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Lack of evidence for dietary fat reduction

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
http://openheart.bmj.com/content/2/1/e000196

Open Heart 2015;2: doi:10.1136/openhrt-2014-000196
  • Meta-analysis
  • Original research article
Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis
  1. Zoë Harcombe1,
  2. Julien S Baker1,
  3. Stephen Mark Cooper2,
  4. Bruce Davies3,
  5. Nicholas Sculthorpe1,
  6. James J DiNicolantonio4 and
  7. Fergal Grace1
+ Author Affiliations
  1. 1Institute of Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, Lanarkshire, UK
  2. 2Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
  3. 3University of South Wales, Pontypridd, UK
  4. 4Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA
  1. Correspondence to Zoë Harcombe; Zoe.Harcombe@uws.ac.uk
Abstract
Objectives National dietary guidelines were introduced in 1977 and 1983, by the US and UK governments, respectively, with the ambition of reducing coronary heart disease (CHD) by reducing fat intake. To date, no analysis of the evidence base for these recommendations has been undertaken. The present study examines the evidence from randomised controlled trials (RCTs) available to the US and UK regulatory committees at their respective points of implementation.

Methods A systematic review and meta-analysis were undertaken of RCTs, published prior to 1983, which examined the relationship between dietary fat, serum cholesterol and the development of CHD.

Results 2467 males participated in six dietary trials: five secondary prevention studies and one including healthy participants. There were 370 deaths from all-cause mortality in the intervention and control groups. The risk ratio (RR) from meta-analysis was 0.996 (95% CI 0.865 to 1.147). There were 207 and 216 deaths from CHD in the intervention and control groups, respectively. The RR was 0.989 (95% CI 0.784 to 1.247). There were no differences in all-cause mortality and non-significant differences in CHD mortality, resulting from the dietary interventions. The reductions in mean serum cholesterol levels were significantly higher in the intervention groups; this did not result in significant differences in CHD or all-cause mortality. Government dietary fat recommendations were untested in any trial prior to being introduced.

Conclusions Dietary recommendations were introduced for 220 million US and 56 million UK citizens by 1983, in the absence of supporting evidence from RCTs.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
I wonder how many more years/decades it will be before doctors, nutritionists, etc., stop advising people to reduce dietary fat?

Interesting also to note that cholesterol levels were not associated with mortality. I know that cholesterol advice has been refined, to specify LDL and HDL, and more recently has been further refined to specify HDL activity rather than levels IIRC (thought I'd posted a thread on this recently but can't find it).

I wonder whether that evidence will hold up?
 

jimells

Senior Member
Messages
2,009
Location
northern Maine
Government dietary fat recommendations were untested in any trial prior to being introduced.

...and now we know why...

Interesting also to note that cholesterol levels were not associated with mortality. I know that cholesterol advice has been refined, to specify LDL and HDL, and more recently has been further refined to specify HDL activity rather than levels

It seems like for many years they have been trying to make the evidence fit the cholesterol theory by constantly adjusting the tests and reference ranges, etc. Maybe it's time for a new theory, before more people are harmed by statins.

The medical industry has been doing the same thing with the worse-than-worthless PSA test. Even the developer of the test says it's worthless, but it will take a generation before doctors stop shoving needles up butts based solely on a flawed test.

I have been directly harmed by the bogus PSA test. In 2007 I asked for a B12 test. Without my consent, the doctor also checked the box for PSA. When it came back out-of-range, the medical machine went into overdrive, with doctors insisting on more PSA tests and prostate biopsy, based solely on the lab report; I had no prostate-related symptoms at all, but that didn't matter once the train left the station. It didn't take much research for me to conclude that it was time to put on the brakes, which of course made me a patient with bad attitude, and even more difficult to get any kind of help for ME.

Even a neurologist spent a half-hour (at least!) trying to bully me into a biopsy - instead of an examination of my neurological problems. My primary care person tried to convince me the ME symptoms (especially fatigue) were possibly/likely caused by prostate cancer, an assertion not supported by any literature I could find - and I really looked.

My partner of seven years moved out in large part due to the fact I refused medical care for high-PSA "disease". Like many people, she preferred to believe "the experts" instead of the evidence. She moved out in mid-winter at a time I was barely able to work a few hours per week, had no money, and had already been denied disability benefits. I heated my modest trailer house that winter by dumpster-diving for scrap wood and free heating oil from that Evil Hugo Chavez.

Somehow I managed to hang on through the never-ending disability appeals process until finally receiving a favorable judgement, in spite of suicidal ideation nearly every day for a few years. The harm I (and so many others!) experienced will never be recognized by the medical machine as it continues to chew up patients and spit out dollar bills.

I wonder if anyone has ever looked into the harms caused by the "Saturated Fat is Evil" lobby. I expect it would be a very long list.
 

perchance dreamer

Senior Member
Messages
1,691
So terrible that high carbs were pushed when fats were demonized. In Perlmutter's fine book Grain Brain, there's a cartoon of a doctor talking to a patient. Oops indeed!

toon-1766.gif
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
I wonder if anyone has ever looked into the harms caused by the "Saturated Fat is Evil" lobby. I expect it would be a very long list.

I think that a number of people have, and the numbers are growing. This article (I don't normally quote the Daily Mail!) mentions some.

I'm reserving judgement on cholesterol in light of the recent research finding that it wasn't levels of HDL but its activity that was associated with something - I forget what it was. I thought I'd posted a thread here but can't find it.

Just did a general search and found this in vitro study. Ignoring the mouse stuff, that may be relevant.
 

*GG*

senior member
Messages
6,389
Location
Concord, NH
My partner of seven years moved out in large part due to the fact I refused medical care for high-PSA "disease". Like many people, she preferred to believe "the experts" instead of the evidence. She moved out in mid-winter at a time I was barely able to work a few hours per week, had no money, and had already been denied disability benefits. I heated my modest trailer house that winter by dumpster-diving for scrap wood and free heating oil from that Evil Hugo Chavez.

Somehow I managed to hang on through the never-ending disability appeals process until finally receiving a favorable judgement, in spite of suicidal ideation nearly every day for a few years. The harm I (and so many others!) experienced will never be recognized by the medical machine as it continues to chew up patients and spit out dollar bills.

I wonder if anyone has ever looked into the harms caused by the "Saturated Fat is Evil" lobby. I expect it would be a very long list.

Why is Hugo Chavez evil? He's probably warmer than us right now. LOL

GG
 

jimells

Senior Member
Messages
2,009
Location
northern Maine
Why is Hugo Chavez evil? He's probably warmer than us right now. LOL

Well, that's what Our Dear Leaders have been telling us since 2002 when Uncle Sam organized and praised the coup d'etat in Venezuela. They are currently attempting another "regime change" even now. Personally, I vehemently disagree with the propaganda.

When Uncle Sam has a grievance against anybody he responds with aggression. After the failed coup Mr Chavez responded by sending free oil to poor Americans, including me. That's the very embodiment of Jesus' message. (And I'm not even a Christian!)