Guest Post: Vegetable Oils, (Francis) Bacon, Bing Crosby, And The American Heart Association

–Gary Taubes responds to the AHA presidential advisory on dietary fats.

Editor’s note: I was planning to write about the American Heart Association’s new statement about dietary fats so I asked Gary Taubes for a brief quote. Taubes, of course, is an investigative science and health journalist who has written three major books (Good Calories, Bad Calories; Why We Get Fat; and The Case Against Sugar) that have challenged our received ideas and beliefs about nutrition. Instead of a quote I received a lengthy response, which he then turned into a post at my suggestion. As Gary says, and as his three books prove, he tends to get carried away on this subject. I am grateful to Gary for allowing me to publish this important statement.

Vegetable oils, (Francis) Bacon, Bing Crosby, and the American Heart Association

The human understanding, once it has adopted opinions, either because they were already accepted and believed, or because it likes them, draws everything else to support and agree with them. And though it may meet a greater number and weight of contrary instances, it will, with great and harmful prejudice, ignore or condemn or exclude them by introducing some distinction, in order that the authority of those earlier assumptions may remain intact and unharmed.
     –Francis Bacon, Novum Organum, 1620

Four hundred years ago, give or take a couple of years, Francis Bacon pioneered thinking about the scientific method by noting that humans are programmed to pay more attention to evidence that agrees with their preconceptions and to reject evidence that doesn’t, and that this thinking leads to very effective religious dogma but not to reliable knowledge of the universe. Hence what was needed was a new technology of reasoning –Novum Organum, per the title of his book in Latinthat would minimize these tendencies, although he recognized that getting rid of them entirely was not an option. Humans didn’t function that way.

In good science, this kind of cognitive bias is addressed, among other methodologies, by deciding in advance of looking at the evidence (or doing a trial) what criteria will be used to judge the worth of the evidence (the results of the trial) without knowledge of whether that evidence supports our hypotheses. This is one reason why clinical trials are done double blind, and the data analyzed by researchers who are blinded to whether the subjects were interventions or controls, such that the biases of the investigators (or even the subjects) don’t bias the interpretation of the results.

For whatever reason, when it comes to heart disease and dietary fat, the investigators whom the American Heart Association chooses to determine what we should or should not eat have never been believers in this kind of, well, scientific methodology. This was the general conclusion of my first investigation into the dietary fat story going on 20 years ago for the journal Science. I’d like to say the situation has improved, but clearly it hasn’t. The latest Presidential Advisory from the AHA on saturated fat is the AHA’s expert authorities – what Inspector Renaud in Casablanca would have called “the usual suspects” – reiterating that they were right fifty years ago, and they were right 20 years ago, and they’re still right. And the techniques they used to come to those conclusions can be used again and again until someone stops them. Which is unlikely to happen.

A Scottish cardiologist/epidemiologist described this pseudoscientific methodology to me as “Bing Crosby epidemiology” – i.e., “accentuate the positive and eliminate the negative.” In short, it’s cherry picking, and it’s how a lawyer builds an argument but not how a scientist works to establish reliable knowledge, which is the goal of the enterprise. Not winning per se, but being right. It’s why I wrote in the epilogue of my first book on nutrition, Good Calories, Bad Calories, that I didn’t consider these people doing research in the nexus of diet, obesity and disease to be real scientists. They don’t want to know the truth; they only wanted to convince maybe themselves and certainly the rest of us that they already do and have all along. While all good science requires making judgments about what evidence is reliable and what isn’t, scientists have to do this keeping in mind that the first principle of good science, now quoting Feynman, “is that you must not fool yourself and you’re the easiest person to fool.” The history of science is littered with failed hypotheses based on selective interpretation of the evidence. Regrettably the AHA experts simply don’t believe that what’s true of far better scientists then themselves, could possibly be true of them as well.

