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    firestarter's Avatar
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    Question Low carb diet in Sweedish Women = higher incidence of heart disease

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    Found this article when reading 'what doctors won't do' on the Guardian (Guardian article )

    One of the things was follow a low carb diet and the doctor in question cited the following article:

    'Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study'

    I can't see any mention of fat intake in the study (although I am skim-reading as it's work time!), but this is a large sample size.

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    firestarter's Avatar
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    Just been reading it through a bit closer. There was no marking for fat intake at the beginning, and they 'controlled' for fat intake (it looks like that's in terms of energy input) in their analysis.

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    Not sure how anyone in the medical profession can consider this to be a quality study.

    Denise Minger took this one apart a while back.

    Are Low-Carb Diets Killing Sweden? (Also: New Interviews and Raw Vegan Immortality) Raw Food SOS

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    Erik W's Avatar
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    Yes, I read about this study when it was published.

    In a population based cohort study of 43 396 women followed up for an average of about 15.7 years and generating about 680 000 person years, 1270 incident cardiovascular events were recorded. After fine controlling for all assessed cardiovascular risk factors that could act as confounding variables, as well as for total energy and saturated and unsaturated fat intake, we found that women had a statistically significant 5% increase in the incidence of cardiovascular events per 2 unit increase in the 20 unit low carbohydrate-high protein score.
    Note, that is a five percent increase in the risk of a heart condition, not in total number of heart conditions.

    That is not much. Also, I'm a man, not a woman. Hah! The benefits clearly outweigh this drawback that only affects a few. We get lower weight, better health, more energy, better skin. Those whose family has a history of heart disease will simply have to make their own decision about diet.

    Here are the total numbers for the heart conditions, among more than 43,000 women. 2.9% incidences of heart condition in close to sixteen years. (Don't know if each condition was for separate women, or if some women with bad hearts sometimes had a condition coming back.) Doesn't sound that much, and keep in mind many of these heart conditions would have existed anyway.

    Overall, the 43 396 women were followed up for an average of about 15.7 years and generated a total of 680 818 person years, with 1270 incident cardiovascular events (703 ischaemic heart disease, 294 ischaemic stroke, 70 haemorrhagic stroke, 121 subarachnoid haemorrhage, and 82 peripheral arterial disease).
    Last edited by Erik W; 02-05-2013 at 07:14 AM.

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    This was epidemiological and the data was handled very poorly. The issues therein were, as usual, thoroughly handled by the inimitable (that means "hot," right?) Denise Minger here

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    I agree ..... a like minded UK doctor writes interesting posts on primal health and added this one on the subject recently ...

    Still no evidence that the Swedes are killing themselves with low-carb diets | Dr Briffa's Blog - A Good Look at Good Health

    ... have a look at his analysis.

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    yeah,good info,Not sure how anyone in the medical profession can consider this to be a quality study. thank you

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    Quote Originally Posted by usrbin View Post
    Not sure how anyone in the medical profession can consider this to be a quality study.

    Denise Minger took this one apart a while back.

    Are Low-Carb Diets Killing Sweden? (Also: New Interviews and Raw Vegan Immortality) Raw Food SOS
    +1

    Minger is awesome!

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    Erik W's Avatar
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    Quote Originally Posted by RichMahogany View Post
    This was epidemiological and the data was handled very poorly. The issues therein were, as usual, thoroughly handled by the inimitable (that means "hot," right?) Denise Minger here
    Good link. Especially noteworthy is what she says about food surveys. Note that the women in the study were not studied first to see what they were eating. They only got to fill out a questionnaire about what food they had been eating the last six months. Point by point, item by item. Such questionnaires are meaningless, because people never get it right. Could anyone here state how many eggs you have had the last six months? How many avocados? How many apples? How much meat, how much chicken, how much lean fish, how much fat fish, porridge, rice, boiled potatoes, fried potatoes, shrimp, etc?

    From Minger's analysis:

    If you haven’t read my Will Eating Red Meat Kill You? guest post on Mark’s Daily Apple from a few months ago (which I can’t hold against you, since I never posted the link!), I recommend hopping over there right now to skim the section on food frequency questionnaires. (If two long blog posts are too much Denise for one day, check out this classic piece by Chris Masterjohn on the unreliability of self-reported data instead.)

    The bottom line—discussed more thoroughly in those aforementioned links—is that bad things happen when you ask people to report what they eat. That badness only amplifies when they’re reporting from memory, and becomes incrementally worse the further back in time you want them to recall. Most folks just aren’t that aware of what goes in their mouths, especially when those things went in their mouths six months ago. As a result, nearly everyone underestimates what they really consume, and some foods—usually the ones we think are bad for us—tend to be a major roulette-wheel spin in terms of accurate reporting. Health-conscious folk may be particularly likely to underreport their intake of “bad” foods out of sheer guilt (who wants those Saturday brownie binges emblazoned forever on paper?). And since not everyone misreports their food intake in a consistent way, no amount of statistical wand-waving can really make up for the inaccuracies in this type of data.
    Not surprisingly, the survey showed a wide range of calorie intake. Many of the women were eating only 1013 calories! According to the survey they filled in. Do you think ten percent of the women were starving to death, or had they filled in the survey wrong?

    (But amazingly, few had more than 2200 calories per day, it seems. Were these women afraid to write down how much chocolate and bad food they had had, perhaps? If you know any women, what do you think?)

    The researchers also focused on "low carb, high protein" in their study. It should be low carb, high fat.

    Furthermore, toward the end of the research paper, the authors actually acknowledge that what they were studying was far from what actual low-carb programs promote: "Among the women studied, carbohydrate intake at the low extreme of the distribution was higher and protein intake at the high extreme of the distribution was lower than the respective intakes prescribed by many weight control diets."

    So their low-carb study wasn't actually a low-carb study, but they still use it to demonize the primal diet.

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    Well, while low-carb diets of all sorts actually have a good standing in Sweden, the majority of the people who follow them obviously don't cut out grains or dairy, plus this article say nothing about fat. This isn't even a good way to record what people eat, it's a joke. As for the 'increased risk', you wanna compare the number of heart attacks in sweden to the number of heart attacks in the states, or the UK, on a per capita?

    Nope, sorry, this is a sad mofo of a research. I can't believe they even bothered to record this shit for 16 years, when they didn't do any planning in advance. This sounds like something somebody made up, and I'm writing this as a swede!

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