3 ms·

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

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.
  - mrinfinite 2y ago
    [flagged]
    - KempyKolibri 2y ago
      Or perhaps I have experience in this field and thought it was worth creating an account to participate in the discussion?
      - mrinfinite 2y ago
        [flagged]
        KempyKolibri 2y ago
        Oh, I see. Unusual use of language, but sure, that’s fairly accurate. That said, I’m here to discuss the article and any related claims around the healthfulness of saturated fat. It may be that someone has some insight that I’m not aware of and I gain some additional knowledge. So I’m not purely here to point out misinformation (though there’s lots of it here!).
        meiraleal 2y ago
        [flagged]
  - KempyKolibri 2y ago
    A null finding in a study does not mean it “doesn’t matter”. Let’s take an extreme example: we want to know if exercise reduces mortality, so we randomise one arm of a cohort of 20 people to an exercise regime, while the other arm does nothing. After four weeks, we compare the death rate in each group. There’s no significant difference. Does this mean exercise “doesn’t matter” for mortality, or it’s in the “doesn’t affect category”? No, of course not - the finding was null because the timescale was too short and even then, the statistical power from a cohort of 20 is going to be very low. Likewise, if you look at the study characteristics, most of the studies were too short to find a significant outcome on an insensitive endpoint like CVD mortality or ACM. FWIW, Dayton 1967 had a followup of 8 years and did find significant increases in mortality endpoints in the SFA group, but those results are pulled towards null in the meta summation by the other, shorter studies. CVD events are more sensitive because they don’t require the participants to die of a heart attack in order to register as a data point. So no, there’s no lying or cherry picking going on here. In order for that to be the case, you’d have to argue that angina and non-fatal heart attacks are not negative health outcomes. If they are, then it’s demonstrably the case that SFA consumption is associated with negative health outcomes, and Nina is telling porkies. As for your accusation that I’m lying - what false claim did I make? Be specific.
snapplebobapple 2y ago
[flagged]
derbOac 2y ago
FWIW I think contrarian scientific viewpoints are important if they're rigorous, and Teicholz makes a reasonable case for the viewpoint that saturated fat reductions are unrelated to mortality. However, I don't think Teicholz herself is really being entirely "factual", bringing purported conflicts of interest into her discourse when it goes on on both sides. People have pointed out that her organization has its own history with this problem: https://thehill.com/blogs/congress-blog/healthcare/257353-coalition-is-full-of-baloney-on-nutrition-guidelines/ https://thehill.com/blogs/congress-blog/healthcare/257353-co.... That isn't addressing your question but I guess I disagree that Teicholz is just dispassionately presenting a rigorous argument, even if I find it compelling myself. Some of what she writes is sort of misleading (as that linked piece points out) even if I think her most cogent arguments are reasonable. A lot of her arguments hinge on how you see things like the Cochrane meta-analysis. Her sensitivity analysis with colleagues is compelling in dismissing the CVE result in that meta-analysis, but at the same time you can whittle away any effect if there's not a big enough N (in a sort of inverse form of p-hacking), so I'm not sure I'm entirely convinced either. Also as that piece points out, Teicholz seems dismissive of anything that's not mortality as an outcome, which I'm not sure I agree with. I'm sympathetic to Teicholz's arguments, I guess I just feel like she doesn't make them any more convincingly to me than those she criticizes. At this point for me personally my reading of the literature is that a lot of things are related to individual physiology, and I'm skeptical of a lot of blanket recommendations regarding nutrition. Reducing saturated fats has been good for me personally so I stick with that.
- KempyKolibri 2y ago
  I think dietary matrix is also important, so dietary patterns can be more useful than focusing on individual nutrients. Hard cheeses seem to be associated with positive health outcomes despite their SFA content, yet for butter the inverse is true. I think what I find frustrating about Nina is the number of fairly basic misreadings of the evidence she makes, despite having been corrected on it (and admitting the error) multiple times. She also grossly mischaracterises the results of studies repeatedly, so misleads laypeople into thinking the evidence base is more heterogenous than it really is. Additionally, she frequently makes contradictory statements regarding her own epistemology. For example, she states that observational studies can “only show association” and therefore cannot be used for causal inference, yet her twitter account is full of examples of her using observational data to draw causal inferences. You mention a sensitivity analysis of Hooper that she conducted. Do you have a link to that?

