US government to withdraw longstanding warnings about cholesterol (2015)

https://www.washingtonpost.com/news/wonk/wp/2015/02/10/feds-poised-to-withdraw-longstanding-warnings-about-dietary-cholesterol/

by winteriscoming • 10 years ago

257 237 10 years ago

washingtonpost.com

conistonwater• 10 years ago

The full dietary guidelines being discussed appear to be here: https://health.gov/dietaryguidelines/2015/guidelines/

empath75• 10 years ago

There is so much that 'everybody knows' about nutrition that is pure bullshit peddled by farmers, agribusiness and processed food companies.

Just one example-- that fat causes heart disease. Pure nonsense pushed by the soda and sugar industry.

https://www.theguardian.com/society/2016/apr/07/the-sugar-co...

Just eat a balanced diet, don't overeat, and don't eat too much processed food and red meat, and you'll probably be fine.

zerofan• 10 years ago

'everybody knows' red meat is bad?

quakeguy• 10 years ago

Rastafari surely do.

tree_of_item• 10 years ago

"Just do it right" isn't very good advice.

And what exactly counts as "processed" food?

dade_3• 10 years ago

A simple answer is anything with the fibre removed, such as white flour & rice, and with artificial flavours and colours. No risk in eliminating these from your diet...

SilasX2• 10 years ago

Great points, they've misled us for so long about--

Just eat a balanced diet, don't overeat, and don't eat too much processed food and red meat, and you'll probably be fine.

Wait, what? Why is the evidence against red meat so much stronger than that against cholesterol or fat?

Edit: or processed food for that matter, although I grant that a higher prior as being bad because of how far it is from what we would have eaten in our ancestral environment (depending, of course, on what you count as processing).

delinka• 10 years ago

"Balanced diet" is the terminology that's honestly hard to define. Until we have that definition, "a variety of types of food" seems better to me. Here, let me offer a correction:

"Eat a variety of foods, avoiding large amounts of any one thing, and don't overeat; you'll probably be fine."

andy_ppp• 10 years ago

"Eat food. Not too much. Mostly plants."

- Michael Pollan

dkbrk• 10 years ago

don't eat too much ... red meat

I believe everything else you've said is correct. But the health effects of red meat and dietary saturated fats have not been unequivocally established.

There are studies saying it is harmful, there are studies saying it is not:

https://en.wikipedia.org/wiki/Beef#Health_concerns

The Harvard School of Public Health recommends consumers eat red meat sparingly as it has high levels of undesirable saturated fat.[34] This recommendation is not without controversy, though. Another study from The Harvard School of Public Health appearing in Circulation (journal) found "Consumption of processed meats, but not red meats, is associated with higher incidence of coronary heart disease and diabetes mellitus."[35]
This finding tended to confirm an earlier meta-analysis of the nutritional effects of saturated fat in The American Journal of Clinical Nutrition which found "[P]rospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of coronary heart disease or cardiovascular disease. More data are needed to elucidate whether cardiovascular disease risks are likely to be influenced by the specific nutrients used to replace saturated fat."[36]

daxorid• 10 years ago

And the injustice here is that no nutritionists or agribusiness executives will go to prison for murdering tens of millions of people prematurely.

Meanwhile, well, you know, Aaron Swartz.

sjg0073• 10 years ago

Sugar does and you can see this in the basic biochemistry of the TCA cycle. Too much sugar gets converted to fat!!

erikb2• 10 years ago

Yes, all that info may be b.s. but at the same time the same could be true about the articles who say it's b.s. Why believe one more than the other?

mistermann• 10 years ago

Interesting, why now I wonder?

pdq2• 10 years ago

Let me know when the government wakes up and inverts the food pyramid, so that breads and grains and carbs are scarce, rather than fats.

mkautzm6• 10 years ago

Carbohydrates are not a bad thing and are indeed an important part of health. The current suggested diet doesn't say, 'bread'. It specifically calls out Whole Grains, which a great deal of evidence suggests are a Good Thing. Suggesting that grains, or even carbs, are somehow worse than literal fat is misleading at best, and delusional at it's worst.

pdq2• 10 years ago

I'm referring to the original 1992 food pyramid: https://en.wikipedia.org/wiki/Food_pyramid_(nutrition)#/medi...

Fats, oils, sweets: sparingly
Bread, cereal, rice & pasta: 6-11 servings

Yes I am in the camp that believe fats and proteins are both much healthier than carbs, and especially refined sugars. The latest nutrition supports low carb diets, as can be seen with Atkins and Keto diets.

jdminhbg2• 10 years ago

The phrase "literal fat" shows just how successful the misguided low-fat crusade was: they don't even need any modifiers to show that they're "bad."

At any rate, it's very easy to design a diet for humans without grains in it that's healthy and that you can thrive on, but impossible to design one without fat. So in that respect at least, literal fat is better than grains.

will_brown• 10 years ago

Suggesting that grains, or even carbs, are somehow worse than literal fat is misleading at best, and delusional at it's worst.

