Carbohidratos y grasas poliinsaturadas más asociadas con aterosclerosis que la grasa saturada

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Carbohidratos y grasas poliinsaturadas más asociadas con aterosclerosis que la grasa saturada

Notapor Fisio » Sab, 12 Oct 2013, 21:35

La teoría del colesterol se cae a cachos. Menuda carnicería. No he tenido tiempo de leerlo bien, aquí lo dejo. Eso sí, es un estudio en mujeres postmenopáusicas.

Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women

Dariush Mozaffarian,
Eric B Rimm, and
David M Herrington

Background: The influence of diet on atherosclerotic progression is not well established, particularly in postmenopausal women, in whom risk factors for progression may differ from those for men.

Objective: The objective was to investigate associations between dietary macronutrients and progression of coronary atherosclerosis among postmenopausal women.

Design: Quantitative coronary angiography was performed at baseline and after a mean follow-up of 3.1 y in 2243 coronary segments in 235 postmenopausal women with established coronary heart disease. Usual dietary intake was assessed at baseline.

Results: The mean (±SD) total fat intake was 25 ± 6% of energy. In multivariate analyses, a higher saturated fat intake was associated with a smaller decline in mean minimal coronary diameter (P = 0.001) and less progression of coronary stenosis (P = 0.002) during follow-up. Compared with a 0.22-mm decline in the lowest quartile of intake, there was a 0.10-mm decline in the second quartile (P = 0.002), a 0.07-mm decline in the third quartile (P = 0.002), and no decline in the fourth quartile (P < 0.001); P for trend = 0.001. This inverse association was more pronounced among women with lower monounsaturated fat (P for interaction = 0.04) and higher carbohydrate (P for interaction = 0.004) intakes and possibly lower total fat intake (P for interaction = 0.09). Carbohydrate intake was positively associated with atherosclerotic progression (P = 0.001), particularly when the glycemic index was high. Polyunsaturated fat intake was positively associated with progression when replacing other fats (P = 0.04) but not when replacing carbohydrate or protein. Monounsaturated and total fat intakes were not associated with progression.

Conclusions: In postmenopausal women with relatively low total fat intake, a greater saturated fat intake is associated with less progression of coronary atherosclerosis, whereas carbohydrate intake is associated with a greater progression.


http://ajcn.nutrition.org/content/80/5/1175.long
Código de descuento Iherb JUY782

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Re: Carbohidratos y grasas poliinsaturadas más asociadas con aterosclerosis que la grasa saturada

Notapor dr.z » Mié, 16 Oct 2013, 13:23

Sólo hay que observar la "Paradoja Israelí", uno de los mayores ratios de grasas poliinsaturadas respecto a saturadas del mundo.

Diet and disease--the Israeli paradox: possible dangers of a high omega-6 polyunsaturated fatty acid diet

Department of Membrane Research and Biophysics, Weizmann Institute of Science, Rehovot, Israel.


Israel has one of the highest dietary polyunsaturated/saturated fat ratios in the world; the consumption of omega-6 polyunsaturated fatty acids (PUFA) is about 8% higher than in the USA, and 10-12% higher than in most European countries. In fact, Israeli Jews may be regarded as a population-based dietary experiment of the effect of a high omega-6 PUFA diet, a diet that until recently was widely recommended. Despite such national habits, there is paradoxically a high prevalence of cardiovascular diseases, hypertension, non-insulin-dependent diabetes mellitus and obesity-all diseases that are associated with hyperinsulinemia (HI) and insulin resistance (IR), and grouped together as the insulin resistance syndrome or syndrome X. There is also an increased cancer incidence and mortality rate, especially in women, compared with western countries. Studies suggest that high omega-6 linoleic acid consumption might aggravate HI and IR, in addition to being a substrate for lipid peroxidation and free radical formation. Thus, rather than being beneficial, high omega-6 PUFA diets may have some long-term side effects, within the cluster of hyperinsulinemia, atherosclerosis and tumorigenesis.

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http://www.ncbi.nlm.nih.gov/pubmed/8960090
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Re: Carbohidratos y grasas poliinsaturadas más asociadas con aterosclerosis que la grasa saturada

Notapor Sergio » Mié, 16 Oct 2013, 22:39

correlation doesn't necessarily equal causation
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Re: Carbohidratos y grasas poliinsaturadas más asociadas con aterosclerosis que la grasa saturada

Notapor Fisio » Jue, 17 Oct 2013, 00:30

Sergio escribió:correlation doesn't necessarily equal causation


Es algo muy difundido por farmacéuticas. Siendo verdad, deja la sensación de que todo debe ser evaluado mediante ECA y que estos tienen menor riesgo de sesgos. Sin embargo sos ECA son también solo correlaciones aislando contexto. Después de un lavado de respondedores al placebo y otras cuantas artimañas al barajar los pacientes, rotura del placebo, etc. Segun Ioannidis el 50% de las conclusiones de los ECA son falsas. Y luego, para rematar, si sale mal no se publica.

Si experimentalmente tienes algo que no cuadra con la epidemiologia, y como no cuadra te lias a llamarlo "paradoja" Alpina, Francesa, Israelí, Española, Japonesa, Albanesa... ahí hay algo que falla, no todo puede ser una paradoja. Y luego siempre nos quedarán las revisiones sistematicas de diseños prospectivos, que siempre podrán dar correlaciones más sólidas, especialmente si se observa dosis-dependencia en el efecto y otras pistas que nos puedan aportar los datos ad hoc.
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