It's pretty embarrassing when a medical doctor loses a diet argument with a layman.
I don't think you understand how debate works. If you make an assertion, you have to back that shit up withsomethingmore than an appeal to authority. Doubly so if that authority is you. "Yous is dubmz! I is doctar!" does not count. You might well be right, but by not bothering to engage the argument constructively you just paint yourself as a contrarian jackhole.
I really appreciate being trolled, when I'm being quoted literature to by a fucking retard that doesn't even read what he's posting. Let's go and read exactly what he just wrote. We will be addressing the text of this study that Dashel most recently linked:
http://ajcn.nutrition.org/content/ea...27725.full.pdf
First, a few words on this study. This is from 2009, and the type of a study is a meta-analysis. What these studies do is define a a specific point they are interested in investigating, and then perform a literature search to find studies that address these points. Then they look at these studies and compare them to their inclusion criteria to see if the study is ok to be included in the analysis. This means that often valid studies get tossed aside, because their end points (what they are investigating) are simply not quite what the study is interested in finding. This will become important later on when I quote the actual text of the article that Dashel is too retarded to read and demonstrate why he, again, is a fucking retard.
Here is a link to the study pdf and here is the wholly unambiguous conclusion it comes to:
In this sentence, you state that the CONCLUSION is wholly unambiguous, and then you quote a single sentence from the DISCUSSION of the study you linked:
Dashel's study_sl said:
The conglomeration
of data from 16 studies with CHD as an endpoint and
8 studies with stroke as the endpoint showed no association of
dietary saturated fat on disease prevalence after adjustment for
other nutrients wherever possible.
However, that is NOT what the study CONCLUDED. The study actually CONCLUDED that more data is necessary with regards to the reduction of CVD risk with the replacement of saturated fats with certain nutrients such as polyunsaturated fatty acids:
The CONCLUSION of the study_sl said:
More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.
Boy. That is pretty ambiguous!
So, let's look at the actual claim that I am making and what this *one* meta-analysis states about it. From the text of the very same study:
Only a limited number of studies provided data that enabled the evaluation of the effects of isocalorically replacing saturated fat with carbohydrate or polyunsaturated fat, and, as such, the statistical power was diminished for the secondary analyses restricted to these studies. Most recently, however, an analysis conducted in a pooled cohort of studies showed a lower CHD risk when saturated fat was replaced with polyunsaturated fat and increased nonfatal myocardial infarction, but not fatal CHD, risk when saturated fat was replaced with carbohydrate (24).
What this says is that within the studies that met inclusion criteria for THIS PARTICULAR meta-analysis, there were a limited number of studies that showed replacing SFAs with PUFAs results in a stepwise decline in CVD risk. This has no implications on the actual fact that multiple studies have demonstrated this safety benefit. This only has to do with the studies that met inclusion criteria for this analysis. And again, when we read the actual conclusion of the analysis, we see that they are COMPLETELY ambiguous (the word is equivocal in science, Dashel, you caveman scientist) to this, because they see that the science does actually support this, but as we'll soon see, only one such study met the inclusion criteria, therefore making statistical importance difficult.
And the next sentence is the one that explains everything:
Dashel's study_sl said:
Inverse associations of polyunsaturated fat and CVD risk have previously been reported (41, 42). Replacement of 5% of total energy from saturated fat with polyunsaturated fat has been estimated to reduce CHD risk by 42% (43). Notably, the amount of dietary polyunsaturated fat in relation to saturated fat (ie, the P: S ratio) has been reported to be more significantly associated with CVD than saturated fat alone, with a reduced CHD risk found with P:S ratios ! 0.49 (44). Only 1 of the 21 studies that met criteria for inclusion in this meta-analysis evaluated the relation of the P:S ratio with CHD (14). No effect was seen in this study,
?
in which the average P:S ratio was ?0.4, nor was there an as- sociation of P:S ratio with CVD in the Israeli Ischemic Heart Study (U Goldbourt, personal communication, 2008). However, these studies were relatively small.
