Normal Plasma Cholesterol in an 88-Year-Old Man Who Eats 25 Eggs a Day
nejm.org
nejm.org
Tell public to reduce animal fat consumption to reduce heart disease
Public reduces animal fat consumption
Heart disease rates continue to stay the same
Conduct studies to prove old hypothesis isn't wrong: Studies show that Atkins style diets have closer to optimal HDL/LDL/Triglyceride blood levels than low fat diets
Ignore study
Claim that it must be genetics that causes "some" people to not get heart disease from high fat, low carb diets
Watch the documentary "Fathead" on Netflix. The movie can be a little annoying in its political overtones, but the fact that the guy eats an extremely high fat diet with low carb and sugar intakes and improves his cholesterol numbers is interesting. Of course, it must be a genetic fluke, according to the low fat promoters. Let's do the math, shall we:
Odds of a person having a genetic mutation where they are immune to cholesterol when most people aren't: low
Odds of a person choosing to make a documentary: low
Odds of a person choosing to make a documentary about themselves going on an extremely high fat diet for 30 days: extremely low
Odds that this same person just happens to be one of these people who is genetically immune to cholesterol....... REALLY?
Before you brush me off, I am aware that high serum cholesterol is a predictor of heart disease. However, a more plausible explanation is that the body manufactures more cholesterol to fight an impending problem.
See e.g. http://blog.sethroberts.net/2011/04/12/statins-reduce-choles... for references.
(Analogy: if you can only look at the drain of a sink, you might conclude that water is likely to cause soap, because clean water almost always comes down before soap water does)
I haven't seen this documentary, maybe he started out thinking he'd prove that his diet was actually bad. If not, then I think it's pretty likely that this documentary was eventually made.
Odds of a person having a genetic mutation where they are immune to cholesterol when most people aren't: low
Odds of a person choosing to make a documentary: low
Odds of a person choosing to make a documentary about themselves going on an extremely high fat diet for 30 days: extremely low
Odds that this same person just happens to be one of these people who is genetically immune to cholesterol....... REALLY?
You have calculated the odds of any given individual creating a documentary about going on a high-fat diet and having a genetic mutation. However the claim you are trying to refute is that this particular individual has a genetic mutation. Since this particular individual is known to have made a documentary about themselves going on a high-fat diet, you must instead look at the conditional probability.
It is likely that making a documentary about going on a high-fat diet is totally uncorrelated with having a genetic mutation. This means that the probability of this person making a documentary about going on a high-fat diet is divided out of the final probability, which reduces simply to the probability that they have a genetic mutation.
Of course it could be possible that making such a documentary is negatively correlated with having a mutation, in which case your point stands. However I highly doubt this is the case.
However it could also be the case that making such a documentary is positively correlated with having a mutation, in which case your point is moot. It is more likely that this is the case, as this particular individual may have known beforehand that his body dealt well with fat; also, other individuals may have made a similar documentary but never published it because the outcome (getting fat) was as expected.
Couldn't it be possible that you're like those that were arguing there was NO WAY the Earth could revolve around the sun?
Cultural/memetic inertia is really hard to overcome, mostly because of this I think.
https://www.nytimes.com/2012/06/03/opinion/sunday/we-only-th...
The "eggs = cholesterol = bad" meme was apparently started by Lyndon Johnson, in an attempt to reduce demand (and therefore the price) of eggs.
BBC Horizon: Why Are Thin People Not Fat? (2009)
- both very interesting programmes that contain surprising amount of cutting edge scientific information.
- both demonstrate how the Lipid Hypothesis has effectively been debunked and it is only now that it has taken 40+ years for this to edge into mainstream, despite copious anectodal and historical evidence to the contrary.
- Fat Head, in particular, also attempts to explain why this enormous gap in science even exists.
http://blakemasters.tumblr.com/post/22866240816/peter-thiels...
In addition to heart disease there is a whole bevy of metabolic disorders that are on the rise (type 2 diabetes, hypertension, PCOS, fatty liver, etc.)
