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2021

May, 2021

Mechanistic Circle-jerking, Part 2: LDL Oxidation on Low-PUFA Diets

  • High-SFA diets increase LDL oxidation more than high-PUFA diets.

  • Antioxidants protect LDL particles from oxidation.

  • High-PUFA diets are usually high in antioxidants.

  • High-SFA diets are usually low in antioxidants.

Do Black Swans Topple Paradigms?

  • Black swans are extremely rare, unpredictable, and incorrectly rationalized events.

  • People misuse the term black swan to describe outliers or otherwise failed predictions.

  • It has been suggested that such failed predictions invalidate entire hypotheses.

  • In the philosophy of science, this is a logical fallacy known as naive falsification.

  • Naive falsification is invalid because of the inherent incompleteness of our knowledge.

  • Having incomplete knowledge means that failed predictions are actually expected.

April, 2021

Polyunsaturated Fat and Lipid Peroxidation (An Independent Analysis)

  • It has been proposed that PUFA are toxic due to their unique capacity to oxidize.

  • When meta-analyzed, the current literature does not support this hypothesis.

  • High-PUFA diets showed a trend toward lowering markers of lipid peroxidation.

Does Nutrition Determine Satiety?

  • Virtually none of the nutritional components tested correlate strongly with satiety.

  • The only strong exception was saturated animal fat.

March, 2021

Overthinking Protein Distribution for Muscle Gains

  • Protein distribution is not limiting for muscle protein synthesis or muscle hypertrophy.

  • Consuming three meals, each containing ~0.5g/kg body weight of protein, is optimal.

  • Hitting your total daily protein target is most important for muscle mass gains.

  • How you distribute your protein is less important for muscle mass gains.

Linoleic Acid and Inflammation (An Independent Meta-Analysis of RCTs)

  • Some suggest that diets high in linoleic acid are inflammatory.

  • They're probably not.

Sugar-Sweetened Beverages and Metabolic Syndrome

  • SSB consumption associates with MetS even after adjustments for energy intake.

  • In human experiments using SSBs, changes in MetS risk factors are a function of weight changes and calorie intake.

  • Epidemiology often fails to adequately capture the effect of calories on certain disease outcomes.

  • SSBs cause MetS to the extent that SSBs contribute to excessive caloric intake.

Plant-Based Diets and Blood Lipids

  • Plant-based diets only seem to lower LDL-C compared to baseline when weight is lost.

  • Plant-based diets seem to lower HDL-C compared to baseline.

  • Plant-based diets don't seem to reliably change TG compared to baseline.

  • Plant-based diets seem to lower ApoB compared to baseline, though it is plausible that weight loss is still confounding.

Do Vegetable Oils Cause Cancer?​

  • It has been suggested that the LA Veterans Administration Hospital Study demonstrates that high PUFA diets increase cancer risk.

  • Upon closer examination of the study methods and analysis methods, the increased cancer risk was very likely not a consequence of increasing PUFA intake.

  • It has also been suggested that PUFA increases skin cancer risk in epidemiology. 

  • Upon closer examination, the epidemiological data supporting this association is extremely weak.

February, 2021

HDL: Marker or Mediator?

  • Higher HDL has been associated with lower risk of CVD in observational literature.

  • However, more robust Mendelian randomization studies divulge no causal, protective link between HDL and CVD.

Does Keto Protect Against Heart Disease?

  • Ketogenic diets typically lower TG and increase HDL.

  • The TG/HDL ratio is a strong correlate for CVD outcomes because it is also a correlate for ApoB.

  • ApoB is a causal agent in the pathogenesis and pathophysiology of CVD.

  • Ketogenic diets tend to increase ApoB.

  • Ketogenic diets are not likely to be uniquely protective against CVD as a function of their tendency to lower the TG/HDL ratio.

Mechanistic Circle-jerking, Part 1: Polyphenols and LDL

  • Olive oil is associated with reductions in heart disease despite the fact that it does not seem to have a reliable effect on atherogenic lipoprotein concentration.

  • The polyphenols in foods like olive oil could modify lipoprotein behaviour, rather than concentration, such that the lipoproteins themselves become less atherogenic.

Impossible Burger versus Beef

  • It has been suggested that the processed nature of Impossible burger makes it inferior to beef.

  • Upon close inspection there are good reasons to suspect that Impossible burger would lead to better health outcomes when compared to beef.

  • Eating the whole foods that are low in saturated fat and sodium is probably still optimal.

