Here’s a link to an interesting 30 day dietary intervention study out of Australia where over 5000 people were self selected to participate in a standard program which advocates a low fat, plant based diet.
Here’s the study’s description of the nutrition intervention:
The CHIP intervention, previously described, encouraged and supported participants to move towards a low-fat, plant-based diet ad libitum, with emphasis on the whole-food consumption of grains, legumes, fruits and vegetables. Specifically, the program recommended less than 20% of calories be derived from fat. In addition, participants were encouraged to consume 2-2.5 litres of water daily and limit their daily intake of added sugar, sodium and cholesterol to 40 g, 2,000 mg, and 50 mg respectively. Furthermore, the program encouraged participants to engage in 30 minutes of daily moderate-intensity physical activity and practice stress management techniques.
All the biometrics measured were lowered including HDL. HDL dropped 8.7% on average and was worse if the individual started out at a higher level. Of note the LDL and Triglycerides dropped some too. They changed more than the HDL typically so the ratios of LDL:HDL and Total Chol:HDL improved.
Interestingly, 323 participants resolved their diagnosis of Metabolic Syndrome because of their changes but 257 participants acquired the diagnosis of Metabolic Syndrome typically because of their lower HDL numbers.
The study didn’t disclose percentages of fat, protein, and carbohydrates that the participants were eating nor do we know if they measured them. So it leaves the question of what exactly caused the changes. A diet with a lower fat intake, in my experience, is replaced with higher carbohydrate intake with a relatively stable level of protein. Think about yogurt. All the yogurt is low fat but plain yogurt is not very palatable so they add fruit and flavorings (ie, carbohydrates). However this is my speculation only.
From experience, I see HDLs routinely rise as patient’s carbohydrate intake drops. We know that a low HDL is one of the most risky signs of cardiovascular disease, too.
Remember that humans can’t eat a zero protein or zero fat diet and live healthy nor long. They can, and many do, eat zero carb diets and remain very healthy. That puts carbohydrates in a different category as proteins and fats.
The Syndrome That’s Sweeping the Nation
One of the most common and damaging diagnoses I see day in and day out is one whose name many of my readers have heard little about. It is a syndrome that is epidemic in the U.S. with a staggering 1/3 of adults meeting its diagnostic criteria. It parallels the rapid increase in overweight and obesity in the U.S. (with 2/3 of adults now falling in these categories). With obesity occurring in children and adolescents at three times the rate that was present in the 1960’s, this syndrome is also becoming more prevalent in these younger ages as well.
One “catches” the syndrome by lack of exercise, having a poor diet (especially one high in simple carbohydrates – sugars and starches), and putting on belly fat. Hours logged in front of the TV, computer, or video games sipping sweet drinks or beer and munching on carbs puts us on the fast lane to developing this malady. The condition we’re talking about is called metabolic syndrome.
Metabolic syndrome arises from insulin resistance in the body and increased fat deposition. Over time, as we fall into a lifestyle that has little regular exercise and lots of starchy or sugary meals, the insulin produced by our pancreas has less and less effect in the body. Eventually our blood sugar starts to rise, despite there being plenty of insulin circulating.
This situation has numerous negative effects on the body. That’s why metabolic syndrome is a risk factor for heart disease, stroke, diabetes, fatty liver, sleep apnea, and several cancers, including colon, kidney and breast. There is even some evidence that it accelerates cognitive (brain function) aging and deterioration.
How is this syndrome diagnosed – how do I know if I have it? The diagnosis is based on having at least 3 of the following 5 characteristics:
- Fasting glucose ≥100 mg/dL (or on meds for diabetes or high blood sugar)
- Blood pressure ≥130/85 mm Hg (or on meds for high blood pressure)
- Triglycerides ≥150 mg/dL (or on meds for high triglycerides)
- HDL-C (“good cholesterol”) < 40 mg/dL in men or < 50 mg/dL in women (or on meds)
- Waist circumference ≥40 inches in men or ≥35 inches in women; if Asian American, ≥ 35 inches in men or ≥ 32 inches in women
Yes, metabolic syndrome can be treated with numerous medications that help reduce blood sugar, lower triglycerides and control high blood pressure. But that’s not the first way to go about this. The real core of treatment involves turning around the habits that got us there in the first place. A healthy low carb diet and a 30 minute brisk (3 to 4 mile per hour pace) walk 5-6 times per week (or the equivalent on a stationary bike, elliptical, swimming, etc.) producing a slow weight loss can typically cure, or greatly improve this syndrome. Of course the challenge is actually doing this and sticking with it. Finding a group or partner to do it with is hugely helpful here. And the health rewards are enormous as you begin to feel better, get your energy back, and minimize the long list of complications of metabolic syndrome.
Beyond the daunting personal impact of metabolic syndrome is the fact that if we try to treat it only with medicines, or if we just wait for all of its complications to show up and then treat them, it will absolutely overwhelm the health system in our country. So if you caught this syndrome, or see yourself heading that way, find a partner and start working on the self-cure. You may or may not need a little help from a medicine, but your efforts are the cornerstone of the cure. So don’t be trendy on this one; make the effort to help this popular syndrome pass you by.
Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville. Contact him at 982-0835