[HN Gopher] Saturated fat: the making and unmaking of a scientif...
       ___________________________________________________________________
        
       Saturated fat: the making and unmaking of a scientific consensus
       (2022)
        
       Author : mgh2
       Score  : 138 points
       Date   : 2024-10-26 20:51 UTC (1 days ago)
        
 (HTM) web link (journals.lww.com)
 (TXT) w3m dump (journals.lww.com)
        
       | dang wrote:
       | We changed the URL from
       | https://www.eviemagazine.com/post/american-heart-association...,
       | which points to this.
       | 
       | (Submitted title was "AHA Was Paid By P&G To Say Heart Disease
       | Caused By Saturated Fat, Not Seed Oils")
        
         | SeanLuke wrote:
         | https://en.wikipedia.org/wiki/Evie_Magazine
        
         | JumpCrisscross wrote:
         | I think that story was actually better than this paper, which
         | appears to have been authored by a controversial figure.
        
           | dang wrote:
           | I'm open to changing it back but that would be just as
           | controversial, no? because it's about the same work.
        
       | robotnikman wrote:
       | I'm not sure how we can prevent organizations from being 'bribed'
       | like this, but something has to be done. Misinformation like this
       | has no doubt contributed to the obesity epidemic
        
         | JumpCrisscross wrote:
         | > _not sure how we can prevent organizations from being
         | 'bribed' like this_
         | 
         | Statute that makes it fraud for a doctor (or anyone with
         | medical certification) to make unsubstantiated health claims or
         | strong claims based on weak science.
        
         | KempyKolibri wrote:
         | The view of SFA consumption as a risk factor for CVD is not the
         | result of bribes, it's the result of the body of research on
         | the subject pointing in that direction.
         | 
         | It's rich of Nina to accuse Keys of cherry picking while
         | claiming that there's no RCT data supporting the diet-heart
         | hypothesis because of the dodgy Hamley meta analysis, while
         | ignoring Hooper 2020, which was far more rigorous and showed a
         | 21% reduction in CVD events when PUFA was substituted for SFA:
         | https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
        
           | tsimionescu wrote:
           | The reduction in that study is 17%, not 21%. And it is 17% of
           | an 8% risk: so, if the study is correct, your risk of CVDs
           | should go from ~9.6% to ~8%. However, this is _not_
           | associated with a lower risk of all-cause mortality. So even
           | if the effect is real, it seems to be quite small.
        
             | KempyKolibri wrote:
             | No, it's 17% for reduction in SFA. It's 21% for replacement
             | of SFA with PUFA.
             | 
             | Yes, it's not significantly associated with a lower risk of
             | ACM, but that doesn't mean they don't increase ACM risk. It
             | just means that in these relatively short RCTs, a
             | significant finding on a very insensitive endpoint like ACM
             | was not found. That's not surprising, you wouldn't
             | necessarily expect to see such a finding. For that you'd
             | want longer or larger RCTs (unlikely due to cost) or
             | prospective cohort studies (which do show a significant
             | effect on ACM).
        
       | dang wrote:
       | Related:
       | 
       |  _Saturated fat: the making and unmaking of a scientific
       | consensus_ - https://news.ycombinator.com/item?id=33942840 - Dec
       | 2022 (6 comments)
        
       | ericyd wrote:
       | The only trendy food advice I'll ever follow is Michael Pollan's:
       | eat food, not too much, mostly plants.
        
         | thefz wrote:
         | I remind this motto as bell but he should have put emphasis on
         | "food you made"
        
           | jvanderbot wrote:
           | His definition of food is narrower than just edible things. I
           | recall the book discussed processed vs more "raw" foods.
        
             | frereubu wrote:
             | The definition I've heard of his for "food" in this
             | sentence was "things your grandparents would recognise",
             | although by this point it might be "your great-
             | grandparents".
        
           | slothtrop wrote:
           | He does, the above was a misquote: what he says is "eat real
           | food". Making it yourself helps ensure that.
        
             | ericyd wrote:
             | It's not a misquote unless he misquoted himself
             | 
             | https://www.nytimes.com/2007/01/28/magazine/28nutritionism.
             | t...
        
         | gushogg-blake wrote:
         | This advice has always come off as paternalistic to me, like
         | the emphasis is on people just not being able to control
         | themselves or something.
         | 
         | The first part is obvious.
         | 
         | The second part smuggles in a fundamentally incorrect take on
         | the "eating too much"/obesity problem, namely that it has
         | something to do with willpower: including "not too much" in the
         | advice implies that we need to be told not to eat too much, but
         | that a diet that naturally induces overeating is otherwise OK.
         | 
         | The third part is arbitrary and unfounded, and if you ignore it
         | you can ignore the second part as well: get some good fatty
         | meat on your plate and you can safely eat to satiety.
        
           | ericyd wrote:
           | I don't think of the second part being about self control and
           | obesity, to me it's just a reinforcement of the idea that
           | each person has different caloric requirements and you should
           | respect your own needs. Of course it's vague so open to
           | interpretation.
           | 
           | The third part feels as arbitrary and unfounded as any other
           | dietary advice I read, so I'm inclined to take the simplest
           | advice available.
        
           | pton_xd wrote:
           | > The first part is obvious.
           | 
           | Is it, though? It seems like many struggle with the first
           | part.
           | 
           | Does snacking on a vending machine Duchess Honey Bun or a
           | sleeve of Oreos qualify as "eat food?" How about popping open
           | a cup of instant ramen or microwaving some frozen taquitos?
           | I'd call all of that eating junk, but I think that's the root
           | of the issue.
        
             | gushogg-blake wrote:
             | No I guess there must be some people for whom it isn't
             | obvious. I was kind of assuming the intended audience for
             | the advice was people who are interested enough in diet to
             | look at a book on nutrition, for example, not people who
             | just eat junk without thinking about it.
             | 
             | But yes for those people I do think the "eat food" thing
             | should be emphasised and laid out in more detail, maybe.
             | Hard for me to have an opinion there as I just can't put
             | myself in the shoes of someone who eats that kind of stuff.
        
         | tsimionescu wrote:
         | Per this spiffy quote, it's a better idea to eat a bag of
         | potato chips fried in palm oil than to eat a stake. I think it
         | can safely be ignored.
        
           | cthalupa wrote:
           | To be fair, Pollan would specifically not consider a bag of
           | potato chips food. It's not included here but he specifically
           | is talking about "real" food and not ultra processed snacks,
           | etc.
           | 
           | I think it's still an oversimplification - people with large
           | amounts of muscle mass, low body fat, and high levels of
           | daily physical activity just don't get a lot of the same
           | metabolic diseases even if they eat huge amounts of animal
           | protein, outside of really poor genetic luck (or
           | complications related to steroid use, etc.) - but it's a
           | pretty good starting point vs. the modern diet.
        
             | tsimionescu wrote:
             | If he has his own special meaning of the common word
             | "food", then it's no longer a spiffy quote. And now you
             | need to get into all the nitty gritty of this
             | recommendation to actually take any advice from it.
             | 
             | Even this term "ultra-processed" is highly suspect when you
             | start investigating it more deeply. Plenty of traditional
             | foods are quite processed - bread being one of the oldest.
             | Is it better to eat 200g of bread (artisanal, wood fired,
             | using traditionally-milled non-GMO pesticide free grains),
             | or a steak?
        
               | cthalupa wrote:
               | Sure. I don't think the quote is super useful - just
               | pointing out that if you were to ask him, he'd say that
               | the potato chips aren't food.
               | 
               | > Is it better to eat 200g of bread (artisanal, wood
               | fired, using traditionally-milled non-GMO pesticide free
               | grains), or a steak?
               | 
               | I don't think there's a real answer here in a vacuum. It
               | depends on what else you eat, your current health, your
               | level of physical activity, etc.
        
       | KempyKolibri wrote:
       | Before anyone gets too excited, best to remember that Nina is
       | regarded as something of a joke in nutrition science circles, and
       | tends to take poetic license with the truth.
       | 
       | If you'd like to take a look at a critical review of her other
       | work on this topic, I'd highly recommend this damning analysis of
       | her "Big Fat Surprise" book:
       | https://thescienceofnutrition.wordpress.com/2014/08/10/the-b...
        
         | readthenotes1 wrote:
         | Are there any similar problems with this essay? I am pretty
         | sure I've heard much of this before ...
        
           | KempyKolibri wrote:
           | It's large and I'm about to go to sleep and only on my phone,
           | so not easy to go through the whole thing, but in short, yes.
           | 
           | Much like in her book, Nina is grossly misrepresenting the
           | evidence, and I'd say just flat-out lies or at the very least
           | misleads the author. See my comment here for an example:
           | https://news.ycombinator.com/item?id=41958014
        
         | nograpes wrote:
         | Thank you for providing this very helpful and needed context. I
         | was indeed getting very excited.
        
         | valval wrote:
         | The essay you linked to reads an awful lot more like a joke
         | than the article in the OP.
         | 
         | To me it's no secret that the mainstream nutrition science is a
         | joke. The latest Nordic nutrition guidelines I've heard of
         | recommend the same amount of sugar and red meat per week -- 350
         | grams.
         | 
         | If that's not enough to tell you everything these organisations
         | do is based on false premises, I have a bridge to sell you.
        
           | KempyKolibri wrote:
           | > The essay you linked to reads an awful lot more like a joke
           | than the article in the OP.
           | 
           | Why?
        
             | valval wrote:
             | The tone is snarky and condescending, which already means
             | it can't be taken seriously. Your initial comment struggles
             | with the same issue to a lesser extent.
        
               | KempyKolibri wrote:
               | If you dismiss valid points addressing the substance of
               | the claim under discussion because of the tone it's
               | conveyed in, and that's the epistemic framework you use
               | to understand whether scientific claims are valid or not,
               | then best of luck to you.
               | 
               | Personally, I think that's hilarious. Enjoy your bacon
               | and butter.
        
               | mistermann wrote:
               | Your framing of "the" reasoning is rather impressive
               | itself.
        
               | norswap wrote:
               | I shouldn't enter into consideration, but it's a
               | shockingly good heuristic to evaluate the credibility of
               | people.
               | 
               | I repeatedly found that people who are thoughtful and not
               | snarky -- and often, nuanced -- when discussing a topic I
               | have no deep expertise on were much more correct on
               | topics that I did have expertise on and could properly
               | evaluate.
               | 
               | We're all on a time budget at the end of the day. And I
               | do share the sentiment: the scientific literature in
               | nutrition is known not to be very good. You don't have to
               | be an expert, it suffices to notice that there are a lot
               | of people coming to contradictory conclusions, and that
               | the consensus seems to have changed drastically over the
               | past decades, not being particularly driven by any
               | groundbreaking changes in available scientific methods.
        
               | KempyKolibri wrote:
               | Ok, I don't share that heuristic personally. That said,
               | if that's yours, then I encourage you to compare
               | Teicholz's output with, say, Walter Willett's (who would
               | take the position that SFA is a risk factor for CVD).
               | 
               | Teicholz is considerably snarkier than Willett so, even
               | by that metric, you should lean in favour of Willett's
               | position that SFA is unhealthy, I guess?
        
               | lemmsjid wrote:
               | I partially agree with you but have some counter
               | thoughts.
               | 
               | Tone is something that can be adopted intentionally or
               | unintentionally. If you hear a pilot on a radio dryly say
               | something in a calm and detached tone, it could be in the
               | context of an emergency. Pilots are enculturated to adopt
               | that tone (for various reasons). Meanwhile particular
               | cultures have different levels of acceptability when it
               | comes to tone: some cultures perceive other cultures as
               | more angry, or detached, because of the norms of
               | communication within those cultures.
               | 
               | In short, I think the tone of "calm, scientific
               | detachment" is often weaponized to lend undeserved
               | credibility to an argument, because people tend to
               | believe people more when they adopt that tone.
               | 
               | Furthermore, tone does have a purpose if used alongside a
               | well done argument. For example, in the article the OP
               | linked to, there is a rather exhaustive refutation of the
               | book in question. The tone of the author previews that
               | their entire opinion on the book is negative, given all
               | the arguments they put forth in their review. If the
               | author of the review had adopted a calm and thoughtful
               | tone, perhaps it would indeed have been more effective
               | because the reader would decide. On the other hand, most
               | people won't read the entire review, so the tone of the
               | author makes it clear what their opinion is.
               | 
               | That said I am not wholly disagreeing with you: would be
               | interesting to do a study using some varying markers to
               | identify tone, and identify, I don't know, argumentative
               | complexity, and see if snarkiness is associated with a
               | lack of complexity. Assuming you can find markers with
               | predictive power.
        
               | ifyoubuildit wrote:
               | It distracts from the points, whether they're valid or
               | not. It suggests that the person is driven by something
               | other than getting to the truth. They're more interested
               | in demonstrating superiority and punishing the enemy.
        
               | KempyKolibri wrote:
               | That just seems like an attempt at mind reading to me.
               | Maybe that's just their writing style? Maybe they're just
               | fed up with having to deal with the same anti scientific
               | nonsense all the time?
               | 
               | Seems a waste of effort trying to attribute motive to
               | such things. Just read what they have to say, verify what
               | they say against their references and then make an
               | inference based on that. Don't see why tone has to come
               | into it at all.
        
               | branz wrote:
               | Although I understand the frustration that comes with
               | feeling like misinformation is being spread, it is also
               | much easier to have a meaningful discussion without such
               | a tone/writing style. Everybody is human, and reading
               | something like that can be quite inflammatory and
               | distract from the conversation. Anyways, that's just my
               | personal opinion, and despite writing this, strong
               | emotions getting involved in public forums with topics
               | like these is kind of inevitable.
        
               | claytongulick wrote:
               | Tone matters.
               | 
               | I'm much more likely to listen to a person who has a
               | calm, neutral or positive tone than someone who is
               | screaming the same words at me.
               | 
               | Words are only a part of human communication, and
               | arguably not the most important part.
               | 
               | "Can I help you?" Has a vastly different meaning
               | depending on the tone and body language of the speaker.
        
               | KempyKolibri wrote:
               | That's a different point.
               | 
               | I claimed that Teicholz was a joke because she makes
               | misleading and often false claims about nutrition science
               | evidence. The response was that the critique I linked to
               | was _more_ of a joke, not because of its content but
               | because of its tone.
               | 
               | So sure, tone matters in certain contexts. If it matters
               | more to someone than the content of what is being said to
               | someone in the context of assessing scientific research,
               | then I think that person has a _wild_ way of interpreting
               | evidence.
        