Carbs/sugars trigger insulin production...fats don't do that. Just look at the Western diet and the substitution of fats with sugars in the food industry in the 70's and you will trace origins of type 2 diabetes that would begin appearing in children - yes, it used to be called adult onset diabetes - now over a million cases.

Carbs are not inherently bad, but there is no doubt way to much in the Western diet and from poor sources.

YCode• 10 years ago

Since 2011 they've been recommending MyPlate: https://choosemyplate-prod.azureedge.net/sites/default/files...

Raphmedia• 10 years ago

Do people eat fruits at each meals?

sjg0073• 10 years ago

This should happen but likely won't since carbs are more plentiful and easier to obtain.

epmaybe2• 10 years ago

The food pyramid hasn't existed for a number of years, thanks to a number of individuals including Michelle Obama.

Choosemyplate.gov is a great first step to changing the dietary habits of children.

blatherard• 10 years ago

This needs a (2015) added to it.

Perceptes• 10 years ago

February 2015, nonetheless. It's almost two years later. I'd like to hear what developments there have been on the topic since this was published.

dang• 10 years ago

Thanks! Added.

rcavezza• 10 years ago

<<< The new view on cholesterol in food does not reverse warnings about high levels of “bad” cholesterol in the blood, which have been linked to heart disease. Moreover, some experts warned that people with particular health problems, such as diabetes, should continue to avoid cholesterol-rich diets.

<<<The greater danger in this regard, these experts believe, lies not in products such as eggs, shrimp or lobster, which are high in cholesterol, but in too many servings of foods heavy with saturated fats, such as fatty meats, whole milk, and butter.

Here is my paraphrased takeaway:

Cholesterol you see in your blood results is still bad. Whole milk, butter, and fatty meats is still bad. Foods like eggs, shrimp, and lobster might be good.

I don't think this changes any of my mental models. The foods that I always thought of as "probably not great" are still classified as such, according to this article.

nether• 10 years ago

Whole milk, butter, and fatty meats is still bad

You're sure of that?

http://www.npr.org/sections/thesalt/2014/02/12/275376259/the...

My main takeaway:

"Almost every single nutrient imaginable has peer reviewed publications associating it with almost any outcome," John P.A. Ioannidis, a professor of medicine and statistics at Stanford and one of the harshest critics of nutritional science, has written.

ubercore2• 10 years ago

Even in that article, they say it's just associated with reduced obesity, and saturated fats in dairy are still associated with heart disease.

kalleboo• 10 years ago

For instance, here's a handy guide to what causes or cures cancer http://kill-or-cure.herokuapp.com/a-z/b

wallace_f• 10 years ago

"Almost every single nutrient imaginable has peer reviewed publications associating it with almost any outcome," John P.A. Ioannidis, a professor of medicine and statistics at Stanford and one of the harshest critics of nutritional science, has written.

This is an illuminating comment on the state of research, and it needs more awareness.

nkozyra• 10 years ago

Still really incomplete. Medium-chain-triglycerides, for example, are still listed as saturated fats but don't carry the same negative weight that long-chain fatty acids do.[1]

"Probably not great" food has vacillated greatly over the decades, eggs being the cliche example. Dietary cholesterol and blood cholesterol are often not directly connected.[2] The relationship between (any) saturated fats and blood cholesterol is not clearcut.

[1] http://www.metabolismjournal.com/article/S0026-0495(03)00070...

[2] https://www.ncbi.nlm.nih.gov/pubmed/22037012

watertom• 10 years ago

Of course then there is Linus Pauling who says that cholesterol has noting to do with heart disease, which he called chronic scurvy, insufficient L-ascorbic acid and lysine is the real underlying cause.

I'm throwing my lot in with Linus, he was as smart or smarter than probably anyone in history, and he wasn't making money from his discovery.

derenrich• 10 years ago

Not sure if you are joking, but Pauling was pretty wrong when talking about vitamin C. His ideas were repeatedly rejected by actual research studies and yet he kept pursuing vitamin C. I assign him very little credibility in this arena.

Also he was making money from the sale of his books.

erikb2• 10 years ago

Foods like eggs, shrimp, and lobster might be good.

You mean "might not be bad". There's a whole lot of gray area between "bad" and "good".

mapt• 10 years ago

Dietary cholesterol is now suspected to be essentially irrelevant to health. We know this because, among other things, some people eat diets with 10-100x as much cholesterol as some other people, and they don't immediately develop heart disease.

Blood cholesterol, on the other hand, seems to be essentially a thing the body does while storing excess quantities of fat. The obese will usually have high blood cholesterol, the non-obese will usually not have high blood cholesterol... whether they're on a zero-fat zero-cholesterol diet or not.

