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I agree with you. This article also mentions they're focusing on fats/saturated fats; which is also a terrible focus.

The real danger is not fat, even saturated/trans-fats, but starches and sugar. The increase in these types of carbohydrates in products like baby formula is actually leading to obesity in infants!

Excess sugar can stress arteries and damage them. Cholesterol is carried to these artier by lipids (LDLs and HDLs, which are not actually cholesterol, but proteins that carry it through your bloodstream). If you eat a lot of sugar, cholesterol can build up between the walls of arteries as they fix the damage. They can eventually break down the wall, releasing plaque into the bloodstream and potentially causing heart complications.

I highly recommend Dr. Lustig's video (UCTV) to learn more:

https://www.youtube.com/watch?v=dBnniua6-oM

A few years back I switched to a keto normal fat/very low carb (excluding fiber) diet. I've lost weight, gained energy and have felt a lot better. Of course this isn't for everyone. Some people have a body type that lends itself to higher carb intake (I knew a runner who'd eat 30 bananas a week) and as always do your research, consult with your doctor, dietitian, etc. before drastic changes in your diet.

It's a common myth that Adkins died of his own diet. He didn't, and Reuters rededicated their column implying that he did. I honestly wonder if the obesity epidemic would have gone down today if the world didn't dismiss his ideas, or the ideas of many nutritionist for decades before him that made similar claims about the dangers of sugar.

It's also a myth that runners need a high carb diet. I was a competitive distance runner for many years with a high carb diet and I'm confident that my performance suffered because of it. You're cells become much more efficient at using energy as you train, so you really don't need to eat that many calories at all. I was running 80+ miles per week, with a not above average calorie intake (for Americans), and my weight was stable.

There's a certain irony in calling something a myth based on your personal anecdote.

Personal anecdotes are considerably more valuable to the individual that generalized truths. Every human body is unique and while trends and generalizations matter, they do not matter as much as empirical observed facts. Much more so in the context of personal health.

> Personal anecdotes

> observed facts

These are not the same thing.

You're forgetting all the biases (& fallacies) which may or may not have affected the experience or the memory leading to the anecdote. These biases (& fallacies) are detectable or the lack of them is verifiable, with the scientific method.

I'm not denying an anecdote is not valuable to the individual. It is, for the individual who made the anecdote; not the rest of us, not the readers.

I'm also will admit I, too, use anecdotal evidence. But that does not mean one has strong evidence when they do; they don't, and neither do I.

I feel like waving my hands around in the air while running around screaming.

The bullshit that's been pushed on us for decades about cholesterol isn't science.

And to add to that, I've never heard any anecdotal evidence that goes "I went on a low cholesterol diet and my symptoms improved".

The scientific method is valuable. Science as it is practiced...? Let's just say it's reputation has been tarnished.

What is this 'bullshit'? There are studies that show correlations between LDL cholesterol and risk of heart attacks (happy to show you some if you're curious).

It's true that we're still making sense of how to operationalize those observations (restrictive diet, exercise, statin therapy, etc). This doesn't make the science worthless; it's just an intermediate step in this particular area of research.

> There are studies that show correlations between LDL cholesterol and risk of heart attacks (happy to show you some if you're curious).

Why wouldn't you? It seems like it would be unambiguously helpful both in general for the thread, and specifically for your argument.

For evidence that the lowering of LDL cholesterol lowers the risk of heart attacks, though, the evidence can't just be an association between heart attacks and naturally high cholesterol, which could obviously both spring from the same cause. An association between low cholesterol diets and heart attack rates, or good evidence that statins lowered mortality would both be interesting.

When disproving a need, an anecdote is pretty effective.

Except nobody is claiming all runners need a high carb diet. If anyone actually claimed that it was that most runners would benefit from a high carb diet (I have no idea if anyone actually makes this claim scientifically).

"most [runners] would benefit" is a pretty weak and unhelpful assertion. If we instead go with "almost all [runners] would benefit" then the anecdote is pretty good evidence against it.

No it's not. Most is quite a strong assertion.

> If we instead go with "almost all would benefit" then the anecdote is pretty good evidence against it.

No, one anecdote is not pretty good [scientific] evidence against anything.

I can give you an anecdote about how I drove through red lights multiple times. That does not mean you should follow the example.

Why not? You have no idea about the circumstances. I was actually talking about driving a bike, I was a teenager, and there was barely (if any) traffic. There's pro and cons there, but what matters is I omitted the details. Hence, YMMV. Plus, the statistical evidence is too small (sample size is one). Good luck reproducing the outcome, too.

Its the same in our runner's example. There's simply hardly any -if any- evidence presented to even make the anecdotal claim. Which still lacks any statistical evidence.

What anecdotal evidence can lead to is scientific research. But we should not conclude on the outcome yet. We must keep an open mind, accept on a method and test circumstances, and gain statistical relevance.

