Taking Apart Bad Science
Today, an article made headlines around the world that was published by The Lancet: Public Health, a side-shoot of the top academic journal at the moment. The article is open access so you can download and read it if you are scientifically minded. I copy-pasted parts of the study to show you the many errors. I incorporate my thoughts here and there, breaking the quotes and bolded particularly important sections I need to talk about.
“Study design and participants
The Atherosclerosis Risk in Communities (ARIC) study is an ongoing, prospective observational study of cardiovascular risk factors in four US communities (Forsyth County, NC; Jackson, MS; suburbs of Minneapolis, MN; and Washington County, MD), initially consisting of participants aged 45–64 years who were recruited between 1987 and 1989 (Visit 1) Study participants were examined at follow-up visits, with the second visit occurring between 1990 and 1992, the third between 1993 and 1995, the fourth between 1996 and 1998, the fifth between 2011 and 2013, and the sixth between 2016 and 2017…”
Note that this study has six different time frames, each of which is several years apart.
“Procedures
Participants completed an interview that included a 66-item semi-quantitative food frequency questionnaire (FFQ), modified from a 61-item FFQ designed and validated by Willett and colleagues,16 at Visit 1 (1987–89) and Visit 3 (1993–95). Participants reported the frequency with which they consumed particular foods and beverages in nine standard frequency categories (extending from never or less than one time per month, to six or more times per day). Standard portion sizes were provided as a reference for intake estimation, and pictures and food models were shown to the participants by the interviewer at each examination…”
Oh dear… how many glasses of orange juice have you consumed dear reader between January 1, 2012 and December 31, 2015? Just curious if you can recall because I could not… How about the number of servings of butter, chicken, or cakes in that same time period? For that matter, what is your serving size of rice? Is that always the same and similar to what the questionnaire counted as a serving size? How ripe was the banana you ate… a very ripe banana has more sugar. Oh and how long were the bananas you ate? Small, medium or large?
Oh boy… I hope that these participants have detailed records for everything they ate for the 25 years length of this study! Because if not… can the statistical analysis of what information they gave have any meaning?
“Statistical Analysis
We did a time varying sensitivity analysis: between baseline ARIC Visit 1 and Visit 3, carbohydrate intake was calculated on the basis of responses from the baseline FFQ. From Visit 3 onwards, the cumulative average of carbohydrate intake was calculated on the basis of the mean of baseline and Visit 3 FFQ responses…”
WOW, hold on now. They collected carbohydrate information from the first and third visit and then they estimated the rest based on these two visits? Do they mean by this that
- The data for years 2,4,5, and 6 didn’t match what they wanted to see?
- The data for years 2,4,5, and 6 didn’t exist?
What kind of a trick might this hide? Not the kind of statistics I would like to consider as VALID STATISTICAL ANALYSIS.
“…We did not update carbohydrate exposures of participants that developed heart disease, diabetes, and stroke before Visit 3, to reduce potential confounding from changes in diet that could arise from the diagnosis of these diseases… The expected residual years of survival were estimated…”
Oh wow! So those who ate a lot of carbohydrates and developed diabetes, stroke, heart disease during the study were excluded? This does not reduce confounding changes but actually increases them. That is because the very thing they are studying is how carbohydrates influence health and longevity, that is no diabetes, no strokes, and no heart disease. By excluding those that actually ended up with them completely changes the outcome to the points the authors are trying to make rather than reflect the reality.
Also, if they presume a change in diet for these participants, why not for the rest? Do you detect any problems here? I do!
37% of kcal from Carbohydrates–from Table 1
The following information was brought to my attention by Dr. Georgia Ede. Mean total energy intake: 1558- 1660 kcal for all participants in the surveys–in table 1 titled “Populations characteristics in the Atherosclerosis Risk in Communities study, by quantile” (page 4). The energy intake from carbohydrates was recorded as 37% to 61%. The 37% is considered to be the low carbohydrate diet. Calculating what 37% of the lowest kcal intake is: (37% * 1558)/4 = 144.115 gr (~144 gr) carbohydrate, where 4 kcal is equal to 1 gr carbohydrate.
In the opinion of the reader: is a diet that contains 144 gr carbohydrate a low carbohydrate diet?
Data Range Manipulation
The table below and the explanation are taken from Dr. Zoë Harcombe’s page analyzing this paper. The carb ranges in the statistical analysis differ in the paper. They are “subjectively selected by the researchers; the number of people that ended up in each range; and the deaths that occurred in that carb range during the 25 year follow-up” notes Dr. Harcombe. “Most covered a 10% range (e.g. 40-50%), but the range chosen for the ‘optimal’ group (50-55%) was just 5% wide. This placed as many as 6,097 people in one group and as few as 315 in another.”
Dr. Zoë Harcombe with highlight and emphasis added by me
When the data-ranges are different in a statistical analysis that is very specifically tailored to present its outcome in ranges, such range manipulation leads to erroneous outcome.
“Results
…High carbohydrate consumption was associated with a significantly higher risk of all-cause mortality compared with moderate carbohydrate consumption…”
Yes, I cherry-picked this sentence because I found it humorous. I think you find it humorous too–either that or cry over it. After spending an entire article showing that low carbohydrate diets are killing us, this sentence is part of their conclusions. And a final meaningless quote–the last sentence of the paper:
“when restricting carbohydrate intake, replacement of carbohydrates with predominantly plant-based fats and proteins could be considered as a long-term approach to promote healthy ageing”
Ahhhh.. they don’t know that plants are carbohydrates!? Interesting.