Read this carefully. Again, they explicitly state that multiple studies have shown replacing significant portions of SFAs with PUFAs results in a decline in CVD risk. Of course, this is based on how much SFA is replaced by PUFA. They explicitly tell you that this benefit is seen when the P:S ratio is > 0.49. AND THEN, they explicitly tell you that the ONLY STUDY that they happened to include in their analysis had a P:S ratio of 0.4. So they explicitly tell you that many studies have demonstrated CVD risk reduction by replacing SFAs with PUFAs in ratios > 0.49, and then tell you that (for whatever reason, I didn't pour over the inclusion criteria) the only study they included is one in which the ratio was less than what is required to gain the benefit. ONE STUDY. So of course they did not find a benefit. And if that isn't explicit enough, they even go on to tell you that the study that did not find a benefit was small, which statistically means that it is not powerful. (The power of a study is related to how many participants something has. A small study is not powerful. Please look this up and understand it.)
And the final paragraph related to SFAs and PUFAs in this analysis puts the nail in the coffin for Dashel's retardicity:
Of note, in intervention trials that have shown protective effects of reducing saturated fat, ie, the Veteran Affairs (19), Oslo Diet Heart (20), and Finnish Mental Hospital (21) studies, the calculated P:S ratios ranged from 1.4 to 2.4?values that are much higher than the threshold of 0.49 above which CHD risk has been reported to be reduced (44). Relatively high P:S ratios (1.25?1.5) were also observed in the Anti-Coronary Club Study, an early trial that showed beneficial effects of a lower fat diet (30? 32% of total energy) (45). The presumed beneficial effects of diets with reduced saturated fat on CVD risk may therefore be dependent on a significant increase in polyunsaturated fat in the diet. Existing epidemiologic studies and clinical trials support that substituting polyunsaturated fat for saturated fat is more beneficial for CHD risk than exchanging carbohydrates for saturated fat in the diet, as described further elsewhere (46).
Again, even though none of the above referenced studies were included in this analysis, the study goes out of its way to identify them as demonstrating that replacing SFAs with PUFAs decreases CVD risk. Especially read the last sentence. This is not presented as something with ambiguity. They are simply stating that the bulk of the science shows the effect that I am claiming, and that for whatever reason, those studies were not included in their analysis, which is why their conclusion of their particular analysis was completely equivocal (ambiguous.)
I hope I made that clear enough for anyone who is actually interested. I think it's a pretty succinct demonstration that even this study, that Dashel claimed was completely UNambiguous, indeed supported the very thing that he is trying to argue against, which is the very thing I am arguing for, that replacing SFAs with PUFAs in reasonable amounts results in a stepwise decline in CVD risk. I just think it's fucking hilarious that Dashel can't even read the studies he is posting.
But hey, let's go further!
Laaksonen DE, Nyyssonen K, Niskanen L, Rissanen TH, Salonen JT. Prediction of cardiovascular mortality in middle-aged men by dietary and serum linoleic and polyunsaturated fatty acids. Arch Intern Med 2005;165:193?9.
http://www.ncbi.nlm.nih.gov/pubmed/15668366
BACKGROUND:
Substitution of dietary polyunsaturated for saturated fat has long been recommended for the primary prevention of cardiovascular disease (CVD), but only a few prospective cohort studies have provided support for this advice.
METHODS:
We assessed the association of dietary linoleic and total polyunsaturated fatty acid (PUFA) intake with cardiovascular and overall mortality in a population-based cohort of 1551 middle-aged men. Dietary fat composition was estimated with a 4-day food record and serum fatty acid composition.
RESULTS:
During the 15-year follow-up, 78 men died of CVD and 225 of any cause. Total fat intake was not related to CVD or overall mortality. Men with an energy-adjusted dietary intake of linoleic acid (relative risk [RR] 0.39; 95% confidence interval [CI], 0.21-0.71) and PUFA (RR, 0.38; 95% CI, 0.20-0.70) in the upper third were less likely to die of CVD than men with intake in the lower third after adjustment for age. Multivariate adjustment weakened the association somewhat. Mortality from CVD was also lower for men with proportions of serum esterified linoleic acid (RR, 0.42; 95% CI, 0.21-0.80) and PUFA (RR, 0.25; 95% CI, 0.12-0.50) in the upper vs lower third, with some attenuation in multivariate analyses. Serum and to a lesser extent dietary linoleic acid and PUFA were also inversely associated with overall mortality.
CONCLUSIONS:
Dietary polyunsaturated and more specifically linoleic fatty acid intake may have a substantial cardioprotective benefit that is also reflected in overall mortality. Dietary fat quality seems more important than fat quantity in the reduction of cardiovascular mortality in men.
