As a doctor, I don't even know what to tell patients anymore. Part of the reason is because the nutritional sciences have been so poor at identifying good and bad. Controlled studies are very difficult to do, if not impossible (try randomizing a group of patients to a plant based diet only, or to a low fat diet, etc). Cohort studies all have their biases (vegetarians may somehow be healthier to begin with that have nothing to do with their vegetarianism, and it's difficult to control for all the unknown confounders). Probably the safest thing to do is to eat less processed junk, and everything else in moderation.
42
The main reason the controversy on fat intake and atherosclerosis continues is we are measuring the wrong metrics. All of these studies, including Framingham Health Study, use cholesterol as the main metric. As science evolved, HDL and LDL cholesterol were also considered.
We now know that it is not about the total cholesterol, or even the total LDL cholesterol that causes arterial disease. It is the number of LDL particles that causes damage to arterial wall linings that promote disease progression. The other major contributor to arterial disease progression is inflammation.
None of these studies take this into account, so the confusion continues.
We now know that it is not about the total cholesterol, or even the total LDL cholesterol that causes arterial disease. It is the number of LDL particles that causes damage to arterial wall linings that promote disease progression. The other major contributor to arterial disease progression is inflammation.
None of these studies take this into account, so the confusion continues.
26
Gregg, what I conclude from reading 20 years of nutrition articles that we know very little that is useful. How can you have any confidence about the LDL, HDL, Total classificationis when there is still widespread disagreement on them, how different they are, how they interact? And there isn't any good definition of what inflammation is inside the arteries (an inflamed cut to the skin, perhaps, but people toss out the term "inflammation" in respect to arteries without ever defining it or saying how it is detected.
I think the author exaggerates that "the health of Americans is at stake." It's not. We already know pretty much what to eat - 1) reduce total calories in general, 2) put more vegetables on the plate, 3) eat fewer commercially prepared foods. One doesn't need to know anything about omegas, fats, cholesterol, etc. The problem is that our society isn't organized to eat like this. The chronic-ness of society isn't inflammation, it's busy-ness. How to tell parents to cut the kiddie practices to 1 per week? To tell bosses that it's out-the-door at 5 pm? To resist that "healthy" quinoa wrap takeout in favor of 2/3 cup of peas at home with some butter, salt, and pepper?
I don't see it happening, but it would do wonders if it did.
I think the author exaggerates that "the health of Americans is at stake." It's not. We already know pretty much what to eat - 1) reduce total calories in general, 2) put more vegetables on the plate, 3) eat fewer commercially prepared foods. One doesn't need to know anything about omegas, fats, cholesterol, etc. The problem is that our society isn't organized to eat like this. The chronic-ness of society isn't inflammation, it's busy-ness. How to tell parents to cut the kiddie practices to 1 per week? To tell bosses that it's out-the-door at 5 pm? To resist that "healthy" quinoa wrap takeout in favor of 2/3 cup of peas at home with some butter, salt, and pepper?
I don't see it happening, but it would do wonders if it did.
45
"I'm not suggesting anything sinister."
Why not?
Why not?
23
The assumption that the mortality benefit associated with statins is due to reduction in cholesterol is also being questioned. There appears to be a minor mortality benefit but it seems to also apply to patients who already have low cholesterol. Therefore, the reduction in cholesterol appears to be a side effect and the use of statins to reduce cholesterol is questionable.
Also, the risk of muscle damage appears to be higher than the probability of benefit.
Also, the risk of muscle damage appears to be higher than the probability of benefit.
14
I want to know whether any of the linoleic fats in that early study were partially hydrogenated. If so, they would contain trans fats, changing the equation.
22
This is such a difficult and complex subject, with no easy answers. I applaud the author's discussion here of publication bias, not just nutrients - so important. With a subject this complex, everything written must be read with intense focus. Even in this carefully crafted article, so many ideas could be presented differently.
-- The author says - Go to plants for unsaturated fats, animals for saturated fats. Yet one of the hottest new health foods is the coconut and its oils - a massive source of saturated fats, seen as quite healthy. Not far behind is palm oil.
- The author noted, re the Minnesota Study, that "no mortality benefit could be found". i.e. look at all causes of death, not just heart disease. Yet later he slips into that old habit of looking at diet only through the lens of rates of heart disease (often, using only male data). Isn't total mortality more significant?
- Discussion of polyunsaturated fats and relationship to cholesterol is everywhere. Yet here, as in most places, it is never noted that the single GREATEST change in the modern human diet is the amount of grain oils we eat. Also, because of the way these are produced, subjects in older studies eating the polyunsaturated oil diet could have been getting more dangerous trans-fats. Some mention of ancestral diet is relevant.
I saw Gary Taubes mentioned in another comment - GCBC is a difficult book but a great service to our understanding. Teicholz' Big Fat Surprise is more accessible.
-- The author says - Go to plants for unsaturated fats, animals for saturated fats. Yet one of the hottest new health foods is the coconut and its oils - a massive source of saturated fats, seen as quite healthy. Not far behind is palm oil.
- The author noted, re the Minnesota Study, that "no mortality benefit could be found". i.e. look at all causes of death, not just heart disease. Yet later he slips into that old habit of looking at diet only through the lens of rates of heart disease (often, using only male data). Isn't total mortality more significant?
- Discussion of polyunsaturated fats and relationship to cholesterol is everywhere. Yet here, as in most places, it is never noted that the single GREATEST change in the modern human diet is the amount of grain oils we eat. Also, because of the way these are produced, subjects in older studies eating the polyunsaturated oil diet could have been getting more dangerous trans-fats. Some mention of ancestral diet is relevant.
I saw Gary Taubes mentioned in another comment - GCBC is a difficult book but a great service to our understanding. Teicholz' Big Fat Surprise is more accessible.
14
I'll take common sense over the latest government recommendations any day. They seem to make a truly amazing number of mistakes and never own up to any of them. The toll on public health is a national disgrace.
18
Ah, the shell game con. A study from 1968-73? The "overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid"? Kind of like comparing the merits of using butter versus margarine. Saturated fat was removed from people's diets and replaced with unsaturated fat. I notice that there was no comparison here to people on a REDUCED or LOW fat (overall) diet. Who sponsored this "news"? The meat or dairy industries perhaps?
5
@AlennaM:
There have been numerous studies of the "low fat" diet as recommended by most health authorities. The biggest and longest was the Women's Health Initiative, which involved over 40,000 women for 7 years.
http://www.hsph.harvard.edu/nutritionsource/low-fat/
Eating a low fat diet had _no effect_ on heart disease, weight loss, cancer, diabetes, or overall mortality.
There have been numerous studies of the "low fat" diet as recommended by most health authorities. The biggest and longest was the Women's Health Initiative, which involved over 40,000 women for 7 years.
http://www.hsph.harvard.edu/nutritionsource/low-fat/
Eating a low fat diet had _no effect_ on heart disease, weight loss, cancer, diabetes, or overall mortality.
17
AlennaM, you should read the BMJ study instead of conjuring up assumed demonizations. It answers all your questions. Or try statnews.com, which covered it on April 12, 2016. The BMJ study is the result of a National Institutes of Health researcher, Christopher Ramsden, who resurrects unpublished studies in his spare time that never saw the light of day. His day job at the NIH is research on the biochemistry of linoleic acid. His point in digging the old research up, and using computer techs to bring the raw data up to today’s computer standards, is not to prove a research point one way or the other, but to show how failure to publish important clinical data that doesn’t go along with ‘settled science’ or the paradigm-du-jour undermines the truth.
