18 ms·

Saturated fat: the making and unmaking of a scientific consensus (2022)

184 points by mgh2 2y ago

dang 2y ago
We changed the URL from https://www.eviemagazine.com/post/american-heart-association-was-paid-procter-gamble-heart-disease-saturated-fat-seed-oils-sugar 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 2y ago
  https://en.wikipedia.org/wiki/Evie_Magazine https://en.wikipedia.org/wiki/Evie_Magazine
- JumpCrisscross 2y ago
  I think that story was actually better than this paper, which appears to have been authored by a controversial figure.
  - dang 2y ago
    I'm open to changing it back but that would be just as controversial, no? because it's about the same work.
robotnikman 2y ago
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 2y ago
  > 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 2y ago
  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.CD011737.pub3/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
  - tsimionescu 2y ago
    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 2y ago
      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).
      - tsimionescu 2y ago
        The 17% result is for overall reduction of SFA consumption on CHD, and is statistically significant (per the standards of nutrition science). The 21% difference when replacing SFA with PUFA between subgroups is not statistically significant, and neither is the 16% reduction for reducing SFA with carbs, so they should be ignored. The study only finds this modest 17% risk of CHD events from reduced consumption of SFAs. As noted elsewhere, this is contradicted by other studies, one of which you cite, which find that SFA reduction is not protective if SFA is substituted with CHO (only if it is substituted with PUFA). Overall, there is no good concluaion to be made, other than that there is a tiny effect from consuming less SFAs, maybe.
dang 2y ago
Related: Saturated fat: the making and unmaking of a scientific consensus - https://news.ycombinator.com/item?id=33942840 https://news.ycombinator.com/item?id=33942840 - Dec 2022 (6 comments)
ericyd 2y ago
The only trendy food advice I'll ever follow is Michael Pollan's: eat food, not too much, mostly plants.
- thefz 2y ago
  I remind this motto as bell but he should have put emphasis on "food you made"
  - jvanderbot 2y ago
    His definition of food is narrower than just edible things. I recall the book discussed processed vs more "raw" foods.
    - frereubu 2y ago
      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 2y ago
    He does, the above was a misquote: what he says is "eat real food". Making it yourself helps ensure that.
    - ericyd 2y ago
      It's not a misquote unless he misquoted himself https://www.nytimes.com/2007/01/28/magazine/28nutritionism.t.html https://www.nytimes.com/2007/01/28/magazine/28nutritionism.t...
- gushogg-blake 2y ago
  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.
KempyKolibri 2y ago
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-big-fat-surprise-a-critical-review-part-1/ https://thescienceofnutrition.wordpress.com/2014/08/10/the-b...
- readthenotes1 2y ago
  Are there any similar problems with this essay? I am pretty sure I've heard much of this before ...
  - KempyKolibri 2y ago
    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 https://news.ycombinator.com/item?id=41958014
- nograpes 2y ago
  Thank you for providing this very helpful and needed context. I was indeed getting very excited.
- valval 2y ago
  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 2y ago
sparrc 2y ago
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 2y ago
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 2y ago
  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.CD011737.pub3/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
  - greentxt 2y ago
    "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?
tomohawk 2y ago
[flagged]
- GrantMoyer 2y ago
  This is insane. To be clear, it's quite possible for a temporary elimination diet to aleviate unexplained symptoms, for instance from an unknown food allergy or intolerance. But then you need to slowly reintroduce foods to find which specific food causes the problem, otherwise your diet is bound to be nutritionally deficient. Eliminating all plants from your diet permanently is insane.
  - tomohawk 2y ago
    I get that alot. If you only eat plants, people think its a bit quirky maybe, but fully accepted. But stop eating them and get great results, people can't handle it.
    - maxk42 2y ago
      It's true. I ran into a friend of my wife's yesterday who is a nurse. The topic of food came up and I mentioned I haven't eaten any plants in over two years. She snidely remarked "How's that constipation going for you?" She's 150 lbs overweight and looks 15 years older than her age. Meanwhile, I lost 20 lbs and cleared up a bunch of medical problems. (Including constipation.) People love to sit on their high horses and make snide remarks while evidence is staring them right in the face. It's wild.
    - GrantMoyer 2y ago
      The reasons one diet is typically accepted and the other isn't is because the two diets are materially different. It's possible to have a nutritionally complete diet of only plants where the vast majority of the nutrients are naturally occurring in the food. The same is not true of a diet without plants; it's not possible to have a nutritionally complete diet without plants without a significant portion of nutrients coming only from supplementation.
elawler24 2y ago
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.
- tomp 2y ago
  what did you eliminate, i.e. what were you eating before? eggs, milk, cheese/yogurt (fermented diary), meat, processed meat?
  - el_benhameen 2y ago
    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 2y ago
    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.
    - deleted 2y ago
      [deleted]
    - geoka9 2y ago
      Maybe try whey isolate?
    - 2y ago
readthenotes1 2y ago
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 2y ago
  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/2017/07/SCS-White-Paper.THI_.8-1-17.pdf 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.CD011737.pub3/full#CD011737-sec-0036 https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
  - snapplebobapple 2y ago
    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.
jvanderbot 2y ago
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 2y ago
  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 2y ago
    More than simply a marker, it's a causal risk factor for ASCVD.
profsummergig 2y ago
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 2y ago
  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 2y ago
    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 2y ago
    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/ https://peterattiamd.com/belindabeck/
ano-ther 2y ago
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 2y ago
