Hong Kong beats the blue zones

[Todd Allen]

https://www.cnn.com/2018/03/02/health/hong-kong-world-longest-life-expectancy-longevity-intl/index.html

and curiously...

https://www.nationalgeographic.com/what-the-world-eats/

[corybroo]

It's good to see improvements somewhere in the world after this news a few days ago.

https://www.ajmc.com/focus-of-the-week/millennials-have-worse-health-than-gen-xers-did-at-same-age-driven-by-mental-health

[Sibiriak]

Quote

Leung's study aims to determine the biggest factors driving high life expectancy in Hong Kong and just how big a role they play. The researchers are testing their core hypotheses that this is because of universal health care, improved childhood care, economic migration and reduced smoking rates among women compared with other parts of the wold, resulting in fewer smoking-related diseases.

 

Curiously,  the researchers aren't considering the hypothesis that increased meat consumption might be driving the  Hongkongers'  increased life expectancy.

[Todd Allen]

2 hours ago, Sibiriak said:

Curiously,  the researchers aren't considering the hypothesis that increased meat consumption might be driving the  Hongkongers'  increased life expectancy

I suppose it ought to be considered but I'd be surprised if it is a significant factor.  Looking at data for longevity by country and meat consumption per capita by country there is a strikingly strong correlation at the bottom end.  Longevity is terrible in countries with very low meat consumption.  But this is mostly in Africa and a lot of people are dying from infectious diseases and traffic accidents, etc. things more related to poverty and poor governance.  Malnutrition is a factor though I haven't seen data to suggest lack of meat, such as B12 deficiency, is a big factor versus a lack of calories or other aspects of inadequate food.  Here's a site with lots of interesting data on longevity and causes of death around the world  https://www.worldlifeexpectancy.com/

But above that bottom tier I don't see a strong correlation one way or the other.  There are places with high meat consumption and good longevity such as Hong Kong, Luxembourg, Austalia, New Zealand, Spain and Italy.  And there are places with high meat consumption and only fair longevity such as Uruguay and the US.  And there is Japan with excellent longevity and fairly low meat consumption though if one adds in seafood it is less of an outlier.

[Gordo]

Yes, what you eat is more important than what you don't eat.  The country level stats don't tell you much - eating more meat is a sign of higher incomes/standards of living, which go hand in hand with better heathcare.  But you look at countries that have plateaued or even had declines in life expectancy, eating less meat, or no meat, is associated with longer life and healthspans (CA adventist cohort), particularly for men.  Even in the poor African countries that eat little to no meat (but don't have good longevity) like Rwanda, they have little to no heart disease or diabetes - if they could get adaquate calories and diversity of diet plus decent healthcare, they'd probably have the highest longevity (African Americans seem to do very well when it comes to the centenarian and super-centenarian stats). 

[Todd Allen]

On 5/10/2019 at 7:58 AM, Gordo said:

Even in the poor African countries that eat little to no meat (but don't have good longevity) like Rwanda, they have little to no heart disease or diabetes

But there are also countries like India with better GDP than most African countries, even lower meat consumption and bad heart disease.  Pakistan and Egypt are also countries with heart disease in excess of what is explainable by GDP despite low meat consumption and diets rich in grains and legumes.  And Japan with minimal heart disease has above average meat consumption, very high egg consumption, high seafood consumption and average dairy consumption for a diet well above average for total animal proteins and one that shoulld be spectaculary bad for TMAO.

[Todd Allen]

On 5/10/2019 at 7:58 AM, Gordo said:

But you look at countries that have plateaued or even had declines in life expectancy, eating less meat, or no meat, is associated with longer life and healthspans (CA adventist cohort), particularly for men. 

But how do we know meat has anything to do with it?  Asian Americans living in Bergen county, New Jersey have longevity just as good if not better without the religious push for abstinence from meat, liquor and smoking.  How do we isolate the various factors?  Perhaps living in California is much more injurious to health than living in New Jersey and people in Loma Linda need to abstain from meat and the other stuff to live as long?  Or maybe the meat has nothing to do with it.  Without well done randomized control studies it is difficult to ascertain causation, especially when there is little signal strength and lots of noise in the data.

