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Saturday, August 16, 2014

Everything you know is wrong

I recently read a book titled "The big fat surprise" by Nina Teicholz. In this book she reviews the history of low fat diets as a healthy approach to eating. As the pages turned, I could not help but recall the movie "Sleeper". In this movie,  Miles Monroe (played by Woody Allen), a jazz musician and owner of the 'Happy Carrot' Health-Food store in 1973, is subjected to cryopreservation without his consent, and not revived for 200 years. After waking his requests for breakfast are viewed with some disbelief.

Dr. Melik: This morning for breakfast he requested something called "wheat germ, organic honey and tiger's milk."
Dr. Aragon: [chuckling] Oh, yes. Those are the charmed substances that some years ago were thought to contain life-preserving properties.
Dr. Melik: You mean there was no deep fat? No steak or cream pies or... hot fudge?
Dr. Aragon: Those were thought to be unhealthy... precisely the opposite of what we now know to be true.
Dr. Melik: Incredible.
It seemed as though it was a joke when the movie aired in 1973 but the truth does not appear so humorous. The joke may have been on us for buying into what may very well be low fat nonsense. As the book describes, the origins of the diet which can be traced back to Ancel Keys, an American physiologist from mid 20th century. The book goes a long way into discrediting the purported science behind the diet, convincing me for one that perhaps significant harm has been foisted upon the American public. The data to support such a massive experiment upon the public was thin at best and perhaps better described as a massive fraud. The work represents a terrible indictment of the scientific peer review system as well, where peer review functioned only to squelch contrary (and what appear to be more accurate) opinions for over 60 years. I have already begun to change what I eat, incorporating more fat and in particular saturated fat. 

This particular set of dogma is not the only dogma now coming into question. Just this week there was a study published in the NEJM which followed more 100,000 people from 17 countries and found that those who consumed less than 3 grams of sodium a day had a 27% increased risk of death. The follows on the heels of a recent IOM report calling into question any cardiovascular or mortality benefits from lowering sodium intake below 2300 mg/day. The American Heart Association remains unconvinced, much as they remain unconvinced about issues with low fat diets. 

Although it garnered limited press, the Cochrane group reviewed studies which examined the benefits conferred from the treatment of mild systolic (140-159 mm Hg) or diastolic hypertension (90-99 mm Hg). (Cochrane Review) They reviewed studies including almost 9000 participants. They were able to demonstrate no effect on morbidity or mortality in the treated group and almost 10% of those treated had to discontinue treatment due to side effects. So why is aggressive treatment of BP in the demographic being used as a quality metric?

There is a theme here. In an attempt to improve the health of people, influential organizations have undertaken grand plans and schemes and based upon the trust which the public has placed in these organizations, massive campaigns have been undertaken. Driven by "hedgehogs" who pressed their agendas forward with little doubt they were doing the right thing, staggering numbers of people were the subjects of what amounts to be huge and uncontrolled experiments. Very disturbing...

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