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> This is a serious problem. How can we trust institutions that are suppose to provide evidence based advice to the general public?

The only serious problem here is that some people immediately trust a random article from someone who denies mainstream science simply because it’s a contrarian take.

I don’t understand the people who will question everything that comes from professionals and institutions, but within minutes of reading an article that is contrarian they think “Yep this all checks out and I have no further questions”. To see it happening in real time in this thread is wild.

You did the same thing but in the opposite direction. That's how easy it is to make an unforced error.

one is based on an entire industry of people working in so many conflicting fields that it would boggle the mind if they could all be bought, and the other is based on one person who built their fame on being contrarian without a lot of evidence.

I think the question still makes sense, why people are willing to ignore a ton of evidence from a lot of different unaffiliated people and focus on one article by one person that really doesn't add up to much of an argument - I think the answer is just that this is what they want to hear, so it must be right.

The claim isn't that everyone in nutrition etc is bought off. You simply don't need to do that.

If you're in the sugar industry, you give funding to people investigating how saturated fat causes heart disease. You support organizations that back up your preferred theory. These orgs run media campaigns, slap a "heart-healthy" label on food products, and sometimes fund research. Forming popular consensus on "fats = bad" leads to additional funding from government or other charitable causes.

Increased funding leads to an increased density of scientists working on the problem, which in turn increases the legitimacy of the field, especially among people just getting into their careers. If it's common wisdom in the cardio field that saturated fats are the worst cause of heart disease, that's where they're going to focus their efforts.

It's one of those things where you simply don't need to buy anyone off. You just put your thumb on the scale early enough, and consistently push popular opinion toward a direction that's beneficial for you.

if somebody can find an even worse cause and they publish it, they stand to found an entirely new field - the incentives are to prove the entire existing field wrong. nobody would hesitate.

You do not have the the ability to know such things.

> that it would boggle the mind if they could all be bought

Buying just a couple or maybe even one can be enough, culture can take care of the rest.

Actually, the initial buy isn't even required, culture is often adequate on its own for forming collective incorrect beliefs.

Well, we read the article, which cites many studies. Maybe she is doing a super selective review of the field, but she does not merely quote one study, but several, all of which indicate that there is no correlation between saturated fat and cardiovascular problems.

IOW, we did not merely "read and trusted one random article" but assessed the presented evidence. You OTOH, merely provided ad-hominem attack on both the author and anyone who dared believe the presented evidence, which smacks of trying to shame people in not voicing their opinion.

Did you actually follow up and read the studies she cited in detail, though? Much of what she claims is misrepresentation, such as the insinuation that the Cochrane review found no evidence of SFA consumption being associated with risk.

I think it speaks to how low institutional trust is and how often it has been abused.

Its isn't that someone says "Yep this all checks out and I have no further questions"

It's that this person is at least sharing references and the last person said "shut up and do what I say"

> Furthermore it erodes trust in government, experts, and science.

Does trust in X erode when X is wrong? Yes.

That is true but also probably misguided.

Scientific knowledge evolves as new discoveries are made, immutable and unequivocal “truth” is the realm of religion, not science (which makes the former much more appealing to many than the latter).

Trust really should not erode if X acted in good faith based on the consensus knowledge at the time.

If. What was proclaimed as nutritional facts decades ago turned out to be tainted by industry/lobbying interests.

If the consensus is evolving, sure. If the consensus is going back and forth for decades, and each time it is presented with the authority of medical or physical science, then it is normal and correct to stop listening at some point.

When scientists have weak theories that they're not sure of, they're not supposed to share those breathlessly with the public, and certainly not try to shape public laws based on the theories they know are weak.

And nutrition science has been guilty of this for over a century. You can find people in the field making confident recommendations and setting dietary standards from the time when they didn't know vitamins were a thing. If you followed the science on nutrition and adjusted your diet accordingly around 150-100 years ago, you could literally get scurvy or other vitamin deficiencies. The field has evolved a little bit, but it's still extremely weak as scientific fields go.

I agree that this reflects poorly on trust. But voting to give more authority to the federal government would make it even worse. Look at how poorly voting works.

Just get rid of the agency altogether.