               | Aurornis wrote:
               | > Tone matters.
               | 
               | Very true. This fact has been deeply exploited by con men
               | across social media in the past decade. When someone
               | knows they're coming from an unfounded, misleading, or
               | deliberately wrong position they make up for it by
               | heaping on friendly tone. They present in a warm,
               | welcoming, and empathetic tone that appears inviting and
               | friendly, unlike the cold academic discussions where
               | facts reign supreme and tone is an afterthought.
               | 
               | It's a real problem right now. There are countless
               | influencers and podcasters pushing bad science who get a
               | free pass because they are all smiles, super nice, and
               | present themselves as helping you (while pitching you
               | products and trying to get you to buy their book)
        
               | AnimalMuppet wrote:
               | There's two kinds of it. One is "This is BS, here's why
               | it's BS, here's more detail on why it's BS, don't fall
               | for this BS." It's heavier on evidence than it is on
               | snark. It uses snark to liven up what could be dull, but
               | all the data is there, and is carefully explained.
               | 
               | The other kind is heavier on snark than it is on
               | evidence. It uses the snark to persuade, _rather than the
               | evidence_. That 's "I can't be bothered to actually make
               | a real case here (whether or not the data is actually on
               | my side), so I'm just going to make the other side look
               | stupid, and hope that you decide to agree with me so that
               | you don't feel stupid too".
               | 
               | The first kind can be persuasive. (In fact, it can be
               | more persuasive than the dry kind of refutation.) The
               | second kind is a _huge_ red flag - if they 're right,
               | it's only by accident, because they can't be bothered to
               | really deal with the evidence.
               | 
               | I suspect that, when different people are reacting to
               | snark in such an article, they're reacting to different
               | versions of it.
        
           | eagleislandsong wrote:
           | > The latest Nordic nutrition guidelines I've heard of
           | recommend the same amount of sugar and red meat per week --
           | 350 grams
           | 
           | Please provide a source. The Danish health authorities
           | absolutely do NOT recommend sugar consumption. Instead, they
           | recommend eating 600g of fruits and vegetables, 100g of
           | legumes, 30g of nuts, and 90g of whole grains DAILY, as well
           | as 350g of fish and no more than 350g of meat WEEKLY. Source:
           | https://foedevarestyrelsen.dk/Media/638651862095615836/AOK-a.
           | ..
        
         | cmsefton wrote:
         | Thank you for this link, very informative.
        
         | Mistletoe wrote:
         | How on earth was this person allowed to publish in this
         | journal? Is it a pay for play?
        
           | KempyKolibri wrote:
           | Some journals are. Others like to carry these kind of
           | articles because heterodox controversial views like this can
           | generate publicity, traffic and citations. Some journals will
           | just publish any old rot.
        
         | lumb63 wrote:
         | I cannot comment on Nina specifically, since I'm not familiar
         | with her work. I'd only like to suggest that being "a joke in
         | nutrition science circles" in the recent past is probably
         | something of a compliment. Mainstream nutrition science led to
         | advice such as putting energy-dense grains at the bottom of the
         | food pyramid, and villainizing fat with respect to CVD, leading
         | to "reduced fat" alternatives which instead use sugar (which is
         | highly addictive). Now, debates center around how much added
         | sugar should be the recommended daily amount (hint: it should
         | be 0). Lawmakers are considering funding overpriced Ozempic via
         | Medicare to fight our rampant obesity, while nutrition science
         | has abdicated its role in helping people maintain healthful,
         | satiating diets.
         | 
         | At least in the United States, the nutrition science of the
         | last 100 years has overseen the most incredible deterioration
         | of metabolic health in human history. There are some folks
         | doing good work out there, as there always have been, but
         | listening to mainstream nutrition science as if their word is
         | law is akin to letting the inmates run the asylum.
        
           | KempyKolibri wrote:
           | The food pyramid put whole grains specifically at the base of
           | the food pyramid. Not sure why you consider this
           | objectionable, the body of evidence overwhelmingly points in
           | the direction of benefits for wholegrain consumption.
           | 
           | Reduced fat is an interesting one. If you actually look at
           | what Keys was investigating all the way back in the mid 20th
           | century, the hypothesis was always that _saturated_ fat
           | increased CVD risk. The translation of that into policy and
           | marketing aimed at _total_ fat cannot be placed entirely at
           | the feet of mainstream nutrition science.
           | 
           | As to the claims that sugar is addictive, this is unsupported
           | - sugar does not meet the DSM-V criteria for addictive
           | substances based on current evidence (https://link.springer.c
           | om/chapter/10.1007/978-1-4899-8077-9_...)
           | 
           | As for added sugar - again, you're labelling policy decisions
           | as nutrition science. The DGs that I'm aware of recommend as
           | little added sugar as possible, but when you're making policy
           | you have to strike a balance between strict enough to make a
           | difference, but not so restrictive that no one listens.
           | That's different from what mainstream nutrition science would
           | claim (which is indeed that there are no benefits to added
           | sugar and several risks).
           | 
           | The same point applies to your claim that nutrition science
           | has a role in getting people to adhere to satiating diets.
           | No, nutrition science is to help us understand what those
           | diets might look like. It is not responsible for getting
           | populations to adhere to them.
        
             | ASalazarMX wrote:
             | The elephant in the room is that nutrition studies (whose
             | results influence health and economic policy) are
             | frequently funded by dominant players of the food industry,
             | creating a huge conflict of interest. This has to end.
        
             | rendang wrote:
             | >put whole grains specifically
             | 
             | This is false, in the 90s when I grew up there was no such
             | criterion, and the posters of the pyramid prominently
             | depicted sliced white bread.
             | 
             | The worst part of the food pyramid was the indication to
             | use all fats and oils sparingly. There's never been any
             | point in which the evidence suggested that olive oil or
             | other monounsaturated fats should be avoided
        
               | KempyKolibri wrote:
               | Agree that the wholesale demonisation of fats was a
               | massive failure of policy. Doubly frustrating because
               | this was known - Ancel Keys' hypothesis was always about
               | saturated fat specifically, and the Keys equation he
               | devised showed the beneficial effects of PUFA. So
               | mainstream nutrition science was on the money, but policy
               | makers and companies less so.
        
             | hn_throwaway_99 wrote:
             | > The food pyramid put whole grains specifically at the
             | base of the food pyramid. Not sure why you consider this
             | objectionable, the body of evidence overwhelmingly points
             | in the direction of benefits for wholegrain consumption.
             | 
             | Citation please or I'm calling extreme bullshit. Everything
             | I've ever read has argued for putting more nutrient dense
             | fruits and vegetables as the basis for a healthy diet.
             | 
             | More importantly, I think the nutrition community was
             | woefully naive to the point of being negligent when they
             | tried to defend the food pyramid. One quote I heard was
             | "When we were recommending lower far intake, we never
             | imagined Snackwells." Well, why TF not??? It should have
             | been blatantly obvious that by demonizing fat and making
             | people feel like carbs were "free" that companies would
             | react appropriately and come up with fat-free, sugar-
             | stuffed replacements that had a huge amount of calories,
             | left you feeling unsatiated, and tasted like sweet
             | cardboard. Probably even worse was frankenfood like
             | Olestra.
             | 
             | I agree with the original point - while I think the field
             | of nutrition science has improved a lot over the past
             | decade, they have a ton to answer for and never did an
             | appropriate "mea culpa" for all the great harm they caused.
        
               | riku_iki wrote:
               | > Citation please or I'm calling extreme bullshit.
               | Everything I've ever read has argued for putting more
               | nutrient dense fruits and vegetables as the basis for a
               | healthy diet.
               | 
               | pic from wikipedia named USDA pyramid 1995-2005: https://
               | en.wikipedia.org/wiki/Food_pyramid_(nutrition)#/medi...
        
               | hn_throwaway_99 wrote:
               | Wut? Was your comment a joke or satire? This entire
               | thread is about how the food pyramid of that era was an
               | unscientific disaster, so linking to a picture of it is
               | not evidence.
        
               | riku_iki wrote:
               | you asked for citation of pyramid putting grains in
               | foundation, you got it, not sure what you are complaining
               | about now.
        
               | hn_throwaway_99 wrote:
               | Sorry, I realized now, I quoted that section just to give
               | context. I was really referring to "Not sure why you
               | consider this objectionable, the body of evidence
               | overwhelmingly points in the direction of benefits for
               | wholegrain consumption."
               | 
               | Even with that first sentence though, the base of that
               | shitty food pyramid really just doesn't talk about "whole
               | grains" - it calls it the "bread, cereal, rice and pasta"
               | group, with a graphic that includes spaghetti, crackers,
               | a baguette, a bowl of cereal, etc. And having lived
               | through that time when the food pyramid was taught in
               | school, they certainly weren't delineating between highly
               | refined flours and things like oatmeal, brown rice,
               | quinoa, etc.
        
               | riku_iki wrote:
               | > Sorry, I realized now, I quoted that section just to
               | give context. I was really referring to
               | 
               | looks like I agree with you on this part:
               | https://news.ycombinator.com/item?id=41964513
        
               | KempyKolibri wrote:
               | What do you want a citation for? Which claim?
        
               | tsimionescu wrote:
               | Your claims that (1) the food pyramid put _whole_ grains
               | at the base, and (2) that there is any consensus at all
               | that a healthy diet should include more whole grains than
               | fruit and vegetables (which is what  "being at the base
               | of the pyramid" means).
        
               | KempyKolibri wrote:
               | Sure, here's a USDA article referring to the "1984 Food
               | Guide Pyramid" where it states cereals should be whole
               | grain (see p38: https://www.ers.usda.gov/webdocs/publicat
               | ions/42215/5831_aib...)
               | 
               | As for whole grains vs fruit vs vegetables, here's a SR
               | and MA of studies looking at different food groups and
               | the RR of all cause mortality: https://www.sciencedirect.
               | com/science/article/pii/S000291652...
               | 
               | Three servings of whole grains per day: 0.79 (21%
               | reduction in ACM) Three servings of vegetables per day:
               | 0.89 (11% reduction in ACM) Three servings of fruit per
               | day: 0.90 (10% reduction in ACM)
               | 
               | So the evidence seems to support the suggestion that
               | consumers should focus on whole grain consumption as a
               | base for their diet.
        
             | hollerith wrote:
             | >The food pyramid put whole grains specifically at the base
             | of the food pyramid. Not sure why you consider this
             | objectionable, the body of evidence overwhelmingly points
             | in the direction of benefits for wholegrain consumption.
             | 
             | Many, many people disagree with that. Most days I eat no
             | grains at all and the rest of the time, I strictly limit my
             | grain intake. For example, I just finished a meal where I
             | used one tablespoonful (uncooked volume) of rice (boiled
             | with some peas). (The meal also included meat and butter,
             | the source of most of my calories.) White rice is the only
             | grain I eat anymore, and I would never eat brown rice,
             | which is loaded with oxalate and other phytotoxins. I added
             | to this just-finished meal B vitamins in the form of pure
             | refined powder (which I liberated from capsules).
             | 
             | It is very obvious from how it makes me feel that brown
             | rice is bad for me.
             | 
             | The cultures that have eaten rice for thousands of years
             | eat almost exclusively white rice. Brown rice was not even
             | possible to make before the spread of tech for precision
             | machining (which reached East Asia in the 1900s). You have
             | to remove the hull from the rice before you can eat it, and
             | before precision machining, removing the hull
             | (traditionally done by pounding the rice with a log) also
             | removed most of the bran and germ. Yes, some bran and some
             | germ remained stuck to the rice -- so it was mostly-white
             | rice, as opposed the polished, completely-white rice we
             | have today with no bran and no germ at all. Still it had
             | only a small fraction of the amount of bran and germ that
             | modern brown rice has.
        
               | Spagbol wrote:
               | I've read the opposite; that brown rice is just white
               | rice with the bran still attached, and that white rice
               | was only eaten by the elite because of the additional
               | work required to seperate it (like white bread only being
               | for the wealthy during the middle ages), and that
               | beriberi was a noticed more in times specifically because
               | of industrialization increasing the availability of white
               | rice: https://en.m.wikipedia.org/wiki/Thiamine_deficiency
               | Apperently a lot of white rice is now enriched with
               | thiamine for this reason
        
               | hollerith wrote:
               | >I've read the opposite; that brown rice is just white
               | rice with the bran still attached, and that white rice
               | was only eaten by the elite because of the additional
               | work required to seperate it (like white bread only being
               | for the wealthy during the middle ages)
               | 
               | I've read that, too, many times, and I stopped believing
               | it after I watched videos (on Youtube) of people
               | preparing rice the traditional way. Particularly, I paid
               | close attention to the _color_ of the rice after the
               | processing steps: it was white with bits of brown stuck
               | to it.
               | 
               | I searched for bookmarks for those videos, but cannot
               | find them.
               | 
               | (I don't know about wheat: I only investigated rice.)
        
               | hollerith wrote:
               | I found the bookmark. Anyone who has ever seen modern
               | brown rice will immediately be able to tell that although
               | there might be bits of bran still stuck to it, this rice
               | has no more than 3 or 4% of the bran of modern brown
               | rice:
               | 
               | https://youtu.be/qGNUPqHvTso?si=WWnY3OLALTBREVMs&t=525
               | 
               | I bookmarked another video, but it has been made private
               | since I watched it.
               | 
               | Here is a very illuminating moment: the rice has already
               | been pounded, then winnowed (the separated hulls
               | removed), but there are still many kernels that need to
               | be hulled (roughly one kernel in every 150 or 200
               | kernels), so the rice is put back in the mortar for
               | another round of pounding. In other words, although there
               | is more pounding to do to make the rice edible, already
               | most of the bran is off the rice (and thrown away along
               | with the hulls). (When only a few unhulled kernels
               | remain, she removes them one by one with her fingers.)
               | This supports my assertion that it is impossible with
               | traditional methods to get the hulls off while leaving on
               | most or even a significant fraction of the bran. Again: I
               | think you need precision machines that only became
               | available in Europe in the 1800s and in East Asia in the
               | 1900s to get the hulls off (which I think you really need
               | to do if you eat rice every day and want to keep your
               | teeth) while leaving most of the bran on the kernel.
               | I.e., people in traditional rice cultures did not have
               | the ability to consume anywhere close to as much rice
               | bran as is possible by eating modern brown rice.
               | 
               | https://youtu.be/qGNUPqHvTso?si=QWYryq16PBHzK8ed&t=436
        
               | KempyKolibri wrote:
               | I don't find n=1s to be a good form of evidence. Many
               | people may disagree, but that doesn't mean they're right.
               | 
               | Look at the dose response curve for wholegrain
               | consumption in this bad boy (and yes, it's looking at
               | whole cereal grains, not including fruits and
               | vegetables). Greater consumption associated with better
               | outcomes: https://www.sciencedirect.com/science/article/p
               | ii/S000291652...
        