22
I just underwent months of radiation and chemo, and a six-hour operation to remove the remains of the cancer. My dietician at the cancer institute argued with me for six weeks to change my unsaturated fats love. I refused to eat butter or cook with pork lard and beef tallow. I was convinced broiled meat/fish, and salads, would rebuild my body.
Thing is the dietician was in her late 50s with the body of a 13-year-old and the skin tone to match. Hard to argue with her health. She said cancer research has changed drastically in the last decade. Our job, she said, is to restore the healthy cells lost to radiation, which kills everything, Her mantra was 4 grams of fat for every 10 grams of protein or don’t bother eating the protein; your body won't use it.
Her winning argument? Why are there 100-year-plus Black woman who still cook everything with pork lard and run around doing their own shopping and cleaning. They’re healthier than you are. Why are there Russian grandmas who clean and rule the roost, but still cook at age 98 with shmaltz and beef tallow. Why aren’t they dead? Why are Mexican peasants who cook exclusively with pork lard so disease-free compared to Americans? And their skin is young by comparison.
I finally believed her. And once I did, the weight flew off me. I’ve lost 30 years off my face and body. As my friend said, “Cancer becomes you.” :-) I don’t eat as much as I once did. Curiously, the deliciousness of the fat now bathing my food has curbed my appetite.
Thing is the dietician was in her late 50s with the body of a 13-year-old and the skin tone to match. Hard to argue with her health. She said cancer research has changed drastically in the last decade. Our job, she said, is to restore the healthy cells lost to radiation, which kills everything, Her mantra was 4 grams of fat for every 10 grams of protein or don’t bother eating the protein; your body won't use it.
Her winning argument? Why are there 100-year-plus Black woman who still cook everything with pork lard and run around doing their own shopping and cleaning. They’re healthier than you are. Why are there Russian grandmas who clean and rule the roost, but still cook at age 98 with shmaltz and beef tallow. Why aren’t they dead? Why are Mexican peasants who cook exclusively with pork lard so disease-free compared to Americans? And their skin is young by comparison.
I finally believed her. And once I did, the weight flew off me. I’ve lost 30 years off my face and body. As my friend said, “Cancer becomes you.” :-) I don’t eat as much as I once did. Curiously, the deliciousness of the fat now bathing my food has curbed my appetite.
75
The World Health Organization recently published a summary of hundreds of studies and concluded process meats are carcinogenic. Most people consume meat that is processed: chicken nuggets, deli slices, hot dogs, etc. That should be enough for sensible people to conclude it's not good for us! We don't say: smoke cigarettes in moderation. Meat is beyond unnecessary. It's bad for us and the planet, being a leading cause of climate change. Also, we could end world hunger if we took all the grains/soy, etc we feed to billions of farm animals and, instead, fed it directly to people. It's time we stop rationalizing a morally indefensible choice, which is really all about being conditioned to crave a certain taste.
14
@Jane Velez-Mitchell:
You just made a huge and unsupported leap by confusing processed meats with all meat. Yes, some types of processed meat are likely bad for us (but the increased risks are tiny in magnitude compared to cigarettes). But humans have eaten meat, fish, eggs, and shellfish since before we were even human, and we have eaten meat for much longer than we have eaten grains or soy. It's an adaptation, not a craving. Quality animal foods contain nutrients that are absent from grains and soy.
You just made a huge and unsupported leap by confusing processed meats with all meat. Yes, some types of processed meat are likely bad for us (but the increased risks are tiny in magnitude compared to cigarettes). But humans have eaten meat, fish, eggs, and shellfish since before we were even human, and we have eaten meat for much longer than we have eaten grains or soy. It's an adaptation, not a craving. Quality animal foods contain nutrients that are absent from grains and soy.
16
Jane is right, actually. It's not that meat is carcinogenic, per say, but it acts as a promoter of cancer. So if you have some sort of predisposition to cancer (e.g eating aflatoxin or a the BRCA1 gene), then eating a diet with a high percentage of animal-based verses plant-based protein will significantly increase your odds of that predisposition developing into a caner. Any meat protein - not just processed meats. And this extends into heart disease research, osteoporosis, dementia, and mental health. The alternative direction of nutrition should go toward PLANTS - which are the foundation of the food chain and contain all of the nutrients, including healthy fats, protein, and the fiber that we need.
There is a pleasure in eating meat, that I would never deny and I myself haven't cut it out completely, but the science is undeniable - though oddly absent from the conversation in not just our common sense conversations about nutrition, the media - but also in our medical guidance to our patients! Check you The China Study - a book by T. Colin Campbell and Thomas M. Campbell, which has a very thorough review of the literature of animal-based verses plant-based diets. As a physician, I was humbled by how little of this I had learned in my medical education. Common sense can misguide us.
There is a pleasure in eating meat, that I would never deny and I myself haven't cut it out completely, but the science is undeniable - though oddly absent from the conversation in not just our common sense conversations about nutrition, the media - but also in our medical guidance to our patients! Check you The China Study - a book by T. Colin Campbell and Thomas M. Campbell, which has a very thorough review of the literature of animal-based verses plant-based diets. As a physician, I was humbled by how little of this I had learned in my medical education. Common sense can misguide us.
10
You condemn processed meat, which I agree with, but then you toss in all meat just for the hell of it. Sorry, but you lost all credibility right there
23
The author of this opinion piece says "I think the state of nutrition research in general is shockingly flawed."
I agree that nutrition research is poor. But is it really so shocking?
Nutrition is extraordinarily complex.
For an appetizer, start with the fact that there is tremendous interpersonal variability in genetics and history, so there will be great variability in response to nutritional interventions. And that makes it difficult to show (non)effect of an intervention.
For the next course, I recommend the "multivariable soup". Unlike drug trials, which can more easily compare drug to placebo, nutrition research is vastly more complex. Our metabolic system is a dance of myriad interacting variables. The complex soup of our nutritional biochemistry makes the notion of 'single nutrient' studies questionable.
For the main course, lets decide what to eat by flipping a coin in the air and seeing which menu item it lands on. Because our ability know what nutrition study participants actually eat, is about as accurate and predictable as flipping a coin. Unless of course we require that they live in the study laboratory for several years.
I imagine the reader's belly is full at this point. So I won't recommend dessert.
Let's just remember how difficult it is to effectively study nutrition. It's a tough situation because we want to quantify everything. But the art of medicine is, well, an art, too.
More blogging on health and healing at www.drshiller.com
I agree that nutrition research is poor. But is it really so shocking?
Nutrition is extraordinarily complex.
For an appetizer, start with the fact that there is tremendous interpersonal variability in genetics and history, so there will be great variability in response to nutritional interventions. And that makes it difficult to show (non)effect of an intervention.
For the next course, I recommend the "multivariable soup". Unlike drug trials, which can more easily compare drug to placebo, nutrition research is vastly more complex. Our metabolic system is a dance of myriad interacting variables. The complex soup of our nutritional biochemistry makes the notion of 'single nutrient' studies questionable.
For the main course, lets decide what to eat by flipping a coin in the air and seeing which menu item it lands on. Because our ability know what nutrition study participants actually eat, is about as accurate and predictable as flipping a coin. Unless of course we require that they live in the study laboratory for several years.