My Take on This Study
There are 3 types of studies on nutrition:
- Bad
- Good
- Meaningless–meaning it repeats something that was already repeated hundreds of times
This study falls into Bad and Meaningless nutrition studies. It is actually not really science–these researchers simply cracked the same database that others already have and manipulated the data to fit their hypothesis.
I have commented all through the quotes from the study of what was shocking to read and see. What is even more amazing is the last 2 sentences, a quote, in the press release by Jennifer Cockerell, Press Association Health Correspondent:
Dr Ian Johnson, emeritus fellow at the Quadram Institute Bioscience in Norwich, said: ‘The national dietary guidelines for the UK, which are based on the findings of the Scientific Advisory Committee on Nutrition, recommend that carbohydrates should account for 50% of total dietary energy intake. In fact, this figure is close to the average carbohydrate consumption by the UK population observed in dietary surveys. It is gratifying to see from the new study that this level of carbohydrate intake seems to be optimal for longevity.‘”
It is not gratifying but horrible to see that the UK, one of the most diseased countries on the planet today, plagued by type 2 diabetes, obesity, and heart disease, should consider its current general carbohydrate consumption levels to be ideal and finds support in this study for what they are currently doing.
I suppose that if type 2 diabetes, obesity, and other metabolic diseases is what the country wants (and why wouldn’t it want that? Guess who profits from sick people?), then indeed, a 50% carbohydrate diet is ideal.
Comments are welcome as always and are moderated for appropriateness.
Angela
Updated on 8/20/2018 by Angela
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Just want to say, thanks! I read about the study in question yesterday and was actually in the process of reevaluating my current commitment to a low-carb diet when I came across your article. It’s beyond sad that we can’t rely on so-called scientific journals like The Lancet to filter out bad science. Aren’t they supposed to use panels of “experts” to review studies prior to publication?
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Yes John, they are supposed to have expert reviewers but there are a few major problems.
1) The researchers paid $5,000 to publish this article! Would it be in the interest of an academic journal to put on capable reviewers who will prevent the incoming $5,000? This is a huge conflict of interest.
2) When I was still working at university and was also an academic reviewer, there were 3 reviewers for each paper. Two of the three had to come to the same conclusion to accept or reject. Here is one of the biggest problems: do the reviewers know enough statistics to tear a paper apart? My personal experience is that the answer to this is: no. I have rejected nearly all papers (not all but close) that I reviewed–and I reviewed a lot–yet ALL of those papers got published because the other two reviewers had no idea of the stats.
3) The data the researchers used must be available for the reviewers to look at to replicate the stats, to see if the statistics selected was even the right type, if there was any data manipulation, etc. This study decided to not release the data and the journal itself made the policy that the data need not be revealed.
I must add that since then we have requested the data (by “we” understand a group of scientists working together to figure this whole thing out) from the authors but have not received a response. We also had to go through a couple of days to find the questionnaire that was used in this paper. Even that was hidden!
In terms of the public making decisions about what they should be doing: I agree. It is major confusing. I support you with your searching out all information before you jump into anything and I can see how confusing that has just now become. But even if it was not confusing and all scientists were telling you one thing and everyone is following that one thing–like we all have followed the SAD (Standard American Diet) and it is failing you, nothing should keep you from trying something else.
We are all different to some degree and react to food differently based on our genetics and also based on our other lifestyle and current health. There is no harm in trying any of the nutritional methods to see what works for you. So experiment. When I started my research for migraines, there was zero information about what to do. Only medications existed, none of which worked. I had absolutely nothing to lose by trying everything from eating rocks to sunlight. It took me many years but I figured it all out and today I am migraine (and medicine) free as are over 4000 people who decided to follow me are. However, I had to start by experimenting on me. There is nothing wrong with an n=1 experiment! All good things start in a garage as n=1. 🙂
So ignore all scientific articles, join FB groups of all kinds of foods: banting, keto, carnivore, zero carbs, NSNG (no sugar no grain), Atkins, vegan, vegetarian, Mediterranean, whatever… the list is long. See what they do and how and what kinds of problem appear. That is the best way to learn. I have a keto group that is originally for migraineurs but I now have a number of non-migraineurs in the group. I have created a safe keto and scientifically acceptable one such that there is no medicine interactions, no sugar crashes, etc. You are welcome to join my keto group. I also have my protocol group, which too is for migraineurs, but that too has several people in it who are not migraineurs. It is a LCHF group. You are welcome to join that as well. Please note on the 3 questions you get at the virtual gates that you are not a migraineurs and you come from this website. That will allow you in by my co-admins without trouble.
Good luck to you!
Angela
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https://web.archive.org/web/20180213125706/http://jasonya.com/wp/the-dawn-of-peer-review/
made I larf, you might like it too
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Cute Chris lol 🙂
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Ever heard of Yoshihiro Sato? If not, here’s a nice article about this so called expert’s fabrications and fraud.
http://www.sciencemag.org/news/2018/08/researcher-center-epic-fraud-remains-enigma-those-who-exposed-him
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Ohhhh! Thank you. You don’t know how I appreciate this just now!!! Thank you, thank you, thank you. I just needed this exact paper. I am up to no good, as usual 😉
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I’m very grateful for the article and the informed discussion that followed. The attention given to this nonsense over PURE says everything we need to know. Eating real food and not boxed rubbish is an enormous threat to vested interests. Look at what they tried to do to Professor Tim Noakes in South Africa.