January, 2021

Bustin' Nuts for Prostate Health?

  • Ejaculating once every 1.42 days may reduce the risk of prostate cancer.

Are Artificial Sweeteners Fattening?

  • It has been suggested that artificial sweeteners cause weight gain.

  • Human experiments shows that artificial sweeteners tend to lead to weight loss.

  • Artificial sweeteners do no increase plasma glucose or plasma insulin.

Can Flaxseed Oil Increase DHA Status?

  • It has been speculated that flaxseed oil can provide us with adequate DHA through its conversion from ALA.

  • Experiments investigating the relationship between flaxseed oil and DHA show that flaxseed oil does not improve DHA status.

  • It would be prudent for vegans to supplement with plant-based sources of DHA.

Red Meat is Perfectly Safe... If You're Dutch?

  • Red meat may increase in all-cause mortality with intakes as low as 15g per day.

  • Cohorts with lower ranges of intake above 15g per day might not see the effect.

  • Understanding relevant ranges of intake is important for interpreting nutrition science.

 

2020

December, 2020

Do Low Carb Diets Reverse Diabetes?

  • It has been claimed that LCHF reverse and/or remit T2DM independent of weight loss.

  • No aggregate of the available literature supports this hypothesis.

  • LCHF has not been shown to reduce fasting blood glucose independent of weight loss.

  • LCHF has not been shown to reduce HbA1C independent of weight loss.

  • LCHF has not been shown to reduce fasting insulin independent of weight loss.

Do the Guidelines Recommend a High PUFA Diet?

  • Some claim that the guidelines suggest a high omega-6/PUFA diet.

  • Following the guidelines as literally as possible, this isn't true.

  • Only absurd interpretations of the guidelines yield high PUFA intakes.

Does Cheese Increase LDL?

  • SFA-rich cheese does not seem to increase LDL-C

  • PUFA-enriched cheese lowers LDL-C.

  • The ratio of PUFA to SFA still affects LDL-C, even when cheese is the exposure.

Heart Disease: LDL or Inflammation?

  • LDL and inflammation are both independently causal of ASCVD.

  • Inflammation causes ASCVD in both high and low LDL contexts.

  • LDL causes ASCVD in the context of both high or low inflammation.

  • Interventions to lower inflammation have largely been unsuccessful in reducing the risk of ASCVD.

  • Interventions to lower LDL have been overwhelmingly successful in reducing the risk of ASCVD.

November, 2020

Cheese vs Tofu (An Independent Meta-Analysis)

  • Tofu tends to lower LDL-C.

  • Cheese doesn't necessarily increase LDL-C.

  • Eat tofu, but maybe don't sweat the cheese either.

Mechanistic Overhyping, Part 4: John McDougall on Dairy and Health

  • Dairy improves bone health in humans, including postmenopausal women.

  • High fat dairy products may encourage weight gain.

  • Many dairy foods are protect against type 2 diabetes and cardiovascular disease.

  • Certain dairy foods provide a combination of risks and benefits for different cancers.

  • Dairy is a vector for zoonotic foodborne pathogens.

  • There is no clear evidence that dairy generally increases the risk of constipation in children.

  • Canada's Food Guide does not encourage the cessation of dairy food consumption.

Does LDL Cause Cardiovascular Disease?*

  • It has been suggested that LDL are not causal in ASCVD.

  • Randomized controlled trials using eight different mechanisms to lower LDL all see reductions in ASCVD events that are predicted by the degree of LDL-lowering achieved.

  • Mendelian randomization studies investigating almost two dozen different mechanisms that lower LDL all see reductions in ASCVD events that are predicted by the degree of LDL-lowering achieved.

  • LDL is causal in ASCVD, but even if it wasn't it would still be a good idea to target LDL to reduce ASCVD events. 

October, 2020

Are Ultra-processed Foods Actually Unhealthy?

  • Many claim that ultra-processed foods are inherently harmful.

  • There is evidence that diets of primarily ultra-processed foods are harmful.

  • Diets of primarily fruit would be likely to be equally harmful.

  • Nevertheless, fruit are still assumed healthy and ultra-processed foods are still assumed unhealthy.

  • Justifications for this double-standard are not obvious and require elucidation.

  • There doesn't seem to be any robust evidence that ultra-processed foods are inherently harmful.

When Saturated Fat Reduces Heart Disease Risk*

  • Saturated fat consumption is associated with higher rates of heart disease.

  • There are sources of saturated fat that are inversely associated with heart disease.

