diff --git a/packages/website/frontend/src/Config/Data/ImageFolders.elm b/packages/website/frontend/src/Config/Data/ImageFolders.elm index f0014cf..917aa14 100755 --- a/packages/website/frontend/src/Config/Data/ImageFolders.elm +++ b/packages/website/frontend/src/Config/Data/ImageFolders.elm @@ -9,10 +9,10 @@ imagePathMaker : ImageFolder -> String -> String imagePathMaker imageFolder name = case imageFolder of Cuck -> - "/" ++ getImageFolderString imageFolder ++ "/" ++ name ++ "/" ++ name ++ ".png" + "/" ++ getImageFolderString imageFolder ++ "/" ++ name ++ "/" ++ name ++ ".jpg" _ -> - "/" ++ getImageFolderString imageFolder ++ "/" ++ name ++ ".png" + "/" ++ getImageFolderString imageFolder ++ "/" ++ name ++ ".jpg" getImageFolderString : ImageFolder -> String diff --git a/packages/website/frontend/src/Config/Helpers/Articles/Markdown.elm b/packages/website/frontend/src/Config/Helpers/Articles/Markdown.elm index e2b6810..6d72dd1 100755 --- a/packages/website/frontend/src/Config/Helpers/Articles/Markdown.elm +++ b/packages/website/frontend/src/Config/Helpers/Articles/Markdown.elm @@ -61,7 +61,7 @@ articleImage pic = [ image [ width fill ] - { src = "/blog/" ++ pic ++ ".png", description = "" } + { src = "/blog/" ++ pic ++ ".jpg", description = "" } ] diff --git a/packages/website/frontend/src/Config/Helpers/Cards/Outer/Helpers.elm b/packages/website/frontend/src/Config/Helpers/Cards/Outer/Helpers.elm index da374cd..91d3f90 100755 --- a/packages/website/frontend/src/Config/Helpers/Cards/Outer/Helpers.elm +++ b/packages/website/frontend/src/Config/Helpers/Cards/Outer/Helpers.elm @@ -190,7 +190,7 @@ cardMaker device cardable contents = , right = 0 } ] - { src = "/blog/" ++ blogArticle.articleImage ++ ".png", description = "" } + { src = "/blog/" ++ blogArticle.articleImage ++ ".jpg", description = "" } ( Tablet, Portrait ) -> image @@ -202,7 +202,7 @@ cardMaker device cardable contents = , right = 0 } ] - { src = "/blog/" ++ blogArticle.articleImage ++ ".png", description = "" } + { src = "/blog/" ++ blogArticle.articleImage ++ ".jpg", description = "" } _ -> none diff --git a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/BigFatSurprise.elm b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/BigFatSurprise.elm index f2bc2a5..1321da8 100755 --- a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/BigFatSurprise.elm +++ b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/BigFatSurprise.elm @@ -78,7 +78,7 @@ Page 16: Yep. Crawford “buries” it by making it Figure 1 in his paper [[5](https://doi.org/10.1016/s0140-6736(68)92034-5)].\u{00A0}I know when I want to bury data in a paper I visualize it and put it at the head of the results. ![][image1] -[image1]: /blog/bigfatsurprise/image1.png +[image1]: /blog/bigfatsurprise/image1.jpg By the way, this “widely cited” paper has been cited only 183 times since it’s publication in 1968. Truly a landmark paper, this one. @@ -146,7 +146,7 @@ Again, emphasis mine. On page 25 you will see this structure: ![][image2] -[image2]: /blog/bigfatsurprise/image2.png +[image2]: /blog/bigfatsurprise/image2.jpg This structure is incorrect on many levels. For one it is not even a fatty acid. It’s actually not anything because it is not a legitimate chemical structure, but it’s closest to pentane which no one would want to consume. In order for it to be a fatty acid it would at least need a carboxyl group at one end. However, that would make the structure into valeric acid which is not commonly found in foods (especially the butter, meat, and cheese Teicholz promotes) and not commonly consumed unless you’re eating valerian root. @@ -428,15 +428,15 @@ Not true. At least not true by the study she cites [[37](https://doi.org/10.1161 Just for kicks, let’s do Teicholz’s work for her. Let’s start with the Blasbalg paper. It appears that in the 20th century butter and lard dropped precipitously at about mid-century. Shortly afterward poultry and shortening consumption rose. Soybean oil also rose concurrently with shortening probably because it was a prominent ingredient. Canola oil consumption also increased in the 90s. ![][image3] -[image3]: /blog/bigfatsurprise/image3.png +[image3]: /blog/bigfatsurprise/image3.jpg ![][image4] -[image4]: /blog/bigfatsurprise/image4.png +[image4]: /blog/bigfatsurprise/image4.jpg What about heart disease? According to a paper by Cooper et al CVD rose until about mid-century, but then begins a steady decline into the millennium [[38](https://www.academia.edu/98361249/Serum_lipoprotein_levels_in_patients_with_cancer)]. ![][image5] -[image5]: /blog/bigfatsurprise/image5.png +[image5]: /blog/bigfatsurprise/image5.jpg You have to ask yourself: does the vegetable oil correlate _perfectly_\u{00A0}with CVD? @@ -585,7 +585,7 @@ That’s a bold claim for which Teicholz cites a review article not on heart dis Teicholz cites no evidence for the increased meat consumption, but no matter. I know how to Google. It seems that meat consumption has increased in Japan over the years, although it still pales in comparison to US consumption which is probably why Japanese heart disease remains comparatively low. ![][image6] -[image6]: /blog/bigfatsurprise/image6.png +[image6]: /blog/bigfatsurprise/image6.jpg Source [here](http://karlandersson.se/2012/11/07/japan-vs-the-west-meat-consumption/)\u{00A0}and [here](http://www.theguardian.com/environment/datablog/2009/sep/02/meat-consumption-per-capita-climate-change). @@ -695,10 +695,10 @@ BFS page 130: > […] Rifkind told Time magazine, “It is now indisputable that lowering cholesterol with diet and drugs can actually cut the risk of developing heart disease and having a heart attack.” ![][image8] -[image8]: /blog/bigfatsurprise/image8.png +[image8]: /blog/bigfatsurprise/image8.jpg ![][image9] -[image9]: /blog/bigfatsurprise/image9.png +[image9]: /blog/bigfatsurprise/image9.jpg ### CHAPTER 6: HOW WOMEN AND CHILDREN FARE ON A LOW-FAT DIET @@ -741,7 +741,7 @@ This has got to be one of the most selective and misleading interpretations of t > Non-starchy vegetables probably protect against cancers of the mouth, pharynx, and larynx, and those of the oesophagus and stomach. There is limited evidence suggesting that they also protect against cancers of the nasopharynx, lung, colorectum, ovary, and endometrium. Allium vegetables probably protect against stomach cancer. Garlic (an allium vegetable, commonly classed as a herb) probably protects against colorectal cancer. Fruits in general probably protect against cancers of the mouth, pharynx, and larynx, and of the oesophagus, lung, and stomach. There is limited evidence suggesting that fruits also protect against cancers of the nasopharynx, pancreas, liver, and colorectum. ![][image10] -[image10]: /blog/bigfatsurprise/image10.png +[image10]: /blog/bigfatsurprise/image10.jpg On page 144 Teicholz derides the study that low-carbers love to hate, T. Colin Campbell’s China Study [[68](https://www.westonaprice.org/book-reviews/the-china-study-by-t-colin-campbell/)]: @@ -1044,12 +1044,12 @@ This may be another one of those reasonable-people-may-disagree type things, but In any case, the paper actually goes on to describe the evidence that exists, and it seems quite positive for ol’ olive oil. In fact, Table 4 and Table 5 show the lowest odds ratios I have ever seen in real life. Most of the studies they review show a significant inverse association between olive oil and some form of heart disease. ![][image11] -[image11]: /blog/bigfatsurprise/image11.png +[image11]: /blog/bigfatsurprise/image11.jpg On page 208 she mentions that Antonia Trichopoulou was steeped in bias and not a great scientist (which is… amusing coming from Teicholz). ![][image12] -[image12]: /blog/bigfatsurprise/image12.png +[image12]: /blog/bigfatsurprise/image12.jpg > “Antonia is perhaps guilty, as we all were, of thinking with her heart,” says her former colleague Elisabet Helsing, who, as the Advisor on Nutrition for WHO Europe, was involved in all the early work on the Mediterranean diet.”Many of us in this field, we were led not by the head but by our hearts. The evidence was never so good.” Or, as Harvard epidemiologist Frank B. Hu wrote in 2003, in a break with his colleagues, the Mediterranean diet “has been surrounded by as much myth as scientific evidence.” @@ -1213,7 +1213,7 @@ On page 288 Teicholz discusses Dr. Atkins and says I decided to check her bibliography and download the Vogue issue in question via ProQuest. She cites it as “Take It Off, Keep It Off Super Diet . . . Devised with the Guidance of Dr. Robert Atkins,” Vogue 155, no. 10 (1970): 84—85.” I looked on pages 84-85 and it wasn’t there. Strange, right? Where did she come up with that citation? As it turns out (as of this writing, at least) it is cited that way on Dr. Robert Atkins’s Wikipedia page: It