I imagine the reader's belly is full at this point. So I won't recommend dessert.
Let's just remember how difficult it is to effectively study nutrition. It's a tough situation because we want to quantify everything. But the art of medicine is, well, an art, too.
More blogging on health and healing at www.drshiller.com
15
Another factor you could mention: the researchers hoped to get more grants, and if they submitted a grant proposal which followed up on this study---i.e., tried to demonstrate that reducing saturated fats increased mortality---their research careers might have been over.
Billions has been spent over the years trying to prove that lowering saturated fat in the diet reduces mortality, nothing on the reverse. Researchers will design studies that might get funded.
Billions has been spent over the years trying to prove that lowering saturated fat in the diet reduces mortality, nothing on the reverse. Researchers will design studies that might get funded.
14
So could it have been the linoleic acid that was responsible for the higher mortality?
9
Headline results of diet studies can be unreliable, because they look at a lot of parameters simultaneously and hence find correlations which may be flukes. Correlation is not causation. The BBC recently reported on a study which showed that marvellously, finding that trimming the fat of your meat was likely to mean you were less likely to believe in God. The study's author quipped that maybe the Vatican should issue a warning against trimming the fat of your meat, since it can diminish your faith..
8
@Jan S:
This study was an actual experimental trial, not a correlational or observational study. Experimental trials get us causation, or at least get us closer to causation.
This study was an actual experimental trial, not a correlational or observational study. Experimental trials get us causation, or at least get us closer to causation.
4
Get out your white suit, your tap shoes and tails. Let's go backwards when forward fails:
It's back to steak, pan fried in butter and french fries, fried in lard. Everything old is new again.
It's back to steak, pan fried in butter and french fries, fried in lard. Everything old is new again.
14
Having a hard time getting over the fact that this study was conducted on 9000 Mental hospital patients...
33
Why not? The researchers had complete control over what was being given to the patients if not what they decided to eat. You think this diet was punishment?
1
Woody Allen's "Sleeper" comes immediately to mind.
28
A refreshingly honest assessment of the science.
If only the NYT would apply such honest and objective diligence to its reporting on climate science, then perhaps it would finally earn its moniker as publisher of all the news that's fit to print.
The Free Press is intended to be a check on the power of politicians, not a cheerleader for them.
If only the NYT would apply such honest and objective diligence to its reporting on climate science, then perhaps it would finally earn its moniker as publisher of all the news that's fit to print.
The Free Press is intended to be a check on the power of politicians, not a cheerleader for them.
16
Although all climate science relies on correlation, the datasets are very large and the statistical techniques are robust in testing various models. Because of these large datasets, it is possible to reliably reconstruct historical climate data that reaches back hundreds, thousands, and even millions of years.
Historical data is a very different animal compared to experimental studies. Scientific disciplines such as geology, cosmology, evolutionary biology, and meteorology are mostly historical sciences. Historical data is all that is available, although some hypotheses are amenable to experimental approaches, such as using bacteria with short generation times to study evolution.
However, scientists can still test hypotheses with historical data that provides strong inferences. For example, there is very good data on the impact of the asteroid that likely caused the end of the mesozoic and set the stage for the cenozoic. We cannot definitively say the asteroid wiped out the dinosaurs, but there is a much better fossil record for animals that are contemporaneous with the dinosaurs.
Finally, all science is based on some measure of uncertainty. Does that mean we decide to do nothing about climate change because we have incomplete knowledge, especially if we estimate the costs and benefits of doing nothing compared to taking action? If we do nothing, we might save money if there is no climate change, but if there is, the costs are likely to far more pervasive.
Historical data is a very different animal compared to experimental studies. Scientific disciplines such as geology, cosmology, evolutionary biology, and meteorology are mostly historical sciences. Historical data is all that is available, although some hypotheses are amenable to experimental approaches, such as using bacteria with short generation times to study evolution.
However, scientists can still test hypotheses with historical data that provides strong inferences. For example, there is very good data on the impact of the asteroid that likely caused the end of the mesozoic and set the stage for the cenozoic. We cannot definitively say the asteroid wiped out the dinosaurs, but there is a much better fossil record for animals that are contemporaneous with the dinosaurs.
Finally, all science is based on some measure of uncertainty. Does that mean we decide to do nothing about climate change because we have incomplete knowledge, especially if we estimate the costs and benefits of doing nothing compared to taking action? If we do nothing, we might save money if there is no climate change, but if there is, the costs are likely to far more pervasive.
6
Climate science is the ONLY science that uses anomalies and not real observational data in the datasets, with the exception of records that start with the satellite era in 1979. In other words, they made them up. (Sea Surface Temperatures date from 2003 with the ARGO buoys. As the ARGO site says, the data before then was five--yes, five--buckets dropped behind commercial ships.)
The 1950-1980 global temp baseline is an estimate. NOAA says so on their website.
The 1950-1980 global temp baseline is an estimate. NOAA says so on their website.
2
If the data are wrong and we switch to non energy sources anyway, what harm is done? If the data are correct and we do it what harm is done? I want to bet on the worst case scenario and the least harm response.
2
Well written and reasoned.
Ruth B. McKay, Ph.D, MPH
Ruth B. McKay, Ph.D, MPH
18
Interesting to note that the "saturated fats" in the control diet included margarine and shortening.
6
"I’m not suggesting anything sinister. I’m sure that both these scientists absolutely believed that their prior epidemiologic work..."
You are too kind. Read Gary Taube's book "Good Calories, Bad Calories" or, better yet, give Taubes a call and interview him for your column. Far from being inoffensive scientists following where they think the evidence led, Keys and his ilk epitomized the anti-scientist who thru deft political maneuvering and outright character assassination (whatever it took, really) made publication of anything that didn't conform to what they proclaimed to be truth possible only at the cost of destroying ones career. Those not agreeing with Keys faced tenure fights, loss of funding, bitter editorials calling their integrity into question, etc.
Taubes writes in his book of going down to talk to one of this clan (he doesn't name which one in the book) thinking he would be writing an article supporting the cholesterol hypothesis, but on arrival realizing he had met the worst scientist ever in his life. And this is the author who wrote a book about the cold-fusion fiasco, so he'd met his share of poor scientists.
You are too kind. Read Gary Taube's book "Good Calories, Bad Calories" or, better yet, give Taubes a call and interview him for your column. Far from being inoffensive scientists following where they think the evidence led, Keys and his ilk epitomized the anti-scientist who thru deft political maneuvering and outright character assassination (whatever it took, really) made publication of anything that didn't conform to what they proclaimed to be truth possible only at the cost of destroying ones career. Those not agreeing with Keys faced tenure fights, loss of funding, bitter editorials calling their integrity into question, etc.
Taubes writes in his book of going down to talk to one of this clan (he doesn't name which one in the book) thinking he would be writing an article supporting the cholesterol hypothesis, but on arrival realizing he had met the worst scientist ever in his life. And this is the author who wrote a book about the cold-fusion fiasco, so he'd met his share of poor scientists.
50
Some people, e.g., my family, ate everything in moderation, and never stinted on red meat with the delicious flavoring from the fat. There have been no heart attacks or clogged arteries for three generations and everyone has lived well into their 80s. (My grandfather--a great fat lover-- died at 94.) So where does genetics fit?
15
Genetics plays a large role in how our body manufactures and metabolizes cholesterol. Two people who eat the same diet and exercise the same amount may have vastly different levels of cholesterol. As your anecdote describes, some people simply don't have to worry much about cholesterol. Others have to a lot.
