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Comment by evidence_first | Hacker News Reader

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

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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to follow the guidelines and the lab values, that in turn cite a bunch of research, yet the medics insist in using outdated values, and claiming the research is bullshit.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...)

> 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...

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