turns out that the actual Vogue article is located in the same issue, but different page numbers. My guess is that Teicholz simply copy-pasted the Wikipedia reference and never even saw the original magazine issue. ![][image13] -[image13]: /blog/bigfatsurprise/image13.png +[image13]: /blog/bigfatsurprise/image13.jpg Page 298, Teicholz discusses the memoirs of a physician: diff --git a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/EverettVegans.elm b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/EverettVegans.elm index 8467d99..53740fe 100755 --- a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/EverettVegans.elm +++ b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/EverettVegans.elm @@ -44,7 +44,7 @@ Also, if insufficiency of K2 and the other fat soluble vitamins are to blame for First of all, the claim of 84% of vegans quitting is just blatantly incorrect according to his own citation, which found a 70% dropout rate for vegans. Second of all, this is a ridiculous question. People stop doing health promoting things for all sorts of reasons, and it probably would have been a good idea for him to read the goddamn reference instead of resorting to conspiracy theories. The study includes an inventory of explanations for participant recidivism, and [the craving of animal products only occurred in the minority of recidivists](https://faunalytics.org/wp-content/uploads/2016/02/Faunalytics-Study-of-Current-and-Former-Vegetarians-and-Vegans-%E2%80%93-Secondary-Findings-.pdf). ![][image1] -[image1]: /blog/everettvegans/image1.png +[image1]: /blog/everettvegans/image1.jpg Furthermore the study includes a table of motivations for pursuing veganism. Only a measly 1-3% of participants had motivations that were purely ethical in nature. While most motivations were health related. So, it seems like people are generally going on plant-based diets for health related reasons, and abandoning the diets without generally suffering health related costs. This isn't the only reason the question is stupid. Plenty of health promoting behaviours have high recidivism rates, such as exercise. @@ -57,7 +57,7 @@ Of those 11, 6 were vague like "sick", "lightheaded", "not healthy", and "health It's not clear why we should accept the implication that a diet is healthy if and only if it can be generally adhered to. There are many examples of diets with poor adherence rates that I don't think Joseph would sign off on being unhealthy, and there are plenty of examples of diets with high adherence rates that Joseph wouldn't consider healthy at all. ![][argument1] -[argument1]: /blog/everettvegans/argument1.png +[argument1]: /blog/everettvegans/argument1.jpg **Claim #3 (**[**04:59**](https://youtu.be/MpxgZGnEF7E?t=299)**):** @@ -70,19 +70,19 @@ Firstly, this is an ecological fallacy. Essentially, Joseph is looking at two te Instead, this research is just looking at the average height of each entire country and the average intake of said foods. Such studies are susceptible to something called the [ecological fallacy](https://en.wikipedia.org/wiki/Ecological_fallacy), meaning what applies on a country average level may not apply on an individual level. ![][image2] -[image2]: /blog/everettvegans/image2.png +[image2]: /blog/everettvegans/image2.jpg In this graph on average as X increases, so does Y. But if you look at each cluster separately, as X increases Y decreases. A real life example of this is the relationship between smoking and longevity. ![][image3] -[image3]: /blog/everettvegans/image3.png +[image3]: /blog/everettvegans/image3.jpg If you plot each country's smoking rate and lifespan you'll see that [the more people smoke the longer they live](https://www.thefunctionalart.com/2018/07/visualizing-amalgamation-paradoxes-and.html). This correlation, of course, breaks at an individual level. I very much doubt that Joseph would approve of this ecological study. [[6](https://pubmed.ncbi.nlm.nih.gov/1140864/)] ![][image4] -[image4]: /blog/everettvegans/image4.png +[image4]: /blog/everettvegans/image4.jpg The study makes no attempt to adjust for socioeconomic or genetic differences in the countries involved. Richer countries tend to have access to more expensive sources of calories, but also have fewer infections and cleaner water, among many other things conducive to better health. They also tend to eat meat. This doesn't tell us what's happening within each of those populations across the spectrum of meat consumption. @@ -95,19 +95,19 @@ Also it's likely that the reason animal protein correlates strongly with height Yovana Mendoza was a so-called "raw" vegan. As you can see from the picture he flashed, she was on a meme starvation diet of only raw food averaging an abysmal ~1000 calories a day. ![][image5] -[image5]: /blog/everettvegans/image5.png +[image5]: /blog/everettvegans/image5.jpg Raw food diets are associated with many stupid beliefs revolving around self-purification, including extensive fasting periods (49% of study participants), not supplementing B12 (7% took any supplement at all), and enemas (16% of them). [[7](https://pubmed.ncbi.nlm.nih.gov/10436305/)] Some believe once you are "purified" you lose your period which is a sign you're clean, for example. As you approach 100% raw food, pretty much half of them complain of amenorrhea, probably due to insufficient calories. ![][image6] -[image6]: /blog/everettvegans/image6.png +[image6]: /blog/everettvegans/image6.jpg As you can see, raw diets associate with considerably low BMI scores. ![][image7] -[image7]: /blog/everettvegans/image7.png +[image7]: /blog/everettvegans/image7.jpg Rawvana also [made a video](https://youtu.be/hMO4m0rZAB8?t=27) telling us how since she's gotten healthier on her raw vegan diet her "eyes have become greener", so I don't know how much stock we should put in her health advice, Joseph. @@ -124,7 +124,7 @@ Both studies showed that vegans had statistically significantly lower retinol st Now, let's get to the mechanistic fuckery. Joseph claims that there are genetic differences in carotenoid to retinol conversion capacity that could lead to deficiency in some who are relying on carotenoids over retinol. Right off the bat, Joseph's own reference contradicts his claim, as the entire variance in the population sample had fasting plasma retinol within the reference range. ![][image8] -[image8]: /blog/everettvegans/image8.png +[image8]: /blog/everettvegans/image8.jpg > _...the lowest plasma concentration was 963.8 nM, indicating that all volunteers had adequate serum vitamin A concentrations._ @@ -169,14 +169,14 @@ Here's a quick intro for vitamin K2. There are many different vitamin K isomers First, we'll look at bioavailability of MK4. He mentions animal livers (especially goose liver), egg-yolks, hard cheese and full-fat dairy. I couldn’t find any study on bioavailability of MK4 from foods rather than supplements. But, we can look at studies with doses one could plausibly obtain from diet alone. In probably the best study on this subject, researchers assessed **420 μg of MK-4 compared to 420 μg of MK-7**. [[35](https://pubmed.ncbi.nlm.nih.gov/23140417/)] As you can see from this chart, the only reasonable way to obtain this is with goose liver. [[36](https://pubmed.ncbi.nlm.nih.gov/11356998/)] ![][image9] -[image9]: /blog/everettvegans/image9.png +[image9]: /blog/everettvegans/image9.jpg The other things he recommended simply don’t have enough. To get this amount it would take **8.9 kilograms of hard cheese, 52.5 liters of whole milk, or 52.4 average eggs.