Edited May 11, 2019 by Todd Allen

[Ron Put]

On 5/11/2019 at 4:27 PM, Todd Allen said:

But how do we know meat has anything to do with it?...

Because of numerous studies over the last century, or so. It's actually amazing that people's love of bacon and steak, and the corresponding confirmation bias, still makes them question it.
An example:

"... Diets that replaced red meat with healthy plant proteins led to decreases in risk factors for cardiovascular disease (CVD), according to a new study from Harvard T.H. Chan School of Public Health and Purdue University.

The study is the first meta-analysis of randomized controlled trials examining the health effects of red meat by substituting it for other specific types of foods....

“Previous findings from randomized controlled trials evaluating the effects of red meat on cardiovascular disease risk factors have been inconsistent. But our new study, which makes specific comparisons between diets high in red meat versus diets high in other types of foods, shows that substituting red meat with high-quality protein sources lead to more favorable changes in cardiovascular risk factors,” said Marta Guasch-Ferré, research scientist in the Department of Nutrition and lead author of the study.

The study included data from 36 randomized controlled trials involving 1,803 participants. The researchers compared people who ate diets with red meat with people who ate more of other types of foods (i.e. chicken, fish, carbohydrates, or plant proteins such as legumes, soy, or nuts), looking at blood concentrations of cholesterol, triglycerides, lipoproteins, and blood pressure—all risk factors for CVD.

The study found that when diets with red meat were compared with all other types of diets combined, there were no significant differences in total cholesterol, lipoproteins, or blood pressure, although diets higher in red meat did lead to higher triglyceride concentrations than the comparison diets. However, researchers found that diets higher in high-quality plant protein sources such as legumes, soy, and nuts resulted in lower levels of both total and LDL (“bad”) cholesterol compared to diets with red meat.

The results are consistent with long-term epidemiologic studies showing lower risks of heart attacks when nuts and other plant sources of protein are compared to red meat, the authors said. The findings also suggest that the inconsistencies found in prior studies regarding the effects of red meat on cardiovascular risk factors may be due, in part, to the composition of the comparison diet. They recommended that future studies take specific comparisons into account.

“Asking ‘Is red meat good or bad?’ is useless,” said Meir Stampfer, professor of epidemiology and nutrition and senior author of the study. “It has to be ‘Compared to what?’ If you replace burgers with cookies or fries, you don’t get healthier. But if you replace red meat with healthy plant protein sources, like nuts and beans, you get a health benefit.” ..."

https://www.hsph.harvard.edu/news/press-releases/substituting-healthy-plant-proteins-for-red-meat-lowers-risk-for-heart-disease/

[Dean Pomerleau]

Welcome Ron! 

Nice find. Here is the abstract from the Harvard meta-analysis Ron referenced, including well known nutrition researcher Walter Willett as a co-author:

Meta-Analysis of Randomized Controlled Trials of Red Meat Consumption in Comparison With Various Comparison Diets on Cardiovascular Risk Factors

Marta Guasch-Ferré

, 

Ambika Satija

, 

Stacy A. Blondin

, 

Marie Janiszewski

, 

Ester Emlen

, 

Lauren E. O’Connor

, 

Wayne W. Campbell

, 

Frank B. Hu

, 

Walter C. Willett

, 

Meir J. Stampfer

Originally published9 Apr 2019

https://doi.org/10.1161/CIRCULATIONAHA.118.035225

Circulation. 2019;139:1828–1845

 

 

Abstract

Background:

Findings among randomized controlled trials evaluating the effect of red meat on cardiovascular disease risk factors are inconsistent. We provide an updated meta-analysis of randomized controlled trials on red meat and cardiovascular risk factors and determine whether the relationship depends on the composition of the comparison diet, hypothesizing that plant sources would be relatively beneficial.

Methods:

We conducted a systematic PubMed search of randomized controlled trials published up until July 2017 comparing diets with red meat with diets that replaced red meat with a variety of foods. We stratified comparison diets into high-quality plant protein sources (legumes, soy, nuts); chicken/poultry/fish; fish only; poultry only; mixed animal protein sources (including dairy); carbohydrates (low-quality refined grains and simple sugars, such as white bread, pasta, rice, cookies/biscuits); or usual diet. We performed random-effects meta-analyses comparing differences in changes of blood lipids, apolipoproteins, and blood pressure for all studies combined and stratified by specific comparison diets.