             | AStonesThrow wrote:
             | Let's get real here: the _benefits_ in the USDA Food
             | Pyramid are _benefits_ for _agribusiness_ and the big
             | subsidized food producers. The benefits that the USDA
             | pushes have nothing to do with good nutrition for the
             | average citizen. This is 100%  "regulatory capture" as we
             | call it around here. The Food Pyramid is a scam and a hoax,
             | and the more it can be ignored, the better.
             | 
             | When I joined a Christian Health Sharing ministry, they
             | determined that I needed remedial help, due to hypertension
             | and dyslipidemia. They assigned me to monthly virtual
             | meetings with a dietician. The dietician's advice
             | _horrified me_ , because it would've made me sicker, and
             | exacerbated my conditions. I approached the ministry's
             | administrators, requested a replacement dietician, and they
             | replaced her alright. The new dietician had basically the
             | same credentials and the same letters after her name, but
             | she was way more flexible, listened to my reasoning, and
             | supported my choices with encouragement.
             | 
             | My parents followed every "diet fad" in the 1970s-1980s,
             | from 2% milk, to margarine, to yolk-less-egg-whites, to
             | reducing red meat, to low-sodium everythings, to bottled
             | fluoridated water. It was sheer torture and disgusting. My
             | mother didn't know the first thing about flavor or pleasure
             | in cooking, and never used the spices in her rack. Our food
             | was always bland. For breakfast she'd slap down a jug of
             | milk, a box of Chex, a bowl and a spoon, and abandon me to
             | go do housework. I would sit there and read the mendacious
             | lies known as "Nutrition Panel" on the side, and simply
             | stewed in my resentment for the whole thing. It's a
             | travesty.
        
               | KempyKolibri wrote:
               | Tbh I know it's not what you're going for, but your
               | parents' dietary decisions generally sound based AF
               | (apart from bottled fluoridated water - depending on the
               | fluoride levels in your drinking water that may or may
               | not be beneficial).
               | 
               | Chex, I suppose it depends on whether it was wholegrain
               | or not. Wholegrain cereal is associated with pretty good
               | health benefits, refined not so much.
        
               | tsimionescu wrote:
               | Replacing butter with Margarine is "based AF" now?
        
               | literalAardvark wrote:
               | Given the knowledge available to them in the 70s, yes. A
               | mistake, but done for good reasons (lowering satfat).
        
               | KempyKolibri wrote:
               | Problem in the 70s was trans fats. Now they're no longer
               | a risk, replacing butter with margarine is a solid
               | evidence-based decision for one's health (though not so
               | much for one's enjoyment!).
        
               | KempyKolibri wrote:
               | Yes. Not so much at the time when some margarines had
               | trans fats in, but now? Yes, absolutely. The evidence
               | suggests that doing so significantly reduces one's risk
               | of CVD.
        
               | tsimionescu wrote:
               | I don't think there is much reason to continue taking you
               | seriously if this is supposed to be the sound scientific
               | advice.
        
               | KempyKolibri wrote:
               | Why would we believe otherwise? The evidence suggests
               | that replacing butter with margarine reduces LDL-c (see
               | https://pubmed.ncbi.nlm.nih.gov/9771853/), and we have an
               | enormous body of evidence showing that LDL-c is a causal
               | agent in atherosclerosis (https://academic.oup.com/eurhea
               | rtj/article/38/32/2459/374510...).
               | 
               | So why wouldn't replacing butter with margarine be a
               | positive step for one's cardiovascular risk profile?
        
             | wathef wrote:
             | Not sure why you're being downvoted, this is one of the
             | best takes here. It sits squarely in the realm of evidence
             | where the majority of these comments are anecdotal and they
             | don't translate to population level studies.
        
             | riku_iki wrote:
             | > The food pyramid put whole grains specifically at the
             | base of the food pyramid. Not sure why you consider this
             | objectionable, the body of evidence overwhelmingly points
             | in the direction of benefits for wholegrain consumption.
             | 
             | my humble research found that diffs in nutrition between
             | whole grains and refined grains carbs is very small
             | compared to say whole grain to some complex carbs from leaf
             | veggies. The same goes to glycemic index, satiety index,
             | etc.
        
             | GuB-42 wrote:
             | The food pyramid makes economic sense.
             | 
             | Grains are cheap and energy dense, if your goal is to feed
             | a large population it makes a lot of sense to put them at
             | the base of the pyramid, that's what will keep you alive,
             | as in, not starving. Higher up are fruits and vegetables,
             | also cheap, they will provide with nutrients that you need
             | to stay healthy on top of the calories that will keep you
             | alive. Higher up are animal products, expensive but rich in
             | proteins and a few other nutrients that are a bit lacking
             | in the base layers, they help you get stronger and more
             | performant in addition to healthy and alive. On top are
             | pleasure foods, not really necessary for your body, but
             | enjoyable.
             | 
             | I take it like a mirror of the "hierarchy of needs" pyramid
             | rather than nutritional advice for people with effectively
             | unlimited resources.
        
             | s1artibartfast wrote:
             | This is the story as old as time. Much of science is good
             | faith, fairly accurate, and nuanced.
             | 
             | Policy and advocacy is deceptive, dishonest, and lacks
             | nuance.
        
           | bjoli wrote:
           | Adherence to guidelines is laughably low in the developed
           | world.
           | 
           | The recommendations regarding fat hasn't changed in 30 years
           | in most countries. FDA recommended limiting saturated fat
           | already in 1980 (didn't bother looking further) and has
           | recommended not exceeding an energy intake from fat over 30%
           | since at least 1990. 30%e from fat is not a low fat diet.
           | 
           | The guidelines from 1980 explicitly mentions reducing
           | saturated fat and sugar.
           | 
           | I think the problem is that we haven't been listening.
        
             | KempyKolibri wrote:
             | Exactly. And we can't blame nutrition science for that.
        
           | Aurornis wrote:
           | > I'd only like to suggest that being "a joke in nutrition
           | science circles" in the recent past is probably something of
           | a compliment.
           | 
           | This is the fallacy that makes pseudoscience thrive right
           | now: The idea that the enemy of my enemy is my friend.
           | 
           | Wannabe influencers position themselves as the anti-
           | establishment position. People who are frustrated with
           | institutions blindly fall in line behind them.
           | 
           | The fallacy doesn't stand up to even the simplest critical
           | thinking, yet it triggers something subconsciously that leads
           | far too many people to see a contrarian statement and assume
           | it must be true.
           | 
           | Meanwhile, these people are grifting away, selling books and
           | pitching Athletic Greens (or the latest sponsor of the day).
           | This person is no exception.
        
             | r3trohack3r wrote:
             | It's a shame that our institutions have burned so much good
             | will and credibility that they've created an environment
             | for this to thrive.
             | 
             | All metrics I see show faith in these institutions going to
             | zero. Most good science I see is making (and has been
             | making for decades) a really strong case that this loss of
             | faith is deserved.
             | 
             | Credentialism is collapsing under the weight of its own
             | corruption.
        
               | ithkuil wrote:
               | The solution is better institutions, not less
               | institutions.
               | 
               | Good institutions have mechanisms in place to correct
               | themselves.
               | 
               | And most of the past failures of our institutions were
               | discovered and corrected by ... the institutions
               | (sometimes the very same institution or other
               | institutions whose role was to counterweight the
               | institution at fault)
               | 
               | Unfortunately the trap we all fell into is that we
               | interpret this success at catching and fixing failures as
               | proof that the institutions have failed and thus that
               | they will never be trustworthy ever again.
               | 
               | We need to train ourselves that the trust we put in the
               | institutions does not mean we trust everything that comes
               | out of them, but we trust that the mistakes will be
               | eventually corrected as they happen.
               | 
               | But that's not what's happening now. The society has
               | equated the point-in-time failure of an institution with
               | the failure of the entire process and also extended that
               | feeling across the board towards areas of our society
               | that haven't failed us much.
               | 
               | Nothing good will come out of that. For one, it will
               | remove any incentive from future institutions to try to
               | be objective and self-correct. If self-correction becomes
               | a "capital sin" for institutions, they will be selected
               | to favour absolute unquestionable truths which cannot
               | possibly ever need a correction.
               | 
               | But also. it completely ignores the fact that most
               | institutions are useful, even while they suffer from
               | failures/corruption and that destroying them altogether
               | is going to throw the baby out with the bathwater.
        
               | s1artibartfast wrote:
               | I haven't seen much self correction out of major
               | institutions, but what I am really looking for is
               | honesty.
               | 
               | I want them to share their uncertainty, nuance, and
               | reasoning. Anything less I view as well intended lies.
               | 
               | Institutions as a concept are critical. Some institutions
               | are net negative. Blindly following and support all
               | institutions because some or even most are useful is a
               | fallacy of its own.
               | 
               | I think the nutritional institution credibility is
               | bankrupt at the moment. given the importance, I am
               | willing to take the risk and put in the work to find my
               | own way in the Forrest.
               | 
               | Furthermore, most institutions can only provide heuristic
               | advice, which even when true, is t always true, or true
               | for everyone. It should never be treated as dogma
        
             | lumb63 wrote:
             | It's not necessarily that fallacy. I just don't nutrition
             | science is a great place to appeal to authority. I see it
             | as similar to arguing for the status quo when the church
             | held that the earth was flat. What we are doing is not
             | working, and we should at least consider listening to
             | dissenting voices.
             | 
             | It might turn out that they're arguing the earth is round,
             | or maybe they're arguing that the earth is a doughnut
             | shape. The validity of what anyone says has to stand on its
             | own merit. But shutting it down because someone is "a joke"
             | (amongst a science that is largely, itself, a joke), is not
             | conducive toward improving our understanding.
        
           | ambientenv wrote:
           | Personally, I don't think the capitalist-driven agenda
           | anywhere in the world gives a flying fricative about the
           | health of anyone, only the health of the profit motive and
           | it's benefits to shareholders. Food and healthcare is but one
           | more example. Love or hate the JRE, I think this episode [1]
           | provides much food (pun intended) for thought. The common
           | person simply does not matter other than as a(n) (addicted)
           | consumer.
           | 
           | [1] https://youtu.be/G0lTyhvOeJs?feature=shared
        
             | s1artibartfast wrote:
             | Sure. The government isn't your mommy, and neither are
             | corporations. People have to take responsibility and look
             | out for their own health. Nobody else is going to do it for
             | you.
        
         | apwell23 wrote:
         | > they have a unique feedback mechanism that suppresses
         | endogenous cholesterol synthesis that most of us don't have.
         | 
         | What unique feedback mechanism is this and how can i find out
         | if i have this too ? circular reasoning "what makes them
         | different is that they are shown to be different"
         | 
         | > they manage to escape heart attacks because their vessels are
         | larger than average. Wow. I don't know what to make of the
         | Masai, except that they are indeed a unique people.
         | 
         | Maybe they are not "unique people" and there are other non-
         | genetic reasons their blood vessels are larger.
         | 
         | I call BS on this so called review because author didn't bother
         | to explain his points.
        
           | KempyKolibri wrote:
           | > What unique feedback mechanism is this and how can i find
           | out if i have this too
           | 
           | Get a blood lipids panel and see what your ApoB is like!
           | 
           | > Maybe they are not "unique people" and there are other non-
           | genetic reasons their blood vessels are larger.
           | 
           | I don't think this effect has been observed in post mortem of
           | other populations, so that would make them fairly unique, no?
        
             | apwell23 wrote:
             | > Get a blood lipids panel and see what your ApoB is like!
             | 
             | not sure how this tell me if i have 'unique feedback
             | mechanism' . wtf does that phrase even mean.
        
               | KempyKolibri wrote:
               | If you have a cholesterol synthesis feedback mechanism
               | then as you increased your consumption of foods that are
               | known to increase LDL-c (butter, lard, tallow) then your
               | LDL-c would not rise or would only rise by a smaller
               | amount than would be predicted by the Keys equation.
               | 
               | So you could get your LDL-c checked, up your butter
               | consumption and then get a retest and compare the results
               | to the expected value.
        
         | bjoli wrote:
         | Yup. I had a nutritionist friend (that I would trust with my
         | life) look through one of her books and she groaned already on
         | the 4th page.
        
           | KempyKolibri wrote:
           | Get her "Deep Nutrition" by Catherine Shanahan for Halloween.
           | I dare you.
        
         | hereme888 wrote:
         | Thanks for that. I read into the intro then scrolled up
         | expecting to see a listing of authorities, only to see a single
         | person publishing this work.
        
         | pk-protect-ai wrote:
         | "nutrition science circles" are the joke on their own.
        
       | sparrc wrote:
       | Nina Teicholz is a bit of a controversial figure in the nutrition
       | world so I'd advise people to take this with a grain of salt...
        
       | bitmasher9 wrote:
       | This is a serious problem. How can we trust institutions that are
       | suppose to provide evidence based advice to the general public?
       | To me this is a crime so large that those involved should be held
       | accountable for a percentage of all heart attacks. Furthermore it
       | erodes trust in government, experts, and science. Right now it
       | seems like the American public is actively feed extremely harmful
       | food and lied to about the health consequences.
       | 
       | Is it possible to create a Reddit style voting system where votes
       | are weighed more depending on a level of trust/expertise to
       | review scientific papers. The voting could be on multiple
       | factors, such as on the different types of validity, the overall
       | impact, how transparent they are with methods and data, how well
       | it fits with other literature, etc. The end result could be a
       | paper titled "A survey of saturated fat's impact on
       | cardiovascular health" where experts very publicly discuss the
       | papers merits and common people interested in their health can
       | review and understand where the science is. Decentralized
       | informational authority.
        
