The Guardian

[Member496333]

My personal view is that the body has no biological need for carbohydrate. Fibre is a carbohydrate. If the body needed fibre, it would need carbohydrate. And even if it were true that we had an absolute essential requirement for fibre, conflating low carb with low fibre bamboozles the very audience that articles like these propose to be protecting.

It’s completely possible for a low carbohydrate diet to contain plenty of fibrous vegetables. It’s also very likely that people eating low carb are more nutritionally aware than the average person on the street. The author just doesn’t care.

 

[Deleted member 371625]

My personal view is that the body has no biological need for carbohydrate. Fibre is a carbohydrate. If the body needed fibre, it would need carbohydrate. And even if it were true that we had an absolute essential requirement for fibre, conflating low carb with low fibre bamboozles the very audience that articles like these propose to be protecting.

It’s completely possible for a low carbohydrate diet to contain plenty of fibrous vegetables. It’s also very likely that people eating low carb are more nutritionally aware than the average person on the street. The author just doesn’t care.

Do you have any information to back up this opinion. There is a mountain of evidence that what you are saying has no basis in truth (trying to be very polite here) so do you have anything to back this up.
A western type die heavy on processed carbs is evidentially unhealthy. However a wholefood (unprocessed) diet based on either plants or plants and meat is evidentially the most healthy diet available for most people. This is not based merely on my opinion.

If BG can only be controlled by LCHF then this is clearly the best diet in those circumstances (as the risks of uncontrolled BG are much greater than the risks of high fat / low fibre diets). However, when this is not the case (i.e. for the vast majority of people), what evidence there is demonstrates that high fat / low fibre diets increase the chances of cardiovascular disease.

 

[bulkbiker]

This may be the best example of conformation bias that I have seen in a while. Research published which disagrees with this forum's collective opinion, therefore it must be rubbish.
How many of the people who have rubbished the work here have actually read it?
It contains compelling statistical evidence that low fibre diets increase the likelihood of poor cardiovascular health from research spanning 50 years. If anyone has evidence that this is not true could you reference it please.
LCHF diets make obtaining fibre more difficult which is probably why the Guardian mentions them (for example it takes 850g of raw kale (44g of carbs) to reach 30g of fibre). How many people eating under 50g of carbs a day are getting 30g of fibre?
If LCHF is the only way possible to control blood sugar, then it is the best (probably the only) diet to have. If it can be controlled some other way (e.g. diet and exercise, or maybe even meds) then LCHF is probably not the healthiest option.
This report is nothing new and agrees with meta analyses done by the Cochrane organisation over many years.

[PLoS which is criticised here is, for any who don't know it, the Public Library of Science, an open access publisher which believes that research should be freely available to the public, It isn't part of a global conspiracy to make us all vegan]

Quote from the report on which the newspaper article is based

"Risk reduction associated with a range of critical outcomes was greatest when daily intake of dietary fibre was between 25 g and 29 g"

Now not one mention in the article that too much fibre would appear to be as bad as too little?

I'm guessing that almost anyone on a well formulated low carb diet eating lots of green veg will be able to get between 25 and 29g of fibre per day so why bring low carb diets into the equation.

" The certainty of evidence for relationships between carbohydrate quality and critical outcomes was graded as moderate for dietary fibre, low to moderate for whole grains, and low to very low for dietary glycaemic index and glycaemic load"

Also it seems to have "moderate" certainty which is another word for "possible" i.e. not proven at all.

Also as I have seen pointed out elsewhere the claims are that higher fibre diets are "less unhealthy" it has not been shown that they are the best way of eating for humans by this study whatever the Guardian may wish you to think.

 

[Member496333]

Surely a properly formulated LCHF diet is a whole food plant & meat based diet?

Unless we’re discussing poorly formulated diets, in which case this can be applied to anything.

 

[Deleted member 371625]

Quote from the report on which the newspaper article is based

"Risk reduction associated with a range of critical outcomes was greatest when daily intake of dietary fibre was between 25 g and 29 g"

Now not one mention in the article that too much fibre would appear to be as bad as too little?

I'm guessing that almost anyone on a well formulated low carb diet eating lots of green veg will be able to get between 25 and 29g of fibre per day so why bring low carb diets into the equation.

This doesn't say that too much fibre is as bad as too little, just that 25-29g of fibre shows the greatest risk reduction. The rate of risk reduction falls above this intake (law of diminishing returns) but is still much lower risk than a low fibre diet.
It is also the nature of the meta analysis that most research has concentrated on this intake (25-29g) which is why the evidence is strongest here (there is simply more evidence available so it is of greater statistical significance).

