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How to Defend Adventist Dietary Principles in Light of New Diet Trends (Part 1)

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In the last several years, new diet ideas have been emerging that not only have attracted a lot of media attention but have also been adopted by some registered dietitians and others as the correct eating pattern for patients and for the population at large. These new ideas challenge previously established dietary principles that have been accepted for years as healthy. They include consuming five or six smaller meals each day vs. three larger meals a day, consuming low carbohydrate/high protein diets, and ingesting a high fat/ketogenic diet, in place of one that is low in fat and high in carbohydrates. Along with these diet ideas have come claims that these eating patterns are healthier than diets and eating patterns that have been recommended by scientists and professional organizations for years. These new ideas stand in direct contradiction to the Adventist dietary recommendations.

The Adventist dietary principles are found in the writings of Ellen G. White although, according to White, God was the author of these principles as expressed in the following quote:

I have had great light from the Lord upon the subject of health reform. I did not seek this light; I did not study to obtain it; it was given to me by the Lord to give to others.” —E.G. White, Ms 29, 1897; cited in CD 493

The following quotes outline the Adventist dietary principles and summarize the rational for following them:

In order to know what are the best foods, we must study God’s original plan for man’s diet. He who created man and who understands his needs appointed Adam his food. . . . Grains, fruits, nuts, and vegetables constitute the diet chosen for us by our Creator.”

God has furnished man with abundant means for the gratification of an unperverted appetite. He has spread before him the products of the earth — a bountiful variety of food that is palatable to the taste and nutritious to the system. Of these our heavenly Father says we may freely eat. Fruits, grains, and vegetables, prepared in a simple way, free from spice and grease of all kinds, make, with milk and cream, the most healthful diet. They impart nourishment to the body and give a power of endurance and a vigor of intellect that are not produced by a stimulating diet.”

It is clear that the diet given to Adventists is one that should abound in foods that are high in carbohydrates, high in dietary fiber, and low in fat. Such a diet provides an adequate, although relatively low, amount of protein exclusively, or mainly, from foods of plant origin. In contrast to the above principles, the new diet ideas emphasize eating foods that are low in carbohydrates and are high in fat and/or protein. Examining some research findings will reveal whether these new diet ideas are truly superior in comparison to the principles given to Adventists.

High fat ketogenic diets

On September 5, 2017, a new study, published in the journal Cell Metabolism, reported novel and surprising findings. The findings included the following: 1) a low-carbohydrate/high-fat ketogenic diet extended longevity in adult mice, and 2) motor function, memory, and muscle mass were preserved in ketogenic diet-fed consuming mice. This study attracted a lot of media attention, perhaps at least in part, due to the findings being somewhat contrary to what we would expect. Media outlets, including National Public Radio and ABC News, reported stories on this new longevity “panacea.” How is it possible that a high-fat diet, comprised mainly of lard, could increase longevity, especially when compared to a low-fat diet? Should Adventists be concerned that their diet, composed mainly of foods that are naturally high in carbohydrates and relatively low in fat, may not turn out to be the best way to eat?

Under normal conditions, glucose is the main fuel in the body. However, when people limit their intake of carbohydrates, which results in an inadequate glucose supply, the body uses fat to produce energy, and in the process, compounds called ketone bodies, often referred to as ketones, are formed. Thus, the term “ketogenic” is simply referring to a condition in which ketones are produced (as in the case of reducing carbohydrate intake). Ketones constitute an alternative fuel source though the body prefers glucose as fuel. Thus, any diet that limits carbohydrate intake (e.g. low carb/high protein, low carb/high fat) will result in ketone production and the body using ketones for energy instead of using glucose.