It is absolutely mind blowing, btw, how much 'scientific' research these days is not statistical relevant yet gets passed good grades (and yields the paper) at say college & universities. I'm not sure if its incompetence or laziness or lack of time or lack of money. I've even witnessed this first hand recently when my significant other was completing an assignment for her higher education degree which I was reviewing. Four interviews lead to a conclusion. Which, yes, is anecdotal ;)

> I can give you an anecdote about how I drove through red lights multiple times.

As evidence for what? If you're trying to disprove an assertion that everyone running a red light gets hit, it's good evidence.

> You have no idea about the circumstances. I was actually talking about driving a bike

Assume good faith.

Plenty of people make that claim, just search carbohydrate loading. The scientific reasoning is very simple. Aerobic exercise performance is limited by the rate of oxygen uptake, turning fats into usable energy takes considerably more oxygen than it does for CHO. You can in a single race/session exhaust your glycogen stores, but the supply of fats is essentially limitless. So for ideal performance you want to maximize your glycogen stores before an event, and for long ones, take additional CHO during, though rate of consumption is usually significantly higher than replenishment through digestion if you are going at all fast.

That point when you have exhausted your glycogen stores is what they call bonking. Now you can fine-tune your low carb diet to hopefully have enough glycogen at any point to sustain you through an exercise session (more realistic for running than cycling) but everyone else just eats a high-carb diet.

Dr. Tim Noakes of "Lore of Running" fame agrees. Not everybody is happy about that though http://foodmed.net/2016/05/03/noakes-exposed-real-beef-dieti...

The average American probably eats 60-70% carbs.

They would do well on more like 25% carbs aka Paleo.

As a distance runner, I don't perform well at 25% carbs. I need more like 40% carbs. So not "high carb", but "higher carb then a sedentary person needs".

Paleo is crap nonsense, but yes, the typical American high-carb diet is bad news.

Edit: Where "paleo" is defined roughly as "eating only foods that [I think] were available ~10,000 years ago": http://www.abc.net.au/science/articles/2013/09/10/3842158.ht...

The point of improving your running economy is not simply to reduce your ml O2/kg body mass/km and kcal/kg/km. That efficiency is nice, but the volume of oxygen you can inhale per minute doesn't change with your diet. A competitive distance runner would use increased efficiency not to reduce their dietary intake, but to increase their speed while maintaining a high-calorie diet.

It doesn't make sense that your cells could become more efficient to the degree that you "don't need to eat that many calories at all". Typical efficiency values are on the order of 1-1.5 kcal/kg/km, so your 80 mpw represents at least 1200 calories per day above baseline. Furthermore, this 1200 calories is just while running - after stopping the workout, you'll need to metabolize protein to help your muscles recover from exertion, and rebuild the glycogen stores which are larger in volume as a result of training, and which are more effectively drained as a result of training, and to rebuild the fat stores which you'll use on your long runs.

And yes, I may be biased in this reasoning due to the fact that I can sit here and type this out while munching on this delicious caramel popcorn and not worry about weight gain. There's no denying that it's high-calorie.

It's a common myth that Adkins died of his own diet.

And there was a whole bunch of nutritionists, doctors, "advocates" that went after him after he was six feet under.

I'd like to see those prominent people that went after him held to account now.

Why? The Atkins diet is based on nonsense and garbage. Just because conventional thinking about fats was wrong doesn't make alternative views automatically correct.

Your comment reminds me of a thread I read in the Primal Diet's forum. http://www.marksdailyapple.com/forum/forum/the-primal-bluepr...

Quite a few of them are having heart attacks: "So my first heart attack, 8 years after a stroke, was unexpected. My heart is determined to kill me. I've had at least 4 attacks, the last one keeping me in hospital 6 days"

Yet they still all stay on that diet, because of some convincing bloggers with no credentials as doctors or researchers and some conspiracy theories.

That thread is fucking scary.

It's about equal to doctors telling me to eat low sat fat and low cholesterol in 2016. The difference is doctors went to school for this and still are wrong.

Except it's not.

The reason we have these publications is that medicine is continually reevaluating its recommendations. Your statement is about as unreasonable as saying 'we don't need computers since sometimes computers stop working'.

Also, if you've ever spoken to a doctor about this, few would disagree that nutrition is an area where we still need more research.

Finally, ask yourself: in the absence of evidence, is a diet that avoids fats/cholesterol (which, a priori, are associated with heart vessel disease[1]) such a silly idea? Now, we know more, and are changing recommendations accordingly.

1. https://www.nhlbi.nih.gov/health/health-topics/topics/athero...

1b. (in case you don't trust a governmental source) https://en.wikipedia.org/wiki/Atherosclerosis

> The reason we have these publications is that medicine is continually reevaluating its recommendations.

The problem with nutrition is that for a very long period of time it wasn't, at all. It was citing ancient half-assed studies and anecdotes, never bothering to reassess or confirm them, and recommendations for low-salt and low-cholesterol are remnants of that time. I have no doubt that since a lot of that stuff has been called out, there will be money available for scientists to improve our understanding in the near future. My only irritation is that there are massive financial interests in maintaining the common wisdom, and that as a consequence, good findings will be ignored or suppressed.