In the 80s the government told us to reduce our fat and cholesterol intake, and research shows that we did a bang up job of reducing it. But why are we continuing to get sicker and fatter?
The nutritional recommendations of the US and most of the world has to be one of the larges and most unethical experiments of all time.
Americans walk a fraction as much as their grandparents every day, and consume several times more sugar. Worse, we consume insane quantities of high fructose corn syrup and its variants.
In the 1970s the US Government massively subsidized corn crops, which led to the creation of high fructose corn syrup. It's no coincidence our obesity epidemic really exploded from roughly then forward.
Have these studies actually shown that those that DO decrease fat intake show no improvement in heart disease? (The answer may be "yes"; but I haven't heart that stated here; only averages.)
But here is the rub. Most studies that show X,Y, and Z lead to heart disease are observational epidemiological studies. This means that researchers collect data from a number of disparate sources and attempt to make sense of it. The problem is that it is very hard to tease out confounding variables.
So I don't put much stock in this type of study. They have their value, but I wouldn't make any life decisions off of them. Their primary purpose is to help formulate hypotheses that can be tested experimentally.
When it comes to experimental tests, the lipid hypothesis has been shown to be wrong over and over. On the contrary, quite a bit of experimental data shows that a grain based, low fat, high carbohydrate increases the markers for heart disease.
We've found heart disease in Egyptian mummies, so it's been with us as long as paper has been. Is it merely a side-effect of living? Even swine have been found to have narrowing of the arteries (http://vet.sagepub.com/content/19/6/676.full.pdf).
If it's influenced by what we eat, can we change our diets and affect it, or is it entirely genetic? Do dietary changes affect it? If so, does anything reverse it?
I agree, animal fats don't appear to be the single cause, but if they aren't, what is?
The problem these days is that easily digestible theories are now taken for fact. Because it's easy to digest and easy to transmit, they get spread very easily by the general population, even though they don't make sense.
"Eat fat, and your body turns that into fat. If you want to lose weight, then stop eating fat."
The funny thing is how violently people react when you explain to them that those theories are possibly wrong. My friend is "trying" to lose weight by cutting out the fat. When I tell her that she needs to cut carbs instead, she gets almost offended, and says that it doesn't work. Meanwhile, I lost 20 lbs in 5 months while on an aggressive South Beach diet (less than 100 g of carbs per day) and my cholesterol was extremely low.
When you look into the actual biochemistry of it, it really looks like the pathways that Atkins/South Beach diet talk about with respect to carbohydrates and blood sugar are the real culprits. The food we eat today is highly processed, and creates an over-balance of blood sugar, and that is the cause of why so many Americans are fat.
The food industry has found cheaper and more predictable ways of making our food (process the carbohydates into a fine powder, so that it's uniform and easy to cook with), but the side effect of this is that it causes our blood sugar to skyrocket and makes us fat because we are mostly sedentary (myself included).
The funny thing is that even the theories on cholesterol are coming into question. The absolute values of HDL/LDL may not be important, but some people are saying it's the ratio of HDL to LDL that matters. So companies like Pfizer that have been drugging people for years with Lipitor may just be extracting money from people with no real benefit.
Actually, from what I've read, the most important ratio is HDL to triglyceride levels.
People still won't believe me when I tell them that they should at the very least try reducing their carb intake. It's surely possible that Good Calories Bad Calories, and the various Intermittent Fasting / Primal proponents are there are full of crap and don't know what they're talking about, but it has at the very least worked for me.
I went from 25+% fat a couple of years ago to about 8% now, shooting for 6-7% soon, and I'm barely at the gym a couple of days a week (I do lift heavy though). There's nothing quite like being really happy with one's shape after years of being really uncomfortable.
The idea that eating food that contains cholesterol magically increases the cholesterol levels in your blood never made any real sense, and has been debunked repeatedly.
(What does increase blood cholesterol? Fructose, mostly. If you're trying to control your cholesterol the maple syrup on your pancakes and - especially - that big glass of orange juice are killer. The eggs, by contrast, are good for you.)
