Salim Yusuf PURE Study


(Richard Morris) #21

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.


(ianrobo) #22

yep, as I mentioned on another thread, you had John McDougall speaking to Jimmy Moore claim that all studies shows fat causes heart disease. If we can stop that kind of talk then it does as you suggest @richard all start to fall apart.


(mcebis) #23

All the crap in our dietary guidelines comes from similar studies and similar evidence. This study doesn’t support the keto diet or LCHF as the people studied were not eating anywhere near that low carb. It does provide some pause to question LDL and cholesterol and almost everything we are told (salt, sat fat, fruit & veg, carbs). In fact the only thing that it agrees with is monosaturated fats and legumes and pulses. The Women’s Health Initiative was an RCT that showed no benefit from low fat and that was higher evidence than this. It was simply explained away. The ‘trick’ here is to say well we have up to date evidence of the same kind that contradicts. Its all no good. Hit the reset button please.


#24

I haven’t had access to the PURE study but this Toronto Star article was sent to me by a friend who knows that I am on Keto. Said friend is also obese with diabetes running in her family. She works out and tries to eat low carb half the time but the other half eats sugar and empty carbs.

Although the headline seems Keto-approved these are some of the takeaways:

Mahshid Dehghan, a nutrition epidemiologist at the Hamilton university’s Population Health and Research Institute, said the healthiest diet would be made up of 50 to 55 per cent carbohydrates and 35 per cent total fat, including both saturated and unsaturated types.

“We’re not advocating an extreme diet,” agreed co-author Andrew Mente. “We’re not saying that people should go on a low-carb, very high-fat diet because we didn’t find any benefit with a very low-carb diet either.

“The message of our study is moderation as opposed to very low or very high intake in consumption of both fats and carbohydrates.” - Dehghan

That paper — one of three from PURE published in The Lancet — found that eating three to four servings of fruit, vegetables and legumes per day reduces the risk of premature death.

Mente said the study also showed raw vegetables appear to confer greater health benefits than those that are cooked because of a loss of nutrients from being exposed to heat.

It is unfortunate that such articles influences people with damaged metabolisms and makes them think that the moderation diet is best for them.


(Will Madams) #25

Does anyone have a working link?


(Doug) #26

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32252-3/fulltext

Hope it works for you, Will.


(Richard Morris) #27

So I met prof Yusuf and asked him a question


(bulkbiker) #28

I bet Georgia Ede was most unimpressed with Dr Mozz…