Saturated fat: the making and unmaking of a scientific consensus (2022)
47 comments
·October 26, 2024KempyKolibri
readthenotes1
Are there any similar problems with this essay? I am pretty sure I've heard much of this before ...
KempyKolibri
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
elawler24
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.
542458
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.
christophilus
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
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.
tomp
what did you eliminate, i.e. what were you eating before? eggs, milk, cheese/yogurt (fermented diary), meat, processed meat?
elawler24
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.
el_benhameen
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.
readthenotes1
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.
ano-ther
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.
profsummergig
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
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.
nradov
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
What are some no-brainer strategies to avoid the damage please? Thanks.
bitmasher9
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
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...
sparrc
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...
ericyd
The only trendy food advice I'll ever follow is Michael Pollan's: eat food, not too much, mostly plants.
thefz
I remind this motto as bell but he should have put emphasis on "food you made"
jvanderbot
His definition of food is narrower than just edible things. I recall the book discussed processed vs more "raw" foods.
frereubu
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".
mgh2
*Original article submitted to HN: https://www.eviemagazine.com/post/american-heart-association...
dang
Related:
Saturated fat: the making and unmaking of a scientific consensus - https://news.ycombinator.com/item?id=33942840 - Dec 2022 (6 comments)
jvanderbot
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.
gurjeet
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.
robotnikman
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
KempyKolibri
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...
JumpCrisscross
> 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.
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...