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Precisely Stephen! Well put!
Angela
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What about this one?
“Taken together, our work has revealed an entire metabolic network at multiple levels,” Uhlenhaut explains. “Another biologically exciting finding is that, contrary to expectations, the key regulator is not centrally located in the brain, but is in fact the internal clock of the muscle cells themselves.”
https://www.helmholtz-muenchen.de/en/news/latest-news/press-information-news/article/44870/index.html
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😀 😀 😀
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1. Also from the Lancet, but a year earlier: ” High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.
Click to access PIIS0140-6736(17)32252-3.pdf
2. And then there’s professor Karin Michels saying that coconut oil is “pure poison”. The video is in German. So if you are not proficient in that language………. Still, here it is.
Thoughts?
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Lol, not even close to being proficient in German.. glad if I can get a word out.. Luckily pretty much everyone speaks English so what I lived there (working for Max Planck Institute as a research fellow) I still managed to live. 😉 Interestingly entire nations live happily on coconut oil and were healthy and happy before we took over their islands and lifestyles… Crazy world we live in.
In terms of the Lancet study: it is the PURE study–different from the one we are discussing now. It is also epidemiological and so similar faultiness but without any statistical manipulation and blatant deliberate misleading of the readers. It was published and not ever cited. It also didn’t make the news or headlines… I think this is the biggest problem: papers that support the LCHF or keto diet are doomed. There are plenty of clinical trials by now as well. I have yet to see one cited. Basically everyone prefers to trend toward the familiar and herd… very much the base of human psychology. 😦
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Given the fact that humans consume food, this kind of info coming from scientists is many times worse than what nowadays is called fake news. Jeez!
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It is Roald. I am working with a group of scientists to change this… More to come. Keep your eyes and ears on the fast lane; this is taking off soon. 🙂
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Sometimes I leave my sanctuary, go out into the world, searching for so called activists. Hard to find them. But gradually you convinced me, Angela, that you are one of a few, you are walking your talk. Chapeau!
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Oh yes Roald. I definitely walk my talk in every which way. If fact, I walk first before I talk… just to be sure I fully understand it. 🙂
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An interesting approach to ask anyone with weight issues to self-report on eating history when we know all too well how much shame people with obesity often carry. If shame is a strong enough emotion to be be associated with homicidality and suicidality, might it just impact how we report on what we eat? One doesn’t have to have a weight issue to introduce a conformity bias into our answers and there are a myriad of other reasons as well why participants of all sizes might find it difficult to report accurately. Self-reports are simply rarely accurate even when we try our best. And using an app like CM [Carb Manager] to keep our food histories (for the Stanton Migraine Protocol) is a constant reminder of how difficult it is to be truly accurate.
Thanks Angela for reviewing this study.
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Thanks Bart! Indeed, extremely difficult to even vaguely recall what I ate last week–even though I am on the keto-carnivore diet and that is pretty limiting! Reporting back a week for those on the SAD (Standard American Diet) is impossible. In addition, while I have yet to get my hands on the 66 survey questions asked, I have the food categories on the questionnaire. I tried to find “steak” or “salmon”… nope… I did find burger and hot dogs. Even the food categories are biased such that those who eat a healthy diet cannot report it accurately, no matter how hard they try.
Thanks,
Angela
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What happened to alcohol as a macro? In other ARIC studies alcohol was associated with type 2 diabetes and mortality at over 21 drinks a week. At that intake, alcohol replaces carbohydrate as a macronutrient.
And now it’s missing and not even adjusted for?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928459/
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Agree puddleg58. It is considered as a macronutrient by some. I personally don’t consider it as a macronutrient (that’s just my opinion) since it really doesn’t provide nutrition–assuming one looks at the metabolic process and what it converts to. See here the toxin it becomes: https://pubs.niaaa.nih.gov/publications/aa72/aa72.htm From the same page:
“The chemical name for alcohol is ethanol (CH3CH2OH). The body processes and eliminates ethanol in separate steps. Chemicals called enzymes help to break apart the ethanol molecule into other compounds (or metabolites), which can be processed more easily by the body. Some of these intermediate metabolites can have harmful effects on the body.
Most of the ethanol in the body is broken down in the liver by an enzyme called alcohol dehydrogenase (ADH), which transforms ethanol into a toxic compound called acetaldehyde (CH3CHO), a known carcinogen. However, acetaldehyde is generally short-lived; it is quickly broken down to a less toxic compound called acetate (CH3COO-) by another enzyme called aldehyde dehydrogenase (ALDH). Acetate then is broken down to carbon dioxide and water, mainly in tissues other than the liver.”
So not sure what exactly is a macronutrient in something the body works very hard to get rid of because it is toxic.
With all this said and done, I agree, they didn’t seem to account for this-though I am not sure what the 66 questions contained–it was an extended version of the 61-question questionnaire from Willett. I found the study so much a waste of my time that I didn’t even go look to see what was or was not on the questionnaire.
