Welcome to Debate Club! Please be aware that this is a space for respectful debate, and that your ideas will be challenged here. Please remember to critique the argument, not the author.
Study that shows eating cholesterol lowing diets causes more deaths.
GaleHawkins
Posts: 8,160 Member
in Debate Club
https://washingtonpost.com/news/wonk/wp/2016/04/12/this-study-40-years-ago-could-have-reshaped-the-american-diet-but-it-was-never-fully-published/?postshare=9991460508518896&tid=ss_tw
'The higher rate of mortality for patients on the special diet was most apparent among patients older than 64.' The (special diet) is the current Standard American Diet of today to lower cholesterol.
https://img.washingtonpost.com/wp-apps/imrs.php?src=https://img.washingtonpost.com/blogs/wonkblog/files/2016/04/MCEgraf.png&w=1484
Why did it take 40 years for this study to become known in the medical community?
'The higher rate of mortality for patients on the special diet was most apparent among patients older than 64.' The (special diet) is the current Standard American Diet of today to lower cholesterol.
https://img.washingtonpost.com/wp-apps/imrs.php?src=https://img.washingtonpost.com/blogs/wonkblog/files/2016/04/MCEgraf.png&w=1484
Why did it take 40 years for this study to become known in the medical community?
0
Replies
-
Are you alleging there is a vast carb-wing conspiracy to suppress the Truth?9
-
Because "they" never want you to collect your social security.0
-
Are you alleging there is a vast carb-wing conspiracy to suppress the Truth?
@bpetrosky I just asked, "Why did it take 40 years for this study to become known in the medical community?" Do you wish to debate the reason it took the factual info from the study 40 years to become known?0 -
From the comments
Ramsden and colleagues conclusions on replacing saturated fat with linoleic acid are not supported by the data. Contrary to their claims, strong and consistent evidence from both randomized clinical trials and prospective observational studies indicate that replacing saturated fat with healthy fats (including n-3 and n-6 polyunsaturated fats) has favorable effects on cardiovascular disease (CVD).
There were major problems with both the design and interpretation of the data from the MCE. The most severe of these are the duration of the trial and the very high rates of dropout. Only ~25% of the study participants received the study diets for more than a year with an average exposure of ~3 years. The short-term duration of the intervention and unusually high rates of non-compliance called the validity of the study into question.
Second, their data on the degree of atherosclerotic progression confirmed through autopsy was on a very small number (n=149). It is highly unlikely for a 1-year intervention to alter plaque that has been built up for decades. In fact, well-known dietary intervention studies such as the Los Angeles Veterans Administration trial1 and the Finnish Mental Hospital trial2 lasted more than 5 years and found that replacing saturated fat with polyunsaturated fats reduced both serum cholesterol and CHD incidence.
Third, the authors found that the excess mortality with the serum cholesterol lowering intervention (“cholesterol paradox”) was primarily confined to patients 65 years and older. Analyses in this sub-sample are plagued by the same issues that we observe with the “obesity paradox3”, where weight loss is often associated with increased mortality in older individuals or hospitalized patients. Also, among those aged ≥65 years, the hazard ratio for death was similar in the intervention group and the control group suggesting that the intervention, per se, had no effect on death.
Fourth, the intervention used in the MCE does not in any way reflect the average American diet. In fact, the level of linoleic acid (13.2%, range: 11.3%-16.5%) in the intervention group is well above the levels consumed by the US population (average 7%).4 It is also important to note that major food sources of linoleic acid such as soybean oil, canola oil, and walnuts also contain substantial amounts of alpha-linolenic acid, a plant-based omega-3 fatty acid.
Fifth, the authors’ meta-analyses looked at CHD mortality, which is not a primary endpoint in many of the trials. The meta-analysis also omitted the Finnish Mental Hospital trial2, an important study with similar levels of linoleic acid intake as the MCE that showed a reduction in both serum cholesterol and cardiovascular events. In fact, a previous meta-analysis, which included the MCE, found significant benefits of replacing saturated fat with polyunsaturated fats on both serum cholesterol and incidence of major cardiovascular events5. The statistical power for analyzing CHD mortality was greatly reduced compared to that for incident CVD events.
