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Comment by array_key_first | Hacker News Reader

Medicine doesn't really ignore nutrition, but the problem is:

1. Most people don't believe it anyway. People want to hear they can eat hamburgers and milkshakes and be healthy. Telling them "we know that gives you heart disease and cancer" does nothing.

2. Nutrition is complicated and different for every person, because everyone has different things they can tolerate. The "perfect" diet is actually worthless because it has a 0% success rate. Really, we have to optimize for how miserable people are willing to be.

3. Most people are unhealthy enough that nutrition is the least of their concerns. That sounds crazy, I know, but if you're obese (which most people are!), then priority is being not obese. Not your nutrition. I know those sound related but they're way less related than you think.

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> Most people don't believe it anyway

Maybe because so much of it is wrong, or (very charitably, as much is industry-biased) outdated?

Lifestyle modification is a definite challenge and I’m not dismissing it.

Still, hamburgers and milkshakes don’t give you heart disease and cancer. Overeating, oxidative stress from low-quality ingredients, etc might.

> Still, hamburgers and milkshakes don’t give you heart disease and cancer. Overeating, oxidative stress from low-quality ingredients, etc might.

What? “Oxidative stress”? Oh come on, at least go full “seed oil” if we’re going to talk nonsense.

We already left the land of reason far behind by the time OP implied hamburgers and milkshakes give people cancer.

Depends on the nutrients that comprise them to the extent they contain a lot of omega-6 or not. Not heart disease so much but the other killer - might as well mention in this context. 'A high omega-3, low omega-6 diet with FO for 1 year resulted in a significant reduction in Ki-67 index, a biomarker for prostate cancer'. https://doi.org/10.1200/JCO.24.00608. Also Prostate Cancer and Prostatic Diseases (2024) 27:700 – 708 'Our preclinical findings provide rationale for clinical trials evaluating ω-3 fatty acids as a potential therapy for prostate cancer'.

Seed oils are not as bad as painted but some caution is needed given for instance the industrial processes used to bring them to market sometimes. Plus the way the oils are cooked when they create free radicals. This is not nonsense.

Red meat is a carcinogen, I don't know what to tell you.

Everything is a carcinogen. Even water. Dose matters, and most of the "omg zomg causes cancer if you eat it!" dietary nonsense purposefully omits absolute amounts or base rates, lest you realize it's actually as likely to give you cancer as smiling at people.

I don't know what else to tell you. Except maybe that if one gets this single concept, that quantities matter, it becomes immediately apparent why most of the "healthy eating" / fitness fads is just pure bullshit.

> hamburgers and milkshakes don’t give you heart disease and cancer

They absolutely do, particularly if you're getting most of your calories from them. If evidence-based medicine doesn't convince you, uh, hamburgers and supermarket milk tends to be processed.

They absolutely do not, unless you’re getting too many calories.

Individual foods are—with some exceptions—neither bad for you nor good for you. A healthy diet can occasionally include doughnuts, and milkshakes. Your overall diet is what matters.

Sure. We’re saying roughly the same thing. For most Americans, hamburgers cause heart disease because we don’t exercise enough or eat enough plants. If you’re backpacking twenty miles a day, sure, eat whatever, you won’t suffer inflammation or obesity from it. (Though you may run nutritional deficiencies. And you’re building bad habits for when your activity necessarily tapers off.)

Hamburgers are not causing heart disease and diabetes for most Americans. Bad diets loaded with too many calories, too many saturated fats, and too many simple carbs are.

Messaging matters. When you tell people hamburgers and bacon and everything they love are bad, they stop listening, give up, or just eat some other junk that wasn’t prohibited. When you tell them some foods are good, they start buying into superfood marketing.

Diet is the only thing that matters. Lots of veggies are extremely useful because they add bulk without adding calories, and along with fresh fruits are great sources of fiber. Cheeseburgers can only come so often because they’re extremely calorie dense and send enormous reward signals to your brain.

Give people the tools they need to thrive, not just “don’t eat these specific bad foods, eat these specific good foods”.

Sure, they are not mercury-level toxic. However, these recommendations are for people who consume way too much of these dishes, and it's a safe assumption that this is the case for a significant part of the population.

Most green vegetables you can eat unlimited amount and stay healthy. They are absolutely "good" food. (Please don't reply with something trite like "oh, but what about the pesticide residues?") The same can be said for high fiber (soluable and insoluable) fruits like apples, oranges, and bananas. As long as eaten whole (minus skin for oranges and bananas), it is almost impossible to overeat these and they are absolutely "good" foods.

I agree 100% with your follow-up. In the last 30 years of medical research, I do not recall anything but negative health results from eating red meat (beef). The real culprit is saturated fat. It is the cigarettes of food. There is almost no healthy level to consume, so keep it to 20g per day or less.

Reading this chain of responses from the original is making my internal bullshit alarm (Brandolini's law) go "wee woo wee woo".

> The real culprit is saturated fat. It is the cigarettes of food. There is almost no healthy level to consume

Not at all an expert, but from what I understood saturated fat isn't particularly good but it's not “no healthy level to consume” either (fortunately because you practically cannot avoid them).

I think you're confusing them with trans-insaturated fat (which I don't think are as bad as cigarettes either, but are still bad).

Hat tip. Good point about trans-fatty acids. That was all the rage to label and remove them about ten years ago.

Agreed (remember where I said overeating). Non-homogenized gently pasteurized milk/cream with minimally processed honey or maple syrup, and fresh ground hamburger, all of which which you can definitely get at supermarkets by the way, are much better for you than Big Macs and McFlurries. Ask yourself why? It’s obviously not “because they aren’t hamburgers and milkshakes”

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