Low-fat diet could kill you, major study shows | Hacker News Reader

Low-fat diet could kill you, major study shows

telegraph.co.uk

85 pointsthomyorkie76 comments

Here's a link to the study (which, by the way, was unnecessarily difficult to find): http://www.thelancet.com/journals/lancet/article/PIIS0140-67...

What a sensationalist and wrong headline. All it says is that "Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality." So whether you have low or high fat in your diet, you could fill a good portion of that total caloric intake with protein instead of carbohydrates and that would still satisfy the claims that you can mitigate against "Higher carbohydrate intake was associated with an increased risk of total mortality".

They also don't define what "low" means in "low-fat" to define at what threshold would "kill you" (eyes roll). Doctors generally recommend 20-35% already[1] so I'm not sure how any of this is groundbreaking.

[1] https://my.clevelandclinic.org/health/articles/reducing-fat-...

Thank you for finding the link to the actual study. Can we have this edited to point to it, rather than the Telegraph's clickbaity reblog of it?

From the study:

> "Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67–0·87], ptrend<0·0001; saturated fat, HR 0·86 [0·76–0·99], ptrend=0·0088; monounsaturated fat: HR 0·81 [0·71–0·92], ptrend<0·0001; and polyunsaturated fat: HR 0·80 [0·71–0·89], ptrend<0·0001)"

This is the sentence immediately before the one you quoted, and I believe it is deceptive to quote the non-result on CVD in particular, rather than the positive result on all-cause mortality.

whether you have low or high fat in your diet, you could fill a good portion of that total caloric intake with protein instead of carbohydrates and that would still satisfy the claims that you can mitigate against "Higher carbohydrate intake was associated with an increased risk of total mortality"

This doesn't contadict any of your points here, but: my understanding is that excess dietary protein is broken down into glucose via gluconeogenesis, in which case I suspect that the high-protein and high-carbohydrate diets wouldn't have significantly different results.

Not exactly. Protein has a higher thermic effect in that it requires more energy from the body to break it down into amino acids. So say you fill both your glycogen and your amino acid requirements, given just proteins and carbs, while both will be converted to glucose, the metabolic effect required by the body to process protein will be higher than the carbohydrate.

> Doctors generally recommend 20-35% already

I did not know that. So it was useful at least for me. However, thanks for reading.

Sigh. I mean, they're right, but they're also still missing the concept of "What kind of fat?". Different kinds of fats effect you differently. This has been known for a long time.

One my favorite blog posts summarizing some research on this point, on Butter vs Margarine, is 8 years old now, and it still hasn't penetrated the mainstream.

http://wholehealthsource.blogspot.com/2009/10/butter-vs-marg...

Golden quote from the comments there:

Re: [comment] touting margarine as a healthier choice.

One thing I've learned is that looking at intermediary effects of food - for instance, lowering LDL cholesterol - is not a good indicator that something is good for you or prevents heart disease.

If you look only at intermediary effects, you might miss some other effects of the food/substance that are harmful. (Cancer lowers cholesterol, but no one advocates getting it.)

I feel like that touches upon one of the problems in diet studies pretty well.

> It's worth mentioning that this study was conducted from the late 1960s until the late 1980s. Artificial trans fat labeling laws were still decades away in the U.S., and margarine contained more trans fat than it does today. Currently, margarine can contain up to 0.5 grams of trans fat per serving and still be labeled "0 g trans fat" in the U.S. The high trans fat content of the older margarines probably had something to do with the result of this study.

You sure thats not mainstream? NYC banned trans fats starting in July 2007. I learned about them in middle or high school 10-15 years ago.

Last time I've been to US, in Cambridge, MA, it was next to impossible to buy a decent non-low fat yoghurt. It was like observing shelves full of junk food everywhere. Sigh.

Same in the grocery stores in the US midwest. If you're lucky, the available options are 80% non-fat (loaded with sugar), 15% low-fat (most sugary, but not all), and 5% full fat. In smaller stores there's no full-fat option at all, typically.

The non-fat ones are the "healthy" single-serving cups advertised in commercials with skinny women eating them in really nice kitchens just before they go running, or whatever. Probiotics, yoghurt's supposed to be healthy I think, blah blah. They're fat-free sugary dessert cups. Candy.