Finally, the authors suggest several biological “hypotheses”, including changes to lipoprotein particle oxidation that may have contributed to increased CHD risk in the intervention group. However, this is merely speculative and evidence from randomized clinical trials do not support the role of linoleic acid in increased inflammation.6
In sum, this report is highly misleading and should not alter current dietary recommendations that emphasize healthy sources of fats (including n-3 and n-6 polyunsaturated fatty acids, and plant-based monounsaturated fat) as a replacement for saturated fat in the context of healthy eating patterns.
REFERENCES
1. Dayton S, Pearce ML, Hashimoto S, Dixon WJ, Tomiyasu U. A Controlled Clinical Trial of a Diet High in Unsaturated Fat in Preventing Complications of Atherosclerosis. Circulation 1969;40(1 SUPPLEMENT II ): II-1:II-63
2. Turpeinen O, Karvonen MJ, Pekkarinen M, Miettinen M, Elosuo R, Paavilainen E. Dietary prevention of coronary heart disease: the Finnish Mental Hospital Study. International journal of epidemiology 1979;8(2):99-118.
3. Tobias DK, Hu FB. Does being overweight really reduce mortality? Obesity (Silver Spring) 2013;21(9):1746-9.
4. US Department of Agriculture. What We Eat in America, NHANES 2011-2012, individuals 2 years and over (excluding breast-fed children), day 1. Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Surveys Research Group (Beltsville, MD) and U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics (Hyattsville, MD).
5. Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS medicine 2010;7(3):e1000252.
6. Johnson GH, Fritsche K. Effect of dietary linoleic acid on markers of inflammation in healthy persons: a systematic review of randomized controlled trials. Journal of the Academy of Nutrition and Dietetics 2012;112(7):1029-41, 41 e1-15.
Competing interests: No competing interests
13 April 2016
Shilpa N Bhupathiraju
Research Associate
Frank B Hu
Department of Nutrition, Harvard T.H. Chan School of Public Health
655 Huntington Ave, Boston, MA 021157 -
@FunkyTobias we understand there was a rebuttal. The question on the floor is "Why did it take 40 years for this study to become known in the medical community?" Are you interested in debating the question or prefer to pass?0
-
Perhaps because it was a piece of *kitten* that couldn't pass peer review.4
-
FunkyTobias wrote: »Perhaps because it was a piece of *kitten* that couldn't pass peer review.
Funky you bring up a good point how many people can die over non-sense peer reviews. Because of a group of peers that were politically correct (at that point in time but not so much today as you can read) wanted to suppress the fact that the cholesterol lowering diet lead to increased death rates in people my age.
About Sylvan Lee Weinberg, MD, MACC, FESC the author of the below article:
Dr. Weinberg is Journal Editor-in-Chief for the Heart Institute of Dayton and Clinical Professor of Medicine at the Wright State University School of Medicine. He is a native of Nashville, Tennessee and a graduate of Northwestern University College of Liberal Arts and Medical School. His internship, medical residency, and fellowship in cardiology occurred at the Michael Reese Hospital in Chicago. Dr. Weinberg founded the first coronary care unit in Ohio at the Good Samaritan Hospital in Dayton where he was Director and Chairman of Cardiology, 1966-1999. He directed the Wright State University fellowship program from 1980-1989 and headed a cardiology group practice, until he retired from practice at the end of 1999.
A past president of The American College of Cardiology and The American College of Chest Physicians, Dr. Weinberg was Editor-in-Chief of Accel, The American College of Cardiology’s international journal on tape of contemporary cardiovascular medicine and surgery from 1985-2000. He is the founding editor of the American Heart Hospital Journal, 2002-present. A founding Co-editor of Heart & Lung from 1972-1985, and founding editor of Dayton Medicine, 1980-present, he has served as an associate editor of the AMA Archives of Internal Medicine, the ACC Review Journal and on a number of editorial boards, including the Journal of the American College of Cardiology, CHEST, Clinical Cardiology, and Heart (formerly The British Heart Journal). He has published widely in medical literature and made more than 230 invited appearances in North America and on five continents overseas.