It isn't easy to get fibre without carbs. To get 30g fibre from kale is about 850g raw (45g carbs) or about 1000g broccoli (40g carbs). This is a lot of green veg, and is pushing up towards 50g of carbs which is more than many here report that they consume.

 

[Deleted member 371625]

Surely a properly formulated LCHF diet is a whole food plant & meat based diet?

Unless we’re discussing poorly formulated diets, in which case this can be applied to anything.

If it is plant based then it contains carbs and fibre. Therefore we need carbs and fibre in our diet.

 

[bulkbiker]

Therefore we need carbs and fibre in our diet.

But if there are no essential dietary carbohydrates.. which is a well accepted scientific truth (not my opinion)... then there surely cannot be any essential dietary fibre. This logical fallacy that we somehow "need" fibre simply cannot be correct.
Edit to add otherwise anyone eating a carnivore diet would be dead plain and simple.

 

[Member496333]

If it is plant based then it contains carbs and fibre. Therefore we need carbs and fibre in our diet.

An argument can be made to support that, for sure. Saying that there is no biological requirement for carbohydrate is not the same as saying there can be no benefits. There is a lot of opinion in many circles that carbohydrates are not an essential macro. The fact that we don’t die if we don’t eat them lends credence to that notion but I’ll stop short of asserting it as fact. It is however my personal view.

Ultimately a low carb diet doesn’t have to be deficient in fibre if one chooses it not to be. So we’re back at the beginning - low carb being conflated with low fibre in order to suit a narrative. The narrative being scare people away from low carb diets at all costs.

Only in my opinion. I’m sure we can disagree

 

[Flora123]

Do you have any information to back up this opinion. There is a mountain of evidence that what you are saying has no basis in truth (trying to be very polite here) so do you have anything to back this up.
A western type die heavy on processed carbs is evidentially unhealthy. However a wholefood (unprocessed) diet based on either plants or plants and meat is evidentially the most healthy diet available for most people. This is not based merely on my opinion.

If BG can only be controlled by LCHF then this is clearly the best diet in those circumstances (as the risks of uncontrolled BG are much greater than the risks of high fat / low fibre diets). However, when this is not the case (i.e. for the vast majority of people), what evidence there is demonstrates that high fat / low fibre diets increase the chances of cardiovascular disease.

You should read the book I’m reading at the moment - Primal Body, Primal Mind. (Newest edition) It covers everything you could possibly want to know about this, and lots more subjects. Fascinating book!

 

[britishpub]

This is a lot of green veg, and is pushing up towards 50g of carbs which is more than many here report that they consume.

Most of them don't count veg

 

[Member496333]

In summary. Poorly formulated dietary strategies are bad for our health. No matter which side of the fence one is sitting

In my view, most likely any data associating high-fat, low-fibre diets with coronary issues is most likely (conveniently) omitting other factors from the picture such as sugar and flour...refined carbohydrates.

 

[Oldvatr]

Do you have any information to back up this opinion. There is a mountain of evidence that what you are saying has no basis in truth (trying to be very polite here) so do you have anything to back this up.
A western type die heavy on processed carbs is evidentially unhealthy. However a wholefood (unprocessed) diet based on either plants or plants and meat is evidentially the most healthy diet available for most people. This is not based merely on my opinion.

If BG can only be controlled by LCHF then this is clearly the best diet in those circumstances (as the risks of uncontrolled BG are much greater than the risks of high fat / low fibre diets). However, when this is not the case (i.e. for the vast majority of people), what evidence there is demonstrates that high fat / low fibre diets increase the chances of cardiovascular disease.

The study that the article refers to in the Lancet is a meta study, which means that it is using results from some 189 other reports all of varying validity. Most of these other reports will be relying on food questionaires filled in by participants, usually over the period of a day or maybe a week, but certainly only a snapshot in time. From the info returned, the researchers then guesstimate the proportion of macro nutrients eaten, and extrapolate it over a longer period. So it is generally NOT measured, and is a rough estimate being made by the researchers of each sub study, This methodology is very weak, especially in regards to nutrition intake, and so cannot possibly be used as PROOF or EVIDENCE that can be shouted from the rooftops, or used to base any real meaningful guidelines or regulations. The refernce to the Lancet is poor too, since it gives an impression of a gold plated peer reviewed study, but it is NOT. Anyone can get a report published in the online Lancet so long as they pay the going price,, and so the reports from this source need to be taken with a large pnch of salt.