The low-fat myth is still going strong, especially when it comes to consumer products.

My wife has a very hard time fining yogurt with normal fat content. We've settled on a product made with whole milk by Stonyfield that is available in most grocery stores in Colorado.

yes really hard to buy a fullfat yogurt... I try to buy them for my children and all they have is lowfat & nofat.

Oh good, I was getting worried that my quesadilla and cereal diet was unhealthy.

PSA: Death is coming. You are going to die. Your parents are going to die. Your kids are going to die. Everyone you know is going to die.

Are there things which you can do to reduce your risk of dying earlier than the average person born at the same time as you? Sure.

Are there things which you can do to definitely prolong your life? No.

Death is a statistics game and 1 out of every 1 people will die at some point in their life.

I don't begrudge anyone their interest in dietary/health news, but articles like this get tossed about as justifications for making huge swings in your diet or telling others to do the same. Whenever I see things like this, it strikes me the same as an article like "The next iphone will use transparent, flexible, waterproof plastic".

Like engineering, your diet involves making tradeoffs about the food you input into your body, optimizing for a desired result (in terms of longevity of life, physical capability while alive, enjoyment of food you are eating, scarcity of resources, environmental impact, cruelty to animals - perceived or otherwise, etc.). Also like engineering, there are hard constraints which hem in the possible solution space. Pick your desired result, and make the tradeoffs you want, just don't forget the hard constraint that death is coming, my friends.

Anecdotally, this might be more on-my-mind than usual because my 66-year-old uncle, who eats fish, fresh fruit and vegetables, and jogs every day, collapsed this weekend from a heart attack and is now in the hospital in a coma. I would have said the above regardless, but it's a rather poignant reminder for me at the moment.

senescence researchers want to have a word with you :p

Then they got hit by a truck ^_^

never run into trucks, they're very unfriendly

Am I missing something or is there not a single link to the study in this article? Didn't see it anywhere on mobile.

After the title there isn't really any info about dietary fats but instead will read about how basically all this study may have found is that those doing "low fat diets" might end up eating really crappy carbs. I can't find the link to the study though so maybe they found something else..

I don't think people eating crappy carbs and drinking soda could really be considered "dieters" they seem more like "unhealthy eaters who happen to be eating low fat".

From the article: "Those doing so tended to eat far too much stodgy food like bread, pasta and rice, the experts said, while missing out on vital nutrients.

Participants eating the highest levels of carbohydrates – particularly refined sugars found in fizzy drinks and processed meals – faced a 28 per cent higher risk of early death."

Also their suggestion goes on to say a good balance is 35% of calories from fat which I would say is still fairly 'low-fat' of a diet IMO but I guess that's pretty subjective and I'm not a dietician.

Very regrettably, most newspapers still do not link to the original journal article when discussing academic work. Even places like the NY Times started doing this routinely only a few years ago, more than a decade after it become trivially easy to do technically.

It's not just academic studies, journalists very frequently don't cite their sources for many factual claims. Their editors and them knowing what or whom it is is way too often enough for them.

It rubs me the wrong way. It feels a lot like: "We know better and can tell you what to think. We don't need to show our work."

That said, it has been getting better, especially for the tech savy younger generation with Twitter links (:P), but their editors are probably trying to keep the number of hyperlinks relatively low.

That's why I like the BBC; they link to the study the article is discussing, and have always done so.

Sigh... this article presents a false dichotomy: you either eat a high fat diet, or you mostly eat refined carbs.

Based on dozens of nutritionists I've talked to, focusing on macronutrients as the primary metric is not great. Personally, I look at these things before macros: is it plant-based, is it whole (not refined/processed).

Your body has minimum protein (and types of protein, AKA essential aminos) and fat (and types of fat, essential fatty acids) requirements, or you will die. And that is not a clickbait headline. So hitting those macros are vital even if you are focusing on whole foods

> Your body has minimum protein (and types of protein, AKA essential aminos) and fat (and types of fat, essential fatty acids) requirements, or you will die. And that is not a clickbait headline.