It’s nonsense. SFA consumption is a risk factor for cardiovascular disease. Nina is misreading the evidence to come to poor quality conclusions. The most rigorous analysis of RCTs on the subject shows this very clearly:

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

"We found little or no effect of reducing saturated fat on all‐cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate‐quality evidence.

There was little or no effect of reducing saturated fats on non‐fatal myocardial infarction (RR 0.97, 95% CI 0.87 to 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both low‐quality evidence), but effects on total (fatal or non‐fatal) myocardial infarction, stroke and CHD events (fatal or non‐fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI."

This is your citation for saturated fat is evil?

I don’t believe saturated fat is evil. I believe that consuming more than 10%E from SFA increases risk of CVD, and replacing SFA with PUFA reduces risk of CVD.

And yes, that is my citation in support of that claim. Quote: “There was a 17% reduction in cardiovascular events in people who had reduced SFA compared with those on higher SFA”

and

“When we subgrouped according to replacement for SFA, the PUFA replacement group suggested a 21% reduction in cardiovascular events”

I explain why the null findings on insensitive endpoints aren’t the gotcha some people think they are here: https://news.ycombinator.com/item?id=41960046

> There was a 17% reduction in cardiovascular events in people who had reduced SFA compared with those on higher SFA

they have table with breakdown of events by type, and in both rows with significant reduction it says that quality of evidence is "very low".

Don’t know where you’re seeing that. Combined cardiovascular events has an RR of 0.83 and the GRADE quality is moderate, not very low.

Yes, and I am talking about subtypes of events in the "summary of findings" table. Those subtypes with "moderate" quality has very insignificant diff in # of events. Those with significant diff in # of events have "very low" quality of evidence.

How would that affect the inference being made here? That is, the claim being made is with regard to combined cardiovascular events. This effect is significant and the GRADE quality is moderate.

One of the main purposes of meta-analyses is to summate multiple studies that may have insufficient statistical power in isolation to find a significant effect, but when summated they do.

I _think_ you're trying to suggest that the insignificant individual event types aren't contributing to the significant findings on the combined event endpoint, so we should ignore the GRADE quality of those (correct me if I'm wrong). But that's not how meta analysis functions - those events are also contributing to the significant finding on that endpoint (which is also why the GRADE quality of the combined endpoint is moderate). They just aren't significant _in isolation_.

> How would that affect the inference being made here?

to me, it looks like several rows clearly don't add up in key findings table(they derive "moderate quality" conclusions from "very low quality" observations), which makes whole publication as data astrology quality.

Right, but that’s because you’re misreading the table. They are deriving moderate quality conclusions from moderate quality data, as I’ve explained.

Looks like we are in disagreement about who is misreading the table.

Well, good luck sustaining the claim that Lee Hooper doesn’t know how to perform a meta analysis and that error got past Cochrane’s notoriously lax peer review process, and you definitely didn’t just make a mistake reading the table.

I salute your self confidence, I must say I’m somewhat envious of it.

I have low opinion about modern academia and quality of "peer review processes".

If you misread data in the way you appear to, that doesn’t surprise me. I can’t imagine you think many studies’ conclusions appear to follow from their results.

It’s just that you’re blaming the studies, rather than your comprehension.

Again, we are in disagreement who misread the data.

Honestly, your steadfast insistence that you couldn’t possibly be wrong on this is fascinating to me. I’m happy to admit I made a mistake if I’m misreading the data, so walk me through what you think I’m getting wrong.

Please be specific: name the event subtypes you’re looking at, give specific references to the table numbers etc. If I’m wrong about this, I want to know.

Meta-analyses are a cool way to perform a garbage in, garbage out exercise.

What’s the evidence that the data going in is garbage? We already ascertained most of it is GRADE quality moderate.

I don’t research the topic for a living, so I don’t know — I’ve read none of the studies.

If the conclusion that comes out of the other end of the pipeline is that we should avoid eating the things we’ve eaten for millions of years, it’s fair to say what went in might have been based on false premises.

Why? Evolution doesn’t select for longevity, it selects for reproductive fitness. We have no reason to believe ancestral foods are more longevity promoting than novel ones, and antagonistic pleiotropy would suggest that all else held equal, ancestral foods are less healthy.

Heck, water treatment plants are novel compared to the pathogen-laced water we’ve been ancestrally consuming, but I doubt you eschew tap water for puddle water.