Re: Dr. McDougall's Recommendations:

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On Fri, 07 Oct 2005 19:24:24 GMT, "Thomas Muffaletto"
<mrgantlet911@xxxxxxxxx> wrote:

>
>
>"Quentin Grady" <quentin@xxxxxxxxxxxxxxx> wrote in message
>news:8aabk1pdjhifuo2sig8csj389boh7q91tu@xxxxxxxxxx
>
>> G'day G'day Tom,
>>
>> The question Loretta asked is "Who is Dr McDougall?"
>
>i wasnt replying to her question to you but your comment of
>
>"The ADA diet allows up to 30% fat by calories."
>
>and that simply isnt true. as you have seen they can see the need for some
>to have upto about 40% of their callories from fat.
>and that is above "up to 30%."

G'day G'day Thomas,

It appears you are correct. The American Dietetic Association and the
American Heart Foundation currently make the recommendation of up to
30% of calories by fat. The American Diabetic Association held a
similar position until recently. Their position is now more flexible.
Their expert consensus allows a combination of monounsaturated fat and
carbohydrate of approximately 60?70% of energy. If one had 55% of
calories from carbs then at most that gives 15% of monounsaturated
fat. Suggested polyunsaturated fats are put at 10%, saturated fats at
less than 10% or 7% depending on LDL levels. That makes a total of
35% fat unless one reduces carbs.


Let's examine that point together.

To refresh our memories here is the quote you base your arguments on.

> Fat ought to make up about 30% of your calories.
> The total amount of fat you eat should be based on the foods
> you like and your goals for eating healthy and blood lipid
>(blood fats) and glucose control. You need an individualized
> eating plan. For example, a young athlete with type 1 diabetes
> might need 4,000 calories a day during football season.
> He probably needs to eat 40% of his calories from fat, just to
> get all those calories. Even though he is eating a higher number
> of calories as fat, he still should choose foods with less
> saturated fat and cholesterol and more monounsaturated fat
> (such as olive oil, canola oil, avocado, nuts, or olives).

Firstly the general recommendation stated without any ifs or buts.

> Fat ought to make up about 30% of your calories.

Put simply, the ADA makes the general recommendation for fat to make
up about 30% of calories. Then it adds a bit of common sense ie
adjustment for individual needs. Never the less the general
recommendation is for about 30% ie a moderate carb level not as is
sometimes stated a low fat level. Don't be fooled though by the
apparent flexibility the only area where fats are allowed to replace
carbs is with monounsaturated fats. This coincides with the option I
have been suggesting to newbies here for years ... some carb can be
replaced with cis-monounsaturated fats eg olive, avocado, nuts and
olives. I am NOT a fan of canola oil because it is often stabilized by
partial hydrogenation that produces a contaminant called
trans-monounsaturated. (The ADA along with many other authorities
recommends trans-monounsaturated fat should be kept to a minimum.)

OK, now let's all look at the counter example quoted.

> For example, a young athlete with type 1 diabetes
> might need 4,000 calories a day during football season.


INHO, the logic given is basically poppy *** to appeal to the
unthinking mind. If you are up for it you will find it helpful to take
a look at these US government guidelines.

http://www.health.gov/dietaryguidelines/dga2005/document/html/chapter2.htm#table3
http://tinyurl.com/75eu6

The highest calorie recommended intake is for a 14 to 18 male and that
is 3200 kJ. All other active people are 3000 kiloCalories or less.

Put simply, the diabetic featured in the counter example is
exceptional. Not only is the diabetic a T1 which makes the case
exceptional but his calorie intake is 25% higher than that recommended
for an active male.

If the footballer had been say a female gymnast then the maximum
recommended calorie intake for an active person is 2400 kCal which
makes 4000kCal 67% in excess of recommendations.

The requirements for calories forms part of their argument. Actually
it doesn't really matter if footballers fit into some category of
"super" active and actually do require 4000 kCal per day. The point is
they are exceptions to the general recommendations.

OK, the real junko logic is ...
> He probably needs to eat 40% of his calories from fat, just to
> get all those calories.

