Thursday, 19 March 2009

"RISCK! RISCK anything!"

As I mentioned in yesterday's blog, the results of the RISCK study were expected towards the end of 2007, although it wasn't scheduled to end before 2008. It's now a quarter of the way through 2009, and The British Nutrition Foundation says it is still awaiting those results, according to their paper entitled Saturated fatty acid consumption: outlining the scale of the problem and assessing the solutions, recently published in British Nutrition Foundation Nutrition Bulletin, 34, 74–84.

One of the early papers states that "further details of the RISCK project and up-to-date results can be found on the RISCK website", and here they are, so I'm not entirely sure what the British Nutrition Foundation is waiting for.

Some details have emerged, quietly, which is rather surprising when you consider that we, the British tax payers, footed the £2.7m bill for the study. So, what have these results shown so far?

The first is that almost a quarter (24%) of the participants gave up on the study. That left just 548 subjects, divided into four groups, so it was a pretty small study.

The second is far more important - the actual results - but I'll come to them shortly.

What was the study actually looking for? The impact of diet on glucose metabolism, and from this statement we know that saturated fat had already been cast in the role of villain:

People who eat food rich in saturated fat found in meat and dairy products, tend to be at greater risk of developing the Metabolic Syndrome ...

The four groups of participants first followed a 'run-in' diet (Diet A), which was supposed to be what the average British adult eats regularly; high in both saturated fat and carbohydrates.

For the next six months each group followed one of the following:

Diet B: high in both monosaturated fats and carbohydrates
Diet C: high in monosaturated fats and low in carbohydrates
Diet D: low in fat and high in carbohydrates
Diet E: low in both fats and carbohydrates

The British Nutrition Foundation recommends "At least half the energy in our diets should come from carbohydrate, mostly as starchy carbohydrates. "

Low-carb diets such as Atkins typically recommend no more than 20% of total calories as carbs.

However, during the first month of the RISCK study all participants ate either 63.5% or 64.6%, and those who were in the high-carb diet groups continued to consume 63.2% and 64.8%.

What about the low-carb diet groups? They had 55% and 56% per day.

So in reality there wasn't the significant difference between high- and low-carb as defined by nutritionists' recommendations and well-known weight-loss diets that the authors claim.

Approximately 56% of those carbohydrates were supplied to participants, and included breakfast cereals, breads, rice, pasta and potatoes

What about the actual results? According to the authors:

During the intervention differences in dietary fat and CHO were highly significant

And how!

Which diet came out worst on triglyceride levels?
Low-fat with high-carbohydrate.

Which came out worst on total cholesterol levels?
High-fat with high-carbohydrate.

Which came out worst on LDL cholesterol levels?
High-fat with high-carbohydrate.

Which diet came out best on triglyderides levels?
High-fat with low-carbohydrate

Which came out best on total cholesterol levels?
High-fat with low-carbohydrate

Which came out best on LDL cholesterol levels?
High-fat with low-carbohydrate

Is this the reason for the early cessation of the study, and the lack of publicity?

The authors concede:

A novel finding of the present study is evidence to suggest that reductions in the GI of the diet were associated with greater reductions in total cholesterol

However, the really interesting point is that the RISCK researchers' idea of a 'low-carb diet' wasn't even typical, and yet it still came out best! How much better would the results have been on a diet less than 20% carbohydrates?

Why is there no mention of the other figures which appear to show conclusively that a high-fat/low-carb diet is healthier? Will these results actually change Dr Jebb's advice to Government, the Food Standards Agency, and the public? I doubt it.

There was an unforeseen risk in the RISCK study. It might just have proved the experts wrong again ...

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