So basically, they're two different things: Long-term, blood cholesterol is mostly created endogenously independent of diet, and dietary cholesterol does not convert to blood cholesterol.

mescalito• 10 years ago

Interesting, for those who enjoy reading (which I guess are probably quite a lot) I'd recommend the big fat surprise[1], a very interesting book about this, which goes way beyond this article.

[1] http://thebigfatsurprise.com/

pcurve• 10 years ago

Just eat in moderation and try to maintain healthy weight.

The last time I checked, average woman in the U.S. is 5'4" but weighs 165lbs; average man clocks in at nearly 200lbs. We can do better.

sjg0073• 10 years ago

Sweet I'm above average!! ;)

clarkmoody• 10 years ago

Wouldn't it be nice if there were more government warnings and less restrictions / regulations?

Imagine if the FDA, instead of blocking new drugs for 10 years and $1B, it simply withheld its endorsement until satisfied by the clinical trials. Consumers could then take the government's recommendations into consideration when making a decision and drugs could get to market much faster.

The history of medical reversals -- and in this case, nutrition reversal -- shows that the government isn't magic.

A whole raft of restrictions could be converted to warnings and recommendations, freeing up industry to innovate and consumers to take a little more responsibility for themselves.

Imagine the history of the past few decades if the state had outlawed any foods with more than X% cholesterol. Or trans-fats. Or any of the other food fads over that time. It would have been terrible, especially now that the recommendation is reversed. The whole time, consumers were allowed to factor government warnings into their decisions, but food producers weren't breaking the law by selling foods with (X+1)% cholesterol.

throwaway2016a3• 10 years ago

Imagine if the FDA, instead of blocking new drugs for 10 years and $1B, it simply withheld its endorsement until satisfied by the clinical trials. Consumers could then take the government's recommendations into consideration when making a decision and drugs could get to market much faster.

I'd go one step further. Give the FDA competition. Have private companies (similar to UL for electronics) that can endorse and test drugs.

Scirra_Tom2• 10 years ago

Private companies have profit incentives. If a horrible substance comes to market they can be paid off to endorse it.

You can argue that no rational company that cares about its reputation would do such a thing, but history has shown time and time again - yes corporations do waive all consideration for public safety in lieu for money.

The government is the perfect institution to endorse safety of substances/drugs/whatever for use by it's citizens. That doesn't mean they are perfect though, but I would trust them a thousand times more than a corporation.

It's extremely wreckless to apply free market economic theories to things like this. In the real world, consumers and businesses are irrational.

alistairSH2• 10 years ago

That worked out really well for the banking industry. You really want a similar scheme for medical care?

mikepurvis• 10 years ago

Do not want. See the role of Moodys and S&P in the 2009 meltdown for what a profit motive does to the ability to "endorse" anything that has the potential to harm.

BurningFrog4• 10 years ago

Or have competition in the form of foreign FDA counterparts.

If the European/Japanese/Other Reputable Country authorities have approved a drug, it could be allowed it in the US, with a clear label, of course.

Foreign physiology and science is the same as American.

afterburner4• 10 years ago

Private corporations aren't magic either. And they don't even have to pretend to give a shit about society.

naasking2• 10 years ago

I'd go one step further. Give the FDA competition. Have private companies (similar to UL for electronics) that can endorse and test drugs.

Because that worked so well with risk analysis in finance. 2008 is calling.

greglindahl3• 10 years ago

Drug approvals are currently much better than nutrition studies. Your suggestion of allowing not-known-to-work "medicine" to be sold would return us to the era of patent medicines, which killed a lot of people. You can look at the supplements market to see people dying from a similar policy right now.

BurningFrog4• 10 years ago

Like anything else, you have to look at both costs and benefits of the alternatives.

The current extremely tough FDA approval process has the benefit you mention: Fewer people are injured by unsafe drugs.

But it also has a big (but harder to observe) cost: If disease X kills 1000 people/year, then each year a cure is delayed kills 1000 people.

The main argument against the current system is that it weighs the deaths of people in the first category vastly more than those in the second.

How many people the FDA process kills this way is hard to calculate, and you can find wildly different estimates. But most discussion assumes it doesn't even exist...

mkautzm6• 10 years ago

The science behind nutrition health is extremely complicated and expecting it to remain constant represent a total misunderstanding of how nutrition research is done and how results are determined.

The history of medical reversals -- and in this case, nutrition reversal -- shows that the government isn't magic.

What it shows is that nutrition science is hardly 'solved' and you'd be hard pressed to find a researcher in the field suggest otherwise.

A whole raft of restrictions could be converted to warnings and recommendations, freeing up industry to innovate and consumers to take a little more responsibility for themselves.

The problem with this is that the average consumer is both A) dumb, and B) doesn't know what they need. Alternative medicine skirts very cleanly around FDA regulation by not making any medical claims on it's product. They still market their product as a solution for various diseases and conditions, but they never make a formal claim. It's a $30,000,000,000 industry of people buying stuff that does nothing, or worse yet, can cause potential harm. To suggest their is no value in regulation of the drug markets is to suggest that people's health has no value. The defense of, 'well, people are responsible for their own decisions' doesn't hold any water when we know that the direct consequences of that mentality can be measured in literally tens of billions of dollars.

