As always, awesome content, delivered in a clear, concise, and thoughtful manner. Gil, thank you for the hours of work you put in to deliver this most valuable and actually usable information!!
This is the best nutrition channel. Thank you for helping us understand the nuances of scientific research. Hey Gil, have you thought about doing a portuguese version of this? Wow, it is very hard to find good quality infirmation in portugese. I would love to share these vídeos with my family. Maybe portuguese subtitles?
Fascinated by the clarity that Gil shows while he breaks down the complexity in diets and diet studies. Great point about the tradeoff of control and relevance in the latter. Useful tips on using olive oil or nuts while not overstating that alone they are not a panacea, but rather an integral part of eating a diet less in processed foods.
As a Mediterranean I can say it's not just about what we eat but when. Dinner is not our biggest meal, nor breakfast. It's lunch, and then maybe a nap. We also often start work later in the day.
As many Americans are crushed by debt and many by the need for status, there is little time for a proper breakfast so we grab a bagel. We work through lunch with a deli sandwich. Some of us work late so we enjoy a late dinner with alcohol and do it all over again.
This is so encouraging! I started following a no oil, low fat, whole-food plant based diet 4 years ago when I had an angioplasty to repair a 90 percent blockage in one of my coronary arteries. I also have genetically high cholesterol. Almost everyone talks about what to eat to avoid heart disease, but this is the first thing I’ve seen addressing those already affected with CVD. Occasionally, I have cheated and have had a little olive oil. It’s great to know that it’s OK as long as I don’t go overboard. Thank you for bringing objective analyses of these studies and topics. Your RUclips channel has become my “go to” place for learning about nutrition because you are not pushing an agenda, and you encourage everyone to verify everything, including your own videos.
That was a fantastic breakdown. I have learned so much from your videos about nutrition. I really appreciate your balanced approach to these topics without being dogmatic about anything.
I just wanted to say that I have been looking for information that your channel provides. I am tired of being confused on what foods to eat. I found your channel today and look forward to binging the content. Thank you for being unbiased and providing the research .
Two of my favorite Doctors on the web are Dr Brad Stanfield and Dr Carvalho, they both take a “just the facts mam” approach and don’t get swept into the hype of the day.
Awesome video as always Gil. I use to be so focused on the "Mediterranean Diet vs Low fat" or the "we're all confused about red meat" part of the videos but now I look forward to the hidden nuggets to do with how science works and how to think scientifically. The one in this video being about control and relevance. So cool and so simple to understand.
Thank you Gil for another great message. You are the voice of reason on a topic that is often very confusing for several reasons. After studying the Mediterranean diet (in the Mediterranean) for several years now I've come to appreciate the lifestyle as another factor for its success. To use part of your closing comments we can take the core of the Mediterranean lifestyle and adapt it to wherever we live.
@@nickarrizza Hi Nick, I appreciate your message. I'm very familiar with Dr. Esselstyn's diet and research of 30 years ago. I credit Dr. Esselstyn with the work he did 30 years ago but from my own work with populations that live long lives without chronic illnesses (including heart disease) who consume olive oil I've had to re-evaluate my thoughts. To keep this brief I would like to just point out that high quality, high polyphenol olive oil has shown in many good, reliable studies to actually be beneficial for health. I appreciate all the messages from the famous doctors about olive oil but it's difficult to argue with the longest living populations that have consumed olive oil for centuries. The olive oil they are consuming is very different from what's in our grocery stores. There is also so much more to the story but I will stop here.
@@nickarrizza Hello again Nick...funding of studies can be an issue but 100s of studies on olive oil are not funded by the olive businesses. Yes olive oil is 100% fat but 86% of that fat is plant based unsaturated fat which has been eaten on this planet by humans since 8000 BC which is well before the epidemic of heart disease that exists today. I wasn't going to mention this but Dr. Esselstyn was part of a study citing the benefits of olive oil. You might want to look it up.
@@carolamendoladanca "Dr. Esselstyn was part of a study citing the benefits of olive oil." That;'s surprising given that his mantra is "No Oil!" Source?
@@carolamendoladanca "100s of studies on olive oil are not funded by the olive businesses." That's true, but I've waded through the meta-analyses and haven't found any studies that showing eating olive oil or EVOO is better for you than no oil at all. In the PREDIMED study, the thickest plaques got thicker on the Mediterranean diet liberally supplemented with EVOO. Had they not stopped the study when they did, that trend would have likely reached significance in 3-6 months (making me think that;'s why they stopped the study when they did). EVOO may be slightly beneficial, neutral, or slightly harmful--I see no way of deciding that issue based on the research I have seen. And as a nutritionist, you know that lumping a processed unsaturated fat is different from an unprocessed one. The human body evolved to eat whole foods.
@@HealingLifeKwikly Hello Karl, I have the study you asked about and will send it to you when I'm back in my office. I'd like to ask if you ever eat tofu? It's plant based but also a processed food that's as processed as the crushing of olives.
So it's nice to know that the reported endothelial function that olive oil could have is not set in stone and that a small, reasonable amount of oil is actually fine. Thanks for this video.
Note: the reported impaired endothelial function also said "no impairment seen when taken with vitamin C". Take it with a salad. Also, we see same impairment with exercise, sex and sleep. Long term we consistently see excellent health outcomes with all of the above.
Nutrition science is on the right track! This high quality study confirms some basics: avoid saturated fat, eat a lot fruit and vegetables and a diet is only good if you can stick to it.
This makes me happy, I try to stick to a moderate protein, high quality fat diet. Olive oil is a must for me but above all I try to avoid processed crap. My life is better for it.
Great work as always. Curious to see if you’re going to get into the microbiome much since it is so heavily influenced from diet and kind of a sub factor to your normal work.
@@NutritionMadeSimple No, haven't even read the papers yet. I have some other plans for the next few weeks (several videos about carbs, insulin and glucose homeostasis, which is going to be a big emphasis on my channel given that this was a major focus of my lab). Cheers!
First off, I absolutely love this channel! Top notch content presented in a clear, unbiased and polite manner. So rare these days. You mentioned that the Mediterranean group ate more fruits and vegetables than the low fat group. How do we know this doesn't account for the differences in outcomes between the two groups? You sort of allude to this near the end of the video, but you also state that the results of this study are "inconsistent with the idea that increasing fat intake is bad for the heart, the group eating the most fat had the best cardiovascular outcomes." Given the other differences between the groups, I don't think this study tells us anything one way or another about eating more fat is good or bad for the heart. There may well be other studies that answer this question, but this isn't one of them. One question I had relates to the low fat group. You mentioned that the low fat group did not meet their targets for legume and whole grain intake and ate less fruits and vegetables than the Mediterranean group. What were they eating instead? Presumably not red meat or refined carbs, as you said those were reduced in both groups. Poultry? Pork? Egg whites? Another factor that could potentially account for differences between the two groups? I had a quick look at the paper, but this information seems to be tucked away in a supplementary appendix that I can't easily find.
You said in ne of your videos that you are half Brazilian and half Portuguese. This place you recorded reminded me of places in Brazil. I'm half American and half Brazilian living in the US for about 20 years. I'm type 2. New to the channel and loving it.
Thanks for yet again a great video! I'm sure I'm not the only one who appreciates your thoroughness and balanced takes on nutrition. This is such a hot topic. I've been trying to find support for the no oil camp studies and so far, have learned what murine means😆!
Great review. Thank Gil. One thought is that all three trials (Lyon, PREDIMED, and CORDIOPREV) were conducted in the Mediterranean region. I wonder if culturally-relevant factors might have advantaged the people in the Mediterranean arms of these studies. Perhaps via psychological and or behavioral mechanisms (perhaps more faith in and more familiarity with the MED protocols). And whether that could have contributed to outcome differences. Just playing with thoughts about possible biases. Feedback?
