Health Authorities Continue to Fail Us

[Todd Allen]

While imperfect this editorial does well reflect my disillusionment with the state of nutritional science and governmental advice.

http://observer.com/2017/02/health-recommendations-wrong-saturated-fat-sodium-intake/

[TomBAvoider]

I agree that the state of nutritional science and governmental advice is a sorry mess - and worse, a scandal (especially given the conflicts of interest and shoddy science). However, the editorial (on observer.com - Jared Kushner's baby, btw.) does itself no favors by citing "authorities" such as Gary Taub. There's enough that's wrong with nutritional science without the dubious contributions of cluless self-styled nutritional authorities.

[Todd Allen]

Gary Taubes is not a nutritional authority but a journalist of science who has pointed out many ways in which the conclusions of conventional nutritional wisdom such as the demonization of fat and cholesterol are insufficiently supported because of major flaws in the underlying science.  He doesn't claim to be a nutritional expert though he does offer ideas with supporting arguments such as obesity is a result of hormonal disregulation and that the dietary guidance to restrict fat has lead to an increase in the consumption of sugar which is a prime suspect as a causative agent of hormonal disregulation.

 

And while arguing his ideas he only suggests they merit further research not that they should be adopted as a new truth.  And he acknowledges how difficult it is to do nutritional science and readily admits that the one big study funded by his organization NUSI was a dismal failure scientifically becaused it failed to establish a proper control group for the variable being tested.  Contrast that to the arrogance of someone like Dean Ornish who claims his diet is "proven" to reverse heart disease based on a few small studies riddled with massive flaws that he refuses to acknowledge.

 

Personally I feel Gary Taubes is worth listening to and he has helped me learn to take advice from nutritional authorities with a grain of salt.

[mccoy]

Todd, I myself like to listen to the different theories. I like the logical and simple theoretical proposal for the insulin theory of metabolic disfunction. Fact is that, if all things were true, there would be no more overweight people around. Some exhibit dramatic weightloss, but many others hit plateaus and stay there for months, years...

Some of'em decrease ever more the carbs, until they'll eat just about meat, cheese, eggs, sometimes avocados and some macadamias at most. They'll eat animal organs to ingest the vitamins and I don't know how they poop with so little fibers. They eat an excess of proteins to reach satiety (unless they follow Rosedale's suggestions, now supported by Fung and some others). All in all, it's often a messy and unhealthy situation on the long run.

 

Only lately I've been listening to the low-fatters: Ornish, Esseltsyn, Barnard, McDougall not yet. These guys have huge credentials. And they are very keen on helping people. Dr. Esseltsyn, as Drewab from this forum testified, called him personally after a mail, even though he was not a patient and gave him suggestions. The science they base upon is solid. The CV disease reversals are scientifically proven, in small samples of course. Is it going to work in everyone? I don't know.  Dean Ornish did not sound arrogant to me in his podcast with Jimmy Moore, where the common points of both theories were discussed. 

 

Diabetes appears to be reversed by either low carb and low fat.

Weight can be lost (and can be regained) by either low carb and low fat.

CV diseases can be reversed (in some documented, proven cases) by low fat but not by low carbs.

Epilepsy can be reversed by ketosis, an extreme form of low-carb, not by low fat

Cancer may be reversed by ketosis

Some cancers can be reversed by a low-fat plant-based diet

 

Both groups can say clearly wrong things (at least, until they generalize):

• The Ornish group says: Fats are the devil
• The Low carbers say: Fruit is the devil

Both can be true though, albeit in specific context, like CVD reversal and prevention (fats and oil are better avoided or taken in great moderation) and diabetes reversal or prevention (fruit is high in sugars).

 

I don't know Taubes very much, although I have a clue now why NUSI was terminated. Dean Ornish is clearly a giant, he has been a consultant of Bill Clinton and of the Obama administration. A humble giant though, if he's willing to put himself in discussion in a podcast directed by a layman (although nutritionally educated) like Jimmy Moore. 

Also, I'm reading the Ornish book published in 2007, on his food spectrum or grouping system and I find it pretty much sensible. His position on fat is also reasonable: if you have CVD, or are at risk or simply want to avoid it at all costs, you'd better eat drastically few fats. If you want to loose weight by checking calories, fat is going to limit the volume of food you can eat hence jeopardizes satiety. That's undisputable.

The low carbers used to insist that there is no need at all to count calories, until they realized that some people do need to count calories and to decrease fats, even if eating little or no carbs.

 

Colin Campbell, the author of the China study, notwithstanding his academical stature had no qualms in answering to Denise Minger, a schoolteacher=layman, about her critique to his book. Denise Minger refused to accept the peace offering, going even more into arguments some of which bespoke of little knowledge of basic statistical science.

The low carbers like the mantra 'correlation is not causation' but such affirmation is not true. The true one is: 'correlation is not necessarily causation'. Sometimes correlation can also be causation though.

Again, Denise Minger criticized Dr. Garth Davis for what he said on protein RDA in his book 'proteholic'. I read the book and followed personally that blog and posted a comment on Denise's point. She apparently misunderstood the statistical significance of RDA, a pretty serious drawback for someone who wants to debunk theories but proves a lack of credibility .

 

Bottom line: I love the democracy of Internet, but in this arena of nutrition it is necessary to proceed with extreme caution. Credentials must be given credit, extreme positions must be viewed with some skepticism and verified. Last but not least, personal empirical experience, if unbiased, has ample room in the evaluation. When people say that fresh fruit is very bad because of fructose, I automatically go back to my 40 years of heavy fruit eating and do not find objective truth in that statement. Ditto when I hear that olive oil is nearly a toxic substance (the vegan killer). Such positions should not be generalized, rather be put in a specific context.

