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Comment by noondip | Hacker News Reader

This presentation conveniently forgot to mention the ill effects, like cardiovascular disease, diabetes and cancer, resulting as a consequence of getting "80% of your calories from fat" and just how unsustainable this way of eating is. I much prefer a high-carb, low-fat vegan diet which has many more benefits and is overall healthier, more sustainable. It's strange people still go for low-carb, ketogenic diets given how much research shows its harms (for example, http://atkinsexposed.org/). It's also puzzling why one would not prefer the only diet clinically proven to reverse heart disease, the top cause of death in the US.

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We know far less about nutrition than we think we do. So if you know about risks and are careful about it, as far as I am concerned, there is nothing wrong with trying out various things. Regarding meat though, a lot of it is panic.

The problem is that it's very hard to conduct proper studies analysing this. 'Observational studies' are useless, because if I take a randomized group of meat-eaters versus vegans, of course the latter group will be significantly more healthy. Vegans are most likely more concerned about their health in general which means less smoking, less alcohol being consumed, healthier sleep, they buy higher quality food in general, due to lack of choice when out in public they cook more themselves (they won't stop at a fast food restaurant), et cetera ... and then there is the Placebo effect, which is very powerful and should not be under-estimated.

The scientific data is not as clear as one might think, and "nutritionists" in general are pseudo-scientists at their best since you can find a study for anything. If not with humans, then with mice, or maybe just some study with some cells. The same with internet sites by the way. And Atkins strictly speaking is not the same as the traditional Ketogenic Diet. Regarding books about nutrition for example, I happen to agree with this reviewer of "The China Study" (not the original one, you'll see) http://www.amazon.com/gp/customer-reviews/R3UR35AKTEYW43/ref...

If anyone wants to find serious information about nutrition, you should search for meta-studies, for example by the Cochrane Collaboration, and then you should read the abstract very carefully and not insert your wishful thinking into it.

There is a lot of damning evidence against eating animals and their products, yet none seems present against eating whole food, high-carb vegan. This much seems perfectly clear from scientific literature and has been for decades. The review you agree with has no citations, lacks credibility and makes dubious claims, like "Researchers still have trouble proving high cholesterol is associated with heart disease" which are patently false.

Atkins is high protein. Keto is high fat.

Well, I understand why the reviewer did not feel the need to make a scientific rebuttal out of a book review. It was not the reviewer who convinced me by the way, I had a look at this book myself. And the claims made compared to the studies cited to support those claims, it's fraudulent, I can't put it any other way.

I will not be able to convince you. Nutrition for many is such an integral part of who they are, that it is similar to criticising someone's religion and they are deep believers. If it works for you, I congratulate you (and I mean that, honestly). Nor do I want a debate in which everyone cites studies left and right that he has found on the internet, and then it is my job to go through dozens of them to find out exactly what they are saying and assess their methodological quality. I don't have the time right now, nor the motivation.

Let me just say: Science is hard, studying nutrition is very hard and especially regarding nutrition, there are so many things to think of and to take into account. And nutrition is also an individual thing, I doubt there is a one-size fits all. I was not the one speaking of truths where in reality we should be more careful about such claims.

You can't deny the fact certain foods, like processed meat, surely have a causal relationship to cancer, probably also heart disease and diabetes. As I've said before, the evidence against animal products and processed food in general is damning, but I've yet to find a single case study of someone getting fat off eating fruit, getting cancer from tofu, or becoming diabetic from eating too many vegetables.

>You can't deny the fact certain foods, like processed meat, surely have a causal relationship to cancer, probably also heart disease and diabetes

Based on what? Your gut feeling?

>getting cancer from tofu

There aren't case studies of people getting cancer from anything. There are studies of large population behavioral patterns and comparisons of cancer rates between patterns. So to check the tofu thing, you need people that consistently eat tofu compared to people that behave the same in other regards except for the tofu. That's very difficult because someone who eats tofu is generally going to have a significantly different diet from someone who doesn't.

https://www.iarc.fr/en/media-centre/pr/2015/pdfs/pr240_E.pdf is a good starting point.