After studying the Mediterranean diet in the Mediterranean (Italy - mostly in the south) I am absolultely convinced that lifestyle makes a difference. But, that doesn't mean we can't take the components of the Med diet and translate it to our lives. I'm so passionate about this. It's become the core of my practice.
I'm suspecting that the higher Vitamin E content of high quality EVO is at least in part responsible for superior cardiovascular health. Some Olives are 2-4 times as rich in this vital nutrient.
Thanks, it raises many issues. 28% less CVD events for men is significant for Mediterranean. 40% for strict diet achievement. C- reactive protein lower in Mediterranean. I need to learn more about about. “Fat is not bad”, talked about ‘ good fat’. Ok for nuts , salmon. Is not Yogurt and cheese saturated fat in Mediterranean. You said @ 9:50 min , olive oil is with nuts unsaturated, I think olive oil is mono saturated. And ‘high quality fat’ meaning ?. Is mono and polyunsaturated fats (even if later, if seed oils is very refined).
Lol, I thought genetics loves its weird acronyms, but nutrition science may have us beat with these trials. We just add "seq" to every new technique. Personally, I eat a Mediterranean diet with moderate fat (nuts and olive oil), but had to up the legumes because of food inflation (beans are cheaper than salmon). I find it easier to follow than other diets, but that's me. The biological relevance vs. control argument was one of my lectures in my genetics class, great explanation!
Would love to see a study comparing a Mediterranean diet but with canola oil vs olive oil. On the surface, canola has half the saturated fat, double the omega6, and 10x the omega3 content of olive oil, so it would be interesting to see if outcomes are significantly different.
This study seems kind of weak to me, there just was not enough of a difference. A healthier diet is always the goal, but it's so relative, especially if you already have health issues. Per my doctor, I followed a low carb diet for years for diabetes and other chronic health issues, which helped control my numbers... but I was still diabetic and taking meds. I decided to try the Mediterranean diet, which was about the same, and then later switched to testing a whole food plant based diet. Though I actually felt better within days, it took eliminating ALL oil, including the EVOO, to see optimum change, and getting my fats from whole food sources like nuts, flax, etc.. It took getting my total fats to around 10-12% to actually reverse long standing diabetes in 2 weeks, even before losing appreciable weight, and eating more complex carbs than I ever had! (nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/)
I don't totally agree that it does not invalidate the study because we have different ways to present data. For example, the Animal Farming industry in NZ states that they are one of the most carbon efficient in the world. Yes, if compared to other animal farming industries in the world, for example in certain parts of Africa. However when we compare animal farming industry products to the alternatives we see that for example cow milk produces 3x more greenhouse gas emitions, uses 9x more land, 5x~6x more water than the most efficient alternative (soy milk). You see, it's also the way the data is presented. Love your videos btw! Abraço de Portugal!
I got such a shock to see my LDL in particular skyrocket to 7.11 after 2 years on keto. My HDL, 2.91 and triglycerides .92. Only found out after having blood work done two weeks ago. So clearly this is evidence for me that eating saturated fat has been the culprit for the LDL raise in my case. Im 59 year old woman and family doctor wants me to go on statins immediately. Ive now cut ALL animal products, feel fine, in fact I feel alert and somehow have more energy (could be my imagination) How long does it take for bloodwork to change? I want to avoid statins if I can. Thanks for the educational videos, really appreciate the clear content.
@@NutritionMadeSimple so Im vegan now and low carb…keto vegan. Im going to get my bloodwork done again end of August and really hoping to see good cholesterol numbers. Its my little experiment on myself!
@@NutritionMadeSimple So followed a whole foods vegan/Mediterranean diet for 3 months. No dairy or saturated animal fats. My LDL reduced from 7.11 to 3.17, HDL rose from 2.91 to 3.03. Non HDL 3.50. Dr still wants me on a statin as she believes these numbers are still too high…I think Ill keep vegan and see if I can improve things…not sure what else I can do . Anyway I think it was an overall good result, oh and no weight gain.
Awesome video as always. Always looking forward for new content from you guys. I was really surprised that the Mediterranean diet had better results,... Even though that I'm part Greek, to be honest makes me kind of happy 😁 ☺️..... Unfortunately the diet in Greece has definitely changed for the worse over the years and they don't eat as healthy as they used to.... With a bad health outcome of course.....
Thank you so much for the video! As someone who has heart disease it was great to see the difference in the results between these two diets. I wonder how Dr. Dean Ornish and Dr. Esselstyn would interpret these results.
I'm sure they would say that the "low-fat" arm was not really "low fat" since participants ate 32% of calories as fat and their diets are 10% fat, and also remove all processed foods and animal products - which this one did not. I've seen such critiques often with this study and similar ones. This isn't something that really compares an Ornish/Esselstyn diet to a Mediterranean one, but we do see benefits in the Mediterranean diet group, and that benefit is also shown in other studies that bolster the Mediterranean diet's reputation. Whether it's better or worse than an Esselstyn/Ornish approach is not clear because we just don't have convincing data/studies that would compare these head to head, or if we do have data, they aren't conclusive about which diet is better. At this point, I would say go with the diet that is sustainable for you and that you actually feel healthy on, that's what I do, as a fellow person with heart disease. What that comes down to for me is an Esselstyn/Ornish diet, but includes some foods on occasion with more fat (avocado, nuts, and even olive oil). I don't do animal products, and I don't do refined grains or any processed junk. That approach seems to be a good one for me.
@@dvdmon There is one recent study from PCRM in which a low-fat vegan diet (but 20% calories from fat) outperformed a Med diet on most markers, but it was much shorter study.
@@NutritionMadeSimple can you make a video about vegetable oils/seed oils and other unsaturated fats vs saturated fats etc. I know your positions you have stated, but are refined oils also good for us or not?
Interesting video! I'd love to see a similar study with a low fat program like Mastering Diabetes. I believe they promote less than 15% of calories from fat and exclude all animal products. I have very little knowledge on the topic but I think the premise is that fat clogs up the insulin receptors leading to excess blood sugar and inflammation. I'd love to see you cover this angle in a video.
I had the same observation, because I am very acquainted with the High Carb Low Fat whole food plant based camp, I know that they’d never in a million years consider that group of the study a low fat group. I think Gil needs to change the title of the video. As far as I can tell they compared two Mediterranean diets, one with a little less fat.
I'm just a Jo-Blow who enjoys reading about nutrition. I'm trying to eat more vegetables. I find that easier to accomplish with the addition of fat like olive oil. The results of this study lead me to believe that I'm better off eating a big salad with dressing than omitting the salad to avoid the fat in the dressing. I haven't seen anything that causes me to think that just adding olive oil without any other changes is beneficial, but the next study could change my mind. We'll see!
Per the S4 table in the PlosMedicine study, the "Low fat" group is taking more red/processed meat, dairy products, pastries/ commercial bakery, refined grains and less vegetables than the Mediterranean group at 1 year. If so, not surprised that the outcome is not as good as the Mediterranean one.
right. the intakes varied over the course of the followup. at 5years they were different from 1year, and at 7y they were different again. in general the diets seemed to converge to their goals over the course of the study. it's certainly possible that the bigger differences seen early on played a role. this is yet another reason to be careful about over interpreting trials like these. always very tricky to pin the effects on a single food when several change... :(
Hi Gil, can you please make a video about OXALATES? I read that they are neutotoxin predominantly found in plants and can cause kidney problems. How to avoid this in plant-dominated diet?
