESE ADULTS Rank Country Adult obesity (%) 1 Nauru 78.7 2 Samoa 74.8 3 Tokelau 63.2 4 Kiribati 50.3 5 Marshall Islands 46.0 6 Federated States of Micronesia 44.0 7 French Polynesia 40.4 8 Saudi Arabia 36.1 9 Panama 33.9 10 United States 33.7 11 United Arab Emirates 32.8 12 Iraq 32.2 13 Mexico 29.4 14 Kuwait 29.0 15 Egypt 28.9 16 Bahrain 28.5 17 New Zealand 25.4 18 Macedonia 25.3 19 Seychelles 25.1 20 Australia 24.8 21 United Kingdom 24.0
  8. 8. ANCEL KEYS (1904-2004) 8 7 US Canada 6CHD (deaths per 1000) Australia 5 4 England & Wales 3 2 Italy 1 Japan 0 0 10 20 30 40 50 Percent calories from fat
  9. 9. CHANGES IN CIGARETTE CONSUMPTION MATCHES THE CHANGING INCIDENCE OF HEART DISEASE 40 All heart disease 5000 Cigarette consumption 35 4000 Cigarettes per capita per yearAnnual deaths per 100,000 30 25 3000 20 15 2000 10 1000 5 0 0 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 Year
  10. 10. COUNTRIES WHERE DATA WERE AVAILABLE WHEN KEYS PUBLISHED 8 US “….the evidence from 22 countries for which data are available 7 Finland Canada US Canada indicates that the association between the percentage of fat 6 AustraliaCHD (deaths per 1000) Australia calories available for consumption in the national diets and 5 NZ Ireland mortality from arteriosclerotic and degenerativeGreat Britain 4 Israel heart disease is England & Wales not valid; the association is specific neither for dietary fat nor Switzerland W. Germany Sweden 3 Chile for heart disease mortality. Clearly this tenuous association Italy Italy Norway 2 Portugal Holland cannot Japan as much support serve Italy for the hypothesis which 1 etiologic factor France implicates fat as anCeylon Denmark in arteriosclerotic and Japan Mexico degenerative heart disease.” 0 0 10 20 30 40 50 Percent calories from fat Yerushalmy J, Hilleboe HE. Fat in the diet and mortality from heart disease; a methodologic note. N Y State J Med 1957; 57: 2343-2354.
  11. 11. “….the evidence from 22 countries for which data are availableindicates that the association between the percentage of fatcalories available for consumption in the national diets andmortality from arteriosclerotic and degenerative heart disease isnot valid; the association is specific neither for dietary fat norfor heart disease mortality. Clearly this tenuous associationcannot serve as much support for the hypothesis whichimplicates fat as an etiologic factor in arteriosclerotic anddegenerative heart disease.”
  12. 12. RICHARD NIXONAPPOINTS EARL “Food Bill” insures that US BUTZ AS farmers receive $5 billion per SECRETARY OF year to grow corn and soy. AGRICULTURE An additional $5 billion for other farmers.
  13. 13. “Food Bill” insures that USfarmers receive $5 billion peryear to grow corn and soy.An additional $5 billion forother farmers.
  14. 14. • Reduce consumption of fat• Switch from saturated fat to vegetable fats• Reduce cholesterol to 1 egg per day• Eat more carbohydrate, especially grainsThe McGovern Report was written by a junior staffer, avegan, who had no training in the nutritional sciences.
  15. 15. UNITED STATES SENATE SELECT COMMITTEE ON NUTRITION AND HUMAN NEEDS (1968-1977) “What right has the federal government to propose that the American people conduct a vast nutritional experiment, with themselves as subjects, on the strength of so very little evidence?” Philip Handler, National Academy of Science
  16. 16. UNITED STATES SENATE SELECT COMMITTEE ON NUTRITION AND HUMAN NEEDS (1968-1977) “Resolution of this dilemma turns on a value judgment. The dilemma so posed is not a scientific question; it is a question of ethics, morals, politics. Those who argue either position strongly are expressing their values; they are not making scientific judgments”. Philip Handler, National Academy of Science
  17. 17. UNITED STATES SENATE SELECT COMMITTEE ON NUTRITION AND HUMAN NEEDS (1968-1977)“…a trial of the low fat diet recommended by the McGovernCommittee and the American Heart Association has neverbeen carried out. It seems that the proponents of this dietarychange are willing to advocate an untested diet to the nationon the basis of suggestive evidence obtained in tests of adifferent diet. This illogic is presumably justified by the beliefthan benefits will be obtained, vis-à-vis CHDprevention, by any diet that causes areduction in plasma lipid levels”.Ahrens EH. Dietary fats and coronary heartdisease: unfinished business. Lancet 1979; 2: 1345-1348.