The first model implies, for example, that dietary fat is uniquely fattening and that, conversely, a low-fat diet is an easy way to reduce or eliminate your body fat. I believe we can mark this model down as "trivially disprovable". :) (It also implies that eating sugar should have some impact; sugar deposits forming around the body...again, nothing of the sort happens.)
And yet, belief in the first model persists. I don't think either model is inherently more intuitive, given our current understanding. People will believe whatever the popular wisdom is as it shows up in USDA guidelines, highschool texrbooks, etc. The question is, why does the obviously wrong model persist in popular wisdom?
In my experiments (on my own) I can say that walnut and stinging nettle also helps to lower bad cholesterol. (btw I don't have medical profession, don't get this as advice.)
I saw lots of people who eats animal fat all the time and have low levels of LDL. Even though I did diet, I couldn't maintain LDL in normal levels. I have to use medication. I believe it is highly related with genetic factors and somehow some people's body couldn't handle things as expected. A bug that we cannot fix. The only way is monkey patching.
""" The patient stated, "Eating these eggs ruins my life, but I can't help it."
What would be extremely interesting is studying any genetic factors and whether they could have possibly even drove him to eat this amount of eggs just to keep his cholesterol levels high, and also, conversely, whether there is any biochemical adaptation, especially anything that is unusual for his genetic makeup, that helps him retain this level of cholesterol consumption without getting ill, that could have resulted from long term exposure to his diet or other environmental factors.
They should test her to see if the adaptation is genetic, and does it affect her as well.
Here's the difference. Nutrition science IS science. It's results come from controlled, replicable experiments, checked via peer review and analyzed correctly for significance.
Nutritionism is the belief that food is just the sum of independent nutrients and other substances, and once we know what nutrients we need we and which substances are bad, we can rearrange and pick and choose to get an ideal diet, coupled with the belief that we know enough from nutrition science to actually understand enough of nutrients and other food substances to actually do this.
Nutritionism IS NOT science. It is to nutritional science what pop psychology is to neurobiology.
Here are some examples (based on real things, but I do not have specific references handy so I'm going to keep the details generic). Suppose nutrition science finds that substance X is vital to health, and that carrots are high in substance X, and that people who eat a couple servings of carrots a week get enough substance X.
Synthesizing substance X (or extracting it from carrots) and adding it to to some other food, and then telling people that they can use that other food as a source of substance X is nutritionalism, not nutrition science. Or making X pills for people and telling them these can supply the X they are not getting from their diet is nutritionist, not nutrition science.
This is because it is possible that in order for our digestive system to actually extract and absorb substance X, it needs something else (substance Y) which is found in carrots, but is not found in those supplements or in the food that the synthetic X is added to--and so people getting X in the supplement or additive form are not actually making it available to their bodies.
The X supplements do not move from nutritionalism until scientists actually do the experiments and show that we can incorporate X in that form, or gain sufficient understanding of the mechanism by which X is absorbed to be able to say it will work in supplement form.
Another example: for almost everything we are told we must eat more of (fish, carbohydrates) or less of (red meat, carbohydrates, fats, cholesterol), there exists some culture for which (1) their traditional diet goes massively against that advice, and (2) people who eat that diet are healthy.
That's because the advice we get in these areas is NOT based on nutrition science. It is based on nutritionalism. The science that says that, say, red meat is bad for you ACTUALLY says that in particular studies of particular populations, red meat was bad. For people that strongly match the characteristics of the populations in those studies (e.g., whose complete diet is similar to the complete diet of the participants, and who live similar lifestyles) the conclusion that they should avoid red meat is probably pretty accurate. Since there are other populations in which red meat consumption does not appear to lead to those bad health effects, however, the proper conclusion is that the dire effects of red meat cannot be generalized outside of populations like the study populations.
Your best bet if you want to avoid nutritionalism is to try to stick to proven traditional diets. If the people of some region or culture have been eating a certain way for hundreds of years, and are in good health, that's pretty damn good evidence that their diet as a whole works. If someone's theory says that they should be in poor health because their diet includes too much X, or doesn't have enough Y, then that someone's theory is incomplete or wrong. In science, when results and theory disagree, results win.