Today’s Presidential Advisory, written by a dozen esteemed experts led by Harvard’s Frank Sacks, may be the most egregious example of Bing Crosby epidemiology that I’ve ever seen. It’s particularly interesting because four years ago the AHA released a report claiming to be evidence-based medicine, co-authored by an intersecting set of these usual suspects, that also claimed that the strongest possible evidence existed to restrict the saturated fat (SFA) in our diet and replace it with polyunsaturates (PUFAs). It was fascinating because multiple other meta-analyses, co-authored by independent researchers, had found the evidence to be weak or lacking. So how could it be the strongest possible? Surely there was room for improvement. That 2013 AHA document, though, made it exceedingly difficult to duplicate the analysis of the AHA experts and establish how they had come to such a paradoxical conclusion. This latest document in effect tells us what they did then and are still doing – i.e., what they’ve been doing all along.

Whether consciously or unconsciously, they assume that what they think is true surely is, and then they methodically eliminate the negative and accentuate the positive until they can make the case that they are surely, clearly and unequivocally right. And they might be, just as a lawyer arguing a case to a jury might always be right, but you can never know it from the lawyer’s argument alone. You have to hear the counter as well and then maybe you can decide.

So let’s look at this process of eliminating the negative: the AHA concludes that only four clinical trials have ever been done with sufficiently reliable methodology to allow them to assess the value of replacing SFAs with PUFAs (in practice replacing animal fats by vegetable oils) and concludes that this replacement will reduce heart attacks by 30 percent. In the history of this debate, this is a huge, if not unprecedented number. These four trials are the ones that are left after the AHA experts have systematically picked through the others and found reasons to reject all that didn’t find such a large positive effect, including a significant number that happened to suggest the opposite. For these trials they carefully identify why these trials were critically if not fatally flawed, and so why their results cannot and should not be used in any reasonable assessment. As Bacon might have said, “with great and harmful prejudice [the AHA experts] ignore or condemn or exclude them by introducing some distinction, in order that the authority of [their] earlier assumptions may remain intact and unharmed.”

They do this for every trial but the four, including among the rejections the largest trials ever done: the Minnesota Coronary Survey, the Sydney Heart Study, and, most notably, the Women’s Health Initiative, which was the single largest and most expensive clinical trial ever done. All of these resulted in evidence that refuted the hypothesis. All are rejected from the analysis. And the AHA experts have good reasons for all of these decisions, but when other organizations – most notably the Cochrane Collaboration – did this exercise correctly, deciding on a strict methodology in advance that would determine which studies to use and which not, without knowing the results, these trials were typically included.

What the AHA experts don’t do (perhaps because they are convinced they can’t possibly be fooling themselves) is make the same effort with the trials that do support their hypothesis and assumptions. If they did, they make little indication of it. Of the four studies that support the 30 percent reduction, all are ancient by the standards of nutrition science. All date to the 1960s. One of them, for instance, is the Oslo Diet-Heart Study. This trial reported a significant reduction in CVD events, in line with the beliefs of the AHA authors, and so it’s included among the four trials considered worthy of making the cut. The Oslo trial was indeed typical for the era, which means very primitive by today’s standards. A single investigator, Paul Leren, has local physicians recommend to him for inclusion in the study patients who are at high risk of heart disease or have already had heart attacks. He randomizes half of these patients, now subjects, to eat a low-SFA, high PUFA diet and then gives them intensive counseling for years (“continuous instruction and supervision,” as Leren puts it), and he compares them to a control group that gets no counseling and eats the standard Norwegian diet.

So one group gets a “healthy” diet and intensive counseling for years; the other group gets nothing. Nada. This is technically called performance bias and it’s the equivalent of doing an unblinded drug trial without a placebo. It is literally an uncontrolled trial, despite the randomization. (In this case, as Leren explains, all the physicians involved also knew whether their patients were assigned to the intervention group or the control, which makes investigator bias all that much more likely.) We would never accept such a trial as a valid test of a drug. Why do it for diet? Well, maybe because it can be used to support our preconceptions, but that’s not really a good answer. I’m guessing that the AHA experts made no attempt to find out if this trial was worthy of rejection because they liked the result If I’m wrong, I apologize and I hope one of them will write to tell me.