In the new study mentioned above, experimental mice were assigned to three diet groups. Group 1 received a high carbohydrate diet (65% of calories were supplied by carbohydrates, 18% by protein, and 17% by fat). Group 2 received a low carbohydrate diet (10% of calories were supplied by carbohydrates, 20% by protein and 70% by fat), while group 3 ingested a ketogenic diet (< 1% of calories were supplied by carbohydrates, 10% by protein, and 89% by fat). In reality, the diet given to group 2 and group 3 was a ketogenic diet since in both cases carbohydrate intake was significantly reduced, but since group 3 received less carbohydrates than group 2, that diet was called a ketogenic diet. In fact, the diet of mice in group 3 was virtually devoid of carbohydrates. The results showed that animals from group 3 lived the longest while animals from group 1, the shortest. The maximum reported lifespan of mice in group 3 was 1,175 days, compared to mice from group 2 having lived for 1,123 days and mice from group 1 having lived 1,064 days.

Taking a look into the study design will give insight regarding the efficacy of the findings and how there is, or whether there may be, any application of this study to human beings. It turns out that these experimental animals were not given a diet that people would consider a diet to look like. A diet is usually composed of a variety of products that include some grains, fruits, veggies, meat. These experimental animals were given as follows:

  • Group 1: corn meal, maltodextrin (basically glucose), sucrose, and soybean oil
  • Group 2: sucrose, soybean oil and lard
  • Group 3 soybean oil and lard

In addition, the “diets” of animals from each group were supplemented with a cocktail of vitamins and minerals. The practical implications of this study are as follows: a human being whose diet is composed of corn meal, glucose, sucrose, and soybean oil may live shorter than one whose diet is composed of only soybean oil and lard. I stated the above conclusion with a dose of sarcasm, and I have done it for a good reason. I do not know, and I cannot think of, a single human being who eats or who would like to eat any of the “diets” given to these laboratory animals. It should be pointed out that the mice in the study consumed their respective “diets” for a little over half of their lives. Can anyone really imagine a human being who adopts a similar “diet” in his/her 40s and continues eating it until his/her death? In reality, any diet, especially a healthy one, should be composed of a variety of foods. These foods, in addition to carbohydrates, protein, fat, vitamins, and minerals, should provide adequate amounts of dietary fiber and tens of thousands of other compounds such as phytochemicals. (A detailed description of a healthy diet can be found in my book Healthy Diet without Secrets available in ABC stores and on Amazon.) Nutrients, phytochemicals, and other compounds found in foods interact with each other, and they have been shown to impact human health.

It is also important to point out this study’s methodological problem. It turns out that mice in group 1 received what the authors of the study refer to as “mineral mix 35” along with “vitamin mix.” Mice in group 2 received “mineral mix 60” and “vitamin mix,” while mice in the ketogenic diet (group 3) received “mineral mix 60,” “vitamin mix,” and “other minerals 27.5.”

Practically speaking, mice in the different diet groups not only received a different composition of minerals but also received different amounts of some minerals. For example, one group of mice received 24 grams per kilogram of body weight of magnesium oxide while those in a different group received about 63 grams per kilogram (about 2.6 times more) of the same mineral (salt). Similarly, one group of mice received about 576 grams per kilogram of potassium citrate while another group only received 196 grams per kilogram.

Consequently, it is not possible to determine whether the difference in lifespan was attributable to the ketogenic nature of the “diet” or to the difference in micronutrient (vitamin and mineral) content and quantity. One of the authors of this study with whom I corresponded admits this to be the case: “Any differences in nutrient composition between the diets . . . could certainly be considered as potential mechanisms for the longevity differences between diet groups.”

Thus, in spite of all the media attention about the new longevity “panacea,” the only reasonable conclusions from the study include the following: 1) lack of clarity on what factors accounted for the difference in the lifespan of the mice, 2) no application to human beings since no human being will ever be willing to adopt any of the “diets” given to the experimental animals, and 3) DO NOT EAT LIKE THAT AT HOME!