WillPostForFood4• 10 years ago

That is why people have been so slow to mobilize around climate change predictions.

BurningFrog4• 10 years ago

The problem with this is that the average consumer is both A) dumb, and B) doesn't know what they need

Note that the customer for prescription drugs is a licensed doctor.

wyager2• 10 years ago

If nutrition science "isn't solved", the government shouldn't be making laws and regulations based on it.

FrancoDiaz3• 10 years ago

The problem with this is that the average consumer is both A) dumb, and B) doesn't know what they need.

Unfortunately, a significant number of bureaucrats and statists would prefer consumers to be dumb (or at least say that they are) in order to maintain power.

Oh and let me guess, you're not one of the dumb ones....it's the other guys right? ;)

Alex3917• 10 years ago

Imagine if the FDA, instead of blocking new drugs for 10 years and $1B, it simply withheld its endorsement until satisfied by the clinical trials.

The way you'd like the FDA to work is literally the way it already works. You're allowed to buy basically any drug you want unless it's scheduled by the DEA. Companies just aren't allowed to market them as being effective for a specific disease without passing clinical trials.

Laforet• 10 years ago

Can doctors legally prescribe them without FDA approval? There are many niche drugs currently unavailable for therapeutic use in the USA because no current manufacturers hold an FDA certification.

Scirra_Tom2• 10 years ago

Wouldn't it be nice if there were more government warnings and less restrictions / regulations? ... A whole raft of restrictions could be converted to warnings and recommendations, freeing up industry to innovate

No, not without specific examples of how government regulations are a burden on innovation. Whenever people argue this point in industry X it always seems difficult to come up with concrete examples.

and consumers to take a little more responsibility for themselves.

Secondly, again no. Consumers are not rational machines who make rational decisions based on time spent researching what they are consuming.

WillPostForFood4• 10 years ago

I was just reading the new laws enacted for 2017 in California, which included a ban on powdered alcohol, even though it has never been for sale in the state. That's one concrete recent concrete example where a warning would have been a nice alternative.

badsock• 10 years ago

Just as an example: 9% of the cases of Idiosyncratic Drug-induced Liver Injury is self-harm caused by people taking non-regulated dietary supplements:

https://www.ncbi.nlm.nih.gov/pubmed/18955056

You have a theory that the average person will wisely assume the responsibility to vet the health effects of what they consume, but empirical reality disagrees with your theory. Right now people are injuring themselves with products at the margin of regulation.

There's a societal cost for lots of people injuring themselves, and offloading the responsibility of researching safety to the average consumer will cause fear and superstition, limiting people's willingness to try new products, and I would argue that that reduces innovation. Regulation in this area has been a net societal benefit.

azinman22• 10 years ago

Don't forget that marketing budgets for pharmaceuticals are also huge. The average person has no chance. The constant bombardment already means people go to their doctor asking for Rx by name even without understanding the medical need or if they're right for it. Now remove regulation... the warnings basically just blur into the background. Already we get so many warnings on prescriptions that they just turn into nothing because people become so habituated to them. It's identical to the paradox that is windows/browser security -- the more you warn, the more people just click through and ignore.

zdean• 10 years ago

The issue with non-regulated dietary supplements may well be caused by the current state of regulation (this is strictly my own opinion/observation).

In the current state of things, we've grown accustomed to seeing warnings when the government thinks there is a potential danger with a particular FDA regulated drug. So perhaps the lack of warnings with supplements is giving people a false sense of security about the dietary supplements...ie, "if they were dangerous, surely there'd be a warning". If, as the parent comment suggests, the paradigm shifts so that the government's position is one of several factors to consider, perhaps then people would look at supplements with a greater degree of caution and suspicion. In other words, changing the paradigm may change people's behavior in terms of how they approach both drugs and supplements.

spqr0a1• 10 years ago

Idiosyncratic Drug-induced Liver Injury (DILI) is only 13-20% of all DILI. The other ~80% being pharmacological. About 40% of all acute liver failure is caused by acetaminophen. http://www.nature.com/ajg/journal/v102/n11/full/ajg2007481a....

Meaning a single FDA approved over-the-counter drug is responsible for over 20 times as much liver failure as all dietary supplements. Some regulation may be beneficial but the current policies are clearly suboptimal.

dcosson• 10 years ago

I've been thinking recently about government regulations like this and about where it should end.