Yeah it is. Well, it would be, if people ever talked about amino acids in headlines.

People die of malnutrition, but good luck finding a population where people dying because they missed out on a specific amino acid is even remotely commonplace. Seriously, to whom does that happen?

https://mobile.nytimes.com/2007/05/21/opinion/21planck.html

Also, http://m.med-health.net/protein-deficiency-diseases.html

These are extraordinary examples that amount to clickbait.

In addition to the American vegan baby who died in 2004 that I linked above, here are some more extraordinary examples.

French vegan baby dead (2008) https://www.theguardian.com/world/2011/mar/29/vegans-trial-d...

Belgian vegan baby dead (2014) http://www.bbc.com/news/world-europe-40274493

Italian vegan baby almost dies (2016) https://broadly.vice.com/en_us/article/4xkk3n/couple-lose-cu...

Another Italian vegan baby almost dies (2016) https://www.thelocal.it/20160629/two-year-old-in-serious-con...

Futhermore, malnutrition - divided into a)protein deficiency, which is the biggest component, and b)micronutrient deficiency - is globally the most important risk factor for illness and death. Over 19% of young children in India have a protein deficiency[1] and over 41% of young children in rural Nigeria[2]. It's obviously worse in undeveloped nations but check the dead babies above if you think it can't happen in the developed world too.

[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005205/ [2]https://www.ncbi.nlm.nih.gov/pubmed/10768411

These are tragic instances of children being underfed or, in the case of the 'vegan babies,' being fed very, very stupidly. Babies should be breastfed and children should get enough to eat. I don't think any mainstream or even oddball medical or dietary understanding is being challenged here.

(promulgating the myth that "complete proteins" are an important idea is still bothersome, but now I'm not sure that's what you were doing)

Do you think someone can survive without getting "complete protein" (aka all essential amino acids)?

The issue I have is with the dietary trend of pairing foods in order to obtain a "complete protein," which is extremely silly. Dying because one of the amino acids is not represented in your diet is something that basically never happens to a well fed person (it would take an extreme example, and the internet can supply those, but...) so I have no issue with it one way or the other in a discussion about diet.

If by "well-fed" you mean getting enough total calories, you are still mistaken.

Kwashiorkor is the condition of not enough protein while actually getting "enough" total calories. What's more, low overall protein intake actually increase your need for essential aminos, due to the body synthesizing non-essentials from its supply of essentials.

There are also serious health effects (eventually leading to death) associated with deficiencies in specific essential aminos. Lysine deficiency is one. You only need 28mg a day but if you are eating mostly wheat it can happen.[1] If you are lysine deficient it comes with its own disorders and it also leads to micronutrient deficiency.

[1]http://www.pnas.org/content/101/22/8285.long

> Your body has minimum protein [macronutrient] requirements

True, but counting macros isn't a practical framework for eating well. Empirically, the US obesity epidemic is not about people missing macronutrient goals; it comes from eating low-quality processed pseudo-foods.

I agree with you, but I'm suggesting hitting (for example) at least 50g complete protein and 50g fat as a requirement of whatever whole foods requirements you want to set. Going on a fruit- or juice-only diet for two weeks could be pretty painful otherwise.

Yeah that's fair - making sure macros are not totally off makes sense.

This article is an example of one reason why AMP is bad. I'm on a laptop and still seeing the AMP (restricted) version. I just saw a blank screen and it took about 4 seconds for any content to appear. The publisher was prevented from displaying their full website to me, because someone linked to the AMP version.

I keep thinking that diet, and fitness in general, is a complex thing to keep track of. I'm reminded that the wealthy, who can afford a personal trainer or physician to give advice for a significant proportion of the time would be better able to manage this, and I wonder when it will be that our own personal digital assistants will be able to help more of us do that.

Problem is of course, privacy.. if Ltd create a PDA which monitors you, then it is Ltd who are doing that for their own purposes. If the PDA is owned by the people who use it, that is better.. but thats unlikely to happen I fear.

I keep seeing the argument that only the wealthy can afford a healthy diet. I just don't buy it. At least in western countries, anybody can do it, it's not that hard. Getting the basics right is just a google search away. Buying reasonably healthy food is not that expensive, and preparation doesn't take long. I know that because I prepare my food myself and it doesn't take me more than two or three hours per week.

