What is a Carbage Article?
In September, a “carbage” (carb garbage) article was published in The Lancet Public Health based on very inadequate data analysis, that made the headlines in less than 5 minutes around the world. I have written two previous blog articles about it. See how bad the science was in that paper here and see the ripple effects of such bad science here.
The headlines of that academic article suggested that the consumption of reduced carbohydrates is dangerous. Lots of news flashes followed and several generations of hard nutrition-science work were swept under the rug by those who benefit from industrial profits and those with conflicts of interests (including some of the original authors, who didn’t declare such conflicts of interests!). However, sensationalism is just about that: no one cares about truth and facts, only headlines. In fact, headlines were twisted to make it even more sensational, stopping just short of suggesting that you will die tomorrow if you don’t eat a slice of cake today.
The Responses
Many scientists and lay people have decided to write about this bad article on their blogs, including me, as noted above. However loud our noises were, the sensationalism of news these days is impossible to out-compete. The creativity with which news media went after the lies and the force with which they pushed the statistical manipulated data as fact and how this was the most important news in this century, that it was impossible to compete with. However, there is always a way to counter and corner: one can write a correspondence or letter to the editor or commentary–depending on the academic journal–and just hope it gets accepted. Well mine did and so did several from other people I know.
Academic Correspondences
By far the most powerful action we could take was to publish our correspondence in the same academic journal, dooming the carbage article by taking it into pieces. Mine published today together with several others–many from colleagues I work with on advancing real nutrition science.
Here is my correspondence, where I make several very strong points in extremely tight sentences. It had to be brief: 250 words and max 5 citations at original submission, which was later changed a tad by the peer reviewer (amazingly even the correspondences are peer reviewed). Since there is no way to link to the correspondence section as a whole (is that a Lancet error?), I am attaching a PDF that includes all correspondences and also the original article authors’ response to these correspondences here: 2018 11 05 LANCET PH reflections & reactions CONTRA SEIDELMANN &Authors’ reply
It is really worthy your time to read all correspondences. They are all excellent. You should also read the response from the authors, which I found shamefully pitiful. I personally think that The Lancet Public Health would do itself a great favor by retracting this article. It is a giant bleeding pimple on the reputation of a baby-journal whose parent is one of the best academic journals today, ranked among the top few.
Comments, as always, are welcome and are moderated for appropriateness.
Angela
Clueless Doctors & Scientists 
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Here’s what the ADA used to recommend – for diabetics
https://web.archive.org/web/20040203222331/http://www.diabetes.org/nutrition-and-recipes/nutrition/starches.jsp
Currently watching these “evidence based” dieticians trashing the BJSM for posting Aseem’s articles and other low carb studies, while of course NOT critiquing the Lancet, let alone Harvard
https://blogs.bmj.com/bjsm/2018/10/19/open-letter-from-academics-practitioners-students-and-members-of-the-public-to-the-british-medical-association-the-british-medical-journal-publishing-group-and-the-british-association-of-sports-an/
then there’s this
It’s going to get worse before it gets better, especially with the vegans in charge.
signed, an anecdote
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LOL Chris I love this part of the ADA nonsense: “…Currently some controversy about carbohydrates is raging due to a few new diet books. These books encourage a low carbohydrate, high protein and moderate fat intake. These diets are not in synch [can they type?] with the American Diabetes Association nutrition recommendations, which are based on years of research and clinical experience. In addition, these trendy diets are hard to follow year after year A way to see how carbohydrates affect your blood glucose is to monitor your blood 1&1/2 to 2 hours after meals. Checking your blood glucose at this point tells you how high your blood glucose went from the carbohydrates you ate. For good diabetes control, keep your after-meal blood glucose levels at 180 or below.” Gosh.. 180 mg/dL (10 mmol/L)??? Really? That’s “control”?