2
"Food for thought"
The purpose of titles of published research articles and lay media headlines is to attract attention ("eyeballs") but all too many readers read no further. Those who do, even those with some foreknowledge of the subject, accept the conclusion uncritically. And, as with the political media, readers are attracted to articles that confirm their biases and shun those that run counter to them. This is why meta analyses are crucial in medical research though their neutral titles attract less attention and they often challenge if not negate the entrenched conventional wisdom.
Perhaps even more important, the understanding of risk is abysmally poor, even among us doctors. The headlines shout: "...doubles your risk" but what is unstated is what your risk was in the first place. Doubling your baseline 1 or 2% risk of something means that your chance of not getting the disease is still 96 or 98%. Furthermore, no recommended treatment is always effective and none are harmless (with the near total exceptions of CPAP for sleep apnea and eyeglasses for myopia). Before agreeing to a recommended treatment you should ask how many people have to be treated to reduce the increased risk for any one individual. You might think twice if that number is 50 or 100, particularly if the risk of serious side effects is more than the chances of benefit.
The purpose of titles of published research articles and lay media headlines is to attract attention ("eyeballs") but all too many readers read no further. Those who do, even those with some foreknowledge of the subject, accept the conclusion uncritically. And, as with the political media, readers are attracted to articles that confirm their biases and shun those that run counter to them. This is why meta analyses are crucial in medical research though their neutral titles attract less attention and they often challenge if not negate the entrenched conventional wisdom.
Perhaps even more important, the understanding of risk is abysmally poor, even among us doctors. The headlines shout: "...doubles your risk" but what is unstated is what your risk was in the first place. Doubling your baseline 1 or 2% risk of something means that your chance of not getting the disease is still 96 or 98%. Furthermore, no recommended treatment is always effective and none are harmless (with the near total exceptions of CPAP for sleep apnea and eyeglasses for myopia). Before agreeing to a recommended treatment you should ask how many people have to be treated to reduce the increased risk for any one individual. You might think twice if that number is 50 or 100, particularly if the risk of serious side effects is more than the chances of benefit.
18
I think, from a complete curious layman point of view, that they are not taking enough factors into consideration. I would like to see research look into ancestry combined with research on gut flora.
There seems to be a link with our ancestors on our tendency to eat meat or not, as modern human precursors came from more than one place, and some of them were omnivores, some herbivores.
We also have colonies of gut flora that determine how well our body processes each type of food. Different colonies are required to process different food efficiently. An individual with more gut flora that handles proteins and fewer gut flora that handles vegetation will likely do well on a fatty, mostly meat diet, like the Inuit. Those, I believe, are they key to figuring out individual healthy diets.
There seems to be a link with our ancestors on our tendency to eat meat or not, as modern human precursors came from more than one place, and some of them were omnivores, some herbivores.
We also have colonies of gut flora that determine how well our body processes each type of food. Different colonies are required to process different food efficiently. An individual with more gut flora that handles proteins and fewer gut flora that handles vegetation will likely do well on a fatty, mostly meat diet, like the Inuit. Those, I believe, are they key to figuring out individual healthy diets.
9
There's a book called "The Jungle Effect" that considers ethnicity; you might find it a thoughtful read.
5
This was the 1960s--what if the source of good fats was also loaded with trans fat. The researchers did not know about trans fat at the time. That would ruin this studies results.
The butter substitute was loaded in trans fat for the 1960s
Australian study that has gotten a lot of press lately--a fatal flaw for the conclusions of that test.
Mike
The butter substitute was loaded in trans fat for the 1960s
Australian study that has gotten a lot of press lately--a fatal flaw for the conclusions of that test.
Mike
13
"Research has shown that studies with statistically significant results are more likely to be published than those without.".......The reason of course is validity. The entire purpose of statistical significance is to demonstrate the degree to which the results obtained were not the consequence of random chance. Even negative (as in no difference) results can be statistically significant. Why would anyone imagine that valid results would not receive greater consideration???
4
@W.A. Spitzer:
The broader point is that many studies going back several decades have found no significant difference or effect of lowering fat, saturated fat, or cholesterol on numerous health conditions. Yet this absence of evidence was never considered to be reason for questioning the predominant "low fat" dietary advice until quite recently.
The broader point is that many studies going back several decades have found no significant difference or effect of lowering fat, saturated fat, or cholesterol on numerous health conditions. Yet this absence of evidence was never considered to be reason for questioning the predominant "low fat" dietary advice until quite recently.
9
Facepalm...it hurts me to read this. This is why I support efforts to overhaul the intro courses in my department. I feel like we statistics professors are failing our students in so many ways...
7
"Of course, this is only one study. It involved only institutionalized patients. Only about a quarter of the participants followed the diet for more than a year."
Corn oil was used for the unsaturated fat, not olive oil.
There are such big caveats with this study. It fairly easy to see why it was not touted as "the truth," early on.
Corn oil was used for the unsaturated fat, not olive oil.
There are such big caveats with this study. It fairly easy to see why it was not touted as "the truth," early on.
6
@Springtime:
Decades of low fat, low cholesterol advice was proclaimed as "the truth" based on even flimsier evidence. Publishing and debating the results of this study is part of the process of correcting decades of terrible nutrition advice.
Then and now public health authorities recommend for people to _eat more_ corn oil. It's been in every round of the USDA guidelines since 1980, it's promoted by HHS and by the American Heart Association today. Will any of these agencies change their recommendations?
Decades of low fat, low cholesterol advice was proclaimed as "the truth" based on even flimsier evidence. Publishing and debating the results of this study is part of the process of correcting decades of terrible nutrition advice.
Then and now public health authorities recommend for people to _eat more_ corn oil. It's been in every round of the USDA guidelines since 1980, it's promoted by HHS and by the American Heart Association today. Will any of these agencies change their recommendations?
10
Could one look at people who have reached a certain age and are healthy, then study their eating habits over the preceding decades?
One would have to look at their actual health, not at "indicators." For example, my cholesterol has been over 240 for at least 40 years. Every doctor has told me to get it down; don't eat saturated fat, take statins, etc. because even if I don't have heart problems, I will eventually. At 79, I still get the same story.
My wife and I go through over a pound of butter, a couple of dozen eggs, and eat red meat/chicken 5 times a week, with no illnesses usually related to diet. My wife still works full time.
How many more are like us? We know several, people in their late 70's thru early 90's who live fairly vigorous lives, but are treated as outliers on the food scene by their doctors. One of my friends, 85ish, is famous for his Argentinian barbecue, serving enough meat to make doctors faint. I have 90 year old friends who like to share croissants and coffee every mid-morning when we take a break from sculpting (real sculpting, not some "seniors" course.)
If we are all such outliers, how come I know so many?
"Inquiring minds want to know."
One would have to look at their actual health, not at "indicators." For example, my cholesterol has been over 240 for at least 40 years. Every doctor has told me to get it down; don't eat saturated fat, take statins, etc. because even if I don't have heart problems, I will eventually. At 79, I still get the same story.
My wife and I go through over a pound of butter, a couple of dozen eggs, and eat red meat/chicken 5 times a week, with no illnesses usually related to diet. My wife still works full time.