Hi Gil, thank you for another clear and concise video. I would liked to learn more about the different fats and what would be considered bad or good and why, besides the olive oil vid do you have any others that go into the fats in more detail?
One of the considerations in U.S. News "Best Diets 2022" was the ease of following the diet. I've heard it said "the best diet is the one you can stick with". The fact that the Mediterranean Diet group was able to meet their macro goals, while the Low Fat group was not, is an interesting observation.
Yep. This is one of my main complaints with Esselstyn/Ornish. They claim that they have miraculous results, but if only 2% of people can stick with them for more than a few months, then their results only only true for 2% of the population. Even so, they haven't shown good evidence that their results are better than the Mediterranean diet. They probably aren't worse, and might even be 5 or 10% better, but unless it's 50-100% better, than it's probably not worth it for most people outside of those who are very sick and need to do something drastic (and may thus have the motivation to do something drastic)
@@ongengwai I probably get 15-20%. The main benefit I see for lower fat is that it's easier (for me anyway) to maintain a healthy weight because dietary fat is so concentrated in calories...
@@dvdmon "They claim that they have miraculous results, but if only 2% of people can stick with them for more than a few months, then their results only only true for 2% of the population." Esselstyn got people to stick with his diet for 12 years with regular coaching and about 80% stuck with the diet for 3 years with just one initial session in his 2014 study.
Hi Gil, thanks for the very detailed and informative video! I was wondering if you could point me to any more literature on the point you made about internal/external validity tradeoffs. I believe you framed it as trading off "control" for "relevance." We face similar issues in quantitative social science, so I'd be cool to see this issue framed from the perspective of nutrition science and generalization. Thanks!
@@NutritionMadeSimple I am not surprised considering the impact that monounsaturated fats found in olive oil, and the healthy fats in fish, has on serum cholesterol profiles (both HDL and LDL). Thanks again for the great video!
Anything above 15-20% fat intake is not going to get results. But that may be hard. Replacing unhealthy fats with healthy ones seems to gain the benefits without the difficulty. This seems to be the most logical conclusion to this study as the low fat group couldn’t even hit below an insanely high target of 1/3 of their calories from fat. Low fat is definitely a misnaming of that group.
Totally agree. If you took away the randomisation and just took the self reports of what people ate and ran a factor analysis on it I don’t think a couple percent or oil quality is going to load in the top three.
Not only did the Mediterranean group eat more fruits and veggies, but the "low fat" group ate more carbs, but not the recommended healthy carbs, so what were those extra carbs from? Refined processed foods seem likely, and they also had a bit more protein which can be problematic as well. I'd like to actually see a WFPB group actually eating low fat.
possible. they had 3 categories for carbs in the intake data (total cereals, whole cereals and "bakery and sweets"). whole cereals were increased on both diets compared to baseline (no significant difference between them). total cereals were decreased in both (also no diff btw them). bakery and sweets were also reduced in both by the end of the follow-up with, no diff btw, but it seems the mediterranean group may have reduced them faster (from the start), the "low fat" group only later. this is all gleaned from the intake data tables. basically I´m cautious about pinning the effects on a single food since they changed whole dietary patterns, and also we should avoid blanket conclusions from a trial like this like "oh so low fat is bad". hope that came through in the video...
@@erastvandoren Esselystn is not controlled, Ornish didn't just change diet, but also had numerous other lifestyle modifications. Barnard's studies have not concentrated on those who already have disease, but the ones I'm familiar with are not well designed, they also aren't nearly as long-term as this one, let alone Esselstyn's or Ornishes - they tend to be months vs. years.
"Helped me so much understand the benefits of low fat versus moderate fat." Except that both of these diets WERE moderate fat diets: Truly low-fat diets--the kind that have achieved the best results for obesity, diabetes, and heart disease--are just 7-15% calories from fat. All the study shows is that a little more EVOO and fruits and veggies is better for you than a little more processed carbs.
The main changes however from what I can see is from fatty fish high in Omega 3 and nuts to fish low in Omega 3, less nuts plus low fat dairy. I don't give much weight to any changes in olive oil intake. Another issue is the lo fat group had 6% more obesity, 10% more diabetes and 20% more smokers the total proportions of obesity about 50%, diabetes 54% and smokers 10%. They reckon they adjusted for it at least when considering kidney function, however I question why was one group statistically in a worse starting position on 3 key measures the only one going the other direction was hypertension but very low percentage. Also how exactly how did they adjust accurately.
Thats very interesting. A lot of plant based doctors are against olive oils and state its bad for the heart. Esselstyn would be a big outspoken critic. He is against nuts too. He has zero tolerance on fat. Furhman is against the Oil too but advocates walnuts and seeds. This study made me rethink things. I have heart disease and dropped olive oil and have a sense of fear of eating nuts and avocado's although I wouldn't have abused the quantity and intake when i was consuming them . I think I'll introduce a little bit back into my plant based diet again. I guess the big change for me is I went from 95% processed junk food to less than 5% a week.
Reduced plaque and improved endothelial function from unsaturated fats is "new" information for me. Nuts, avocados, and olive oil are fine and probably beneficial if you have room for the calories.
I read the study and one of the authors did comment that both diets reduced events. The Mediterranean has less events so was better but either way there is a benefit to be had.
If people are still concerned about eating olive oil despite this study, then they can go for whole olives and still get the benefits! There is an argument that any oil makes it easier to gain weight and the weight gain in of itself increases risk of negative health outcomes. So for that reason it may make sense to go for whole olives (more satiating) over the oil. It’s extremely easy to overeat calories from any oil.
Yeah, that's an option, it's definitely a lot easier to overconsume calories with oil than with whole olives. On the other hand, olives tend to have a lot of salt as well, so that's a concern on the side of whole olives.
I don't know if it's true but I read that oleocanthal, which seems to be one of the most effective polyphenol in OO, is produced during the pressing process. Also I wouldn't be surprised if the absorbtion of the polyphenols was higher when eating OO than olives.
"If people are still concerned about eating olive oil despite this study" I don't see anything in this study that proves olive oil is beneficial--did I miss something?
I would agree insofar as if you need to lose weight and find it hard to do so, that reducing all high-fat foods will help. You should of course start with the foods that are highest in saturated fat, and then work your way down. For those who are at a reasonable weight and consume olive oil, there's no reason to omit it if you are happy with said weight.
@@dvdmon "For those who are at a reasonable weight and consume olive oil, there's no reason to omit it if you are happy with said weight." It may contribute to heart disease.
I’m right in between Mediterranean and low fat, since I consume between 30 to 35% of my calories in fat, vegan, but my protein is more like 10 to 12%. I don’t think people in the HCLF camp would ever call that a low fat diet, so good luck convincing them. Last I checked one of their recommendations, they said 30 grams of fat was as much as you could get (this is what Dr Khambatta said in an interview with Plant Chompers about approaches to diabetes). That’s 11% in a 2,000 calorie diet, or three times lower than the low fat group in this study.
Salmon is not a mediterranean, sardines and anchovies are mediterranean and also loaded with EPA & DHA. Not that you are not eating the mediterranean diet when salmon is your choice for fish, just that the graphic with salmon seemed odd.
Now that's fascinating. Thank you for the video. I wonder if the effect is not also due to HDL. I know that you've said that HDL shouldn't really be a factor after all, but I read that HDL can be oxidized, and that when it is oxidized it is unable to function properly to remove the cholesterol from the plaques. There is a study called "Extra Virgin Olive Oil Polyphenols Promote Cholesterol Efflux and Improve HDL Functionality" that shows that olive oil increases cholesterol efflux.