Low carbohydrate/high protein diets

As already mentioned, ketone production is a result of an inadequate supply of carbohydrates in one’s diet. Thus, not only are low-carbohydrate/high-fat diets ketogenic, the same is true of any low carbohydrate diets such as low carbohydrate/high protein diets. Some people who followed low-carbohydrate/high protein-diets noted improvements in blood cholesterol level, blood glucose, and other biomarkers. These improvements convinced many about the health aspects of these diets. These diet advocates have even suggested that low-carbohydrate/high-protein diets may be important in the prevention of cardiovascular diseases or diabetes. It must be emphasized, however, that these apparent improvements do not mean that individuals who adhere to these diets decrease their risk of cardiovascular diseases or any other chronic health conditions. As it is explained below, the opposite is true. These diets increase the risk of developing these diseases despite any improvements of these risk factors.

While the cholesterol profile of some individuals who adhered to low-carbohydrate/high-protein diets may have improved, most studies have shown that low carbohydrate diets are not nearly as effective at lowering serum cholesterol as are high-fiber, low-fat diets. For example, a study published in 2008 in the Journal of the American College of Cardiology showed that people who followed a low-carbohydrate/high-protein diet lowered total cholesterol level by less than one percent. Cholesterol reduction among those who adhered to a high-carbohydrate diet was about 11 percent (11 times more effective). Similarly, individuals in the first group reduced their LDL cholesterol level by just 1.5 percent and those in the high carbohydrate diet by more than 16 percent (10.5 times more effective). The same study showed that other parameters, such as blood glucose level, diastolic blood pressure, or serum insulin level, were better controlled among individuals on the high-carbohydrate diet. In a meta-analysis published recently in the British Journal of Nutrition, the authors showed that low-carbohydrate diets actually increased LDL cholesterol.

There are many problems associated with adopting low-carbohydrate/high-protein diets.The most important of them has to do with them increasing the risk of at least several serious health problems. Two studies described below will illustrate their health effect. In September 2009, a team of researchers from Harvard published a study conducted with mice. Mice were divided into three groups. The first group was given a low-carbohydrate/high-protein diet. This diet provided 12 percent of calories from carbohydrates, 45 percent from protein, and 43 percent from fat. The second group of mice received a diet called the “western diet.” This diet provided 43 percent of calories as carbohydrates, 42 percent from protein, and 15 percent from fat. The third group received a typical diet for mice, comprised of 65 percent of calories from carbohydrates, 20 percent from protein, and 15 percent from fat.

After six weeks of the experiment, researchers examined the thickness of atherosclerotic deposits in the arteries of all three groups of the mice. “At six weeks, mice on the low-carbohydrate/high-protein diet had significantly more atheroma [degeneration of the walls of arteries caused by accumulation of fatty deposits and other compounds and scar tissue] than mice on the western diet (5.4% vs. 2.2% respectively). . . . This difference was maintained after 12 weeks on the diets (15.3% vs. 8.8% respectively).”This conclusion implies that the arteries of mice consuming a low-carbohydrate/high-protein diet clogged arteries twice as fast as did the arteries of mice consuming the western diet.

Clogging of the arteries causes heart disease and other cardiovascular diseases which are the main causes of death in many countries in which people consume a western diet. What was the effect of the typical mouse diet (this diet could be described as a high-carbohydrate diet) on atherosclerosis (Group 3)? “Chow-fed mice had minimal, although quantifiable, amounts of plaque at both 6 (0.5%) and 12 (1.3%) weeks, which was significantly less than that seen in low carbohydrate/high protein diet and western diet-fed mice.”Thus, the animals fed the low-carbohydrate/high-protein diet experienced the clogging of their arteries about 11 to 12 times faster than did mice eating the chow diet (5.4/05 = 10.8 and 15.3/1.3 = 11.8). The authors further stated that “these data demonstrate the low-carbohydrate/high-protein diet-fed mice developed more extensive atherosclerosis than western diet-fed mice, despite similar dietary fat and cholesterol content, and reduced weight gain.”

