On @joerogan with @drjkahn, @chriskresser cited the egg feeding trial literature to support flat-earth-style claims that saturated fat doesn't increase cholesterol. The problem? This literature readily acknowledges that saturated fat causes higher cholesterol. 🤣 1/n
Here is one paper, that he actually cites in his articles.
I agree with commenters that these results don't make sense. Worst case, saturated fats raise LDL, trigs, and HDL in low-carb subjects. The fact that the low-carb subjects are lowering HDL suggests that the low-carb subjects aren't adhering to the diet. 1/6
But actually this raises an important question that @whsource and @CakeNutrition have raised... What does real-world, long-term LCHF actually look like? Is becoming nonadherent and sneaking Skittles the norm or the exception for low-carb dieters? 2/6
Furthermore, could becoming somewhat nonadherent on a low-carb diet actually be WORSE than not trying to be low-carb at all? This is what these data might seem to be suggesting occurs. @CakeNutrition has pointed out that this might happen as well. 3/6
Receiving a paycheck dependent on performance in promoting partisan claims about science--e.g. paid roles as author, speaker, and director promoting partisan claims--is a serious conflict of interest when writing articles that purport to be scientific. 1/8
Nina Teicholz (@bigfatsurprise), whose financial situation is described above, wrote an article which purports to be scientific and presents these very same views for which she receives compensation. Yet, she does not disclose this financial conflict of interest. 2/8
To be clear, Nina Teicholz (@bigfatsurprise) is disincentivized from evaluating new information on her hypotheses objectively because changing her opinion in light of new information would come into conflict with prior paid commitments. 3/8
Eating is one of the most primal acts. And we eat more than we make love. Thus, criticizing someone's diet is like criticizing their spouse's looks, but worse. Plus, you're criticizing their mom as well, because they eat that way because of their mom. It's bad all around.
Combine this emotional valence with nutrition science's probabilistic nature. When everyone is defending the equivalent of their spouse's looks and their mother at the same time...
it's easy to want to tell some weasely science that makes heavily qualified suggestions it is clueless and to stfu and stop talking about your wife/mom. If it was a big bad science that could tell YOU to stfu (like physics), there would be no problem, but it isn't.
I gained some notoriety over the past month or so for the crazily unexpected exchange that I had with @joerogan--which led to the upcoming @DominicDAgosti2 vs. @BioLayne, @chriskresser vs. @drjkahn, and an undisclosed but if it comes through, a truly EPIC matchup I'm told :) 1/n
But what really got me some respect from experts was my stuff I did at the beginning of the year with the dietary trends, e.g. medium.com/@kevinnbass/th… and another one I will be posting soon. 2/n
I think that this work goes about 30% deep on the dietary trend data, compared to the level it could go with more work. And I think the scientific literature really needs to be updated on this subject. 3/n
I don't have any substantive scientific disagreement with @DaveKeto. The issue is whether it is appropriate to support people who deny that LDL has an important role in cardiovascular disease. That there are other factors besides LDL that cause CVD is universally accepted. 1/7
Yet that high LDL causes CVD is equally universally accepted. Therefore if you support people who deny the role of LDL in CVD, I cannot see how you are not supporting science denialism and therefore in serious violation of basic ethical norms. 2/7
Furthermore, because of the tremendous public health implications of LDL-CVD and the suggestability of people who are not well-informed about CVD (the vast majority), there is also the likelihood of serious harm resulting from disseminating LDL denialist claims. 3/7
LDL increase during weight loss is likely to be proportional to rate of WL. Higher WL rate will produce higher transient LDL, but for a shorter period. Key is, in the long-term, if lower weight maintained, overall LDL exposure should be lower despite transient increase. 1/3
That said, if LDL is expected to spike particularly high during WL, maybe statin might be good idea? I am thinking it would depend on expected duration of weight loss and pre-existing cardiovascular disease risk. And also evidence, of which I think there is none.😁 2/3
But I think key point is that weight loss lowers overall risk if it can be maintained. I don't think the transient increase in LDL during weight loss should be the primary concern. Longer term higher weight is the bigger concern and risk for CVD (and other diseases). 3/3
What Mendelian randomization can tell us about the association between insulin and obesity.
The most generous Mendelian randomization (published by @davidludwigmd) shows that 1 standard deviation higher genetically determined insulin (insulin-30) causes 0.1 point BMI. 98th percentile (1/50 people) for insulin secretion = 0.2 BMI points. clinchem.aaccjnls.org/content/64/1/1…
If my interpretation is right, this implies that insulin cannot be responsible for the vast bulk of the genetic component of obesity, since genetics is thought to be responsible for ~65% of the inter-individual variation in BMI, per @JohnSpeakman4. nature.com/articles/s4136…
I don't claim to know more than @garytaubes. He probably knows a lot more than I do. I just know what some of his sources say. Many of those do not say what he says they do. I don't know why that is, but I am sure that this is true and that I can demonstrate it.
Confronting GCBC last December for the second time (this time at least somewhat competently) was a truly trying intellectual experience for me. I had to reconcile that someone of Gary's ability could be so wrong.