Of some interest the Mediterranean Diet ended up with about 50 g of "extra virgin olive oil" daily.. and wine WAS allowed. While the "low-fat" diet intervention recommended 20 to 30 g of "sunflower or regular olive oil". Wine was NOT allowed. Would have been interesting if the "low fat" group was allowed their 25 g of oil only as "extra virgin olive oil".. Might make it possible to ascertain if "extra virgin olive oil" had some magical properties and if lesser amounts would have given the same benefit as found in the Mediterranean Diet group's larger portions.
7:53 Although both diets resulted in similar Weight, Cholesterol, ApoBs, BG, & TGs, the OO diet (with the higher fat %) resulted in lower C-Reactive Protein and CVD in the long run.
As a vegan, I try to take some influence from the Mediterranean diet. I'm not into the low fat/no oil thing some vegans are, I use canola and olive oil as well as supplement with microalgae omega 3's
Funding doesn't make a study bad as you say. But I expect it has a big influence on publication bias. So studies that don't show the desired outcome are more likely to be ignored. Would love to hear your thoughts on publication bias.
Perhaps the low-fat group should have been eating flax to balance out the omega3/6. Also vegans would state high fat or low-fat dairy still has a poor ratio of saturated to unsaturated fat, high cholesterol and IGF-1. The study may prove dairy is a contributing factor to CVD.
I'm a bit confused what "Lo Fat" actually ate more. They ate less from everything healthy (nuts ... , whole grains, legumes, vegetables) it seems. I guess one outcome is, that vegetables, ... taste better with fat :).
they seem to have eaten a bit more dairy for example. but yeah I agree it's surprising that there wasn't a bigger difference in specific foods given the macros
@@NutritionMadeSimple I often try to think in terms of replacement. And it was good that you focused on what the macros actually meant. I would have totally guessed wrong. The "Lo Fat" ate less vegetables, not more legumes and whole grains, less nuts and olive oil and on the other hand increased low fat dairy and other things (I'll look in the study on the weekend probably to understand what exactly that is). Now it seems they just replaced health promoting food with "cleaner" versions of not health promoting food. Now the direction of the outcome is not that surprising. And the inflammation is then not surprising, too. I would have guessed that from my limited understanding. That way it's less applicable to my eating habits than I initially thought. I would definitely increase the intake of vegetables, legumes and whole grains (just because it's the food I eat anyway) if I would decide to eat less fat.
@@OatmealTheCrazy But then we would think the mechanism is through ApoB/LDL. But it's through inflammation. It would definitely be interesting to understand what the difference is (guess: health promoting in "Mediterranean" vs. only cleaner food on "lo fat" - would be consistent with the inflammation problem). But we would have to look at the study. I'll try to find time on the weekend to read it carefully.
I guess it's hard to eat veggies and raw salads with limited oil. And maybe it had nothing to do with oil or veggies, but with limiting protein intake. Very informative, but I will still be limiting my intake of fats, even if it's from oilive oil.
Mediterranean Keto is what I am switching to from standard Keto as want to reduce cholesterol and LDL (HDL ok) . Why are there no studies where instead of more carbs, but more proteins?
This channel has never had a "debate" - you must be looking for the Joe Rogan podcast. ;-) Debates often don't end up being terribly enlightening because it takes time to analyze studies and talk through different aspects of them. This channel mainly is great at educating the layman about how to discern different dietary cliches and whether they make any sense once you actually look through the data - but that analysis can take time...
What if the Lo Fat arm cohorts were so diligent and specific so as to eat fish instead of meat but they dutifully & assiduously avoided fatty fish whereby the other arm felt pressure to boost fats thus overly favored the fatty fish? Then the OM-3's would be a confounding variable.
Great video, but I don’t think the study supports the statement “fat isn’t bad”. The study shows that olive oil is better than butter, but not if no processed oil at all would be best :)
So if adding olive oil was beneficial to these diets what do you think could happen if you ate saturated fats but still added olive oil to what you eat? Thanks for the great analysis.
Spain is number one producer of olive oil. EVOO was the only extracted fat I ate for years. I stopped it because of high BP. I also ate meat fish eggs some cheese olives (salt). So not cear if it was the EVOO but sure it did not prevent. Went WFPB no SOS to control BP with no pills.
Me, @ Thanksgiving table: "Did you know that in the Lyon Diet Heart study..." My family: "Why can't you be normal and just tell racist or misogynistic jokes!?"
I'm from the mediterranean region and eat a medit diet :D getting all my fat calories from nuts, grains and fatty fish and fatty fruits I'm also pesca which is very easy on a med diet
Your explanations of (08:22) "because of" vs. "despite", (09:57) funding, and (11:50) control vs. relevance are absolutely brilliant !! 👏👏👏
Dietetic student just finishing my finals and I've binged many videos on your channel - super informative and well presented. Thank you!
As always, awesome content, delivered in a clear, concise, and thoughtful manner. Gil, thank you for the hours of work you put in to deliver this most valuable and actually usable information!!
My pleasure!
This is the best nutrition channel. Thank you for helping us understand the nuances of scientific research. Hey Gil, have you thought about doing a portuguese version of this? Wow, it is very hard to find good quality infirmation in portugese. I would love to share these vídeos with my family. Maybe portuguese subtitles?
This is by far the best nutrition channel on RUclips. No bias, just straight up facts. Keep it up Gil, I will continue watching for sure!
Fascinated by the clarity that Gil shows while he breaks down the complexity in diets and diet studies. Great point about the tradeoff of control and relevance in the latter. Useful tips on using olive oil or nuts while not overstating that alone they are not a panacea, but rather an integral part of eating a diet less in processed foods.
What an awesome summary of the study. 🙏
As a Mediterranean I can say it's not just about what we eat but when. Dinner is not our biggest meal, nor breakfast. It's lunch, and then maybe a nap. We also often start work later in the day.
Later in the day or earlier in the evening, the middle of the day is too hot 🥵
Same in indian culture, we eat lunch like a king and dinner like a beggar
As many Americans are crushed by debt and many by the need for status, there is little time for a proper breakfast so we grab a bagel. We work through lunch with a deli sandwich. Some of us work late so we enjoy a late dinner with alcohol and do it all over again.
The Mediterranean is huge, there's South Europe Mediterranean and North Africa Mediterranean, each country has their own Mediterranean diet
D’accordissimo
This is so encouraging! I started following a no oil, low fat, whole-food plant based diet 4 years ago when I had an angioplasty to repair a 90 percent blockage in one of my coronary arteries. I also have genetically high cholesterol. Almost everyone talks about what to eat to avoid heart disease, but this is the first thing I’ve seen addressing those already affected with CVD. Occasionally, I have cheated and have had a little olive oil. It’s great to know that it’s OK as long as I don’t go overboard. Thank you for bringing objective analyses of these studies and topics. Your RUclips channel has become my “go to” place for learning about nutrition because you are not pushing an agenda, and you encourage everyone to verify everything, including your own videos.
Do you know of any cooking books etc that are good for recipes on your diet?
@@BigBoomOfDoom2 Dr. Esselstyne(sp?), Dr. Greger, and Forks Over Knives.
I bet the olive oil makes it easier to stick to the rest of the diet.
@@TonyDiCroce I was thinking the same thing.
Bro is cheating on olive oil lmao
That was a fantastic breakdown. I have learned so much from your videos about nutrition. I really appreciate your balanced approach to these topics without being dogmatic about anything.
I just wanted to say that I have been looking for information that your channel provides. I am tired of being confused on what foods to eat. I found your channel today and look forward to binging the content. Thank you for being unbiased and providing the research .
Wow, an actuality thorough, balanced and comprehensive overview of dietary science on RUclips. I've never clicked subscribe faster in my entire life.