Why are we so sure that we can't trust people to make an educated decision about an experimental drug or any of the many other things we regulate, many of which only impact themselves and don't put the general public at risk in any way. Yet one of our most deeply held values is trusting them to make an educated decision about who should run the country. It's certainly not any less complex of a topic when you consider all of the policy areas that there are to evaluate politicians across.

baddox6• 10 years ago

You didn't show any evidence of the FDA being a net benefit. You only showed that the FDA probably could have reduced that specific type of liver injury by regulating those specific supplements. But the government is not magic, and the FDA almost certainly has also caused injuries by overly or erroneously regulating other things. I have no idea what the net effect is, but you certainly haven't shown it to be positive.

oh_sigh2• 10 years ago

What dietary supplements can cause liver injury?

lend0003• 10 years ago

And people will also choose to eat potato chips, not exercise, smoke, and drink heavily. You can't protect people from themselves, and even if it was an ethical government job to do so, i.e. take away people's freedoms because the government says it knows better, like with marijuana (I am REALLY humoring you, if you can't tell), there is no practical argument either. How much do you think your high estimate of X% who get sick by their own incompetence (which of course goes down significantly when people realize that they shouldn't blindly trust everything in our markets -- that blind, oft-misguided trust is another side effect of the FDA/USDA) will be DWARFED by the percentage of people saved by life saving drugs that make it to market faster/would otherwise be blocked. Do you know how many people the FDA has sentenced to die directly by rejecting appeals from terminally ill patients to get access to experimental drugs/procedures? Not to mention the indirect damage of delaying medicinal progress...

ageofwant4• 10 years ago

These kind of context-less banding about of figures always serve the point the bander is trying to make, and rarely the truth. It leaves out the fact, for example, that regulated medicine is responsible for the rest. If we exclude approved regulated alcohol, the liver damage caused by unregulated 'medicine' is almost noise.

Veratyr2• 10 years ago

You have a theory that the average person will wisely assume the responsibility to vet the health effects of what they consume, but empirical reality disagrees with your theory. Right now people are injuring themselves with products at the margin of regulation.

I know this is an incredibly callous opinion but isn't this natural selection at work?

People even go further and knowingly partake of substances known to be harmful (cigarettes). We don't stop them from that, why should we stop them from consuming medication that hasn't yet been deemed safe?

Educating and providing support for those that need it I agree with but if people freely and knowingly choose to act in a self destructive manner with a sound mind, I'm not convinced it benefits society or themselves to forcibly preserve their life.

BurningFrog4• 10 years ago

From your link:

    RESULTS: DILI was caused by a single prescription 
    medication in 73% of the cases, by dietary supplements 
    in 9%, and by multiple agents in 18%. More than 100 
    different agents were associated with DILI; 
    antimicrobials (45.5%) and central nervous system 
    agents (15%) were the most common.

    CONCLUSIONS: DILI is caused by a wide array of medications, 
    herbal supplements, and dietary supplements. Antibiotics are 
    the single largest class of agents that cause DILI.

So FDA approved drugs cause 73% of these liver injuries, while unregulated supplements cause 9%. I don't understand how that is an argument for FDA regulation?

anexprogrammer3• 10 years ago

<s>

Yes! We could replace those flawed and lobbied against restrictions with advice. The market would be free once again to innovate.

Bayer could once again offer Heroin as an addiction free drug. We could get long missed radium cures and snake oil. They could be free to advertise to their heart's content. They can tell us cigarettes are good for us.

The companies can be trusted to have our health at heart. They can spend adequately on SEO to ensure their messages are dominant. Silly government warnings and or indivduals having problems with side effects or Heroin forum posts can sensibly be lost in the far reaches of search.

</s>

Seriously? I can't think of anything more stupid, even though the system is horribly flawed.

Want to go back to food adulteration, and poisons sold as cures? Endless advertorials pushing pointless product? We have an entire vitamins and supplements industry that's pointless (and problematic) for most people.

Go read the history of those regulations and restrictions. I don't want the pre-drug and food adulteration acts world back, thank you very much. How is this the highest voted post?

asdfasdfa111122• 10 years ago

It was under basically the same regulatory regime that Purdue Pharma marketed Oxycontin 12-hour extended release as a drug unlikely to cause abuse.

It wasn't that long ago that Phen-Phen (sp?) was legally marketed and sold.

We currently allow prescription of extraordinarily strong methamphetamine to children, who often spend their formative years under the influence.

---

We still have a long ways to go.

nommm-nommm• 10 years ago

Ummm... Artifical transfats have already been outlawed. http://www.cnn.com/2015/06/16/health/fda-trans-fat/

tmuir• 10 years ago

You are describing a world in which all decisions made by all humans are informed by perfect logic. The beautiful paradox of such a world is that wouldn't require any government, or any other external system of control. Any external system of control in a perfectly logical and rational world would be unable to demonstrate any value whatsoever, as there would be no conflicts to resolve whatsoever.

Thus, in lieu of 100% of humans being 100% rational, 100% of the time, a nonzero amount of government, creating nonzero amounts of regulation it is an absolute necessity.

jwatte• 10 years ago

The strip mining of the public good that drug companies would do if all sales were allowed boggles the mind.