Results:

Thirty-six studies totaling 1803 participants were included. There were no significant differences between red meat and all comparison diets combined for changes in blood concentrations of total, low-density lipoprotein, or high-density lipoprotein cholesterol, apolipoproteins A1 and B, or blood pressure. Relative to the comparison diets combined, red meat resulted in lesser decreases in triglycerides (weighted mean difference [WMD], 0.065 mmol/L; 95% CI, 0.000–0.129; P for heterogeneity <0.01). When analyzed by specific comparison diets, relative to high-quality plant protein sources, red meat yielded lesser decreases in total cholesterol (WMD, 0.264 mmol/L; 95% CI, 0.144–0.383; P<0.001) and low-density lipoprotein (WMD, 0.198 mmol/L; 95% CI, 0.065–0.330; P=0.003). In comparison with fish, red meat yielded greater decreases in low-density lipoprotein (WMD, –0.173 mmol/L; 95% CI, –0.260 to –0.086; P<0.001) and high-density lipoprotein (WMD, –0.065 mmol/L; 95% CI, –0.109 to –0.020; P=0.004). In comparison with carbohydrates, red meat yielded greater decreases in triglycerides (WMD, –0.181 mmol/L; 95% CI, –0.349 to –0.013).

Conclusions:

Inconsistencies regarding the effects of red meat on cardiovascular disease risk factors are attributable, in part, to the composition of the comparison diet. Substituting red meat with high-quality plant protein sources, but not with fish or low-quality carbohydrates, leads to more favorable changes in blood lipids and lipoproteins.

 

PMID: 30958719

[Michael R]

The Blue Zones are not about life expectancy (average lifespan calculated from birth), but about cohort incidence of "exceptional longevity" — in the best cases, centenarians, or at least what is currently "exceptional longevity" (age >85 in most studies).

[Ron Put]

33 minutes ago, Michael R said:

The Blue Zones are not about life expectancy (average lifespan calculated from birth), but about cohort incidence of "exceptional longevity" — in the best cases, centenarians, or at least what is currently "exceptional longevity" (age >85 in most studies).

Which dovetails with current protein intake studies in places like Okinawa, which generally find reduced protein before age of 65 and increase of protein intake post 65-70 correlate with longevity. Plant protein substitution for animal protein generally correlates separately. Here is a longinsh article discussing protein intake and longevity:

"Lifespan and metabolic health are influenced by dietary nutrients. Recent studies show that a reduced protein intake or low-protein/high-carbohydrate diet plays a critical role in longevity/metabolic health. Additionally, specific amino acids (AAs), including methionine or branched-chain AAs (BCAAs), are associated with the regulation of lifespan/ageing and metabolism through multiple mechanisms. Therefore, methionine or BCAAs restriction may lead to the benefits on longevity/metabolic health. Moreover, epidemiological studies show that a high intake of animal protein, particularly red meat, which contains high levels of methionine and BCAAs, may be related to the promotion of age-related diseases. Therefore, a low animal protein diet, particularly a diet low in red meat, may provide health benefits. However, malnutrition, including sarcopenia/frailty due to inadequate protein intake, is harmful to longevity/metabolic health. "
https://www.sciencedirect.com/science/article/pii/S2352396419302397#bb0020

Specifically to the title of this post, here is a thesis addressing specifically Hong Kong, Taipei and Shanghai :
Changing cardiovascular disease mortality and advancing longevity : Hong Kong, Shanghai and Taipei

Edited May 12, 2019 by Ron Put

[Gordo]

I'm interested in reading more about those crazy rich Asians.

