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Dr. Echo - re: LOW FAT diet. Be OPEN to EVIDENCE.


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#1 calmcookie

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Posted 08 February 2006 - 11:39 AM

Dr. Echo,

I understand what you're saying about dietary fat ... I had the same view for 21 years and taught that to my patients (as a Clinical Nurse Specialist in Diabetes). BUT, PLEASE BE OPEN TO THE POSSIBILITY THAT THIS IS SIMPLY NOT TRUE. Have you ever read "The Diabetes Solution" by Dr. Richard K. Bernstein? He has had type 1 diabetes for 53 years and is an MD and diabetes specialist in New York. He eats a very high fat diet (both saturated and monounsatured) and was able to reverse his retinopathy, kidney failure and atherosclerosis. This is not just an anecdotal account ... others have followed his approach, with great success. I have sent patients to his clinic.

His book was recommended to me by a 72 year old Professor of Nutrition, from the University of Toronto (Dr. Bob Bruce MD, PhD). Bottom line is ... if you are OPEN to looking at that book, I believe your view on fat may be altered. If not, that's your choice.

Caveat: The problem with SATURATED (animal based) fat is that for certain genetic types, it will increase appetite and make people eat MORE FOOD. That's what causes the study results on the "hazards" of dietary fat. For that reason, monounsaturates are preferred (olive oil, canola, nuts, avocados etc). But it is not FAT, per se, that is causing problems ... it's appetite stimulation, leading to excess calories.

I wish you well, C.C.

Edited by calmcookie, 08 February 2006 - 11:48 AM.


#2 Echo

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Posted 09 February 2006 - 01:21 AM

CC Why the giant/cap/bold letters, I can't help but think you are shouting at me. As we found out before, we're probably more on the same track than would appear at first glance. The benefits of reducing atherosclerosis and heart attacks with very low fat diets is very well documented going back to the Posch trial in the 1970's, continuing with the work of Dean Ornish. More recently and locally, look up the work of Dr. Lance Gould at the Texas Med Center demonstrating amazing improvements in coronary circulation demonstrated by PET scans after low fat diets. That's not to say that this is the only way or the best way. There are drawbacks and most people can't stick with such a diet for life. Other dietary interventions can be beneficial also. some may be better to prevent/control diabetes, others for weight, others for this or that. Moreover, many thin people with good diets have very high LDL cholesterols and it all has to do with LDL receptors and clearance. In addition, you can only get minor benefits with dietary interventions unless folks really get compulsive about it and totally gungho. that's one of the reasons for the lack of benefit in the study quoted by RogerD yesterday. The study came out in JAMA and scanning through it, the low fat group only lowered their cholesterol by some 2-4% if I recall correctly. That's nothing, so you get nothing. All patients should eat a proper diet and exercise and lose weight to a normal BMI, but in clinical practice, the real reduction in death, heart attack, strokes, and acute coronary syndromes comes with drastic lowering of LDL cholesterol that can be achieved with statin drugs such as lovastatin/Mevacor, simvastatin/Zocor, atorvastatin/Lipitor, prevastatin/Pravachol, fluvastatin/Lescol, and rosuvastatin/Crestor with or without Zetia. Now listen everybody, including you CC: Every major prospective randomized placebo controlled trial all over the world with any of these drugs with hundreds of thousands of patients has proven this dozens of times over. There is no debate or discussion on this one point except by extremists blinded to the truth. It is to the point that it is morally unconscienable to do a secondary prevention trial say on heart attack victims and have a placebo arm where half the patients don't get a statin. Can't do that study anymore in the civilized world. Morally repugnant to deny half the patients proven care. You can now only do comparative trials and each study seems to show that pounding the LDL lower and lower is better. Notice I've shift the discussion away from DIET, as most patients only seem to have a minor impact in the area. Hope this clears things up. Echo