Why do I know this about Oslo? Because I was curious, always a good thing, and, of course, because it disagrees with my preconceptions and my biases. Still, my curiosity could not be satisfied by reading the published literature because Leren didn’t give the necessary details in the published studies. He probably didn’t have the space. He did in a monograph he published in 1966. I bought a copy a few weeks ago. That’s how curious I was. It’s in this monograph that Leren assesses the state of the science, just as our AHA experts do now, fifty-one years later, and he then describes in pretty good detail what he actually did in the trial. He also discusses the dietary changes achieved in his intervention group, and here’s where the performance bias, rather than the PUFA/SFA shift, may have determined the study outcome.

Leren mentions in passing that sugar consumption in his intervention group was very low, about 50 grams a day, which is 40 pounds a year and is probably less than half of the per capita consumption in Norway in that era. (I’m extrapolating back from this data — i.e., guessing.) So this is a critical problem with performance bias in a diet study, any diet study. As we’re taught in eight grade science classes, good scientific experiments change a single variable with an intervention such that we can see the effect of that change. In this trial, the variable that’s supposed to be different is the SFA/PUFA ratio, but the performance bias introduces another one. One group gets continuous counseling to eat healthy, one group doesn’t. Now how can that continuous counseling influence health status? One way is that apparently the group that got it decided to eat a hell of lot less sugar. This unintended consequence now gives another possible explanation for why these folks had so many fewer heart attacks. I don’t know if this is true. The point is neither did Leren. And neither do our AHA authorities. Although we can speculate that had they decided in advance what criteria they would use to reject studies and then have the studies assessed blindly, such that the individuals making the choice had no knowledge of the results of the study, they would have rejected this one, too. And the others, as well. All of the four studies used to support the 30 percent number had significant flaws, often this very same performance bias. Reason to reject them.

The PrediMed trial is another good example of the AHA’s Bing Crosby epidemiology. The AHA authorities, as they say in passing, would like us to eat a Mediterranean diet, and so they conclude the evidence from PrediMed supports this advice. PrediMed may be the most influential clinical trial of the last decade, but it, too, was critically flawed. No, fatally flawed. You had to read the supplemental data in this case to find out. The researchers randomized subjects to three arms, one of which got nuts (Mediterranean) and regular counseling; one got olive oil (Mediterranean) and counseling; one (non-Mediterranean) got bupkus and no counseling. Hence, significant performance bias. Midway through the trial, the researchers actually realize that this was a problem and decide to address it. Here’s how they describe this revelation on page 10 of the supplemental material:

“The initial dietary protocol for the Control group started with the delivery of a leaflet summarizing the recommendations to follow a low-fat diet (Table S2-S3) and scheduled one yearly visit. In October 2006, 3 years into the trial, we realized that such a low-grade intervention might potentially represent a weakness of the trial and amended the protocol to include quarterly individual and group sessions with delivery of food descriptions [my italics] shopping lists, meal plans and recipes (adapted to the low-fat diet) in such a way that the intensity of the intervention was similar to that of the Mediterranean diet groups, except for the provision of supplemental foods for free. This amendment of the protocol in no way meant a change in the quality and specific goals of the recommendations to the control group; it was only an enhancement in the eagerness of the intervention to make it similar to that delivered to participants in the Mediterranean diet groups.”