There may well be an association between longevity and fibre intake, but this report is not a reliable source of evidence. The fact that the report is a pay per view shows that the authors are not wanting scrutiny, and so we cannot see what their claims are being based on, and so we are expected to accept their findings without question. Nope, not a hope. At least with magic we know we are being fooled.

 

[hankjam]

<snipped>

It isn't easy to get fibre without carbs. To get 30g fibre from kale is about 850g raw (45g carbs) or about 1000g broccoli (40g carbs). This is a lot of green veg, and is pushing up towards 50g of carbs which is more than many here report that they consume.

As mentioned previously, if most of the population is not low carbing and still not getting enough fibre would this suggest they are not eating their "greens"?
I find it odd that low carbers are getting so much grief and yet they must make a pretty small percentage of the low fiber eaters.

Me, I eat a lot of fish, lamb and fermented cabbage and am thankful I had to change my ways as I have not been is such good shape for the last 45 years.

 

[Dillinger]

This may be the best example of conformation bias that I have seen in a while. Research published which disagrees with this forum's collective opinion, therefore it must be rubbish.
How many of the people who have rubbished the work here have actually read it?
It contains compelling statistical evidence that low fibre diets increase the likelihood of poor cardiovascular health from research spanning 50 years. If anyone has evidence that this is not true could you reference it please.

Afternoon.

Here is the link to the study that is being discussed. The bulk of it is behind a paywall. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31809-9/fulltext

I'm guessing the reason many are having a pop at this is these types of study are relatively common, are routinely reactionary (Fat bad! Carbs good!) and are actually pretty insubstantial when you look at the details.

In terms of 'confirmation bias' what struck me is this from the abstract; they say they wanted "to establish an evidence base for quantitative recommendations for intakes of dietary fibre." That sounds very much to me like they 'know' we should be eating fibre and wanted to find out just how much and lo and behold they discovered that we should be eating fibre at a rate that 90% of the population doesn't. If you 'know' what you want to come out of your study then you are not doing a study you are engaged in marketing.

Their fibre recommendation is very precise which is peculiar to say the least from observational studies; there is a 4 gram leeway; between 25 g and 29 g is the best. How much worse is 24 g than 25 g? Is 35 g really no good as well?

Another thing is the oblique use of numbers versus improvements. Look at this sentence (from the study):

"Observational data suggest a 15–30% decrease in all-cause and cardiovascular related mortality, and incidence of coronary heart disease, stroke incidence and mortality, type 2 diabetes, and colorectal cancer when comparing the highest dietary fibre consumers with the lowest consumers Clinical trials show significantly lower body weight, systolic blood pressure, and total cholesterol when comparing higher with lower intakes of dietary fibre"

15-30% meaning what? Is that absolute or relative? (i.e. the difference between a 4% and a 3% chance of all-cause mortality is 33% relative reduction or the less glamorous 1% absolute). Which is this? If they don't say I'm guessing it's relative. Or are they saying that in the high fibre group 30% of the population avoided all-cause mortality? That they are now immortal? That would be good; but probably not what they mean, so why not detail the average life extension in those lucky 30% - could it be that it's insubstantial? Eat 200 kg of kale a day and live 3 days longer on average? Not so good.

How do those numbers cover those different outcomes is it 15-30% for each or in aggregate; i.e. are they all added up to get to that 15-30% figure or is for each bad outcome?

All in all this is a study looking at observational dietary studies (i.e. asking people often over a very long period what they eat which is famously problematic - what did you eat last year for instance?) and seeing how that correlates with their health.

There's nothing causative about it at all. What is the biological mechanism whereby fibre prevents coronary heart disease and type 2 diabetes? They don't know and/or aren't telling, probably because there is none.

Presumably, they discounted other health impacting habits like smoking? But they don't say that so it's possible that people who eat yams and don't smoke also tend not to do other health impairing things either (drink, drugs, no exercise and so on) and therefore live longer. To put that down to their yam consumption is stretching it a bit isn't it?

As mentioned above though these data specifically excluded people with chronic disease, i.e. diabetes, and so can't be held to be applicable to us as none of the 4,000 or so people who were the subject of these trials were diabetics.

I would say the risk from running high blood sugars which has been proven by clinical trials ( always keep this in mind; it's the basis for all our treatment on the NHS - https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000390 ) and well understood mechanisms of arterial and neurological damage far outweighs the risk from fibre 'deficiency' that might (or might not) arise by avoiding carbohydrates.

In short the confirmation bias on display here is in that study not in the pretty measured response on this forum.