         | KempyKolibri wrote:
         | It's nonsense. SFA consumption is a risk factor for
         | cardiovascular disease. Nina is misreading the evidence to come
         | to poor quality conclusions. The most rigorous analysis of RCTs
         | on the subject shows this very clearly:
         | 
         | https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
        
           | greentxt wrote:
           | "We found little or no effect of reducing saturated fat on
           | all-cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials,
           | 55,858 participants) or cardiovascular mortality (RR 0.95;
           | 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both
           | with GRADE moderate-quality evidence.
           | 
           | There was little or no effect of reducing saturated fats on
           | non-fatal myocardial infarction (RR 0.97, 95% CI 0.87 to
           | 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both
           | low-quality evidence), but effects on total (fatal or non-
           | fatal) myocardial infarction, stroke and CHD events (fatal or
           | non-fatal) were all unclear as the evidence was of very low
           | quality. There was little or no effect on cancer mortality,
           | cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum
           | triglycerides or blood pressure, and small reductions in
           | weight, serum total cholesterol, LDL cholesterol and BMI."
           | 
           | This is your citation for saturated fat is evil?
        
             | KempyKolibri wrote:
             | I don't believe saturated fat is evil. I believe that
             | consuming more than 10%E from SFA increases risk of CVD,
             | and replacing SFA with PUFA reduces risk of CVD.
             | 
             | And yes, that is my citation in support of that claim.
             | Quote: "There was a 17% reduction in cardiovascular events
             | in people who had reduced SFA compared with those on higher
             | SFA"
             | 
             | and
             | 
             | "When we subgrouped according to replacement for SFA, the
             | PUFA replacement group suggested a 21% reduction in
             | cardiovascular events"
             | 
             | I explain why the null findings on insensitive endpoints
             | aren't the gotcha some people think they are here:
             | https://news.ycombinator.com/item?id=41960046
        
               | riku_iki wrote:
               | > There was a 17% reduction in cardiovascular events in
               | people who had reduced SFA compared with those on higher
               | SFA
               | 
               | they have table with breakdown of events by type, and in
               | both rows with significant reduction it says that quality
               | of evidence is "very low".
        
               | KempyKolibri wrote:
               | Don't know where you're seeing that. Combined
               | cardiovascular events has an RR of 0.83 and the GRADE
               | quality is moderate, not very low.
        
               | riku_iki wrote:
               | Yes, and I am talking about subtypes of events in the
               | "summary of findings" table. Those subtypes with
               | "moderate" quality has very insignificant diff in # of
               | events. Those with significant diff in # of events have
               | "very low" quality of evidence.
        
               | KempyKolibri wrote:
               | How would that affect the inference being made here? That
               | is, the claim being made is with regard to combined
               | cardiovascular events. This effect is significant and the
               | GRADE quality is moderate.
               | 
               | One of the main purposes of meta-analyses is to summate
               | multiple studies that may have insufficient statistical
               | power in isolation to find a significant effect, but when
               | summated they do.
               | 
               | I _think_ you're trying to suggest that the insignificant
               | individual event types aren't contributing to the
               | significant findings on the combined event endpoint, so
               | we should ignore the GRADE quality of those (correct me
               | if I'm wrong). But that's not how meta analysis functions
               | - those events are also contributing to the significant
               | finding on that endpoint (which is also why the GRADE
               | quality of the combined endpoint is moderate). They just
               | aren't significant _in isolation_.
        
               | riku_iki wrote:
               | > How would that affect the inference being made here?
               | 
               | to me, it looks like several rows clearly don't add up in
               | key findings table(they derive "moderate quality"
               | conclusions from "very low quality" observations), which
               | makes whole publication as data astrology quality.
        
               | KempyKolibri wrote:
               | Right, but that's because you're misreading the table.
               | They are deriving moderate quality conclusions from
               | moderate quality data, as I've explained.
        
               | riku_iki wrote:
               | Looks like we are in disagreement about who is misreading
               | the table.
        
         | Aurornis wrote:
         | > This is a serious problem. How can we trust institutions that
         | are suppose to provide evidence based advice to the general
         | public?
         | 
         | The only serious problem here is that some people immediately
         | trust a random article from someone who denies mainstream
         | science simply because it's a contrarian take.
         | 
         | I don't understand the people who will question everything that
         | comes from professionals and institutions, but within minutes
         | of reading an article that is contrarian they think "Yep this
         | all checks out and I have no further questions". To see it
         | happening in real time in this thread is wild.
        
           | mistermann wrote:
           | You did the same thing but in the opposite direction. That's
           | how easy it is to make an unforced error.
        
             | exe34 wrote:
             | one is based on an entire industry of people working in so
             | many conflicting fields that it would boggle the mind if
             | they could all be bought, and the other is based on one
             | person who built their fame on being contrarian without a
             | lot of evidence.
             | 
             | I think the question still makes sense, why people are
             | willing to ignore a ton of evidence from a lot of different
             | unaffiliated people and focus on one article by one person
             | that really doesn't add up to much of an argument - I think
             | the answer is just that this is what they want to hear, so
             | it must be right.
        
               | fwip wrote:
               | The claim isn't that everyone in nutrition etc is bought
               | off. You simply don't need to do that.
               | 
               | If you're in the sugar industry, you give funding to
               | people investigating how saturated fat causes heart
               | disease. You support organizations that back up your
               | preferred theory. These orgs run media campaigns, slap a
               | "heart-healthy" label on food products, and sometimes
               | fund research. Forming popular consensus on "fats = bad"
               | leads to additional funding from government or other
               | charitable causes.
               | 
               | Increased funding leads to an increased density of
               | scientists working on the problem, which in turn
               | increases the legitimacy of the field, especially among
               | people just getting into their careers. If it's common
               | wisdom in the cardio field that saturated fats are the
               | worst cause of heart disease, that's where they're going
               | to focus their efforts.
               | 
               | It's one of those things where you simply don't need to
               | buy anyone off. You just put your thumb on the scale
               | early enough, and consistently push popular opinion
               | toward a direction that's beneficial for you.
        
               | exe34 wrote:
               | if somebody can find an even worse cause and they publish
               | it, they stand to found an entirely new field - the
               | incentives are to prove the entire existing field wrong.
               | nobody would hesitate.
        
           | pierrebai wrote:
           | Well, we read the article, which cites many studies. Maybe
           | she is doing a super selective review of the field, but she
           | does not merely quote one study, but several, all of which
           | indicate that there is no correlation between saturated fat
           | and cardiovascular problems.
           | 
           | IOW, we did not merely "read and trusted one random article"
           | but assessed the presented evidence. You OTOH, merely
           | provided ad-hominem attack on both the author and anyone who
           | dared believe the presented evidence, which smacks of trying
           | to shame people in not voicing their opinion.
        
             | KempyKolibri wrote:
             | Did you actually follow up and read the studies she cited
             | in detail, though? Much of what she claims is
             | misrepresentation, such as the insinuation that the
             | Cochrane review found no evidence of SFA consumption being
             | associated with risk.
        
         | keybored wrote:
         | > Furthermore it erodes trust in government, experts, and
         | science.
         | 
         | Does trust in X erode when X is wrong? Yes.
        
           | Kurtz79 wrote:
           | That is true but also probably misguided.
           | 
           | Scientific knowledge evolves as new discoveries are made,
           | immutable and unequivocal "truth" is the realm of religion,
           | not science (which makes the former much more appealing to
           | many than the latter).
           | 
           | Trust really should not erode if X acted in good faith based
           | on the consensus knowledge at the time.
        
             | keybored wrote:
             | If. What was proclaimed as nutritional facts decades ago
             | turned out to be tainted by industry/lobbying interests.
        
             | tsimionescu wrote:
             | If the consensus is evolving, sure. If the consensus is
             | going back and forth for decades, and each time it is
             | presented with the authority of medical or physical
             | science, then it is normal and correct to stop listening at
             | some point.
             | 
             | When scientists have weak theories that they're not sure
             | of, they're not supposed to share those breathlessly with
             | the public, and certainly not try to shape public laws
             | based on the theories they know are weak.
             | 
             | And nutrition science has been guilty of this for over a
             | century. You can find people in the field making confident
             | recommendations and setting dietary standards from the time
             | when they didn't know vitamins were a thing. If you
             | followed the science on nutrition and adjusted your diet
             | accordingly around 150-100 years ago, you could literally
             | get scurvy or other vitamin deficiencies. The field has
             | evolved a little bit, but it's still extremely weak as
             | scientific fields go.
        
         | tonymet wrote:
         | I agree that this reflects poorly on trust. But voting to give
         | more authority to the federal government would make it even
         | worse. Look at how poorly voting works.
         | 
         | Just get rid of the agency altogether.
        
       | elawler24 wrote:
       | High cholesterol and heart attacks are common in my family. This
       | year, after my dad had intensive open heart surgery, my doctor
       | recommended trying a strict plant-based diet for 90 days with a
       | blood test before and after. She had been studying medical
       | journals on the topic primarily from Canada (she said it's easier
       | to find medical research not funded by corporations there).
       | 
       | Before the doing the plant-based diet, I had such high
       | cholesterol that I would have needed to start taking statins
       | before age 35. After the 90 day diet experiment, my cholesterol
       | dropped by 130 mg/dL. I no longer need to be put on medication,
       | and am within a healthy range.
        
         | readthenotes1 wrote:
         | A family member went on the ornish-like diet + atorvastatin for
         | 7 years* after open heart surgery for block in the left main.
         | 
         | Hen tested (via ultra fast CT scan) the blood flow after the
         | experiment -- there was no change.
         | 
         | It may sound depressing, but it's actually very good for what
         | is normally a progressive disease.
         | 
         | The experimenter is currently now doing another 7 year
         | experiment, eating a somewhat healthier than normal diet +
         | statins.
         | 
         | After getting off the ornish diet, there was hardly any change
         | in total cholesterol.
         | 
         | *The diet was ornish-like because it was hard to get anything
         | to eat when going out. The experimentar ate salmon if there was
         | nothing better.
        
           | hyuuu wrote:
           | i didnt realize that the diet im doing right now has a name,
           | ornish! Just to clarify, so this diet actually works in
           | preventing further damage?
        
             | readthenotes1 wrote:
             | The relative was also taking statins, so it is hard to say.
             | 
             | following the normal course of events leads to subsequent
             | surgical interventions based on the people I've seen...
        
           | Aurornis wrote:
           | > Hen tested (via ultra fast CT scan) the blood flow after
           | the experiment -- there was no change. > It may sound
           | depressing
           | 
           | I think this is a fundamental misunderstanding of the purpose
           | of enforcing low cholesterol.
           | 
           | The goal would be to prevent further damage and restriction.
           | By all accounts that test is a positive result.
           | 
           | Atherosclerosis is correlated with lifetime exposure to high
           | cholesterol. Once you reach the point of having open heart
           | surgery for severe problems, the goal is to slow further
           | progression as much as possible.
           | 
           | Hoping to reverse a lifetime of accumulated exposure to high
           | cholesterol with 7 years of slightly below average
           | cholesterol just isn't going to happen. Stopping further
           | progression is great though!
        
             | emptiestplace wrote:
             | Did you stop reading at the end of the part you quoted?
             | Their very next words literally say this.
        
         | christophilus wrote:
         | I had a similar experience, except with blood pressure. After
         | switching to a plant based diet, it's the lowest it's been in
         | my adult life.
        
           | drewg123 wrote:
           | For me it was both.. I had pretty bad BP and high enough
           | cholesterol to that my doctor wanted me on a statin. Now my
           | BP is normal, and my cholesterol is in the "low risk" range.
           | My doctor said she'd never seen such an improvement before.
           | 
           | In my case it was not the suggestion of a doctor, but rather
           | dating and now marrying a vegan. I converted to a plant based
           | diet starting with eating plant based just with her, and then
           | I became fully vegan for health reasons.
        
           | apwell23 wrote:
           | were the results from cutting out carbs in plant based diet.
           | could you have achieved same thing with animal based low carb
           | diet?
        
             | christophilus wrote:
             | In my case, I didn't cut carbs. Quite the opposite. The
             | diet could be described as high carb.
        
               | apwell23 wrote:
               | thats really interesting. did your a1c numbers go down
               | too?
        
         | 542458 wrote:
         | For what it's worth, the linked article does not dispute that
         | diet can affect blood cholesterol, but does argue that it
         | doesn't necessarily equal long term health.
         | 
         | > In other words, although diet could successfully lower blood
         | cholesterol, this reduction did not appear to translate into
         | long-term cardiovascular gains.
         | 
         | That said, as other commenters here have highlighted the author
         | of the study has a spotty track record so, uh, big grain of
         | salt.
        
         | tomp wrote:
         | what did you eliminate, i.e. what were you eating before? eggs,
         | milk, cheese/yogurt (fermented diary), meat, processed meat?
        
           | el_benhameen wrote:
           | Not OP, but I recently discovered that I have moderately high
           | lipoprotein-a levels and decided to try to reduce my LDL as a
           | result. I cut most eggs, all butter, all full-fat milk,
           | almost all cheese, and switched from whole to skim yogurt. My
           | LDL dropped about 20% between the beginning of August and the
           | middle of October.
        
           | elawler24 wrote:
           | Before, I ate low sugar / carb and high on cheese, meat,
           | whole milk, yogurt, and veggies (close to keto). Now I eat a
           | lot of rice, beans, while grains, and veggies. I'm trying to
           | figure out how to get enough protein though, that's the trade
           | off.
        
             | geoka9 wrote:
             | Maybe try whey isolate?
        
         | jokethrowaway wrote:
         | We have the lowest average cholesterol ever and cardiovascular
         | diseases are on the rise, so does it really make a difference?
        
           | Buttons840 wrote:
           | Life expectancy has increased, so maybe it does make a
           | difference?
           | 
           | Truth is, it's complicated and neither your observation, nor
           | mine, is enough to conclude anything.
        
         | Buttons840 wrote:
         | I got a high LDL reading of about 200 (this is like top 3%
         | percentile, if I remember correctly). I panicked and switched
         | to an extremely low fat vegan diet, and I couldn't handle
         | waiting so I paid to have my LDL tested again. My LDL had
         | dropped to 130 after one week on that diet.
         | 
         | For me, at least, saturated fat is the most important nutrient
         | I can monitor and avoid. Low saturated fat, high fiber is the
         | diet for me.
         | 
         | I wasn't able to keep the vegan diet, but it was worth trying
         | for a time because I learned some new recipes and new habits.
        
           | EasyMark wrote:
           | This past year I switched to a whole foods diet. I eat eggs,
           | whole milk & cheese, veggies, fruit, white meat, saturated &
           | unsaturated natural oils (nothing manufactured like margarine
           | or anything hydrogenated), root veggies (potatoes, sweet
           | potatoes, turnips), beans/lentils (I'm not afraid of soy
           | based things) grain based breads including whole wheat, whole
           | wheat pasta. I tend to avoid red meat (pork and beef). I quit
           | fast food and anything I suspected of a manufactured element.
           | I was bordering on high cholesterol and pre diabetes. Since
           | then I've dropped 35 lbs and everything is back in the normal
           | range. I don't think you have to go vegan, just get away from
           | all the over salted, over manufactured, sugar "enhanced"
           | garbage. We're omnivores, I think we have the machinery to
           | process normal foods. I admit this worked for me and may not
           | work for everyone. The only "vice" I allow myself is a couple
           | of diet cokes a day, but most days it's just coffee. I only
           | will have a drink or two socially on the weekend and tend to
           | stick to wine or clear spirits and lime/lemon.
        