Sound of throat clearing… Imagine a drug trial, in which “three years into the trial” the investigators realize that it might be a problem that they neglected to give the control group a placebo. Oops. Would editors of a prestigious journal buy the idea that “such a low-grade intervention might [might!!] potentially represent a weakness of the trial?” Would such a trial get published in any respectable journal? In nutrition, and because the cognoscenti in the nutrition community like the results, it’s published in the New England Journal of Medicine, the most prestigious medical journal in the world, and makes it to the front page of the New York Times. And the admission of this potential weakness is only made in the supplemental material. Not in the paper itself. Imagine had the study found that the Mediterranean diet was actually harmful. That giving nuts and olive oil increased the risk of death. Do you think the assembled experts of the AHA would have included it in this assessment, or would they have found this performance bias problem and rejected it on that basis? I’m voting for the latter, but we’ll never know.

Ultimately this AHA document is a recapitulation of what the AHA experts have been arguing for decades. The only reason to publish it is because it’s been taken heat lately from folks like me and Nina Teicholz and a host of others who point out that we’re dealing with a pseudoscience here and the public deserves far better. Those of us who have become critics may indeed be biased about what we believe now – I certainly am — but ultimately we’re arguing for better science. This kind of post-hoc analyses of clinical trials, whether subgroup analysis or otherwise, can only be hypothesis generating. That’s basic logic. We don’t have to take a vote. Just open a basic science or biostatistics textbook. What the AHA experts are doing here is saying that their assessment of the data leads to what they consider a compelling hypothesis: replacing SFA with PUFA should reduce heart disease by 30 percent. But that’s all they can say. By deciding what data to include and what not based on their preconceptions of what’s true and what’s not, they cannot say this is a fact, as they claim, only that it’s still a reasonable hypothesis and has yet to be refuted.

This leads to three further critical points.

A: One reason why the AHA’s four favored trials were done in the 1960s was not just to see if exchanging SFA for PUFA reduced heart disease risk, but to see if it reduced mortality. Like any drug, it’s not enough to show that an intervention has positive effects, benefits, you have to demonstrate that those benefits counterbalance the negatives, the risks. In the 1960s, the researchers and the public health authorities understood that and so most of these trials looked at total mortality as an endpoint. Only the Finnish Mental Hospital study showed a benefit of the diet on longevity and that was only in men. Not in women. (In fact, all the trials used to establish the 30 percent reduction number were done only in men. The Women’s Health Initiative was done in large part to see if what might be true for men would also be true for women, but the AHA doesn’t like this study, so we’re stuck with all men.)

Recently the epidemiologists discussing dietary fats and disease have taken again to focusing only on CHD, but they don’t say why. Even the Cochrane meta-analyses focus only on heart disease. My guess is they do this because the clinical trials showed no benefit for total mortality (they were mostly underpowered) and total mortality is hopelessly confounded in the observational studies. Personally, I’d rather die of heart disease than cancer or Alzheimer’s, but that’s may be because my familial experience has been with cancer and Alzheimer’s and it wasn’t pretty. Either way, if I’m going to change my diet and start consuming vegetable oils I want to know if I’m going to live longer. The AHA doesn’t even address that question. The first rule of medicine, preventive or otherwise, is still do no harm, and they’re making no attempt to assess harm. You can argue that they’re the AHA so what they care about is heart disease. But it’s not good enough. It’s never been good enough. And this leads to the second point.

B: The AHA experts do acknowledge that they’re discussing the same decades-old trials that we’ve been arguing about for, well, decades, and they do acknowledge implicitly that these trials cannot resolve this controversy, and then they state explicitly what would be necessary to do so:

“The core trials reviewed in this section were started in the late 1950s and early 1960s. Readers may wonder why at least 1 definitive clinical trial has not been completed since then. Reasons include the high cost of a trial having upward of 20 000 to 30 000 participants needed to achieve satisfactory statistical power, the feasibility of delivering the dietary intervention to such a large study population, technical difficulties in establishing food distribution centers necessary to maintain high adherence for at least 5 years, and declining CVD incidence rates caused by improved lifestyle and better medical treatment [my italics]. These linked issues, which must be managed to obtain a definitive result, remain the central considerations for dietary trials on CVD and indeed are the overarching reason why few of these trials have ever been done. Finally, by the 1980s, with rising rates of breast and colon cancer, the US government committed to conducting the WHI (Women’s Health Initiative), a trial that studied a diet aimed at decreasing total fat in the diet to 20% with the expectation that saturated fat would likewise be substantially decreased. Consequently, carbohydrates were increased in the diet. Details are discussed subsequently.”