  And also why it is so easily compromised by commercial interests.
  - s1artibartfast 2y ago
    Most of the lies come from the government, which has its own comprimises
- GuB-42 2y ago
  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 2y ago
mgh2 2y ago
*Original article submitted to HN: https://www.eviemagazine.com/post/american-heart-association-was-paid-procter-gamble-heart-disease-saturated-fat-seed-oils-sugar https://www.eviemagazine.com/post/american-heart-association...
- dang 2y ago
  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 https://news.ycombinator.com/item?id=41957788 but of course these things can get lost in the shuffle
gurjeet 2y ago
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 2y ago
  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 2y ago
Doctors who prescribe medication to reduce your cholesterol is like Geek Squad disabling your AV because you've got too many viruses
butterlettuce 2y ago
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 2y ago
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.
- deleted 2y ago
  [deleted]
- jodrellblank 2y ago
  > "switched to a low saturated fat diet with minimal other changes" Does that mean switched fat to non-fat, or switched saturated fat to other types of fat? It seems that would be an important distinction for threads like this.
naveen99 2y ago
There is a u shape to ldl levels and longevity just like with bmi: https://pmc.ncbi.nlm.nih.gov/articles/PMC4908872/ 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…
- KempyKolibri 2y ago
  Because LDL drops when you have cancer, or a heart attack. That is, the U shape is a result of reverse causation. When you look at longitudinal data there’s no U shape - it’s straight as an arrow. Higher LDL-c -> more heart disease.
  - deleted 2y ago
    [deleted]
jqgatsby 2y ago
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 2y ago
  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 2y ago
  > 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.
  - jqgatsby 2y ago
cmiller1 2y ago
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 2y ago
  There is some contrarianism bias. Going against the grain feels more interesting and intellectually stimulating.
- tpush 2y ago
  Engineers disease. All nutrition threads on HN are complete train wrecks of nonsense. I wish dang would ban them all outright.
- cthalupa 2y ago
  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.
  - KempyKolibri 2y ago
    I was also taken in by this kind of stuff, and you’ve hit the nail on the head here.
addicted 2y ago
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 2y ago
  She is not saying it is good, she is saying we can't conclude it is bad.
tuukkah 2y ago
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 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 https://news.ycombinator.com/item?id=41209509 "A database for dietary AGEs and associated exposure assessment" https://news.ycombinator.com/item?id=41962796 https://news.ycombinator.com/item?id=41962796
- ta988 2y ago
  AGEs could also simply be markers of poor lifestyle.
  - tuukkah 2y ago
    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#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 2y ago
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 https://en.wikipedia.org/wiki/French_paradox
- chasebank 2y ago
  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-the-war-on-salt/ https://www.scientificamerican.com/article/its-time-to-end-t...
  - alfiopuglisi 2y ago
    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 2y ago
      Before refrigeration sodium consumption was 10x
tonymet 2y ago
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.
deleted 2y ago
[deleted]
davebrown10 2y ago
There is no such thing as scientific consensus. In a 2003 lecture at the California Institute of Technology Michael Crichton said, "Let’s be clear: the work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right, which means that he or she has results that are verifiable by reference to the real world. In science consensus is irrelevant. What is relevant is reproducible results. The greatest scientists in history are great precisely because they broke with the consensus. There is no such thing as consensus science. If it’s consensus, it isn’t science. If it’s science, it isn’t consensus. Period." https://www.aei.org/carpe-diem/michael-crichton-explains-why-there-is-no-such-thing-as-consensus-science/ https://www.aei.org/carpe-diem/michael-crichton-explains-why...
- KempyKolibri 2y ago
  I hate this Crichton quote so much. It gets thrown around all the time and no one thinks about how demonstrably false it is. Science obviously has plenty to do with consensus. When an evolutionary scientist publishes a paper, do they have to reference or recapitulate the theory of evolution? No, because that position is scientific consensus. Ditto for the hypothesis that smoking increases cancer risk. Consensus doesn’t mean “impossible to change”, it just means it is generally agreed upon. If some evidence about smoking and cancer comes out down the line, the consensus can change. It’s still the consensus, though.
  - meiraleal 2y ago
    > I hate this Crichton quote so much. You seem to hate lots of things and this subject makes you desperate to call yourself a specialist. There are 3 days you have been desperately trying to shutdown discussions in this thread. What is your problem?
    - KempyKolibri 2y ago
      In what way am I shutting down discussion? I’m just participating in it. There’s a great deal of misinformation on this thread that could lead people to make lifestyle decisions that would put them at risk. Don’t see why there’d be an issue in discussing the evidence behind this misinformation so people can come to their own, hopefully informed, decision instead of a misinformed one. I’m not interested in poor attempts at mind reading (“this subject makes you desperate to call yourself a specialist”) but I’m happy to discuss the evidence on this subject if you’d like.
latedoomer 2y ago
The link between saturated fat and LDL cholesterol is extremely clear. Far from coming from low-quality studies, the relationship has been observed in RCT metabolic ward studies. The best data you can get on the acute effects of diet and we are talking hundreds of these experiments all observing the same relationship. Does high LDL cause heart disease? That is probably less clear, I am not a scientist, so I really don't know what the latest is on this. LDL is present in Atherosclerotic plaques so it's not crazy to think it plays a role. If I was to guess, as a complete non-expert, low-fiber intake and inflammation probably play a role in turn LDL into atherosclerosis.
- KempyKolibri 2y ago
  I’d say the evidence on LDL and atherosclerosis is even clearer than the SFA evidence. The EAS consensus paper is really good, I’d recommend giving it a read: https://academic.oup.com/eurheartj/article/38/32/2459/3745109 https://academic.oup.com/eurheartj/article/38/32/2459/374510...