Fat has a 125% higher calorific value per 100 g than carbohydrate or
protein. Why doesn't this mean one should eat a high fat diet if one
needs a high calories intake? Well water has 100% less calories than
carbohydrate and real foods that people eat a mixture of fat,
carbohydrate, protein, water and fibre amongst other things.

http://www.avocado.org/health-nutrition/nutrition-facts.php
gives 55 kCal per 30 grams.
That equates to 183 kCal per 100 g.

http://www.weightlossforall.com/calories-bread.htm
gives a range of values ALL in excess of 216 kCal per 100 g.
The 216 kCal per 100 g is for a truly low fat bread described as
wholemeal bread.

Once the junko logic has been stripped from the ADA argument we see
that is would have been more appropriate to recommend eating wholemeal
bread if getting sufficient calories was their concern.

> Even though he is eating a higher number of calories as fat,
> he still should choose foods with less saturated fat and cholesterol
> and more monounsaturated fat(such as olive oil, canola oil, avocado, nuts, or olives).

Well the good news is that the ADA DOES recognise the Mediterranean
diet, something the rest of the world did years ago without the
expenditure of millions of dollars. I was well aware they had been
part sponsors for a high oleic acid diet(the cis-monounsaturated found
in olive oil amongst other things) and that it had been highly
successful in changing certain parameters associated with diabetic
risk factors. I was mistaken in thinking it hadn't appeared in their
simplified public recommendations. It has been in the expert opinions
for quite a few years. Sort of now you see, now you don't.

>> Dr McDougall happens to believe the ADA is making a general
>> recommendation of 30% calories fat.
>
>well he is right about that - a general recommendation of 30% but anyone
>that read a few pages on their web site would realize they dont want anyone
> to go to that web site or any book to deveolop a diet.
>or esle their simply wouldnt be a need to recommend dietitians as often as
>they do.

Fair enough point.

>>>Fat ought to make up about 30% of your calories.
>>
>> Your cut and paste give above confirms that Dr McDougall is reasonable
>> holding this belief.
>
>i wasnt questioning him but did point out that you saying "up to 30%" simply
>isnt true.
>30% is a general recommendation and not the maximum .

>> Since Dr McDougal espouses an ultra low fat diet, 7 to 10% of calories
>> from fat, perhaps we shouldn't upset him by mentioning exceptions that
>> exceed the general ADA rule you quote. "Fat ought to make up about 30%
>> of your calories."
>
>I cant really picture a Dr. reading this group. so i dont think he will be
>to upset.

He might but its pretty certain he won't post here. Imagine for a
moment the raucous duck impersonations from the gallery of regulars
and the insistent questions on post prandial blood glucose levels when
one has a C:P:F ratio similar to 80:10:10

>> The paragraph you omitted
>>
>> "Conversely, a small woman with type 2 diabetes who needs to lose some
>> weight, may need to keep the amount of fat she eats at about 25% of
>> calories or below to achieve her nutrition and diabetes goals."
>>
>> Clearly 25% fat is still way, way higher than Dr McDougall's idea of
>> low fat.
>
>
>
>i left it out because it had nothing to do with you saying " that the ADA
>allows up to 30% "
>i simply gave an example when they might recommend 40% of calories from fat.
>and clearly 30% fat is lower than 40% fat.
>however I am glad you metioned that. i hear just about every low carber
>here say the ADA thinks one size fits all and in this 1 thread i see a range >of recommendations from 25% to 40% from the ADA - does atkins or bernstien
>or any other low car book seller have such a wide range of general >recommendations? so if anyone thinks a 1 size fits all its not
>the leading organizations around the world
>more like just those selling low carb books.

The 40% calories from fat is

A exceptional, the ADA quotes it for a T1 super athlete.

B comes with tight restrictions, that is the tolerance of fats is
restricted to cis-monounsaturated fats which in practice means oleic
acid.

I happen to agree with their tight restrictions to oleic acid and am
personally comfortable with them being tighter. I wouldn't restrict
the replace of carbs by oleic acid to super active T1 males, though.
IMHO, it makes sense for overweight sedentary T2s ... at least it does
to those who can heed the restrictions.

>>>that might be close to what my dietitian told my wife to eat.
>>
>> Might be? Either it is or it isn't.
>
>
>very true
>
>
>>
>>>she was told to eat close to 1/2 of what I was told to eat.

Well I guess we shall never know whether in fact she eats close to
half the fat you eat ... unless you do some number crunching and are
more forthcoming with the information.

