36 replies to this topic

[NeverSayDie]

Medicine is about balancing risk against favorable outcome. The present system has a lot of flaws. It could be a lot better. But you are simply being disingenuous in your analysis.

No, I understand that. I understand that with drug-based approaches, there is a trade off and a delicate balance of risk vs. reward. And like I said, I do not dispute that fact that drugs can be effective at relieving the physical manifestations of disease.

I just think that there is less of a balancing act with naturopathic medicine. Your risk tends to drop to almost zero, yet benefits are still readily achieved.

"Button A causes all pharmaceuticals to disappear. Button B maintains the status quo"

This seems to be intimating that the alternatives are drug treatment or no treatment at all. To be fair, it should be drug treatment vs. non-drug alternative approach. Once again, I am not an advocate of people eschewing pharmaceutical based approaches and then doing absolutely nothing. I am a proponent utilizing a form of medicine that does not produce the inherent hazards that most pharmaceuticals possess.

Once again, I do not doubt that these drugs produce an apparent effect with the symptoms of disease. This is not what I am disputing. They do this with tremendous risk.

Alternative forms of medicine also show benefits with management and even the reversal of disease. These modes of treatment work in an entirely different way and they achieve this with virtually zero risk from the treatment itself.

So, you have to forms of treatment that show benefits. One comes with moderate/high risk for complications such as kidney failure, liver damage, etc...while the other simply does not possess these risks. If someone can show me that diet/whole food supplementation has the equivalent chance or producing kidney failure, liver damage, etc- this would change the scope of this debate greatly.

[NeverSayDie]

Do Cholesterol Drugs Do Any Good?

Research suggests that, except among high-risk heart patients, the benefits of statins such as Lipitor are overstated
http://www.businessw...68052092994.htm

[oehaut]

Low SaFa and lower of LDL-C/increasing HDL-C is consensus advice. You need to disprove the consensus which is based on hundreds of studies. I do appreciate that you provided a study for a start. However, cherry picking evidence is sometimes as bad as making up stuff. Outliers are expected. You need to provide a review of all evidence (or link to systematic review, meta-analyses, etc). Most of the discussion is taking place in the nutrition subforum, however.
Addendum: I am not sure if you are aware, but studies on total cholesterol are completely irrelevant. As pointed out we're talking LDL/HDL.

Kismet, did you ever look at the consensus for yourself? I haven't. But look what Uffe Ravnskov found in this article when he did

Recently the Swedish Food Administration published a list of 72 studies that they claimed were in support of their warnings (that we shorten our lives or run a greater risk of getting a heart attack or a stroke by eating too much saturated fat.)

Together with eleven colleagues I scrutinized the list and found that only two of them were in support.

Eleven studies did not concern saturated fat at all. Sixteen studies were about saturated fat, but were not in support. Three reviews had ignored all contradictory studies. Eleven studies gave partial or doubtful support. Eight studies concerned reviews of experiments where the treatment included not only a "healthy" diet, but also weight reduction, smoking cessation and physical exercise. So how did they know whether the small effect was due to less saturated fat or to something else? Furthermore, all of them had excluded trials with a negative outcome.

Twenty-one studies were about surrogate outcomes. In most of the reports the authors claimed that saturated fat raises cholesterol. But again, high cholesterol is not a disease. Twelve studies were listed because they had shown that people on a diet with much saturated fat and little carbohydrates reacted more slowly on insulin than normally. From that observation the authors claimed that saturated fat causes diabetes, but they had jumped to the wrong conclusion.

So what if the ''consensus'' you are reffering to isn't one? What if it was all made up? It seems weird that everyone looking at the data from themselves come to very different conclusion than the maintream one.

Why is that? Uffe and al. just have an angenda? They don't know how to read papers? They want to sell a book?

Maybe they are just right? Maybe the evidence are pretty weak? And that it is much more of a political /economical issue as exposed in Gary Taube's Good Calorie Bad Calorie ?

You're right that the ''consensus'' is that SFAs raise TC. But does that means more mortality? That's the very important question afterall. So what if it raise your TC a bit if it doesn't kill you any faster?

Edited by oehaut, 25 December 2009 - 06:50 PM.

[kismet]

Kismet, did you ever look at the consensus for yourself? I haven't. But look what Uffe Ravnskov found in this article when he did

I don't understand what is so difficult about the concept called burden of proof? I didn't check other forms of consensus, either: Vegetables and fruits being healthy*. The necessity of water for our survival. Obama being American citizen, 9/11 not being an inside-job, vaccine efficacy, the efficacy of HAART, the failure of homeopathy and quantum woo. I did not double-check the consensus that buildings and bridges are usually well built and do not fall apart when entering. I am not testing the consensus that a shotgun shot to the head hurts, if a someone robs the bank I'll stay put or run; there's no need to test the consensus. I don't have wings, consensus says I can't fly, won't double check, either.

We'd be long dead of old age before having double-checked all consensus statements that our life is built on.