Content Updated: November 19, 2014
Funky read Dr. Weinberg's 2004 review of some of his heart doctor peers:
"The low-fat “diet–heart hypothesis” has been controversial for nearly 100 years. The low-fat–high-carbohydrate diet, promulgated vigorously by the National Cholesterol Education Program, National Institutes of Health, and American Heart Association since the Lipid Research Clinics-Primary Prevention Program in 1984, and earlier by the U.S. Department of Agriculture food pyramid, may well have played an unintended role in the current epidemics of obesity, lipid abnormalities, type II diabetes, and metabolic syndromes. This diet can no longer be defended by appeal to the authority of prestigious medical organizations or by rejecting clinical experience and a growing medical literature suggesting that the much-maligned low-carbohydrate–high-protein diet may have a salutary effect on the epidemics in question......
A balanced appraisal of the diet–heart hypothesis must recognize the unintended and unanticipated role that the LF-HCarb diet may well have played in the current epidemic of obesity, abnormal lipid patterns, type II diabetes, and the metabolic syndrome. Defense of the LF-HCarb diet, because it conforms to current traditional dietary recommendations, by appealing to the authority of its prestigious medical and institutional sponsors or by ignoring an increasingly critical medical literature, is no longer tenable. The categoric rejection of experience anMd an increasingly favorable medical literature, though still not conclusive, which suggests that the much-maligned LCarb-HP diet may have a favorable impact on obesity, lipid patterns, type II diabetes, and the metabolic syndrome, is also no longer tenable."
The peer reviewed source of the above Dr. Weinberg remarks is below.
content.onlinejacc.org/article.aspx?articleid=1133027#tab1
@FunkyTobias going forward our MFP peers can peer review our posts as well as theirs and decide if they are positive or negative when peer reviewed in light to the MFP Mission Statement:
"Our mission is to achieve a healthier world by empowering individuals to reach their personal health and fitness goals."
Mission Statement source: https://myfitnesspal.desk.com/customer/portal/questions/14424909-mission-statement
1 -
I feel like I've been hearing these conclusions for years; it's nothing new to me.1
-
GaleHawkins wrote: »https://washingtonpost.com/news/wonk/wp/2016/04/12/this-study-40-years-ago-could-have-reshaped-the-american-diet-but-it-was-never-fully-published/?postshare=9991460508518896&tid=ss_tw
'The higher rate of mortality for patients on the special diet was most apparent among patients older than 64.' The (special diet) is the current Standard American Diet of today to lower cholesterol.
https://img.washingtonpost.com/wp-apps/imrs.php?src=https://img.washingtonpost.com/blogs/wonkblog/files/2016/04/MCEgraf.png&w=1484
Why did it take 40 years for this study to become known in the medical community?
In the paper, they try to answer to the question:
"With today’s recognition of publication bias and requirements for trial registration and timely publication on completion of registered trials, the omission of key results of these two trials from the literature might seem difficult to understand. In the case of the MCE, the crude study results were clearly at odds with prevailing beliefs. One can speculate that the investigators and sponsors would have wanted to distinguish between a failed theory and a failed trial before publication. While robustly designed and carefully executed, the MCE had several unique features that complicated analysis and could have biased results. The MCE investigators might have been concerned that heavy censoring or the complicated health and social histories of study participants could have impacted results. In addition, the methods of adjusting survival time analyses for covariates were just emerging, and statistical software packages were not widely available, even at the time the Broste thesis was written. Failure to measure cholesterol concentrations for participants who left the hospital before one year could have introduced bias and would have reduced power for some analyses, and the heavy censoring might have further contributed to the possibility of type II errors. There would have been little or no scientific or clinical trial literature at the time to support findings that were so contrary to prevailing beliefs and public policy. And, finally, it is possible that medical journal reviewers would not have accepted study results for the reasons cited above."
http://www.bmj.com/content/353/bmj.i12460 -
GaleHawkins wrote: »FunkyTobias wrote: »Perhaps because it was a piece of *kitten* that couldn't pass peer review.
Funky you bring up a good point how many people can die over non-sense peer reviews. Because of a group of peers that were politically correct (at that point in time but not so much today as you can read) wanted to suppress the fact that the cholesterol lowering diet lead to increased death rates in people my age.