184 points by mgh2 2y ago

dang 2y ago

We changed the URL from https://www.eviemagazine.com/post/american-heart-association-was-paid-procter-gamble-heart-disease-saturated-fat-seed-oils-sugar 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 2y ago
https://en.wikipedia.org/wiki/Evie_Magazine https://en.wikipedia.org/wiki/Evie_Magazine
JumpCrisscross 2y ago
I think that story was actually better than this paper, which appears to have been authored by a controversial figure.
- dang 2y ago
  I'm open to changing it back but that would be just as controversial, no? because it's about the same work.

robotnikman 2y ago

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 2y ago
> 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 2y ago
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.CD011737.pub3/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
- tsimionescu 2y ago
  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 2y ago
    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).
    - tsimionescu 2y ago
      The 17% result is for overall reduction of SFA consumption on CHD, and is statistically significant (per the standards of nutrition science). The 21% difference when replacing SFA with PUFA between subgroups is not statistically significant, and neither is the 16% reduction for reducing SFA with carbs, so they should be ignored. The study only finds this modest 17% risk of CHD events from reduced consumption of SFAs. As noted elsewhere, this is contradicted by other studies, one of which you cite, which find that SFA reduction is not protective if SFA is substituted with CHO (only if it is substituted with PUFA). Overall, there is no good concluaion to be made, other than that there is a tiny effect from consuming less SFAs, maybe.

dang 2y ago

Related: Saturated fat: the making and unmaking of a scientific consensus - https://news.ycombinator.com/item?id=33942840 https://news.ycombinator.com/item?id=33942840 - Dec 2022 (6 comments)

ericyd 2y ago

The only trendy food advice I'll ever follow is Michael Pollan's: eat food, not too much, mostly plants.

thefz 2y ago
I remind this motto as bell but he should have put emphasis on "food you made"
- jvanderbot 2y ago
  His definition of food is narrower than just edible things. I recall the book discussed processed vs more "raw" foods.
  - frereubu 2y ago
    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 2y ago
  He does, the above was a misquote: what he says is "eat real food". Making it yourself helps ensure that.
  - ericyd 2y ago
    It's not a misquote unless he misquoted himself https://www.nytimes.com/2007/01/28/magazine/28nutritionism.t.html https://www.nytimes.com/2007/01/28/magazine/28nutritionism.t...
gushogg-blake 2y ago
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.

