Gil Carvalho MD PhD🌈 Profile picture
Jul 16, 2020 9 tweets 2 min read Read on X
@USDA just released its literature review report (835 pages!!!) that will steer the 2020-2025 Guidelines

1st impressions:

1) focus on obesity/overweight (70% of Americans!), particularly children, and food insecurity/racial disparities (couldn't agree more) 👍💪

(cont.)
2) focus on *dietary patterns* over isolated nutrients or foods 💪💪👍

(cont.)

full report: dietaryguidelines.gov/sites/default/…
"dietary patterns associated with positive outcomes: vegetables, fruits, legumes, whole grains, low- or nonfat dairy, lean meat/poultry, seafood, nuts, and unsaturated vegetable oils and low red and processed meats, sugar-sweetened foods and drinks, and refined
grains"

(cont.)
"negative health outcomes are
associated with dietary patterns characterized by higher intake of red and processed meats,
sugar-sweetened foods and beverages, and refined grains"

(cont.)
USDA currently recommends 3 Food Patterns: Healthy U.S.-Style, Healthy Vegetarian and Healthy Mediterranean-Style

"these patterns provide majority of energy from plants (vegetables, fruit, legumes, whole grains,
nuts/seeds) and limit added sugar, solid fats, and sodium"

(cont.)
it seems we may be progressing from the past USDA shenanigans over SFA/cholesterol

"replacing saturated fat with unsaturated fats lowers incidence of CVD"

(cont.)
"The recommended shift from sat to unsat fat occurs best within healthy diet pattern:vegetables,fruit,legumes,whole grains,nuts/seeds,some veg oil, low-fat dairy, lean meat/poultry, fatty fish; lower red & processed meat, sugar-sweetened food and drinks, refined grains"

(cont.) Image
some uncertainty expressed about role of dietary cholesterol and type of carbs (somewhat understandable, and not damaging, as it is accurately balanced by accurate emphasis on dietary patterns)

(cont.)
bottomline:

1 - no huge differences or surprises

2- some areas to polish up but overall seems pretty balanced and evidence-based

3 - expect industry push-back shenanigans + back-pedaling by USDA + PCRM lawsuits in the months to come 🤣🤦‍♂️

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Gil Carvalho MD PhD🌈

Gil Carvalho MD PhD🌈 Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @NutritionMadeS3

Sep 29
fascinating new mendelian randomization study quantifies risk associated with triglyceride-rich lipoproteins (VLDLs etc) & their remnants

concludes ~4x more atherogenic particle for particle than LDL particles (maybe even more)

interesting implications
jacc.org/doi/abs/10.101…
this indicates that 2 populations with the same ApoB level would have different risk depending on what type of ApoB particles are elevated (LDLs? VLDLs? both?)

some contrary views presented by Sniderman:
sciencedirect.com/science/articl…
"does this mean LDL doesnt matter?"

NO. the study shows all these ApoB particles are atherogenic but points to TG-rich lipoproteins as being even more so *particle for particle*. most people have many more LDLs so the risk attributable to those will still predominate
Read 6 tweets
Jan 10
“Are eggs good or bad?”

A fascinating recent study looked at this perennial question.

HT @TheBhupiThakur


🧵🔽sciencedirect.com/science/articl…
Re: heart disease in particular, we can find heterogeneity in the literature. Some studies point to a signal of risk for eggs, others find no stat sig effect.

One of the main differences between science and Social Media content is how they deal with heterogeneity.
Social Media feeds you polarization. One FB forum argues eggs are poison, and shows you only the studies reporting risk.

Another argues eggs are a perfect, risk-free superfood, and shows you only favorable studies.
Read 18 tweets
Oct 11, 2023
The Twinkie diet

In 2010, a nutrition Professor set up an experiment

he ate 1800 cals/day mainly from ultraprocessed sweets, Doritos, sugary cereal and Oreos
edition.cnn.com/2010/HEALTH/11…
over 2 months, he lost 27lbs. his BMI came down to the normal range

his LDL-C dropped 20%. his triglycerides, 39%

his anecdote illustrates a couple points:

▶️we can lose weight on almost any type of food, as long as we cut calories enough
▶️ some foods make it easier to cut calories. calorically concentrated junk food makes it easier to overconsume calories, so for most people they're not ideal. most people won't achieve the precise control on a day to day basis that the Prof exercised in his experiment
Read 6 tweets
Jul 6, 2022
Does high ApoB still raise risk if I´m “metabolically healthy”?

The evidence indicates it DOES.

(thread)
The idea that cholesterol level is completely irrelevant has largely subsided.

As the public is exposed to more scientific evidence, it has become increasingly obvious that blanket denial is not realistic.

So a more nuanced idea emerged.

“it´s about context”
According to this idea, high cholesterol/apoB increases risk in “sick” people (e.g. insulin-resistant/obese/diabetic) but is harmless for the insulin-sensitive & lean
Read 12 tweets
May 27, 2022
"low cholesterol correlates with higher all-cause mortality so having high cholesterol is protective"

a misunderstanding that refuses to die

we know with a very high degree of certainty that this idea is *wrong*

3 lines of evidence:
1) lowering cholesterol via randomized clinical trials or genetically determined shows, if anything, *lower* total mortality

this comfortably supersedes the associational U-curve
ncbi.nlm.nih.gov/pmc/articles/P…
thelancet.com/action/showPdf…
academic.oup.com/ije/article/44…
thelancet.com/journals/lanhl…
2) even the authors of some of the U curve studies have alerted (in no uncertain terms) against concluding causality from those associations

bmj.com/content/371/bm…
bmj.com/content/371/bm…
Read 7 tweets
Jan 10, 2022
How I got COVID and how you can avoid it 🧵

For the last year+ I've been essentially secluded, helping my mom recover from cancer (so far, successfully, but it's a daily battle)
She's >70yo, transplanted, immunosuppressed and recovering from cancer

COVID could be devastating for her

it could be lethal

so we've done everything in our power to keep her safe
I gave up everything. professional, social, personal life to give her a fighting chance

I have ZERO regrets. best decision i've ever made

we almost lost her twice last year. she was so sick and frail her doctors sat us all down and told us to accept it was the end
Read 21 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(