Epic video and breakdown
Two of my favorite Doctors on the web are Dr Brad Stanfield and Dr Carvalho, they both take a “just the facts mam” approach and don’t get swept into the hype of the day.
Another great video, Dr. Gil!
Awesome video as always Gil. I use to be so focused on the "Mediterranean Diet vs Low fat" or the "we're all confused about red meat" part of the videos but now I look forward to the hidden nuggets to do with how science works and how to think scientifically. The one in this video being about control and relevance. So cool and so simple to understand.
Thank you Gil for another great message. You are the voice of reason on a topic that is often very confusing for several reasons. After studying the Mediterranean diet (in the Mediterranean) for several years now I've come to appreciate the lifestyle as another factor for its success. To use part of your closing comments we can take the core of the Mediterranean lifestyle and adapt it to wherever we live.
@@nickarrizza Hi Nick, I appreciate your message. I'm very familiar with Dr. Esselstyn's diet and research of 30 years ago. I credit Dr. Esselstyn with the work he did 30 years ago but from my own work with populations that live long lives without chronic illnesses (including heart disease) who consume olive oil I've had to re-evaluate my thoughts. To keep this brief I would like to just point out that high quality, high polyphenol olive oil has shown in many good, reliable studies to actually be beneficial for health. I appreciate all the messages from the famous doctors about olive oil but it's difficult to argue with the longest living populations that have consumed olive oil for centuries. The olive oil they are consuming is very different from what's in our grocery stores. There is also so much more to the story but I will stop here.
@@nickarrizza Hello again Nick...funding of studies can be an issue but 100s of studies on olive oil are not funded by the olive businesses.
Yes olive oil is 100% fat but 86% of that fat is plant based unsaturated fat which has been eaten on this planet by humans since 8000 BC which is well before the epidemic of heart disease that exists today.
I wasn't going to mention this but Dr. Esselstyn was part of a study citing the benefits of olive oil. You might want to look it up.
@@carolamendoladanca "Dr. Esselstyn was part of a study citing the benefits of olive oil." That;'s surprising given that his mantra is "No Oil!" Source?
@@carolamendoladanca "100s of studies on olive oil are not funded by the olive businesses." That's true, but I've waded through the meta-analyses and haven't found any studies that showing eating olive oil or EVOO is better for you than no oil at all. In the PREDIMED study, the thickest plaques got thicker on the Mediterranean diet liberally supplemented with EVOO. Had they not stopped the study when they did, that trend would have likely reached significance in 3-6 months (making me think that;'s why they stopped the study when they did). EVOO may be slightly beneficial, neutral, or slightly harmful--I see no way of deciding that issue based on the research I have seen. And as a nutritionist, you know that lumping a processed unsaturated fat is different from an unprocessed one. The human body evolved to eat whole foods.
@@HealingLifeKwikly Hello Karl, I have the study you asked about and will send it to you when I'm back in my office.
I'd like to ask if you ever eat tofu? It's plant based but also a processed food that's as processed as the crushing of olives.
I like your visual images and words you flash to make it easier to follow your presentation. Thank you for offering these kinds of educational videos.
So it's nice to know that the reported endothelial function that olive oil could have is not set in stone and that a small, reasonable amount of oil is actually fine. Thanks for this video.
Note: the reported impaired endothelial function also said "no impairment seen when taken with vitamin C". Take it with a salad. Also, we see same impairment with exercise, sex and sleep. Long term we consistently see excellent health outcomes with all of the above.
Nutrition science is on the right track! This high quality study confirms some basics: avoid saturated fat, eat a lot fruit and vegetables and a diet is only good if you can stick to it.
Love you work mate. You explain things so well and with humour unlike some buggers on here. I`ll keep watching from Australia cheers.
This makes me happy, I try to stick to a moderate protein, high quality fat diet. Olive oil is a must for me but above all I try to avoid processed crap. My life is better for it.
Great work as always. Curious to see if you’re going to get into the microbiome much since it is so heavily influenced from diet and kind of a sub factor to your normal work.
I wish I could embrace puns with your level of confidence. Thanks delivering awesome, concise, unbiased content as always :)
Lovely video with a lot of clarity and usable recommendations. Thank you!
Nicely done, as always!
Thanks! do you have one coming on this study? always curious to see different takes
@@NutritionMadeSimple No, haven't even read the papers yet. I have some other plans for the next few weeks (several videos about carbs, insulin and glucose homeostasis, which is going to be a big emphasis on my channel given that this was a major focus of my lab).
Cheers!
that makes sense!!!!
Thanks! Amazing breakdown of the study as usual. One of my favorite nutrition oriented RUclips accounts.
First off, I absolutely love this channel! Top notch content presented in a clear, unbiased and polite manner. So rare these days.
You mentioned that the Mediterranean group ate more fruits and vegetables than the low fat group. How do we know this doesn't account for the differences in outcomes between the two groups? You sort of allude to this near the end of the video, but you also state that the results of this study are "inconsistent with the idea that increasing fat intake is bad for the heart, the group eating the most fat had the best cardiovascular outcomes." Given the other differences between the groups, I don't think this study tells us anything one way or another about eating more fat is good or bad for the heart. There may well be other studies that answer this question, but this isn't one of them.
One question I had relates to the low fat group. You mentioned that the low fat group did not meet their targets for legume and whole grain intake and ate less fruits and vegetables than the Mediterranean group. What were they eating instead? Presumably not red meat or refined carbs, as you said those were reduced in both groups. Poultry? Pork? Egg whites? Another factor that could potentially account for differences between the two groups? I had a quick look at the paper, but this information seems to be tucked away in a supplementary appendix that I can't easily find.
You said in ne of your videos that you are half Brazilian and half Portuguese. This place you recorded reminded me of places in Brazil. I'm half American and half Brazilian living in the US for about 20 years. I'm type 2. New to the channel and loving it.
Thanks for yet again a great video! I'm sure I'm not the only one who appreciates your thoroughness and balanced takes on nutrition. This is such a hot topic. I've been trying to find support for the no oil camp studies and so far, have learned what murine means😆!
Great review. Thank Gil. One thought is that all three trials (Lyon, PREDIMED, and CORDIOPREV) were conducted in the Mediterranean region. I wonder if culturally-relevant factors might have advantaged the people in the Mediterranean arms of these studies. Perhaps via psychological and or behavioral mechanisms (perhaps more faith in and more familiarity with the MED protocols). And whether that could have contributed to outcome differences. Just playing with thoughts about possible biases. Feedback?
After studying the Mediterranean diet in the Mediterranean (Italy - mostly in the south) I am absolultely convinced that lifestyle makes a difference. But, that doesn't mean we can't take the components of the Med diet and translate it to our lives. I'm so passionate about this. It's become the core of my practice.
I'm suspecting that the higher Vitamin E content of high quality EVO is at least in part responsible for superior cardiovascular health. Some Olives are 2-4 times as rich in this vital nutrient.
Can't get enough of these videos.
Kudos doc
Thanks, it raises many issues. 28% less CVD events for men is significant for Mediterranean. 40% for strict diet achievement. C- reactive protein lower in Mediterranean. I need to learn more about about. “Fat is not bad”, talked about ‘ good fat’. Ok for nuts , salmon. Is not Yogurt and cheese saturated fat in Mediterranean. You said @ 9:50 min , olive oil is with nuts unsaturated, I think olive oil is mono saturated. And ‘high quality fat’ meaning ?. Is mono and polyunsaturated fats (even if later, if seed oils is very refined).
