@arx
zuviele Kh verursachen herzinfakte
Falsch!
Die Zufuhr von Kohlenhydraten mit hohem glykämischen Index mit nachfolgend erhöhten Blutglukosespiegeln und entsprechend hohem Anstieg des Insulinspiegels war mit erhöhtem koronaren Risiko korreliert. Dieses Ergebnis in o. a. Weise zu verallgemeinern ist schlicht falsch.
Und auch wenn´s jetzt langatmig wird:
Bzgl. NHS und der Aussage "Fett macht fett" sieht´s etwas anders aus:
Am J Clin Nutr 1988 Mar;47(3):406-12
Energy intake and other determinants of relative weight.
Romieu I, Willett WC, Stampfer MJ, Colditz GA, Sampson L, Rosner B, Hennekens CH, Speizer FE.
Channing Laboratory, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115.
The relationships of relative weight to energy intake and to physical activity were studied among 141 females aged 34-59 y. As observed in previous studies Quetelet index (wt/ht2) was inversely related to energy intake (r = -0.11). However, obese women tended to be older (r = 0.16), exercise less (r = -0.30), and drink less alcohol (r = -0.16) than nonobese women. Older women had lower energy intake (r = -0.23) and exercised less (r = -0.12) than younger women. Energy intake and physical activity were positively related (r = 0.23). After adjustment for age, physical activity, alcohol, and smoking, the inverse correlation between relative weight and energy intake was significantly reduced (p = 0.04) from r = -0.11 to r = -0.02. Obese women reported higher intakes of total fat, and relative weight was significantly correlated with intakes of total fat (r = 0.20) and saturated fatty acids (r = 0.16). These data highlight the importance of considering factors that may confound the relationship between energy intake and obesity, and they suggest that fat intake may play a role in obesity that is independent of total energy intake.
Und zur NHS und dem Zusammenhang zw. Fettverzehr und Herzinfarkt (der durchaus richtig ist!!!):
Lancet 1993 Mar 6;341(8845):581-5
Intake of trans fatty acids and risk of coronary heart disease among women.
Willett WC, Stampfer MJ, Manson JE, Colditz GA, Speizer FE, Rosner BA, Sampson LA, Hennekens CH.
Channing Laboratory, Department of Medicine, Harvard Medical School, Boston, Massachusetts.
Trans isomers of fatty acids, formed by the partial hydrogenation of vegetable oils to produce margarine and vegetable shortening, increase the ratio of plasma low-density-lipoprotein to high-density-lipoprotein cholesterol, so it is possible that they adversely influence risk of coronary heart disease (CHD). To investigate this possibility, we studied dietary data from participants in the Nurses' Health Study. We calculated intake of trans fatty acids from dietary questionnaires completed by 85,095 women without diagnosed CHD, stroke, diabetes, or hypercholesterolaemia in 1980. During 8 years of follow-up, there were 431 cases of new CHD (non-fatal myocardial infarction or death from CHD). After adjustment for age and total energy intake, intake of trans isomers was directly related to risk of CHD (relative risk for highest vs lowest quintile 1.50 [95% Cl 1.12-2.00], p for trend = 0.001). Additional control for established CHD risk factors, multivitamin use, and intakes of saturated fat, monounsaturated fat, and linoleic acid, dietary cholesterol, vitamins E or C, carotene, or fibre did not change the relative risk substantially. The association was stronger for the 69,181 women whose margarine consumption over the previous 10 years had been stable (1.67 [1.05-2.66], p for trend = 0.002). Intakes of foods that are major sources of trans isomers (margarine, cookies [biscuits], cake, and white bread) were each significantly associated with higher risks of CHD. These findings support the hypothesis that consumption of partially hydrogenated vegetable oils may contribute to occurrence of CHD.
Und noch einer:
N Engl J Med 1997 Nov 20;337(21):1491-9
Dietary fat intake and the risk of coronary heart disease in women.
Hu FB, Stampfer MJ, Manson JE, Rimm E, Colditz GA, Rosner BA, Hennekens CH, Willett WC.