It just simply isn’t worth anyone’s time to read this paper…
Did you notice that they called a 144 carbs grams a day low carbs? Right there Ia m blown out of the water–I have not even noticed that oops.. . People consumed 37% of their calories from carbs and they ate just under 1600 calories.. that is about 144 carbs grams. That is almost as bad in carbs as the SAD. This study is just trash.
Angela
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Acetate is the same energy substrate you make from fat, and alcohol is easy to convert to fat (hence alcoholic steatosis). It has 7 calories per gram, more than carbs and less than fat. Muscle can’t use it directly but many other cells can. People can gain weight because they drink too much as well as eat too much. All of this makes it a (toxic) macronutrient, and maybe one reason reported energy intake was so low.
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It seems to have similar metabolism to excess fructose (that which didn’t convert to glucose) and which can end up causing NAFLD puddleg58. So while yes, calories and it converts to triglycerides, it is also a trouble-maker. So I agree that it is a macronutrient, I just don’t see the difference between alcohol and excess fructose. They become the exact same thing. We consider fructose in the macronutrient category of carbs. While I know you are right, it makes little sense to me to differentiate between them.
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It makes sense to differentiate because there are two pathways for alcohol disposal, one to energy or fat synthesis, the other the microsomal detox pathway (MEOS), which is how a toxic excess of alcohol is disposed of. MEOS evolved to deal with PUFAs, so drinking alcohol to excess when the diet is high in PUFA produces high levels of toxic products from PUFA including TNE and ONE, which are always increased in liver diseases.
This diversion of PUFAs also happens, probably to a lesser extent, when the beta-oxidation capacity of liver is overloaded, which explains why excessive fructose, especially in a high-calorie diet, can have similar effects to alcohol.
On a ketogenic diet beta-oxidation is upregulated so that toxic PUFA products like HNE or ONE can be disposed of, and the levels drop below normal, which is why higher PUFA intakes in keto (high fat) diets are still consistent with good liver health.
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This is a great explanation puddleg58. Thank you! Great info for the keto book I am working on! 🙂
Angela
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Thanks for pointing out their errors and invalid scientific methods that make their report totally useless. What a waste of time and money. One would think that they would be to embarrassed to submit and publicize such a fiasco!
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I agree Joycee690. I would be ashamed to even submit such article to a journal, let alone bask in the sun of its publicity–knowing it is all fake.
Thanks,
Angela
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Whenever I see in a study that so many assumptions have been made, it makes me extremely suspicious of any conclusions. Ditto statistical massaging, especially the ever-evil concept of “relative risk”.
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Yep.. that “relative risk” of a totally massaged data gave me serious trouble.
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“We adjusted the ARIC analyses for demographics (age, sex, self-reported race), energy intake (kcal per day), study centre, education, exercise during leisure activity, income level, cigarette smoking, and diabetes.” Can anybody comment on the accuracy of such adjustments – it seemed to fail dismally in the observational studies on HRT.
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It does Michael. Any kind of adjustment that adjusts the very thing looking for is a major flaw in the study. I wrote about this in the article. This is a terrible flaw.
Angela
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Another study trying to tighten the belt around the ever expanding waistline of evidence to the contrary… add this one to The 7 countries study… The China Study… and many more… oh dear must dash I’m burning my bacon!
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Totally agree Steve! Any bacon left? 🙂
Angela
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Regarding the point about not updating the carbohydrate exposures of certain participants, unless I misunderstand your argument, what I think they are saying is that, rather then excluding them from the study, they just ignored any changes in their carbohydrate intake reported in Visit 3.This is still a problem since 1. the ongoing carbohydrate intake you have ascribed to this group is likely to be incorrect so any conclusions you reach for this group may be wrong; and 2. you would want to see if there were any differences in this group between people who made changes and those who didn’t.
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Angus I agree. They ignored the changes for sure–it is unclear if they removed the previous data or just left it in and continued with estimation based on previous data.
However, ignoring changes, whether they leave people in the study and ignore their data or estimate the status of these people instead of using the actual data, these mean one thing: excluding the changes from the study and thus excluding real data from the study.
Since they explain that they estimated all data based on the past after study 3, and didn’t actually use the remaining actual data, what they did then has become irrelevant in the findings. That is because estimation of what people did cannot be used for statistical analysis and state what people actually did–they never analyzed facts.
It is also important to note that people received 1 visit every so many years and they had to recall over a year’s worth of foods they ate and list them in some groupping that may or may not have been familiar to them. For example, I did a survey like this just last year for some reason and there were qestions where providing “zero” was not an option yet I consumed zero. Allowing the option of “1 or less” is not equal to zero either. How informative is something like this for any sort of analysis?
There is a comment by Dysconnected (below or above, wherever this blog puts it) where there is a suggestion of behavioral changes and data manipulation by the people under data collection themselves. Such data manipulation is extremely common and is a very human thing to do. Those who had type 2 diabetes (DM in that comment standing for diabetes mellitus) or gained weight, may have changed what they entered on the questionnaire based on what they should have been eating rather than what they actually ate. This is probably the single biggest problem in a survey form of questionnaire.
This whole study is seriously at best a “scientific mischief”.
Thanks for your comment,
Angela
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Please also consider that we do have a much more rigorous study of the effect of the human body on consuming 1600 calories a day over 6 months, it was called the Minnesota starvation experiment nd subjects did starve.