The only evidence you provide is from a site that has clear biases against a diet which has a heavy non-vegan component. See the the Talk section of the Atkins page on wikipedia (search for the referenced website):

https://en.wikipedia.org/wiki/Talk:Atkins_diet

EDIT: for those downvoting. Look at the "Expert opinions" section, it has the details that others have given about the referenced site.

Sorry, what should I be looking at on there? If you want evidence for eating high-carb vegan over low-carb keto, read dietary guidelines from any non-profit nutritional or health authority. They all uniformly and strongly advise people away from animal products and on to low-fat starchy vegetables and fruit.

The "Expert opinions" section.

A few people discussing the website somehow invalidates it and its thousand-plus cited references? I don't think so.

Science isn't a democracy. If they are wrong, it doesn't matter how many people cited it. Look at what happened with the austerity paper.

What a strange view of science...

Hyper-responders.

(if anyone more knowledgeable can correct me, by all means do so, because I don't even know if this is true)

Supposedly, 1/3 of the population are hyper-responsive to dietary cholesterol - as in, consuming it raises their blood cholesterol. The other 2/3 can eat a high animal fat diet and see little to no change in blood cholesterol.

If true, those numbers are probably enough to clinically prove that a high fat diet is, in general, bad, while simultaneously giving millions of people the ability to go keto and say, "see, it's healthy, doctors don't know what they're talking about!"

The problem is that most people don't know if they're hyper-responders so promoting a high fat diet as healthy for everyone is irresponsible.

I'm just talking about cholesterol here. Avoiding red meat and eating plant fiber seem to provide benefits besides just lowering cholesterol.

Please don't link to websites with a clear agenda against Atkins. A search of pubmed will reveal the positive effects of Atkins and similar diets on weight-loss, regulating insulin levels, energy levels, etc.

>It's also puzzling why one would not prefer the only diet clinically proven to reverse heart disease, the top cause of death in the US.

Because it really isn't. The dietary recommendations we get from the USDA are soiled with non-scientific politics (see: http://goo.gl/bjk0Ik). Moreover, the state of nutritional epidemiology is absolutely abysmal -- even worse than social psychology -- so you have to be very careful about which papers you take seriously. The fact that it's still possible to publish studies relying on BMI is a disgrace, as is the fact that they're still applying linear models to body-mass/mortality curves, which are known to be U-shaped.

Moreover, if you were to go on pubmed instead of pro-vegan sites, you'd find plenty of papers that raise serious questions as to the link between various types of fat and CHD (not to mention glycemic load and all that other jazz). Here's a good starting point: http://goo.gl/ObRJAx

Assuming you're serious about health, rather than being vegan for reasons pertaining to animal rights, I encourage you to read both of these papers. In all seriousness, though, I doubt any of this will change your mind, as I strongly suspect you're vegan for other reasons.

Please, not Gary Taubes - see http://plantpositive.com/1-the-journalist-gary-taubes-1/

The second paper you've linked, the systematic review, is actually mostly in favor of a vegan diet. How does that raise questions about consuming animal fat and CHD?

We can criticize Taubes for his low-carb advocacy, but that article is only indirectly related to low-carb diets: it's about how the USDA standards were determined. Moreover, a rebuttal from a site called "plant positive" hardly stacks up against a peer-reviewed source... just saying...

The second paper draws distinctions between several forms of fat hilighting the weak evidentiary link between most fats and CHD. Trans fats are an obvious exception. I posted it in response to the claim that low-fat diets are almost certainly healthier. At the very least, that paper reveals that eating meat isn't incompatible with longevity and good health, contrary to claims you've been making all over this comments section.

But since you asked, here's what 5s on sci-hub revealed, clicking literally on the first two links without looking:

- http://goo.gl/tWB3LA // Maternal vegan diet causing a serious infantile neurological disorder due to vitamin B12 deficiency

- http://search.proquest.com.sci-hub.io/docview/197420736?pq-o... // yeah, ok, it's raw-vegan, but the B12 issue applies to all vegans (as noted in the refs of paper 1), especially since many can't seem to distinguish between B12 contents and bioavailable B12 ...