         | apwell23 wrote:
         | curious. Was there a change in your a1c after your experiment?
        
       | readthenotes1 wrote:
       | Although the author of the article appears to be controversial, I
       | am concerned that none of the responses citing her controversial
       | nature are actually rebutting anything in the paper.
       | 
       | I believe most of what was written here appears to be factual.
       | What am I missing?
       | 
       | (Someone attacking the currently held beliefs taught by science
       | is by nature controversial. More important question is whether
       | they are pointing out flaws in those beliefs. )
        
         | KempyKolibri wrote:
         | I'm happy to discuss the paper. All her takes on the Seven
         | Countries Studies are just poor. France wasn't excluded by
         | design, for example. All this is covered by a white paper here:
         | https://www.truehealthinitiative.org/wp-content/uploads/2017...
         | 
         | As for the claims about RCTs, she straight-up lies, quote:
         | "including by the prestigious Cochrane group, most recently in
         | 2020. Altogether, >20 review papers, including umbrella
         | reviews, have been published, with the vast majority concluding
         | that the data from randomized, controlled trials do not provide
         | consistent or adequate evidence for continued recommendations
         | limiting the intake of saturated fat"
         | 
         | So what did the 2020 Cochrane paper _actually_ say? Let's look:
         | " There was a 17% reduction in cardiovascular events in people
         | who had reduced SFA compared with those on higher SFA" "When we
         | subgrouped according to replacement for SFA, the PUFA
         | replacement group suggested a 21% reduction in cardiovascular
         | events"
         | 
         | So she invokes the respectability of Cochrane yet claims their
         | findings are incorrect, and tries to pass it off as a Cochrane
         | reviewing showing that saturated fat is unrelated to heart
         | disease? This alone should tell you everything you need to know
         | about Teicholz. She relies on her audience not knowing the
         | papers she references, because she misrepresents them to fit
         | her agenda. She's completely dishonest.
         | 
         | Ref to Cochrane:
         | https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
        
           | snapplebobapple wrote:
           | You picked out the one result in five or six from the summary
           | of result that supports the reducing saturated fats and
           | ignored the rest that said it disnt matter (and of those
           | result all cause and cardiovascular mortality were in there
           | in the saturated fat doesnt affect category). There are
           | straight up lies here but they are in your response.
        
             | KempyKolibri wrote:
             | A null finding in a study does not mean it "doesn't
             | matter". Let's take an extreme example: we want to know if
             | exercise reduces mortality, so we randomise one arm of a
             | cohort of 20 people to an exercise regime, while the other
             | arm does nothing. After four weeks, we compare the death
             | rate in each group. There's no significant difference.
             | 
             | Does this mean exercise "doesn't matter" for mortality, or
             | it's in the "doesn't affect category"? No, of course not -
             | the finding was null because the timescale was too short
             | and even then, the statistical power from a cohort of 20 is
             | going to be very low.
             | 
             | Likewise, if you look at the study characteristics, most of
             | the studies were too short to find a significant outcome on
             | an insensitive endpoint like CVD mortality or ACM. FWIW,
             | Dayton 1967 had a followup of 8 years and _did_ find
             | significant increases in mortality endpoints in the SFA
             | group, but those results are pulled towards null in the
             | meta summation by the other, shorter studies.
             | 
             | CVD events are more sensitive because they don't require
             | the participants to die of a heart attack in order to
             | register as a data point.
             | 
             | So no, there's no lying or cherry picking going on here. In
             | order for that to be the case, you'd have to argue that
             | angina and non-fatal heart attacks are not negative health
             | outcomes. If they are, then it's demonstrably the case that
             | SFA consumption is associated with negative health
             | outcomes, and Nina is telling porkies.
             | 
             | As for your accusation that I'm lying - what false claim
             | did I make? Be specific.
        
               | snapplebobapple wrote:
               | Ok, lets nitpick further:
               | 
               | for cvd risk mortality if you exclude the largest single
               | study that also had a long duration (WHI 2006) it made
               | CVD risk mortality significant, so one of those long
               | duration studies is dragging the results the opposite
               | way.
               | 
               | We need to remember we are talking about relative risk so
               | what does a 17% increase correspond to? 15 more incidents
               | per 1000 participants with a ci of 24 to 2 incidents per
               | 1000 participants among studies that were mostly moderate
               | to high risk individuals. It's a rounding error on a low
               | risk event that is probably an even lower risk event for
               | most of the population. If you look at something that
               | actually exists and is relevant you will see 100% plus
               | changes to relative risk. All cause mortality relative
               | risk is 2.29 in this study on the effect of smoking on
               | women, for example:
               | https://pmc.ncbi.nlm.nih.gov/articles/PMC6219821/
               | 
               | Figure six explores saturated fat cut offs and all but 2
               | of the events trend down for the last observation which
               | is only at 13% energy from saturated fat, probably need
               | to look at higher saturated fat levels to make sure the
               | chart isn't an upside down U and we aren't stuck in the
               | most deadly part of the curve arguing about whether we
               | should cut more when we could increase consumption more
               | to solve the issue.
               | 
               | I'm sure there's more but I am out of time.
        
               | KempyKolibri wrote:
               | > for cvd risk mortality if you exclude the largest
               | single study that also had a long duration (WHI 2006) it
               | made CVD risk mortality significant, so one of those long
               | duration studies is dragging the results the opposite
               | way.
               | 
               | Right, and the proposed pathway by which SFA increases
               | CVD risk is via increases in ApoB/LDL-c. What LDL-c
               | differences did they achieve in WHI 2006?
               | 
               | Additionally, the substitution is important. DGs
               | recommend replacing SFA with PUFA, whereas in WHI the
               | intervention group largely replaced SFA with CHO.
               | Interestingly, the control group had higher levels of
               | PUFA and MUFA, which may also explain the paltry change
               | in serum cholesterol.
               | 
               | If you want to claim that 15 more incidents per 1000 of a
               | disease that is one of the top killers in the western
               | world is a rounding error, then go for it. I don't think
               | that's a reasonable position, personally.
               | 
               | As for the speculation about higher levels being healthy
               | - speculate away, but I don't see why anyone should
               | believe it's the case when a) it runs contrary to the
               | body of evidence on the subject b) there's no actual
               | evidence backing up that speculation.
        
               | pierrebai wrote:
               | But your example is not reflective of the study. Are you
               | saying that the 17% reduction is for some reason
               | significant but the other ones, all of which would
               | inconveniently disagree with the result you want, are
               | not, even though they are in the same study?
               | 
               | IOW, you're saying that among the study results, all that
               | agree with your POV are valid, all that don't are
               | invalid. That's quite some bias there.
        
               | KempyKolibri wrote:
               | The answer to your question is literally answered by my
               | comment that you're replying to. Frequentist statistics
               | cannot be used to affirm the null. That is, you cannot
               | say "cardiovascular deaths was not significantly
               | associated, therefore SFA does not cause CVD mortality".
               | 
               | So I'm not disagreeing with or omitting anything in the
               | study. The study said no significant association with CVD
               | mortality. Ok, no problem. That doesn't mean SFA doesn't
               | cause CVD mortality.
               | 
               | However, the study _does_ show that SFA is associated
               | with CVD events. So there's a significant finding. It's
               | not cherry picking, this is just how frequentist
               | statistics works.
        
         | derbOac wrote:
         | FWIW I think contrarian scientific viewpoints are important if
         | they're rigorous, and Teicholz makes a reasonable case for the
         | viewpoint that saturated fat reductions are unrelated to
         | mortality.
         | 
         | However, I don't think Teicholz herself is really being
         | entirely "factual", bringing purported conflicts of interest
         | into her discourse when it goes on on both sides. People have
         | pointed out that her organization has its own history with this
         | problem: https://thehill.com/blogs/congress-
         | blog/healthcare/257353-co....
         | 
         | That isn't addressing your question but I guess I disagree that
         | Teicholz is just dispassionately presenting a rigorous
         | argument, even if I find it compelling myself. Some of what she
         | writes is sort of misleading (as that linked piece points out)
         | even if I think her most cogent arguments are reasonable.
         | 
         | A lot of her arguments hinge on how you see things like the
         | Cochrane meta-analysis. Her sensitivity analysis with
         | colleagues is compelling in dismissing the CVE result in that
         | meta-analysis, but at the same time you can whittle away any
         | effect if there's not a big enough N (in a sort of inverse form
         | of p-hacking), so I'm not sure I'm entirely convinced either.
         | 
         | Also as that piece points out, Teicholz seems dismissive of
         | anything that's not mortality as an outcome, which I'm not sure
         | I agree with.
         | 
         | I'm sympathetic to Teicholz's arguments, I guess I just feel
         | like she doesn't make them any more convincingly to me than
         | those she criticizes.
         | 
         | At this point for me personally my reading of the literature is
         | that a lot of things are related to individual physiology, and
         | I'm skeptical of a lot of blanket recommendations regarding
         | nutrition. Reducing saturated fats has been good for me
         | personally so I stick with that.
        
           | KempyKolibri wrote:
           | I think dietary matrix is also important, so dietary patterns
           | can be more useful than focusing on individual nutrients.
           | Hard cheeses seem to be associated with positive health
           | outcomes despite their SFA content, yet for butter the
           | inverse is true.
           | 
           | I think what I find frustrating about Nina is the number of
           | fairly basic misreadings of the evidence she makes, despite
           | having been corrected on it (and admitting the error)
           | multiple times. She also grossly mischaracterises the results
           | of studies repeatedly, so misleads laypeople into thinking
           | the evidence base is more heterogenous than it really is.
           | 
           | Additionally, she frequently makes contradictory statements
           | regarding her own epistemology. For example, she states that
           | observational studies can "only show association" and
           | therefore cannot be used for causal inference, yet her
           | twitter account is full of examples of her using
           | observational data to draw causal inferences.
           | 
           | You mention a sensitivity analysis of Hooper that she
           | conducted. Do you have a link to that?
        
       | jvanderbot wrote:
       | The book Outlive has a great discussion about CVD and diet. There
       | is a link, and food types matter, but reducing foods to their
       | saturated fat content is of course ridiculous as we now know.
        
         | hyuuu wrote:
         | how is it ridiculous? so far, reducing saturated fat intake has
         | a direct correlation with lowering LDL that is a marker for
         | cardio risk no?
        
           | aeries wrote:
           | More than simply a marker, it's a causal risk factor for
           | ASCVD.
        
       | profsummergig wrote:
       | Anyone else have alternative takes on cholesterol based on
       | personal experience?
       | 
       | Some alternative theories I've come across:
       | 
       | - There's a theory that cholesterol is good for you. It's
       | necessary for brain functioning. Low levels of "bad" cholesterol
       | have been linked to depression.
       | 
       | - There's a theory that the high levels of cholesterol in blood
       | clots found around ripped arteries may be due to the body trying
       | to heal a rupture with cholesterol.
       | 
       | - There's a theory that seed oils and table sugar, which have
       | only been mass consumed for the last 100 years or so, are what
       | cause heart disease.
       | 
       | Personally, I have a very high level of both good and bad
       | cholesterol. They shot up after I started eating a lot of non-veg
       | food. And after they shot up, I stopped having depressive
       | episodes.
        
         | elawler24 wrote:
         | I do have a fear that staying vegan will have other negative
         | effects, unrelated to cholesterol - esp brain and bone density
         | related. For me that means cutting out cheese, milk, and butter
         | as much as possible. But having fish and lean meats 1-2 times
         | per week.
        
           | jokethrowaway wrote:
           | I tried going vegan for ~10 years after reading the
           | scientific research, then started getting stomach ulcers and
           | constant diarrhea.
           | 
           | Tried with paleo (meat and veggies) as I thought the carbs
           | were the culprit and I decreased the frequence of the
           | accidents.
           | 
           | Finally I went carnivore and within a week I had zero
           | symptoms. I was strict carnivore for 8 weeks (lost 8kgs) then
           | I tried reintroducing other food but without great success.
           | 
           | These days I eat mainly butter, eggs and steak and I've been
           | good for 2.5 years now (I was eating organs too at first but
           | I don't really feel any difference if I don't eat them).
           | Eating the occasional sweet from a bakery makes me feel a bit
           | bloated. Eating some fruit For 1.5 years eating vegetables
           | would cause the diarrhea to reappear, after 1.5 years I can
           | eat vegetables occasionally without problems. It's like a
           | "limit" got reset or something.
        
           | nradov wrote:
           | If you're concerned about bone density then why are you
           | cutting out dairy products? Those are one of the best sources
           | for the calcium we need (although it is possible to get
           | enough from other foods or supplements).
           | 
           | https://peterattiamd.com/belindabeck/
        
             | poincaredisk wrote:
             | Personally (not the parent) I'm vegan for moral reasons, so
             | I'm being vegan despite (not for) it's health effects. As
             | every extreme diet, it requires monitoring nutrition intake
             | and occasional supplementation in order to avoid micro- and
             | macroelement deficiencies and health problems.
        
         | nradov wrote:
         | Cholesterol by itself isn't harmful. For most people with
         | typical genetics, cholesterol only becomes a problem when
         | arterial plaques form as a reaction to vascular damage.
         | Limiting cholesterol is one fairly effective approach to
         | preventing those plaques, but a better approach is to avoid the
         | damage in the first place. In other words, it doesn't matter if
         | a little extra cholesterol is floating around in your
         | bloodstream as long as it doesn't stick to the walls.
        
           | profsummergig wrote:
           | What are some no-brainer strategies to avoid the damage
           | please? Thanks.
        
             | nradov wrote:
             | Don't smoke, keep your blood pressure under control, and
             | don't become insulin resistant.
        
