The Links between Diet, Health and Cardiovascular Disease Are Complex and Confusing. Those Seeking Deeper Understanding Will Benefit from Reading Gary Taubes, an Accomplished Science Journalist, Whose Book, Good Calories, Bad Calories, Summarises the Physiological and Epidemiological Evidence

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The links between diet, health and cardiovascular disease are complex and confusing. Those seeking deeper understanding will benefit from reading Gary Taubes, an accomplished science journalist, whose book, Good Calories, Bad Calories, summarises the physiological and epidemiological evidence.

The facts that have emerged since the advent of the low-fat hypothesis in the 1960s are surprising. Fat and cholesterol in the diet do not translate to higher blood lipids, including cholesterol levels. Blood lipids do not correlate as strongly as expected, and in some cases not at all, with cardiovascular disease.

Components of blood lipids and their combinations have progressively become the focus of study, prevention and treatment, but the evidence for health benefit is not clear for all.

Prof Noakes has been at pains to state that a low-carbohydrate diet is not for everyone, but only for the carbohydrate-intolerant fraction (roughly half) of the population. For the individual carbohydrate-intolerant patient who has progressed to the metabolic syndrome (overweight, high blood pressure, prediabetes and blood lipid abnormalities), the conventional wisdom is to prescribe medication and a low-fat diet. Contrary to what is often stated, the low-fat and low-carb diets are neither equally effective nor sustainable for weight reduction. Studies show that the former is unsustainable much beyond a year, with the latter showing greater and more sustainable improvements for metabolic syndrome.

Most low-fat diets are calorie restricted and by definition must be high-carbohydrate diets, which would not be good for the carbohydrate-intolerant. …