We do not have to prove consensus, which exists to be relied on. The doubters ALWAYS (and this time caps is really justified) have to disprove consensus and provide convincing arguments. Convincing in the sense that extraordinary claims, require extraordinary evidence.

*but thank doG I am actually interested in becoming an expert in the future so I am taking the time to double-check the consensus. And I have usually tried to adress the points you made about nutrition in as far as I have read the literature or have had the time to do so. I even considered doing another post in the recent nutrition thread because you somehow misunderstood the MUFA vs SaFa argument I was making and that the evidence you provided actually supports this viewpoint. However, you yourself surely now just how useless studies on total chol. are (and therefore my concise rebuttal to Jay's paper is justified and sufficient); TC was dropped as a good marker of CVD risk years if not decades ago. non-HDL TC, TC/HDL ratio perhaps?

Twenty-one studies were about surrogate outcomes. In most of the reports the authors claimed that saturated fat raises cholesterol. But again, high cholesterol is not a disease.
But high cholesterol is a disease (and/or invariably linked to disease), that's another "consensus statement".

So what if the ''consensus'' you are reffering to isn't one? What if it was all made up?

No, look, that's not what consensus means. You can look it up in a dictionary, although, I am sure you know the meaning and were just trying to make a point. Consensus is a statement issued and accepted by most professionals of the field in question. Therefore the effects of sat. fat are consensus, which is not a gurantee of truth, however.
IMHO the word you wanted to use is conspiracy (or some weaker derivative thereof; and I don't mean conspiracy in the tinfoil hat-sense), lapse or blunder. It is possible that certain dearly held consensus beliefs turn out to be scientific blind alleys, poltical blunders or even bona fide "conspiracies".

It seems weird that everyone looking at the data from themselves come to very different conclusion than the maintream one.

Well, I know at least one person whom I'd trust above most experts and who strongly supports the consensus and most likely has read the relevant literature. 

You're right that the ''consensus'' is that SFAs raise TC. But does that means more mortality? That's the very important question afterall. So what if it raise your TC a bit if it doesn't kill you any faster?

High cholesterol is a disease (and that's a shorthand for high TC, LDL & low HDL - dyslipidemia, obv.). That's another consensus statement that needs rebuttal if you want to make this point. And as I have certainly explained: If SaFas raise cholesterol and generally worsens important ratios and markers of disease, and they do (at least in virtually all studies I've seen), then they're 'guilty' by extension. If the evidence from RCTs is mixed we still need to be cautious. As long as there are no actual health benefits of SaFa we need to be cautious and preemptively reduce intakes based on strong surrogate and good prospective data.
Blind belief in RCTs is *not* evidence-based medicine. A bad RCT will prove nothing.

Granted, if you're Joe Sixpack and don't care about optimal health, SaFa is not that much of a problem as the risks definitely seem overstated but real nonetheless.

Furthermore, yes, I do believe that the people you named may have an axe to grind and, no, I'd not trust their opinion over that of other health experts. Especially not after reading several (sometimes rather unconvincing and biased) articles "refuting" the consensus.

(BTW; I am not responding to 'NeverSayDie' as I can't help you anymore. However, I am not putting you on my ignore list so that I can warn people if and when you continue to post in this style )

Edited by kismet, 25 December 2009 - 10:56 PM.

[oehaut]

I don't understand what is so difficult about the concept called burden of proof? I didn't check other forms of consensus, either: Vegetables and fruits being healthy*. The necessity of water for our survival. Obama being American citizen, 9/11 not being an inside-job, vaccine efficacy, the efficacy of HAART, the failure of homeopathy and quantum woo. I did not double-check the consensus that buildings and bridges are usually well built and do not fall apart when entering. I am not testing the consensus that a shotgun shot to the head hurts, if a someone robs the bank I'll stay put or run; there's no need to test the consensus. I don't have wings, consensus says I can't fly, won't double check, either.?

Well, that's a little stretchy here. SFAs and health is not as clear cut as a shotgun in the face. There's many factors that can come and make a difference so I think it is worth it to re-check the consensus on this one. No I don't think you need to check if you can fly without wings, but I do think you need to check an issue when there's many political and economical influence at work.

We'd be long dead of old age before having double-checked all consensus statements that our life is built on.

They're many consensus i'm not concern about and not that many that I need to adress so i'll take the time to check 'em and i'll have sufficient time to do it

We do not have to prove consensus, which exists to be relied on. The doubters ALWAYS (and this time caps is really justified) have to disprove consensus and provide convincing arguments. Convincing in the sense that extraordinary claims, require extraordinary evidence.

I don't think saying that SFAs are harmful by themselves is an extraordinary claim.

So we should always listen blindly to the ''expert''? Never question? Never listen to contradictory voice? Not that we should believe, but at least listen and verify no?