KempyKolibri 2y ago

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-big-fat-surprise-a-critical-review-part-1/ https://thescienceofnutrition.wordpress.com/2014/08/10/the-b...

readthenotes1 2y ago
Are there any similar problems with this essay? I am pretty sure I've heard much of this before ...
- KempyKolibri 2y ago
  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 https://news.ycombinator.com/item?id=41958014
nograpes 2y ago
Thank you for providing this very helpful and needed context. I was indeed getting very excited.
valval 2y ago
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 2y ago

sparrc 2y ago

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 2y ago

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 2y ago
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.CD011737.pub3/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
- greentxt 2y ago
  "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?

tomohawk 2y ago

[flagged]

GrantMoyer 2y ago
This is insane. To be clear, it's quite possible for a temporary elimination diet to aleviate unexplained symptoms, for instance from an unknown food allergy or intolerance. But then you need to slowly reintroduce foods to find which specific food causes the problem, otherwise your diet is bound to be nutritionally deficient. Eliminating all plants from your diet permanently is insane.
- tomohawk 2y ago
  I get that alot. If you only eat plants, people think its a bit quirky maybe, but fully accepted. But stop eating them and get great results, people can't handle it.
  - maxk42 2y ago
    It's true. I ran into a friend of my wife's yesterday who is a nurse. The topic of food came up and I mentioned I haven't eaten any plants in over two years. She snidely remarked "How's that constipation going for you?" She's 150 lbs overweight and looks 15 years older than her age. Meanwhile, I lost 20 lbs and cleared up a bunch of medical problems. (Including constipation.) People love to sit on their high horses and make snide remarks while evidence is staring them right in the face. It's wild.
  - GrantMoyer 2y ago
    The reasons one diet is typically accepted and the other isn't is because the two diets are materially different. It's possible to have a nutritionally complete diet of only plants where the vast majority of the nutrients are naturally occurring in the food. The same is not true of a diet without plants; it's not possible to have a nutritionally complete diet without plants without a significant portion of nutrients coming only from supplementation.

elawler24 2y ago

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.

tomp 2y ago
what did you eliminate, i.e. what were you eating before? eggs, milk, cheese/yogurt (fermented diary), meat, processed meat?
- el_benhameen 2y ago
  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 2y ago
  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.
  - deleted 2y ago
    [deleted]
  - geoka9 2y ago
    Maybe try whey isolate?
  - 2y ago

readthenotes1 2y ago

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 2y ago
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/2017/07/SCS-White-Paper.THI_.8-1-17.pdf 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.CD011737.pub3/full#CD011737-sec-0036 https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
- snapplebobapple 2y ago
  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.

jvanderbot 2y ago

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 2y ago
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 2y ago
  More than simply a marker, it's a causal risk factor for ASCVD.

profsummergig 2y ago

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 2y ago
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 2y ago
  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 2y ago
  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/ https://peterattiamd.com/belindabeck/

ano-ther 2y ago

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 2y ago
And also why it is so easily compromised by commercial interests.
- s1artibartfast 2y ago
  Most of the lies come from the government, which has its own comprimises
GuB-42 2y ago
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 2y ago

mgh2 2y ago

*Original article submitted to HN: https://www.eviemagazine.com/post/american-heart-association-was-paid-procter-gamble-heart-disease-saturated-fat-seed-oils-sugar https://www.eviemagazine.com/post/american-heart-association...

dang 2y ago
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 https://news.ycombinator.com/item?id=41957788 but of course these things can get lost in the shuffle

gurjeet 2y ago

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 2y ago
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 2y ago

Doctors who prescribe medication to reduce your cholesterol is like Geek Squad disabling your AV because you've got too many viruses

butterlettuce 2y ago

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 2y ago

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.

deleted 2y ago
[deleted]
jodrellblank 2y ago
> "switched to a low saturated fat diet with minimal other changes" Does that mean switched fat to non-fat, or switched saturated fat to other types of fat? It seems that would be an important distinction for threads like this.

naveen99 2y ago

There is a u shape to ldl levels and longevity just like with bmi: https://pmc.ncbi.nlm.nih.gov/articles/PMC4908872/ 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…