So a rigorous test probably can’t be done. And, more importantly, if this is what it takes to rigorously test the hypothesis—“20,000 to 30,000 participants needed to achieve satisfactory statistical power”— then why are we even discussing these other trials with nothing like that number? (And, of course, that’s why they had to dismiss the WHI as meaningful because that trial does have this kind of statistical power.) They’ve effectively eviscerated their own case. If this was a legal case, the judge would now throw it out and we’d all be having coffee in the lobby (with or without cream) discussing how this fiasco played out and why it ever got to court to begin with. And this leads to the third point.

C: Did I say that the first rule of medicine, as Hippocrates pointed out, is do no harm? I believe I did. Back in 1981, Geoffrey Rose, a pioneer thinker in the field of preventive medicine, wrote an article in the BMJ on the strategy of preventive medicine, and he pointed out the same problem about vegetable oils that confronts us today. Again history keeps repeating itself in this world, in part because these researchers and authorities don’t think we have to do the experiments necessary to resolve this controversy and find out if the AHA’s hypothesis is indeed true. They’re too hard. (Imagine if physicists took this tack with their science. Why bother raising ten billion dollars to build a single accelerator so technology challenging that we have to work out the technological details as we go along, just because that’s what’s necessary to answer the next question they want to see answered? Too hard. They’ll never do it. Let’s not try. We can speculate and pretend it’s fact. Sigh.) As Rose observed, it’s one thing to tell people not to eat something because we evolved to eat very little of it and there’s good evidence that eating less of it will reduce chronic disease risk. This is what Rose called removing an “unnatural factor and the restoration of `biological normality’—that is, of the conditions to which presumably we are genetically adapted.” As Rose put it, “Such normalizing measures [for instance, telling people not to smoke] may be presumed to be safe, and therefore we should be prepared to advocate them on the basis of a reasonable presumption of benefit.”

But telling people to eat something new to the environment — an unnatural factor, à la virtually any vegetable oil (other than olive oil if your ancestor happen to come from the Mediterranean or mid-East), which was what concerned Rose and concerns us today — is an entirely different proposition. Now you’re assuming that this unnatural factor is protective, just like we assume a drug can be protective say by lowering our blood pressure or cholesterol. And so the situation is little different than it would be if these AHA authorities were concluding that we should all take statins prophylactically or beta blockers. The point is that no one would ever accept such a proposal for a drug without large-scale clinical trials demonstrating that the benefits far outweigh the risks. So even if the AHA hypothesis is as reasonable and compelling as the AHA authors clearly believe it is, it has to be tested. They are literally saying (not figuratively, literally) that vegetable oils — soy, canola, etc — are as beneficial as statins and so we should all consume them. Maybe so, but before we do (or at least before I do), they have a moral and ethical obligation to rigorously test that hypothesis, just as they would if they were advising us all to take a drug. And then, well, they should probably do it twice, since a fundamental tenet of good science is also independent replication. And what we need here is good science.

 

Also on the AHA paper:

Related CardioBrief posts:

 

Comments

  1. Great article Gary. There was one HUGE flaw with the WHI trial. As they say about something really awful in Tipperary (they like understatement), they didn’t like it.
    I’ve cycled numerous times in the satfat centre of the universe, the Perigord/Dordogne/Gascony area of France. People thin, fit, very low heart disease. They fry in butter, eat cheese by the ton, eat duck, foie gras etc. But what do they know?
    Maybe they’re not real ducks but paraducks?

  2. dearieme says

    Congratulations to the writer for an incisive analysis, and to the blogger for carrying this piece. One point of detail: the original authors wrote

    “declining CVD incidence rates caused by improved lifestyle and better medical treatment”. I challenge them to demonstrate that the decline is caused by ‘better medical treatment’, and by ‘improved lifestyle’ (beyond the cessation of smoking).