*but thank doG I am actually interested in becoming an expert in the future so I am taking the time to double-check the consensus. And I have usually tried to adress the points you made about nutrition in as far as I have read the literature or have had the time to do so. I even considered doing another post in the recent nutrition thread because you somehow misunderstood the MUFA vs SaFa argument I was making and that the evidence you provided actually supports this viewpoint. However, you yourself surely now just how useless studies on total chol. are (and therefore my concise rebuttal to Jay's paper is justified and sufficient); TC was dropped as a good marker of CVD risk years if not decades ago. non-HDL TC, TC/HDL ratio perhaps?

What was the point that you were doing? That MUFA are healthier than SFAs? I've never misunderstood that. It seems to be the case. However, once again, SFAs by themselves don't appear to be a problem in a good context. Look, i'm not thinking people should consume 50% of cal from SFAs. You said it yourself, the risk from consuming SFAs are certainly overstated. Now tell me, if someone is physically active, don't eat too much, is it really a concern if he get 15% of his calorie as SFAs instead of 8% ? I really don't think so. And the evidences are on this side too.

I understand your point, that in doubt we better abstain. Since SFAs don't appear to bring in any benefits, it's better to leave 'em out. Well okay, but that leave MUFA and PUFA to be consume. PUFA should not be more than 3-5% of our calorie, so that mean someone should get about 30% of his calorie from MUFA? How is someone supposed to do that, considering dietary source of fat is always mixed. Drink olive oil and avoid every other source of fatty food?

No, look, that's not what consensus means. You can look it up in a dictionary, although, I am sure you know the meaning and were just trying to make a point. Consensus is a statement issued and accepted by most professionals of the field in question. Therefore the effects of sat. fat are consensus, which is not a gurantee of truth, however.
IMHO the word you wanted to use is conspiracy (or some weaker derivative thereof; and I don't mean conspiracy in the tinfoil hat-sense), lapse or blunder. It is possible that certain dearly held consensus beliefs turn out to be scientific blind alleys, poltical blunders or even bona fide "conspiracies".

No. I just believe it is possible that people are corrupted and not always acting for the right, but mainly for the money and/or fame. We've gotten to a point where i'm not inclined to believe the authority that easily. There as been waayyyy too many corruption going on for wayyy too many time in the human history. I don't want to be cynic, but I think it's important to look for other opinions and compare their interests and their version of the facts.

Well, I know at least one person whom I'd trust above most experts and who strongly supports the consensus and most likely has read the relevant literature. 

I'd be very happy to ear his interpretation of the evidence and why so many people are getting to the wrong conclusion then.

High cholesterol is a disease (and that's a shorthand for high TC, LDL & low HDL - dyslipidemia, obv.). That's another consensus statement that needs rebuttal if you want to make this point. And as I have certainly explained: If SaFas raise cholesterol and generally worsens important ratios and markers of disease, and they do (at least in virtually all studies I've seen), then they're 'guilty' by extension. If the evidence from RCTs is mixed we still need to be cautious. As long as there are no actual health benefits of SaFa we need to be cautious and preemptively reduce intakes based on strong surrogate and good prospective data.
Blind belief in RCTs is *not* evidence-based medicine. A bad RCT will prove nothing.

Granted, if you're Joe Sixpack and don't care about optimal health, SaFa is not that much of a problem as the risks definitely seem overstated but real nonetheless.

Furthermore, yes, I do believe that the people you named may have an axe to grind and, no, I'd not trust their opinion over that of other health experts. Especially not after reading several (sometimes rather unconvincing and biased) articles "refuting" the consensus.

I'm just curious. What would it take so that you re-consider your stand on this SFAs issue? There are many studies out there that compared them to PUFA-6 and in many case PUFA-6 is not any better. No studies seems to have compare them directly with MUFA for CHD mortality.

As I told you, I think the health ''benefits'' from SFAs come from avoiding PUFA-6. You've got to be eating something. Even Walter Willet admit that a low-fat diet is not the answer now. So if we aim for about 30% fat, and don't get too much PUFA-3 & -6, it leaves MUFA and SFAs. I then think that we should favor MUFA over SFAs, but i'm not sure getting lower than 10% as SFAs is a necessity.

[RickSantos]

Read Anthony Colpo's book "The Great Cholesterol Con". Take the references, read the studies full text, no summaries.

You will see that the anti saturated fat anti cholesterol dogma of the last 50 years is completely unfounded. The whole thing has its basis in the fraud of Ancel Keys.



I don;t care how many people I offend saying it- IT IS THE TRUTH.

Edited by RickSantos, 26 December 2009 - 01:12 PM.

[Tygo]

I'm not sure if these are the best cholesterol levels for longevity, but Dr. Davis from The Heart Scan Blog, a cardiac surgeon, recommends that people aim for these levels:

HDL Cholesterol: > 60 mg/dl
LDL Cholesterol: < 60mg/dl
Triglycerides: < 60mg/dl

According to him, adequate vitamin D status, enough omega-3 and eliminating wheat from your diet will vastly improve your numbers.

Edited by Tygo, 30 December 2009 - 10:15 PM.