KempyKolibri 2y ago
Because LDL drops when you have cancer, or a heart attack. That is, the U shape is a result of reverse causation. When you look at longitudinal data there’s no U shape - it’s straight as an arrow. Higher LDL-c -> more heart disease.
- deleted 2y ago
  [deleted]

jqgatsby 2y ago

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 2y ago
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 2y ago
> 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.
- jqgatsby 2y ago

cmiller1 2y ago

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 2y ago
There is some contrarianism bias. Going against the grain feels more interesting and intellectually stimulating.
tpush 2y ago
Engineers disease. All nutrition threads on HN are complete train wrecks of nonsense. I wish dang would ban them all outright.
cthalupa 2y ago
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.
- KempyKolibri 2y ago
  I was also taken in by this kind of stuff, and you’ve hit the nail on the head here.

addicted 2y ago

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 2y ago
She is not saying it is good, she is saying we can't conclude it is bad.

tuukkah 2y ago

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 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 https://news.ycombinator.com/item?id=41209509 "A database for dietary AGEs and associated exposure assessment" https://news.ycombinator.com/item?id=41962796 https://news.ycombinator.com/item?id=41962796

ta988 2y ago
AGEs could also simply be markers of poor lifestyle.
- tuukkah 2y ago
  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#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 2y ago

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 https://en.wikipedia.org/wiki/French_paradox

chasebank 2y ago
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-the-war-on-salt/ https://www.scientificamerican.com/article/its-time-to-end-t...
- alfiopuglisi 2y ago
  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 2y ago
    Before refrigeration sodium consumption was 10x

tonymet 2y ago

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.

deleted 2y ago

[deleted]

davebrown10 2y ago

There is no such thing as scientific consensus. In a 2003 lecture at the California Institute of Technology Michael Crichton said, "Let’s be clear: the work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right, which means that he or she has results that are verifiable by reference to the real world. In science consensus is irrelevant. What is relevant is reproducible results. The greatest scientists in history are great precisely because they broke with the consensus. There is no such thing as consensus science. If it’s consensus, it isn’t science. If it’s science, it isn’t consensus. Period." https://www.aei.org/carpe-diem/michael-crichton-explains-why-there-is-no-such-thing-as-consensus-science/ https://www.aei.org/carpe-diem/michael-crichton-explains-why...

KempyKolibri 2y ago
I hate this Crichton quote so much. It gets thrown around all the time and no one thinks about how demonstrably false it is. Science obviously has plenty to do with consensus. When an evolutionary scientist publishes a paper, do they have to reference or recapitulate the theory of evolution? No, because that position is scientific consensus. Ditto for the hypothesis that smoking increases cancer risk. Consensus doesn’t mean “impossible to change”, it just means it is generally agreed upon. If some evidence about smoking and cancer comes out down the line, the consensus can change. It’s still the consensus, though.
- meiraleal 2y ago
  > I hate this Crichton quote so much. You seem to hate lots of things and this subject makes you desperate to call yourself a specialist. There are 3 days you have been desperately trying to shutdown discussions in this thread. What is your problem?
  - KempyKolibri 2y ago
    In what way am I shutting down discussion? I’m just participating in it. There’s a great deal of misinformation on this thread that could lead people to make lifestyle decisions that would put them at risk. Don’t see why there’d be an issue in discussing the evidence behind this misinformation so people can come to their own, hopefully informed, decision instead of a misinformed one. I’m not interested in poor attempts at mind reading (“this subject makes you desperate to call yourself a specialist”) but I’m happy to discuss the evidence on this subject if you’d like.

latedoomer 2y ago

The link between saturated fat and LDL cholesterol is extremely clear. Far from coming from low-quality studies, the relationship has been observed in RCT metabolic ward studies. The best data you can get on the acute effects of diet and we are talking hundreds of these experiments all observing the same relationship. Does high LDL cause heart disease? That is probably less clear, I am not a scientist, so I really don't know what the latest is on this. LDL is present in Atherosclerotic plaques so it's not crazy to think it plays a role. If I was to guess, as a complete non-expert, low-fiber intake and inflammation probably play a role in turn LDL into atherosclerosis.

KempyKolibri 2y ago
I’d say the evidence on LDL and atherosclerosis is even clearer than the SFA evidence. The EAS consensus paper is really good, I’d recommend giving it a read: https://academic.oup.com/eurheartj/article/38/32/2459/3745109 https://academic.oup.com/eurheartj/article/38/32/2459/374510...