About Sylvan Lee Weinberg, MD, MACC, FESC the author of the below article:
Dr. Weinberg is Journal Editor-in-Chief for the Heart Institute of Dayton and Clinical Professor of Medicine at the Wright State University School of Medicine. He is a native of Nashville, Tennessee and a graduate of Northwestern University College of Liberal Arts and Medical School. His internship, medical residency, and fellowship in cardiology occurred at the Michael Reese Hospital in Chicago. Dr. Weinberg founded the first coronary care unit in Ohio at the Good Samaritan Hospital in Dayton where he was Director and Chairman of Cardiology, 1966-1999. He directed the Wright State University fellowship program from 1980-1989 and headed a cardiology group practice, until he retired from practice at the end of 1999.
A past president of The American College of Cardiology and The American College of Chest Physicians, Dr. Weinberg was Editor-in-Chief of Accel, The American College of Cardiology’s international journal on tape of contemporary cardiovascular medicine and surgery from 1985-2000. He is the founding editor of the American Heart Hospital Journal, 2002-present. A founding Co-editor of Heart & Lung from 1972-1985, and founding editor of Dayton Medicine, 1980-present, he has served as an associate editor of the AMA Archives of Internal Medicine, the ACC Review Journal and on a number of editorial boards, including the Journal of the American College of Cardiology, CHEST, Clinical Cardiology, and Heart (formerly The British Heart Journal). He has published widely in medical literature and made more than 230 invited appearances in North America and on five continents overseas.
Content Updated: November 19, 2014
Funky read Dr. Weinberg's 2004 review of some of his heart doctor peers:
"The low-fat “diet–heart hypothesis” has been controversial for nearly 100 years. The low-fat–high-carbohydrate diet, promulgated vigorously by the National Cholesterol Education Program, National Institutes of Health, and American Heart Association since the Lipid Research Clinics-Primary Prevention Program in 1984, and earlier by the U.S. Department of Agriculture food pyramid, may well have played an unintended role in the current epidemics of obesity, lipid abnormalities, type II diabetes, and metabolic syndromes. This diet can no longer be defended by appeal to the authority of prestigious medical organizations or by rejecting clinical experience and a growing medical literature suggesting that the much-maligned low-carbohydrate–high-protein diet may have a salutary effect on the epidemics in question......
A balanced appraisal of the diet–heart hypothesis must recognize the unintended and unanticipated role that the LF-HCarb diet may well have played in the current epidemic of obesity, abnormal lipid patterns, type II diabetes, and the metabolic syndrome. Defense of the LF-HCarb diet, because it conforms to current traditional dietary recommendations, by appealing to the authority of its prestigious medical and institutional sponsors or by ignoring an increasingly critical medical literature, is no longer tenable. The categoric rejection of experience anMd an increasingly favorable medical literature, though still not conclusive, which suggests that the much-maligned LCarb-HP diet may have a favorable impact on obesity, lipid patterns, type II diabetes, and the metabolic syndrome, is also no longer tenable."
The peer reviewed source of the above Dr. Weinberg remarks is below.
content.onlinejacc.org/article.aspx?articleid=1133027#tab1
@FunkyTobias going forward our MFP peers can peer review our posts as well as theirs and decide if they are positive or negative when peer reviewed in light to the MFP Mission Statement:
"Our mission is to achieve a healthier world by empowering individuals to reach their personal health and fitness goals."
Mission Statement source: https://myfitnesspal.desk.com/customer/portal/questions/14424909-mission-statement
Gale, your understanding of peer review is on par with your ability to vet sources. Nonexistent.14 -
Do you know how many studies there are and how many get added to them every year?
More than anyone could ever read in a lifetime, even if they were to limit themselves to their own field.
If a seemingly revolutionary study falls through the cracks, it's probably because it wasn't all that revolutionary.10 -
GaleHawkins wrote: »@FunkyTobias we understand there was a rebuttal. The question on the floor is "Why did it take 40 years for this study to become known in the medical community?" Are you interested in debating the question or prefer to pass?