  18. 18. 2010: …no significant evidence for During 5-23 y of follow-up of concluding that dietary 347,747 subjects, 11,006 developed CVD or stroke. saturated fat is Intake of saturated fat was not associated with an associated with an increased increased risk of risk of CHD, stroke or CVD. Consideration of age, sex and coronary heart disease study quality did not change or cardiovascular the results. disease.Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating theassociation of saturated fat with cardiovascular disease. Am J ClinNutr 2010; 91: 535-546.
  19. 19. 2011:There were no cleareffects of dietary fatchanges on total mortalityor cardiovascular mortality.
  20. 20. CONSUMPTION OF ANIMAL FAT IN USA FALLS AS INCIDENCE OF HEART DISEASE RISES 40 All heart disease 15 Animal fat 35 Pounds animal fat per year per personAnnual deaths per 100,000 30 10 25 20 15 5 10 5 0 0 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 Year
  21. 21. Economic Within 5 years of The presence of A high fat dietconsiderations the widespread the genetic reversesdrove the adoption adoption of these predisposing allknownof the current guidelines rates of condition, carbohy coronary risk CONCLUSION:dietary guidelines diabetes and drate- factors in personswithout proper obesity increased resistance, explain with carbohydrate-scientific explosively. s why large resistanceevaluation or numbers of whereas a highproof. Keys was wrong. persons in predisposed carbohydrate diet worsens those Fat in the diet does not cause populations factors. become obese and diabetic when heart disease. exposed to a high carbohydrate diet. Diet-heart hypothesis is wrong.
  22. 22. Economic Within 5 years of The presence of A high fat dietconsiderations the widespread the genetic reversesdrove the adoption adoption of these predisposing allknownof the current guidelines rates of condition, carbohy coronary riskdietary guidelines diabetes and drate- factors in personswithout proper obesity increased resistance, explain with carbohydrate-scientific explosively. s why large resistanceevaluation or numbers of whereas a highproof. persons in carbohydrate diet predisposed worsens those populations factors. become obese and diabetic when exposed to a high carbohydrate diet.
  23. 23. MILLIONS OF YEARS
  24. 24. 28YEARS
  25. 25. INFLUENCE OF 1977 DIETARY GUIDELINES ON % OBESITY IN USA 50 40 Dietary goals forPercent with BMI> 30kg.m2 Americans released 30 20 45-64 years 10 30-44 years 65 years & over 18-29 years 0 1971-74 1976-80 1988-94 1999-00 2005-06 2001-02 Year
  26. 26. DIABETES AND OBESITY RATES IN THE US HAVE SORED SINCE THE ADOPTION OF THE 1977 DIETARY GUIDELINES% of Americans with diabetes % of US children who are obese 1980 2010 1980 2010 % of US adults who are obese 1980 2010
  27. 27. CHANGES IN US MACRONUTRIENT INTAKES – 1971 - 2000 NHANES MEN NHANES WOMEN 3000 CHO:FAT:PROT 3000 CHO:FAT:PROT 42:37:17 49:33:16 45:36:17 52:33:15 +6.8% 2500 2500 Carbohydrate-induced Hyperphagia 2000 2000Energy intake (kcal) +21.7% 1500 1500 +23.4% 1000 1000 +38.4% -5% +11% 500 500 -14% +3% 0 0 71-74 76-80 88-94 99-2000 71-74 76-80 88-94 99-2000 Intake Carbohydrates Fat Saturated fat Hite AH, Feinman RD, Guzman GE, et al. In the face of contradictory evidence: report of the
  28. 28. Economic Within 5 years of The presence of A high fat diet The Woman’s CONCLUSION:considerations the widespread the genetic reverses Health Initiativedrove the adoption adoption of these predisposing allknown Randomizedof the current guidelines rates of condition, carbohy coronary risk Controlled Dietarydietary guidelines diabetes and drate- factors in persons Modification Trialwithout properscientific obesity increased explosively. Explosive increase in rates resistance, explain s why large with carbohydrate- resistance (WHIRCDMT) of which myevaluation orproof. of obesity and Type II numbers of persons in whereas a high carbohydrate diet opponent was Project Leader diabetes in the US has predisposed populations worsens those factors. proves that the prescription of a been caused by an become obese and diabetic when high carbohydrate diet to persons increased carbohydrate exposed to a high carbohydrate diet. with either known heart disease or intake resulting from the diabetes constitutes 1977 Dietary Guidelines medical malpractice.