Thank you so much indeed for the long hours and hard work for these usable real quality contents 🙏🙏🙏
Lol, I thought genetics loves its weird acronyms, but nutrition science may have us beat with these trials. We just add "seq" to every new technique. Personally, I eat a Mediterranean diet with moderate fat (nuts and olive oil), but had to up the legumes because of food inflation (beans are cheaper than salmon). I find it easier to follow than other diets, but that's me. The biological relevance vs. control argument was one of my lectures in my genetics class, great explanation!
First!
Thanks for the, as usual informative and inspirational video.
Would love to see a study comparing a Mediterranean diet but with canola oil vs olive oil. On the surface, canola has half the saturated fat, double the omega6, and 10x the omega3 content of olive oil, so it would be interesting to see if outcomes are significantly different.
the Lyon trial used canola + olive oil and got great results (although always tricky to directly compare, and their control diet was less "clean"...)
@@williammorgan7769 why? it is higher in omega 3.
@@williammorgan7769 yeah, I hear people spout that but where is the evidence?
@@Julottt an entire bottle contains less than one serving of fish.
This study seems kind of weak to me, there just was not enough of a difference. A healthier diet is always the goal, but it's so relative, especially if you already have health issues. Per my doctor, I followed a low carb diet for years for diabetes and other chronic health issues, which helped control my numbers... but I was still diabetic and taking meds. I decided to try the Mediterranean diet, which was about the same, and then later switched to testing a whole food plant based diet. Though I actually felt better within days, it took eliminating ALL oil, including the EVOO, to see optimum change, and getting my fats from whole food sources like nuts, flax, etc.. It took getting my total fats to around 10-12% to actually reverse long standing diabetes in 2 weeks, even before losing appreciable weight, and eating more complex carbs than I ever had! (nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/)
thanks for videos sir, i learned so much from you🙏
I don't totally agree that it does not invalidate the study because we have different ways to present data. For example, the Animal Farming industry in NZ states that they are one of the most carbon efficient in the world. Yes, if compared to other animal farming industries in the world, for example in certain parts of Africa. However when we compare animal farming industry products to the alternatives we see that for example cow milk produces 3x more greenhouse gas emitions, uses 9x more land, 5x~6x more water than the most efficient alternative (soy milk). You see, it's also the way the data is presented.
Love your videos btw!
Abraço de Portugal!
you are a star, this is really great.
I got such a shock to see my LDL in particular skyrocket to 7.11 after 2 years on keto. My HDL, 2.91 and triglycerides .92. Only found out after having blood work done two weeks ago. So clearly this is evidence for me that eating saturated fat has been the culprit for the LDL raise in my case. Im 59 year old woman and family doctor wants me to go on statins immediately. Ive now cut ALL animal products, feel fine, in fact I feel alert and somehow have more energy (could be my imagination) How long does it take for bloodwork to change? I want to avoid statins if I can. Thanks for the educational videos, really appreciate the clear content.
it can change in as little as a few days but certainly over weeks or a couple months you should see a difference
@@NutritionMadeSimple so Im vegan now and low carb…keto vegan. Im going to get my bloodwork done again end of August and really hoping to see good cholesterol numbers. Its my little experiment on myself!
@@carpenanne very interested to hear about your results! Hope it works for you
@@NutritionMadeSimple So followed a whole foods vegan/Mediterranean diet for 3 months. No dairy or saturated animal fats. My LDL reduced from 7.11 to 3.17, HDL rose from 2.91 to 3.03. Non HDL 3.50. Dr still wants me on a statin as she believes these numbers are still too high…I think Ill keep vegan and see if I can improve things…not sure what else I can do . Anyway I think it was an overall good result, oh and no weight gain.
@@carpenanne wow that's a huge drop. great job!
Thank you for the video
Awesome video as always. Always looking forward for new content from you guys. I was really surprised that the Mediterranean diet had better results,... Even though that I'm part Greek, to be honest makes me kind of happy 😁 ☺️..... Unfortunately the diet in Greece has definitely changed for the worse over the years and they don't eat as healthy as
they used to.... With a bad health outcome of course.....
Love the Mediterranean diet! Cooking a Mediterranean meal series on my new RUclips channel in a few weeks! Thank you for getting
The word out!
Thank you so much for the video! As someone who has heart disease it was great to see the difference in the results between these two diets. I wonder how Dr. Dean Ornish and Dr. Esselstyn would interpret these results.
I'm sure they would say that the "low-fat" arm was not really "low fat" since participants ate 32% of calories as fat and their diets are 10% fat, and also remove all processed foods and animal products - which this one did not. I've seen such critiques often with this study and similar ones. This isn't something that really compares an Ornish/Esselstyn diet to a Mediterranean one, but we do see benefits in the Mediterranean diet group, and that benefit is also shown in other studies that bolster the Mediterranean diet's reputation. Whether it's better or worse than an Esselstyn/Ornish approach is not clear because we just don't have convincing data/studies that would compare these head to head, or if we do have data, they aren't conclusive about which diet is better. At this point, I would say go with the diet that is sustainable for you and that you actually feel healthy on, that's what I do, as a fellow person with heart disease. What that comes down to for me is an Esselstyn/Ornish diet, but includes some foods on occasion with more fat (avocado, nuts, and even olive oil). I don't do animal products, and I don't do refined grains or any processed junk. That approach seems to be a good one for me.
@@dvdmon There is one recent study from PCRM in which a low-fat vegan diet (but 20% calories from fat) outperformed a Med diet on most markers, but it was much shorter study.
Thanks for the great video!
Glad you liked it!
@@NutritionMadeSimple can you make a video about vegetable oils/seed oils and other unsaturated fats vs saturated fats etc. I know your positions you have stated, but are refined oils also good for us or not?
Dr Gil always delivers
Great information and science based. We need more of this.
Thank you very much ! Greats from Berlin
Interesting video! I'd love to see a similar study with a low fat program like Mastering Diabetes. I believe they promote less than 15% of calories from fat and exclude all animal products. I have very little knowledge on the topic but I think the premise is that fat clogs up the insulin receptors leading to excess blood sugar and inflammation. I'd love to see you cover this angle in a video.
Apparently you didn’t watch the entire video
@@Krunch2020 point to the place in the video where he covers this specifically
I had the same observation, because I am very acquainted with the High Carb Low Fat whole food plant based camp, I know that they’d never in a million years consider that group of the study a low fat group. I think Gil needs to change the title of the video. As far as I can tell they compared two Mediterranean diets, one with a little less fat.
Thank you, Nutrition Made Simple!, for the very educational video!
I'm just a Jo-Blow who enjoys reading about nutrition. I'm trying to eat more vegetables. I find that easier to accomplish with the addition of fat like olive oil. The results of this study lead me to believe that I'm better off eating a big salad with dressing than omitting the salad to avoid the fat in the dressing. I haven't seen anything that causes me to think that just adding olive oil without any other changes is beneficial, but the next study could change my mind. We'll see!
Great information as always! Thanks, Gil.
Per the S4 table in the PlosMedicine study, the "Low fat" group is taking more red/processed meat, dairy products, pastries/ commercial bakery, refined grains and less vegetables than the Mediterranean group at 1 year. If so, not surprised that the outcome is not as good as the Mediterranean one.
right. the intakes varied over the course of the followup. at 5years they were different from 1year, and at 7y they were different again. in general the diets seemed to converge to their goals over the course of the study. it's certainly possible that the bigger differences seen early on played a role. this is yet another reason to be careful about over interpreting trials like these. always very tricky to pin the effects on a single food when several change... :(
Hi Gil, can you please make a video about OXALATES? I read that they are neutotoxin predominantly found in plants and can cause kidney problems. How to avoid this in plant-dominated diet?