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
BACKGROUND: The relation between dietary intake of specific types of fat, particularly trans unsaturated fat and the risk of coronary disease remains unclear. We therefore studied this relation in women enrolled in the Nurses' Health Study. METHODS: We prospectively studied 80,082 women who were 34 to 59 years of age and had no known coronary disease, stroke, cancer, hypercholesterolemia, or diabetes in 1980. Information on diet was obtained at base line and updated during follow-up by means of validated questionnaires. During 14 years of follow-up, we documented 939 cases of nonfatal myocardial infarction or death from coronary heart disease. Mutivariate analyses included age, smoking status, total energy intake, dietary cholesterol intake, percentages of energy obtained from protein and specific types of fat, and other risk factors. RESULTS: Each increase of 5 percent of energy intake from saturated fat, as compared with equivalent energy intake from carbohydrates, was associated with a 17 percent increase in the risk of coronary disease (relative risk, 1.17; 95 percent confidence interval, 0.97 to 1.41; P=0.10). As compared with equivalent energy from carbohydrates, the relative risk for a 2 percent increment in energy intake from trans unsaturated fat was 1.93 (95 percent confidence interval, 1.43 to 2.61; P<0.001); that for a 5 percent increment in energy from monounsaturated fat was 0.81 (95 percent confidence interval, 0.65 to 1.00; P=0.05); and that for a 5 percent increment in energy from polyunsaturated fat was 0.62 (95 percent confidence interval, 0.46 to 0.85; P= 0.003). Total fat intake was not signficantly related to the risk of coronary disease (for a 5 percent increase in energy from fat, the relative risk was 1.02; 95 percent confidence interval, 0.97 to 1.07; P=0.55). We estimated that the replacement of 5 percent of energy from saturated fat with energy from unsaturated fats would reduce risk by 42 percent (95 percent confidence interval, 23 to 56; P<0.001) and that the replacement of 2 percent of energy from trans fat with energy from unhydrogenated, unsaturated fats would reduce risk by 53 percent (95 percent confidence interval, 34 to 67; P<.001). CONCLUSIONS: Our findings suggest that replacing saturated and trans unsaturated fats with unhydrogenated monounsaturated and polyunsaturated fats is more effective in preventing coronary heart disease in women than reducing overall fat intake.
Nicht nur Übergewicht per se ist ein Risikofaktor. Hierzu nochmal NHS:
JAMA 1995 Feb 8;273(6):461-5
Weight, weight change, and coronary heart disease in women. Risk within the 'normal' weight range.
Willett WC, Manson JE, Stampfer MJ, Colditz GA, Rosner B, Speizer FE, Hennekens CH.
Channing Laboratory, Brigham and Women's Hospital, Boston, MA.
OBJECTIVE--To assess the validity of the 1990 US weight guidelines for women that support a substantial gain in weight at approximately 35 years of age and recommend a range of body mass index (BMI) (defined as weight in kilograms divided by the square of height in meters) from 21 to 27 kg/m2, in terms of coronary heart disease (CHD) risk in women. DESIGN--Prospective cohort study. SETTING--Female registered nurses in the United States. PARTICIPANTS--A total of 115,818 women aged 30 to 55 years in 1976 and without a history of previous CHD. MAIN OUTCOME MEASURE--Incidence of CHD defined as nonfatal myocardial infarction or fatal CHD. RESULTS--During 14 years of follow-up, 1292 cases of CHD were ascertained. After controlling for age, smoking, menopausal status, postmenopausal hormone use, and parental history of CHD and using as a reference women with a BMI of less than 21 kg/m2, relative risks (RRs) and 95% confidence intervals (CIs) for CHD were 1.19 (0.97 to 1.44) for a BMI of 21 to 22.9 kg/m2, 1.46 (1.20 to 1.77) for a BMI of 23 to 24.9 kg/m2, 2.06 (1.72 to 2.48) for a BMI of 25 to 28.9 kg/m2, and 3.56 (2.96 to 4.29) for a BMI of 29 kg/m2 or more. Women who gained weight from 18 years of age were compared with those with stable weight (+/- 5 kg) in analyses that controlled for the same variables as well as BMI at 18 years of age. The RRs and CIs were 1.25 (1.01 to 1.55) for a 5- to 7.9-kg gain, 1.64 (1.33 to 2.04) for an 8- to 10.9-kg gain, 1.92 (1.61 to 2.29) for an 11- to 19-kg gain, and 2.65 (2.17 to 3.22) for a gain of 20 kg or more. Among women with the BMI range of 18 to 25 kg/m2, weight gain after 18 years of age remained a strong predictor of CHD risk. CONCLUSIONS--Higher levels of body weight within the "normal" range, as well as modest weight gains after 18 years of age, appear to increase risks of CHD in middle-aged women. These data provide evidence that current US weight guidelines may be falsely reassuring to the large proportion of women older than 35 years who are within the current guidelines but have potentially avoidable risks of CHD.
Nicolai Worm halte ich übrigens für äußerst kompetent. Nur so konträr wie es dargestellt wird, sind er und die DGE nicht. Die Sache mit der Fettmodifikation zugunsten der Fettreduktion ist völlig richtig. Aber
man soll 30% fett,sonst zuviele kh->herzinfakt
ist Blödsinn. Davon steht nicht drin.
jeckyll
ps: sorry für dieses lange posting


Aber manchmal kann ich´s mir nicht verkneifen.