  • Higher chocolate, cheese, and yogurt intakes associated with lower rates of CVD.

Mechanistic Overhyping, Part 3: Oils, Nuts, and LDL

  • It has been asserted that nuts are preferable to olive oil for CVD prevention due to a superior capacity to lower LDL-C.

  • Almonds do lower LDL-C more than olive oil relative to baseline.

  • Both nuts and olive oil lower CVD risk to approximately the same degree.

  • CVD risk primarily tracks ApoB, not LDL-C.

  • Neither nuts nor almonds raise or lower ApoB to a statistically significant degree.

Logical Fallacies on Nutrition-Twitter, Part 1

  • Nutrition Twitter is a good place to find examples of sophistry and logical fallacies.

September, 2020

Ketogenic Diets and Bone Mineral Density

  • There are good reasons to suspect that ketogenic diets may reduce bone mineral density.

  • When meta-analyzed, the available data seems to suggest that ketogenic diets don't seem to lower bone mineral density.

Mechanistic Overhyping, Part 2: Protein and Cancer

  • A cocky coprophilic YouTuber named Gojiman claims that dietary protein causes cancer through increased IGF-1.

  • His supporting evidence is a mendelian randomization study which shows that enormous levels of IGF-1 that seem potentially unattainable through diet alone.

  • Population data does not divulge an association between total protein and total cancer.

  • Perhaps if one is genetically predisposed to high IGF-1 levels, the highest levels of protein intake could add to one's total risk.

Mechanistic Overhyping, Part 1: Dairy and Diabetes

  • It has been claimed that palmitate is "toxic" to pancreatic β-cells due to mechanistic interactions between the two.

  • This is used as the basis for the claim that dairy products cause type II diabetes.

  • However, aggregated human outcome data and dose-response curves support an inverse association between dairy consumption and type II diabetes.

August, 2020

Are Plant-Based Diets Anti-Inflammatory?

  • Plant-based diets are typically touted as anti-inflammatory in the blogosphere.

  • Turns out it might actually be true, though more controlled trials are needed.

Weight Loss: Low Carb or Low Fat?

  • It has been suggested that low carb diets could independently increase energy expenditure and thus increase fat mass loss if given enough time.

  • When stratified by study duration, low carb diets show no detectable advantages on fat mass loss, but a statistically significant increase in energy expenditure.

  • However, these findings could be the result of methodological shortcomings within the primary studies that contribute the most statistical weight.

Why Not Eat Both?

  • There is a group of vegans who espouse complete abstinence from all added oils.

  • However, unsaturated oils reduce heart disease more than whole grains when compared to saturated fats.

  • Unsaturated oils also reduce stroke more than whole grains when compared to dairy fat.

  • As a caveat, cheese likely reduces heart disease regardless of its saturated fat content.

  • Eat whole grains, unsaturated oils, and cheese to confer greater reductions in heart disease risk.

July, 2020

Polyunsaturated Fat and Cardiovascular Disease (An Independent Analysis)

  • The absolute amount of PUFA in the diet doesn't seem to modulate CVD risk.

  • CVD risk appears to be modulated by the extent to which PUFA replaces SFA.

Olive Oil and Cardiovascular Disease (An Independent Analysis)*

  • Regular consumption of olive oil may reduce the risk of CVD and stroke.

Anti-Nutrients, Part 2: Oxalate

  • There are case reports of oxalate-induced illness and death in the literature.

  • These case reports almost universally involve individuals with pre-existing health conditions.

  • These case reports also almost universally involve juicing, blending, or otherwise processing high oxalate foods.

  • Star fruit is the only whole food associated with oxalate-induced illness, but only really in people with chronic kidney disease.

  • High oxalate mono-diets are fucking bad for you.

An Open Letter to the British Journal of Sports Medicine*

  • Zoe Harcombe is a fraud and her PhD should be revoked.

How Diet Gurus Miss the Point

  • People may be sicker due to eating poor diets, but it is mostly driven by social disparity.

  • Predatory expansions in lending created population-wide dependencies on credit.

  • People have less money, savings, and time to invest in healthy diets than before.

  • Dietary advice often ignores the social/economic barriers to healthy dietary patterns.

  • Policy changes to expand access to healthy diets are more useful than diet advice.

June, 2020

 

Saturated Fat and Cardiovascular Disease (An Independent Analysis)*

  • Most meta-analyses find weak or null associations between SFA and CVD.