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.
- mrinfinite 2y ago
  [flagged]
  - KempyKolibri 2y ago
    Or perhaps I have experience in this field and thought it was worth creating an account to participate in the discussion?
    - mrinfinite 2y ago
      [flagged]
      - KempyKolibri 2y ago
        Oh, I see. Unusual use of language, but sure, that’s fairly accurate. That said, I’m here to discuss the article and any related claims around the healthfulness of saturated fat. It may be that someone has some insight that I’m not aware of and I gain some additional knowledge. So I’m not purely here to point out misinformation (though there’s lots of it here!).
        meiraleal 2y ago
        [flagged]
- KempyKolibri 2y ago
  A null finding in a study does not mean it “doesn’t matter”. Let’s take an extreme example: we want to know if exercise reduces mortality, so we randomise one arm of a cohort of 20 people to an exercise regime, while the other arm does nothing. After four weeks, we compare the death rate in each group. There’s no significant difference. Does this mean exercise “doesn’t matter” for mortality, or it’s in the “doesn’t affect category”? No, of course not - the finding was null because the timescale was too short and even then, the statistical power from a cohort of 20 is going to be very low. Likewise, if you look at the study characteristics, most of the studies were too short to find a significant outcome on an insensitive endpoint like CVD mortality or ACM. FWIW, Dayton 1967 had a followup of 8 years and did find significant increases in mortality endpoints in the SFA group, but those results are pulled towards null in the meta summation by the other, shorter studies. CVD events are more sensitive because they don’t require the participants to die of a heart attack in order to register as a data point. So no, there’s no lying or cherry picking going on here. In order for that to be the case, you’d have to argue that angina and non-fatal heart attacks are not negative health outcomes. If they are, then it’s demonstrably the case that SFA consumption is associated with negative health outcomes, and Nina is telling porkies. As for your accusation that I’m lying - what false claim did I make? Be specific.

snapplebobapple 2y ago

[flagged]

derbOac 2y ago

FWIW I think contrarian scientific viewpoints are important if they're rigorous, and Teicholz makes a reasonable case for the viewpoint that saturated fat reductions are unrelated to mortality. However, I don't think Teicholz herself is really being entirely "factual", bringing purported conflicts of interest into her discourse when it goes on on both sides. People have pointed out that her organization has its own history with this problem: https://thehill.com/blogs/congress-blog/healthcare/257353-coalition-is-full-of-baloney-on-nutrition-guidelines/ https://thehill.com/blogs/congress-blog/healthcare/257353-co.... That isn't addressing your question but I guess I disagree that Teicholz is just dispassionately presenting a rigorous argument, even if I find it compelling myself. Some of what she writes is sort of misleading (as that linked piece points out) even if I think her most cogent arguments are reasonable. A lot of her arguments hinge on how you see things like the Cochrane meta-analysis. Her sensitivity analysis with colleagues is compelling in dismissing the CVE result in that meta-analysis, but at the same time you can whittle away any effect if there's not a big enough N (in a sort of inverse form of p-hacking), so I'm not sure I'm entirely convinced either. Also as that piece points out, Teicholz seems dismissive of anything that's not mortality as an outcome, which I'm not sure I agree with. I'm sympathetic to Teicholz's arguments, I guess I just feel like she doesn't make them any more convincingly to me than those she criticizes. At this point for me personally my reading of the literature is that a lot of things are related to individual physiology, and I'm skeptical of a lot of blanket recommendations regarding nutrition. Reducing saturated fats has been good for me personally so I stick with that.

KempyKolibri 2y ago
I think dietary matrix is also important, so dietary patterns can be more useful than focusing on individual nutrients. Hard cheeses seem to be associated with positive health outcomes despite their SFA content, yet for butter the inverse is true. I think what I find frustrating about Nina is the number of fairly basic misreadings of the evidence she makes, despite having been corrected on it (and admitting the error) multiple times. She also grossly mischaracterises the results of studies repeatedly, so misleads laypeople into thinking the evidence base is more heterogenous than it really is. Additionally, she frequently makes contradictory statements regarding her own epistemology. For example, she states that observational studies can “only show association” and therefore cannot be used for causal inference, yet her twitter account is full of examples of her using observational data to draw causal inferences. You mention a sensitivity analysis of Hooper that she conducted. Do you have a link to that?