** The amount of goose liver it would take to get this dose of MK-4 is roughly **115g of liver,** however this has **over 10,000μg of retinol, the upper limit is 3000μg** and hypervitaminosis A is no joke. But regardless, let’s say someone managed to eat this amount of MK-4 regularly. Is it actually absorbed? It wouldn't appear so. ![][image10] -[image10]: /blog/everettvegans/image10.png +[image10]: /blog/everettvegans/image10.jpg At no time point after the oral administration of 420μg of MK4 is it actually detectable in the blood. @@ -191,10 +191,10 @@ What Joseph didn't mention was that 29% of the vegan children did not consume vi I mention this because it's clear that a large chunk of the cohort was not actually supplementing vitamin B12 and vitamin D. Both of which are nutrients that are strongly associated with normal growth. There was also little to no consideration for other dietary variables, and the analysis itself is cross-sectional with extremely small sample-sizes. ![][image11] -[image11]: /blog/everettvegans/image11.png +[image11]: /blog/everettvegans/image11.jpg ![][image12] -[image12]: /blog/everettvegans/image12.png +[image12]: /blog/everettvegans/image12.jpg Perhaps also worth noting are the similar lean mass, lower fat mass, and preferable LDL-C and hs-CRP values of the vegans. But he didn't mention that. @@ -205,7 +205,7 @@ Perhaps also worth noting are the similar lean mass, lower fat mass, and prefera Let's start with the British study. These results are trivially explainable by the lower caloric intakes for vegans in his reference. ![][image13] -[image13]: /blog/everettvegans/image13.png +[image13]: /blog/everettvegans/image13.jpg Also, while the vegans tended to fall below the 50th percentile for weight, the vast majority experienced normal growth, and the lower weight (and in some cases height) may be attributable to the lower caloric intake. The authors actually take note of this, but Joseph didn't mention it. @@ -224,17 +224,17 @@ In the Farm Study was a 1989 study involving children ages four months to ten ye Across vegan children, growth was skirting the 50th percentile on average. This is exactly where these growth trajectories should be. ![][image14] -[image14]: /blog/everettvegans/image14.png +[image14]: /blog/everettvegans/image14.jpg Same for weight. ![][image15] -[image15]: /blog/everettvegans/image15.png +[image15]: /blog/everettvegans/image15.jpg We also have the VeChi Diet Study. [[40](https://pubmed.ncbi.nlm.nih.gov/31013738/)] Vegan and omnivorous children had similar caloric intakes. Omnivores had the highest protein, fat, and added sugar intake, while vegans had the highest total carb and fibre intake. In fact, the vegans were still able to consume a median of 2.25g of protein per kg bodyweight. While there were a few outliers in each group, growth was generally very similar overall. ![][image16] -[image16]: /blog/everettvegans/image16.png +[image16]: /blog/everettvegans/image16.jpg There are explanations for the children who may have been stunted or wasted, and they're nothing that is necessarily inherent to vegan diets themselves. These reasons include: short parents, inadequate caloric intake, exclusively breastfeeding longer than recommended (probably due to hippie vegan parents doing dumb hippie things). @@ -259,12 +259,12 @@ Joseph then concludes (from two studies were the majority did not supplement B12 If Joseph wanted to know if B12 supplements work differently than animal foods, he could turn his attention to this interventional study that found that fortified cereal was more effective at raising B12 than pork. [[46](https://pubmed.ncbi.nlm.nih.gov/31519167/)] ![][image17] -[image17]: /blog/everettvegans/image17.png +[image17]: /blog/everettvegans/image17.jpg Also, various doses of cheapo, vanilla-ass cyanocobalamin rescue vitamin B12 deficiency in clinically deficient vegans. [[47](https://pubmed.ncbi.nlm.nih.gov/29499976/)] This is confirmed by clinically meaningful reductions in both methylmalonic acid and total homocysteine. If Joseph knows of any better biological correlates for B12 absorption and utilization, as well as evidence that they're uniquely affected by animal foods, I'd love to hear from him about it. ![][image18] -[image18]: /blog/everettvegans/image18.png +[image18]: /blog/everettvegans/image18.jpg **Claim #14 (**[**11:38**](https://youtu.be/MpxgZGnEF7E?t=698)**):** @@ -323,7 +323,7 @@ Firstly, despite whole wheat flour being higher in phytic acid than white wheat Secondly, other compounds that are common in plant foods but are absent (or virtually absent) from animal foods may have pleiotropic effects that mitigate or even overcome the effect of phytates on iron absorption, with vitamin C probably being the most prominent example. In regards of counteracting phytic acid, 50mg (less than an orange worth) does more than 50g of meat. [[62](https://pubmed.ncbi.nlm.nih.gov/2911999/)] ![][image19] -[image19]: /blog/everettvegans/image19.png +[image19]: /blog/everettvegans/image19.jpg It also doesn't follow that one needs to consume animal products to meet iron needs, which Joseph heavily implies. Increased intake through diet and/or supplementation are clearly possible. @@ -370,7 +370,7 @@ Vegans, especially those who menstruate, might want to err on the side of cautio Previously having less edible material is trivially true of animal foods produced from modern animal agriculture. ![][image20] -[image20]: /blog/everettvegans/image20.png +[image20]: /blog/everettvegans/image20.jpg **Claim #21 (**[**14:58**](https://youtu.be/MpxgZGnEF7E?t=898)**):** @@ -379,7 +379,7 @@ Previously having less edible material is trivially true of animal foods produce What point is Joseph trying to make here? We could try to formalize it, perhaps. ![][argument2] -[argument2]: /blog/everettvegans/argument2.png +[argument2]: /blog/everettvegans/argument2.jpg **Claim #22 (**[**15:34**](https://youtu.be/MpxgZGnEF7E?t=934)**):** @@ -398,12 +398,12 @@ Lastly, one of the two "high quality" studies in the review that Joseph cited ev Here is the prevalence of depression forest plot from that meta-analysis. ![][image21] -[image21]: /blog/everettvegans/image21.png +[image21]: /blog/everettvegans/image21.jpg And mean depression scores. ![][image22] -[image22]: /blog/everettvegans/image22.png +[image22]: /blog/everettvegans/image22.jpg Also, just for flavour, I'll point out that Joseph's reference was funded by the beef industry. @@ -484,7 +484,7 @@ On average, vegans do in fact tend to have a lower bone mineral density and high BMI has been shown to causally increase bone mineral density, which in turn has been shown to causally decrease risk of fracture. This effect mediation has been found independently in observational studies, and the differences in bone mineral density seem to align with what we would expect based on the differences in BMI. [[89](https://pubmed.ncbi.nlm.nih.gov/33784428/)][[90](https://pubmed.ncbi.nlm.nih.gov/36260985/)][[91](https://pubmed.ncbi.nlm.nih.gov/24862213/)][[92](https://pubmed.ncbi.nlm.nih.gov/15817133/)] ![][image23] -[image23]: /blog/everettvegans/image23.png +[image23]: /blog/everettvegans/image23.jpg So the question that is interesting here, from a causal perspective, is whether vegans have weaker bones and higher risk of fracture independently of BMI and other important confounders such as calcium and vitamin D. Vitamin D has not been taken into account at all in the EPIC-Oxford study. BMI and dietary calcium were adjusted for, but only via categorisation, which is known to bias results when examining continuous variables with non-linear responses. [[93](https://pubmed.ncbi.nlm.nih.gov/17938055/)] @@ -527,7 +527,7 @@ These data don't represent any official guidelines. And I'm not sure how shitty In fact, some animal foods rank higher than some plant foods, and in the aggregate there is non-inferiority between some animal foods and some plant foods. For example, seafood ranks particularly high, and is non-inferior to both fruits and vegetables. Both meat and dairy are also non-inferior to grains. If Joseph wants to make some kind of claim about a vegan conspiracy to suppress the health value of animal foods, he'll have to explain why seafood gets such a remarkable score here. ![][image24] -[image24]: /blog/everettvegans/image24.png +[image24]: /blog/everettvegans/image24.jpg # EVEN MOAR NUTRIENTS THO @@ -574,7 +574,7 @@ Regarding creatine, all studies he cited were on supplemental creatine with dose I'm sorry, Joseph. But tracer studies disagree. [[113](https://pubmed.ncbi.nlm.nih.gov/33693735/)] In fact, tofu appears to be on par with pork, and better than eggs, in terms of its contribution to total positive protein balance in the human body. ![][image25] -[image25]: /blog/everettvegans/image25.png +[image25]: /blog/everettvegans/image25.jpg If you're going to try to make this point to shit on tofu, would you please be consistent and also shit on pork and eggs? @@ -637,7 +637,7 @@ Bruh, this is a meta-analysis of rodent studies with a blurb about how the resul In isolation, leghemoglobin actually had better bioavailability than iron(II)-sulfate, and when part of a food matrix, here as fortification for corn tortillas, had similar (ie non stat sig different) bioavailability compared to bovine heme iron. [[124](https://pubmed.ncbi.nlm.nih.gov/16478282/)] ![][image26] -[image26]: /blog/everettvegans/image26.png +[image26]: /blog/everettvegans/image26.jpg As an added fun fact that may blow up the brains of Joseph's audience, leghemoglobin is actually evolutionarily just as old as hemoglobin. See the following figure from Biochemistry 6th edition by Berg, Tymoczko and Styer. @@ -686,10 +686,10 @@ Show me the study that actually divulges that any of these sorts of foods have a Well, as long as we're appealing to authorities, we should point out that both the French and German governments recommend limiting meat intake to no more than 500g per week and 600g per week, respectively. ![][image27] -[image27]: /blog/everettvegans/image27.png +[image27]: /blog/everettvegans/image27.jpg ![][image28] -[image28]: /blog/everettvegans/image28.png +[image28]: /blog/everettvegans/image28.jpg # VEGAN MIDGET BABIES THO @@ -720,7 +720,7 @@ Finally, two cautionary narrative review articles by Miedziaszczyk et al. and Pa This just seems like pure speculation. Maybe optimal is not achievable without a supplement on any natural diet. I mean, think about it. What's the argument for omnivorous diets necessarily providing optimal amounts of all nutrients? If there's no argument for that, then it's possible that even the diet that he's recommending is horribly insufficient in some way. ![][image29] -[image29]: /blog/everettvegans/image29.png +[image29]: /blog/everettvegans/image29.jpg How has Joseph determined that the optimal range for nutrient intakes aren't above what could be obtained from omnivorous diets? Seems like his argument here is begging the question. If it's the case that optimal levels of nutrients are only practical to obtain from supplements, then we'd all benefit— not just vegans. diff --git a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/FeldwitzFuckery.elm b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/FeldwitzFuckery.elm index ec6e54b..b767eaa 100755 --- a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/FeldwitzFuckery.elm +++ b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/FeldwitzFuckery.elm @@ -19,7 +19,7 @@ articleFeldwitzFuckery = ![][image1] -[image1]: /blog/feldwitzfuckery/image1.png +[image1]: /blog/feldwitzfuckery/image1.jpg Thank you for reading! If you like what you've read and want help me create more content like this, consider pledging your [Support](https://www.uprootnutrition.com/donate). Every little bit helps! I hope you found the content interesting!""" , articleReferences = diff --git a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/HunterGatherers.elm b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/HunterGatherers.elm index 0c31d61..fc82db0 100755 --- a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/HunterGatherers.elm +++ b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/HunterGatherers.elm @@ -30,14 +30,14 @@ This presents a significant problem for Paleo diet advocates who choose to cite For example, if you remind a Paleo-dieter that hunter-gatherers typically had an average life expectancy of around 30 years, they will often immediately retort by stating that those estimates are confounded by infant and child mortality. But therein lies the problem— they can't have it both ways. A Paleo diet advocate cannot use that argument without tacitly admitting that infant and child mortality is typically enormously high among hunter-gatherer populations. Which it most certainly is [[1](https://www.sciencedirect.com/science/article/abs/pii/S1090513812001237)]. ![][image1] -[image1]: /blog/huntergatherers/image1.png +[image1]: /blog/huntergatherers/image1.jpg Approximately 26.8% of infants and 48.8% of prepubescent children die in hunter-gatherer populations. With such a high proportion of children dying, how could it be the case that the apparent health of elderly hunter-gatherers is **not** coloured by this? Remember, hunter-gatherer populations likely appear healthier because the least resilient members of those populations are already dead. Paleo diet advocates cannot admit that hunter-gatherer populations had high rates of infant and child mortality without also admitting that the resulting population is a heavily biased sample. This type of confounding is known as survivorship bias. Basically, survivorship bias is a type of selection bias that can occur when those who did not survive a selection event or process are overlooked in favour of those who did survive. For example, let's say we were trying to construct better body armour for soldiers to wear in combat. Perhaps we might conduct a study of the soldiers who returned from battle. We could collect bullet wound distribution pattern data to help ascertain where soldiers were most likely to get shot. ![][image2] -[image2]: /blog/huntergatherers/image2.png +[image2]: /blog/huntergatherers/image2.jpg However, as we see in the graphic above, this sort of analysis would exclude all those who were shot and did **not** survive. It would also overlook the sorts of bullet wound distribution patterns that tended to lead to death, which would actually have given us a significantly clearer picture of how we might construct better body armour. @@ -52,7 +52,7 @@ Right off the bat it is quite easy to identify that this is a blatant appeal to To explore this question, let's first briefly consider how Darwinian natural selection works. Essentially, it is the process by which random gene mutations are selected for by different environmental challenges. Some mutations are better at dealing with certain environmental challenges than other mutations. As a result, these more adaptive mutations increase an organism's chances of producing offspring. These organisms subsequently pass on these adaptive mutations to their offspring as well. ![][image3] -[image3]: /blog/huntergatherers/image3.png +[image3]: /blog/huntergatherers/image3.jpg In this image we see that black mice are less likely to get eaten by the bird than tan mice. For this reason, the random mutations that produces black mice rather than tan mice ends up being naturally selected for by the environment. However, environmental challenges like getting eaten aren't quite the same as environmental challenges that affect the long-term health of an organism. @@ -63,14 +63,14 @@ Getting eaten when you're young is an acute event. Developing a life-threatening So, the question ends up being: how long after reproductive age does natural selection still robustly apply to human beings? Surely selection pressure doesn't end at reproductive age, because human children need human adults to raise them and care for them. But does selective pressure exist to a meaningful degree for those in the age ranges that typically associate with life-threatening chronic disease? Some scholars have attempted to estimate the force of natural selection as a function of age [[6](https://pubmed.ncbi.nlm.nih.gov/30124168/)]. ![][image4] -[image4]: /blog/huntergatherers/image4.png +[image4]: /blog/huntergatherers/image4.jpg Applying the above graph to human beings, our best estimations suggest that the forces of natural selection rapidly wane down to nil shortly after sexual maturity, which would be approximately 16 to 17 years of age. Around the ages of 30 to 40 is when humans likely enter the "selection shadow", which is the zone wherein natural selection no longer robustly applies. It seems highly unlikely that the fate of a population could ever hinge on the fitness of middle-aged people who are past their prime. For fun, let's estimate the age range wherein peak human performance is likely to occur. Perhaps we could look at the average age range of Olympic athletes [[7](https://venngage.com/blog/olympics/)]. ![][image5] -[image5]: /blog/huntergatherers/image5.png +[image5]: /blog/huntergatherers/image5.jpg The average age range of Olympic athletes is between ~22.5 and ~25.5, which is well before the age range seen within the selection shadow. Which honestly makes sense if you think about it. As you age it becomes less likely that natural selection will select against deleterious traits, like losing athletic performance. Once inside the selection shadow, there is likely insufficient selective pressure to extend peak physical performance into higher and higher age ranges. @@ -79,7 +79,7 @@ The selection shadow may actually be observable in some existing traditional pop Using a measurement of atherosclerotic cardiovascular disease (ASCVD) progression known as coronary artery calcification (CAC) scoring, researchers were able to quantify the prevalence of ASCVD by age group among the Tsimané [[8](https://pubmed.ncbi.nlm.nih.gov/28320601/)]. ![][image6] -[image6]: /blog/huntergatherers/image6.png +[image6]: /blog/huntergatherers/image6.jpg It should also be noted that CAC scores are indicative of advanced ASCVD [[9](https://pubmed.ncbi.nlm.nih.gov/24530667/)]. The exclusive use of CAC scoring in this study of the Tsimané leaves us with many interpretive challenges. For example, if CAC scores are representative of advanced ASCVD (so called "hard plaques"), what proportion of less advanced ASCVD (so-called "soft plaque") might have been overlooked? It is difficult to say for sure. But the bottom line is that the Tsimané experience increases in chronic disease at approximately the same time as modern populations— well inside the selection shadow. @@ -106,12 +106,12 @@ Without scientific evidence to help inform our attitudes toward the relative hea Novel foods do not