It is therefore hard to see how this particular study can possible have identified all of the calories being eaten, unless it is a much bigger headline
— new study disprove the 1st law of thermodynamics – can can get fat from eating nothing at all. …..
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Thanks Amanda. Not sure I understand everything you wrote but indeed, this study cannot account for the calories consumed–after all, everything is from memory and the 66 food items listed on the questionnaire may or may not cover all of what was eaten and also the quantities listed may not match anything the subjects ate.
In terms of the First Law of Thermodynamics is a universal law and is not applicable to each person within or for each meal within at all. Not sure if this is what you meant. Here is the First Law of Thermodynamics (Conservation): energy is always conserved, it cannot be created or destroyed; energy can be converted from one form into another only. However, this is to be understood in a “closed” environment, as in a test tube when they use energy to heat matter and can capture the heat produced by that matter and the two equal in a closed environment. It is supposed to be applicable to the universe only but it was created when the universe was considered to be “constant.” We now know that the universe is expanding and that it may not be a closed system. If that’s true, the First Law of Thermodynamics may not be applicable for our universe and anything within it. I also have a problem with this law because it ignores time, our 4th dimension, which is a form of energy (as per Einstein) and is forever increasing and is one directional.
But this is past the topic at hand. We can get from eating next to nothing because the body is adaptive and our metabolism slows. A slower metabolism optimizes the energy used and is thus a change of the way we metabolize (burn) the same energy available. So we change to accommodate the smaller amount of calories in order to survive. This is a Darwinian adaptation example.
Thanks for your comment,
Angela
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Also:
A puzzling factor that I don’t see discussed within the paper itself is that the percentage of subjects diagnosed with Diabetes (DM) at baseline is the INVERSE of what you’d expect… the lowest-carb-intake quintile has 17% of subjects with diabetes, and this falls to 8% and 9% for the two highest carb-intake quintiles. This makes no sense… we know that diabetes tends to be higher in individuals with higher carb intake.
So the quintiles were NOT identical in other ways at baseline… the lowest quintile started out with TWICE the number of diabetics as the higher quintiles. Is there any surprise they would end up having shorter expected lifespans?
One possible explanation is that the lower quintile knew that they had DM by the time the study started and were reporting lower carb intake because they knew that’s what they should be doing.
Regardless of cause, this difference in DM diagnosis at baseline is crucial, and methodologically raises many questions about the validity of the conclusions. I don’t see this discussed in the paper, or anywhere else for that matter, but I may be missing something.
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Excellent points Dysconnected! Love your analysis. I think you are very right. Yet more possibility of fudging the data!
Thanks for your comment,
Angela
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Great analysis
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Thanks Rodrigo.
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1. Whose idea was it? Who initiated the “research “
2. Who paid for it?
These are the most apposite questions!
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Paddy, the NIH (National Institute for health) paid for it–or so it is stated in the paper–they fund research for nutrition many studies. Often big name researchers are “just funded” in bulk and they can do with the money as they wish. I cannot say which is true in this case.
Whose idea was it? We will never know but we can speculate based on the author-list. The most famous name in the author list is Dr. Walter Willet–he is toward the end of the list. I found it interesting that he is neither the first nor the last on the author list… there are certain rules in academia based on which one can estimate who did what. Having his name in the middle caused suspicion in my mind. Why his name is there and not up front or at the end? Usually papers like this use the biggest names in order to gain publishing considerations but his name is somewhat hidden in plain view from the careless reader. Then I looked up his affiliation. He is vegan (listed on his affiliation) as member of the advisory board of “Oldways” a company that is sponsored by Kellogg’s and alike.
In addition to your questions, which are good, I would ask:
1) What is the purpose of the study?
2) Do the findings have any meaning?
3) Are there major flaws in the study such that it misleads?
Given that Willet is named as one of the authors and the study is riddled with errors and so blatantly comes to the wrong conclusion, I have my suspicions of the purpose of the study. I cannot state my opinion but I can suggest that it is not a good one.
Thanks for your comment,
Angela
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Willett is a vegan? Why am I not surprised?
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Cavenewt,
I was just as intrigued finding that out–vegetarian by the way now that I looked the second time around. You can find that out here, where if you scroll down to his name, it is listed what he stands for: “Walter Willett, MD, DrPH, Vegetarian, African Heritage” but I personally don’t know him. And we can see how much we can trust what we read online…
Thanks for your comment,
Angela
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“He may look like Wyatt Earp but he’s no straight shooter”. Priceless comment from Richard Feinman.
Thanks for the breakdown. As I suspected yet another attempt to promote (vegan) dogma over science.
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Thanks Chris C. Indeed, someone just commented on FB to me that vegans can (are) using this paper as proof… though this paper also doomed those on the high-carbs end, a.k.a. vegan. Apparently few people read these days. Or shall we say they have “selective understanding” of what they read.
Thanks for your comment,
Angela
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A “vegan dietician” stated that since over 60% of the world’s “available food supply” is carbs, we “have no option” but to eat high carb diets.
The cart should be behind the horse.
Another thought I had, people don’t usually reduce their carbs until after their metabolism is broken. Maybe if the low(er) carbers remained high carb they would have died even sooner. I have written my epitaph
“See! We told him fifteen years ago that dangerous low carb diet would kill him!”
