Some comments on diet made by Dr Davis last year:
In the four years since the original Track Your Plaque book was written, we've learned an enormous amount about the value of different diet approaches, particularly by way of small LDL observations. Small LDL is without a doubt the number one reason people end up with coronary plaque. Wheat and processed carbohydrates are the culprits in causing small LDL, not fats. The entire Track Your Plaque diet is going to be rewritten. It will actually resemble the original advice from the book, but the entire fat conversation needs to be replaced with one that does NOT restrict fat. However, I am not as accepting of saturated fats as Gary Taubes and others. As much as I've resisted this idea, there may be a need to dissect saturated fats down to its fatty acid components and pick and choose among various saturated fat sources to discover what is desirable or undesirable. However, I need to reflect on this issue some more and that's why I'm dragging my feet on reissuing the diet.
>>>>>I also remain uncertain on how much we need to micromanage our fat intake and composition. I believe that a review of the original saturated fat feeding studies will be required, much as Taubes did for his wonderful book. Another twist is that meat in 2007 is not the same as meat in 1927--saturated fat content and composition is different due to livestock raising practices; hormones and antibiotics introduce some other differences. Should we eat organic free-range meat only? If possible, I believe that we should
>>>>>>>>>One of the great difficulties with diet, including the efforts we're making here, is that food is rarely eaten in isolation. Many other factors are changing alongside changes in diet. Re: parameters to track for effects of diet. This list includes small LDL (among the most sensitive), triglycerides and VLDL, HDL, blood sugar, blood pressure, weight, c-reactive protein. You can see that, while food choices affect all these factors, so do other things (weight, fish oil, niacin, vitamin D, etc.). Several things we know for certain about diet relevant to plaque control and regression: --Processed carbohydrates and wheat products are very important causes of small LDL and related patterns. --Low glycemic index foods are desirable over high. --Monounsaturated oils are, at worst, neutral and, at best, antiinflammatory, slightly LDL reducing, HDL raising. --Polyunsaturated oils are proinflammatory. --The omega-3 fatty acid variety of polyunsaturates are the exception with enormous positive health benefits. --Proteins are probably fairly neutral though necessary in some minimum quantity. --Saturated fat raises LDL, raises HDL, but exerts other (uncertain?) effects. When trying to understand the effects of diet on lipid/lipoprotein patterns, the most flagrant association is that of processed/high-glycemic index carbohydrates with small LDL, low HDL, high triglycerides/VLDL/IDL, increased CRP, increased BP, increased blood glucose. |