Such an open policy would only work if all information (including internal information proprietary to the maker) was available to inform buyers, and while I think a fully informed market w would be great, I don't see any real chance of that happening.

SixSigma• 10 years ago

Govt everywhere : "Don't be obese"

Result: highest rate of obesity in history

BeetleB• 10 years ago

A whole raft of restrictions could be converted to warnings and recommendations, freeing up industry to innovate and consumers to take a little more responsibility for themselves.

When I look at how little regard people have for this when taking supplements, I find it hard to believe they'll take more responsibility for themselves.

Not against all supplements myself, but once I learned how poorly controlled they are - how there is virtually no manufacturer I can trust who is actually giving me what the label claims (so many mg of nutrition per capsule, harmful ingredients not on the labeling, etc) - I pretty much stopped taking all of them. The risks outweigh the benefits.

jljljl• 10 years ago

"Eat food, not too much, mostly plants."

- Michael Pollan

jdminhbg2• 10 years ago

The oft-cited and never-defined Tautology Diet.

SwellJoe• 10 years ago

There is a whole book defining the quote above. It's a very enjoyable read, and reasonably well-cited.

Dylan168077• 10 years ago

Saying to eat a "balanced" diet is a tautology. Saying "do whatever, but mostly plants" is not.

kelukelugames• 10 years ago

My surgeon friend told me medical studies are like the bible. You can find a paper that says something is bad for you and another that says it is good for you. So just believe the one that makes you happier.

lkbm2• 10 years ago

You can definitely find contradictory studies. The solution is not to abandon research, but to recognize that A study means very little, unless it's a systematic review or meta-analysis (in which case it's a study of many studies).

Don't pick the one study that shows what you want. Pick all the studies and go with whatever the preponderance of evidence suggests. That's science, and it's by far our most effective and reliable way of learning useful and non-obvious truths about the world.

singularity20012• 10 years ago

that good insight needs to be put in a quotable format

known2• 10 years ago

Sounds like US is endorsing https://en.wikipedia.org/wiki/French_Paradox

d0mdo0ss• 10 years ago

The sugar industry has a history of lobbying public attention away from sugar and towards cholesterol. It has even enlisted places like Harvard School of Public Health on this task:

http://time.com/4485710/sugar-industry-heart-disease-researc...

https://www.theguardian.com/society/2016/apr/07/the-sugar-co...

thomasvarney723• 10 years ago

I recommend Peter Attia's (currently unfinished) series, "The straight dope on cholesterol". He's a surgeon interested in health and fitness. http://eatingacademy.com/?s=cholesterol

jordache• 10 years ago

oh so now butter is bad again? WTF. Can't believe anything the nutritionists put out.

petilon2• 10 years ago

This doesn't go far enough. That there is a link between high cholesterol and heart disease is only a hypotheses, not a scientifically proven fact. Lowering cholesterol does not necessarily lower heart disease. Read more here: http://www.nytimes.com/2008/01/27/opinion/27taubes.html

Because the link between excessive LDL cholesterol and cardiovascular disease has been so widely accepted, the Food and Drug Administration generally has not required drug companies to prove that cholesterol medicines actually reduce heart attacks before approval. See: http://www.nytimes.com/2008/01/17/business/17drug.html

Meanwhile drug companies are making billions selling cholesterol lowering medicines called statins. But lowering cholesterol using drugs is not useful. Read more about that here: https://www.bloomberg.com/news/articles/2008-04-15/heart-dis...

Not only that, these statins are dangerous drugs. Its side effects include loss of short term memory, for example. Read more about that here: https://www.scientificamerican.com/article/its-not-dementia-...

djsumdog2• 10 years ago

I agree with you. This article also mentions they're focusing on fats/saturated fats; which is also a terrible focus.

The real danger is not fat, even saturated/trans-fats, but starches and sugar. The increase in these types of carbohydrates in products like baby formula is actually leading to obesity in infants!

Excess sugar can stress arteries and damage them. Cholesterol is carried to these artier by lipids (LDLs and HDLs, which are not actually cholesterol, but proteins that carry it through your bloodstream). If you eat a lot of sugar, cholesterol can build up between the walls of arteries as they fix the damage. They can eventually break down the wall, releasing plaque into the bloodstream and potentially causing heart complications.

I highly recommend Dr. Lustig's video (UCTV) to learn more:

https://www.youtube.com/watch?v=dBnniua6-oM

A few years back I switched to a keto normal fat/very low carb (excluding fiber) diet. I've lost weight, gained energy and have felt a lot better. Of course this isn't for everyone. Some people have a body type that lends itself to higher carb intake (I knew a runner who'd eat 30 bananas a week) and as always do your research, consult with your doctor, dietitian, etc. before drastic changes in your diet.