To examine the impact of the low-carbohydrate/high-protein diet on the rate of blood flow, the researchers performed a surgery on the mice from groups 1 and 2. The goal of the surgery was to tie off the femoral artery in order to stop the blood flow. Normally, a reduction of blood flow will cause the organ to grow new arteries to make up for the reduction in blood flow, a “natural bypass.” The blood flow was stopped for 28 days during which time the researchers assessed the growth rate of new blood vessels. After this period, the femoral artery was untied, and the researchers measured the rate of blood flow to that artery. The results showed that the low-carbohydrate diet caused “abnormal neovascularization” and that “recovery of perfusion after ischemia was approximately 39% less in mice on the low carbohydrate/high protein diet compared with mice on the western diet at 28 days after surgery.”The conclusion from the above described experiment was obvious: “Exacerbated atherosclerosis occurred on the low carbohydrate/high protein diet independent of significant alterations in traditional atherogenic serum lipids, serum inflammatory markers, and histological indicators of inflammatory infiltration.” This conclusion is consistent with a statement made earlier in this article that despite any improvements in biomarkers, such as cholesterol or blood glucose, these diets do not decrease the risk of disease development and do not slow down disease progression. Actually, the opposite is true.

The study described above was carried out on mice. You may be wondering if low-carbohydrate/high-protein diets have a similar effect on atherosclerosis in humans. Results of another study published in the journal Angiology give a clear answer. It was conducted on 26 individuals (14 men and 12 women) aged 29 to 71 years. These individuals were divided into two groups. The first group received a diet in which carbohydrates provided 70 percent of the calories, protein and fat provided 15 percent each, while the ratio of unsaturated to saturated fats was 2:1. Individuals in the second group consumed a low carbohydrate/high protein diet. “The overall effect seen in the high carbohydrate group was a 23% regression in the extent of CAD [coronary artery disease] and a 22% reduction in the severity of CAD which was statistically significantly different from the effects seen with advancement in CAD following a high-protein diet. The overall effect, seen in patients treated who followed high-protein diets was a progression in the overall extent of CAD of 39.7%.”

Thus, while individuals subjected to the high carbohydrate/low fat diet experienced a regression of atherosclerosis, those on the low carbohydrate/high protein diet experienced the opposite effect, a progression of the disease. Keep in mind that the low carbohydrate/high protein diet can be considered ketogenic due to the low supply of carbohydrates.

What impact on atherosclerosis do the Adventist dietary principles have?

In contrast to research findings that showed detrimental impact of low-carbohydrate diets on atherosclerosis, findings from research studies that implemented dietary principles that are consistent with the Adventist dietary principles and lifestyle have shown atherosclerosis reversal. Perhaps the best example of such studies was conducted by the team led by Dr. Ornish. The researchers included 28 individuals between 35 and 75 years old who had coronary heart disease documented by angiography. Patients, in addition to a low-fat vegetarian diet, underwent a stress-management seminar and were engaged in moderate physical activity.

Atherosclerotic plaques in coronary arteries of these individuals were reduced from 40.0 to 37.8 percent after one year of treatment. Among patients with initial plaque thickness of 50.0 percent or higher, a reduction, on average, from 61.1 to 55.8 percent was documented. Among people who did not make dietary or other lifestyle modifications included in this study, plaque thickness increased, on average, from 42.7 to 46.1 percent. Those with an initial size of these plaques higher than 50 percent experienced an increased arterial plaque thickness from 61.7 to 64.4 percent.

The results were summarized as follows: “Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs.” Considering the successful treatment described above, Dr. Ornish’s team decided to extend the study for four more years. The graph below illustrates the findings after five years. It shows further regression of arterial narrowing in the experimental group that was subjected to lifestyle change that included eating a vegetarian diet while the control group experienced a progression of the disease.

In both phases of the study, the first year and the extended four years, participants with the strictest adherence to the diet protocol had the highest degree of atherosclerosis regression.

Would similar impact be seen if patients follow any low-carbohydrate diet? The opposite is true: they would experience disease progression rather than regression. This conclusion is supported by a Polish study conducted with mice. A group of mice with established atherosclerosis was assigned to several experimental diets and was fed for 10 weeks. The experimental diets consisted of a control diet, a diet with added margarine, one with added fructose, a high-fat diet called the western diet, high cholesterol diet with added egg yolk, or a low carbohydrate/high protein diet. As illustrated in the graph below, mice fed the low-carbohydrate/high-protein diet had the worst outcome in terms of atherosclerosis progression, followed by a group of mice fed the western (high fat) diet.