               | amy-petrik-214 wrote:
               | This is all true. And of course let us remember
               | cholesterol is essential. Many hormones are made from it
               | (cortisol, vitaminD, testosterone, estrogen). Being
               | essential (not intending the meaning of "essential
               | vitamin" which means the body cannot synthsize - as a
               | vitamin it would be non-essential) - but being essential
               | for physiology rather than diet, the body can synthesize
               | cholesterol. So there is this axis of people who have low
               | cholesterol super healthy diets.. and their body just
               | makes lots of cholesterol anyway, so now they have high
               | cholesterol and are taking statin drugs for it, because
               | biology and population variation.
               | 
               | The other thing cholesterol is used to make, also quite
               | nice to have, is bile. Used for fat digestion and such. A
               | lot of bile. From a lot of cholesterol. Seems like a
               | waste though, to excrete all that finely synthesized
               | bodily chemical. BUt aha, the body realizes this and so
               | resorbs it. THus there is a cycle and recycle of
               | cholesterol and bile. Aha! What if we can trick the body
               | to not resorb it and just release it. Such a drug has
               | been developed. Well, hard to call it a drug. There is no
               | fanciness, no elegant molecular binding to an esoteric
               | receptor, no, nothing of the sort. It's called metamucil,
               | and as the name tells us, it mostly works by being a big
               | chonky mucinous blob of very impressively thick goop. The
               | "magic" of how it works is literally the bile gets
               | trapped in the thick goop and excreted. And thus we've
               | bled off some bile from the cholesterol recycling loop,
               | and thus, cholesterol. And that's why this weird blobby
               | old person fiber supplement is cholesterol magic.
        
               | jkolio wrote:
               | Kind of sucks for your guts, though, don't it? Bile is
               | corrosive, that's why reflux is an issue and digestive
               | tablets that contain ox bile shouldn't be taken on an
               | empty stomach. Not fun when it reaches your bowels,
               | either.
        
               | profsummergig wrote:
               | Thanks.
               | 
               | Certain famous men in the past smoked pipe all day and
               | lived very long lives. E.g. Winston Churchill and
               | Bertrand Russell. Do you have any theories on why smoking
               | didn't harm them as much. Do you think back then there
               | might not have been some interaction factor that's
               | prevalent today, etc.?
        
             | kelipso wrote:
             | Generally speaking, decreasing inflammation in your body.
             | Can google how to reduce inflammation.
        
           | KempyKolibri wrote:
           | What's the evidence for the claim "cholesterol by itself
           | isn't harmful?"
        
             | AnthonBerg wrote:
             | How do you feel about starting with the opening paragraph
             | on Wikipedia?
             | 
             |  _Cholesterol is the principal sterol of all higher
             | animals, distributed in body tissues, especially the brain
             | and spinal cord, and in animal fats and oils._ --
             | https://en.m.wikipedia.org/wiki/Cholesterol
        
               | KempyKolibri wrote:
               | How does that paragraph interact with the claim that high
               | serum cholesterol is not harmful?
        
               | jerf wrote:
               | If you're going to nail people on specific questions, you
               | need to _stick_ to those specific questions, not read a
               | reaction to your very specific "cholesterol by itself
               | isn't harmful?" as anything other than an answer to your
               | question.
        
               | KempyKolibri wrote:
               | Do you think the original person making the claim was
               | referring to high serum cholesterol, or shadow boxing
               | against an imaginary interlocutor who claims even a
               | single individual cholesterol molecule is harmful?
               | 
               | I thought it was obvious, hence the original broad quote,
               | but the bizarre Wikipedia response made me think that
               | perhaps I wasn't clear enough. Hence the clarification
               | with my follow up.
        
               | meiraleal wrote:
               | you asked:                 What's the evidence for the
               | claim "cholesterol by itself isn't harmful?"
               | 
               | And got a response that is more than just an evidence. A
               | smart person would not just change the goalpost but one
               | with nefarious intentions, maybe.
        
               | KempyKolibri wrote:
               | Do you think the original person making the claim was
               | referring to high serum cholesterol, or shadow boxing
               | against an imaginary interlocutor who claims even a
               | single individual cholesterol molecule is harmful?
               | 
               | I thought it was obvious, hence the original broad quote,
               | but the bizarre Wikipedia response made me think that
               | perhaps I wasn't clear enough. Hence the clarification
               | with my follow up.
        
               | AnthonBerg wrote:
               | Is the world often bizarre to you?
        
               | KempyKolibri wrote:
               | Not interested in the meta-talk, let's stick to the
               | subject.
               | 
               | So for clarification on your view - do you think that
               | high levels of LDL-C (proxying for ApoB) increase risk of
               | CVD?
        
               | AnthonBerg wrote:
               | Not interested in the conversation partner with the track
               | record displayed here.
        
               | KempyKolibri wrote:
               | More meta talk, zero reference to the issue actually
               | under discussion. Disappointing.
        
               | meiraleal wrote:
               | > Do you think the original person making the claim was
               | referring to high serum cholesterol
               | 
               | What I think is that your behavior is quite strange, to
               | create a fake profile just to post a link "debunking" the
               | author. Do you have something personal against her?
               | 
               | And then when you got corrected, in place of recognizing
               | you said something wrong, you double-down your irrational
               | behavior: "shadow boxing against an imaginary
               | interlocutor". Yeah because the original interlocutor
               | makes stupid questions.
        
               | KempyKolibri wrote:
               | I have issues with people pushing anti-science that can
               | lead to harms. I have issues with Teicholz for this
               | reason in the same way I have issues with Andrew
               | Wakefield.
               | 
               | By "imaginary interlocutor" I was referring to a
               | misreading of the parent reply, not mine. This was the
               | person who said: "Anyone else have alternative takes on
               | cholesterol based on personal experience?"
               | 
               | The question is then whether when that person said
               | "alternative takes on cholesterol" they meant
               | "alternative takes on the function of an individual
               | molecule of cholesterol" and not "alternative takes on
               | the significance of high serum cholesterol". Considering
               | their next two bullet points refer to high and low levels
               | of serum cholesterol, I thought it was fairly obvious.
               | 
               | Apparently it wasn't for some people, and those same
               | people are then claiming that making this clear is some
               | sort of dodge/goalpost shift/deceptive behaviour. But it
               | clearly isn't. If you read the above, where someone was
               | _obviously_ referring to high serum cholesterol, and in
               | response someone says  "cholesterol by itself isn't
               | harmful", is it reasonable to quote that claim and ask
               | for evidence, by which you mean "I want evidence that
               | high serum cholesterol isn't harmful"? If it _is_
               | reasonable, which I believe it is, then no deception,
               | goalpost shifting or correcting has actually taken place
               | here.
        
             | nradov wrote:
             | That's a broad question. Let's turn that around. What harm
             | do you think serum cholesterol could be causing? Like which
             | specific mechanism of action are you concerned about here?
        
               | KempyKolibri wrote:
               | Sure, that's fair. I believe that ApoB-tagged
               | lipoproteins are a causal agent in atherosclerosis via
               | the mechanism laid out in the 2019 EAS consensus (that
               | is, the response to retention hypothesis).
               | 
               | The full pathway and supporting evidence can be found
               | here: https://academic.oup.com/eurheartj/article/41/24/23
               | 13/573522...
        
               | nradov wrote:
               | Sure, no argument with that but let's go another step
               | back in the casual chain. What's causing the arterial
               | wall injury (or loss of ability to repair damage) in the
               | first place to even allow that mechanism to come into
               | play?
               | 
               | If a patient is already accumulating arterial wall damage
               | then it might be necessary to limit serum cholesterol
               | through dietary changes or statins or something. But I
               | would claim that those interventions usually come too
               | late, and that most of the damage can be prevented
               | through other interventions thus making serum cholesterol
               | levels less relevant.
               | 
               | It's like if you have a truck driving around full of
               | toxic waste. Maybe that's cause for concern, but if you
               | can take other measures to ensure it won't crash and
               | spill the cargo then maybe it's fine.
        
               | KempyKolibri wrote:
               | What's the evidence that this only takes place in
               | individuals with arterial wall injury or without the
               | ability to repair damage?
               | 
               | These factors may increase the effect of high LDL-c on
               | CVD, but I'm not sure on what basis we should assume that
               | those without them aren't at risk from high LDL-c.
        
         | profsummergig wrote:
         | I just remembered something:
         | 
         | Pregnant women have extremely high cholesterol (ridiculously
         | high).
         | 
         | - There's a theory that if evolution designed pregnant women to
         | have high cholesterol, then cholesterol cannot be the poison
         | it's made out to be.
        
           | Aurornis wrote:
           | > Pregnant women have extremely high cholesterol
           | (ridiculously high).
           | 
           | Cholesterol levels rise during second and third trimesters,
           | but it's not true at all to say that all pregnant women have
           | "ridiculously high" cholesterol. Around 24% of women who have
           | normal range cholesterol will go over the normal range for a
           | few months, but it's not accurate at all to say they all have
           | "ridiculously high" cholesterol
           | 
           | Here is a good overview:
           | https://pmc.ncbi.nlm.nih.gov/articles/PMC4989641/
           | 
           | Cholesterol metabolism is related to hormones that change
           | during pregnancy, so downstream fluctuations in cholesterol
           | aren't surprising. Do not mistake this for intentional
           | evolutionary pressure to increase cholesterol.
           | 
           | > if evolution designed pregnant women to have high
           | cholesterol, then cholesterol cannot be the poison it's made
           | out to be.
           | 
           | This is an incredibly pseudoscientific way of thinking.
           | Pregnancy puts many pressures on the body, not all of which
           | are good.
           | 
           | Did you know that blood coagulability also rises during
           | pregnancy, which is clearly linked to cardiac events. There
           | is an increased risk of cardiac events during pregnancy.
           | 
           | Saying "X happens during pregnancy therefore X must be good"
           | is an extremely unscientific and uninformed take. I'm not
           | surprised it's being leveraged by the cholesterol truthers,
           | but it's wrong. This is the level of reasoning that seems to
           | appeal to people on TikTok and Twitter who consume feel-good
           | science in 15 second clips, but it makes anyone who has read
           | any actual research on the subject depressed at how
           | susceptible people have become to bad science that is
           | dangerous to their health.
        
           | exe34 wrote:
           | do you know how many women died during pregnancy before
           | modern times?
        
           | EasyMark wrote:
           | pregnancy tends to be a limited time thing to me and the body
           | quickly goes back to "normal levels" after it's over. Few
           | women are constantly pregnant.
        
         | adrian_b wrote:
         | I do not know how much truth exists in the theory that an
         | excess of saturated fats is harmful, but I have acted based on
         | this theory and it was very beneficial for me.
         | 
         | A few years ago, I have been diagnosed with incipient
         | atherosclerosis. This was an unpleasant surprise for me, so I
         | have immediately made serious changes in the food that I eat.
         | 
         | At that time, I was eating very high quantities of dairy, which
         | has a high proportion of saturated fat.
         | 
         | Because I could not see any other factor that could cause the
         | atherosclerosis, I have eliminated dairy from my food and I
         | have changed completely the composition of the fats contained
         | in my food.
         | 
         | I eat only food that I cook myself, so I know exactly which is
         | the composition of the fat contained in it. Nowadays, at least
         | 90% of my daily intake of fat comes from a combination of oils
         | that I use when cooking food (typically 60 mL of extra virgin
         | olive oil + 20 mL of cold-pressed sunflower oil + 10 mL of cod
         | liver oil + 1 drop of an oil containing D3 and K2 vitamins).
         | 
         | Instead of any other kinds of dairy, now I use only a cheese
         | substitute that looks and tastes like melted cheese, but it is
         | made from whey protein concentrate (which has almost no fat)
         | mixed with some vegetable oil and a few other ingredients for
         | better flavor.
         | 
         | After changing completely the fatty acid profile of my fat
         | consumption, after a year the symptoms of atherosclerosis have
         | disappeared and there have been also other very noticeable
         | signs of improved cardiovascular health. For instance,
         | previously, I had cold feet and when sleeping I had to take
         | care to keep them warm. Some months after changing the diet,
         | they had become warm (presumably due to improved blood flow)
         | and I have no longer needed any protection against lower
         | temperatures.
         | 
         | So my diet change has very certainly improved a lot my health
         | in a relatively short time of no more than a year, and that has
         | persisted for the last three years. I cannot know if this is
         | really caused by the change in the fatty acid profile, but I
         | cannot see any other significant difference, except if the
         | abundant dairy that I was eating before contained some other
         | harmful substance or if the significant increase in the amount
         | of eaten EV olive oil and cold-pressed sunflower oil has
         | provided some benefits beyond the better fatty acid profile.
         | 
         | Logically, it is plausible that a reasonable amount of
         | saturated fat, which is correlated with the amount of physical
         | work, should not have any harmful effect.
         | 
         | As long as you burn enough calories daily to use all the fat
         | intake for energy, it should not matter if that fat is
         | saturated fat. However, when the fat is not completely used and
         | some of it is deposited, then it is plausible that it is
         | preferable if oleic acid (mono-unsaturated fatty acid) is the
         | most abundant in food, because in normal conditions this is the
         | most abundant fatty acid in the human reserve fat. When other
         | fatty acids are much more abundant than oleic acid, they must
         | be processed and converted before storage and the capacity for
         | the conversion may be overwhelmed.
         | 
         | The negative connotations for "seed oils" are not applicable to
         | all seed oils, but they refer only to the seed oils where
         | linoleic acid is the most abundant acid.
         | 
         | Linoleic acid is an essential nutrient, but the need for it can
         | be satisfied with 15 to 20 mL per day of a suitable seed oil,
         | like sunflower oil. A greater daily intake than that can cause
         | problems, because the excess linoleic acid must be converted
         | into other fatty acids and also because some of its derivatives
         | have physiological roles for which an excess quantity is not
         | desirable.
         | 
         | Given these, it seems plausible that some fat composition is
         | preferable to others. Like I said, I have acted on this
         | assumption and it has worked very well for me, even if the real
         | mechanism cannot be known, at least not yet.
        
           | KempyKolibri wrote:
           | Glad to hear you've improved your condition. The evidence
           | suggests that crossing the 10% total energy as SFA threshold
           | increases CVD incidence. There is no evidence (that I've
           | seen) than "using up" this energy changes this risk factor.
           | 
           | Obviously the resulting obesity from consuming excess
           | calories is a risk factor for CVD in itself, but the body of
           | evidence would suggest that someone consuming >10% E from
           | SFA, even if they're in caloric equilibrium, will be at
           | greater CVD risk than someone consuming less, all else held
           | equal.
           | 
           | The main mechanism by which SFA is thought to increase CVD
           | risk is by downregulation of LDL receptors, which occurs
           | during the digestion/absorption of SFA, and is not a result
           | of excess SFA hanging around in the body in some way. If you
           | consume SFA, this pathway will be in play, regardless of how
           | much is burned vs stored.
           | 
           | There's no good evidence that seed oils/linoleic acid,
           | refined or not, pose a risk for humans. There's a lot of talk
           | on the subject about on social media, but it's almost
           | entirely speculation based on animal studies.
           | 
           | I once bought the anti seed oil line, but on closer
           | investigation of the evidence I changed my view and have
           | replaced most of my SFA intake with MUFA/PUFA, mostly in the
           | form of canola and olive oil.
        