As it is, the latest findings on salt and cholesterol are still not general knowledge, and the old common wisdom (as exemplified by popular science articles sparked by industry press releases, advice from primary care doctors) is nearly as dominant as it was before. A large part of that is that there's not been a lot of new advice to replace the old bad advice, leaving a hole, but the fact that statins and "diet" food are such a huge category creates a very dominant voice. That the loudest advocates for new findings come from faddish diets whose rationales reek of crank is also depressing.

> Finally, ask yourself: in the absence of evidence, is a diet that avoids fats/cholesterol (which, a priori, are associated with heart vessel disease[1]) such a silly idea?

We don't need science if we are just going to rely on easy, intuitive explanations of everything. Anybody can decide that eating fat makes you fat and fills your arteries with fat; you don't need any particular expertise for that.

> We don't need science if we are just going to rely on easy, intuitive explanations of everything. Anybody can decide that eating fat makes you fat and fills your arteries with fat; you don't need any particular expertise for that.

Science comes in when you want to know how plaque consisting of macrophages containing fats/cholesterol on arterial walls are embedded, and how macrophage uptake of fats/cholesterol is increased/decreased. There's current work in trying to understand the role of TMAO (primarily from animal foods) in increasing macrophage uptake of fats/cholesterol:

http://journals.lww.com/co-lipidology/Abstract/2016/04000/Tr...

The research in this area is promising enough that insurance may derive TMAO-based measures of heart health:

https://www.thepermanentejournal.org/files/Winter2015/Artery...

It is not that simple.

I for example have Thyrodid disease, and every single doctor I went, including "free" ones (paid with public money) and the most expensive ones (I tried paying a famous expensive guy that help celebrities), all of them failed on me a lot, to the point I am mostly self-treating, I go to the medic only as a "ritual" of sorts, but I read my own blood tests, and decide my own medication.

I tried with many of them, presenting research I found about it, and they all said it was bullshit, that researchers know nothing about medicine, that only experience matters, and so on...

Some told me that the wrong blood test numbers they use, are correct because the laboratory says so, and they just do what the lab says.

After hearing this multiple times, I decided to take my blood test papers, and read them carefully, and found they do quote their source for the numbers! It is there, written where the numbers came from.

Yet, when I went to read the source... the research paper I was trying to show the medics were there! So, the medics claim to follow the guidelines and the lab values, that in turn cite a bunch of research, yet the medics insist in using outdated values, and claiming the research is bullshit.

To be honest, I don't even understand what is going on, I met so many medics like that, that now I mostly refuse to go to medics and fix my health in the way I can, I now assume that medics are literally evil, since they intentionally lie to me, or are intentionally negligent and ignore the guidelines they claim to follow.

The few medics I trust, sometimes I go to them even when what I need from them is completely unrelated to their field (one medic that greatly helped me with my thyroid, was specialized in eye diseases, another one that helped me with vitamin D deficit, was an medic specialized in arthritis, and I don't even have arthrists, I went to that medic out of desperation after hearing good things about her...)

doctors do NOT go to school for nutrition. I assumed they knew about it, but turns out they don't. Most med schools don't teach any classes about nutrition or at most 1 or 2.

The link between LDL-C and CHD is widely accepted because there is strong evidence for it:

https://www.ncbi.nlm.nih.gov/pubmed/26780009

"SUMMARY: The naturally randomized genetic evidence suggests that LDL-C has a causal and cumulative effect on the risk of CHD, and that the clinical benefit of exposure to lower LDL-C is determined by the absolute magnitude of exposure to lower LDL-C independent of the mechanism by which LDL-C is lowered."

I don't understand your point about statins. The Bloomberg article you linked said statins were very effective in preventing heart attacks, just not necessarily due to their cholesterol-lowering effect. If that's the case, statins would still seem to be warranted in a lot of people.

For people who do not already have heart disease, statins have no apparent benefit. For people who have had a heart attack, statins are indeed useful. Not because of its cholesterol lowering effect, but due to its ability to dial back inflammation in arteries. For more on this here's yet another Bloomberg article on statins: https://www.bloomberg.com/news/articles/2008-01-16/do-choles...

So you are right, statins are indeed useful in a lot of people: people who have already had a heart attack. But that's not who statins are being marketed to. See here: http://www.nytimes.com/2008/07/08/health/08well.html?fta=y

Any argument you're trying to make is weakened when you use bloomberg or NYT as citations.

Why don't people link to the actual studies?

I would appreciate a citation where statins are reported to have no benefit in people who have not had a heart attack (termed 'primary prevention').

It's true that the evidence is not overwhelming (ref. 1) but I am not aware of studies that show no benefit.

[1] http://jamanetwork.com/journals/jama/article-abstract/258403...

The ACALM study found an association between high cholesterol and sharply reduced risk of death from 4 cancers. The numbers were large -- 22%, 43%, 47% and 30% lower risk of death. This may be due to wide-spread use of statins among those with high cholesterol. https://www.sciencedaily.com/releases/2016/07/160708123619.h...