Atherosclerotic plaque progression in experimental mice fed with different diet type:

Adopted from: Kostogrys et al. Atherosclerosis. 2012; 223(2):327-331 (full reference included at end of article).

Low carbohydrate/high fat and low carbohydrate/high protein diets in perspective

As stated in the beginning, ketogenic diets are somewhat new and are advocated by a handful of individuals. To date, there is a limited number of studies that have assessed the impact of these diets on longevity and health outcomes. It is important for these new dietary recommendations to be considered in perspective. In contrast to the health effects of these diets, the health effects of diets that are based on carbohydrate-containing foods, including whole grains, fruits, and vegetables, have been assessed by hundreds of studies over the last several decades. These studies led scientists to conclude that diets that are composed of high amounts of carbohydrate containing foods reduce risk of diagnosis and death from a number of health conditions, including heart disease, cancer, stroke, type 2 diabetes, and obesity.

Consumption of these products is recommended by the most prestigious American and international health and nutrition organizations. Recommendations to ingest adequate amounts of fruits, vegetables, whole grains, and other plant foods are usually included in different dietary guidelines for disease prevention and in guidelines for specific disease management. For example, the Academy of Nutrition and Dietetics (formerly the American Dietetic Association), the Dietitians of Canada, the American Cancer Society, the American Institute for Cancer Research, the World Cancer Research Fund, the American Heart Association, the American Stroke Association, the National Institutes of Health, the American Academy of Pediatrics, the United States Department of Agriculture, the United States Department of Health and Human Services, the American Diabetes Association, the Canadian Diabetes Association, and others, promote the consumption of whole grain products, fruits, and vegetables. Consuming low-carbohydrate/high-fat and/or low-carbohydrate/high-protein diets is not supported by any professional organization. Additionally, such diets have never been promoted for prevention of chronic health conditions such as heart disease or cancer. Furthermore, many professional organizations have condemned such diets, warning people against their potentially detrimental consequences.

There are several reasons why ketogenic diets, whether low-carbohydrate/high-fat or low-carbohydrate/high protein, should not be recommended. First, they restrict consumption of products such as fruits, vegetables (including beans), and grains. Hundreds of research studies in the past decades have shown that these products are associated with a lower risk of heart disease, hypertension, cancer of certain organs, diabetes, dementia (including Alzheimer’s disease), and many others.

Second, these diets promote consumption of both fat, especially saturated fat, and protein from meat and animal products. Countless research manuscripts have shown that intake of these foods is associated with many health problems. The following comment adequately illustrates the opinion of the vast majority of health professionals regarding advising people to eat unlimited amounts of high animal fats. Dr. Fredrick Stare, who was chair of the Nutrition Department at Harvard, commented on Dr. Atkins’ book during a Senate meeting in 1973 saying, that “any book that recommends unlimited amounts of meat, butter, and eggs, as this one does, in my opinion is dangerous. The author who makes the suggestion is guilty of malpractice.” (Dr. Atkins was a well-known promoter of a low carbohydrate/high protein diet.)

Third, high-protein and/or high-fat diets do not provide the body with an adequate amount of several nutritional compounds including dietary fiber and some vitamins and minerals. The following quote, from an article published in the Journal of the American College of Cardiology, highlights the problem: “These diets do not meet the nutritional requirements of healthy people based on the current dietary reference intakes for many vitamins and minerals and recommendations for dietary fiber. When used for weight loss, these diets are associated with several potential adverse effects and nutrient deficits, and the long-term consequences of their continued use are unknown. On the basis of evidence currently available, LC-HP [low carbohydrate/high protein] diets cannot be recommended as part of a long-term care plan for weight management in patients who smoke or have common diseases that affect the cardiovascular system, such as hypertension, hyperlipidemia, diabetes mellitus, and coronary atherosclerotic vascular disease, where endothelial dysfunction is a feature.”