In addition to the excellent references above, there is also this breakdown of the CA Adventists by diet (the sample size is quite large, note that men particularly benefit from a plant based or plants + fish diet when it comes to longevity):

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191896/table/T4/

Table 4

Associations of Dietary Patterns With All-Cause and Cause-Specific Mortality From a Cox Proportional Hazards Regression Model Among Participants in the Adventist Health Study 2, 2002–2009

Characteristic	Deaths, Hazard Ratio (95% CI)
	All-Cause	Ischemic Heart Disease	Cardiovascular Disease	Cancer	Other
All (N = 73 308), No. of deathsa,b	2560	372	987	706	867
Vegetarian
Vegan	0.85 (0.73–1.01)	0.90 (0.60–1.33)	0.91 (0.71–1.16)	0.92 (0.68–1.24)	0.74 (0.56–0.99)
Lacto-ovo	0.91 (0.82–1.00)	0.82 (0.62–1.06)	0.90 (0.76–1.06)	0.90 (0.75–1.09)	0.91 (0.77–1.07)
Pesco	0.81 (0.69–0.94)	0.65 (0.43–0.97)	0.80 (0.62–1.03)	0.94 (0.72–1.22)	0.71 (0.54–0.94)
Semi	0.92 (0.75–1.13)	0.92 (0.57–1.51)	0.85 (0.63–1.16)	0.94 (0.66–1.35)	0.99 (0.72–1.36)
Nonvegetarian	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]
Men (n = 25 105), No. of deathsa	1031	169	390	273	368
Vegetarian
Vegan	0.72 (0.56–0.92)	0.45 (0.21–0.94)	0.58 (0.38–0.89)	0.81 (0.48–1.36)	0.81 (0.53–1.22)
Lacto-ovo	0.86 (0.74–1.01)	0.76 (0.52–1.12)	0.77 (0.59–0.99)	1.01 (0.75–1.37)	0.89 (0.69–1.15)
Pesco	0.73 (0.57–0.93)	0.77 (0.45–1.30)	0.66 (0.44–0.98)	1.10 (0.73–1.67)	0.60 (0.39–0.93)
Semi	0.93 (0.68–1.26)	0.73 (0.33–1.60)	0.75 (0.43–1.32)	1.15 (0.65–2.03)	1.03 (0.62–1.71)
Nonvegetarian	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]
Women (n = 48 203), No. of deathsa,c	1529	203	597	433	499
Vegetarian
Vegan	0.97 (0.78–1.20)	1.39 (0.87–2.24)	1.18 (0.88–1.60)	0.99 (0.69–1.44)	0.70 (0.47–1.05)
Lacto-ovo	0.94 (0.83–1.07)	0.85 (0.59–1.22)	0.99 (0.81–1.22)	0.85 (0.67–1.09)	0.93 (0.75–1.17)
Pesco	0.88 (0.72–1.07)	0.51 (0.26–0.99)	0.90 (0.66–1.23)	0.86 (0.61–1.21)	0.81 (0.58–1.15)
Semi	0.92 (0.70–1.22)	1.09 (0.60–1.98)	0.93 (0.64–1.34)	0.85 (0.56–1.30)	0.97 (0.64–1.47)
Nonvegetarian	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]

^aAdjusted by age (ie, attained age as time variable), race (black, nonblack), smoking (current smoker, quit <1 year, quit 1–4 years, quit 5–9 years, quit 10–19 years, quit 20–29 years, quit ≥30 years, and never smoked), exercise (none, ≤20 min/week, 21–60 min/week, 61–150 min/week, and ≥151 min/week), personal income (≤$20 000/y, >$20 000–$50 000/y, >$50 000–$100 000/y, and >$100 000/y), educational level (up to high school graduate, trade school/some college/associate degree, bachelor degree, and graduate degree), marital status (married/common-law and single/widowed/divorced/separated), alcohol (nondrinker, rare drinker [<1.5 servings/mo], monthly drinker [1.5 to <4 servings/mo], weekly drinker [4 to <28 servings/mo], and daily drinker [≥28 servings/mo]), region (West, Northwest, Mountain, Midwest, East, and South), and sleep (≤4 h/night, 5–8 h/night, and ≥9 h/night).

^bAlso adjusted by sex (male and female), menopause (in women) (premenopausal [including perimenopausal], postmenopausal), and hormone therapy (in postmenopausal women) (not taking hormone therapy, taking hormone therapy);

^cAlso adjusted by menopause (premenopausal [including perimenopausal], postmenopausal) and hormone therapy (postmenopausal women) (not taking hormone therapy, taking hormone therapy).