belong to the domain of foods that have the potential to be antagonistic pleiotropic, since we did not evolve consuming them. Conversely, the ancestral food in our scenario is likely to be antagonistically pleiotropic. Thus, the novel food is to be favoured over the ancestral food in this case. This concept can be illustrated clearly with a couple of simple tables. ![][image7] -[image7]: /blog/huntergatherers/image7.png +[image7]: /blog/huntergatherers/image7.jpg To summarize, we can infer that ancestral foods are likely to have both positive short-term health value, as well as negative long-term health value. However, in the absence of empirical data, our doxastic attitude toward the health value of novel foods should be one of agnosticism. When the thriving potential of novel foods and ancestral foods show non-inferiority, we infer that the novel foods is less likely to be detrimental for long-term health. Altogether, the argument can be summarized like this: ![][argument1] -[argument1]: /blog/huntergatherers/argument1.png +[argument1]: /blog/huntergatherers/argument1.jpg Essentially, once you equalize advantages across a given novel food and a given ancestral food, the inherent disadvantages of antagonistic pleiotropy would leave us favouring the novel food over the ancestral food for long-term health. From here we can infer a priori that a diet that maximizes benefits and minimizes risks for the most amount of people is likely to be a diet that is on some level unnatural or non-ancestral. It is also important to discuss what this position is **not** arguing. It is **not** being argued that every novel food is going to be superior to every ancestral food, and it is **not** being argued that all ancestral foods are bad. @@ -130,7 +130,7 @@ The most I would have to grant is that a hunter-gatherer diet is likely an impro The last inference is the icing on the cake, and a bit more convoluted, but it is necessary to argue it to an ancestral diet advocate. This is next argument cuts to the core of their epistemology regarding ancestral diets and health. All we need to do is prime the ancestral diet advocate for the inference by asking them if they identify as "**F**" (as defined below). If they do, then we proceed. If they don't, then their motivations for advocating for ancestral diets diets isn't clear at all. ![][argument2] -[argument2]: /blog/huntergatherers/argument2.png +[argument2]: /blog/huntergatherers/argument2.jpg Essentially, if our interlocutor identifies as "**F**", then all we need to do is demonstrate to them that "**N**" exists, and we're essentially home free. If they accept that "**N**" exists and they also identify as "**F**", then they should be in favour of substituting such a novel food for such an ancestral food. If they don't, then they have a contradiction. This is where the ancestral diet advocate could face quite a dilemma. diff --git a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/MeatApologetics.elm b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/MeatApologetics.elm index ae21e11..6e06959 100755 --- a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/MeatApologetics.elm +++ b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/MeatApologetics.elm @@ -44,7 +44,7 @@ While there are some plant foods that are high in saturated fat, we need not con Confounding is a causal concept. All posited confounders need to be validated as genuine confounders using evidence that meets these authors' bar for causal inference. Otherwise we don't have a reason to consider them confounders at all. The truth is that virtually all accepted confounders in this domain are validated via epidemiological data itself. I can formalize the argument like this: ![][argument1] -[argument1]: /blog/meatapologetics/argument1.png +[argument1]: /blog/meatapologetics/argument1.jpg In the above syllogism, the authors could very easily be affirming P and ¬P. If the authors are rejecting epidemiological evidence while simultaneously positing confounders that will be validated with epidemiological evidence, their position would entail a contradiction. @@ -71,7 +71,7 @@ Absolute risk and certainty are concepts that don't strongly interact. You can h It's also not clear why the authors would choose to favour absolute risk over relative risk, considering that the maximum possible absolute risk differences are going to be dictated by event rates in the comparator population. This concept can be easily illustrated referring to populations that have longer follow-up times, such as with the literature on LDL and cardiovascular disease risk [[8](https://pubmed.ncbi.nlm.nih.gov/30571575/)]. ![][image1] -[image1]: /blog/meatapologetics/image1.png +[image1]: /blog/meatapologetics/image1.jpg The distance between the two green lines represents the absolute risk difference between low and high LDL over 10 years. Whereas the distance between the two red lines represents the absolute risk difference between low and high LDL over 30 years. Here we can see that if insufficient follow-up is observed, absolute risk differences will inevitably be smaller. This is because event rates naturally increase with time. @@ -80,7 +80,7 @@ The meta-analysis by Vernooij et al. (2019) that the authors cited to support th But we can take it a step further. We can reveal the inconsistency in their reasoning by formalizing their argument against nutritional epidemiology, and showing that their criticisms apply to, say, human experiments as well. ![][argument2] -[argument2]: /blog/meatapologetics/argument2.png +[argument2]: /blog/meatapologetics/argument2.jpg Using the authors' own logic, we can show that they would have to dismiss human experimental evidence on the same basis. This is because human experimental evidence is vulnerable to the same types of limitations that the authors are positing as presumably invalidating for nutritional epidemiology. @@ -101,21 +101,21 @@ This is the second time the authors have shifted the goalpost regarding what typ From the wider literature, the typical threshold for harm with meat is at approximately 100g/day on average [[5](https://pubmed.ncbi.nlm.nih.gov/28446499/)]. ![][image2] -[image2]: /blog/meatapologetics/image2.png +[image2]: /blog/meatapologetics/image2.jpg The Oxford-EPIC cohort lacks power in those ranges [[10](https://pubmed.ncbi.nlm.nih.gov/23497300/)]. Data on the exposure contrasts in the 45-and-Up Study are even more unpersuasive [[11](https://pubmed.ncbi.nlm.nih.gov/28040519/)]. We have far more robust data than this, with better internal validity, follow-up times, and measurements. In this Japanese cohort with a follow-up of 14 years, diet and lifestyle covariates were largely balanced across the quantiles of red meat intake [[12](https://pubmed.ncbi.nlm.nih.gov/33320898/)]. In fact, many covariates we'd suspect to be detrimental actually favoured meat consumption. Despite this, total meat was still associated with a statistically significant 21% increase in all-cause mortality among men between the ages of 65 and 79 years old, and a borderline-significant 41% increase in all-cause mortality risk among women between the ages of 45 and 54 years old. ![][image3] -[image3]: /blog/meatapologetics/image3.png +[image3]: /blog/meatapologetics/image3.jpg These results could indicate that meat consumption is more likely to lead to premature death due to an unmeasured cause earlier in life than with men. Perhaps the seemingly premature increase in mortality could plausibly be attributed to an unmeasured female-specific endpoint, such as breast cancer [[13](https://pubmed.ncbi.nlm.nih.gov/31389007/)]. Again, just to hammer the point home, we can actually defeat the authors' position with a simple modus tollens. ![][argument3] -[argument3]: /blog/meatapologetics/argument3.png +[argument3]: /blog/meatapologetics/argument3.jpg Given the weight and strength of the evidence in favour of meat restriction for longevity, it would be quite hilarious to see the authors attempt to reject P2. The evidence they referenced from the Oxford-EPIC cohrot and the 45-and-Up Study could be used in an attempt to reject P2. However, that evidence is very easily superseded by higher internal validity evidence with greater power, not to mention in populations that don't suffer from the same supposed confounding. @@ -194,12 +194,12 @@ Just because meat is an integral part of our evolutionary history does not actua Appeal to nature fallacies basically affirm that because something is natural (or in this case, "evolutionary"), it then follows that it is good. However, taking this position leads to hilarious consequences. Let me demonstrate by formalizing the authors' position once more. ![][argument4] -[argument4]: /blog/meatapologetics/argument4.png +[argument4]: /blog/meatapologetics/argument4.jpg It should be obvious straight away why this is problematic. There are plenty of things that are natural or "evolutionary" that we also consider to be undesirable, and we can illustrate that with a reductio ad absurdum. ![][argument5] -[argument5]: /blog/meatapologetics/argument5.png +[argument5]: /blog/meatapologetics/argument5.jpg If animal foods are good by virtue of them being natural or "evolutionary", the authors will have to explain to me why something like rape is not good. As they share the same property of being evolutionary. @@ -240,12 +240,12 @@ For the last time, posited confounders require validation that meets the authors The authors reference a cross-sectional analysis of the Tsimane population conducted by Kaplan et al. (2017) [[21](https://pubmed.ncbi.nlm.nih.gov/28320601/)]. It's questionable whether or not their results qualify as low burdens of chronic disease for that population in the first place. ![][image4] -[image4]: /blog/meatapologetics/image4.png +[image4]: /blog/meatapologetics/image4.jpg This is made even more questionable after accounting for ~15-year age overestimations that were likely to have biased their results [[22](https://immunityageing.biomedcentral.com/articles/10.1186/s12979-019-0165-8)][[23](https://pubmed.ncbi.nlm.nih.gov/27511193/)][[24](https://pubmed.ncbi.nlm.nih.gov/34038540/)]. After this adjustment, the cardiovascular disease burden within the Tsimane is likely largely comparable with the results of the MESA cohort. ![][image5] -[image5]: /blog/meatapologetics/image5.png +[image5]: /blog/meatapologetics/image5.jpg Here on the chart above we see Tsimane age estimates using DNA methylation on the Y axis, against Tsimane age estimates using the methods of Kaplan et al. on the X axis. Kaplan et al. (2017) estimated the ages of the Tsimane participants using written records, relative age lists, dated events, photo comparisons of people with known ages, and cross-validation of information from independent interviews of kin. diff --git a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/NagraGoodrich.elm b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/NagraGoodrich.elm index f5d22c6..0999a0e 100755 --- a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/NagraGoodrich.elm +++ b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/NagraGoodrich.elm @@ -114,7 +114,7 @@ Tucker concedes that LAVAT showed a slight benefit for vegetable oils compared t Without further elaboration, would have to either accept that the increase in CVD mortality in LAVAT is noteworthy, or accept that the CVD mortality increase in MCE is at least just as unnoteworthy as LAVAT, if he wishes to stay consistent. We can syllogize the logical entailments of accepting the CVD mortality risk in MCE as "not slight" like this: ![][argument1] -[argument1]: /blog/nagragoodrich/argument1.png +[argument1]: /blog/nagragoodrich/argument1.jpg # LA VETERANS ADMINISTRATION HOSPITAL STUDY @@ -137,7 +137,7 @@ Matt responds to ecological data that Tucker presented earlier, stating that he Without further elaboration, it's unclear why Tucker would not be OK with a priori inferences about the potentially confounding effects of TFA in MCE being used in debate, when he also relies on such a priori inferences. Such as when he infers from ecological data that seed oils are likely to be detrimental. We can syllogize the logical entailments of accepting the use of a priori inferences in debate like this: ![][argument2] -[argument2]: /blog/nagragoodrich/argument2.png +[argument2]: /blog/nagragoodrich/argument2.jpg # LYON DIET-HEART STUDY @@ -170,14 +170,14 @@ Tucker correctly states that the LA-derived metabolite, malondialdehyde (MDA), i If Tucker wants to remain consistent, he'll have to explain why the atherogenic properties of ALA that are entailed from his stated position don't seem to matter. He seems to singling out LA based on characteristics that he admits are shared by ALA. Without further elaboration, Tucker should have to accept ALA as atherogenic, and the reasoning can be syllogized like this: ![][argument3] -[argument3]: /blog/nagragoodrich/argument3.png +[argument3]: /blog/nagragoodrich/argument3.jpg **Direct contradiction (2:18:19):** Tucker directly contradicts himself when he suggests that corn oil is not a seed oil. At **1:43:50**, he cited two primary interventions that demonstrate that seed oils produce harm, but the sole oil used in those trials was corn oil. ![][argument4] -[argument4]: /blog/nagragoodrich/argument4.png +[argument4]: /blog/nagragoodrich/argument4.jpg # TUCKER CONCEDES @@ -200,7 +200,7 @@ Tucker objects to Matt's use of LAVAT to demonstrate a potential benefit of seed Without additional clarification, Tucker would need to reject his own reliance on LDHS to prove the effect of LA-reduction in the context of an ALA-rich diet. Such an entailment can be syllogized like this: ![][argument5] -[argument5]: /blog/nagragoodrich/argument5.png +[argument5]: /blog/nagragoodrich/argument5.jpg **Rule violation (**[**2:13:03**](https://youtu.be/QGNNsiINehI?t=7983)**):** @@ -231,7 +231,7 @@ Tucker takes the position that silent and non-fatal AMIs are not important outco This one is pretty straight forward. Either silent and non-fatal AMIs are important and we should care about them, or they are not important and we shouldn't care about them. If Tucker wishes to remain consistent while also preserving his own arguments, we'd need to accept that silent and non-fatal AMIs are important, and that we should care about them. This entailment can by syllogized like this: ![][argument6] -[argument6]: /blog/nagragoodrich/argument6.png +[argument6]: /blog/nagragoodrich/argument6.jpg **Rule violation (**[**2:25:20**](https://youtu.be/QGNNsiINehI?t=8720)**):** @@ -258,7 +258,7 @@ Tucker takes the position that ecological studies are of critical importance, su Again, we have another relatively simple inconsistency to address. In order for Tucker to make his case against seed oils, he systematically rejected all nutritional epidemiology except for ecological studies. Yet, claiming that ecological studies are the worst form of epidemiology entails a contradiction, as it means that Tucker is simultaneously holding the view that it is both the best and the worst form of epidemiology at the same time. If Tucker wished to resolve the inconsistency, he'd probably have to acknowledge that ecological studies are not the worst form of epidemiology. This can be syllogized like this: ![][argument7] -[argument7]: /blog/nagragoodrich/argument7.png +[argument7]: /blog/nagragoodrich/argument7.jpg # SYDNEY DIET-HEART STUDY @@ -269,7 +269,7 @@ Tucker makes the claim that we can't know whether or not the margarine used in S If Tucker maintains that it cannot be known whether or not TFA was confounding in SDHS, then he cannot posit that it can be known one way or the other. Either position that Tucker took could work for his argument on this subject, but they're just not compatible with each other, and that can be illustrated like this: ![][argument8] -[argument8]: /blog/nagragoodrich/argument8.png +[argument8]: /blog/nagragoodrich/argument8.jpg **Rule violation (**[**2:57:59**](https://youtu.be/QGNNsiINehI?t=10679)**,** [**2:58:53**](https://youtu.be/QGNNsiINehI?t=10733)**):** @@ -312,7 +312,7 @@ Tucker breaks rules two again. Rather than letting Matt complete his point about Tucker concedes that margarine and mayonnaise are not the same thing as isolated vegetable oils. However, at [**3:14:30**](https://youtu.be/QGNNsiINehI?t=11670), Tucker rejects that there are differences between margarine, mayonnaise, and isolated vegetable oils. Another layer of hilarity would be to point out that if Tucker maintains that mayonnaise is the same as an isolated seed oil, he'd be holding the position that corn oil is not a seed oil, but mayonnaise is. ![][argument9] -[argument9]: /blog/nagragoodrich/argument9.png +[argument9]: /blog/nagragoodrich/argument9.jpg # DISCUSSION diff --git a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/PlantBasedMeta.elm b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/PlantBasedMeta.elm index 10aa297..cdb39bf 100755 --- a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/PlantBasedMeta.elm +++ b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/PlantBasedMeta.elm @@ -58,216 +58,216 @@ If you have enjoyed my work and want me to continue producing this sort of conte **Body Weight: Plant-based (vs Control)** ![][image5] -[image5]: /blog/plantbasedmeta/image5.png +[image5]: /blog/plantbasedmeta/image5.jpg **Body Weight: Plant-based (vs Baseline)** ![][image6] -[image6]: /blog/plantbasedmeta/image6.png +[image6]: /blog/plantbasedmeta/image6.jpg **Body Weight: Plant-based by Duration (vs Control)** ![][image7] -[image7]: /blog/plantbasedmeta/image7.png +[image7]: /blog/plantbasedmeta/image7.jpg **Body Weight: Plant-based by Duration (vs Baseline)** ![][image8] -[image8]: /blog/plantbasedmeta/image8.png +[image8]: /blog/plantbasedmeta/image8.jpg **Body Weight: Plant-based by Weight Loss (vs Control)** ![][image9] -[image9]: /blog/plantbasedmeta/image9.png +[image9]: /blog/plantbasedmeta/image9.jpg **Body Weight: Plant-based by Weight Loss (vs Baseline)** ![][image10] -[image10]: /blog/plantbasedmeta/image10.png +[image10]: /blog/plantbasedmeta/image10.jpg # BODY FAT MASS **Body Fat Mass: Plant-based (vs Control)** ![][image11] -[image11]: /blog/plantbasedmeta/image11.png +[image11]: /blog/plantbasedmeta/image11.jpg **Body Fat Mass: Plant-based (vs Baseline)** ![][image12] -[image12]: /blog/plantbasedmeta/image12.png +[image12]: /blog/plantbasedmeta/image12.jpg **Body Fat Mass: Plant-based by Duration (vs Control)** ![][image13] -[image13]: /blog/plantbasedmeta/image13.png +[image13]: /blog/plantbasedmeta/image13.jpg **Body Fat Mass: Plant-based by Duration (vs Baseline)** ![][image14] -[image14]: /blog/plantbasedmeta/image14.png +[image14]: /blog/plantbasedmeta/image14.jpg **Body Fat Mass: Plant-based by Weight Loss (vs Control)** ![][image15] -[image15]: /blog/plantbasedmeta/image15.png +[image15]: /blog/plantbasedmeta/image15.jpg **Body Fat Mass: Plant-based by Weight Loss (vs Baseline)** ![][image16] -[image16]: /blog/plantbasedmeta/image16.png +[image16]: /blog/plantbasedmeta/image16.jpg # FAT FREE MASS **Fat Free Mass: Plant-based (vs Control)** ![][image17] -[image17]: /blog/plantbasedmeta/image17.png +[image17]: /blog/plantbasedmeta/image17.jpg **Fat Free Mass: Plant-based (vs Baseline)** ![][image18] -[image18]: /blog/plantbasedmeta/image18.png +[image18]: /blog/plantbasedmeta/image18.jpg **Fat Free Mass: Plant-based by Duration (vs Control)** ![][image19] -[image19]: /blog/plantbasedmeta/image19.png +[image19]: /blog/plantbasedmeta/image19.jpg **Fat Free Mass: Plant-based by Duration (vs Baseline)** ![][image20] -[image20]: /blog/plantbasedmeta/image20.png +[image20]: /blog/plantbasedmeta/image20.jpg **Fat Free Mass: Plant-based by Weight Loss (vs Control)** ![][image21] -[image21]: /blog/plantbasedmeta/image21.png +[image21]: /blog/plantbasedmeta/image21.jpg **Fat Free Mass: Plant-based by Weight Loss (vs Baseline)** ![][image22] -[image22]: /blog/plantbasedmeta/image22.png +[image22]: /blog/plantbasedmeta/image22.jpg # BODY MASS INDEX **Body Mass Index: Plant-based (vs Control)** ![][image23] -[image23]: /blog/plantbasedmeta/image23.png +[image23]: /blog/plantbasedmeta/image23.jpg **Body Mass Index: Plant-based (vs Baseline)** ![][image24] -[image24]: /blog/plantbasedmeta/image24.png +[image24]: /blog/plantbasedmeta/image24.jpg **Body Mass Index: Plant-based by Duration (vs Control)** ![][image25] -[image25]: /blog/plantbasedmeta/image25.png +[image25]: /blog/plantbasedmeta/image25.jpg **Body Mass Index: Plant-based by Duration (vs Baseline)** ![][image26] -[image26]: /blog/plantbasedmeta/image26.png +[image26]: /blog/plantbasedmeta/image26.jpg **Body Mass Index: Plant-based by Weight Loss (vs Control)** ![][image27] -[image27]: /blog/plantbasedmeta/image27.png +[image27]: /blog/plantbasedmeta/image27.jpg **Body Mass Index: Plant-based by Weight Loss (vs Baseline)** ![][image28] -[image28]: /blog/plantbasedmeta/image28.png +[image28]: /blog/plantbasedmeta/image28.jpg # WAIST HIP RATIO **Waist Hip Ratio: Plant-based (vs Control)** ![][image29] -[image29]: /blog/plantbasedmeta/image29.png +[image29]: /blog/plantbasedmeta/image29.jpg **Waist Hip Ratio: Plant-based (vs Baseline)** ![][image30] -[image30]: /blog/plantbasedmeta/image30.png +[image30]: /blog/plantbasedmeta/image30.jpg **Waist Hip Ratio: Plant-based by Duration (vs Control)** ![][image31] -[image31]: /blog/plantbasedmeta/image31.png +[image31]: /blog/plantbasedmeta/image31.jpg **Waist Hip Ratio: Plant-based by Duration (vs Baseline)** ![][image32] -[image32]: /blog/plantbasedmeta/image32.png +[image32]: /blog/plantbasedmeta/image32.jpg **Waist Hip Ratio: Plant-based by Weight Loss (vs Control)** ![][image33] -[image33]: /blog/plantbasedmeta/image33.png +[image33]: /blog/plantbasedmeta/image33.jpg **Waist Hip Ratio: Plant-based by Weight Loss (vs Baseline)** ![][image34] -[image34]: /blog/plantbasedmeta/image34.png +[image34]: /blog/plantbasedmeta/image34.jpg # VISCERAL ADIPOSE TISSUE **Visceral Adipose Tissue: Plant-based (vs Control)** ![][image35] -[image35]: /blog/plantbasedmeta/image35.png +[image35]: /blog/plantbasedmeta/image35.jpg **Visceral Adipose Tissue: Plant-based (vs Baseline)** ![][image36] -[image36]: /blog/plantbasedmeta/image36.png +[image36]: /blog/plantbasedmeta/image36.jpg # INTRAHEPATIC LIPID **Intrahepatic Lipid: Plant-based (vs Control)** ![][image37] -[image37]: /blog/plantbasedmeta/image37.png +[image37]: /blog/plantbasedmeta/image37.jpg **Intrahepatic Lipid: Plant-based (vs Baseline)** ![][image38] -[image38]: /blog/plantbasedmeta/image38.png +[image38]: /blog/plantbasedmeta/image38.jpg **Intrahepatic Lipid: Plant-based by Duration (vs Control)** ![][image39] -[image39]: /blog/plantbasedmeta/image39.png +[image39]: /blog/plantbasedmeta/image39.jpg **Intrahepatic Lipid: Plant-based by Duration (vs Baseline)** ![][image40] -[image40]: /blog/plantbasedmeta/image40.png +[image40]: /blog/plantbasedmeta/image40.jpg **Intrahepatic Lipid: Plant-based by Weight Loss (vs Control)** ![][image41] -[image41]: /blog/plantbasedmeta/image41.png +[image41]: /blog/plantbasedmeta/image41.jpg **Intrahepatic Lipid: Plant-based by Weight Loss (vs Baseline)** ![][image42] -[image42]: /blog/plantbasedmeta/image42.png +[image42]: /blog/plantbasedmeta/image42.jpg # INTRAMYOCELLULAR LIPID **Intramyocellular Lipid: Plant-based (vs Control)** ![][image43] -[image43]: /blog/plantbasedmeta/image43.png +[image43]: /blog/plantbasedmeta/image43.jpg **Intramyocellular Lipid: Plant-based (vs Baseline)** ![][image44] -[image44]: /blog/plantbasedmeta/image44.png +[image44]: /blog/plantbasedmeta/image44.jpg # CARDIOVASCULAR @@ -276,64 +276,64 @@ If you have enjoyed my work and want me to continue producing this sort of conte **Systolic Blood Pressure: Plant-based (vs Control)** ![][image45] -[image45]: /blog/plantbasedmeta/image45.png +[image45]: /blog/plantbasedmeta/image45.jpg **Systolic Blood Pressure: Plant-based (vs Baseline)** ![][image46] -[image46]: /blog/plantbasedmeta/image46.png +[image46]: /blog/plantbasedmeta/image46.jpg **Systolic Blood Pressure: Plant-based by Duration (vs Control)** ![][image47] -[image47]: /blog/plantbasedmeta/image47.png +[image47]: /blog/plantbasedmeta/image47.jpg **Systolic Blood Pressure: Plant-based by Duration (vs Baseline)** ![][image48] -[image48]: /blog/plantbasedmeta/image48.png +[image48]: /blog/plantbasedmeta/image48.jpg **Systolic Blood Pressure: Plant-based by Weight Loss (vs Control)** ![][image49] -[image49]: /blog/plantbasedmeta/image49.png +[image49]: /blog/plantbasedmeta/image49.jpg **Systolic Blood Pressure: Plant-based by Weight Loss (vs Baseline)** ![][image50] -[image50]: /blog/plantbasedmeta/image50.png +[image50]: /blog/plantbasedmeta/image50.jpg # DIASTOLIC BLOOD PRESSURE **Diastolic Blood Pressure: Plant-based (vs Control)** ![][image51] -[image51]: /blog/plantbasedmeta/image51.png +[image51]: /blog/plantbasedmeta/image51.jpg **Diastolic Blood Pressure: Plant-based (vs Baseline)** ![][image52] -[image52]: /blog/plantbasedmeta/image52.png +[image52]: /blog/plantbasedmeta/image52.jpg **Diastolic Blood Pressure: Plant-based by Duration (vs Control)** ![][image53] -[image53]: /blog/plantbasedmeta/image53.png +[image53]: /blog/plantbasedmeta/image53.jpg **Diastolic Blood Pressure: Plant-based by Duration (vs Baseline)** ![][image54] -[image54]: /blog/plantbasedmeta/image54.png +[image54]: /blog/plantbasedmeta/image54.jpg **Diastolic Blood Pressure: Plant-based by Weight Loss (vs Control)** ![][image55] -[image55]: /blog/plantbasedmeta/image55.png +[image55]: /blog/plantbasedmeta/image55.jpg **Diastolic Blood Pressure: Plant-based by Weight Loss (vs Baseline)** ![][image56] -[image56]: /blog/plantbasedmeta/image56.png +[image56]: /blog/plantbasedmeta/image56.jpg # CHEMISTRY @@ -342,142 +342,142 @@ If you have enjoyed my work and want me to continue producing this sort of conte **Hemoglobin A1C: Plant-based (vs Control)** ![][image57] -[image57]: /blog/plantbasedmeta/image57.png +[image57]: /blog/plantbasedmeta/image57.jpg **Hemoglobin A1C: Plant-based (vs Baseline)** ![][image58] -[image58]: /blog/plantbasedmeta/image58.png +[image58]: /blog/plantbasedmeta/image58.jpg **Hemoglobin A1C: Plant-based by Duration (vs Control)** ![][image59] -[image59]: /blog/plantbasedmeta/image59.png +[image59]: /blog/plantbasedmeta/image59.jpg **Hemoglobin A1C: Plant-based by