    To be clear: I suggest that they are merely assuming an explanation. That’s certainly compatible with the intellectual sloppiness of the rest of this ‘advisory’ from the AHA.

  3. Joseph Chemplavil, MD, FACE says

    Dietary Fat Controversy – Common Sense Diet!

    “There is no evidence to support the theory that dietary fat causes CHD (coronary heart disease). On the contrary, it is difficult to believe that dietary fat plays any significant role in its causation. Diet does not appear to have any significant predisposing effect, but hypercholesterolemia plays a decisive role in the causation of CHD in young persons.”

    “An important factor seems to be the amount of fat in the food and its composition. Animal fats containing mainly saturated fatty acids increase the fat content of the blood to a greater extent than same quantity of unsaturated fatty acids which may even lower the cholesterol content of the blood. However, the problem is by no means straightforward.” (http://dollarsfordieting.com/PDFs/can_heart_attacks_be_prevented.pdf)

    These excerpts are from an article this author wrote, as a medical student, in 1970. After reading the above post, it appears that the needle hasn’t moved much in the controversy over dietary fat in CHD. Is the jury still out or is it a hung-jury? Who is the impartial judge, without a self-serving bias to make the verdict on this? While we are patiently waiting on the final answer for our ideal diet to have a healthy long life, we should follow the old adage, everything in moderation, that too in moderation.

    This author has been recommending a common sense diet in his office practice, to his patients mostly with obesity, diabetes, hypertension, and hypercholesterolemia for decades, which may need fine-tuning as and when new research and official recommendations pour in.

    HOW TO LOSE WEIGHT WITHOUT “DIETING”! Eat Less & Exercise More, For The Long Haul!

     Do’s:

    1. What to eat:                                                                                                                          
           A. Fish; Chicken; Vegetables; Peas, Beans, Lentils (Legumes);  Vegetable oils (e.g. Canola oil, extra-virgin Olive oil); Nuts and Seeds.
           B. Only one fruit a day, or a piece of a large fruit.
           C. Limit starch (even brown) such as: potatoes, bread, pasta and rice
           D. Consume fewer foods with sodium (salt), saturated fats, trans fats, cholesterol, added sugars, and refined grains.
     
    2. What to drink:

    A. Water; And only one 4-ounce glass of fruit juice a day.
           B. Drinks sweetened with Splenda, Nutrasweet, Equal or Stevia, Etc.

    3. Exercise regularly

    A. Exercise non-stop for at least 20 minutes a day and increase it gradually to reach 40 minutes a day, 5 days a week.                               
    B. Continue life-style activities as well.

     Don’t Eat:

    A. Bologna, salami, pastrami, pepperoni, sausage, ham, bacon, hot dog, corn beef or processed meats or lunch meats or cold cuts (due to fat and salt).
    B. Pickles, chips, canned soups or other canned foods. Avoid sodas, (even diet), if you have high blood pressure, due to salt content.
    C. Snack in between meals.
    D. Anything that says ‘no added sugar’, unless it has an artificial sweetener.
    E. Anything that you don’t like, just to be on a diet.

     You can eat:

    A. Steak, pork-chops, lamb-chops and turkey (Fresh meat without skin and fat); Fried foods, occasionally.
    B. Eat the food you love to eat, only less of it.
     
    Joseph Chemplavil, MD, FACE             

  4. The American Heart Association continues perpetuating lies about Saturated Fat and continues to advocate using and consuming Polyunsaturated Fats almost 20 years after Lancet published a study showing that saturated fat does not cause heart disease, atheroma and arterial plaque because there’s NO saturated fat in any of them, and that those conditions that AHA harps about are actually caused by VEGETABLE OILS.

    https://www.researchgate.net/publication/15263780_Dietary_polyunsaturated_fatty_acids_and_composition_of_human_aortic_plaques

  5. Marshall E. Deutsch says

    Very interesting, but why on earth would we assume that a drug can be effective by lowering cholesterol?. How is lowering cholesterol a good thing?

