Atkins Autopsy

Every now and then I'm reminded of something that kind of bugs me about LC diet promoters.  There simply aren't many long term low carbers in our general population (as a percent).  So when I see these long term meta studies looking at correlations between various biomarkers and CVD, for example, I wonder how this translates to someone who follows a low carb diet for the long run.  Real life examples ... people who may have yo-yo'd a bit with LC as well.  Do the low fasting trigs of a low carber correlate with reduced CVD?  But I hold no illusions that some meta study will be done following thousands of low carbers.  (Still, I can dream)

In the absence of that, the next best thing would be for prominent "leaders" in the field to share their personal experience/results.  So it's always bothered me a little bit that Dr. Atkins didn't leave instructions for an autopsy to be made public.  After all, what better vindication of low carbing can one imagine than Atkins possessing clean arteries (or at least arteries similar to those of others)?  This would have definitively been Dr. Atkins last laugh at the medical establishment.  I can only be left to wonder that either Dr. A didn't practice what he preached, or he had misgivings regarding its impact on his CV system.  

No ... I'm not a Dr.A died of a heart attack conspiracy theorist.  But I do think that there is/was value in prominent long term low carbers sharing their actual "results".


randyfeingersh said…
Nathan Pritikin did request that his autopsy be made public before he died in the early 80
s. The results were remarkable and published int he New England Journal of Medicine.

Since many low carb fundamentalist consider the Pritikin diet an Anti-Atkins diet, I think this is noteworty.

I've seent the full report in NEJM, but can't find it currently. Very happy to have found your blog site. From what I've seen your one of a kind.

Austin, Tx

Here's some snippets and links:

"The results of his autopsy were published in the New England Journal of Medicine, and showed that Nathan Pritikin's arteries were free of any signs of heart disease, and were as "soft and pliable" as a teenager's. "In a man 69 years old," wrote pathologist Jeffrey Hubbard, "the near absence of atherosclerosis and the complete absence of its effects are remarkable."
randyfeingersh said…
I should have included this in my last post.

Here's a prospective study that shows an association of lower carb/high protein diet with increased mortality.

Objective: We have evaluated the effects on mortality of habitual low carbohydrate–high-protein diets that are thought to contribute to weight control.

Design: Cohort investigation.

Setting: Adult Greek population.

Subjects methods: Follow-up was performed from 1993 to 2003 in the context of the Greek component of the European Prospective Investigation into Cancer and nutrition. Participants were 22 944 healthy adults, whose diet was assessed through a validated questionnaire. Participants were distributed by increasing deciles according to protein intake or carbohydrate intake, as well as by an additive score generated by increasing decile intake of protein and decreasing decile intake of carbohydrates. Proportional hazards regression was used to assess the relation between high protein, high carbohydrate and the low carbohydrate–high protein score on the one hand and mortality on the other.

Results: During 113 230 persons years of follow-up, there were 455 deaths. In models with energy adjustment, higher intake of carbohydrates was associated with significant reduction of total mortality, whereas higher intake of protein was associated with nonsignificant increase of total mortality (per decile, mortality ratios 0.94 with 95% CI 0.89 –0.99, and 1.02 with 95% CI 0.98 –1.07 respectively). Even more predictive of higher mortality were high values of the additive low carbohydrate–high protein score (per 5 units, mortality ratio 1.22 with 95% CI 1.09 –to 1.36). Positive associations of this score were noted with respect to both cardiovascular and cancer mortality.

Conclusion: Prolonged consumption of diets low in carbohydrates and high in protein is associated with an increase in total mortality.

Austin, TX
CarbSane said…
Welcome to my blog Randy -- thanks for reading and commenting! Pritikin is certainly too restrictive for me, but I do admire that he put his money where his mouth was re: autopsy.

As regards long term low carbing, I do find myself concerned over the autopsies done on the Masai:
I don't know too many low carbers who live a super active "warrior" lifestyle.

Atkins did have heart trouble and to simply deny that diet had any part in that is not sufficient IMO. Even if it wasn't classic athero, I find the sudden cardiac death stats/studies I've been reading quite disturbing as regards the longterm healthfulness of the extreme high fat very low carb diet.
randyfeingersh said…
Thanks for the welcome CarbSane. I'm very excited to have found your blog as I'm interested in the exactly the same issues from a logical, evidence base perspective.

Too too many, on all on all sides of the dietary arena, seem to become attached to their eating style such that it takes on the trappings of a religious beleif system, under the umbrella of "objectivity". Its wavers between humor and idioticy when the macinations of these "true believers" start spinning conspricy theories under the guise of scientific reasoning.

I've been wanting to see a technical discussion of the issues you've presented, but between the extremes of low carb and vegan mentalities I'd almost given up.

I'm especially think that there might be something to be learned by the relationship between NEFAs, health and low carb diets. I plan to review your posts on these issues.

Austin TX
CarbSane said…
The NEFA stuff is the most disconcerting to me. I hear you on the polarization in the nutrition/fitness world. I think people find something that works for them and convince themselves that it must be the healthiest way to live and everyone else will find Utopia when they finally come around. I do have a personal concern re: occasional racing heart and the NEFA's that fuels my interest in this aspect. Although the ticker checked out just fine when I had some heart-issue-mimicking symptoms after my second go-round on LC, I really don't want to take chances.

While I believe we wear our health somewhat on our faces/outward appearance, there are certainly any number of people who look quite healthy and are not. I continue to look at the long term female low carbers of a certain age and I'm not sure I'm re-assured by what I see.

LC for weight loss? Yes. It is my considered opinion that a certain level of obesity is so damaging to one's health that pretty much "whatever it takes" to reverse the situation is going to be "healthier". Obviously there are dangerous starvation plans out there, but we're talking reasonable. In caloric deficit it seems we just have to let our bodies do what they will with dietary and stored reserves -- there's essentially no such thing as eating excess fats or carbs if we're in caloric deficit. But losing weight faster can be riskier. I guess it's a balance -- being in chronic deficit for the shortest period of time but not in such deficit that our bloodstreams are flooded with circulating lipids especially.

Although I fashioned my plan for the long term, I'm not married to the idea that one has to continue with a weight loss strategy in all perpetuity to maintain the weight loss. I think this is where some get boxed in. Particularly the long term low carbers who will agonize over a +/- 5-7lb fluctuation if they have any carby days.

There are examples of longevity amongst high carb consuming cultures. There's no such thing for the carnivore cultures. The Masai have athero. There's evidence that those Inuit who survived the elements could live long lives, but their omega 3 intake is just insane compared to what most get in their VLC diet even with supps.

I would welcome your and others' interpretations of the various postings on NEFA. I keep hoping to come across something that demonstrates that in the LC state the NEFA's are less "toxic" because I do still eat mostly LC these days. Not finding that yet!

I love Austin BTW. Been there a few times. If memory serves there's a great BBQ a little ways away -- Salt Lick?