Dillinger

 

[Deleted member 371625]

The study that the article refers to in the Lancet is a meta study, which means that it is using results from some 189 other reports all of varying validity. Most of these other reports will be relying on food questionaires filled in by participants, usually over the period of a day or maybe a week, but certainly only a snapshot in time. From the info returned, the researchers then guesstimate the proportion of macro nutrients eaten, and extrapolate it over a longer period. So it is generally NOT measured, and is a rough estimate being made by the researchers of each sub study,

And you know this without reading the report?

 

[Deleted member 371625]

But if there are no essential dietary carbohydrates.. which is a well accepted scientific truth (not my opinion)... then there surely cannot be any essential dietary fibre. This logical fallacy that we somehow "need" fibre simply cannot be correct.
Edit to add otherwise anyone eating a carnivore diet would be dead plain and simple.

Of course carbs/fibre are not essential. You can live without them.
However, there is a mountain of evidence suggesting that you will not live as long as if you do eat them.

To reiterate, If BG can only be controlled by LCHF then this is clearly the best diet in those circumstances (as the risks of uncontrolled BG are much greater than the risks of high fat / low fibre diets). However, when this is not the case (i.e. for the vast majority of people), what evidence there is demonstrates that high fat / low fibre diets increase the chances of cardiovascular disease

 

[Member496333]

Afternoon.

Here is the link to the study that is being discussed. The bulk of it is behind a paywall. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31809-9/fulltext

I'm guessing the reason many are having a pop at this is these types of study are relatively common, are routinely reactionary (Fat bad! Carbs good!) and are actually pretty insubstantial when you look at the details.

In terms of 'confirmation bias' what struck me is this from the abstract; they say they wanted "to establish an evidence base for quantitative recommendations for intakes of dietary fibre." That sounds very much to me like they 'know' we should be eating fibre and wanted to find out just how much and lo and behold they discovered that we should be eating fibre at a rate that 90% of the population doesn't. If you 'know' what you want to come out of your study then you are not doing a study you are engaged in marketing.

Their fibre recommendation is very precise which is peculiar to say the least from observational studies; there is a 4 gram leeway; between 25 g and 29 g is the best. How much worse is 24 g than 25 g? Is 35 g really no good as well?

Another thing is the oblique use of numbers versus improvements. Look at this sentence (from the study):

"Observational data suggest a 15–30% decrease in all-cause and cardiovascular related mortality, and incidence of coronary heart disease, stroke incidence and mortality, type 2 diabetes, and colorectal cancer when comparing the highest dietary fibre consumers with the lowest consumers Clinical trials show significantly lower body weight, systolic blood pressure, and total cholesterol when comparing higher with lower intakes of dietary fibre"

15-30% meaning what? Is that absolute or relative? (i.e. the difference between a 4% and a 3% chance of all-cause mortality is 33% relative reduction or the less glamorous 1% absolute). Which is this? If they don't say I'm guessing it's relative. Or are they saying that in the high fibre group 30% of the population avoided all-cause mortality? That they are now immortal? That would be good; but probably not what they mean, so why not detail the average life extension in those lucky 30% - could it be that it's insubstantial? Eat 200 kg of kale a day and live 3 days longer on average? Not so good.

How do those numbers cover those different outcomes is it 15-30% for each or in aggregate; i.e. are they all added up to get to that 15-30% figure or is for each bad outcome?

All in all this is a study looking at observational dietary studies (i.e. asking people often over a very long period what they eat which is famously problematic - what did you eat last year for instance?) and seeing how that correlates with their health.

There's nothing causative about it at all. What is the biological mechanism whereby fibre prevents coronary heart disease and type 2 diabetes? They don't know and/or aren't telling, probably because there is none.

Presumably, they discounted other health impacting habits like smoking? But they don't say that so it's possible that people who eat yams and don't smoke also tend not to do other health impairing things either (drink, drugs, no exercise and so on) and therefore live longer. To put that down to their yam consumption is stretching it a bit isn't it?

As mentioned above though these data specifically excluded people with chronic disease, i.e. diabetes, and so can't be held to be applicable to us as none of the 4,000 or so people who were the subject of these trials were diabetics.

I would say the risk from running high blood sugars which has been proven by clinical trials ( always keep this in mind; it's the basis for all our treatment on the NHS - https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000390 ) and well understood mechanisms of arterial and neurological damage far outweighs the risk from fibre 'deficiency' that might (or might not) arise by avoiding carbohydrates.