    • I second your comment based on personal experience.

      In 1993 I was invited to participate in a study conducted by the Air Force, Texas College of Osteopathic Medicine (TCOM) and Merck on a cholesterol-lowering (statin) drug that Merck planned to market. The first 30 days of the study consisted of an almost zero-fat low-salt diet consisting mostly of boiled vegetables. It included only small amounts of chicken or turkey breast meat. At the end of the 30 days we were each given a bottle of pills marked only with our name, control number and dosage directions. We had no way of knowing if the contents were the placebo or the drug, but we were told to continue on the low-fat low-salt diet.

      Within a week I developed the worst sore throat I had ever had, and two days later I awakened with the left side of my face paralyzed. The doctor’s diagnosis was Bell’s Palsy caused by a viral attack on a facial nerve.

      As required by the study instructions, I reported the problem to the study monitor team and they dropped me immediately from the study and told me to immediately stop the diet and stop taking the pills. I asked them if, since I was no longer in the study, they would reveal whether I had been taking the drug or the placebo, but they refused.

      Fortunately, after a heavy dose of antiviral drugs and prednisone for several weeks, I regained normal control of my facial muscles.

      I firmly believe the viral attack was caused by the absence of adequate animal fat in my diet, combined with, what I believe was the station drug that I received.

      To this day I refuse to take statins much to the consternation of primary care physicians I’ve had. I’m 75, and at my last cardiologist visit the cardiologist told me not to bother coming back anytime soon because I had no heart problems.

  6. This reminds me of the HIV and circumcision trials in South Africa. The non-circ’d men received zero counseling and were set loose to do go on as usual-causal unprotected sex, while the circ’d men were given extensive STD counseling, including HIV prevention and told to abstain from sex for 6 weeks. The conclusion? Male circumcision decreases HIV transmission and so we continue to cut newborn babies boys with the idea that someday, maybe it might reduce their STD risk? Total insanity.

  7. What an absolute brilliant article. Says it all. Having read all Taube’s books and many more, telling people to eat vegetable oils without the science to verify this is basically criminal. I believe many people have died prematurely due to the garbage fed to us by the pharmaceutical and food companies supported by the so called “experts”

    • dearieme says

      I have enquired, in all seriousness, whether Dr Keys and his disciples are responsible for more premature deaths than Mao. Presumably some day someone will have a decent go at making the estimate.

  8. Thank you for posting.

  9. Thought provoking stuff from Gary, as always.

    Of course the elephant in the room is the dog that DID bark in the night, to mix more metaphors: the “epidemics” of obesity, diabetes (yes even Type 1 – autoimmune) and other metabolic diseases, which all curiously increased at a rapid rate at the same time this advice was given to reduce CVD, and are continuing to do so, most of which are CVD risks in themselves and which centre around hyperinsulinemia/insulin resistance.

    • The current explanation by “The Experts” is that actually no-one is following their dietary recommendations. But if no-one is actually following them how can they be responsible for reducing CVD, as the same Experts still claim. And how come there were no such “epidemics” before this advice was invented? The only possible explanation is that in all the millennia before low fat diets and industrially produced Omega 6 seed oils were invented we were secretly eating them, and as soon as they WERE invented we stopped. How likely is that?

      • When the Real World differs so significantly from the results of trials, then the trials must be suspect. It becomes ever harder to dismiss as anecdotes all those thousands of n=1 trials – which I prefer to see as case studies – when there are just so many of them. I suspect pretty much EVERYONE currently eating low carb, high fat, keto, Paleo, Mediterranean or whatever, will ALREADY have eaten low fat based on Omega 6 oils, and will have the test results to compare. OK we might all be going to die prematurely tomorrow, often after decades of “failing to comply” with dietary recommendations, or like so many of our ancestors, including recent ones, maybe we won’t.