Because of the reasons in the rebuttal. Bad science should not be loudly proclaimed and promoted just because it fits your personal belief system.11 -
GaleHawkins wrote: »Are you alleging there is a vast carb-wing conspiracy to suppress the Truth?
@bpetrosky I just asked, "Why did it take 40 years for this study to become known in the medical community?" Do you wish to debate the reason it took the factual info from the study 40 years to become known?
There were several plausible reasons listed in the blog article about why the original article wasn't published, but they're all speculation. Since there is no proveable answer to the question of why the study wasn't published, picking one of the possibilities to debate is more about the debaters personal biases and worldview.
Unfortunately, the headline of the blog article in the original link is click bait for people who look for evidence of conspiracy. Like almost every click bait headline, nothing promised is ever delivered except for increased pageviews.3 -
The Illuminati, Freemasons, Lizard People and the Rothschild's are in on this.4
-
Most likely because it didn't support the prevailing agenda of the day: Ancel Key's war on fat, saturated fat, and cholesterol.
This is an extremely common and dangerous problem. 1. Researchers who don't want to publish results that contradict their agenda. 2. Journals do not want to publish negative data. They like the freak articles that get attention. All published scientific data are affected by this bais. It's called "publication bias."
In fact, drug companies, for example, will run numerous studies on the same drug and then throw out all the studies that don't support the drug's effectiveness, only publishing the ones that do... even if the majority of studies were negative! It's like flipping a coin 100 times and withholding 50 of those results... does that seem honest?
This a not a conspiracy. It's a fact. It's legal. It's allowed. Many people have died because of it. And it's a shame.
According to a systematic review discussed by Dr. Ben Goldacre (see link), around half of all trials disappear and positive findings are twice as likely to be published.
"This is a cancer at the core of evidence-based medicine."
https://www.ted.com/talks/ben_goldacre_what_doctors_don_t_know_about_the_drugs_they_prescribe?language=en#t-355186
What's the answer? Because the "fixes" have not been enforced and haven't been enough.
"We need to force people to publish all trials conducted in humans, including the older trials... and we need to tell everyone about this problem."2 -
stevencloser wrote: »Do you know how many studies there are and how many get added to them every year?
More than anyone could ever read in a lifetime, even if they were to limit themselves to their own field.
If a seemingly revolutionary study falls through the cracks, it's probably because it wasn't all that revolutionary.
This ^^
One study doesn't prove anything. It's just one piece in a very large puzzle. If there are multiple studies that show X and few that show Y, X will always drive recommendations and advice. As well it should.
Also your title is incorrect. The study did not show "eating cholesterol lowing diets causes more deaths". It showed a higher incidence of death in one group of study population. That is a very big difference.8 -
Today's word is p-hacking
Data dredging (also data fishing, data snooping, equation fitting and p-hacking) is the use of data mining to uncover patterns in data that can be presented as statistically significant, without first devising a specific hypothesis as to the underlying causality.11 -
FunkyTobias wrote: »Today's word is p-hacking
Data dredging (also data fishing, data snooping, equation fitting and p-hacking) is the use of data mining to uncover patterns in data that can be presented as statistically significant, without first devising a specific hypothesis as to the underlying causality.
The "chocolate for weightloss" study hoax was made like that too. Check for enough markers with sufficiently few people and you're bound to find one that happens to have statistical significance.5
Categories
- All Categories
- 1.4M Health, Wellness and Goals
- 391.2K Introduce Yourself
- 43.4K Getting Started
- 259.7K Health and Weight Loss
- 175.6K Food and Nutrition
- 47.3K Recipes
- 232.3K Fitness and Exercise
- 387 Sleep, Mindfulness and Overall Wellness
- 6.4K Goal: Maintaining Weight
- 8.5K Goal: Gaining Weight and Body Building
- 152.7K Motivation and Support
- 7.8K Challenges
- 1.3K Debate Club
- 96.4K Chit-Chat
- 2.5K Fun and Games
- 3.2K MyFitnessPal Information
- 22 News and Announcements
- 895 Feature Suggestions and Ideas
- 2.2K MyFitnessPal Tech Support Questions