To be clear, my claim isn't that vegan diets are unhealthy. Rather, it's that we don't really know much due to the poor state of nutritional epidemiology, and that there's at least some evidence showing that veganism is really hard to get right.

The paper doesn't categorize low-fat vegan diets. The closest to it was recognized though: "only a Mediterranean dietary pattern was related to CHD in RCTs." (assuming saturated fat from meat was replaced with MUFAs or PUFAs).

Also, the B12 boogeyman? Just take a weekly supplement and be fine.

>The paper doesn't categorize low-fat vegan diets

The point wasn't to do a systematic review of the literature, but rather to counter your argument whereby those skeptical of the lipid hypothesis are equivalent to climate change deniers.

If you're actually interested in this stuff, I invite you to cultivate a genuine interest in the matter and use this nifty little link to get to all the paywalled papers your heart desires: http://sci-hub.io/

Further, I'd be happy to share what I think good guidelines are for separating wheat from chaff in nutritional epidemiology studies.

>Also, the B12 boogeyman? Just take a weekly supplement and be fine.

I mean no disrespect, but I find this answer to be as comical as it is widespread. In one fell swoop, you've (A) implied that vegan diets are not balanced (B) ignored the body of literature surrounding the (possible) toxicity of artificial vitamins (C) undermined your sustainability argument. Moreover, B12 is but one example; I again invite you to make liberal use of sci-hub, pubmed and google scholar.

> Also, the B12 boogeyman? Just take a weekly supplement and be fine.

Or just eat a couple spoonfuls of nutritional yeast every day.

What happens if you forget? Does your body tell you? Do you suddenly get hungry for nutritional yeast?

You may as well argue that people shouldn't live up North because they won't get enough vitamin D without supplementation.

No - I'm curious about this. Vitamin D deficiency and rickets is a slow-onset condition with a long period for remediation without permanent damage.

And no one ever died or had their brains explode from being on the South Beach Diet.

B12 deficiency manifests itself as acute and irreversible nervous system damage. It's a fair question - do you notice when you don't get enough B12?

Studies suggest vitamin D deficiency can cause brain and nerve damage.

You can say the same thing for magnesium deficiency - it causes permanent damage over time. Furthermore, 75% of the population is deficient in it, and it's nearly impossible to detect and diagnose a deficiency. Your body doesn't tell you "hey, time to eat some magnesium" the way it tells you to eat food. Chances are you (yes, you) are deficient in magnesium, unless you take a supplement.

Yes, B12 deficiency is serious, but there are other equally important vitamins and minerals that even non-vegetarians are deficient in, whose symptoms are difficult to detect, and require supplementation to fix.

Vegetarian diets don't have the monopoly on required supplementation.

I don't think it forgot to mention them. I think it's arguing against them.

I think the presenter who has an MD and a PhD from the WashU School of Medicine and a BA in Biology from Princeton (Of course I don’t think that having a diploma (or three) from a University makes what you say any more or any less true[0]) is arguing against the lipid hypothesis[1] and for the sugar hypothesis[2]: that sugar is actually the cause of all those ill effects.

There doesn't seem to be a consensus, though in the past the consensus seemed to be for the lipid hypothesis though that appears to be rapidly breaking down.

[0] Lots of people without degrees of any sort are saying the same thing, they’re all just as right/wrong

[1] https://en.wikipedia.org/wiki/Lipid_hypothesis

[2] https://proteinpower.com/drmike/2006/01/05/the-sugar-hypothe...

Interesting. Just a personal question - have you ever been clinically obese (25% body fat or more) for an extended period of time (2 or more years)?

> It's also puzzling why one would not prefer the only diet clinically proven to reverse heart disease, the top cause of death in the US.

Because bacon is delicious.

Mmmmmmmmm.

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