[Todd Allen]

On 5/12/2019 at 5:01 PM, Michael R said:

The Blue Zones are not about life expectancy (average lifespan calculated from birth), but about cohort incidence of "exceptional longevity"

And here is a paper suggesting genetics plays a role in Okinawan longevity:

Who Are the Okinawans? Ancestry, Genome Diversity, and Implications for the Genetic Study of Human Longevity From a Geographically Isolated Population

Quote

In conclusion, we have demonstrated that the Okinawans are relatively homogeneous at the genetic level, Okinawan centenarians tend to cluster into an even more homogeneous group suggesting some shared genetic mechanisms for longevity, and that Okinawan centenarian siblings show a high relative risk of longevity. Given their high life expectancy, the high prevalence of centenarians, and the availability of a reliable age registration system (77), the aforementioned factors support the notion that the Okinawans could be a valuable population for future larger scale studies of genetic basis of healthy aging and longevity.

I'd also suggest the possibility that WW II played a role as Okinawans suffered terrible hardship through the war with great loss of life which might bias statistics for survivors.  For example here is a story on increased longevity among holocaust survivors: https://www.timesofisrael.com/surviving-holocaust-contributed-to-longevity-study-finds/

And the longevity advantage appears to have disappeared by 2000 Declining longevity advantage and low birthweight in Okinawa.  Which makes me doubt the validity of using Okinawa as evidence that very high carbohydrate diets produce optimal health and longevity.  I think it would be fair to say a diet rich in blue sweet potatoes can be compatible with extreme longevity but it is a bit of a leap for those who say it is causal or that high carbohydrate intake will produce greater longevity in all other populations or is optimal for all individuals.

Edited May 15, 2019 by Todd Allen

[Ron Put]

38 minutes ago, Todd Allen said:

And here is a paper suggesting genetics plays a role in Okinawan longevity....

And the longevity advantage appears to have disappeared by 2000.... Which makes me doubt the validity of using Okinawa as evidence that very high carbohydrate diets produce optimal health and longevity. ...

If the longevity advantage has disappeared (except in older population samples), why would you conclude that genetics plays a predominant role -- no evidence of dramatic change there, right?

Similarly, why would you assume that the restricted, carbs-heavy diet prevalent during the early and mid 20th century was not responsible for the increased longevity spurt -- as the diet changed and the caloric intake increased, the longevity advantage disappeared, right?

Methinks both support the notion that a caloric deficit, combined with low protein/low fat diet made up mostly of whole carbs, are responsible for the burst of longevity. This is generally supported by animal studies as well.

See, for instance this, which should address most of your objections. Not sure it will convince you, but it's a good read and rather informative:

"... since the Okinawan mortality advantage has all but disappeared except in older cohorts (aged 65-plus),22,23 it would be informative to have a more detailed,population-based epidemiologic analysis of the traditional diet, energy intake,energy expenditure, phenotype, and the subsequent mortality experience of this older cohort. These data might help answer the question as to whether Okinawans were truly calorically restricted and to what degree, the phenotypic consequences, and the current consequences for age-related mortality and lifespan. Importantly, an in-depth epidemiologic analysis of this older cohort usinglonger-term population data might also provide significant new information on the potential human effects of CR. ...

To assess whether there was evidence for CR in elderly Okinawans and if so, for what period of time, we analyzed long-term trends in whole-population caloric intake and energy balance for the years 1949–1998. These data demonstrate that the Okinawan population appeared to be in a relative “energy deficit”consistent with CR until the 1960s, eating approximately 10.9% fewer calories than would normally be recommended for maintenance of body weight,according to the Harris–Benedict equation (FIG. 1A).29 Consistent with adaptation to a long-term energy deficit, the BMI of adult Okinawans remained stable at a very lean level of approximately 21 kg/m2until the 1960s. During the 1960s the Okinawan adult BMI began to rise (FIG. 1A). This was coincident with a shift to consistently positive energy balance.To further clarify whether these population data indeed support a CR state for Okinawans before 1960, analysis of body weight by age strata was performed for the year 1949, when the Okinawan population appeared to be under CR conditions. Studies in nonhuman primates show that there is consistently lower body weight at all ages and relatively small weight gain beyond adulthood in male CR monkeys in contrast to those with ad libitum access to food.8Comparisons between the effects of CR on body weight in nonhuman primates(FIG. 1B) and Okinawan men in 1949 (FIG. 1C) show several similarities…."