I just responded to the tweet of Sarah Boseley “Whenever a critic starts with a personal attack on integrity, education, or expertise, such as “According to a small group of dissident scientists, whose work usually first appears in minor medical journals,” we know that what follows is incorrect. Here: https://www.nutritioncoalition.us/lowcarbohydrate-diets-have-these-been-adequately-researched”
It will definitely get worse before it gets better. The war is on. Guess who will win? Those who stay alive without a heart attack or T2D long enough to fight.. and they will be:…. us
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Scary wasn’t it? The ADA used to claim I think a maximum improvement of 0.8% in HbA1c for “medical nutrition therapy”. When John Buse was in charge they backtracked and permitted a minimum of 135g carbs for a maximum of six months, and only for weight loss, NOT BG control, and revised the improvement to 1.8%
Meanwhile in their very own forums people were routinely achieving 5 – 8% improvement in A1c and sometimes up to 13%. What did these hundreds if not thousands of people have in common?
1) they did not eat the ADA diet
2) they were not studied. In fact I knew a number of people, mostly in the States but some in the UK, Australia, Canada and Germany, who were excluded from studies for being “too well controlled” because their A1c was under 8%, or in a few cases under 6.5%
It matters not how many thousands or millions of such people there are, as long as they are excluded from studies “there is no evidence”.Of course the likes of Feinman, Westman, Phinney, Volek et al WERE doing studies back then, and now there are the likes of VIRTA and David Unwin (and David Ludwig with Type 1s) but the Idiot Brigade still insist “there is no evidence!” I think there are now in excess of a hundred low carb studies in credible journals and their response is to try to prevent further publication by attacking the BJSM.
Hey guys (and girls) the genie is out of the bottle . . .
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Indeed Chris! In fact, Nina Teicholz and Sarah Hallberg’s new organization pulled together a database with over 70 clinical trials on LCHF diets that exist but no one gives a damn and are simply ignored.
It is gonna be more and more difficult to ignore millions of people who reversed their health conditions by not listening to their doctors. After awhile this will start to bankrupt the entire healthcare… You just wait and watch. 😉 My medical provider is after me to get my annual physical because I have not seen my doc as long as I have changed my diet… They must see me for their records at least once every 3 years though now that I am “old lady” I am supposed to go every year.. so I will go and take some well-deserved time to read a book while visiting my doctor. 🙂 There is no other reason.
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Yes I’m overdue for my six monthly checkup. Apart from my thyroid that blew up a few years back and is currently mostly back under control, my blood glucose, blood pressure and lipids have not varied much for years and I no longer seem to catch even colds. But “the computer says” . . .
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lol yes.. my physical is coming up in two weeks. I have not seen my doctor in 3 years but now that I am older and on Medicare, I “must get an annual physical” thing going on… I am expecting him to faint once he sees me, since all my markers have major improved and now that I lift weights for fun (serious weights), I also built up some muscles lol. I think I am in a better shape than he is. Luckily my doc listens to me and will not bug me about my lipids, which on my diet will be high in LDL. 😉 Not looking forward to the physical though… going into a place full of a bunch of sick people when I am completely healthy is not my way of spending a day.
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Oh yes there is that. When I took my mother to the hospital I always had to monitor her for several days afterwards to see what she had caught this time. Once she was mortified to discover she had wet herself – but closer inspection showed the wet was just on the outside of her clothes – she had sat in a pool of someone else’s urine.
A friend with leukemia had a good plan – he was allowed to wait in his car and they would text him when it was time to go in.
The absolute worst one was the flu vaccination clinic where we used to live – they would call all the old folks in at the same time to sit around for an hour or two exchanging viruses. What with MRSA and all the other goodies I keep away from medical premises as much as possible.
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Oh wow (I used different words in my mind that cannot be posted on my wall) about the urine on your mom’s clothing. Amazing!!!
I agree with you about MRSA and other lovely diseases. I stay far away form medical facilities as much as possible. Unfortunately the older I get the more I must go–not by my own choice but because Medicare requires it in the US (that is the NHL equivalent to old people like me) to have a darn 40-minute physical every year. This is my first year with this… what the hell can they do for 40 minutes??? Never had a physical like that. Hoping that most of that is waiting here and there so taking my iPad to catch up on my reading.