In short the confirmation bias on display here is in that study not in the pretty measured response on this forum.

Dillinger

Excellent contribution to the discussion. Thank you for taking the time to post. Zoë Harcombe-style debunking

 

[bulkbiker]

Afternoon.

Here is the link to the study that is being discussed. The bulk of it is behind a paywall. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31809-9/fulltext

I'm guessing the reason many are having a pop at this is these types of study are relatively common, are routinely reactionary (Fat bad! Carbs good!) and are actually pretty insubstantial when you look at the details.

In terms of 'confirmation bias' what struck me is this from the abstract; they say they wanted "to establish an evidence base for quantitative recommendations for intakes of dietary fibre." That sounds very much to me like they 'know' we should be eating fibre and wanted to find out just how much and lo and behold they discovered that we should be eating fibre at a rate that 90% of the population doesn't. If you 'know' what you want to come out of your study then you are not doing a study you are engaged in marketing.

Their fibre recommendation is very precise which is peculiar to say the least from observational studies; there is a 4 gram leeway; between 25 g and 29 g is the best. How much worse is 24 g than 25 g? Is 35 g really no good as well?

Another thing is the oblique use of numbers versus improvements. Look at this sentence (from the study):

"Observational data suggest a 15–30% decrease in all-cause and cardiovascular related mortality, and incidence of coronary heart disease, stroke incidence and mortality, type 2 diabetes, and colorectal cancer when comparing the highest dietary fibre consumers with the lowest consumers Clinical trials show significantly lower body weight, systolic blood pressure, and total cholesterol when comparing higher with lower intakes of dietary fibre"

15-30% meaning what? Is that absolute or relative? (i.e. the difference between a 4% and a 3% chance of all-cause mortality is 33% relative reduction or the less glamorous 1% absolute). Which is this? If they don't say I'm guessing it's relative. Or are they saying that in the high fibre group 30% of the population avoided all-cause mortality? That they are now immortal? That would be good; but probably not what they mean, so why not detail the average life extension in those lucky 30% - could it be that it's insubstantial? Eat 200 kg of kale a day and live 3 days longer on average? Not so good.

How do those numbers cover those different outcomes is it 15-30% for each or in aggregate; i.e. are they all added up to get to that 15-30% figure or is for each bad outcome?

All in all this is a study looking at observational dietary studies (i.e. asking people often over a very long period what they eat which is famously problematic - what did you eat last year for instance?) and seeing how that correlates with their health.

There's nothing causative about it at all. What is the biological mechanism whereby fibre prevents coronary heart disease and type 2 diabetes? They don't know and/or aren't telling, probably because there is none.

Presumably, they discounted other health impacting habits like smoking? But they don't say that so it's possible that people who eat yams and don't smoke also tend not to do other health impairing things either (drink, drugs, no exercise and so on) and therefore live longer. To put that down to their yam consumption is stretching it a bit isn't it?

As mentioned above though these data specifically excluded people with chronic disease, i.e. diabetes, and so can't be held to be applicable to us as none of the 4,000 or so people who were the subject of these trials were diabetics.

I would say the risk from running high blood sugars which has been proven by clinical trials ( always keep this in mind; it's the basis for all our treatment on the NHS - https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000390 ) and well understood mechanisms of arterial and neurological damage far outweighs the risk from fibre 'deficiency' that might (or might not) arise by avoiding carbohydrates.

In short the confirmation bias on display here is in that study not in the pretty measured response on this forum.

Dillinger

An analysis worthy of Zoe Harcombe herself.. nice one.

 

[Deleted member 371625]

You should read the book I’m reading at the moment - Primal Body, Primal Mind. It covers everything you could possibly want to know about this, and lots more subjects. Fascinating book!

I couldn't comment on the book as I haven't read it. However, the sales blurb includes the following "On that diet (primal) we grew tall, strong and disease free". Really!
If the book is as accurate as this statement it is possibly full of (to quote Churchill) terminological inexactitudes.

 

[bulkbiker]

what evidence there is demonstrates that high fat / low fibre diets increase the chances of cardiovascular disease

Not as much as you seem to think.. and probably none at all.. all based on poor epidemiological data.

there is a mountain of evidence suggesting that you will not live as long as if you do eat them.

No there really isn't... there are some studies that show association but as @Dillinger has pointed out these are mostly not worth the paper they are written on. Mankind has eaten a LCHF based diet for millennia if you think we have somehow developed an intolerance for this way of eating then I fear you are mistaken. I have no intention of changing either the way I eat or passing on my personal experience to others.