It's a common myth that Adkins died of his own diet. He didn't, and Reuters rededicated their column implying that he did. I honestly wonder if the obesity epidemic would have gone down today if the world didn't dismiss his ideas, or the ideas of many nutritionist for decades before him that made similar claims about the dangers of sugar.

baron816• 10 years ago

It's also a myth that runners need a high carb diet. I was a competitive distance runner for many years with a high carb diet and I'm confident that my performance suffered because of it. You're cells become much more efficient at using energy as you train, so you really don't need to eat that many calories at all. I was running 80+ miles per week, with a not above average calorie intake (for Americans), and my weight was stable.

FrancoDiaz3• 10 years ago

It's a common myth that Adkins died of his own diet.

And there was a whole bunch of nutritionists, doctors, "advocates" that went after him after he was six feet under.

I'd like to see those prominent people that went after him held to account now.

adevine• 10 years ago

I don't understand your point about statins. The Bloomberg article you linked said statins were very effective in preventing heart attacks, just not necessarily due to their cholesterol-lowering effect. If that's the case, statins would still seem to be warranted in a lot of people.

petilon2• 10 years ago

For people who do not already have heart disease, statins have no apparent benefit. For people who have had a heart attack, statins are indeed useful. Not because of its cholesterol lowering effect, but due to its ability to dial back inflammation in arteries. For more on this here's yet another Bloomberg article on statins: https://www.bloomberg.com/news/articles/2008-01-16/do-choles...

So you are right, statins are indeed useful in a lot of people: people who have already had a heart attack. But that's not who statins are being marketed to. See here: http://www.nytimes.com/2008/07/08/health/08well.html?fta=y

tkyjonathan• 10 years ago

Your comment reminds me of a thread I read in the Primal Diet's forum. http://www.marksdailyapple.com/forum/forum/the-primal-bluepr...

Quite a few of them are having heart attacks: "So my first heart attack, 8 years after a stroke, was unexpected. My heart is determined to kill me. I've had at least 4 attacks, the last one keeping me in hospital 6 days"

Yet they still all stay on that diet, because of some convincing bloggers with no credentials as doctors or researchers and some conspiracy theories.

tekromancr• 10 years ago

That thread is fucking scary.

ggrothendieck• 10 years ago

The ACALM study found an association between high cholesterol and sharply reduced risk of death from 4 cancers. The numbers were large -- 22%, 43%, 47% and 30% lower risk of death. This may be due to wide-spread use of statins among those with high cholesterol. https://www.sciencedaily.com/releases/2016/07/160708123619.h...

dosomeresearch• 10 years ago

The link between LDL-C and CHD is widely accepted because there is strong evidence for it:

https://www.ncbi.nlm.nih.gov/pubmed/26780009

"SUMMARY: The naturally randomized genetic evidence suggests that LDL-C has a causal and cumulative effect on the risk of CHD, and that the clinical benefit of exposure to lower LDL-C is determined by the absolute magnitude of exposure to lower LDL-C independent of the mechanism by which LDL-C is lowered."

kazinator• 10 years ago

The greater danger in this regard, these experts believe, lies not in products such as eggs, shrimp or lobster, which are high in cholesterol, but in too many servings of foods heavy with saturated fats, such as fatty meats, whole milk, and butter.

Translation: the lobbyists for various polyunsaturated "edible plastics" are currently in the lead.

overgard• 10 years ago

The USG is frankly incompetent when it comes to this matter. I guess it's happy news that they're not creating more chaos but yay? Hollow victory

known2• 10 years ago

Current reference intake is 300 mg https://en.wikipedia.org/wiki/Dietary_Reference_Intake#Macro...

test_pilot• 10 years ago

Youtube is where most people get their dietary advice now. The most influential diet advice is coming from young attractive healthy looking people. Whatever they're eating seems to be working. Obviously most of these people won the genetic lottery, but they've also nurtured their body correctly with food and exercise.

This seems like a much better approach in convincing people what to eat anyway. Look at the results and imitate healthy people if you want to look and stay healthy.

galfarragem• 10 years ago

I use to look around in a naive way and take my conclusions:

- Grandfather, 89, ate everything moderately during his life, mostly organic. He evites fat and bread and walks every day. Low energy person.

- Grandmother, passed at 82, cancer. Same diet as my grandfather. Much less exercise though.

- Grandmother, 92, ate a lot until 50's, mostly organic, obese. Since then barely eats, mostly vegetables and yogurt. Right weight and good health. No exercise.

- Grandfather, passed at 71. Ate more fat than anyone I know. Death by heart attack or stroke. Very energetic person with a lot of exercise.

Can you see a pattern? I can't.

singularity20012• 10 years ago

The minimum sample size for any meaningful statistic is 7

mtw2• 10 years ago

For those who are curious, the 2015-2020 Dietary Guidelines is available here https://health.gov/dietaryguidelines/2015/resources/2015-202... (PDF)

Unfortunately it does not highlight the danger of sugar & processed food. Someone can follows these dietary guidelines and still be able to have a high intake of sugar, HCFS, processed food and all sorts of food chemicals (emulsifiers etc.), all prevalent in the american food industry, and get cardiovascular disease.