https://www.researchgate.net/publication/5859391_Caloric_Restriction_the_Traditional_Okinawan_Diet_and_Healthy_Aging_The_Diet_of_the_World's_Longest-Lived_People_and_Its_Potential_Impact_on_Morbidity_and_Life_Span

Edited May 15, 2019 by Ron Put

[Todd Allen]

On 5/10/2019 at 7:58 AM, Gordo said:

he country level stats don't tell you much - eating more meat is a sign of higher incomes/standards of living, which go hand in hand with better heathcare. 

There is correlation between a country’s animal protein consumption and the health and longevity of the population.  Wealth is a possible confounder as it also correlates with animal protein consumption.  But wealth alone doesn't fully explain the "paradox".

From:  https://en.wikipedia.org/wiki/Vegetarianism_by_country

The top country by a wide margin is India with 31 to 42% vegetarian.  And the lowest country is Portugal at 1.2%.

https://www.worldlifeexpectancy.com/country-health-profile/india
LIFE EXPECTANCY / BIRTH     68.8   world rank 125
HEALTHY LIFE EXPECTANCY  59.3   world rank 127
GDP PER CAPITA USD          $7,200   world rank 125

https://www.worldlifeexpectancy.com/country-health-profile/portugal
LIFE EXPECTANCY / BIRTH     81.5  world rank 19
HEALTHY LIFE EXPECTANCY  72.0  world rank 22
GDP PER CAPITA USD        $30,300  world rank 44

Vegetarianism doesn’t seem to provide health or longevity benefits to Indians with respect to their GDP while the lack of vegetarianism doesn’t prevent Portuguese from having health and life expectancy well above their GDP ranking.  We know other factors have significant impacts on health such as alcohol, smoking and obesity.  However all of those factors should be favoring the longevity of Indians over the Portuguese.

India’s alcohol liters 5.7, M/F smoking % 20.4/1.9 and M/F obesity % 2.7/5.1
Portugal’s alcohol liters 12.3, M/F smoking % 31.5/13.7, and M/F obesity % 20.3/21.2

The wiki page on vegetarianism by country also has data on India by state:
Rajasthan has the highest fraction of vegetarians: 74.9% and Telegana is the lowest at 1.4%.

https://en.wikipedia.org/wiki/List_of_Indian_states_by_life_expectancy_at_birth
Life expectancy is worse in Rajasthan 67.7 vs Andhra Pradesh (includes Telangana) 68.5 and vegetarianism in Andhra Pradesh is 1.75% so that isn’t biasing things much.
We might also consider the Indian states with the best and worst life expectancies, Kerala 74.9 with 3% vegetarian vs Assam 63.9 with 20.6% vegetarian.

 

[Todd Allen]

18 hours ago, Ron Put said:

If the longevity advantage has disappeared (except in older population samples), why would you conclude that genetics plays a predominant role

I have not concluded genetics plays a predominant role.   Nor did I state an opinion.  Here is what I wrote:

Quote

And here is a paper suggesting genetics plays a role in Okinawan longevity:

 

18 hours ago, Ron Put said:

Similarly, why would you assume that the restricted, carbs-heavy diet prevalent during the early and mid 20th century was not responsible for the increased longevity spurt

There is insufficient data to make assumptions.  One might based on the data ask the question to what degree a carb heavy diet affected the longevity of the Okinawans either positively or negatively.  But the are other factors potentially in play here and without isolation one should not infer causality.  I pointed out two possibly confounding factors, genetics and the impact of WW II.  Caloric restriction is another.  There are many more.  For example, pork was their primary source of meat and lard was their primary cooking fat.  Perhaps the Okinawans were healthy due to the pork and lard and/or the negligible intake of refined vegetable oils and refined grain products?

[Gordo]

Todd, are you serious?  You can look at the relative performance of diet among the healthiest, longest lived large cohort ever studied to see what impact various differences in diet play on mortality, but instead you want to look at a 3rd world country where 70% of the population doesn't even have a toilet, where per capita income is $1,591/year, with among the worst air quality in the world, to draw your conclusions about optimal diet?