❤what you say at the end “ that’s it right there “ . Nice Gil, how many millions of books have been written to say just that? 😂
Hi Gil, thank you for another clear and concise video. I would liked to learn more about the different fats and what would be considered bad or good and why, besides the olive oil vid do you have any others that go into the fats in more detail?
Yes, he has quite a few. Search for Mediterranean Diet, fat, etc. Lots of great stuff!
One of the considerations in U.S. News "Best Diets 2022" was the ease of following the diet. I've heard it said "the best diet is the one you can stick with". The fact that the Mediterranean Diet group was able to meet their macro goals, while the Low Fat group was not, is an interesting observation.
Yep. This is one of my main complaints with Esselstyn/Ornish. They claim that they have miraculous results, but if only 2% of people can stick with them for more than a few months, then their results only only true for 2% of the population. Even so, they haven't shown good evidence that their results are better than the Mediterranean diet. They probably aren't worse, and might even be 5 or 10% better, but unless it's 50-100% better, than it's probably not worth it for most people outside of those who are very sick and need to do something drastic (and may thus have the motivation to do something drastic)
@@dvdmon Easy. I aim for ~15% fat and probably end up with 20~25% fat - still reap the benefits of lower fat diet.
@@ongengwai I probably get 15-20%. The main benefit I see for lower fat is that it's easier (for me anyway) to maintain a healthy weight because dietary fat is so concentrated in calories...
@@dvdmon agreed
@@dvdmon "They claim that they have miraculous results, but if only 2% of people can stick with them for more than a few months, then their results only only true for 2% of the population." Esselstyn got people to stick with his diet for 12 years with regular coaching and about 80% stuck with the diet for 3 years with just one initial session in his 2014 study.
Hi Gil, thanks for the very detailed and informative video! I was wondering if you could point me to any more literature on the point you made about internal/external validity tradeoffs. I believe you framed it as trading off "control" for "relevance." We face similar issues in quantitative social science, so I'd be cool to see this issue framed from the perspective of nutrition science and generalization. Thanks!
Great video! Love your channel. Parabéns!
great video as usual! I'm curious why you said you were surprised by the findings?
based on 2 diets that look pretty health-promoting I wouldn't have expected a big difference in outcomes...
@@NutritionMadeSimple I am not surprised considering the impact that monounsaturated fats found in olive oil, and the healthy fats in fish, has on serum cholesterol profiles (both HDL and LDL). Thanks again for the great video!
Sooo nice vid! Do understand correctly that the macronutrient composition doesnt get to 100 en% ?
Anything above 15-20% fat intake is not going to get results. But that may be hard. Replacing unhealthy fats with healthy ones seems to gain the benefits without the difficulty. This seems to be the most logical conclusion to this study as the low fat group couldn’t even hit below an insanely high target of 1/3 of their calories from fat. Low fat is definitely a misnaming of that group.
Totally agree. If you took away the randomisation and just took the self reports of what people ate and ran a factor analysis on it I don’t think a couple percent or oil quality is going to load in the top three.
Exactly
The whole study of fat intake is contaminated with studies claiming 25-30% calories from fat (38% in PREDIMED) is "low-fat."
Not only did the Mediterranean group eat more fruits and veggies, but the "low fat" group ate more carbs, but not the recommended healthy carbs, so what were those extra carbs from? Refined processed foods seem likely, and they also had a bit more protein which can be problematic as well.
I'd like to actually see a WFPB group actually eating low fat.
possible. they had 3 categories for carbs in the intake data (total cereals, whole cereals and "bakery and sweets"). whole cereals were increased on both diets compared to baseline (no significant difference between them). total cereals were decreased in both (also no diff btw them). bakery and sweets were also reduced in both by the end of the follow-up with, no diff btw, but it seems the mediterranean group may have reduced them faster (from the start), the "low fat" group only later. this is all gleaned from the intake data tables. basically I´m cautious about pinning the effects on a single food since they changed whole dietary patterns, and also we should avoid blanket conclusions from a trial like this like "oh so low fat is bad". hope that came through in the video...
You can. Ornish, Esselstyn, Barnard.
@@erastvandoren that means a life eating tree bark!
@@erastvandoren Esselystn is not controlled, Ornish didn't just change diet, but also had numerous other lifestyle modifications. Barnard's studies have not concentrated on those who already have disease, but the ones I'm familiar with are not well designed, they also aren't nearly as long-term as this one, let alone Esselstyn's or Ornishes - they tend to be months vs. years.
@@Hanover-ek4jy Seriously? Well, I'm eating delicious strawberries right now...
Helped me so much understand the benefits of low fat versus moderate fat. Awesome!
"Helped me so much understand the benefits of low fat versus moderate fat." Except that both of these diets WERE moderate fat diets: Truly low-fat diets--the kind that have achieved the best results for obesity, diabetes, and heart disease--are just 7-15% calories from fat. All the study shows is that a little more EVOO and fruits and veggies is better for you than a little more processed carbs.
Ok admittedly I've come across this az well.
The main changes however from what I can see is from fatty fish high in Omega 3 and nuts to fish low in Omega 3, less nuts plus low fat dairy. I don't give much weight to any changes in olive oil intake. Another issue is the lo fat group had 6% more obesity, 10% more diabetes and 20% more smokers the total proportions of obesity about 50%, diabetes 54% and smokers 10%. They reckon they adjusted for it at least when considering kidney function, however I question why was one group statistically in a worse starting position on 3 key measures the only one going the other direction was hypertension but very low percentage. Also how exactly how did they adjust accurately.
Thats very interesting. A lot of plant based doctors are against olive oils and state its bad for the heart. Esselstyn would be a big outspoken critic. He is against nuts too. He has zero tolerance on fat. Furhman is against the Oil too but advocates walnuts and seeds. This study made me rethink things. I have heart disease and dropped olive oil and have a sense of fear of eating nuts and avocado's although I wouldn't have abused the quantity and intake when i was consuming them . I think I'll introduce a little bit back into my plant based diet again. I guess the big change for me is I went from 95% processed junk food to less than 5% a week.
I have not seen all your videos or searched but please consider reviewing studies which compare Mediterranean diet with a WFPB diet. Thanks!
Reduced plaque and improved endothelial function from unsaturated fats is "new" information for me. Nuts, avocados, and olive oil are fine and probably beneficial if you have room for the calories.
They took statins.
@@erastvandoren Is that a joke?
What bothers me is that the entire study hinges on people being honest about how they actually ate for 7 years.
excellent realization that the vast majority of randomized trials are subject to this same caveat of observational studies (esp. the longest ones)
You make some awesome videos. I would very much like to see one on GMO.
Love the Bossa Nova outro music!
He's a great teacher
I read the study and one of the authors did comment that both diets reduced events. The Mediterranean has less events so was better but either way there is a benefit to be had.
Hello sir @Nutrition Made Simple! Could you please make a video about the effects of Diet Soft drinks. PLEASE I need to hear your opinion on this.
If people are still concerned about eating olive oil despite this study, then they can go for whole olives and still get the benefits! There is an argument that any oil makes it easier to gain weight and the weight gain in of itself increases risk of negative health outcomes. So for that reason it may make sense to go for whole olives (more satiating) over the oil. It’s extremely easy to overeat calories from any oil.
Yeah, that's an option, it's definitely a lot easier to overconsume calories with oil than with whole olives. On the other hand, olives tend to have a lot of salt as well, so that's a concern on the side of whole olives.
I don't know if it's true but I read that oleocanthal, which seems to be one of the most effective polyphenol in OO, is produced during the pressing process. Also I wouldn't be surprised if the absorbtion of the polyphenols was higher when eating OO than olives.
"If people are still concerned about eating olive oil despite this study" I don't see anything in this study that proves olive oil is beneficial--did I miss something?