Fourth, low-carbohydrate/high-protein diets do not provide adequate amounts of carbohydrates. The main function of carbohydrates in the body is energy synthesis. Each cell of the body needs energy in order to stay alive. Both carbohydrates and fats are composed of carbon, oxygen, and hydrogen. Proteins, on the other hand, also contain nitrogen. Two things result from not providing sufficient amounts of carbohydrates for energy: the body will start making its own carbohydrates from protein, and protein, along with fat, will be used for energy.

To use amino acids (which are the basic building blocks of protein) to make carbohydrates, nitrogen will first have to be split from the protein. Nitrogen is rapidly converted to ammonia, which is eventually excreted from the body as urea. Carbon, oxygen, and hydrogen molecules are then used to make glucose, which is then used as an energy source. Therefore, dietary advice to limit carbohydrate intake does not make sense because when people do not provide carbohydrates from the foods they eat, theor bodies will make carbohydrates from non-carbohydrate sources (protein). However, it must also be recognized that this process of making the body’s own carbohydrates is associated with the liver and the kidneys overload in converting nitrogen into ammonia and urea in order to get rid of this toxic compound from the body.

Another side effect of not providing an adequate amount of carbohydrates is higher than usual utilization of fat as an energy source and synthesis of ketones. One of the side effects of ketone synthesis is acidic breath. High concentration of ketone bodies is toxic and is associated with all sorts of health problems. For example, research published in the British Journal of Ophthalmology described two cases of vision loss by children fed a low carbohydrate diet. In the first case, this problem developed between the 43th and 56th month of life. The eye examination showed 6/24 vision in both eyes (which means that the child needed about four times magnification in order to read letters compared to a child with normal vision), which could not be corrected with glasses. This child also developed color blindness.

Within six weeks of giving this child a vitamin B1 supplement, vision improved to 6/12. Vitamin B1 is found in products such as cereals or beans (consumption of both or either of them is not recommended by the low carbohydrate diet advocates). The acidification of the organism by the ketone bodies results in a destruction of vitamin B1. In the second case, a seven-year-old girl, after a year of consuming a diet that resulted in ketones, had 6/36 vision in one eye and 6/24 in the second. After administration of 50 mg a day of vitamin B1, within three months her sight had improved to 5/6 in both eyes.

Ketone bodies cause serious health problems in children born to women who ate low-carbohydrate diets during pregnancy. In one study, which estimated the effect of such diets among 122 women and their children, researchers observed “serious neurological disorders” and lowered IQ among the children.

Intake of low carbohydrate diets is associated with a variety of adverse effects, such as acidic breath, constipation, headaches, muscle cramps, lack of energy and/or feeling sick. The prevalence of the above-mentioned problems may be illustrated by a study published in the Annals of Internal Medicine in 2004. The experiment involved 238 people who were divided into two groups. Individuals placed in one of these two groups followed a low carbohydrate/high protein diet. In fact, the carbohydrate content was very low, providing less than 20 grams per day. This diet was composed of an unlimited amount of meat, eggs, and cheese, two cups of vegetable salad and one cup of other low carbohydrate vegetables. Among these individuals, 68 percent became constipated, 60 percent experienced a headache, 38 percent had acidic breath, 35 percent had muscle spasms, 25 percent felt weak, 23 percent had diarrhea, and 13 percent had skin problems.

Are low carbohydrate/high protein diets effective in weight loss?

A review of research publications that described the effect of low-carbohydrate/high-protein diets on weight reduction showed that any decrease in body mass was attributed to reduced caloric intake, not to carbohydrate restriction nor ingesting high amounts of protein. One of the body’s reactions to eating very high amounts of dietary protein is suppression of appetite. The obvious result is the consumption of less food which means smaller amounts of consumed calories. The caloric deficit is the reason for the weight loss. Studies have additionally revealed that people lose a relatively higher amount of weight during the first few months of following a low carbohydrate/high protein diet compared to individuals who follow a low-fat diet. However, this difference disappears at the end of about 12-month period. 