 

Edited May 15, 2019 by Gordo

[mccoy]

India also appears to be having a surge in T2D, due to the excessive consumption of refined sugars and starches.

[Ron Put]

22 hours ago, Todd Allen said:

I have not concluded genetics plays a predominant role....

 

There is insufficient data to make assumptions.  ...  I pointed out two possibly confounding factors, genetics and the impact of WW II.  Caloric restriction is another.  There are many more.  For example, pork was their primary source of meat and lard was their primary cooking fat.  Perhaps the Okinawans were healthy due to the pork and lard and/or the negligible intake of refined vegetable oils and refined grain products?

It's a given that individual genetics plays a role. But what were you trying to say then? That as the high carb, low calorie, low fat and low protein diet disappeared (and with it the longevity surge), genetics stopped playing a role?

WW II?! In what way not related to high carb, low calorie, low fat and low protein diet, specifically? Did WWII cause genetic changes? Or, did WWI spurt significant extension in longevity in the US, too? Or England? Or the rest of Japan?

I'll chalk the pork and lard comment to robust levels of confirmation bias :) The facts is, we don't know for absolutely certain. But, we have considerable evidence which supports the conclusions in the studies I cited, and considerable evidence which contradicts your beliefs (as long as we speak of longevity likelihood and not just rapid weight loss).

[Todd Allen]

1 hour ago, Ron Put said:

It's a given that individual genetics plays a role. But what were you trying to say then?

What I'm trying to say is there are many factors affecting the longevity of Okinawans.   You brought up the caloric restriction of Okinawans as if that somehow supported the case that their longevity was due to a high carbohydrate diet.  But it reduces the clarity of the situation.  What is due to CR vs genetics vs the war vs other specifics of their diet vs macro nutrient composition.  How do these factors interact?  The example of Okinawa makes it possible to say a high carb diet can be compatible with longevity.  But we can't even say their high carb diet was the optimal approach for their longevity under their specific circumstances of the time let alone believe it is sufficient evidence to generalize to a superiority of high carbohydrate diets for other groups in different circumstances.

 

[Ron Put]

Actually, there is a preponderance of the evidence showing that high whole carbohydrate, low protein diets extend life span. I've posted some studies above, here is another one which was done recently:

"However, the low-protein, high-carbohydrate diet appeared to promote hippocampus health and biology in the mice, on some measures to an even greater degree than those on the low-calorie diet.” http://www.sci-news.com/medicine/low-protein-high-carbohydrate-diet-longevity-06635.html

Obviously, you'll believe whatever you want to....

[mccoy]

There is a known disadvantage though of the high-carb diet, which is potential increase of blood-sugar.

This becomes a predominant aspect in older and sedentary people and in those who suffer prediabetic conditions.

Even in healthy individuals prolonged glycemic peaks are believed to be deleterious to health and longevity.

And the usual arguments that whole grain cereals do not increase glycemic load is not necessarily true, as per the studies of segal and elinav on people monitored by DEXG6.

The Okinawans were all right probably because they moved around all time and because their caloric intake was low anyway.

With the above I do believe that this regimen is necessarily detrimental, but it apparently needs to be monitored pretty closely, avoiding those foods and those amounts which to the specific individuals cause glicemic peaks.

For example:

• Zucchini: I couldn't believe that when I saw it, but blood glucose may be spiked by these very watery vegetables (my personal observation)
• String beans: very strange, but some people anecdotally refer that their blood glucose is spiked by these (Ben Greenfield in his more recent podcast with Joe Rogan)

 

Edited May 17, 2019 by mccoy

[Todd Allen]

On 5/15/2019 at 6:04 PM, Gordo said:

Todd, are you serious? 

By sheer numbers I find India of interest.  And because it is one extreme of the spectrum of vegetarianism.  Roughly 1 in 6 people live in India and I expect another 1 in 6 are poorer than the average Indian.  Heart disease is the leading cause of death in India and one of the major concerns of meat is the possibility it contributes to heart disease.  Vegetarianism is very high in India for cultural and religious reasons.  The state in India with the best longevity, Kerala, living more than 6 years longer than the average for India as a whole, has less than 1/10th the rate of vegetarianism of the national average.  Gordo have you seen anything which would suggest the benefits of vegetarianism should only apply to the wealthy or do you have some other explanation why not eating vegetarian is compatible with remarkable improvement in life expectancy in India?