No consideration of the fifty preceding high carb years (yes including vegetarian and vegan) or the undiagnosed diabetes.
It’s literally sickening that this unscientific crap gets front page headlines while competent science from PURE and the similar Czech study, VIRTA etc. are ignored or at best slated.
Here;s our UK equivalent (you may need a bucket to barf in)
https://onlinelibrary.wiley.com/doi/epdf/10.1111/nbu.12333
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Great comment Chris C. You are totally right. I work with thousands of migraine sufferers. Many of the new members coming in are vegan, some are “oil free vegan” whatever that means… I now have a new rule for those wishing to remain in my group: a 5-hour blood glucose test, sort of my version of the Kraft in-situ test without measuring insulin. I do ask for a fasting insulin at least and my 5-hour bs test is every 30 minutes. Frankly, all vegans who have so far completed this test have major chronic insulin resistance (CIR) and theirs is much harder to reverse than those who come in from the SAD diet.
Unfortunately not one has ever been diagnosed with CIR and so they continue to add insult to injury by eating carbs all day long. Luckily most change their diets when they realize what is happening and many of them become very happy meat-eaters and they recover, only it takes them longer. I feel very sad for those vegans who don’t understand the nutritional compromises they make.
I am looking at the UK as the leader in the field of nutritional change. I am surprised about this article you attached. It was published on the 10th of August. But then it is by Bruce A. Griffin… need I say more. Is there any mention of statins in the article?? I would expect that. 😉
Cheers,
Angela
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We have David Unwin, Aseem Malhotra and a small but rapidly increasing number of other clueful doctors and nurses in the UK. There are even a few dieticians indignantly claiming that they never attacked low carb diets and never recommended high carb low fat diets for diabetes. Unfortunately the rest of the dieticians who do exactly that rather spoil their claims.
After the recent conferences in the UK and Switzerland and even a half decent BBC programme there has been a backlash from Conventional Wisdom, of which this paper is a part. The WHO are taking pride in their association with the Seventh Day Adventists and most dietetic organisations the world over are making alliances with vegan groups. Most sensible Twitter accounts and blogs have their “embedded vegan” who calls in reinforcements when necessary. I have no doubt this is organised and coordinated. Then there are the doctors and personal trainers who reinforce Conventional Wisdom by shouting loudly.
A friend asked his cynical and sarcastic doctor why we cannot get insulin (or c-peptide) tested.
“We would find so many diabetics it would bankrupt the NHS!”
I wish I could get mine done, I predict it would find I have little or no Phase 1 insulin, probably since childhood, but still at 65 a pretty decent Phase 2 response – as long as I kick down the insulin resistance through low carb. It would be absolutely diagnostic for the many adult-onset Type 1s who are misdiagnosed Type 2 simply from age of onset, but then it would permit them access to endocrinologists, DSNs and insulin courses like DAFNE which all cost money. All power to you for doing this, the spirit of Joseph Kraft would approve.
I’ve seen you on Twitter but have only now discovered your blog. I used to have migraines, but they were comparatively mild and infrequent so I lived with them since I NEVER had normal headaches – ie. without the visual and sometimes aural disturbances. Since going low carb/Paleo/keto, not a one, along with all the minor infections etc. that used to plague me. It’s taken about a decade for my doctor to get on board. Some of her colleagues, not so much, especially the extremely obese one who later became diabetic. You’d think like fat dieticians they might notice something going wrong and do some research.
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Indeed Chris C you do! We have several in the US too. Aseem in particular is very visible (he is a FB friend) and does a TON of work to push the country in the right direction. David and his wife both are doing a great job as well. We do have great doctors like this in the US only non as public as Aseem.
I keep wondering about the same thing as you do: how come all metabolically unhealthy doctors, nurses, nutritionists are not aware of their problems? I suspect it has something to do with believing in what they preach and walking their talk, not realizing that it is killing them the same way as we didn’t know. Those healthcare providers who take the time to educate themselves are all LCHF/keto supporters. It is only those who either have a vested interest (financial or otherwise) or those who either have no time to continue to update their education or are ignorant of any changes who cannot relate to themselves either.
I didn’t realize the WHO has any form of association with the Seventh day Adventists!! Wow! That explains a lot. Vegan groups are extremely visible everywhere–they tend to always respond the same things to posts over and over again… clearly a cult or religion in its own right.
I think many people are misdiagnosed as type 2 with LADA. There is one migraine sufferer in my group whose fasting insulin is <2. She is one such person–or is heading there–but her doctor ignores it and says all is fine. I sent the warning message out but it was promptly ignored. We can only do so much. I am very much working in the spirit of Joseph Kraft–I wish I had the same powers as he did and could request insulin tests as well. Since I cannot, I can use beta hydroxybutyrate as a proxy–it is a pretty good proxy for insulin, way better than glucose. I combine the two on one graph and that can tell me a LOT.
I am glad your health is under control with LCHF. I am mostly carnivore with dairy. My fasting insulin is in the middle of the range (2-22) now, which is high for someone 3+ years on keto already!! I think I was undiagnosed diabetic. I had to BEG my doc to order a fasting insulin test. But once I got it and it was high (high relative to what I eat) he now asks for it all the time–it is coming down but VERY slowly.