We are not going to reverse the obesity epidemic anytime soon!

dwc• 10 years ago

Dietary guidelines typically self-moderate to something that they think the populace has a chance of adopting. I.e., they don't want people to completely shrug it off as too drastic of a change.

I would like to see a different approach: show the actual best diet guidelines, and then explain which partial steps will do the most good. Or something like that. It's better to be up front with what's known and then proceed to harm reduction rather than telling people that these partial steps are where they should end up.

yellowgatorade• 10 years ago

Are there any studies showing that "processed food" is, on its own, dangerous? Or is the inherent danger largely due to the HFCS, sugar, and other items that are usually added in the process?

mtw2• 10 years ago

A few studies https://www.ncbi.nlm.nih.gov/pubmed/26514947 http://thorax.bmj.com/content/early/2016/11/25/thoraxjnl-201... http://cancerres.aacrjournals.org/content/early/2016/11/05/0... http://cebp.aacrjournals.org/content/4/8/895.short https://www.ncbi.nlm.nih.gov/pubmed/20479151

I am sure there is a meta-analysis somewhere but this would take a bit of time to find

calvano915• 10 years ago

"Unfortunately it does not highlight the danger of sugar"

From the guidelines: When added sugars in foods and beverages exceed 10 percent of calories, a healthy eating pattern may be difficult to achieve.

Third year nutrition undergrad. Was told that this recommendation will likely be reduced further as more future research justifies doing so.

For most people that follow the recommendations, their diet may not be optimal but it will be markedly improved from average, at least in regards to preventing chronic diseases that are among the top causes of death (CVD, diabetes, etc) and improving overall wellness/health.

I disagree that the recommendations do not sway people toward healthier/less processed foods. See Table 1-1.

fulldecent• 10 years ago

This is a link to a non-authoritative source. Could someone please provide a link to the authoritative source so that I may investigate by myself?

pombrand• 10 years ago

For those of you who still believe it's OK or even good to eat a lot of saturated fats, if you look at the studies it's not much of a controversy:" Whether saturated fat is a risk factor for cardiovascular disease (CVD) is a question with numerous controversial views.[1] Although most in the mainstream heart-health, government, and medical communities hold that saturated fat is a risk factor for CVD, some hold contrary beliefs." https://en.wikipedia.org/wiki/Saturated_fat_and_cardiovascul...

Anecdotally, I've read 50% of people who go on Keto see a huge 2-3x increase in triglycerides and LDL-P (Particle count as measured by NMR) - the #1 risk factor for cardiovascular disease. More LDL particles bouncing around in your arteries = bad. People with a condition that makes them break down more LDL have much less artheroscleriosis: http://www.nejm.org/doi/pdf/10.1056/NEJMoa054013 People with a condition that makes them have more LDL particles get more artheroscleriosis: https://en.wikipedia.org/wiki/Familial_hypercholesterolemia Read Peter Attila's exposition that goes in detail (eating cholesterol is fine though): http://eatingacademy.com/nutrition/the-straight-dope-on-chol... Keto could work, but it's a hyper-pro level high-risk diet requiring frequent blood work and still avoiding saturated fats keeping them primarily monounsaturated which makes it very hard to follow. Plus it sucks for weightlifting..

Surprisingly, very low fat diets might be great for you, it might not be the absolute macronutrient composition that matters, but rather the specifics of the nutrients (GI, fiber, other nutrients etc) and your genetic makeup: https://deniseminger.com/2015/10/06/in-defense-of-low-fat-a-... Scary correlations about saturated fats and neurodegenerative disease therein too.

Personally I'm sticking with a "balanced" ~10/45/45 carbs from protein, low GI carb/monounsaturated fat vegan diet - not wanting to risk side effects of any extreme (although I'm having to ensure adequate calcium, K2, D, B12 and DHA and EPA intake - If I didn't find it unethical to eat fish a pescetarian variety would likely be easier/healthier/less gassy). Tip for you vegetarians/vegans: look up low FODMAP foods; foodstuffs low in carbs indigestible in the small intestine which tend to produce more gas.

LargeCompanies• 10 years ago

Hmmm this was just on the homepage then quickly removed.. top of the page then boom gone? Any reason why this is?

Also I've been on statins since 37 after feeling my heart race and not being able to catch my breathe after being with girlfriend at the time. That was some scary stuff and after the statin and change of diet I no longer have those type of bouts anymore. So maybe it's my change in diet (cut out 75% fried food and sugar intake is 50% less) and the statin combined and or maybe the statin is just a placebo and my change is diet helped eliminate those heart racing attacks?

I had a lot of those attacks from 37 to about 39...im now 41 and haven't dealt with any such attacks unless I eat a say Five Guys or In and Out.

US government to withdraw longstanding warnings about cholesterol (2015)

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