Comment by scottlocklin | Hacker News Reader

Comment by scottlocklin | Hacker News Reader

Parent Full thread

Now do France.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1768013/

Correlational studies are inherently flawed when you have something as complex as diet. It's probably quite true that in a random sample of 80,000 health care workers in America, the people with more grease in their diets drop dead faster. It doesn't happen in France, Spain etc etc. Meaning it probably has nothing to do with saturated fatty acids, and probably much to do with whatever goes along with it. Who knows what it actually is? Soybean oil, wonder bread, dunkin doughnuts, HFCS, diet coke, being disgustingly overweight, never walking anywhere, granola, fruit juice (bleh -sugar water), dietary iron, twinkies, nacho "cheese," brined ham, trail mix, marshmallows, potato chips, microwave popcorn, soy protein -any number of things the Frogs and Spaniards don't eat or do, but fat Americans do. Using linear regression, grease/saturated fat probably correlates well with all this other garbage, and with dropping dead sooner, assuming you censor out other world populations with different national diet tendencies. Of course including Spaniards in the data set, you get a different answer.

Personally, I think the biggest factor is a primarily sedentary lifestyle, which could be the exacerbating factor that multiplies the negative effects of sugar and saturated fats intake.

We're spending more collective time as a society sitting on our butts than ever before, so many people drive everywhere instead of walking or riding a bike. We can get everything delivered to our homes instead of having to go to a store, walk around and pick it out ourselves. So much more happens purely online now, even something as simple as going to the corner store to rent a movie is a thing of the past.

All of these things used to add up to at least some physical exercise. Perhaps not ideal amounts, but it got people moving at least. Obviously this is not universal, a lot of people still do get their movement and fresh air, but my thinking is that it's less than ever before, combined with access to high-calorie food that is also easier than ever before.

So in that sense, physical activity, or the lack of it, is the force multiplier in regards to one's diet. I try to get at least 30 minutes of some sort of activity in every day, and preferably more. Just a walk outside or cleaning the apartment or doing a project. Most days I walk to the stores to shop, as a conscious choice to get my physical activity covered.

High-quality studies don't just do a linear regression. For instance, it's possible to control for confounding factors by keeping a factor constant and varying others, in a regression model. I believe this was for example done in studies that showed the correlation between smoking and lung cancer, or high blood pressure and heart disease and so on.

In any case, when faced with a large body of literature with some conflicting results the thing to do is to look at reviews or meta-analyses. From my reading there is no argument that the majority of meta-analyses show a strong correlation between high levels of saturated fats in the diet and high incidence of cardiovascular disease- and if I remember correctly, even the so-called "French paradox" is not observed in high-quality reviews and meta-analyses, but only in smaller studies.

Note also (from the linked paper):

>> The French paradox concept was formulated by French epidemiologists3 in the 1980s.

In a similar manner, you can find many studies showing benefits from the consumption of olive oil, but the majority of them are from Spanish, Greek and Italian research teams (I'm Greek. Perhaps not everyone has the same context as me but the number of times I've heard Greeks say how healthy olive oil is... And how red wine is good for the heart. Greece, of course, produces both).

The moderate consumption red wine seems to be a plausible component of the low number of realized CHD deaths?

It's a nice story, but it's about as likely as brie causing fewer realized CHD deaths. There's no way you could deconvolute either from their diet; the red wine meme is probably just upper middle class people telling each other their vices are healthy.

The "French paradox" isn't the only one indicating the statistics are horse shit on saturated fat: consider the Israeli paradox.

https://en.wikipedia.org/wiki/Israeli_paradox

Yeah the red wine health benefits were denied recently when the underlying study failed to take account for other variables such as social class and lifestyles. Amazing how flawed some of the old studies are. Wouldn’t be surprised if somehow the alcohol lobby was involved back then

The idea that moderate drinking is protective for the heart is the result of studies that looked at mortality in relation to wine consumption but did not control for participants who had stopped drinking because they already had an underlying condition.

In at least one study (can dig it out if wanted) the result was that it looked as if moderate drinking was associated with better cardiovascular outcomes than no drinking at all (as well as drinking too much) because the people who didn't drink at all had stopped drinking on doctors' orders, essentially.

More recent studies have excluded participants with underlying heart conditions and the effect disappeared. Again, I can dig out the links if required (but it'll take me a bit of work).

That was my first thought that wine drinkers tend to richer, so live longer. But when I looked deeper, those studies actually controlled for various factors including income and education.

I was always wondering how French can survive so much bearnaise, and cheese.

The "secret" is that they're not actually eating that much sauce béarnaise, rich cheeses or decadent gâteaus, nor are they binging on red wine constantly.

Sauce béarnaise is supposed to be served in rather small amounts, being an extremely rich and flavorful sauce when made in the traditional way, so a small amount provides the desired amount of taste to a dish.

It's all a matter of savoring small amounts of high-quality and extremely flavorful food, as treats rather than everyday snacks or baseline meals.

I know multiple French families that eat cheese everyday multiple times a day and do drink cup of wine nearly every day (adults).

They are not fat if anyone wonders nor are some super great exception as far as I know.

They are probably eating relatively small absolute amounts of good cheese, rather than covering food in mountains of lower-quality cheese.

A cup of wine (assuming a literal cup, so 280ml) is probably on the higher end of what is advisable, but not horrible.

I also assume they're not snacking constantly outside of meals, which makes a huge difference.

I would not call that small amount of cheese. It is normal portion to make you full and there was essentially infinite amount of it.

I did not said I see any of that horrible. AFAIK, cheese is good thing to eat. I don't know why you insist on minimizing it.

Cheese is very high in saturated fats, and should be eaten in moderation, which the article we're commenting on also supports.

Quality over quantity.

Reply on news.ycombinator.com