In terms of doctors ordering a fasting insulin and/or c-peptide, it is like the CAC scan!! If they get that, they cannot treat you with drugs when you don;t need it, nor can they let you become sick and then make money off of you. These would be preventive tests. Conflict of interest.
Interestingly I belong to Kaiser Permanente, a big HMO in the US, and once my doc got the fasting insulin ordered and saw my result, he automatically added c-peptide as well last time. Totally impressive. I think he is a keeper!! I have not seen him for 3+ years either… I just have not been ill with anything. For ordering blood tests, all he needs is a consult and they now provide 10-minute phone consult option!! So I need not even visit his lobby full of sick people. I think there is some hope!
Glad your migraines went away. LCHF/keto/carnivore, and particularly intermittent fasting, are great migraine preventive. I am also migraine free–except when I go somewhere to eat out and unbeknownst to me the meat is marinated with more sugar than sugar itself… darn it… not sure what they used because what I ate was not even sweet but I was sicker than a dog for 4 days with a migraine a few weeks back after it…
Keep up the good health!
Angela
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I was sent to a dietician for my “cholesterol”. I was already eating “low fat” because, well, you just do. She carefully removed even more fat from my diet and replaced it with even more carbs. I quickly gained 15 kilos, all around my gut, my blood pressure went through the roof and my lipids got WORSE as did all my symptoms.
Naturally she accused me of “failing to comply” with the diet. Yet when I actually ate the exact opposite of what I was told, everything went back to better than normal. This is so commonplace as to be unremarkable.
I wonder how they justify telling themselves that they are “failing to comply” with their diet when the exact same thing happens to them . . . fortunately a few are catching on.
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I think Chris this has a few answer possibilities and since this is cluelessdoctors, I can say it in the open.
Many of these nutritionists or doctors actually are familiar with and may even eat LCHF diets! However, they are not permitted to tell you about it. for a few reasons.
1) The company they work for must follow the USDA guidelines–not sure why since they certainly ignore the FDA guidelines! So there is some confusion there
2) It may hurt their license if they advise against “evidence based” medicine (see Gary Fettke, Tim Noakes, and several more). While millions of people are following the LCHF diet and there is plenty of evidence, these don’t count–these are millions of n=1 anecdotal evidences. What would count is clinical trials and published papers. The problem is that if a scientists wants to publish something that opposes dogma, neither can she/he get funds to run the experiment, nor can the paper be published. If by a small chance the study was funded privately or otherwise and research is published, no one cites that.
3) There are no positive headlines only negative. It makes the news only if it harms you but not if it benefits you, unless it is something that everyone seems to like, such as chocolate or red wine. If red meat or whole milk is good for you, you will not hear that in the news.
4) Sadly some doctors make money and have no financial incentive to get you healthy. They only make money if you are sick so what’s the point of making you healthy? There is an inherent conflict of interest with doctors who run small offices or work for small firms. I am a Kaiser Permanente member where a doctor gets no incentive for prescribing drugs or keeping you unhealthy. So when I need a blood test, I need not see my doctor for that. I can request it by email. If I am sick, I can request a phone “meeting” and need not see him. This is REAL healthcare… I don’t know of other healthcare networks or HMOs that do this.
5) Look around and see how many of your doctors, nurses, nutritionists, dietitians, and aids are fat… They are the ones who follow the guidelines and don’t know any better.
I think this was quite comprehensive of an answer lol..
Hope you have fun this holiday weekend.
Angela
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Oh yes, over here we have NHS Evidence and worse still NICE (which isn’t) who write “guidelines” which are often interpreted as Rules. I’ve heard tales of doctors being threatened with disciplinary action for, eg, prescribing test strips to Type 2 diabetics or even discussing low carb diets. Things got bad here for a while, the doctors were running scared of “Big Brother”, but the PCT (a kind of local government owned HMO) went away and the Practice Manager was replaced by a human, and now they are more able to consider outcomes rather than “follow rules and tick boxes”. I saw the same kind of management in industry who would squander pounds in order to save pennies, and then award themselves a bonus.
Our NHS is in the process of being sold off to Virgin and some of your HMOs/Insurance companies. Sadly Kaiser are not interested, I’ve read more good thing about them than bad.
Yes a study of 30 genetically modified mice is regarded as “evidence” but no matter how many millions of people report the same thing they remain “just anecdotes”. Then when someone actually does study them (eg. VIRTA) the study is condemned, while studies like the above which SHOULD be condemned become front page news. Lots of profit and ego massages to be lost from rocking the boat. Even quite recently I recall someone who had published a LOT and is well known and well regarded complaining that he was told “of course” he could have a grant to cover the low fat arm of his study, but “if” he wanted a low carb arm he would have to finance it himself.
I see things going in both directions at once, patients and more and more medical professionals from the grass roots up countered by ever more desperate messaging from the top. The desperation in some of these “studies” is palpable.
