I wonder if this is because it has less to do with fat and carbs and more to do with processed foods.
The Mediterranean diet is regarded as quite healthy by many health professionals but, it is also high in carbs and fat. But these are healthy, unprocessed carbs and fats. Whole grains and olive oil.
People going for high fat, low carb / low fat, high carb are usually doing so while also sticking to real foods.
No, they are not. Dietary cholesterol has little to zero impact on blood cholesterol, and saturated fat we don't have reliable data that points to it being harmful either, when accounting for other influences.
Yes. Sugar (and all of its downstream phenomena - diabetes, insulin resistance, the ease in which sugar adds calories without satiation signals) is well established to contribute to CVD. Long-chain (animal based) sat fat and trans fat is also well established to contribute to CVD. The high calorie density of fatty foods plays a big role, as does the overall palatability and "eatability" of low fiber, high fat, high sugar, delicious foods, making portion control challenging. That should be uncontroversial at this point.
The jury is unclear on:
- How the chain length of sat fats impact things (medium-chain triglycerides seem to be protective, but the boundary between medium and long is fuzzy)
- How the ratio of the various omega-N (3/6/9) unsat fats impacts health, particularly inflammation
- The whole "seed oil" thing is probably MAHA/conspiracy style false signal at the end of the day, but it hasn't been fully debunked and there are almost certainly facets of truth to it (seed oils are a form of ultra-processed food, and all UPFs are problematic)
Confounders, confounders everywhere. This whole field is just extremely challenging and noisy.
There are many people with type 2 diabetes that are not overweight; and also many people with overweight and even obesity who do not develop type 2 diabetes. The estimate is that around 537 million people have diabetes worldwide, while overweight and obesity is estimated to affect 1.1 billion people.
Carbohydrates do cause insulin resistance and diabetes. India has average BMI of 21,9, yet has very high incidence of diabetes - largely thanks to its carbohydrate-based diet.
High-fat high-carb diet certainly is. There is however no conclusive data that high-fat low-carb diet OR low-fat high-carb diet contribute to CVD.
I wonder if this is because it has less to do with fat and carbs and more to do with processed foods.
The Mediterranean diet is regarded as quite healthy by many health professionals but, it is also high in carbs and fat. But these are healthy, unprocessed carbs and fats. Whole grains and olive oil.
People going for high fat, low carb / low fat, high carb are usually doing so while also sticking to real foods.
When people say "fat" is bad for you, they mean saturated fat. Mediterranean diet is quite low on saturated fat, while still having the good fats.
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> There is however no conclusive data that high-fat low-carb diet ... contributes to CVD.
Have to be a little careful with this claim. Dietary saturated fat and cholesterol are problematic either way.
No, they are not. Dietary cholesterol has little to zero impact on blood cholesterol, and saturated fat we don't have reliable data that points to it being harmful either, when accounting for other influences.
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Yes. Sugar (and all of its downstream phenomena - diabetes, insulin resistance, the ease in which sugar adds calories without satiation signals) is well established to contribute to CVD. Long-chain (animal based) sat fat and trans fat is also well established to contribute to CVD. The high calorie density of fatty foods plays a big role, as does the overall palatability and "eatability" of low fiber, high fat, high sugar, delicious foods, making portion control challenging. That should be uncontroversial at this point.
The jury is unclear on:
- How the chain length of sat fats impact things (medium-chain triglycerides seem to be protective, but the boundary between medium and long is fuzzy)
- How the ratio of the various omega-N (3/6/9) unsat fats impacts health, particularly inflammation
- The whole "seed oil" thing is probably MAHA/conspiracy style false signal at the end of the day, but it hasn't been fully debunked and there are almost certainly facets of truth to it (seed oils are a form of ultra-processed food, and all UPFs are problematic)
Confounders, confounders everywhere. This whole field is just extremely challenging and noisy.
Sugar doesn't cause insulin resistance or (type 2) diabetes. Both are a result of being overweight.
Of course, you can get overweight by eating too much sugar, but it's really about not eating too many calories long-term, regardless of the source.
And of course, refined sugar isn't healthy at all and consumption should be kept to a minimum, outside of exercise.
There are many people with type 2 diabetes that are not overweight; and also many people with overweight and even obesity who do not develop type 2 diabetes. The estimate is that around 537 million people have diabetes worldwide, while overweight and obesity is estimated to affect 1.1 billion people.
Carbohydrates do cause insulin resistance and diabetes. India has average BMI of 21,9, yet has very high incidence of diabetes - largely thanks to its carbohydrate-based diet.