>>>> With regard to protein he surprisingly finds the 13 to 15% protein
>>>> typical in the US and the ADA diet as too high.
>>>> He suggests it leads to kidney failure in old age.
>>>> As you may guess others disagree pointing out that some amino acids
>>>> eg arginine found in larger proportions in vegetable proteins repair
>>>> kidney damage.
>>>
>>>
>>>that would be very hard to prove.
>>
>> It is an ongoing controversy.
>
>yes but if you look at who is saying what. even the doctors that review
>studies
>not sponsered by beef, egg and cheese companies and clearly speak out in
>favor of the low carb results in short term studies
>always add the bit about " not enough informaton on the effects of long term
>saftey for diets higher in fat"
>its very hard to prove anything with any study and im sure you will agree
>that at this point
>more scientists around the world are in favor on low fat diets for long term
>use than those are in favor of high fat diets.

This comment I find most fascinating. In your posts you have praised
the money the ADA has spent on nutrition research and pointed out that
they are now including the replacement of carbs by monounsaturated
fats as a HEALTHY option. You have made much of the rather
exceptional example of a T1 footballer having 40% of calories by fat
yet somehow deep down you still believe the ADA recommends a low fat
diet and that this is the prevailing scientific opinion.

Firstly of course the ADA general recommendation is for a moderate fat
diet.

Secondly they don't say a thing in their recommendation about "not
enough information on the effects of long term safety for diets higher
in fat" when they restrict fat substitution to oleic acid.

>in the real world - the scientific world of nutrtion you can say its the
>exact opposite of what goes on here.

I think you are generalizing.

My recommendations have been for T2 diabetics to be aware of the
option of replacing some carbs with cis-monounsaturated fats from
essentially unprocessed sources. There's nothing particular
impressive about that, it is simply that I've aligned myself with the
scientific world of nutrition in this matter. My impression is that in
ASD there are many who have adopted a diet that uses the same general
principle. Some have found this option for themselves from reading the
literature. Some have adopted the principle from following the
examples of success enjoyed by others.

There are some who DON'T except the notion of restricting the
replacement of some carbs with cis-monounsaturated fats. Some of these
are neo-Atkinites. They exist but don't appear to be in the majority
here. Perhaps it is a matter of perception ie perhaps they irritate
you more.

For years I made it pretty plain that I regard the followers of Atkins
as lacking in ambition. IMHO it is so easy to improve upon. South
Beach is one improvement. The Hamptons Diet is another. BOTH go
along the scientific community to approve the replacement of
carbohydrates with oleic acid.

>in here there are more those in favor higher fat diets and saying it is
>healthier than low fat diets
>but in the scientific world after reviewing millions of dollors and hours of
>research they are in favor
>of diets low in fat.

The ADA favours moderate fat even if they call it low fat.

>who is right ?

And for whom?

The Okinawans who have until recently had four times the number of
centenarians than the mainland Japanese have a diet that is about 23%
protein, 22% fat and 50% carbs. Note that their protein level is
higher and their fat lower that typical.

The ADA position is,
"No evidence to suggest that usual protein intake (15?20% of total
energy) be modified if renal function is normal"
(B level evidence)

The people of Crete who were previously had the healthiest diet as
assessed by longevity had up to 40% of calories from fat mostly oleic
acid from olive, almonds and now avocados.

The point is that percentages of macronutrients aren't as important as
some people would make out. Work it out with a dietitian if you like
and ultimately check it out with reality. Each of us is different.
The majority opinion here seems to be to test, test, test and use that
feed back to decide the composition issue. If people are willing to
accept some restrictions and use some common sense to get a good
mineral and vitamin intake the truth appears to be that there is a
wide latitude for individual adjustment.


BTW, IMHO it is what else is with those macronutrients and WHICH fats
and WHICH proteins one eats that matter more ... that and the reality
of how a particular composition works out for you.

[snip]


[repetition snipped]

[Snipped, my comments on why McDougall's claims should not be taken at
face value]

>non diabetic and now that I have it - it is less likely she will have to
>deal with it.

Good luck with that. I was curious to know because in general
non-diabetics have much greater tolerance to lower fat diets.
It becomes less true if beta cell death increases, for whatever
reason. Thank you for the information. It helps me follow your
comments and assess their relevance to T2 diabetics.

Best wishes,

--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin
.