How many more are like us? We know several, people in their late 70's thru early 90's who live fairly vigorous lives, but are treated as outliers on the food scene by their doctors. One of my friends, 85ish, is famous for his Argentinian barbecue, serving enough meat to make doctors faint. I have 90 year old friends who like to share croissants and coffee every mid-morning when we take a break from sculpting (real sculpting, not some "seniors" course.)
If we are all such outliers, how come I know so many?
"Inquiring minds want to know."
95
Sounds like my 95-year-old dad!
2
".. when it comes to nutrition, personal beliefs often trump science"
The average person accepts or "believes" the conventional wisdom that they get from doctors, agri-business ads, and government. Agri-business has had far too much influence over the dietary information that flows out to the public.
The average person accepts or "believes" the conventional wisdom that they get from doctors, agri-business ads, and government. Agri-business has had far too much influence over the dietary information that flows out to the public.
34
Perhaps in the name of scientific transparency, every rejected journal article submission should be publicly available online. These submissions would of course be separated from accepted articles and readers would need to electronically acknowledge that the difference is understood. A watermark could be added to each page indicating that the article was rejected. Researcher and publication bias (whether conscious or not) has been undermining science for generations and something needs to be done to address this problem.
15
Has it ever occurred to the RCT champions that all humans are not alike? Might it be possible that what is "good" for one person is "bad for another? Does anyone think that there might be a reason for the varied choices people make in their diets, one eschewing red meat for example or another loving dairy products? Maybe, left to our own devices, we choose diets that are beneficial for us as individuals. Perhaps these choices meet short-term needs, like for days of intense activity, medium term needs, like pregnancy, or long term needs as in growth and survival. I believe that the wider the scope of an issue (such as basic nutrition) and the longer the term of the study, the less applicable is the randomized control trial. The universe is not random, people are not random and our appetites and dietary choices are not random either.
13
You're misunderstanding the point of an RCT. Of course, there is always individual variation. An RCT measures whether a treatment works for a group of people, on average, compared to a control.
An RCT is our best tool for attempting to isolate the effects of a particular treatment, _while controlling for both non-random factors and random variation_. It does so randomly allocating equal amounts of noise/variation into both treatment groups.
An RCT is our best tool for attempting to isolate the effects of a particular treatment, _while controlling for both non-random factors and random variation_. It does so randomly allocating equal amounts of noise/variation into both treatment groups.
5
Actually gh, it has occurred to RCT champions. In fact, it's why they separate groups out into many subgroups and constantly have to 'correct' for all of these other variables. Also, the research does not attach labels such as 'good' and 'bad' to outcomes, people do (this can be confusing as scientists will often include what they suspect to be true in the publication). You might have a drug that lowers cholesterol, for instance, but if that doesn't also correlate to a reduction in mortality or morbidity, claiming that lowering cholesterol in this way is 'good' might be premature.
RCT is the gold standard for acquiring good evidence one way or the other. It could well be true that, the majority of the time, people 'naturally' choose foods that they need, but you need evidence to show that. I'll grant that I suspect this is true, at least to some extent, in healthy individuals and I'm sure this has occurred to many scientists. However, as someone who's illness caused my 'natural' diet inclinations to give me issues, I can easily falsify the assertion that this is always generally true.
I would also argue that the universe could be random, but that is irrelevant to the topic at hand.
RCT is the gold standard for acquiring good evidence one way or the other. It could well be true that, the majority of the time, people 'naturally' choose foods that they need, but you need evidence to show that. I'll grant that I suspect this is true, at least to some extent, in healthy individuals and I'm sure this has occurred to many scientists. However, as someone who's illness caused my 'natural' diet inclinations to give me issues, I can easily falsify the assertion that this is always generally true.
I would also argue that the universe could be random, but that is irrelevant to the topic at hand.
4
Few random thoughts:
1. Psychiatric patients on medication, particularly anti-psychotics, typically have higher levels of cholesterol.
2. Quality of meat is not considered, in terms of what feed (grain or grass) or antibiotics is given. I believe factors like these, even vegetables and fertilizers, are never factored in, though they probably should be.
3. Upon closely reading other scientific studies on health, as myself an amateur, I have concluded that all scientists publish what they want to believe is true, and it is that majority which "manufactures consented" truth for all those to rely their beliefs on science and subject themselves to such authority figures... not very different from religion.
1. Psychiatric patients on medication, particularly anti-psychotics, typically have higher levels of cholesterol.
2. Quality of meat is not considered, in terms of what feed (grain or grass) or antibiotics is given. I believe factors like these, even vegetables and fertilizers, are never factored in, though they probably should be.
3. Upon closely reading other scientific studies on health, as myself an amateur, I have concluded that all scientists publish what they want to believe is true, and it is that majority which "manufactures consented" truth for all those to rely their beliefs on science and subject themselves to such authority figures... not very different from religion.
9
"I have concluded that all scientists publish what they want to believe is true"....Do you actually know any scientists, or have you simply concluded that what you want to believe is true?
11
"Psychiatric patients on medication ... typically have higher levels of cholesterol."
This (and your other statements) are not simply "random thoughts." They are factually unsupported claims and "not very different from religion."
This (and your other statements) are not simply "random thoughts." They are factually unsupported claims and "not very different from religion."
2
Speaking of publication bias, this is just another example of the distorting effects of the premium the media place on sensationalism in pieces on health, as elsewhere. This piece doesnt consider any of the covariates that may have affected results in the Minnesota study, which are legion, especially compliance, total caloric intake, carbohydrate, salt, blood pressure, glucose tolerance, smoking etc. So it's as distorted as anything in the literature if not more.
4
It's _less_ distorted than the endless observational studies because this was an actual experimental trial, with a control group. Yes, all of those other factors could have varied, but they would have been similarly variable in both the experimental group and the control group. That's the power of a randomized controlled trial.
All of the "saturated fat/meat/cholesterol are bad" studies are observational studies using self-reported food intake surveys for data, not controlled experimental studies. Now which type of study has more confounding variables?
All of the "saturated fat/meat/cholesterol are bad" studies are observational studies using self-reported food intake surveys for data, not controlled experimental studies. Now which type of study has more confounding variables?
18
Review of the paper indicates that there is no evidence the randomization was actually successful. further, diet duration was mainly a year and only relatively early deaths while pts were still in the hospital were enumerated. The difference in frequency of death seemed limited to patients over age 65 in whom a year of lower cholesterol may have made little difference in lipid effects. There was no measurement of LDL and HDL cholesterol or triglycerides. The total mortality difference was 22% and the coronary and stroke death rates are unclear. The autopsies were conducted only on 500 deaths. All of these deficiencies in the data make any firm conclusions highly suspect.
7
If you do any serious reading on and think carefully about this subject you soon see that the idea of saturated fats as bad for people is simply nonsense. This means doing more than just reading the headlines and more than doing the SMH routine and concluding that no one knows anything because the topic is confusing. Ultimately the body makes cholesterol, as needed by the body. Similarly "increased" cholesterol is an indication, a marker, of something else going on in the body. This is somewhat obvious in terms of reduced cholesterol NOT reducing all-cause mortality. In that context, "statins" may "work" in terms of, or because, they are anti-inflammatory, to some extent, and not because they reduce cholesterol. But there are certainly better anti-inflammatory drugs. And poly-unsaturated fats are just bad for people and most living things, if the idea is to replace any significant part of the diet with such fats. Such fats have no large place in the diet. If the idea is that such plant oils are necessary, then eat the plants that contain the oils. As noted by Adam C, previously, people have been eating meat since the beginning, and I would suggest that the idea that the original diet of the species is harmful to it is absurd.