I would agree insofar as if you need to lose weight and find it hard to do so, that reducing all high-fat foods will help. You should of course start with the foods that are highest in saturated fat, and then work your way down. For those who are at a reasonable weight and consume olive oil, there's no reason to omit it if you are happy with said weight.
@@dvdmon "For those who are at a reasonable weight and consume olive oil, there's no reason to omit it if you are happy with said weight." It may contribute to heart disease.
I’m right in between Mediterranean and low fat, since I consume between 30 to 35% of my calories in fat, vegan, but my protein is more like 10 to 12%. I don’t think people in the HCLF camp would ever call that a low fat diet, so good luck convincing them. Last I checked one of their recommendations, they said 30 grams of fat was as much as you could get (this is what Dr Khambatta said in an interview with Plant Chompers about approaches to diabetes). That’s 11% in a 2,000 calorie diet, or three times lower than the low fat group in this study.
@@geekbot5000 ruclips.net/video/-_nXKpeZZFs/видео.html
It’s a long interview, if you have time, it’s interesting
I think 30-35 percent is moderate or medium, not low.
Salmon is not a mediterranean, sardines and anchovies are mediterranean and also loaded with EPA & DHA. Not that you are not eating the mediterranean diet when salmon is your choice for fish, just that the graphic with salmon seemed odd.
Now that's fascinating. Thank you for the video. I wonder if the effect is not also due to HDL. I know that you've said that HDL shouldn't really be a factor after all, but I read that HDL can be oxidized, and that when it is oxidized it is unable to function properly to remove the cholesterol from the plaques. There is a study called "Extra Virgin Olive Oil Polyphenols Promote Cholesterol Efflux and Improve HDL Functionality" that shows that olive oil increases cholesterol efflux.
Of some interest the Mediterranean Diet ended up with about 50 g of "extra virgin olive oil" daily.. and wine WAS allowed.
While the "low-fat" diet intervention recommended 20 to 30 g of "sunflower or regular olive oil". Wine was NOT allowed.
Would have been interesting if the "low fat" group was allowed their 25 g of oil only as "extra virgin olive oil"..
Might make it possible to ascertain if "extra virgin olive oil" had some magical properties and if lesser amounts would have given the same benefit as found in the Mediterranean Diet group's larger portions.
Was medication considered in this study? Statistics on this would be very interesting
Very interesting. So it would be good to learn why Esselstyn has success with his heart patients by getting oil consumption very, very low.
7:53 Although both diets resulted in similar Weight, Cholesterol, ApoBs, BG, & TGs, the OO diet (with the higher fat %) resulted in lower C-Reactive Protein and CVD in the long run.
As a vegan, I try to take some influence from the Mediterranean diet. I'm not into the low fat/no oil thing some vegans are, I use canola and olive oil as well as supplement with microalgae omega 3's
Also eat nuts and avocados as well.
I am surprised that what seem like relatively minor differences in fat and carbs consumed resulted in much less minor differences in health outcomes.
There were also differences in red meat, dairy, vegetable, and processed carb consumption--all favoring the Med diet.
Funding doesn't make a study bad as you say. But I expect it has a big influence on publication bias. So studies that don't show the desired outcome are more likely to be ignored. Would love to hear your thoughts on publication bias.
Perhaps the low-fat group should have been eating flax to balance out the omega3/6.
Also vegans would state high fat or low-fat dairy still has a poor ratio of saturated to unsaturated fat, high cholesterol and IGF-1.
The study may prove dairy is a contributing factor to CVD.
Neither of these diets would come even remotely close to Caldwell Esselstyn’s plant based, oil free diet.
@@anabolicamaranth7140 ,
This is true.
I'm a bit confused what "Lo Fat" actually ate more. They ate less from everything healthy (nuts ... , whole grains, legumes, vegetables) it seems.
I guess one outcome is, that vegetables, ... taste better with fat :).
they seem to have eaten a bit more dairy for example. but yeah I agree it's surprising that there wasn't a bigger difference in specific foods given the macros
@@NutritionMadeSimple So....replacing healthy fat with saturated fat on average?
it was mostly low fat dairy and the SFA intake was pretty low,
@@NutritionMadeSimple I often try to think in terms of replacement. And it was good that you focused on what the macros actually meant. I would have totally guessed wrong.
The "Lo Fat" ate less vegetables, not more legumes and whole grains, less nuts and olive oil and on the other hand increased low fat dairy and other things (I'll look in the study on the weekend probably to understand what exactly that is).
Now it seems they just replaced health promoting food with "cleaner" versions of not health promoting food. Now the direction of the outcome is not that surprising. And the inflammation is then not surprising, too. I would have guessed that from my limited understanding.
That way it's less applicable to my eating habits than I initially thought. I would definitely increase the intake of vegetables, legumes and whole grains (just because it's the food I eat anyway) if I would decide to eat less fat.
@@OatmealTheCrazy But then we would think the mechanism is through ApoB/LDL. But it's through inflammation.
It would definitely be interesting to understand what the difference is (guess: health promoting in "Mediterranean" vs. only cleaner food on "lo fat" - would be consistent with the inflammation problem). But we would have to look at the study. I'll try to find time on the weekend to read it carefully.
I guess it's hard to eat veggies and raw salads with limited oil. And maybe it had nothing to do with oil or veggies, but with limiting protein intake.
Very informative, but I will still be limiting my intake of fats, even if it's from oilive oil.
I agree with you. The study was rigged to make olive oil look healthier than it is.
Mediterranean Keto is what I am switching to from standard Keto as want to reduce cholesterol and LDL (HDL ok) . Why are there no studies where instead of more carbs, but more proteins?
15:12 did that salad have grilled calamari? Yum!
I assume that any differences in physical activity between and within the groups were fully accounted for?
Thank you.
Low fat is below 10-20% of calories from fat in my book.
Okinawa traditionnal diet contains less than 10% of calories from fat.
Right. This study was a set-up to deceive people about what is really healthiest (and sell olive oil)
Gil, please try to get Drs Esselstyn or Gregor on your channel to debate the low fat vs healthy fat issue
This channel has never had a "debate" - you must be looking for the Joe Rogan podcast. ;-) Debates often don't end up being terribly enlightening because it takes time to analyze studies and talk through different aspects of them. This channel mainly is great at educating the layman about how to discern different dietary cliches and whether they make any sense once you actually look through the data - but that analysis can take time...
What if the Lo Fat arm cohorts were so diligent and specific so as to eat fish instead of meat but they dutifully & assiduously avoided fatty fish whereby the other arm felt pressure to boost fats thus overly favored the fatty fish? Then the OM-3's would be a confounding variable.
Great video, but I don’t think the study supports the statement “fat isn’t bad”. The study shows that olive oil is better than butter, but not if no processed oil at all would be best :)
I agree that this study in isolation wouldn't be very conclusive. suggestive maybe.
So if adding olive oil was beneficial to these diets what do you think could happen if you ate saturated fats but still added olive oil to what you eat? Thanks for the great analysis.
depends what the olive oil replaces
What can I find good data sets of foods and vitamins (especially commercial sets)?
Spain is number one producer of olive oil. EVOO was the only extracted fat I ate for years. I stopped it because of high BP. I also ate meat fish eggs some cheese olives (salt). So not cear if it was the EVOO but sure it did not prevent. Went WFPB no SOS to control BP with no pills.
Me, @ Thanksgiving table: "Did you know that in the Lyon Diet Heart study..."
My family: "Why can't you be normal and just tell racist or misogynistic jokes!?"
I'm from the mediterranean region and eat a medit diet :D getting all my fat calories from nuts, grains and fatty fish and fatty fruits I'm also pesca which is very easy on a med diet