Oats and nuts, maybe some fruit for breakfast. Lentils, potatoes, or rice; frozen veggies and some protein for lunch. Sandwiches or eggs with some veggies for dinner. It might not be perfect, but it's certainly not terribly unhealthy.

It gets more difficult when you're cooking for/dining with your family and not everyone's on board with sandwich and egg dinners all the time. Kids, yeah, they'll eat what you give them (sooner or later) but a spouse/SO is another matter. Not impossible, but harder.

Exercise, diet, just so much easier when you're single. Stupid-easy. And before kids, especially the exercise part.

the privacy problem is solved by free software and self-hosted/self-contained solutions. of course, there is a potential revenue problem, but there's always hosting, support, and other angles you can take to make monies.

Or, y'know, they could charge money for it and not sell the private stuff because they are making money. Comply with HIPAA etc.

https://www.hhs.gov/hipaa/for-professionals/privacy/laws-reg...

Not too much and not too little, seems to be the way to go. But, given the amount of previous research about harmful effects of fat, it's hard to tell whether this is just an outlier. In fact I wouldn't be surprised if "High-fat diet could kill you, major study shows" has appeared in headlines more than once.

"Loosening the restriction on total fat and saturated fat and imposing limits on carbohydrates when high to reduce intake to moderate levels would be optimal."

Emphasis mine. What...?

> But, given the amount of previous research about harmful effects of fat

Dietary fat has been shown to be healthy over and over again. There's nothing controversial about saying dietary fat is good for you; it is established science at this point.

I believe what the quote was trying to say about saturated fat is that they feel it is less dangerous than carbohydrates and sugars, and while the UK food industry has been busy trying to reduce the amount of saturated fat, they've sometimes been replacing them with sugar/carbohydrate ingredients which could be even worse for your health.

It is frankly disappointing that even thirty years later, many people still believe that dietary fat is unhealthy.

Because people think fat in nutrition = fat in the body. And looking at the amount of low-fat products on the shelves, people just don't care enough to work out the difference themselves.

Not to mention the government and most nutritionists have lied about cholesterol and saturated fat for what, like 40 years now?

https://www.amazon.com/Death-Food-Pyramid-Politics-Interests...

Not an easy task when the medical profession and governments have said that fat in nutrition == fat in the body for decades.

With this kind of "science" in our history it isn't surprising that many don't believe today's climate scientists.

Hmm? https://www.hsph.harvard.edu/nutritionsource/2016/12/19/satu...

I would take the results of this with a grain of salt. Linking saturated fats and coronary heart disease is not as simple as we'd like it to be. The first reference this article lists in particular has many reasons to stay skeptical[1].

[1] http://www.bmj.com/content/355/bmj.i5796/rr-4

fwiw: https://www.xperthealth.org.uk/Home/News/ArtMID/454/ArticleI...

The usual pattern of research is for randomised controlled trials (RCTs) to be performed to confirm or deny trends identified in observational studies. In the case of SFAs however, there have already been a number of RCTs performed; and even a number of systematic reviews and meta-analyses pooling their outcomes (e.g. 6-11). This raises the immediate question, why are observational studies still being produced on the subject? It is notable that the evidence from these RCT’s and meta-analyses does not support the conclusions of the Harvard Group’s observational data. For example, a recent Cochrane review (the gold-standard of evidence) found that there was no statistical difference in all-cause or cardiovascular disease mortality in participants with higher SFA intake (12).

There's a difference between dietary and saturated fat.

Saturated fat is specific, "dietary fat" isn't.

It's way too easy to binge on carbs and it's really really hard to eat too much fat. I've guzzled 6 packs of beer and eaten entire pizzas in a sitting more times than I care to admit. (Also because I lost count after the first dozen times or so).

Now that I'm on a low-carb high-fat diet, I find myself eating until I'm full, and at that point I simply have too much fat and protein in my stomach for my body to even want any more food, so I stop. Then I wake up the next morning to find yet another half-pound of body fat has mysteriously vanished and my clothes fit better.

