Savvy Eating, 26 June 2019: About Protein, Mediterranean Diet and Liver Fat, Blueberries False Studies, Keto and Cholesterol, Granola Bars

Most of What You Know About Protein Is Wrong offers a quiz by Dr. David L. Katz and Mark Bittman, from Heated/Medium, 18 June 2019.

Common “wisdom” has it that the more protein you eat, the better — and that the best protein comes from animal products. But these are misconceptions.

While it’s true that essential amino acids are generally found in lower percentages in plants than in animal foods, nearly all plant foods contain complete protein, and many (beans, lentils, certain whole grains, and seeds) have high concentrations. The complete suite of these compounds is widely distributed in our food choices. And, as you already know, generally speaking, not only you (your personal health) but we (our collective health) are better off eating more plants.

If you live in the United States, there’s almost no chance that, unless you’re in hospice or intensive care, you’re protein-deficient. Epidemiological research shows clearly that the average American is getting daily protein complete in amino acids and well in excess of requirements and recommendations for health. In fact, “getting enough protein” is highly effective meat and dairy industry marketing.

Excess calories from protein do not turn into muscle; they turn into fat. For protein to become muscle, it must be needed in response to physical demands on that muscle. Once the comparatively tiny carbohydrate reserve known as glycogen is full, and once the body “spills” calories as heat, it stores calories as fat and only fat. Eat too much protein, and you will gain fat.

Mediterranean diet cuts liver fat better than other diets was written by Abigail Klein Leichman for Israel21c.org, 16 June 2019. Reducing fat in the liver, rather than simply losing weight, is key to lowering health risks associated with obesity, say Israeli researchers.

Illustration from the study “The beneficial effects of Mediterranean diet 
over low-fat diet may be mediated by decreasing hepatic fat content” in 
the Journal of Hepatology.

In a new study published in the Journal of Hepatology reveals another astounding benefit: a low-carb Mediterranean diet is more effective than other low-fat diets in reducing hepatic (liver) fat content. Furthermore, reducing liver fat – not just visceral fat in the abdomen and around internal organs — is more important than previously believed in lowering health risks associated with obesity over the long term, say the researchers from Ben-Gurion University, Soroka University Medical Center, Tel Aviv University and the Nuclear Research Center Negev (all in Israel) and from Leipzig University in Germany and Harvard University in the United States.

Their study supports the emerging understanding that excess liver fat is not merely a sign of health risks associated with obesity, including cardiovascular disease and diabetes, but is likely also a cause.

Blueberries Can’t Treat Heart Disease, why blueberry supplements are a total waste of time for your heart health, was authored by Gid M-K, for Health/Medium, 4 June 2019. My blog post from 5 June 2019 extolled the heart protective virtues of eating blueberries. Here’s another look.

People who took the blueberry supplements didn’t improve on any of the primary markers of heart health compared to placebo, which means that, based on this research, it’s unlikely that blueberries confer any benefit to heart health at all. Which is exactly the opposite of what most news stories reported.

So how did the story get so muddled? Well, it turns out that there were some significant results. In a smaller subgroup analysis of the trial results, there were barely-significant (p=0.04) associations between people who had the highest dose of frozen blueberry powder and arterial stiffness, which was one of the secondary surrogate outcomes the trial looked at. There was also a very modest improvement in one type of cholesterol in an even smaller group of people, once more than half of the trial participants were excluded. And this was what the trial focused on.

The problem is that, if you flip a coin enough times, you will almost always get at least one heads. Similarly, if you do enough statistical tests, you’ll probably find at least one positive result. And this study did a lot of tests. From these results we can say that blueberries probably don’t help with:

1. Blood pressure
2. Blood sugar
3. Cholesterol
4. Insulin

On the other hand, there may be a very small benefit in terms of arterial stiffness from blueberries, although since a smaller intake of blueberries actually made this worse it’s extremely unlikely that this is the case.

Why did this study report such positive results despite not finding anything much? Well, we could speculate. There are many possible reasons. One potential cause could be that the funder, who also appear to employ two of the lead authors of the study — the Highbush Blueberry Council — had some influence, although it’s impossible to tell.

Ketogenic Diet and Cholesterol Changes—Risks and Rewards was reported by Elizabeth Hubscher for ASweetLife.org, June 2019.