At one point I came to a conclusion: intelligence and writerly skill are unrelated to scientific competence. I am reminded of a conversation that I once had with a mathematician. He said that one of the reasons he loves math is that no matter what, he can always do math.
Take two suicidal men in 1800. One is wheelchair-bound and has no ready means of a swift death. Another works in a tall building. One day, he jumps and kills himself. The former changes his mind. Do we conclude then that suicidality is not a primary cause of suicide? 2/n
Any number of things can influence a suicidal person's decision to commit suicide. A concerned phone call from a mother. A confidant stopping a person in a rough spot. Having access to firearms. Becoming drunk and losing one's inhibitions. Being dispositionally impulsive. 3/n
Because I know the criticism is almost certainly coming in response to my MD thread, here's an interesting slide on residency training, from drum.lib.umd.edu/bitstream/hand…
The sources I've looked at say LCME has EBM as core competency. But when??? During 3rd, 4th year rotations? You might scratch the surface but a serious understanding of how to evaluate science while running around the hospital, taking exams, deciding your career? *No way.*
So we're left with a shallow understanding of science and EBM during medical school, followed by 3 hours per month of EBM as a resident?
So I repeat, physicians aren't trained to understand how science works. They're trained to apply it.
It'd not either/or. I'm claiming to make scientific statements. Thus, communicating facts takes priority over communicating ethics. I also try, when warranted, to violate my ethics in my thinking as a check on my own bias. Because I want to do my job, not appear to do it.1/6
Do "ethics" play a role for me personally? If by ethics, you mean a way of behaving that is consistent with the application of civilized values and the facts, yes. I don't think of ethics as a choice but derived from the facts and the common culture we have all inherited.2/6
This makes ethics contingent on an appropriate understanding of the facts. This is probably the position most people hold, and for good reason.3/6
Yes, I have much more joint pain than usual, and apparently slower healing. My knocks and bangs just aren't going away. And it is debilitating since I am now training both BJJ and resistance, and I cycle a ton. 1/n
Still, I don't fully believe my own symptoms until I get objective biomarkers. The placebo effect is extremely powerful, and I could be expressing psychological symptoms through my body. I am exceedingly overworked, so who knows? 2/n
In the context of the mind-immune system connection, it's also conceivable that I am stressed and this is manifesting in my joints. I just don't think I experience this, but I could be misremembering. It's a serious possibility. And so. 3/n
I've made an infographic explaining conditioned immunosuppression. This was first established in rodents in the 1980s but also shown to be operative many, many times in humans.
Now, here's a brief thread here explaining a few things about this pathway and its importance.
The pathway for conditioned immunosuppression is thought to operate through the amygdala, insula, and part of the prefrontal cortex. This was first shown in 2002, but lots of work has since explained the pathway in more detail. See:
If holistic management cannot be reductively studied, then we should be able to take Savory-trained farmers and pair them off against conventional farmers in matched (and various) ecological conditions.
If holistic management produces the miracles you claim, then Savory-trained farmers should overwhelmingly outperform their controls. We should see increasing top soil and net sequestration.
Your show has positively impacted my life and scientific trajectory, @joerogan.
However, contrary to tweets attached--JRE *does* present a unbalanced perspective on nutrition that overwhelmingly promotes a low-carb narrative.
In this thread, I will show this with data. 1/n
Here is a screenshot of my spreadsheet that I used to analyze these data. The two colored left-hand columns are an indication of the positions taken on the podcast re: carbohydrates. Green is positive, red is negative. Right column is Joe's view; left is guest. 2/n
I will make the spreadsheet publicly available upon request (note: screenshot is not final), and in this thread, I will be communicating the methods after I have presented the data. 3/n
I was asked by Gary Taubes for an interview for his new book in December. At that point I was still open to being collegial with the low carb community. Earlier, for instance, I had corresponded quite a bit with Nina Teicholz. Gary wrote this is why he contacted me.
Before responding to Gary, I re-read Good Calories Bad Calories. I had been contacted by important people before (David Ludwig for instance, who seems to be a great guy and super smart), but I still thought of Gary as THE leader of low carb. 2/21
So I was shocked, flattered and a little confused. Gary wrote that he wanted to interview me about why I become WFPB after being low carb. But what could I offer him that he did not already know? So before responding, I started reading GCBC again, wanting to understand this. 3/21
I'm going to tweet interesting facts from it. And from the papers it cites that are interesting enough to look up. 2/n
Here's one. In this study in Sardinia, soldiers had a greater survival if they were short. At 70 years of age, the shorter men (<160 cm, or about 5'3") lived 2 years longer than men taller than 5'3". tandfonline.com/doi/abs/10.108… 3/n
80% of Alt Nutrition gurus commit one of two mistakes: 1. Blinded by desire for recognition and sometimes even resentment or jealousy (as toward successful relatives), they're biased toward claims that undermine the establishment and inflate their sense of self-importance. 1/4
They will systematically misread science if it allows them to gratify their egos in this way. This is actually sad and I'm 100% not making fun of it.
2. They just do not understand the work that the best scientists put into their publications. 2/4
If most Alt Nutrition gurus understood the hard work that scientists actually do in peeling back layer upon layer upon layer of questions as they think about and write up their work, they would shit themselves. 3/4