  29. 29. Economic Within 5 years of The presence of A high fat dietconsiderations the widespread the genetic reversesdrove the adoption adoption of these predisposing allknownof the current guidelines rates of condition, carbohy coronary riskdietary guidelines diabetes and drate- factors in personswithout proper obesity increased resistance, explain with carbohydrate-scientific explosively. s why large resistanceevaluation or numbers of whereas a highproof. persons in carbohydrate diet predisposed worsens those populations factors. become obese and diabetic when exposed to a high carbohydrate diet.
  30. 30. WHY DOES OBESITY OCCUR ONLY IN SOME WHEN ALL EAT HIGH CARBOHYDRATE DIETS? Largest man in the American police world in 1903 officer in 2012
  31. 31. Obesity cannot be due simply to doing too littleexercise.In a homeostatically-regulated system, anyreduction in energy expenditure will be matchedby an exactly equal reduction in energy intake.Conversely any sustained increase in energyconsumption should be matched by an increasein energy expenditure.Hence the problem must be that the homeostathas been broken by the 1977 Dietary Guidelines.
  32. 32. THE CONDITON OF CARBOHYDRATE RESISTANCE KF Petersen, S Dufour, DB Savage. PNAS. 104; 12587–12594, 2007. 180 Meal Meal 250 Meal Meal 10am 2:30pm Insulin-resistant 10am 2:30pmPlasma glucose concentrations Plasma insulin concentrations 160 Insulin-sensitive 200 140 150 (µU/mL) (mg/dL) 120 100 100 80 50 60 0 10am 12pm 2pm 4pm 6pm 10pm 12am 2am 4am 6am 10am 12pm 2pm 4pm 6pm 10pm 12am 2am 4am 6am 180 28 P = 0.00005Plasma triglyceride concentrations 160 24 140 De novo lipogenesis 20 120 (mg/dL) 16 (mg/dL) 100 80 12 60 8 40 20 4 0 0 10am 12pm 2pm 4pm 6pm 10pm 12am 2am 4am 6am Insulin sensitive Insulin resistantPetersen KF, Dufour S, Savage DB, et al. The role of skeletal muscle insulin resistance in the
  33. 33. The metabolism of every human is not the same. Those with carbohydrate resistance are unable to metabolize carbohydrate safely.