The ketogenic diet is high-fat, low carb, and sufficient protein to allow the body to burn fat and use ketones instead of glucose for fuel. This can lead to weight loss, as well as reductions in A1C and other cardiovascular risk factors.

Some of our cholesterol level is controlled by our genes, but diet can influence the amount of LDL and HDL cholesterol in our bodies. According to the Harvard School of Public Health, “the biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet—not the amount of cholesterol you eat from food.” Some individuals, however, respond strongly to cholesterol in their diet.

Increased lipid and cholesterol levels have been reported in people on ketogenic diets. According to lipidologist Dr. Sarah Hallberg, “cholesterol levels improve for most people when in ketosis… but there can be a temporary rise in LDL-P or LDL-C if [a person] is losing a significant amount of weight.” In some individuals, ketogenic diets raise LDL and total cholesterol levels for more than a brief time. In the IUH/Virta diabetes reversal study, a significant number of patients experienced an increase in LDL-C over the course of a year. Elite athletes on ketogenic diets demonstrated increased LDL and total cholesterol levels as well. These people may be part of the population of “responders” whose cholesterol levels are closely linked to their diet.

According to the latest guidelines of t e American College of Cardiology (ACC), LDL is just one piece of a complex puzzle when it comes to determining an individual’s cardiovascular risk. They recommend assessing a variety of factors including age, sex, race, bodyweight, blood pressure, medication use, family history of heart disease, inflammation, history of diabetes, and triglyceride levels, in addition to looking at blood cholesterol levels. The ketogenic diet seems to have positive effects on other blood lipids involved in cardiovascular health, including HDL, triglycerides, and the triglyceride/HDL ratio.

The Crumbling Reputation of Granola Bars, was reported by Andy Bellatti for Elemental/Medium 18 June 2019. As Clif and KIND bars feud on social media, a dietitian shares which bars end up in his cart.

The makers of Clif and KIND bars are going at it like bitter rivals over who has the superior — or in this case “healthier” — offering.

Although Clif bars are oat-based and some varieties contain heart-healthy fats from peanuts, almonds, and hazelnuts, other varieties are quite high in added sugar and get a good portion of their fats from added oils which are less nutrient-rich than whole foods sources of fat. Compared to the wide array of bars out there, Clif bars fall in “middle of the pack” territory (bonus points for the company’s commitment to organic agriculture, which is important from both an ecological and sustainability standpoint).

With only four or five grams of sugar, some KIND bars have less sugar than a classic Clif bar (average of 20 grams). But those low sugar options contain palm kernel oil (not the healthiest of oils) and alkalized cocoa, which is code for “cocoa stripped of its more healthful properties.”

“Granola bar” is the least accurate term because most bars these days are not made from granola, which is traditionally a mixture of oats, nuts, and seeds. Don’t let the word “granola” fool you. While there are some nutritious varieties out there, most pack a hefty caloric punch as a result of added sugars and calorically dense oil.

The term “protein bar” is more accurate since most of these bars are meant to provide protein in a pinch. But, here’s my issue with that: Too much emphasis on protein — a nutrient that most of us already consume enough of. Sure, a hit of protein after an intense workout is needed, but you don’t need a protein bar after a 20-minute walk.

“Snack bar” is a better descriptor since these bars are not meant to be meals, but rather snacks to keep you fueled during the day.

Snack bars are a flavorful opportunity to add extra nutrition. Check out out these contenders:

- Plant-Based bars rich in fiber (such as NuGo Fiber D’Lish, Health Warrior Superfood Protein Bars, Bearded Brothers bars)
- Bars with a low amount of added sugar (such as Pro Bar LIVE probiotic bars, Dang plant-based keto bars, Zeno bars)
- Bars with healthy fats (such as Only What You Need bars (first ingredient is pumpkin seeds), 88 Acres bars (first ingredient is a blend of pumpkin, sunflower, and flax seeds)
- Bars made almost entirely from whole food ingredients (for example, Core bars, Lara bars (specifically these flavors: apple pie, banana bread, blueberry muffin, cashew cookie, cherry pie, key lime pie, peanut butter & jelly, peanut butter cookie, and pecan pie); Mediterra bars, Rx bars)