I tend to pick a time that is far away from sick visit time but which is already flu vaccine time and for the past few years I have received my flu vaccine even before the nurses. 🙂 Victory. 😀 In the US we can also get our flu shots in drug stores. So when things get hairy we can drop in when there is no one else in there.
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The other side of the coin is when you actually are ill and need to see the doctor she is usually booked up three weeks in advance, and over four weeks “the computer” won’t make a booking, because she is spending most of her time testing people who aren’t actually ill.
Hope your appointment goes well, we get a maximum of ten minutes here.
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Yes, I suppose that is one of the many negatives of socialized medicine–particularly the NHS from what I hear. The health plan I have allows same day appointments but even in the US this is insurance company variant.
Our normal appointments here too are 10-15 minutes. No idea what’s so special about a physical to last 40 minutes.. I will report after (it is next week) if there is anything unusual or weird.
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Their reply “we saw what we wanted to see. So there!”
Is your recommended carbohydrate level really 130 g? In the UK the government recommends 230 – 300g. and diabetics are grudgingly now permitted a minimum of 135g but only for six months (unless they quietly changed things since I last looked). Some dieticians recommend 450g or more.
Despite the sterling work of David Unwin and several others, the NHS is backing DIRECT and their very low calorie diet of high carb shakes (low carb by default) for diabetics, and recently a vegan diet which produced only a tiny improvement over the abysmal results of the standard high carb low fat diet. I smell money at work. Likewise for the attacks on Aseem Malhotra after politician Tom Watson “reversed” his diabetes and lost scads of weight. Dear dieticians, if you are so all-knowing why didn’t YOU achieve this? You can’t, and don’t want to. Your sponsors would be displeased.
This “study” was basically clickbait with a press release guaranteeing its publication in the mainstream media, sadly (SADly haha!) one of an increasing number of late as the Carb Empire strikes back.
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Hi Chris,
The 130 gr is the minimum recommended, yes. It is in the relevant papers–I believed I linked to those on my original article critic on my blog but here is the link to it in case I missed it–this is from 2015. Here I just looked at the minimum recommended because that is lower than what the authors of the Carbage article complained about. So if the government established minimum is lower and people in the article eat higher carbs amounts, then we have little to talk about. The actual recommendation is much higher–probably the same as the UK since the two systems are so interconnected in medical and medicinal methods. I have saved an official document from the government a couple of years ago that actually states that the “minimum necessary carbs is zero” but I cannot find it… I just have too many papers now saved in various folders. I believe it was by The Academic Press–a long document–which is what the USDA uses as its nutritional guideline.
Dr. David Unwin and others, like Dr. Aseem Malhotra, all are pressing–quite successfully–toward a lower carbohydrate diet. In the US we are a bit more fortunate in that we can express our opinion a little freer and more openly. So here we have Dr. Sarah Hallberg in her clinic and also at Virta Health, and Phinney and Volek at Virta Health, and others at other institutions where low carbs diets–including ketogenic–are supported. For example, I started my ketogenic life 3+years ago with the help of the ketogenic diet department of Kaiser Permanente, the largest HMO in the US. It has ketogenic departments in several locations–primarily for seizure control, especially for children, but they will accept referrals from the primary care physician in network and I asked mine to refer me. No doubt, not everyone has the same options even here but here we have option to choose a different doctor and we also have the option to not follow doctor instructions. This are a few great benefits of the kind of non-socialized medical care we can still get.
Aseem–a Facebook and academic friend of mine–was absolutely furious when one of his interviews were completely modified and chopped such that they stated the exact opposite from what he stated originally. I am not surprised about the attacks on him–also his book is the #1 best seller all over the place… people tend to get envious. Yes, money and profits are everywhere standing in the way of health and true science.
I think all of us who try to tell the truth about nutrition and its connection to health are attacked continuously–I know, because I am too attacked everywhere and I am a small fish. It has just become a daily routine to trash such as spam. I seldom get into arguments these days. I may post one comment to see if I can provide more information to break down barriers but after that I just close all antennas and doors and block/ignore.
Cheers,
Angela
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