         | fmajid wrote:
         | There's almost no correlation between cholesterol ingested as
         | food and your own blood serum cholesterol. It's almost as if we
         | have a digestive system to break down nutrients into their
         | constituents rather than release them unmodified into the
         | bloodstream.
        
           | reissbaker wrote:
           | Yup, ingesting cholesterol doesn't lead to higher blood serum
           | cholesterol. Although in this case the article was about
           | ingesting saturated fat leading to higher blood serum
           | cholesterol (in my personal experience this is true, and
           | switching to a low saturated fat diet dropped my LDL
           | cholesterol and triglycerides).
           | 
           | In general it matters what you replace the saturated fat
           | with, though: you should replace it with unsaturated fat.
           | Replacing it with carbs/simple sugars can apparently elevate
           | LDL cholesterol and triglycerides:
           | https://pmc.ncbi.nlm.nih.gov/articles/PMC2943062/
           | 
           | Olive oil is good, candy is bad. (News at 11.)
        
             | KempyKolibri wrote:
             | Technically speaking it does, but only if you're starting
             | from a point of very low dietary cholesterol intake or
             | you're genetically predisposed to have high sterol
             | absorption.
             | 
             | So if you're, say, a vegan with very little cholesterol
             | intake then adding some would result in significantly
             | higher serum cholesterol. However, for most people in
             | western populations, they're already above the point where
             | the effect tails off, which is why dietary guidelines
             | generally don't focus on dietary cholesterol anymore.
        
         | Aurornis wrote:
         | > Some alternative theories I've come across: > - There's a
         | theory that cholesterol is good for you. It's necessary for
         | brain functioning. Low levels of "bad" cholesterol have been
         | linked to depression.
         | 
         | These aren't alternative theories, they're just reductive takes
         | that try to ignore the big picture.
         | 
         | Reductive takes are really seductive for people who want to
         | reduce everything into "good" or "bad" categories, but the body
         | doesn't work like that.
         | 
         | The part that confuses people is that the message has been
         | simplified to "cholesterol bad" for so long that people are
         | confused to discover that cholesterol is actually used by the
         | body. Upon discovering these facts, reductive logic switches
         | from "cholesterol bad" to "cholesterol good", which is just as
         | reductive.
         | 
         | The truth is that cholesterol is useful within the body, but
         | that doesn't mean that more of it is better. Despite all of the
         | proponents of alternative theories trying to spin a different
         | story, the bottom line is that cumulative lifetime LDL exposure
         | is still correlated with heart disease.
         | 
         | That is the only thing you need to know about the debate if you
         | want to reduce it to something simple. More LDL over time means
         | more heart disease. A lot of people will try to "well
         | actually..." various things around this, but it's true.
         | 
         | Even the comments below are trying to tell you your own
         | observation is impossible (that diet can't affect cholesterol
         | levels) when that's clearly not true.
         | 
         | Cholesterol has become a hotbed of alternative medicine that
         | doesn't follow the science but sells well on social media.
         | Don't put too much confidence behind "alternative theories"
         | when we have decades of evidence that excessively high
         | cholesterol levels over a lifetime are correlated with heart
         | disease.
        
           | KempyKolibri wrote:
           | Just want to say you have solid takes. You're getting all my
           | upvotes. Thanks for fighting the good fight against this kind
           | of nonsense.
        
         | exe34 wrote:
         | > They shot up after I started eating a lot of non-veg food.
         | And after they shot up, I stopped having depressive episodes.
         | 
         | do you know the parable of the drunk gentleman looking for his
         | keys under a streetlamp at night? a policeman asked him where
         | did he drop his keys, he pointed at a dark alleyway further
         | away, so the policeman asked why he didn't look there instead,
         | he replied "well there's no bloody light over there".
         | 
         | is it possible that you were deficient in some other nutrient,
         | possibly even a trace one like some metal ion or maybe just
         | some amino acid, and that's what caused the improvement in
         | symptoms when you started eating flesh again? is it possible
         | that you simply enjoyed the taste and then felt better about
         | yourself? or any number of other changes in your life at the
         | same time - taking more time cooking your meals, learning new
         | recipes, trying new spices with it, etc?
        
         | hereme888 wrote:
         | Cholesterol is a necessary part of every cell in our body. It
         | allows flexibility of cell membranes despite variations in
         | temperature, and also converts into steroid hormones.
         | 
         | LDL doesn't mean much, but rather the ratio of HDL:LDL. Low
         | cholesterol is bad for the brain. Of course these are
         | oversimplified statements.
         | 
         | There are known cases of older men with low testosterone level
         | and high LDL, who after testosterone replacement therapy
         | experienced a significant decrease in LDL. It's thought that
         | the liver kept churning cholesterol in attempts to synthetize
         | enough testosterone to no avail.
         | 
         | I believe that depression and cognitive dysfunction is a side-
         | effect of too low cholesterol when people take statins,
         | especially older folks, but excessive LDL also accumulates in
         | arteries and lead to hypertension and/or diminished blood flow
         | to organs, which itself leads to dementia, heart attacks, etc.
        
           | EasyMark wrote:
           | Unless research has changed since I las tread, about 75% of
           | your cholesterol is manufactured in the human body and not
           | ingested, so ingested cholesterol is of limited in fluence. I
           | suspect the overall health of the body affects it more than
           | eating saturated fats.
        
       | ano-ther wrote:
       | Nutrition science is hard. The effects are long-term and easily
       | confounded by all the other things one eats. Randomized
       | controlled trials are not easy to pull off. It's only loosely
       | regulated and and a big market. And everyone eats, so everyone
       | has an opinion.
       | 
       | Perhaps that's why there is a lot of sketchy results, hyperbole
       | in communication, and a cycle of debunking (of the debunking)
       | around.
        
         | lazyeye wrote:
         | And also why it is so easily compromised by commercial
         | interests.
        
         | GuB-42 wrote:
         | Looking at the hype cycle, I am beginning to think that what
         | you eat doesn't really matter, with a few caveats.
         | 
         | And it makes sense. We are omnivores, the entire point of being
         | omnivores is to be able to fuel our body with whatever food is
         | available, and it probably played an important role in the
         | development of the human species. It means our body is very
         | tolerant regarding what we eat, and while some types of food
         | may be healthier than others, the effect will be small compared
         | to other factors like generics, lifestyle, exposure to harm,
         | etc...
         | 
         | What I think is important though is that we should have a diet
         | as varied as possible. It is not necessary, but the less varied
         | your diet is (it includes veganism), the more you need to pay
         | attention. With a varied diet, you are very unlikely to miss
         | something, and if you eat too much of the same thing, you may
         | exceed the ability for your body to deal with a particular
         | substance, making it toxic. Another problem is the
         | psychological aspect. Essentially, the abundance of food that
         | we have now messes with our brain, causing addictive behavior.
         | And I think this is the focus of most serious nutrition science
         | today, and that's also what Ozempic is all about.
        
           | literalAardvark wrote:
           | I believe you're mostly correct.
           | 
           | I've also found that particle sizes are also important:
           | keeping things in their natural sizes and chewing them
           | yourself does a couple of important things such as mixing
           | them with enzymes, sending signalling about what's coming
           | into the digestive tract, and making food the right size,
           | instead of ultra fine, which provides a different mix of
           | nutrients to the lower parts of the gi tract (and lowers
           | absorbed calories from nuts).
        
           | valval wrote:
           | What? Your diet is by far the most important part of your
           | health. You can be sedentary and still remain healthy if you
           | eat the right things.
           | 
           | We're good survivors for sure, but try eating only deep fried
           | donuts for a year and let me know how omnivorous you feel.
        
             | GuB-42 wrote:
             | > Your diet is by far the most important part of your
             | health.
             | 
             | If it was the case, we wouldn't have an article like this.
             | We would have very obvious results, and we don't. Some
             | claim we do, but if you look closer, it is not obvious at
             | all.
             | 
             | Note that by "it doesn't matter", I don't mean that
             | anything goes. Only eating deep fried donuts is not good,
             | for the same reason eating only apples is not good, you
             | won't get everything you need from a single food source. If
             | you do that, you will get what are now very obvious and
             | easily identified diseases, like scurvy, anemia, etc...
             | Also, eating too little or too many calories is also not
             | good, especially too little, but the effect (starving to
             | death) is even more obvious.
             | 
             | What I meant by "it doesn't matter" is that with a varied
             | diet and the right number of calories, the details don't
             | matter. And I am convinced that a base diet of fried donuts
             | to the appropriate amount of calories, with supplementation
             | (vitamins, ...) to compensate for deficiencies is fine, or
             | at least, not terrible.
             | 
             | And I also believe that "the appropriate number of
             | calories" is the tricky part. Hunger mechanisms are
             | supposed to regulate this, but they are not adapted to
             | modern society, where rich food is plentiful. Hence the
             | psychological aspect, which Ozempic targets.
        
       | mgh2 wrote:
       | *Original article submitted to HN:
       | https://www.eviemagazine.com/post/american-heart-association...
        
         | dang wrote:
         | Yes, when we change the URL I almost always post the original
         | link in the thread - I did that at
         | https://news.ycombinator.com/item?id=41957788 but of course
         | these things can get lost in the shuffle
        
       | gurjeet wrote:
       | TL;DR from the fine article:
       | 
       | Summary
       | 
       | The idea that saturated fats cause heart disease, called the
       | diet-heart hypothesis, was introduced in the 1950s, based on
       | weak, associational evidence. Subsequent clinical trials
       | attempting to substantiate this hypothesis could never establish
       | a causal link. However, these clinical-trial data were largely
       | ignored for decades, until journalists brought them to light
       | about a decade ago. Subsequent reexaminations of this evidence by
       | nutrition experts have now been published in >20 review papers,
       | which have largely concluded that saturated fats have no effect
       | on cardiovascular disease, cardiovascular mortality or total
       | mortality. The current challenge is for this new consensus on
       | saturated fats to be recognized by policy makers, who, in the
       | United States, have shown marked resistance to the introduction
       | of the new evidence. In the case of the 2020 Dietary Guidelines,
       | experts have been found even to deny their own evidence. The
       | global re-evaluation of saturated fats that has occurred over the
       | past decade implies that caps on these fats are not warranted and
       | should no longer be part of national dietary guidelines.
       | Conflicts of interest and longstanding biases stand in the way of
       | updating dietary policy to reflect the current evidence.
        
         | loeg wrote:
         | Can't tldr this article without including the author's name and
         | reputation, and that many of the representations made are
         | false. In particular, this statement is false:
         | 
         | > [nutrition experts] have largely concluded that saturated
         | fats have no effect on cardiovascular disease, cardiovascular
         | mortality or total mortality
        
       | AStonesThrow wrote:
       | Doctors who prescribe medication to reduce your cholesterol is
       | like Geek Squad disabling your AV because you've got too many
       | viruses
        
       | butterlettuce wrote:
       | I've read that saturated fats from red meat get processed by our
       | gut creating a metabolite called "trimethlylamine N-Oxide"
       | (TMAOs) and that this is what increases one's risk for CVD.
        
       | reissbaker wrote:
       | For me personally there's a very clear link between saturated fat
       | and blood serum LDL and triglycerides: I had very high levels of
       | both despite exercising regularly, switched to a low saturated
       | fat diet with minimal other changes, and my LDL and triglycerides
       | dropped enormously and are now in the "good" range. I don't know
       | enough to know whether cholesterol actually increases heart
       | disease risk, but for me personally there's a clear diet link
       | between saturated fat and LDL cholesterol + triglycerides. YMMV!
       | I suppose something else in the high saturated fat diet could
       | have been causing the problem, but it certainly seems like a good
       | proxy metric for me at least.
        
       | naveen99 wrote:
       | There is a u shape to ldl levels and longevity just like with
       | bmi: https://pmc.ncbi.nlm.nih.gov/articles/PMC4908872/
       | 
       | By the guidelines nunbers, Low is worse than normal, "normal" is
       | low, a little high is protective when you have other
       | morbidities...
        
       | jqgatsby wrote:
       | I'm surprised there's no discussion here about the inflammatory
       | role of vegetable oils (aka seed oils). I think it's likely that
       | these oils are actually causing inflammatory diseases generally,
       | through a mechanism that isn't understood.
       | 
       | Anecdotally (fwiw), in my household my daughter had been
       | struggling with severe rashes that appeared to be triggered by
       | food. An elimination diet caused us to conclude that she is
       | highly reactive to vegetable oils (canola (rapeseed) oil,
       | sunflower seed oil and soybean oil have all been introduced as
       | food challenges and all produce a reaction within 3-6 hours)
       | 
       | We currently cook only with tallow and her symptoms have improved
       | considerably (we tried olive oil and avocado oil for awhile but
       | it was unclear on her)
       | 
       | As a challenge to anyone objecting to this comment, I ask you to
       | look up the history of canola oil and say whether such a
       | substance would be accepted into the food supply today.
       | 
       | And my question to everyone is, what is the mechanism by which
       | seed/vegetable oils could lead to rashes? The only theory I've
       | heard has been around omega-3/6 balance, but I am looking for
       | alternative theories. I conjecture it has something to do with
       | heating, as she isn't affected by ice cream containing these
       | oils.
        
         | mind-blight wrote:
         | My understanding is that just vegetable oils are generally bad
         | for cooking because of how they retain heat. Even if they have
         | a high smoke point, it's easier for them to get to it.
         | 
         | Have you doing that she has the same issue with coconut oil?
         | Specifically, the saturated ones that come in a jar?
        
         | lotsofpulp wrote:
         | > As a challenge to anyone objecting to this comment,
         | 
         | You are free to comment whatever you want, but I don't see any
         | evidence to support your hypothesis on a population wide basis.
         | 
         | >I ask you to look up the history of canola oil and say whether
         | such a substance would be accepted into the food supply today.
         | 
         | If you are referring to genetically modified rapeseed plants to
         | be herbicide resistant, then it would most definitely be
         | accepted into the food supply today. Genetically modifying
         | plants still happens all over the world.
        
