“Healthy diet”: grains? low carb? fats? More important: Natural, unprocessed food
I haven’t realized up to now how much the diet recommendations for cardiovascular issues and general health are subject to debate. This is relevant for us with FM, as diets generally considered healthy are also ones recommended and with evidence for helping us, either generally or even specifically. The general import is that the supposed evidence for unsaturated and against unsaturated fats and for carbs/grains is being challenged and even the wikipedia skeptics are featuring that prominently. More importantly the final general advice is to “eat natural food and avoid processed food”, which seems easily understandable.
Someone made me aware that a new hypothesis on plaque (atherosclerosis) not being caused by LDL, not being helped by statins, and lipid deposits developing through the vasa vasorum, not invading thru the arterial lumen is being offered by Vladimir Subbotin, summarized here.
Vladimir Subbotin unfolds his hypothesis here Neovascularization of coronary tunica intima (DIT) is the cause of coronary atherosclerosis. Lipoproteins invade coronary intima via neovascularization from adventitial vasa vasorum, but not from the arterial lumen: a hypothesis, summarized here.
The analogy he cites is that draining swamps reduces but doesn’t get rid of malaria, unlike the analogy that a fire engine is not the cause of a fire. Draining swamps causes other problems, question is if lowering LDL does. What he says is that lowering LDL does make a difference, but “protects only 30-40% of those at risk” (Summary (4)), which is not enough to make it “a fundamental cause” and is less than is being assumed or implied. He also clarifies in the last paragraph that “he does not claim that his hypothesis offers an immediate solution” and he “does not intend to suggest an immediate solution”.
In association with him I found Zoë Harcombe’s meta-review and further articles by her alone or together with many other researchers which show & argue that the studies on which American diet recommendations are based were flawed, biased and possibly industry-influenced. These arguments are being featured prominently in wikipedia Dietary Guidelines for Americans - Wikipedia.
One abstract about alternatives Problems with the 2015 Dietary Guidelines for Americans: An Alternative - PubMed seems to imply that eating some refined grains, low-fat dairy and unsaturated oils, whilst limiting saturated fats & sodium, leads to many health problems. But in the details Problems with the 2015 Dietary Guidelines for Americans: An Alternative the focus is on stressing “eat natural food and avoid processed food”. The arguments against grains, low-fat dairy products and unsaturated fats (omega 6 is stressed) are all directed mainly against the processing and refining, and this also leading to unhealthy compensations like sugar, eating more etc. The argument against even whole grains are added sugar, them being less nutritious(?) and “only” being added to the human diet 10.000 years ago(?).
An abstract from 2020 argues that there is no evidence “that a low saturated fat, low cholesterol diet reduces coronary events in FH individuals” (familial hypercholesterolaemia). Dietary Recommendations for Familial Hypercholesterolaemia: an Evidence-Free Zone - PubMed But for a subset (insulin resistant) a low carb diet might help (trials needed).
In a review from 2019 Harcombe argues that all evidence suggests that saturated fats do not lead to CV issues.
Her arguments here aren’t really deeper, but shows some mainline arguments, that seem to fall short: Problems with the 2015 Dietary Guidelines for Americans: A Response to a Rebuttal
This article seems to me to suggest that both normal carb and low carb arguments need verification.
And 2020 she also argues “The new European guidelines for prevention of cardiovascular disease are misleading - PubMed”
I can now see that/why it is probably no problem adding some unrefined coconut oil with its saturated fats. Just I have no issues with Alzheimer’s or appetite control etc.
And what I see is that all these arguments are important for the general population of Europe & (esp.?) America. But I don’t ever eat refined fats or oils and hardly any processed food anyway, so it seems no problem to continue with unrefined omega 3 fats and oils, olive or canola, with avoiding too much omega 6, no problem to lower my LDL with a Mediterranean diet as I have done, even if it’s unsure that that’ll prevent CV issues.
Arguments what humans did or ate 2 million or 10.000 years ago don’t impress me in the least, my focus is valid modern evidence and my own experience. So I can’t follow the arguments here for low carbs / stopping whole grains and would need better arguments / clinical evidence for this. I didn’t see any difference when I reduced wholemeal gluten-free berry muesli with added nuts and bread and potatoes. But the ethical reasons for not using animals are more important to me and my lipidologist argued it’s better to keep some carbs in for that reason.
Fruits (sugar) & Lectins - getting even more complicated…
I keep getting confused what has too much sugar, and want to know if plums and grapes are OK, so just looked it up. Turns out plums are OK-ish because they have a low glycemic index, whilst grapes are not:
7 High Sugar Fruits to BAN (plus, which fruit to eat instead) (Gundry MD is the lectin guy, author of the Plant Paradox diet.)
Don’t eat much, keep to summer & fall when they are ripe, worst are grapes, ripe mangoes, ripe bananas, lychees, pineapple, whilst apples & pears need to be kept down, but are good for fibre sometimes.
Best are unripe bananas, avocadoes, raspberries & other berries, figs (not sure if dried also) & coconuts. Lemons & limes in moderation.
Regarding lectins I just read all of this differentiating detailed article, in which fibromyalgia is mentioned:
Bottom line for me is I need to carry on keeping sugars down for my blood fats, but since I have eliminated so many foods that cause GI problems, I can very well see that I do not need to reduce lectins at all for that, since I have absolutely no problems with most beans, with soy, with peanuts.
Here https://www.restartmed.com/wp-content/uploads/2018/09/Foods-high-in-Lectins-1.pdf is says lectins can cause fatigue, brain fog, pain & sleep issues. It has foods listed in different categories, e.g. from ideal to never to eat.
Here High Lectin Fruits & Low Lectin Fruits List - Lectin Foods Base is says organic will likely be better, so I’m safer there.