I switched to a roughly 40/30/30 split of carbs/protein/fat (including lots of saturated fat and at least 120g of protein/day) a couple of years ago. I have never been so lean and my athletic performance has improved hugely.

Saturated fat is my friend.

I'm assuming "when high" refers to carbohydrate intake.

Though really, the sentence works regardless /s.

Whenever I ask who we should send to colonize Mars, I humorously propose Bedouins since they are use to living in the harsh desert climate. Joke aside, inside our cultural realm the most sustainable group seems to be the "family in 50s". I take the same approach to dieting, eating a normal portion of variated traditional food will give you all the nutrients you need. Naturally not arguing that you should reject scientific studies.

  early death

So... what exactly does that mean? Before 50? Under 65? Any age lower than normal? Anything earlier than expected? Especially if injured or ill, for any reason? Otherwise healthy?

  ...risk

  ...heart attack

I don't know what these vague qualitative assessments indicate. Link between "risk" of heart attack and "low-fat" diet?

Another article covering the same story, minus the scary headline:

http://www.cbc.ca/news/health/canadian-researchers-fat-carbo...

I think the real news here is that the NHS, FDA, and all other government agencies cannot be trusted. They lie to make money for corporations. Following their recommendations is just stupid. That'd be a good thing for parents to teach their children.

This isn't the most reputable source, but there are a lot of good points in here https://www.youtube.com/watch?v=oLtQLDptI1g

You don't need carbs to survive. You do need both fats and proteins (for production of hormones and tissues).

You can get glucose through glucogenesis of fats AND proteins not just carbs.

Stick to getting 1/3 of your calories from each one of 3 main groups: carbs, proteins and fat. And while you're at it, stick to good carbs and good fat.

I'm still confused if apoe4s should do a low fat diet?

I've seen it recommended but with all the damage carbs can do I'm thinking high fat is still the way to go?

Carbs get a bad rap these days, but provided most of your carbohydrates are complex, you really shouldn't be concerned. The trouble is with the lack of satiety response for foods high in simple sugars without mitigating factors (fruit juices, table sucrose, table syrups, and to a lesser extent honey). In addition, people differ genetically and this can affect optimal intake. For instance, I do well on a diet with lots of starchy carbohydrates, so my diet is based primarily on bread, steamed grain (rice, wheat, quinoa) and green vegetables (bok choy, spinach, broccoli), but I try to limit simple sugars.

There are fads of forsaking entire categories of macronutrient because this is the simplest thing to explain after counting calories.

Don't know why people think fat is bad in the first place. But then again I have been keto for ~2 years. ¯\_(ツ)_/¯

Did they consider that people who are unhealthy are more likely to be told to avoid fat?

There may be some selection bias.

seems like articles like this are always read as justification for KFC, butter, cheese and burgers rather than "hey maybe eating all those nuts and avocados is a good idea???"

There is nothing wrong with butter and cheese, unless you happen to be fat and are trying to eat fewer calories. The main thing to avoid in burgers are the buns.

Even if you are fat there’s nothing wrong with butter and cheese. Especially if you are fat, IMO.

Correct, I was being a bit tongue in cheek.

as a consumer I don't know what to believe.

It seems like every other day some counter study is released.

I gave up and just decided to eat whatever the fuck I want.

It is not too complicated. Eliminate or significantly reduce, bread, potatoes, rice, skim milk, sugary stuff, and cereals from your diet and you will be healthier.

At our household we just got rid of bread and starch/carb sides and serve more vegetables to make up for it.

more vegetables, legumes, and beans to make up for it.

I switched my Western diet to strictly vegetarian Korean dishes a decade ago and feel so much better.

Basically, what I learned is that Western diet is designed to kill you. There's just no way all that carb and sugar is healthy.

And yet people in the blue zones eat quite a bit of carbs. Sardinians eat noodles, people on Okinawa eat rice...

Thats exactly what many in the food industry intended. It is the same plan as the tobacco industry, as seen in the famous "Doubt is our product" memo: http://www.kevinhabits.com/doubt-is-our-product-fascinating-...

Everything can eventually kill you all studies show.

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