4 ms·

Allow me to don my doctor hat and provide some comment here. I'll leave the statistical analysis to the mathematicians below. 1. The study was self-selected -

by robbiep 12y ago

Allow me to don my doctor hat and provide some comment here. I'll leave the statistical analysis to the mathematicians below. 1. The study was self-selected - we don't know to what degree. Did they place flyers in vegetarian recruiting grounds? 2. They explicitly state that they are not including 8 patients that experienced thrombotic or embolic events or had progression, blaming them on other factors. That may be the case, but it is not ok to exclude patients on that basis and report your adverse event as 1% due to that. 3. There is no marker of cardiac function provided in the study / we have no idea if the groups had similar baseline function. This is a critical point because amongst the 'non-adherent' group there is one patient who underwent a heart transplant. A heart transplant is a very rare procedure and is only reserved for extremely severe heart failure. If a patient in a study eventually underwent a heart transplant, that patient very likely had horrific cardiac function at the beginning of the trial. What is more telling is that such information could have been statistically provided very easily: They could have chosen to provide a summary of number of patients who had experienced infarcts; number of patients with aberrant ECG rhythms; number of patients on spironolactone (a medication reserved for use for late in heart failure); Left ventricular ejection fraction estimated from TTE; The list goes on. Instead they provide only the sexes, 'symptom reduction', and adverse events. In my opinion this study provides little more than anecdote that patients should switch entirely to a plant based diet, and at this point I would certainly not recommend a patient of mine to switch. However it should be studied in greater detail and it would be interesting if stronger evidence emerged.

acconrad 12y ago
I'm surprised you didn't point out that the diet itself was flawed. The basis of the plant-based diet was vegetables and fruits, and yet they explicitly excluded fructose. You can't have any fruits then! Nearly every fruit contains fructose in some appreciable amount, among the lowest in concentrations are raspberries and strawberries. Even vegetables have significant amounts of fructose, such as asparagus and tomatoes (though technically a fruit as well). I feel like with a study that self reports from it's patients, especially of this size, a diet this restrictive is nearly impossible to keep 24/7.

by robbiep 12y ago

acconrad 12y ago

I'm surprised you didn't point out that the diet itself was flawed. The basis of the plant-based diet was vegetables and fruits, and yet they explicitly excluded fructose. You can't have any fruits then! Nearly every fruit contains fructose in some appreciable amount, among the lowest in concentrations are raspberries and strawberries. Even vegetables have significant amounts of fructose, such as asparagus and tomatoes (though technically a fruit as well). I feel like with a study that self reports from it's patients, especially of this size, a diet this restrictive is nearly impossible to keep 24/7.