  34. 34. METABOLIC PROFILE OF PERSONS WITH CR INGESTING A HIGH CARBOHYDRATE DIET Elevated blood glucose concentrations Elevated blood insulin concentrations Elevated HbA1c concentrations Elevated blood triglyceride concentrations Reduced blood HDL-cholesterol concentrations (HDL-C) Increased small LDL-cholesterol particles (LDL-C P) Increased blood uric acid concentrations Increased blood ultrasensitive CRP concentrations Additional features: Fatty liver Obesity Hypertension
  35. 35. BLOOD RISK FACTORS FOR CORONARY HEART DISEASE Total Cholesterol Ultrasensitive CRP Fibrinogen Glucose HbA1c Homocysteine HDL-cholesterol LDL-Cholesterol LDL- Cholesterol particle size or number Lp (a) Insulin Omega 6 to Omega 3 ratios Triglycerides Uric Acid
  36. 36. THE DIETARY FAT HYPOTHESIS FOR HEART DISEASE Atherogenic Dyslipidaemia (AD) Increased LDL High fat cholesterol Arterial diet Increased “clogging” triglycerides Reduced HDL cholesterolOBESITY, DIABETES, HYPERTENSION, GOUT, METABOLIC SYNDROME ARE SEPARATE/DISTINCT DISEASES
  37. 37. RELATIVE IMPORTANCE (BASED ON HAZARD RATIO) OFDIFFERENT RISK FACTORS FOR CORONARY HEART DISEASE RISK FACTOR HAZARD RATIO (RANGE) Diabetes 2.04 (1.76 – 2.35) Age 1.87 (1.73 – 2.02) Current smoking 1.79 (1.66 – 1.94) Systolic blood pressure 1.31 (1.26 – 1.37) Total [Cholesterol] 1.22 (1.17 – 1.27) [Triglyceride] 1.19 (1.15 – 1.23) [HDL-Cholesterol] 0.83 (0.78 – 0.87) Di AE, Gao P, Pennells L, et al. Lipid-related markers and cardiovascular disease
  38. 38. PREDICTIVE VALUE OF HbA1c FOR CORONARY HEART DISEASE EVENTS AND ALL-CAUSE MORTALITY 8 Coronary heart disease events 7 All-cause mortality Age-adjusted relative risk (95% CI) 6 5 Carbohydrate resistance 4 “Pre-diabetes” 3 2 1 Total Cholesterol Hazard Ratio 0 <5.0 5-5.4 5.5-5.9 6.0-6.4 6.5-6.9 >7.0 Known diabetes Hemoglobin A1C concentrations (%)Khaw KT, Wareham N, Bingham S, et al. Association of hemoglobin A1c with cardiovascular disease and mortality in adults:
  39. 39. CUMULATIVE INCIDENCE OF IHD FOR DIFFERENT RANDOM BLOOD GLUCOSE CONCENTRATIONS Ischemic heart disease Myocardial infarction 100 >11mmol/L (>198 mg/dL) 90 9-10.9 mmol/L (162-197 mg/dL) 7-8.9 mmol/L (126-161 mg/dL) 80 5-6.9 mmol/L (90-125 mg/dL) <5 mmol/L (<90 mg/dL) Cumulative incidence (%) 70 Overall log rank p<0.001 60 50 40 30 20 10 0 20 30 40 50 60 70 80 90 100 20 30 40 50 60 70 80 90 100 Age (Years) Age (Years)Benn M et al. Non-fasting glucose, ischemic heart disease and myocardial infarction. Journal of the American College of Cardiology 59; 2012.
  40. 40. BLOOD GLUCOSE (mmol/L) IN THE NORMAL RANGE PREDICTS CARDIOVASCULAR OUTCOME 2.0 1.5Hazard Ratio Total Cholesterol 1.0 Hazard Ratio 0.5 Group 1 Group 2 Group 3 Group 4 Group 5 IFG 2.8-4.4 4.5-4.6 4.7-4.9 5.0-5.2 5.3-5.5 5.6-7.0 Shaye K, Amir T, Shlomo S, Yechezkel S. Fasting glucose levels within the high normal range .
  41. 41. Economicconsiderations Within 5 years of the widespread The presence of the genetic CONCLUSION: A high fat diet reverses allknown The Woman’s Health Initiativedrove the adoption adoption of these predisposing Randomizedof the currentdietary guidelines guidelines rates of diabetes and condition, carbohydrate- Their abnormal coronary risk factors in persons Controlled Dietary Modification Trialwithout proper obesity increased resistance, carbohydrate with carbohydrate- (WHIRCDMT) ofscientificevaluation or explosively. explains why large numbers of metabolism explains resistance whereas a high which my opponent wasproof. persons in predisposed why those with carbohydrate diet worsens those Project Leader proves that the populations carbohydrate factors. prescription of a become obese and diabetic when resistance develop high carbohydrate diet to persons exposed to a high carbohydrate diet. obesity, diabetes and with either known heart disease or coronary heart disease diabetes when eating a high constitutes medical carbohydrate diet. malpractice.