[Mechanism]

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[Todd Allen]

Both Dean Ornish and John McDougall make statements as if they are fact that aren't substantiated by the work they have done and without referencing any other work that does substantiate it.  I find that arrogant.  For example, while their prescribed diets differ, McDougall's is higher starch than Ornish's, they both make assertions that their whole foods high carb low fat plant based diets are healthy and animal foods and especially saturated fat are killers.  At the same time they each admit that processed foods high in sugars and refined flours are problematic but as far as I have seen neither has ever attempted to isolate what factors make their diets healthy.  Is it restricting fat?  Is it really the exclusion of animal products?  Maybe it is excluding Doritos and soda pop?  Maybe it is excluding meats cured in sugar, salts, nitrates and a bunch of other crap that is then fried, grilled or baked to have that tasty browned and/or charred exterior chock full of AGEs?  Maybe getting people to stop smoking, exercise, sleep better, take up meditation and other stress management plays a role?  If you want to state that a vegan diet is healthier than one that contains carefully sourced high quality animal products such as sushi and gently prepared fresh organ meats then you need to do a test that isolates that as a factor.  If you want to categorically state saturated fats are harmful you need to test high quality uncontaminated fats prepared in ways that don't damage them.  And to be really certain you need to also test them in the context of a low carb diet as it might be high insulin impeding their metabolism that makes them problematic.  And if the results for any of those tests is mixed or small it needs to be a large sample size and long duration.  Ideally randomized control trials - double blind are best at establishing causation though this is nearly impossible in the case of human nutrition.  Given the expense of doing high quality nutrition science shockingly little has actually been done.  And without it anyone who is science minded and has integrity will qualify their claims and statements as "this is suggested by this case or study" versus claiming undisputable fact.

 

Here's an example of a nutrition debate including Atkins, Ornish, McDougall and others that illustrates this problem.  You can see examples of this in every one of these experts' presentations and the subsequent Q&A, but I found the degree of unsubstantiated statements declared as fact by Ornish and McDougall particularly offensive.

 

https://www.youtube.com/watch?v=feCpP40ZHqI

[mccoy]

Todd, I've just read Dean Ornish' book  published in 2007. I also listened the podcast where he speaks with Jimmy Moore, notorious champion of the ketogenic diet.

 

His regimen is not totally plant-based, since he allows in his 1st group, the healthiest one, non-fat dairy products and egg withes. From his site:

 

 

 

 

Foods are neither good nor bad, but some are more healthful for you than others — predominantly fruits, vegetables, whole grains, legumes, soy products, nonfat dairy, and egg whites in their natural forms, as well as some good fats that contain omega 3 fatty acids. These are the foods that are rich in good carbs, good fats, good proteins and other protective substances. There are at least 100,000 substances in these foods that have powerful anti cancer, anti-heart-disease and anti-aging properties.  What you include is as important as what you exclude.

 

Also, he does not totally rule out meat and fish unless you are trying to reverse heart disease or diabetis or prostate cancer.

 

He explains sensibly why the diet is low fat, at least it is very sensible when trying to loose weight (less fat= more volume).

 

He insists on fibers and, above all, he doesn not demonize fresh fruit, rather encourages it. he's not at all fanatic in his books, rather recognizing the necessity to compromise at times.

 

Also, he is a giant in the nutrition science and his research work is widely known and acclaimed. He's been a personal consultant of Bill CLinton and of the Obama administration. I think he has the best credentials in absolute in the field of nutrition.

 

Main subject of his work is in the field of cardio-vascular disease, and this probably expalins the emphasis on low fat.

 

Such a gigantic figure is so humble to desire to speak in Jimmy Moore's podcast, who preaches just the contrary of Ornish, and willing to find some common ground.

 

Maybe he does not make references because he takes for granted that it's well known. He has shown and proved, together with Esseltsyn, that CV conditions can be reversed, at least in part.

 

I could not connect right now to the Vid you linked, I'm going to do it later, but so far the evidence I have is of absolute credibility and competence.

[mccoy]

I agree with the balanced approach. We tend to take camps rather than lean on the preponderance of evidence with nuance.

 

Here is more data ( sorry not full text) a low fat diet ( if that is doing it , at the very least not a detriment) compatible with squeekly clean arteries.

 

This and the Okinawa epidemiology have me question my > 50% fat diet ( mostly nuts) since few indiginous cultures can compare with my high nut consumption except for the !kung and even them, not quite. Lots of examples of low fat thriving cultures though. Ditto for intermittent fasting - I have 1-2 meals a day but off the top of my head can't say where this is naturally occurring with good long term data.

 

 

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)30752-3.pdf

 

Coronary atherosclerosis in indigenous South American Tsimane: a cross-sectional cohort study

 

Very interesting article. I too tend to have an high-fat diet but, in the context of an otherwise healthy and fiber-rich diet it seems to be all right. My latest lipid panel was taken in response to a worrying thread started by Dean, but the profile was all right. My CVD risk according to the AHA is also in the lowest range.

 

In the context of CVD, though, less fat makes sense, especially of the sturated type. Right now I'm reducing saturated fats, since I believe that caution is never too much against the #1 killer disease. Besides, I prefer a cautious dietary scheme than undergoing all kind of medical analyses and scans.

[Mechanism]

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