Some seem to feel there is something inherently toxic about meat or even all animal sourced foods.  A fear similar to that of ionizing radiation.  That there is no safe dose and the greater the dose the greater the risk of morbidity and mortality.  But we have so many contradictory examples involving very large numbers of people.  From Hong Kong with super high meat consumption and excellent longevity to Portugal with good longevity beating many far wealthier nations despite a very low rate of vegetarianism.  None of this data tells us whether eating meat is healthy or not.  But it does suggest that if meat is unhealthy the effect is dwarfed by other factors for a substantial fraction of humanity.

We have a thread on olive oil with opinions ranging the full gamut from superfood to toxin.  My opinion is the healthfulness of meat consumption is greatly more complex than the healthfulness of olive oil.  Meat comprises so many very different tissues processed and prepared in wildly different ways, sourced from a wide range of species living under a wide range of conditions, etc.  If the answers on olive oil are so muddled why should we believe the answers with respect to meat aren’t?
 

[Gordo]

This is why India has high heart disease:

https://food.ndtv.com/health/why-is-india-experiencing-a-cardiovascular-disease-epidemic-771837

They also don't eat a plant based whole food diet by the way.  Ghee is worse than butter and they love it over there.  They also love fried foods, and dairy.

As for eating a super heathy mostly plant based diet with some meat, vs. no meat - yea, its not going to make a whole lot of difference, as you can see from the adventist studies.  Eating fish doesn't make any difference and may actually help women live a bit longer.  Eating other meat may shave a few months or up to 1-2 years off one's life, probably due to the elevated growth factors (can't rule out other reasons), particularly if/when a person gets cancer.  If you don't end up with heart disease, you'll probably get cancer.

Edited May 18, 2019 by Gordo

[Ron Put]

16 hours ago, mccoy said:

There is a known disadvantage though of the high-carb diet, which is potential increase of blood-sugar.

This becomes a predominant aspect in older and sedentary people and in those who suffer prediabetic conditions.

.... With the above I do believe that this regimen is necessarily detrimental, but it apparently needs to be monitored pretty closely, avoiding those foods and those amounts which to the specific individuals cause glicemic peaks.

For example:

• Zucchini: I couldn't believe that when I saw it, but blood glucose may be spiked by these very watery vegetables (my personal observation)
• String beans: very strange, but some people anecdotally refer that their blood glucose is spiked by these (Ben Greenfield in his more recent podcast with Joe Rogan)

 

No, whole grains and unprocessed plant foods in general are not bad for you :) I thought this one was largely put to bed a decade ago, particularly for healthy subjects (but in many respects, for those on the larger side).

There is a lot on the subject, here is the first one that popped up for me:

"Despite initial enthusiasm, the relationship between glycemic index (GI) and glycemic response (GR) and disease prevention remains unclear. This review examines evidence from randomized, controlled trials and observational studies in humans for short-term (e.g., satiety) and long-term (e.g., weight, cardiovascular disease, and type 2 diabetes) health effects associated with different types of GI diets. A systematic PubMed search was conducted of studies published between 2006 and 2018 with key words glycemic index, glycemic load, diabetes, cardiovascular disease, body weight, satiety, and obesity. Criteria for inclusion for observational studies and randomized intervention studies were set. The search yielded 445 articles, of which 73 met inclusion criteria. Results suggest an equivocal relationship between GI/GR and disease outcome. The strongest intervention studies typically find little relationship among GI/GR and physiological measures of disease risk. Even for observational studies, the relationship between GI/GR and disease outcomes is limited. Thus, it is unlikely that the GI of a food or diet is linked to disease risk or health outcomes. Other measures of dietary quality, such as fiber or whole grains may be more likely to predict health outcomes. Interest in food patterns as predictors of health benefits may be more fruitful for research to inform dietary guidance."

https://www.mdpi.com/2072-6643/10/10/1361/htm