  • Most meta-analyses are merely pooling risk ratios rather than stratifying by SFA intake.

  • When studies are stratified by SFA intake, CVD risk increases between ~15-35g/day.

  • When studies are stratified by SFA intake, no other intake range is associated with risk.

  • Comparing similarly low SFA intakes or similarly high SFA intakes yields weak results.

  • Comparing low SFA intakes to high SFA intakes reveals an increase in CVD risk.

  • This finding supports the hypothesis that SFA's relationship to CVD is sigmoidal. 

  • Typical meta-analysis methods tend to hide this relationship between SFA on CVD risk.

 

Vitamin B6 on a Vegan Diet

  • Vitamin B12, vitamin D, calcium, iron, and zinc aren't overly concerning on vegan diets.

  • Nutritional adequacy on a vegan diet can mostly be met with proper food selection.

  • Vitamin B6 deficiency could be more common in both vegan and vegetarian populations. 

  • Vitamin B6 from non-animal foods is not particularly bioavailable to humans.

  • Supplementing with vitamin B6 as P-5-P could be prudent on vegan diets.

May, 2020

 

The Benefits of High Fibre Diets.

  • Meeting the DRI for fibre intake confers consistent benefits to CVD and CHD risk.

  • There is evidence that suggests eating even more fibre could confer additional benefits.

 

Vitamin A: Are Animal Foods Just Chopped Liver?

  • Genetic impairments in the conversion of carotenoids to retinol do not impact retinol status or make deficiency more likely.

  • Dietary carotenoids from whole plant foods can easily maintain adequate retinol status.

  • The only case reports of vitamin A toxicity from whole foods are attributable to liver consumption.

 

"But My Fad Diet, Bro!", Part II: Vegan/Plant-Based Horseshit

  • Many vegan/plant-based talking points are utter nonsense.

April, 2020

Hunter-Gatherer Health is Built on Dead Children

  • Infant and child mortality rates among hunter-gatherer populations are staggering.

  • Hunter-gatherers appear healthier because the least resilient of them are already dead.

  • Reductions in child mortality likely contribute to our current rates of chronic disease.

 

"But My Fad Diet, Bro!", Part I: Paleo/Keto Horseshit

  • Many low-carb/keto talking points are utter nonsense.

March, 2020

 

What About Dietary Cholesterol?

  • Studies finding null effects of DC on CVD may be confounded by baseline DC intakes.

  • DC increases LDL cholesterol on average.

  • DC doesn't increase HDL cholesterol on average.

  • LDLp causes CVD, not LDL-C, so DC may not be a big deal after all.

 

Does Saturated Fat Protect LDL Particles?

  • MUFA protects LDL from oxidation as well as, if not better than, SFA.

  • MUFA increases LDL clearance and endothelial function compared to SFA.

  • The lag-time to LDL oxidation is determined primarily by antioxidant status and PUFA.

  • Plant-fat polyphenols protect LDL particles from oxidation to a greater degree than SFA.

  • There is no reason to prefer SFA over MUFA for CVD prevention.

  • Plant-derived oils tend to confer greater CVD protection than animal-derived oils.

  • The fat portion of your calories should probably be primary MUFA and PUFA.

 

Anti-Nutrients, Part 1: Phytate II

  • Phytate may help those with hemochromatosis avoid symptoms of iron overload.

  • Phytate seems to help mitigate the burden of AGEs in diabetic patients.

  • Eating more phytate may make you better at mitigating its harmful effects.

  • There are many promising benefits of phytate that are being actively researched.

 

Nutrients of Lesser Concern

  • Deficiencies in vitamin B5, manganese, and phosphorus almost never happen in free-living humans.

  • Deficiencies in choline are difficult to characterize because choline requirements largely depend on overall diet quality.

February, 2020

Do Low Carb Diets Reverse Insulin Resistance?

  • LCHF diets induce a state of insulin resistance and HCLF diets improve insulin sensitivity, as demonstrated by direct measurements of insulin sensitivity.

  • LCHF studies tend to report insulin sensitivity via HOMA-IR, which is not a direct measurement of insulin sensitivity and isn't validated in LCHF subjects.

 

Vitamin K2: Preventative, not Curative (Update)

  • Vitamin K2 may help to prevent arteries from calcifying.

  • Vitamin K2 may accelerate the progression of preexisting CAC.

  • Those with the highest and lowest CAC scores have the lowest chances of a heart attack.

  • Vitamin K2 may help ensure greater plaque stability by increasing the burden of CAC.

