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Headline

The cholesterol and calorie hypotheses are both dead — it is time to focus on the real culprit: insulin resistance

Comment

This is not a systematic review of the literature but, rather, a selective review. It also contains some false assumptions and errors. The study fails to reflect the recent research about the role of central adipose tissue and insulin resistance. There is good evidence that weight loss - by any means - improves insulin sensitivity - even by gastric restriction surgery. Intake of both fats and sugars contributes to adiposity. Next, the article is in error about the peasant Mediterranean diet being high fat, and neglects to mention that it includes carbohydrate staples at every meal - whether this is bread, burghul, rice or couscous. The two best-studied diets for good health - peasant Mediterranean and Okinawan diets - are, in fact, low to moderate fat and high carbohydrate, within the setting of relative poverty (reducing total intake). So, both these exemplar diets are the antithesis of the LCHF diets recommended by the authors. There is no evidence cited to support the high-fat recommendations made. Looking rationally at the evidence, which shows protein to be the best nutrient for satiety, a low-to-moderate fat and low-to-moderate carbohydrate with moderate protein diet would make more sense, with reduction in overall volume and increase in physical activity. It's also incorrect to say that indications for statins are expanding. On the contrary - more recent evidence has shown that statins are effective for secondary prevention. It seems that the authors have focussed more on looking for evidence for their own approach than analysing what the evidence actually shows.

Posted date

1 NOV 2017

Posted time

10:39

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