  42. 42. Economic Within 5 years of The presence of A high fat dietconsiderations the widespread the genetic reversesdrove the adoption adoption of these predisposing allknownof the current guidelines rates of condition, carbohy coronary riskdietary guidelines diabetes and drate- factors in personswithout proper obesity increased resistance, explain with carbohydrate-scientific explosively. s why large resistanceevaluation or numbers of whereas a highproof. persons in carbohydrate diet predisposed worsens those populations factors. become obese and diabetic when exposed to a high carbohydrate diet.
  43. 43. A HIGH FAT DIET REVERSES ALL CORONARY RISK FACTORS MORE EFFECTIVELY THAN A LOW FAT DIET ApoB/ApoA-1 High Carbohydrate Low Fat ApoB Low Carbohydrate High Fat Total Saturated Fatty Acids 12% CHO 60% Fat KetogenicDIet Small LDL-C particles Triglyceride/HDL-C HDL-C Triglyceride AUC Triglyceride Leptin HOMA Insulin Glucose Abdominal fat Body mass 10 0 -10 -20 -30 -40 -50 -60 Percent changeVolek JS, Fernandez ML, Feinman RD, Phinney SD. Dietary carbohydrate restriction induces a unique metabolic state positively
  44. 44. “Meta-analysis … on data obtained in 1,141 obesepatients, showed the low carbohydrate diet to beassociated with significant decreases in body weight,body mass index, abdominal circumference, systolicblood pressure, diastolic blood pressure, plasmatriglycerides, fasting plasma glucose,glycatedhaemoglobin, plasma insulin and plasma C-reactive protein, as well as an increase in high-densitylipoprotein cholesterol. Low-density lipoproteincholesterol and creatininedid not changesignificantly,whereas limited data exist concerningplasma uric acid”.Santos FL et al.
  45. 45. THE DIETARY CARBOHYDRATE HYPOTHESIS FOR HEART DISEASEHyperglycaemic HyperinsulinaemicAtherogenic Dyslipidaemia (HHAD) Low  Glucose Omega  Insulin 3, high Omega 6 High  Triglycerides carbohydrate  HDL-C • Arterial inflammation * (fructose) diet  Small LDL-C • Metabolic syndrome particles • Coronary heart disease/stroke  Uric acid* • Obesity  CRP • Diabetes Fatty liver • Hypertension ONE CAUSE, ONE TREATMENT FOR ALL CONDITIONS
  46. 46. Economic Within 5 years of The presence of the A high fat diet CONCLUSION:considerations the widespread genetic reversesdrove the adoption adoption of these predisposing allknownof the current guidelines rates of condition, carbohyd coronary riskdietary guidelines diabetes and rate- factors in personswithout proper obesity increased resistance, explains with carbohydrate-scientific explosively. why large numbers resistanceevaluation or of persons in whereas a highproof. predisposed carbohydrate diet populations become worsens those obese and diabetic factors. when exposed to a high carbohydrate diet.
  47. 47. The 48 836-personEconomic Within 5 years of The presence of A high fat diet Woman’s Healthconsiderations the widespread the genetic reverses Initiative of whichdrove the adoption adoption of these predisposing allknown my opponent wasof the current guidelines rates of condition, carbohy coronary risk the Projectdietary guidelines diabetes and drate- factors in persons Director proveswithout proper obesity increased resistance, explain with carbohydrate- that the 1977 USscientific explosively. s why large resistance Dietary Guidelinesevaluation or numbers of whereas a high accelerate diseaseproof. persons in carbohydrate diet progression in predisposed worsens those persons with populations factors. either known heart become obese and disease or diabetic when diabetes. Thus his exposed to a high landmark study carbohydrate diet. provides the definitive evidence disproving Keys’ false diet-heart hypothesis.
  48. 48. WOMEN’S HEALTH DIETARY MODIFICATION TRIAL 48 836 post-menopausal women 40% assigned to low fat 60% to self-selected eating pattern dietary behaviour Subjects reduced energy from Control subjects received a copy fat to 20% and from saturated fat of Dietary Guidelines for to 7% and increased fruit and Americans “as well as other vegetable intake to at least five health-related material but had servings per day and grains to at no contact with nutritional least six servings per day. interventionists”. Subjects were followed for 8.1 years.Howard BV, Van HL, Hsia J, et al. Low-fat dietary pattern and risk of cardiovascular disease: the Womens
  49. 49. Conclusion: The study “did notsignificantly reduce the risk of coronaryheart disease, stroke, or cardiovasculardisease in postmenopausal women andachieved only modest effects oncardiovascular risk factors”. But was that all they found?