 

Why Does LDL Cause Heart Disease?

  • Native ApoB is necessary to initiate atherosclerosis.

  • Modifying ApoB such that it doesn't bind to intimal proteoglycans inhibits the development of atherosclerosis.

  • Get your ApoB checked.

 

The Elusive Choline Requirement

  • Choline requirements are difficult to characterize, but we know a baseline exists.

  • Genetics can either decrease or increase choline requirements in certain contexts.

  • Dietary choices that increase B-vitamins, betaine, and protein likely decrease choline requirements.

  • Dietary choices that increase the intakes of fat, calories, sugar, and alcohol likely increase choline requirements.

January, 2020

There's Something in the Whey

  • Whey protein isolate is apparently better than most non-soy plant-based proteins at increasing essential amino acids and leucine in the blood.

  • If your goal is sports performance or muscle hypertrophy, whey protein isolate likely as an advantage over most plant-based proteins.

  • Whey protein isolate seems to uniquely potentiate the availability of leucine to skeletal muscle when compared to most plant-based proteins.

Do Vegetable Oils Make us Hungrier?

  • There are plausible mechanisms by which linoleic acid increases hunger.

  • So far fatty acid substitution trials consistently fail to show any effect of fatty acid saturation on satiety.

  • Vegetable oils do not appear to independently increase hunger, and may even reduce it.

  • Don't guzzle oil of any variety, and enjoy your foods.

 

Pizza is Badass

  • Pre-made restaurant pizza usually sucks.

  • Homemade pizza can be highly nutritious.

  • Not all Western foods are garbage.

2019

December, 2019

 

Healthy Processed Foods

  • There are certain processed foods that contribute positively to health.

  • Protein isolates such as whey protein can help the elderly meet their protein needs.

  • Yeast extracts are rich in B-vitamins and can improve certain markers of health.

  • Many fruit juices have been shown to have positive health benefits.

  • Consuming collagen peptides can improve tendon and skin health overall.

 

Anti-Nutrients, Part 1: Phytate

  • Phytate-rich foods do inhibit the absorption of minerals from other foods in the diet.

  • The phytate-to-mineral ratio of the diet is a decent proxy for overall mineral status, but is likely due to inappropriate food pairing.

  • Pairing phytate-rich foods with mineral-rich foods is the most relevant consideration regarding the inhibition of mineral absorption.

  • Food avoidance on the basis of phytate is probably unjustified.

  • Soaking, vitamin C, and perhaps even meat itself can improve the bioavailability of minerals from phytate-rich foods.

  • Many phytate-rich foods are healthy and nutritious in ways unrelated to their mineral content.

 

The Heuristics of Weight Loss

  • There are many explanations for obesity, but most of them are bullshit.

  • Excess calories from hyper-palatable, Western junk food likely drives obesity.

  • Limiting junk food is something almost all popular weight loss diet have in common.

  • Over-eating is difficult on a diet consisting only of whole foods.

 

Dietary Fructose and NAFLD

  • Fructose does increase liver fat content in hypercaloric conditions.

  • Fructose only transiently increases liver fat content in eucaloric conditions.

  • Regardless of fructose intake, obesity is the primary cause of NAFLD.

  • Weight loss reverses NAFLD regardless of the macronutrient ratios of the diet.

November, 2019

 

Vitamin K2: Preventative, not Curative

  • Vitamin K2 is likely to be powerfully protective against arterial calcification.

  • Vitamin K2 seems highly effective at building and maintaining bone.

  • Vitamin K2 could make pre-existing arterial calcification worse.

 

Do Processed Foods Make Us Fat?

  • Processed foods usually taste super awesome and can cause us to overeat.

  • Processed foods cause us to burn fewer calories, making fat gain more likely.

  • Processed foods often lack protein and can negatively affect our lean body mass.

 

Nutritional Ketosis and Muscle Hypertrophy

  • Muscle hypertrophy occurs when anabolism outweighs catabolism. 

  • We have an obligate need to catabolize lean tissue while in ketosis.

  • Ketogenic diets unavoidably cost us anabolic potential by default.

  • Amino acids used to make glucose cannot be used to build muscle.

  • Typical gains are still achievable in ketosis, but require extra protein.

 

Advantages of Early Time-Restricted Feeding?

  • eTRF seems to improve glucose disposal, insulin sensitivity, and feelings of satiety.

  • eTRF could be anti- and/or pro-inflammatory in different ways, with negative effects on blood lipids.