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Agree Chris. I think that the choice is given to the people and we just have to learn to see when we can ignore the medical professionals and when we cannot. Here is a comment I received on my Facebook post of a different article that was written by Dr. Aseem Malhotra (https://www.theguardian.com/society/2018/aug/30/modern-medicine-major-threat-public-health):
“Have to also comment life expectancy has stalled it’s actually reduced, a lot to do with austerity, increase in poverty, sanctions punishments on those in poverty and disabled, I will state a 100 people a day are dying in the U.K. on benefits, 80 a day in the ‘too ill to work category’ government doesn’t keep further details, one would expect it to be higher people are sick, 10 people die in the ‘sick but able to work soon’ category, I think definitely medications must be in this, but starving vulnerable people with cutting all their benefits because they were too sick to attend an appointment, missed it because their child was having brain surgery , or because they were a minute later or early, stress anxiety, a year to appeal benefits as welfare reform is another word for abolishing it and trying to privatise the nhs etc -mental health has also increased exponentially under the Conservative party since 2010 due to their punitive measures even their own agencies say is pointless other than causing harm. This has also had a massive increase on suicide in the U.K. since 2010.
While I agree most medications cause more harm, I feel it would be unfair for this article to give the impression medication use increase and lifespan were the only connection, it’s a little one sided comment to affirm its argument. Stupidly It didn’t need it. Hope you didn’t mind me adding some context not whole to why death has not just stalled but reduced in U.K. since 2010.”
This is from a migraineur who had a major car accident many many years ago and is handicapped. When she joined my group on FB, she had mini strokes and seizures continuously as her writing was as garbled as her thinking–look at her writing now that I removed her from about 20 meds out of the 40 she was taking. And she get punished is she is not taking them even though she has made a significant recovery.
I think the NHS is in big trouble, in general. I am glad Kaiser is not joining anything–I like them to be independent and stay the way they are. They are opening a university around here too. 🙂
Back to the people: people drive the market and all forces within the market. No matter what the healthcare industry says, the millions of n=1 experiments tell people differently from what the healthcare industry tells them and people are smart. We may not be able to write scientific journal articles for lack of funds or for being turned down all the time (I gave up), but the people will change the market. Where I live, they already have. My neighborhood vegan store now sells beef, chicken, fish, eggs, and all dairy. I have been trying ot convince them to get pork lard but they have yet to go that far lol.. but hey, I will take the beef… it is the best beef around and it is sold in a vegan store. So yeah.. changes are happening. 🙂
Angela
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Sadly, it’s all about the money. We can’t give up the right but there’s a long and dark road ahead.
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It is Adrian. 😦 We just have to educate the masses who are given the wrong information. One by one we will win and go around this nutritional mess.
Angela
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This is amazing. Thank you for breaking that study down.
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Thanks Nick!
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Well done. Best retort I have seen so far.
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Thanks Swolver!
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And………it’s mainstream.
https://www.yahoo.com/news/low-carb-diet-linked-elevated-mortality-risk-study-233354036.html
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Yes indeed. Mainstream and misleading millions. Stupid, stupid, stupid… [[[hitting head into the wall]]]
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To counter the carb hype, I just prepared a delicious in between snack for Lucitta and me: Baked chicken thighs à la Ro, with crispy bacon slices.
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Yum! Any left for me?
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Nope 🙂
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Darn it.. not nice to leave friends out. OK.. Got to top that with spare ribs tonight! 🙂
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Bon appetit.
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Merci 🙂
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I wonder how/why this starts spreading…
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Calle, everything that is full of stuff that people want to hear and/or that which will make money to the industry, will spread. There are many studies that this paper selectively excluded, that prove the exact opposite; have you heard of any of those in the news? One was published in The Lancet (not the Public Health journal but the REAL main The Lancet) not too long ago. Can you tell me what it was about and when it was published? How about the study that was released a few months ago with 1.5 years long clinical trial with LCHF diet on reversing Type 2 diabetes. Did that make the news? nope.
The reason why is quite clear to me: no one makes money on people becoming healthy without medicines and eating foods that are not in giant volumes in warehouses. A lot of processed food manufacturers are laying off employees (Kellogg’s just laid off over 11k people) and things are not selling even on sale. So the entire industry is collapsing under our own eyes. They will pay and do anything and everything, respectively, to get the “old news” to spread to gain back their lost business.
It makes complete sense to me. Hope this helps.
Angela
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Remember Richard Feynman, who already in 1974 called stuff like this…….cargo cult science? Oh and then there are of course also those great peer reviews which give even more substance to it 😈
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Yes Roald. He is equally displeased with this paper today. 😦 Embarrassment for all scientists. Shameful that this sort of junk can be published…
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Garbage science like this is being spread through all major news outlets as facts (to people that dont read past the headlines or care to read the original publication cited in some articles) shows how desperate and threatened the processed food industry is by the current low carb movement. I feel all the news outlets that shill out these studies implying them as facts should be embrassed as it shows they have no basic understanding of how inaccurate these survey based studies are or that they are clearly being paid to mislead the public.
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Indeed Jackson. Unfortunately garbage science like this spreads and people are gullible and believe it. There is much money to be made in misleading the public!
Thanks for your comment,
Angela
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Different Feinman. Both, though, are awesome.
The physics Feynman, sadly, is no longer with us. He died in 1988 of cancer. FWIW here is his cargo cult article: http://calteches.library.caltech.edu/51/2/CargoCult.htm
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Oops,sorry.. I meant to write “would have”.. I still hold the crown to typo queen! 🙂
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Aha! Still, this might encourage people to go to check out The Other Richard Feinman. https://feinmantheother.com
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Agree Cavenewt! 🙂 To get real science on nutrition, that’s where the road starts.
Angela
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