And, of course, there is always the idea that much of the "research" over the past years has been intended to buttress the the concepts that are best and most profitable to industry, and therefore may not be the best science.
And, of course, there is always the idea that much of the "research" over the past years has been intended to buttress the the concepts that are best and most profitable to industry, and therefore may not be the best science.
16
"And poly-unsaturated fats are just bad for people and most living things".....Based on what evidence? If something is "bad for most living things" it follows that there is a demonstrable reason. What is the reason?
6
We store long-term energy reserves in the form of saturated fat, a non-insulinogenic substance whose aliphatic structure is one of the least chemically reactive organic functionalities (far less so than polyunsaturated oils). Likewise, our muscles are made of red meat, and cholesterol is one of the fundamental workhorses and building blocks of the human body, so essential that it is present in every cell.
It is a priori unlikely that eating the things we're literally made of (and have consumed since the dawn of our species) should have deleterious effects on health. If these things are found to be correlated with poor health, then suspicion should fall first on other more recently introduced elements of our lifestyle. I nominate large-scale agriculture--which Jared Diamond has called our biggest mistake--and the vertical processed food industry it has spawned. The profitability of that industry and its incestuous relationship with government, research funding and media have greatly skewed our perspective on nutrition and disease.
It is a priori unlikely that eating the things we're literally made of (and have consumed since the dawn of our species) should have deleterious effects on health. If these things are found to be correlated with poor health, then suspicion should fall first on other more recently introduced elements of our lifestyle. I nominate large-scale agriculture--which Jared Diamond has called our biggest mistake--and the vertical processed food industry it has spawned. The profitability of that industry and its incestuous relationship with government, research funding and media have greatly skewed our perspective on nutrition and disease.
77
It is a great and unproven leap in saying that an essential component of living cells, systems and organisms can't be harmful in excess. Further, the absorption of dietary fats and cholesterol from the gut results in very different forms of the component fats and cholesterol than are synthesized de novo from specific precursors of the membrane biogeneris pathways of the cells where they are used for membrane stability and as the anchoring sites for most transmembraneous signaling processes. Too much of a good thing can be harmful depending on the route and environment of its ingestion.
2
Also, the major findings of the Framingham study have absolutely nothing to do with diet, except that we shouldn't be eating so much that we are obese.
They are again:
1. Cigarette smoking definitely increases the risk of heart disease.
2. Elevated blood pressure increases the risk of stroke
3. High levels of HDL cholesterol reduce the risk of heart disease.
4. An enlarged left ventricle increase the risk of stroke.
5. Some genes increase the risk of heart disease.
Probably genetics is the one real cause and basis of heart disease.
Of course, the idea that some people can't really do anything to prevent heart disease doesn't set well with the mentality that says we can always change our health outcome.
You can't make a buck off of the truth.
They are again:
1. Cigarette smoking definitely increases the risk of heart disease.
2. Elevated blood pressure increases the risk of stroke
3. High levels of HDL cholesterol reduce the risk of heart disease.
4. An enlarged left ventricle increase the risk of stroke.
5. Some genes increase the risk of heart disease.
Probably genetics is the one real cause and basis of heart disease.
Of course, the idea that some people can't really do anything to prevent heart disease doesn't set well with the mentality that says we can always change our health outcome.
You can't make a buck off of the truth.
12
http://www.nytimes.com/2016/04/04/health/dashing-hopes-study-shows-chole...
This study found that a drug that raised HDL significantly and lowered LDL did not have any effect on the rates of stroke or heart attack.
This study found that a drug that raised HDL significantly and lowered LDL did not have any effect on the rates of stroke or heart attack.
6
@Casey:
You missed the major _negative_ findings of the Framingham Study, which are that both total and LDL cholesterol do _not_ predict risk with any meaningful accuracy.
Agreed that genes are very important, but HDL and blood pressure are both modifiable (to a certain extent) by diet & lifestyle factors. Problem is, health authorities have been recommending the wrong diet to improve these risk factors.
You missed the major _negative_ findings of the Framingham Study, which are that both total and LDL cholesterol do _not_ predict risk with any meaningful accuracy.
Agreed that genes are very important, but HDL and blood pressure are both modifiable (to a certain extent) by diet & lifestyle factors. Problem is, health authorities have been recommending the wrong diet to improve these risk factors.
3
My observation. while caring for the post cardiac arrest/ MI patient. Most experience have experienced high levels of stress, most eat highly processed foods. I have observed the obese tend to suffer from congestive heart failure but not massive MIs. The low fat diet that is high in sugar gained in popularity along with the rates of thyroid problems, auto immune disorders and resulted in the same amount of people having MIs. They do not die because of the introduction of heart caths (we call them cash labs at 45,000$ a pop) Just an observation.
13
I'll say it again; while we navel gaze (at our lipid profiles and mortality statistics) the planet will go down in flames around us; we cannot continue to eat an environmentally unsustainable (animal based) diet. If reading this gives people the idea that they should it is a great disservice to the all living creatures.
28
Why not? We evolved with canines, which suggests that we're at least omnivorous. I'm grateful to have lived through what may have been the final generation that got to make decisions for ourselves. I fear the future will be coerced.
7
It's not the animal based part of our diet that is unsustainable, it is the petrochemical based agriculture that is unsustainable. Just look at how wheat, corn and soy are grown. Eating a vegetarian diet does not free us from an unsustainable diet. If people eat good healthy fats, they need less of everything else -- smaller portions and better satiation. Eating sustainably raised animals fed their natural diets allows us to also eat sustainably raised plant foods (also fed their natural diets).
7
You take a perfectly healthy person and tell them that they are sick because their cholesterol number is above this "magic" range that, by the way, seems to change every year.
You give them medicine that makes the drug companies billions of dollars and doesn't cut their mortality rate one bit. In fact, we are starting to see that the evidence was there all along that a person's cholesterol number probably means nothing more than one person's number is higher than another person's number.
I want to know who we are going to prosecute for this fraud once the whole truth comes out.
You give them medicine that makes the drug companies billions of dollars and doesn't cut their mortality rate one bit. In fact, we are starting to see that the evidence was there all along that a person's cholesterol number probably means nothing more than one person's number is higher than another person's number.
I want to know who we are going to prosecute for this fraud once the whole truth comes out.
136
The higher mortality rate is most likely attributed to high doses of omega-6 in the corn oil. Switch to canola and/or olive oil and fish that are high in omega-3. These oils have some omega-6, but far less than corn oil has.
13
Canola isn't better. Processed seed oils are highly inflammatory and high in omega-6.
3
"...personal beliefs often trump science."
____________________
Well, that's partially b/c "science" keeps changing their collective mind.
"Coffee is bad for you. Not it's not, it's good for you."
"Cholesterol causes heart attacks. No it doesn't."
"Don't take a daily aspirin. Yes, you should take one."
Like a couple of lawyers: "Did. Did not." Over-and-over-and-over...
____________________
Well, that's partially b/c "science" keeps changing their collective mind.
"Coffee is bad for you. Not it's not, it's good for you."
"Cholesterol causes heart attacks. No it doesn't."
"Don't take a daily aspirin. Yes, you should take one."
Like a couple of lawyers: "Did. Did not." Over-and-over-and-over...