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Soinio M, Laakso M, Lehto S, Hakala P, Ronnemaa T. Dietary fat predicts coronary heart disease events in subjects with type 2 diabetes. Diabetes Care 2003;26:619?24.
http://www.ncbi.nlm.nih.gov/pubmed/12610011
OBJECTIVE:
To investigate whether quantity or quality of dietary fat predicts coronary heart disease (CHD) events in middle-aged type 2 diabetic subjects.
RESEARCH DESIGN AND METHODS:
The dietary habits of 366 type 2 diabetic men and 295 women, aged 45-64 years and free from CHD, were assessed with a 53-item food frequency questionnaire. They were followed up for 7 years.
RESULTS:
Men in the highest tertile of the polyunsaturated/saturated fat (P/S) ratio (>0.28) had a significantly lower risk for CHD death than men in the two lowest tertiles (5.0 vs. 14.2%, P = 0.009). The risk for all CHD events was 14.2 vs. 23.2%, respectively (P = 0.044). P/S ratio did not predict CHD events in women. In Cox multiple regression analyses taking into account other cardiovascular risk factors, the highest P/S ratio tertile was associated with the lowest rate of CHD death in men (P = 0.048).
CONCLUSIONS:
Low P/S ratio in men predicted future CHD events in type 2 diabetic subjects independently of conventional CHD risk factors.
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Hu FB, Stampfer MJ, Manson JE, et al. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 1997;337:1491?9.
http://www.nejm.org/doi/full/10.1056...99711203372102
Our findings suggest that replacing saturated and trans unsaturated fats with unhydrogenated monounsaturated and polyunsaturated fats is more effective in preventing coronary heart disease in women than reducing overall fat intake.
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Hu FB, Stampfer MJ, Manson JE, et al. Dietary saturated fats and their food sources in relation to the risk of coronary heart disease in women. Am J Clin Nutr 1999;70:1001?8.
http://ajcn.nutrition.org/content/70/6/1001.abstract
The multivariate RR for a 1% energy increase from stearic acid was 1.19 (95% CI: 1.02, 1.37). The ratio of polyunsaturated to saturated fat was strongly and inversely associated with CHD risk (multivariate RR for a comparison of the highest with the lowest deciles: 0.58; 95% CI: 0.41, 0.83; P for trend < 0.0001). Conversely, higher ratios of red meat to poultry and fish consumption and of high-fat to low-fat dairy consumption were associated with significantly greater risk.
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AND FINALLY
Jakobsen M. Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr May 2009 vol. 89 no. 5 1425-1432.
http://ajcn.nutrition.org/content/89/5/1425.full
Background: Saturated fatty acid (SFA) intake increases plasma LDL-cholesterol concentrations; therefore, intake should be reduced to prevent coronary heart disease (CHD). Lower habitual intakes of SFAs, however, require substitution of other macronutrients to maintain energy balance.
Objective: We investigated associations between energy intake from monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), and carbohydrates and risk of CHD while assessing the potential effect-modifying role of sex and age. Using substitution models, our aim was to clarify whether energy from unsaturated fatty acids or carbohydrates should replace energy from SFAs to prevent CHD.
Design: This was a follow-up study in which data from 11 American and European cohort studies were pooled. The outcome measure was incident CHD.
Results: During 4?10 y of follow-up, 5249 coronary events and 2155 coronary deaths occurred among 344,696 persons.For a 5% lower energy intake from SFAs and a concomitant higher energy intake from PUFAs, there was a significant inverse association between PUFAs and risk of coronary events (hazard ratio: 0.87; 95% CI: 0.77, 0.97); the hazard ratio for coronary deaths was 0.74 (95% CI: 0.61, 0.89).For a 5% lower energy intake from SFAs and a concomitant higher energy intake from carbohydrates, there was a modest significant direct association between carbohydrates and coronary events (hazard ratio: 1.07; 95% CI: 1.01, 1.14); the hazard ratio for coronary deaths was 0.96 (95% CI: 0.82, 1.13). MUFA intake was not associated with CHD. No effect modification by sex or age was found.
Conclusion: The associations suggest that replacing SFAs with PUFAs rather than MUFAs or carbohydrates prevents CHD over a wide range of intakes.