Controversial Thoughts: Why Epidemiology Is So Misleading and PUFA

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Paul Saladino35m · 2020-10-30

Claims Made

54

Claims Supported

27

Support Rate

50%

Support rate

27 of 54 claims supported

27 supported27 partial / not

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38

Well SupportedIn Eastern epidemiological studies, higher red meat consumption in men was associated with lower rates of heart disease, and in women with lower rates of breast cancer.Well SupportedRandomized controlled trials showing that red meat is not inflammatory should be considered as part of the overall body of evidence.Partially SupportedThe unhealthy user bias suggests that individuals who disregard mainstream health advice and consume red meat may also engage in other risky behaviors.Well SupportedRed meat intake was inversely associated with cardiovascular disease mortality in men and cancer mortality in women in Asian countries.Partially Supported

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A. Volkovreader

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Bookmarking — the dossier-vs-overview split is the right call. Most of the time I want overview; sometimes I want receipts.

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N. Park

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Would love a "what would change this verdict" RSS feed. Sign me up if it exists.

A study on 223,000 men and women in Asia found mortality risk from cerebrovascular disease was inversely associated with dairy, meat, and fish consumption.

Partially SupportedVegetarian death rates are similar to the general population when controlling for healthy behaviors.

Partially SupportedStudies suggesting meat is associated with negative cardiovascular outcomes may be influenced by confounding factors like healthy user bias or unhealthy user bias.

Partially SupportedSaturated fat has been shown in interventional trials to not be harmful, despite raising LDL.

Partially SupportedInterventional animal models investigating fat effects differ from human epidemiology due to confounding biases.

Well SupportedReplacing saturated fat with linoleic acid lowers cholesterol but may increase the risk of death from all causes.

Partially SupportedIn rat models, saturated fats were protective against colon cancer, while polyunsaturated fats worsened outcomes.

Well SupportedA reduction of about 30 mg/dL in total cholesterol was indicated in the low saturated fat group of the Minnesota Coronary Experiment.

Partially SupportedAnimal studies suggest polyunsaturated fats are detrimental for colon cancer, while saturated fats appear protective.

Partially SupportedSubstituting linoleic acid for saturated fats in the Sydney Diet Heart Study cohort did not establish clinical benefits and increased death rates from all causes, coronary heart disease, and cardiovascular disease.

Partially SupportedHealthy user bias occurs when individuals who adopt one healthy behavior also tend to engage in other healthy behaviors.

Partially SupportedLinoleic acid oxidation products stimulate CD36 gene expression in human macrophages, promoting uptake of oxidized LDL and fatty streak formation.

Well SupportedEpidemiological data generally suggests that individuals who consume more fruits and vegetables are healthier than those who do not.

Partially SupportedAnimal studies show higher linoleic acid intake is linked to LDL oxidation, cancer, and cardiovascular disease.

Partially SupportedMarine omega-3 PUFA intake was associated with a substantial decrease in total mortality in a Chinese study, but in NHANES, it was inversely associated with total mortality only for participants consuming 33-100 mg/day of EPA and DHA.

Partially SupportedHigher linoleic acid intake was inversely associated with all-cause mortality in NHANES.

Partially SupportedHigher ALA intake was modestly associated with lower all-cause mortality in the NHANES cohort.

Not SupportedObservational epidemiology associating red meat consumption with increased cancer risk in men may be confounded by unhealthy user bias.

Partially SupportedIncomplete publication has led to overestimating the benefits of replacing saturated fat with linoleic acid-rich vegetable oils.

Partially SupportedHigh intake of linoleic acid was associated with a 2.39 hazard ratio for death from breast cancer in post-menopausal women diagnosed with breast cancer.

Partially SupportedPaul Saladino has no coronary artery calcium score despite elevated LDL and high linoleic acid intake.

Partially SupportedA meta-analysis found linoleic acid consumption was associated with better outcomes in American and Italian cohorts, but worse outcomes in a Chinese cohort.

Partially SupportedArachidonic acid (found in meat) was consistently linked with reduced all-cause mortality in US and Chinese cohorts.

Partially SupportedIncreased linoleic acid consumption is associated with worse health outcomes, including breast cancer.

Partially SupportedDietary unsaturated fats may have potent carcinogenic effects on colon carcinogenesis.

Partially SupportedThe association of red meat with cancer or heart disease may be due to unhealthy behaviors of red meat consumers rather than a direct causal link.

Partially SupportedThe association between fruit and vegetable consumption and improved health outcomes may be due to other healthy behaviors practiced by those individuals.

Partially SupportedThe prevailing narrative for 70 years has promoted the idea that saturated fat from animal foods raises LDL and is bad for health.

Partially SupportedHigher total polyunsaturated fat intake is associated with younger age, higher BMI, higher education, and increased alcohol consumption and smoking.

Partially SupportedA weak reverse association was found between dietary PUFA intake and all-cause mortality in the NHANES cohort.

Partially SupportedEpidemiology can only establish association, not causation, making it difficult to definitively link specific foods like red meat to cardiovascular disease.

Not SupportedEpidemiological data on polyunsaturated fatty acids (PUFAs) is not settled and can be misleading.

Partially SupportedObserved health benefits in vegetarians may be due to non-dietary factors or other dietary aspects besides meat avoidance.

Not SupportedEpidemiological data on linoleic acid and breast cancer is not settled and may be influenced by healthy user bias.