The prospective cohort study of more than 135,000 participants from 18 countries finds that nutritive carbohydrates increase human mortality, whereas dietary fat reduces it, calling for a fundamental change of current nutritional guidelines

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13 Oct 2017 16:37 - +1433
This seems to get a little confusing in the middle. The article mentions that dietary sugar has a larger effect on mortality, and in fact, a high carb diet that was low on dietary sugar provided the highest lifespan benefits (in rodents). They conclude, though, that low-carb is the way to go despite this contradictory evidence.
13 Oct 2017 18:18 - +303
> and individuals with pre-existing cardiovascular diseases (but not diabetes) were excluded So you exclude people with cardiovascular disease for which high consumption of saturated fat is suspected to be a factor, but include people with diabetes, for which consumption of refined carbohydrates is a major factor and find a correlation of high carbohydrates consumption and higher mortality?
13 Oct 2017 18:44 - +206
Uhm, yeah, so the referenced study suffer from several methodological problems. The findings from the PURE study in no way supports the bold conclusions drawn from it. A couple of aspects: 1. They lump all carbohydrates together instead of classifying according to quality. Fruits, veggies and whole-grains are not the same as pastries and sodas. It should be mentioned that in most of the countries, refined sugars served as the biggest source of carbohydrates. When they analyzed fruits, veggies and legumes, these food groups were inversely associated with risk of outcomes. 2. Some of the findings may well stem from the fact that data was collected from low-income countries. Bangladesh for instance has rice as the top contributor of not only carbohydrates, but also protein and total fat. This may lead to confounding of the relationship between carbs and outcomes by poverty and malnutrition. To me, it is amazing that this has slipped through the peer review process. 3. In the evaluation of fats and outcomes no assessments were carried out for trans fatty acids which are consumed regularly in South Asia. 4. There are other irregularities in the data such as the estimated fat intake in China which has been reported to be much higher in other studies. This questions the reliability of the methods that was used for data collection. There are large discrepancies in the data, and the data does not seem to support the conclusions. At all. Nobody recommends a high intake of refined carbohydrate and sugars, and nobody should be surprised when carbohdyrates are associated with adverse outcomes when these are the main sources of carbohydates, but also protein and total fats. This does in no way support a LCHF diet like some people are suggesting. The data simply does not match such recommendations.
13 Oct 2017 15:52 - +187
ELI5? I don't know what nutritive carbohydrates mean.
13 Oct 2017 15:20 - +82
13 Oct 2017 17:57 - +68
For those who didn't read it, this is a commentary on the results of the PURE study that came out recently, not new research.
13 Oct 2017 17:07 - +37
13 Oct 2017 19:00 - +36
If they didn't discern between sugar and slow carbs, I can't really see how one can say all carbs are bad.
13 Oct 2017 19:39 - +21
Then why are vegans, who eat little saturated fat and no cholesterol known to have the lowest rates of dietary disease and cancer
13 Oct 2017 19:12 - +9
13 Oct 2017 17:59 - +8
13 Oct 2017 18:28 - +8
13 Oct 2017 18:59 - +7
13 Oct 2017 18:17 - +7
13 Oct 2017 19:13 - +7
13 Oct 2017 19:42 - +5
13 Oct 2017 17:57 - +4
13 Oct 2017 19:27 - +4
Doesn't take into account that poorer countries with bad healthcare are more likely to eat carbohydrate staple foods.
13 Oct 2017 18:33 - +4
13 Oct 2017 19:26 - +3
13 Oct 2017 14:18 - +2
Totally recommend this awesome Joe Rogan podcast on the Keto diet and it’s mental and nutritional benefits. Even if you can’t be ketosis, a modified Atkins or low carb in general delivers awesome benefits.
13 Oct 2017 20:17 - +1
In Japan and other Asian countries they eat a heaping steaming bowl of carbohydrates at every single meal. Yet they seem to live forever. Is that accounted for in this research? Is it to do with the *type* of carbohydrates consumed?
13 Oct 2017 20:50 - +1
I don't have time to read the study in depth right now, but I would argue that this is just another example of the golden rule, "moderation in everything". Carbohydrates are super cheap these days, so most people eat too much of them. Quality fat is not cheap and even low quality fat is not as cheap as carbohydrates. In the past I could see the situation not being so skewed, so possibly people didn't get as much carbohydrates and maybe a bit too much fat, so the correct advice at the time would have been to eat less fat.
13 Oct 2017 21:05 - +1
The sugar lobby disagrees with your findings. Our current diabetic and obesity epidemic has made them rich.
13 Oct 2017 20:17 - +1
What does this mean? What foods are good for me?
13 Oct 2017 20:30 - +1
> However, reconstituting only 10% of energy of the ketogenic diet by sugar abolished this effect (Roberts et al., 2017), suggesting that specifically sugar (rather than carbohydrates in general) has the most relevant effect on lifespan. Along this line, it is also interesting to note that when nutritive sugar content is kept constant, a different (and less extreme) high-carb diet exerts the best effects on murine lifespan. By contrast, a high-fat diet still containing the same amount of sugar, but no other carbs reduced lifespan slightly. Lastly, when combining high-fat and high-carb components from the two previous diets, the worst effect on lifespan was observed (Keipert et al., 2011). Moreover, lifespan extension in mice was also obtained when dietary protein was replaced by carbs, possibly independent of the total uptake in calories (Solon-Biet et al., 2014). Taken together, these studies suggest that dietary sugar may be one important, but not the only, nutritional factor in limiting healthspan in rodents, hence additional studies are definitely required to establish firm evidence in model organisms. > Take from that what you will but it suggests if you have a diet with low suger the carb effect on mortality is reduce and if you have a diet low in fat and/or protein your calorific carbs are irrelevent. In fact a high carb diet seems to have the best outcome: requoting: > Along this line, it is also interesting to note that when nutritive sugar content is kept constant, a different (and less extreme) high-carb diet exerts the best effects on murine lifespan. >
13 Oct 2017 20:30 - +1
This is the study btw:
13 Oct 2017 20:14 - +1
Surely a dietary study using rats is irrelevant to humans. Doesn't our evolutionary history and physiology come into play in studies like this at all?

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