Even tho the studies conclusions agree with my own belief that dietary carbohydrates drive hyper-insulinaemia which drives cardiovascular disease, I’m not going to use the observed association at 28% to infer cause. An association less than 200% just doesn’t meet the Bradford Hill standard for causation.
Mind you if you drill into the Australian Dietary Guidelines 2013 evidence report for a statement like
“Consumption of 1-3 serves per day of wholegrain cereals is associated with a reduced risk of cardiovascular disease”
Then drill into just the first study [https://www.ncbi.nlm.nih.gov/pubmed/12740068] cited as contribution to an evidence rating of “Excellent” you will find the headline observation is
“Epidemiological studies indicate that individuals with higher levels (in the highest quintile) of whole-grain intake have a 29% lower risk for Atherosclerotic cardiovascular disease than individuals with lower levels (lowest quintile) of whole-grain intake”
That observation is simply inadequate to infer that wholegrains in the diet can cause a reduction in cardio vascular disease.
The PURE study results are equally inadequate to assert that an observed 28% correlation between carbs and mortality is causal.
What the PURE study DOES however give us is a NON-CORRELATION between Saturated fat (or total fat) and cardiovascular disease or all cause mortality.
You can use non-correlation to infer non-Causation.
The game is over in Australia for the NH&MRC and the DAA (who provided their systematic literature review) claiming that dietary Saturated fat or Total fat causes CVDs or increases risk of all cause mortality. And if they are honest they will have to drop that claim.