10
It seems to me, the studies were clear that polyunsaturated fats did exactly what they were supposed to do: lower cholesterol. But it also seems that what failed the test was whether lowering cholesterol was beneficial or resulted in higher mortality.
41
I can only go on my own experience. When previously I ate without any personal research into diet as a guide, I put on weight. My BMI went to 27.. Then after retiring and with time to see about health and diet, I discovered that the promoted diets by dieticians etc were no healthy ones. Vested interests were skewing the research. Those like John Yudkin were marginalised.
So I selected a high protein breakfast option and only use saturated fats, coconut oil. I dropped 24 kg and my bmi is around 22. That convinced me the "saturated fat is bad" option is a bad choice.
So I selected a high protein breakfast option and only use saturated fats, coconut oil. I dropped 24 kg and my bmi is around 22. That convinced me the "saturated fat is bad" option is a bad choice.
29
I am beginning to wonder whether these so-called meta analyses where several previous studies are combined to generate greater statistical significance are flawed in ways that, while not specifically defined, are creating misleading analyses. I often read where such study is reported with the caveat that it is after all, a meta analysis. Also, as studies become older, critical details affecting data interpretation may be unavailable or worse, intentionally hidden.
6
Meta-analysis is a method to objectively scrutinize a body of scientific studies on some issue/topic. It is typically carried out by organizations which had nothing to do with any of the original research, no conflict of interest in the outcome nor any preconceived notion of what the 'truth' might be. The Cochrane Reviews are the long acknowledged gold standard. It starts by gathering all of the possibly relevant studies and evaluating them for methodological rigor, statistical power and level of validity (e.g. cross sectional or linear, observational or RCT, unblinded vs single blinded vs double blinded). In the course of this initial analysis, some studies are excluded from further analysis due to flaws in any or all of the screening factors, i.e. if the design, conduct and/or statistical analysis of the study were fatally flawed, they might as well not have been done in the first place and do not deserve inclusion in the next phase of the analysis. Then the data from the remaining studies are combined, which increases the statistical power of the evidence, thereby strengthening the scientific validity of the conclusion(s) far beyond the 'conventional wisdom'. The "caveat that it is after all, a meta analysis" is usually raised by those whose positive results are debunked by the meta analysis.
10
sleepdoc -
Thank you for the informative explanation of a meta-analysis.
Thank you for the informative explanation of a meta-analysis.
It seems to me, the studies were clear that polyunsaturated fats did exactly what they were supposed to do: lower cholesterol. But it also seems that what failed the test was whether lowering cholesterol was beneficial or resulted in higher mortality.
20
May I suggest that you read the "Zone Diet" by Barry Sears.
1
Dr. Ancel Keys deserves a monument. Perhaps the keel of a ship extending above the surface of a calm sea.
14
The authors indicate the limitations of the data, especially autopsy results. I am not sure we can conclude the deaths in the low cholesterol group were cardiovscular; low cholesterol is seen with cancer patients. Anyway, why would anyone think that lowering cholesterol in nursing home patients is going to prolong life? Atherosclerosis is a disease that takes decades to develop, and probably begins in adolescence. Would you expect smoking cessation in nursing home patients to impact the incidence of lung cancer, also a disease that takes decades? A meaningful prospective study has to include younger people, such as the Framingham longitudinal study. Thiis is not to say a heart healthy diet cannot be beneficial at any age, but we need to be realistic. We also need to be very worried about young people in our country who consume huge amounts of sat-fat (think pizza and potato chips) as well as carbohydrates. Metabolic disease and atherosclerosis go hand in hand. The future looks grim in more ways than one. We do not need more publications encouraging (or at least justifying) saturated fat laden diets.
23
What if a diet higher in saturated fat is healthy for you? We don't know because the studies are not consistent. You are not being very scientific. You are just going by your prejudices.
13
@MDMD:
Except that saturated fats "per se", or saturated fats in the context of naturally fatty foods, have never been demonstrated to cause any harm. Swapping out saturated fats for polyunsaturated "vegetable" oils, as recommended, is usually swapping out a whole food for a highly processed one. Potato chips are cooked in high linoleic acid seed oils, not saturated fats. The average pizza contains refined carbohydrates in the crust and the sauce, some saturated fat in the cheese, and who knows what else in the toppings. Swapping out pizza and potato chips for quality meat, eggs, and butter would be an improvement in nutritional quality.
We also have numerous randomized controlled trials, with human subjects, where eating more naturally fatty foods improves both cardiovascular and metabolic disease risk factors.
Except that saturated fats "per se", or saturated fats in the context of naturally fatty foods, have never been demonstrated to cause any harm. Swapping out saturated fats for polyunsaturated "vegetable" oils, as recommended, is usually swapping out a whole food for a highly processed one. Potato chips are cooked in high linoleic acid seed oils, not saturated fats. The average pizza contains refined carbohydrates in the crust and the sauce, some saturated fat in the cheese, and who knows what else in the toppings. Swapping out pizza and potato chips for quality meat, eggs, and butter would be an improvement in nutritional quality.
We also have numerous randomized controlled trials, with human subjects, where eating more naturally fatty foods improves both cardiovascular and metabolic disease risk factors.
15
Diet seems to be one of the only areas in science where simply positing a plausible theory is enough to generate public health campaigns, even though evidentiary confirmation of the theory is lacking. And then the idea, such asreducing fat consumption, is drilled into people's heads through constant repetition so that when evidence does come in, it won't be believed. Just try telling people that 2% milk is not better for them than whole milk and that it's probably worse. They won't believe you.
32
Not probably worse--definitely worse. There have been several studies that showed that whole fat dairy was not associated with cardiovascular disease, but low fat dairy was.
11
“He who does not expect the unexpected will not find it.” (Heraclitus)
7
Like another commenter, I immediately thought of "Good calories, bad calories", the book by Gary Taubes, which extensively covered the extreme bias in diet recommendations for decades, that, in my opinion, led to all the added sugar and crap in our "food" today (the processed crap that should never actually be labeled as food).
I already had my doubts about the impartiality of the "health care" field (another misnomer, since it's really the sickness care field), but that book by Taubes clinched it for me.
I actually eat very healthily, and don't follow Taubes' advice either, which was more of a low-carb diet, which I think is equally bad.
Frankly, I think Michael Pollen's is the only sane advice "Eat Food. Not too much. Mostly Plants". But that is far too simple for most people, not eye-catching or complicated enough to write endless articles about, and robs the "food" industry of all the revenue gained by pedaling crap labeled as food. Can't make a lot of extra money on a plant like spinach or broccoli.
What a sad state of affairs eating has become. And what's worse, is that society has begun to think some of it is normal. I am of normal weight, though well into middle age, and about the same weight I was in college. But I've had family members tell me I'm too thin. Many of them are, in my opinion, verging on seriously overweight, but I think that has become the new normal, because it's not grossly overweight.
I already had my doubts about the impartiality of the "health care" field (another misnomer, since it's really the sickness care field), but that book by Taubes clinched it for me.
I actually eat very healthily, and don't follow Taubes' advice either, which was more of a low-carb diet, which I think is equally bad.
Frankly, I think Michael Pollen's is the only sane advice "Eat Food. Not too much. Mostly Plants". But that is far too simple for most people, not eye-catching or complicated enough to write endless articles about, and robs the "food" industry of all the revenue gained by pedaling crap labeled as food. Can't make a lot of extra money on a plant like spinach or broccoli.
