Food consumption and the actual statistics of cardiovascular diseases

[ChrisSmolinski]

Food consumption and the actual statistics of cardiovascular diseases: an epidemiological comparison of 42 European countries

Results: We found exceptionally strong relationships between some of the examined factors, the highest being a correlation between raised cholesterol in men and the combined consumption of animal fat and animal protein (r=0.92, p<0.001). The most significant dietary correlate of low CVD risk was high total fat and animal protein consumption. Additional statistical analyses further highlighted citrus fruits, high-fat dairy (cheese) and tree nuts. Among other non-dietary factors, health expenditure showed by far the highest correlation coefficients. The major correlate of high CVD risk was the proportion of energy from carbohydrates and alcohol, or from potato and cereal carbohydrates. Similar patterns were observed between food consumption and CVD statistics from the period 1980–2000, which shows that these relationships are stable over time. However, we found striking discrepancies in men’s CVD statistics from 1980 and 1990, which can probably explain the origin of the ‘saturated fat hypothesis’ that influenced public health policies in the following decades.

Conclusion: Our results do not support the association between CVDs and saturated fat, which is still contained in official dietary guidelines. Instead, they agree with data accumulated from recent studies that link CVD risk with the high glycaemic index/load of carbohydrate-based diets. In the absence of any scientific evidence connecting saturated fat with CVDs, these findings show that current dietary recommendations regarding CVDs should be seriously reconsidered.

http://journals.co-action.net/index.php/fnr/article/view/31694

[Fansome]

https://en.wikipedia.org/wiki/Gary_Taubes

If you can get a look at his 2002 NYT Magazine article, it's worth the effort. I believe that article jumpstarted this whole debate, at least in popular culture. He continues to roil the debate.

[ChrisSmolinski]

Yes, Gary has done great things in the LCHF field.

[Josh]

They should look into low cholesterol diets and alsheimers.

[Pigmeat]

https://en.wikipedia.org/wiki/Gary_Taubes

If you can get a look at his 2002 NYT Magazine article, it's worth the effort. I believe that article jumpstarted this whole debate, at least in popular culture. He continues to roil the debate.

Eat your vegetables, Al. You need the fiber. We all know how cranky you act when you get more irregular than you already are.

[KaySeeks]

http://journals.co-action.net/index.php/fnr/article/view/31694

Link is dead. Do you have the title? If so, we might be able to find it that way.

an epidemiological comparison of 42 European countries

So this would not look at, for example, the Okinawan diet, which certainly consumes quite a bit of fish protein but also rice as a source of carbohydrate.

[ChrisSmolinski]

http://journals.co-action.net/index.php/fnr/article/view/31694

Link is dead. Do you have the title? If so, we might be able to find it that way.

an epidemiological comparison of 42 European countries

Archive.org to the rescue!

https://web.archive.org/web/20170803112117/http://journals.co-action.net/index.php/fnr/article/view/31694

Conclusion: Our results do not support the association between CVDs and saturated fat, which is still contained in official dietary guidelines. Instead, they agree with data accumulated from recent studies that link CVD risk with the high glycaemic index/load of carbohydrate-based diets. In the absence of any scientific evidence connecting saturated fat with CVDs, these findings show that current dietary recommendations regarding CVDs should be seriously reconsidered.

So this would not look at, for example, the Okinawan diet, which certainly consumes quite a bit of fish protein but also rice as a source of carbohydrate.

RE Okinawa and the "blue zones, it seems to be more wishful thinking / fantasy vs reality:

https://www.biorxiv.org/content/10.1101/704080v1

Supercentenarians and the oldest-old are concentrated into regions with no birth certificates and short lifespans

The observation of individuals attaining remarkable ages, and their concentration into geographic sub-regions or ‘blue zones’, has generated considerable scientific interest. Proposed drivers of remarkable longevity include high vegetable intake, strong social connections, and genetic markers. Here, we reveal new predictors of remarkable longevity and ‘supercentenarian’ status. In the United States, supercentenarian status is predicted by the absence of vital registration. The state-specific introduction of birth certificates is associated with a 69-82% fall in the number of supercentenarian records. In Italy, which has more uniform vital registration, remarkable longevity is instead predicted by low per capita incomes and a short life expectancy. Finally, the designated ‘blue zones’ of Sardinia, Okinawa, and Ikaria corresponded to regions with low incomes, low literacy, high crime rate and short life expectancy relative to their national average. As such, relative poverty and short lifespan constitute unexpected predictors of centenarian and supercentenarian status, and support a primary role of fraud and error in generating remarkable human age records.

[KaySeeks]

So this would not look at, for example, the Okinawan diet, which certainly consumes quite a bit of fish protein but also rice as a source of carbohydrate.