         | mvellandi wrote:
         | I don't know about rashes and reactions. But in health circles,
         | seed oils are generally considered safe and retain higher
         | nutritional value if cold pressed. This makes them suitable at
         | least for salads, but not frying.
        
         | hollerith wrote:
         | Paul Saladino advocates a theory that humans cannot handle a
         | lot of linoleic acid in the diet: it decreases the performance
         | of membranes, particularly of mitochondria (which in turn
         | causes insulin resistance, obesity and other problems cause by
         | chronic lack of ATP).
         | 
         | Saladino says that it would have been impossible for an
         | ancestral human (particularly in Northern Eurasia where meat
         | from grass-eating animals constituted the majority of calories)
         | to get more than about 3% of calories as linoleic acid whereas
         | the US average is now about 11%. Sunflower seed oil for example
         | is 67% linoleic. corn oil, 53%, soybean oil, 52%. (Most of the
         | omega-6 fatty acid in the human diet is linoleic acid.)
         | 
         | Here is Paul Saladino explaining it:
         | 
         | https://www.youtube.com/watch?v=j75kc5qamXs
        
           | aeries wrote:
           | Paul Saladino isn't a credible source of information or
           | theories. He's a non-practicing psychiatrist and social media
           | influencer who's gotten rich making contrarian videos and
           | selling supplements.
        
             | hollerith wrote:
             | I've learned a lot from people who make Youtube videos for
             | a living.
        
               | daveguy wrote:
               | To be fair, there's a difference between "people who make
               | YouTube videos for a living" and people who make videos
               | to spout contrarian "theories" so they can sell snake
               | oil.
        
               | alfiopuglisi wrote:
               | Well, at least they don't sell seed oil :)
        
               | aeries wrote:
               | Watching Youtube videos can make us _believe_ we
               | understand a topic better, but that 's not necessarily
               | the case. And without a good understanding of that topic
               | to begin with, it's hard to know why we're wrong.
               | 
               | Imagine watching a super compelling Youtube video
               | explaining why dinosaurs never existed, and so you now
               | think that's a credible hypothesis. You would probably
               | know more facts about dinosaurs and paleontology than the
               | average person, but I'd argue that your understanding of
               | dinosaurs has actually gone down.
               | 
               | I see a similar thing happening here. You and Paul are
               | able to cite lots of facts about Linoleic Acid. But
               | there's a whole body of experimental human research
               | showing that, if anything, LA-rich oils probably slightly
               | _improve_ insulin sensitivity, inflammation, lipids etc.
               | But Paul either isn 't aware of this or chooses not to
               | show you because it contradicts his claims. So you're
               | left with the wrong impression about LA and seed oils,
               | despite thinking that your understanding has gone up.
        
         | aeries wrote:
         | Except the human studies we have suggest that seed oils are
         | probably not inflammatory. A few examples are listed in this
         | video: https://www.youtube.com/watch?v=-xTaAHSFHUU
        
           | meiraleal wrote:
           | It is important to remember that the title of this post is
           | "Saturated fat: the making and unmaking of a scientific
           | consensus".
        
             | cthalupa wrote:
             | And the author of the article has a long history of
             | misrepresenting science and has direct financial incentive
             | to push her specific view.
             | 
             | https://www.thelancet.com/journals/lancet/article/PIIS0140-
             | 6...
             | 
             | The BMJ got in trouble for believing her and had to issue
             | retractions because of it:
             | 
             | https://www.theverge.com/2015/10/26/9616122/bmj-nina-
             | teichol...
             | 
             | There is no evidence that Nina Teicholz should be given the
             | benefit of the doubt when it comes to her arguments and
             | plenty of evidence that she should be treated with
             | skepticism.
        
               | meiraleal wrote:
               | Behaving like bullies trying to prevent people that agree
               | with the author to discuss isn't in the spirit of this
               | forum.
        
               | exe34 wrote:
               | > Except the human studies we have suggest that seed oils
               | are probably not inflammatory. A few examples are listed
               | in this video:
               | https://www.youtube.com/watch?v=-xTaAHSFHUU
               | 
               | which part of that do you consider bullying? is it any
               | opinion that goes against the underdog?
        
         | cthalupa wrote:
         | > I'm surprised there's no discussion here about the
         | inflammatory role of vegetable oils (aka seed oils).
         | 
         | Because there's very little scientific evidence to be concerned
         | about seed oils themselves and a lot to show that they're fine
         | to good for you.
         | 
         | If you want to talk specifically about inflammation, there's
         | not really any evidence that inflammatory markers in humans are
         | increased by seed oils themselves, e.g.
         | https://www.ahajournals.org/doi/10.1161/01.ATV.0000163185.28...
         | 
         | The idea that seed oils cause inflammation is largely based on
         | mechanistic studies that don't seem to bear out when the larger
         | and more complex ecosystem of our biology is introduced.
         | 
         | > And my question to everyone is, what is the mechanism by
         | which seed/vegetable oils could lead to rashes? The only theory
         | I've heard has been around omega-3/6 balance, but I am looking
         | for alternative theories.
         | 
         | Canola oil has high levels of omega-3s. If it was the omega-3/6
         | balance theory then it would be one of the best options for oil
         | use.
         | 
         | Individuals can have bad reactions for a variety of reasons, of
         | course. And there is a very high correlation between seed oils
         | and food that is just generally shitty for you, so if you cut
         | them out of your diet you are also cutting a lot of garbage
         | out, which will likely have an impact independent of the oils
         | themselves, and this is likely what drives a good portion of
         | anecdotal positive experiences.
        
           | profmarshmellow wrote:
           | There are countless peer reviewed studies and articles on
           | both sides of the argument sure - but the sheer volume of
           | anecdotal evidence and the overwhelming consensus across 100K
           | and even 1M+ subreddits against seed oils is unique. You
           | don't see this level of unified backlash against most other
           | everyday substances.
        
         | throw_pm23 wrote:
         | Could it be some other chemical to blame that you are exposed
         | to day-to-day? With so many additives, preservatives,
         | colorants, detergents, cleaning products, cosmetics, perfumes,
         | paints, disinfectants, plastic packaging, synthetic clothing,
         | herbicides, pesticides, glues in furniture, car exhaust, rubber
         | dust, and other chemicals around us, canola oil would not be my
         | first guess of something causing rashes or allergies.
        
         | GeoAtreides wrote:
         | > there's no discussion here about the inflammatory role of
         | vegetable oils (aka seed oils)
         | 
         | that's because it's literally a 4chan /pol/ schizo theory
        
         | LarsDu88 wrote:
         | Your daughter might simply be allergic to a substance in one of
         | these oils and may not be reflective of the experience of the
         | population at large.
        
         | phkahler wrote:
         | My understanding is that the culprit is partially hydrogenated
         | oils (PHOs). Which are chemically the same thing (it seems?) as
         | polyunsaturated fats.
         | 
         | We need our carbon chains to be consistenty hydrogenated one
         | way or the other, but not with both types in one molecule.
        
         | ChumpGPT wrote:
         | I don't know if you're familiar with Ray Pete, but he writes
         | about seed oils and the affect they have on our health.
         | 
         | https://raypeat.com/articles/articles/unsaturated-oils.shtml
         | 
         | You said that you suspect it is the heating of the oils, but
         | even the oil found in ice creme has been heated somewhere in
         | the process unless it is cold pressed. Can she eat sun flower
         | seeds, olives or avocado without a reaction? Have you tried
         | coconut oil as an alternative?
        
         | scellus wrote:
         | Although not probable in this case as far as I know: if
         | vegetable oils seem to cause problems for you, you should be
         | aware of sitosterolemia (phytosterolemia), caused by rare
         | mutations in genes ABCG5 and ABCG8. It needs to be homozygous
         | for symptoms.
         | 
         | (I have it, discovered by a full-genome sequencing by myself,
         | accidentally around the age of 50.)
        
       | cmiller1 wrote:
       | Sort of meta-question: why do nutrition takes from grifters and
       | quacks like this spread so well particularly among the Hacker
       | News community while I see few articles about normal science-
       | based nutrition?
        
         | loeg wrote:
         | There is some contrarianism bias. Going against the grain feels
         | more interesting and intellectually stimulating.
        
         | tpush wrote:
         | Engineers disease. All nutrition threads on HN are complete
         | train wrecks of nonsense. I wish dang would ban them all
         | outright.
        
         | cthalupa wrote:
         | I'm someone who was once taken in by a lot of this nonsense.
         | They're good at finding a handful of studies they can present
         | in a way that seems convincing, and couple that with the
         | general mistrust people have for the modern diet, and you've
         | set the stage quite well. Further prevent people from realizing
         | that no nutritional scientist anywhere is suggesting that the
         | shit we shovel into our mouths daily is the right course of
         | action. Next, present them with diets that necessarily result
         | in caloric restriction, along with cutting out one or two of
         | the half dozen awful things we eat, and have people see
         | personal success in their weight going down, lipid markers
         | improving, etc., from where they were prior when they were
         | eating the absolute worst sort of diet they could.
         | 
         | Now they seem like people who are renegades fighting against
         | the establishment for the good of personal health.
         | 
         | It all unravels once you start really digging in to things, but
         | if you don't have the time or inclination for it, them
         | appearing as a guest on a podcast and presenting you with this
         | snazzy package specifically designed to lead you astray is
         | really coupled with some testimonials from people touting it's
         | efficacy makes a compelling case.
        
       | addicted wrote:
       | Why are all these articles by Nina Teicholz.
       | 
       | There's nothing "unmade" in the scientific opinion. It's her
       | opinion because she insists that saturated fat is good, but
       | provides no scientific evidence. Almost all scientific studies
       | and scientists (including the authors of the few studies she
       | might quote, because she often distorts them including completely
       | presenting the opposite of what they demonstrate) disagree with
       | her saying.
       | 
       | And yeah, she's not a scientist, does no scientific research
       | herself, and has no particular training in this area.
        
         | xchip wrote:
         | She is not saying it is good, she is saying we can't conclude
         | it is bad.
        
       | tuukkah wrote:
       | An alternative mechanism for how some foods deteriorate
       | cardiovascular and brain health depends on how foods are cooked:
       | https://en.wikipedia.org/wiki/Advanced_glycation_end-product
       | 
       | "Dietary advanced glycation products intake is associated with
       | dementia" https://news.ycombinator.com/item?id=41209509
       | 
       | "A database for dietary AGEs and associated exposure assessment"
       | https://news.ycombinator.com/item?id=41962796
        
         | ta988 wrote:
         | AGEs could also simply be markers of poor lifestyle.
        
           | tuukkah wrote:
           | Sure, and especially if seared steaks and other high-dAGE
           | foods are considered as a marker of poor lifestyle.
           | 
           | But if you are saying it's just correlation you're wrong,
           | because the research has also described the mechanism.
           | Wikipedia has a nice list of the effects:
           | https://en.wikipedia.org/wiki/Advanced_glycation_end-
           | product...
           | 
           | > _" In the context of cardiovascular disease, AGEs can
           | induce crosslinking of collagen, which can cause vascular
           | stiffening and entrapment of low-density lipoprotein
           | particles (LDL) in the artery walls. AGEs can also cause
           | glycation of LDL which can promote its oxidation. Oxidized
           | LDL is one of the major factors in the development of
           | atherosclerosis."_
           | 
           | > _" AGEs have been implicated in Alzheimer's
           | Disease,cardiovascular disease, and stroke. The mechanism by
           | which AGEs induce damage is through a process called cross-
           | linking that causes intracellular damage and apoptosis."_
           | 
           | (AGE is a bad search term but the term glycotoxin is used as
           | well.)
        
       | krona wrote:
       | No mention of the French paradox:
       | 
       | > _the paradoxical epidemiological observation that French people
       | have a relatively low incidence of coronary heart disease (CHD),
       | while having a diet relatively rich in saturated fats,[1] in
       | apparent contradiction to the widely held belief that the high
       | consumption of such fats is a risk factor for CHD._
       | 
       | https://en.wikipedia.org/wiki/French_paradox
        
         | chasebank wrote:
         | This is true for salt too.
         | 
         | "Intersalt, a large study published in 1988, compared sodium
         | intake with blood pressure in subjects from 52 international
         | research centers and found no relationship between sodium
         | intake and the prevalence of hypertension. In fact, the
         | population that ate the most salt, about 14 grams a day, had a
         | lower median blood pressure than the population that ate the
         | least, about 7.2 grams a day. In 2004 the Cochrane
         | Collaboration, an international, independent, not-for-profit
         | health care research organization funded in part by the U.S.
         | Department of Health and Human Services, published a review of
         | 11 salt-reduction trials. Over the long-term, low-salt diets,
         | compared to normal diets, decreased systolic blood pressure
         | (the top number in the blood pressure ratio) in healthy people
         | by 1.1 millimeters of mercury (mmHg) and diastolic blood
         | pressure (the bottom number) by 0.6 mmHg. That is like going
         | from 120/80 to 119/79."
         | 
         | [0] https://www.scientificamerican.com/article/its-time-to-
         | end-t...
        
           | alfiopuglisi wrote:
           | 7.2 grams a day is still a lot. Low-sodium diets aim for less
           | than 3 grams a day, and it is not that difficult to go even
           | lower. Whether a near-zero sodium intake is good or not, it's
           | another can of worms, but a study looking at a huge-salt diet
           | vs. a high-salt diet does not look very useful.
        
             | tonymet wrote:
             | Before refrigeration sodium consumption was 10x
        
         | paulpauper wrote:
         | I think it's a combination of low-stress lifestyle and
         | demographics. Or differences of reporting. I am skeptical that
         | there is a genotypical protection to heart disease unique to
         | the French.
        
           | fwip wrote:
           | The claim is not that French people are resistant to heart
           | disease. It is a datapoint that reality may not fit the "fat
           | -> heart disease" model.
        
         | tonymet wrote:
         | "The French paradox" is preposterous. Rather than re-assessing
         | the "low fat" model, the approach was to call French nutrition
         | a "paradox". Resolving the paradox itself should have been done
         | before presenting the low fat model as a fact.
        
       | tonymet wrote:
       | It's probably better off if we don't give a handful of biased
       | people control over the diets of millions. Maybe it is better to
       | make decisions locally from personal connections. Maybe the
       | transmission of knowledge through local groups had the positive
       | effect of a sort of charcoal filter for knowledge. A bit of
       | humility could be good for us. We spent all this time building
       | and abusing a global authoritarian control network without ever
       | considering the side effects.
        
       ___________________________________________________________________
       (page generated 2024-10-27 23:01 UTC)