Conclusion

In conclusion, eating low-carbohydrate/high-protein and/or low-carbohydrate/high-fat diets is associated with inadequate intake of several nutrients and undesirable side effects including constipation, acidic breath, muscle spasms, and headaches. In addition, while findings have shown protective effects of high-carbohydrates/plant-based diets composed of unrefined plant products, diets that are low in carbohydrates, high in protein or fat, or both, constitute the cause of atherosclerosis and other serious health problems.

Good evidence of the efficacy of consuming a diet that is consistent with the Adventist dietary principles is found in the dietary guidelines issued by professional organizations and governmental agencies. In the past, the food guide pyramid, which showed grains as the foundation of a healthy diet was on the bottom of the pyramid, with fruits and vegetables being recommended in abundance. The newest pictorial version of the guidelines is illustrated by “MyPlate.” The plate shows that half of what we eat should be composed of fruits and vegetables. In addition, more than a quarter of the foods we ingest should be selected from grain products. Protein foods may include low-fat meat but may also be chosen from legumes (beans), nuts, and seeds. The Adventist dietary principles, though given to God’s people more than a century ago, have been vindicated by modern scientific research findings over decades.

 

Notes & References:

Mansoor N, Vinknes KJ, Veierød MB, Retterstøl K. Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. British Journal of Nutrition, 2016;115(3):466-79.

Tay J, Brinkworth G, Noakes M, Keogh J, Clifton P. Metabolic Effects of Weight Loss on a Very-Low-Carbohydrate Diet Compared With an Isocaloric High-Carbohydrate Diet in Abdominally Obese Subjects. Journal of American College of Cardiology, 2008;51:59–67.

Van het Hof K, West C, Weststrate L, Hautvast J. Dietary Factors That Affect the Bioavailability of Carotenoids. Journal of Nutrition, 2000;130:503–506.

Vovolis V, Koutsostathis P. IgE-mediated allergy to raw cabbage but not to cooked. Allergy, 2009;64:961–967.

Wardlaw G, Hampl J. Perspectives in Nutrition. Mcgraw-Hill College; 6th edition. 2003.

Whitney E, Rolfes S. Understanding Nutrition. Wadsworth Publishing; 12 edition. 2011.

Wing R, Vazquez J, Ryan C. Cognitive effects of ketogenic weight reducing diets. International Journal of Obesity and Related Metabolic Disorders,1995;19:811–816.

Wachtel-Galor S, Wong K, Benzie I. The effect of cooking on Brassica vegetables. Food Chemistry, 2008;110:706–710.

Fleming RM. The effect of high-protein diets on coronary blood flow. Angiology. 2000 Oct;51(10):817-26.

Foo SY, Heller ER, Wykrzykowska J, Sullivan CJ, Manning-Tobin JJ, Moore KJ, Gerszten RE, Rosenzweig A. Vascular effects of a low-carbohydrate high-protein diet. Proceedings of the National Academy of Sciences USA. 2009;106(36):15418-23.

Yancy WS Jr, Olsen MK, Guyton JR, Bakst RP, Westman EC. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Annals of Internal Medicine. 2004;140(10):769-77.

Ornish D, Brown S, Scherwitz L, Billings J, Armstrong W, Ports T, McLanahan L, Kirkeeide R, Brand R, Gould L. Can lifestyle changes reverse coronary heart disease? Lancet, 1990;336:129−133.

Kostogrys RB, Franczyk-Żarów M, Maślak E, Gajda M, Mateuszuk L, Jackson CL, Chłopicki S. Low carbohydrate, high protein diet promotes atherosclerosis in apolipoprotein E/low-density lipoprotein receptor double knockout mice (apoE/LDLR(-/-)). Atherosclerosis. 2012;223(2):327-331.

 

Further Reading:
How to Defend Adventist Dietary Principles (Part 2)

 

Roman Pawlak, Ph.D, RD is Associate Professor of Nutrition in the Department of Nutrition Science at East Carolina University.

Photo by Kimber Pine on Unsplash.

 

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