RE Okinawa and the "blue zones, it seems to be more wishful thinking / fantasy vs reality:

https://www.biorxiv.org/content/10.1101/704080v1

Supercentenarians and the oldest-old are concentrated into regions with no birth certificates and short lifespans

The observation of individuals attaining remarkable ages, and their concentration into geographic sub-regions or ‘blue zones’, has generated considerable scientific interest. Proposed drivers of remarkable longevity include high vegetable intake, strong social connections, and genetic markers. Here, we reveal new predictors of remarkable longevity and ‘supercentenarian’ status. In the United States, supercentenarian status is predicted by the absence of vital registration. The state-specific introduction of birth certificates is associated with a 69-82% fall in the number of supercentenarian records. In Italy, which has more uniform vital registration, remarkable longevity is instead predicted by low per capita incomes and a short life expectancy. Finally, the designated ‘blue zones’ of Sardinia, Okinawa, and Ikaria corresponded to regions with low incomes, low literacy, high crime rate and short life expectancy relative to their national average. As such, relative poverty and short lifespan constitute unexpected predictors of centenarian and supercentenarian status, and support a primary role of fraud and error in generating remarkable human age records.

This is pre-print, so it is unclear (at least to me) whether this conclusion has been peer-reviewed. Let's see if it survives the peer-review process.

Also, longevity and risks of various diseases have some overlap, obviously, but if we take the allegedly-fraudulent people out of the equation, what are the remaining observations of the general population of the blue zones?

[KaySeeks]

So this would not look at, for example, the Okinawan diet, which certainly consumes quite a bit of fish protein but also rice as a source of carbohydrate.

RE Okinawa and the "blue zones, it seems to be more wishful thinking / fantasy vs reality:

https://www.biorxiv.org/content/10.1101/704080v1

Supercentenarians and the oldest-old are concentrated into regions with no birth certificates and short lifespans

The observation of individuals attaining remarkable ages, and their concentration into geographic sub-regions or ‘blue zones’, has generated considerable scientific interest. Proposed drivers of remarkable longevity include high vegetable intake, strong social connections, and genetic markers. Here, we reveal new predictors of remarkable longevity and ‘supercentenarian’ status. In the United States, supercentenarian status is predicted by the absence of vital registration. The state-specific introduction of birth certificates is associated with a 69-82% fall in the number of supercentenarian records. In Italy, which has more uniform vital registration, remarkable longevity is instead predicted by low per capita incomes and a short life expectancy. Finally, the designated ‘blue zones’ of Sardinia, Okinawa, and Ikaria corresponded to regions with low incomes, low literacy, high crime rate and short life expectancy relative to their national average. As such, relative poverty and short lifespan constitute unexpected predictors of centenarian and supercentenarian status, and support a primary role of fraud and error in generating remarkable human age records.

I had some time to look at the paper. I have a background in applied statistics, but not related to health or bio-statistics, so I get their approach and it looks solid to me.

If true, and I think that in general their methods are probably sound, it shows the risks and dangers of basing conclusions upon outliers (the "supercentinarians") as opposed to the general main body of data, in this case, that would be the general population of these "blue zones". I have a feeling (unproven) that what has been going on is that someone identified some regions of the world as having a lot of outliers to the longevity norms. The ever-cautious scientists said, "we need to study these regions and individuals more before we draw conclusions", but the people who are less scrupulous and make paid TV adverts for a living jumped ahead and made an industry out of promoting them, garnering a lot of flashy attention. This paper, if upheld, would fall into the the former category, the normal workload of validating the observations, as ever-cautious scientists would do. Not sexy but necessary.

[ChrisSmolinski]

Related, a new article from the Journal of the American College of Cardiology:

Saturated Fats and Health: A Reassessment and Proposal for Food-based Recommendations: JACC State-of -the-Art Review
https://www.sciencedirect.com/science/article/pii/S0735109720356874

The recommendation to limit dietary saturated fatty acid (SFA) intake has persisted despite mounting evidence to the contrary. Most recent meta-analyses of randomized trials and observational studies found no beneficial effects of reducing SFA intake on cardiovascular disease (CVD) and total mortality, and instead found protective effects against stroke. Although SFAs increase low-density lipoprotein (LDL)-cholesterol, in most individuals, this is not due to increasing levels of small, dense LDL particles, but rather larger LDL which are much less strongly related to CVD risk. It is also apparent that the health effects of foods cannot be predicted by their content in any nutrient group, without considering the overall macronutrient distribution. Whole-fat dairy, unprocessed meat, eggs and dark chocolate are SFA-rich foods with a complex matrix that are not associated with increased risk of CVD. The totality of available evidence does not support further limiting the intake of such foods.

IMHO a huge dis-service was done via the "war on fat" as it green-lighted food manufacturers to start churning out high sugar (and high margin) products, legitimized by the "Heart Healthy" label.