What a sad state of affairs eating has become. And what's worse, is that society has begun to think some of it is normal. I am of normal weight, though well into middle age, and about the same weight I was in college. But I've had family members tell me I'm too thin. Many of them are, in my opinion, verging on seriously overweight, but I think that has become the new normal, because it's not grossly overweight.
127
I read "Good Calories, Bad Calories," too. I didn't believe it at first and tended to think of Gary Taubes as a con man. In the last few years, much of what he has said has become mainstream. I now think he did a great job in getting health researchers to do their jobs.
11
"But the most common reason research isn’t published is because researchers don’t write it up and submit it."
Sometimes you need the noise to put the signal in context.
Sometimes you need the noise to put the signal in context.
6
Did you notice the use of the unnatural oil - Corn oil - in the study? Let your readers know that just like Corn Syrup, Corn Oil cannot be made in your grandma's kitchen. It is made in a chemical factory So much for a controlled study. I guess their research budget couldn't afford any natural oils like Sunflower, Olive, Peanut etc.
57
How does anything you wrote imply that it isn't a controlled study? Just because you don't like the oil they used in the control doesn't mean it's not controlled. Please think before you write.
4
The corn oil bothered me too. Thanks for the reminder that unsaturated fats/oils include both omega-3 and omega-6 variants.
10
@Jaque:
Public health and nutritional authorities have recommended for decades for people to _eat more_ corn oil, with absolute certainty that it was more healthful than saturated fats. It's been in every round of the USDA dietary guidelines since 1980.
Public health and nutritional authorities have recommended for decades for people to _eat more_ corn oil, with absolute certainty that it was more healthful than saturated fats. It's been in every round of the USDA dietary guidelines since 1980.
7
In the Minnesota Coronary Experiment, is there any explanation for why the death rate increased when the serum cholesterol was reduced?
11
Why no discussion of the age of the participants? Late in life the body is not as adaptive to change.
4
Of course, simply looking around at our ever more obese co-workers, friends, families and selves tells you that saturated versus unsaturated fat is the lesser of our worries.
27
The type of fat is just part of the bigger picture. It's becoming painfully obvious that there's something very wrong with the modern lifestyle.
1
In the cited experiment, only a quarter of those on the diet stayed on it longer than a year. Can it be that for those who didn't, the benefits were wiped out (for starters) and the resumption of more saturated fats did more damage than they might have otherwise? I'm thinking, as a parallel, of yo-yo dieting in which overweight people cut calories and successfully lose weight, but when they go back to their former eating habits, gain back more weight than they'd lost.
4
Is not the clue to the problem that the best studies control something that in real life is wildly uncontrolled? These studies limit total calories to a number that is presumably reasonable for both "healthy" and "unhealthy" diets. In real life, eating habits vary from reasonable to gross. It may well be that two or three hamburgers a week hurt nobody. One could hardly say the same about two or three double cheeseburgers with bacon every day. I fear that loss of nuance in reporting may lead too many people to assume that overeating of fatty diets is OK.
5
Hmm... is worrying about fats in your diet increasing stress hormones such as adrenaline and cortisols thus negating any benefit. The enjoyment of that steak could counteract the marbleing...
Dieting nazis love to slather on guilt.
Dieting nazis love to slather on guilt.
17
While the article points out that effects of fats may be debatable, the steep environmental costs of eating a diet high in beef are not. Our high beef diet leads to destruction of rain forests all over the planet, pollution of our water and air in the U.S. by fecal waste of livestock, erosion of topsoil for future generations, and an increase in obesity and chronic diseases.
38
@Honolulu:
Environmental concerns about poorly-managed livestock are legit, but...
Red meat consumption in the US has _declined_ over the past three decades while rates of obesity and diabetes have increased.
Environmental concerns about poorly-managed livestock are legit, but...
Red meat consumption in the US has _declined_ over the past three decades while rates of obesity and diabetes have increased.
19
This seems to confirm what we already knew: go with the omega-3 vegetable oils, not the omega-6 vegetable oils. Olive oil is the best. That's part of why the Mediterranean diet proves so effective.
19
This is not what the study confirms at all. The study wasn't comparing olive oil to corn oil. Stop making things up.
16
Olive oil is mainly monounsaturated omega-9 fatty acid (Oleic Acid).
5
Does it?
Ancel Keys dropped France out of his 7 countries study when he couldn't explain how the French eat so much saturated fat yet have so few heart attacks.
Ancel Keys dropped France out of his 7 countries study when he couldn't explain how the French eat so much saturated fat yet have so few heart attacks.
5
Since the 1960's various studies have condemned almost every food as hazardous to our health but with the amount of chemicals in fertilizer, in the air, with genetically modified foods now and some purely chemical manufactured foods, who knows what's best to eat? The only answer is the most boring answer - moderation in all things - but generaly, eat less and move more.
12
Regardless of whether the study affirms the risk of saturated vs unsaturated fats in the diet, shouldn't we be looking at the elephant in the room? Doesn't this study (along with many others) show that there is no direct co-relation between high cholesterol and heart disease incidents? This seems to be the real value in this old study.
106
That's the big question. If lowering cholesterol does not reduce heart disease, and may raise the incidence of death from other diseases that are not included in the studies, how much influence will pharmaceutical companies have in the research results?
52
From what I understand, the cholesterol hypothesis was based on the thinnest of reeds.
The Farmingham study found no relationship between LDL cholesterol and heart disease risk, but found that HDL cholesterol lowered risk. From that, they conjectured that it was the ratio of HDL to LDL that mattered and, since they had no means of directly measuring HDL cholesterol (it's measurement is based on a calculation of LDL and total cholesterol), they decided the best way to control the ratio was to reduce LDL.
But notice that no relationship was found between LDL and heart disease.
And now an industry has grown up around controlling LDL, so it's unlikely to go away.
The Farmingham study found no relationship between LDL cholesterol and heart disease risk, but found that HDL cholesterol lowered risk. From that, they conjectured that it was the ratio of HDL to LDL that mattered and, since they had no means of directly measuring HDL cholesterol (it's measurement is based on a calculation of LDL and total cholesterol), they decided the best way to control the ratio was to reduce LDL.
But notice that no relationship was found between LDL and heart disease.
And now an industry has grown up around controlling LDL, so it's unlikely to go away.
47
With new research hinting that saturated fats, and fats in general, are not the evil we once thought they were, it will be imperative to get physicians, nutritionists, and "experts" on board with recommending a diet based on a healthy amount of fat.
41
I'd say hat tip to Gary Taubes who objectively looked at a lot of historical dietary research and, if I recall correctly, it included the referred study http://garytaubes.com/
32
He's so wonderful, isn't he? He's, like, the Elon Musk of nutrition!
3
Wasn't Ancel Keys one of the people who pooh-poohed John Yudkin's sugar research?
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Yes. Ancel Keys did a lot of good as the first researcher to promote the virtues of the Mediterranean diet, but he also started the war on fat, which essentially caused the current obesity crisis. He died aged 100, having lived his golden years in Italy, enjoying a--presumably fat-rich--Mediterranean diet.
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He was the primary pooh-pooher!
Anyone who studies the procedures followed in the approval of aspartame comes away with a complete disgust of government and it's manipulation toward greater and greater profit at the expense of public health. This stuff is today's tobacco.
Indeed perhaps it is the additional income generated by the selling of all the fat that was removed from low fat foods that influenced the low
fat products fostered on this country and it's people.