        My epitaph – “See! We told him fifteen years ago that dangerous low carb diet would kill him!”

  10. What you’d expect from Gary Taubes… always superb detail inviting debate at every turn. The CEOs in the Food Industry organisations all know what the truth is… as do their contemporaries in the Pharmaceutical Industry organisations. It’s just that the truth is seriously inconvenient at best… just imagine the legal fall out if the truth ever broke free… in the summary the Judge mentions; …”so the whole food industry it appears has known since the 50’s and 60’s that glucose is the problem and has never stood forward to exonerate saturated fats… and the drug industry has know the same but kept quiet… focusing on patent drugs to fix, the problems associated with uncontrolled glucose intake… that there is a simple cure, increasing natural fats and reducing to the smallest common denominator the glucose or glucose bearing foods we all consume every day… sounds like these two organisations are complicit in a world wide experiment to make offensive sums of income to me… how can these industries in good conscience look back and condone their actions over the past 60 to 70 years, knowing they have been responsible for countless deaths”… just imagine the “payday” that would be for any prosecution lawyer organisation!.. don’t shake your head… it is coming.

    • …”how can these industries in good conscience look back and condone their actions over the past 60 to 70 years, knowing they have been responsible for countless deaths?” In a word…Greed. They have no conscience. Great reply & insight Peter Leid; you hit the nail on the head. They are complicit.

  11. For those who would like more information on whether or not to believe a journalist or a well respected nutrition research Frank Saks who wrote the AHA position paper check out this critique of Mr. Taubes:

    http://plantpositive.com/14-the-journalist-gary-taubes/

  12. I urge anyone reading this article to not be misled by it. Gary has a track record of misrepresenting the studies and the facts.
    Have a read here if a fact check of some his misleading claims on this subject. The video in the page also show the journal articles and what they actual say and how they differ to what Taubes says. Don’t risk your life believing Gary Taubes.

    http://plantpositive.com/11-the-journalist-gary-taubes

    http://plantpositive.com/12-the-journalist-gary-taubes/

  13. Dr. Robert H. Eckel, co-chair of the working group who puts out this garbage, is a self-proclaimed “six-day creationist”. How can we realistically expect the AHA to meet the high bar of the scientific method when the guy steering the ship thinks the world was created in six days?

    I don’t like to judge people based on religion, but even the Pope recognizes that there may be a few holes in the Book of Genesis. By comparison, a 1960’s study must seem like yesterday to the AHA.

  14. Nanci Guest says

    Since when do “books” prove something? When the author states it? Research barely proves things, rather provides strong associations. Books on the other hand prove nothing. Taubes is not a research scientist. He’s a cherry picker. Oh yeah and a journalist who understands headlines.

    • JDPatten says

      Or, perhaps he just doesn’t soothe your particular confirmation bias.
      We are every one of us subject to it. It’s characteristic of humanity.
      The trick is to recognize it, then give it a good intellectual observation. That’s not so characteristic.

    • At the very least Gary has drawn attention to the flimsy science that our nutritional recommendations are based on, surely everyone should be able to find common ground on this point. There will probably always be intense debate surrounding the question of the ideal human diet and there’s probably much room for variation, but at this point in time, as Gary has said previously, we need to go back to the foundations and ensure that the proper scientific method is implemented so that we can be sure our recommendations are coming from facts, and not epidemiological surveys that can be interpreted in more ways than there are diets.

  15. Katherine Flegal says

    Very nice commentary, Gary! Another example of possible “Bing Crosby” epidemiology is a 2016 Lancet paper on BMI and mortality, with a huge sample of over 10 million people. The paper considered 239 studies, of which the senior author was previously aware of at least 238, and violated its own listed eligibility criteria to include those studies and exclude other studies, thus ‘”eliminating the negative.” . See doi: 10.1016/j.jclinepi.2017.04.007

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