  50. 50. “...THE HR FOR THE 3.4% OF WOMEN WITH CVD AT BASELINE WAS 1.26 (95% CI 1.03-1.54)....”This is entirely predictable as a high carbohydrate diet producesHHAD(hyperglycaemichyperinsulinaemicatherogenicdyslipidaemia) inthose who are metabolically vulnerable.
  51. 51. “The results of this study do not changeestablished recommendations on diseaseprevention. Women should continue to …work with their doctors to reduce theirrisks for heart disease including followinga diet low in saturated fat, trans fat andcholesterol”.E Nabel, Director, NHLBI.
  52. 52. “This study shows that just reducing total fatintake does not go far enough to have animpact on heart disease risk. While theparticipants’ overall change in LDL “bad”cholesterol was small, we saw trends towardsgreater reductions in cholesterol and heartdisease risk in women eating less saturatedand trans fat”.J Rossouw, Project Director, WHIRCDMT
  53. 53. THE UPTON SINCLAIR THEOREM“It is difficult to geta man to understandsomething, when hissalary dependsupon his notunderstanding it”.
  54. 54. Shikany JM, Margolis KL, Pettinger M, et al. Effects of a low-fat dietary intervention on glucose, insulin, and insulinresistance
  55. 55. “….women with diabetes at baseline didexperience adverse glycemic effects of the low-fat diet, which indicated thatunless accompanied by additionalrecommendations to guide carbohydrateintake”.Shikany JM et al.
  56. 56. The Look AHEAD Trial was terminatedprematurely in October 2012 after 11.5years as it was found that even whencombined with exercise, the Prudent diethad no measureble effect on developmentof arterial disease and its complications inpersons with Type 2 Diabetes. Continuingthe trial was considered “pointless”.
  57. 57. CONCLUSION:Economic Within 5 years of The presence of A high fat diet The 48 836-personconsiderations the widespread the genetic reverses Woman’s Healthdrove the adoption adoption of these predisposing allknown Initiative provesof the current guidelines rates of condition, carbohy coronary risk that the 1977 US The WHI provides the definitivedietary guidelineswithout proper diabetes and obesity increased drate- resistance, explain factors in persons with carbohydrate- Dietary Guidelines accelerate disease evidence from a randomizedscientificevaluation or explosively. s why large numbers of resistance whereas a high progression in persons withproof.controlled clinical trial that persons in predisposed carbohydrate diet worsens those either known heart disease or disproves the diet-heart hypothesis. populations become obese and factors. diabetes. Thus the research of my Following the 1977 US “Prudent” Diet diabetic when exposed to a high opponent provides the definitive Guidelines worsens the outcome of carbohydrate diet. evidence that disproves Keys’ those who are the most vulnerable false diet-heart hypothesis. because they have either heart disease or diabetes.
  58. 58. Economic Within 5 years of The presence of A high fat diet The 48 836-personconsiderations the widespread the genetic reverses Woman’s Healthdrove the adoption adoption of these predisposing allknown Initiative of whichof the current guidelines rates of condition, carbohy coronary risk my opponent was CONCLUSION:dietary guidelines diabetes and drate- factors in persons the Project Leaderwithout proper obesity increased resistance, explain with carbohydrate- proves that thescientific explosively. s why large resistance 1977 US Dietaryevaluation or numbers of Guidelinesproof. The Diet Heart Hypothesis of Ancel Keys is WRONG. persons in whereas a high carbohydrate diet accelerate disease predisposed worsens those progression in Its widespread promotion in the name of good science populations factors. persons with represents the single greatest error in medicine in the become obese and diabetic when either known heart disease or past 60 years. exposed to a high carbohydrate diet. diabetes. Thus that landmark study provides the definitive evidence disproving Keys’ false diet-heart hypothesis.

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