Duration (vs Baseline)** ![][image60] -[image60]: /blog/plantbasedmeta/image60.png +[image60]: /blog/plantbasedmeta/image60.jpg **Hemoglobin A1C: Plant-based by Weight Loss (vs Control)** ![][image61] -[image61]: /blog/plantbasedmeta/image61.png +[image61]: /blog/plantbasedmeta/image61.jpg **Hemoglobin A1C: Plant-based by Weight Loss (vs Baseline)** ![][image62] -[image62]: /blog/plantbasedmeta/image62.png +[image62]: /blog/plantbasedmeta/image62.jpg # BLOOD GLUCOSE **Blood Glucose: Plant-based (vs Control)** ![][image63] -[image63]: /blog/plantbasedmeta/image63.png +[image63]: /blog/plantbasedmeta/image63.jpg **Blood Glucose: Plant-based (vs Baseline)** ![][image64] -[image64]: /blog/plantbasedmeta/image64.png +[image64]: /blog/plantbasedmeta/image64.jpg **Blood Glucose: Plant-based by Duration (vs Control)** ![][image65] -[image65]: /blog/plantbasedmeta/image65.png +[image65]: /blog/plantbasedmeta/image65.jpg **Blood Glucose: Plant-based by Duration (vs Baseline)** ![][image66] -[image66]: /blog/plantbasedmeta/image66.png +[image66]: /blog/plantbasedmeta/image66.jpg **Blood Glucose: Plant-based by Weight Loss (vs Control)** ![][image67] -[image67]: /blog/plantbasedmeta/image67.png +[image67]: /blog/plantbasedmeta/image67.jpg **Blood Glucose: Plant-based by Weight Loss (vs Baseline)** ![][image68] -[image68]: /blog/plantbasedmeta/image68.png +[image68]: /blog/plantbasedmeta/image68.jpg # URIC ACID **Uric Acid: Plant-based (vs Control)** ![][image69] -[image69]: /blog/plantbasedmeta/image69.png +[image69]: /blog/plantbasedmeta/image69.jpg **Uric Acid: Plant-based (vs Baseline)** ![][image70] -[image70]: /blog/plantbasedmeta/image70.png +[image70]: /blog/plantbasedmeta/image70.jpg **Uric Acid: Plant-based by Duration (vs Control)** ![][image71] -[image71]: /blog/plantbasedmeta/image71.png +[image71]: /blog/plantbasedmeta/image71.jpg **Uric Acid: Plant-based by Duration (vs Baseline)** ![][image72] -[image72]: /blog/plantbasedmeta/image72.png +[image72]: /blog/plantbasedmeta/image72.jpg # WHITE BLOOD CELL COUNT **White Blood Cell Count: Plant-based (vs Control)** ![][image73] -[image73]: /blog/plantbasedmeta/image73.png +[image73]: /blog/plantbasedmeta/image73.jpg **White Blood Cell Count: Plant-based (vs Baseline)** ![][image74] -[image74]: /blog/plantbasedmeta/image74.png +[image74]: /blog/plantbasedmeta/image74.jpg **White Blood Cell Count: Plant-based by Duration (vs Control)** ![][image75] -[image75]: /blog/plantbasedmeta/image75.png +[image75]: /blog/plantbasedmeta/image75.jpg **White Blood Cell Count: Plant-based by Duration (vs Baseline)** ![][image76] -[image76]: /blog/plantbasedmeta/image76.png +[image76]: /blog/plantbasedmeta/image76.jpg #TRIMETHYLAMINE N-OXIDE **Trimethylamine N-Oxide: Plant-based (vs Control)** ![][image77] -[image77]: /blog/plantbasedmeta/image77.png +[image77]: /blog/plantbasedmeta/image77.jpg **Trimethylamine N-Oxide: Plant-based (vs Baseline)** ![][image78] -[image78]: /blog/plantbasedmeta/image78.png +[image78]: /blog/plantbasedmeta/image78.jpg # MALONDIALDEHYDE **Malondialdehyde: Plant-based (vs Control)** ![][image79] -[image79]: /blog/plantbasedmeta/image79.png +[image79]: /blog/plantbasedmeta/image79.jpg **Malondialdehyde: Plant-based (vs Baseline)** ![][image80] -[image80]: /blog/plantbasedmeta/image80.png +[image80]: /blog/plantbasedmeta/image80.jpg **Malondialdehyde: Plant-based by Duration (vs Control)** ![][image81] -[image81]: /blog/plantbasedmeta/image81.png +[image81]: /blog/plantbasedmeta/image81.jpg **Malondialdehyde: Plant-based by Duration (vs Baseline)** ![][image82] -[image82]: /blog/plantbasedmeta/image82.png +[image82]: /blog/plantbasedmeta/image82.jpg # ENDOCRINE @@ -486,44 +486,44 @@ If you have enjoyed my work and want me to continue producing this sort of conte **Insulin: Plant-based (vs Control)** ![][image83] -[image83]: /blog/plantbasedmeta/image83.png +[image83]: /blog/plantbasedmeta/image83.jpg **Insulin: Plant-based (vs Baseline)** ![][image84] -[image84]: /blog/plantbasedmeta/image84.png +[image84]: /blog/plantbasedmeta/image84.jpg **Insulin: Plant-based by Duration (vs Control)** ![][image85] -[image85]: /blog/plantbasedmeta/image85.png +[image85]: /blog/plantbasedmeta/image85.jpg **Insulin: Plant-based by Duration (vs Baseline)** ![][image86] -[image86]: /blog/plantbasedmeta/image86.png +[image86]: /blog/plantbasedmeta/image86.jpg **Insulin: Plant-based by Weight Loss (vs Control)** ![][image87] -[image87]: /blog/plantbasedmeta/image87.png +[image87]: /blog/plantbasedmeta/image87.jpg **Insulin: Plant-based by Weight Loss (vs Baseline)** ![][image88] -[image88]: /blog/plantbasedmeta/image88.png +[image88]: /blog/plantbasedmeta/image88.jpg # INSULIN-LIKE GROWTH FACTOR 1 **Insulin-Like Growth Factor 1: Plant-based (vs Control)** ![][image89] -[image89]: /blog/plantbasedmeta/image89.png +[image89]: /blog/plantbasedmeta/image89.jpg **Insulin-Like Growth Factor 1: Plant-based (vs Baseline)** ![][image90] -[image90]: /blog/plantbasedmeta/image90.png +[image90]: /blog/plantbasedmeta/image90.jpg # INFLAMMATION @@ -532,168 +532,168 @@ If you have enjoyed my work and want me to continue producing this sort of conte **High Sensitivity C-Reactive Protein: Plant-based (vs Control)** ![][image91] -[image91]: /blog/plantbasedmeta/image91.png +[image91]: /blog/plantbasedmeta/image91.jpg **High Sensitivity C-Reactive Protein: Plant-based (vs Baseline)** ![][image92] -[image92]: /blog/plantbasedmeta/image92.png +[image92]: /blog/plantbasedmeta/image92.jpg **High Sensitivity C-Reactive Protein: Plant-based by Duration (vs Control)** ![][image93] -[image93]: /blog/plantbasedmeta/image93.png +[image93]: /blog/plantbasedmeta/image93.jpg **High Sensitivity C-Reactive Protein: Plant-based by Duration (vs Baseline)** ![][image94] -[image94]: /blog/plantbasedmeta/image94.png +[image94]: /blog/plantbasedmeta/image94.jpg **High Sensitivity C-Reactive Protein: Plant-based by Weight Loss (vs Control)** ![][image95] -[image95]: /blog/plantbasedmeta/image95.png +[image95]: /blog/plantbasedmeta/image95.jpg **High Sensitivity C-Reactive Protein: Plant-based by Weight Loss (vs Baseline)** ![][image96] -[image96]: /blog/plantbasedmeta/image96.png +[image96]: /blog/plantbasedmeta/image96.jpg # LOW SENSITIVITY C-REACTIVE PROTEIN **Low Sensitivity C-Reactive Protein: Plant-based (vs Control)** ![][image97] -[image97]: /blog/plantbasedmeta/image97.png +[image97]: /blog/plantbasedmeta/image97.jpg **Low Sensitivity C-Reactive Protein: Plant-based (vs Baseline)** ![][image98] -[image98]: /blog/plantbasedmeta/image98.png +[image98]: /blog/plantbasedmeta/image98.jpg **Low Sensitivity C-Reactive Protein: Plant-based by Duration (vs Control)** ![][image99] -[image99]: /blog/plantbasedmeta/image99.png +[image99]: /blog/plantbasedmeta/image99.jpg **Low Sensitivity C-Reactive Protein: Plant-based by Duration (vs Baseline)** ![][image100] -[image100]: /blog/plantbasedmeta/image100.png +[image100]: /blog/plantbasedmeta/image100.jpg # TUMOR NECROSIS FACTOR **Tumor Necrosis Factor: Plant-based (vs Control)** ![][image101] -[image101]: /blog/plantbasedmeta/image101.png +[image101]: /blog/plantbasedmeta/image101.jpg **Tumor Necrosis Factor: Plant-based (vs Baseline)** ![][image102] -[image102]: /blog/plantbasedmeta/image102.png +[image102]: /blog/plantbasedmeta/image102.jpg # INTERCELLULAR ADHESION MOLECULE 1 **Intercellular Adhesion Molecule 1: Plant-based (vs Control)** ![][image103] -[image103]: /blog/plantbasedmeta/image103.png +[image103]: /blog/plantbasedmeta/image103.jpg **Intercellular Adhesion Molecule 1: Plant-based (vs Baseline)** ![][image104] -[image104]: /blog/plantbasedmeta/image104.png +[image104]: /blog/plantbasedmeta/image104.jpg **Intercellular Adhesion Molecule 1: Plant-based by Duration (vs Control)** ![][image105] -[image105]: /blog/plantbasedmeta/image105.png +[image105]: /blog/plantbasedmeta/image105.jpg **Intercellular Adhesion Molecule 1: Plant-based by Duration (vs Baseline)** ![][image106] -[image106]: /blog/plantbasedmeta/image106.png +[image106]: /blog/plantbasedmeta/image106.jpg # VASCULAR CELLULAR ADHESION MOLECULE 1 **Vascular Cellular Adhesion Molecule 1: Plant-based (vs Control)** ![][image107] -[image107]: /blog/plantbasedmeta/image107.png +[image107]: /blog/plantbasedmeta/image107.jpg **Vascular Cellular Adhesion Molecule 1: Plant-based (vs Baseline)** ![][image108] -[image108]: /blog/plantbasedmeta/image108.png +[image108]: /blog/plantbasedmeta/image108.jpg **Vascular Cellular Adhesion Molecule 1: Plant-based by Duration (vs Control)** ![][image109] -[image109]: /blog/plantbasedmeta/image109.png +[image109]: /blog/plantbasedmeta/image109.jpg **Vascular Cellular Adhesion Molecule 1: Plant-based by Duration (vs Baseline)** ![][image110] -[image110]: /blog/plantbasedmeta/image110.png +[image110]: /blog/plantbasedmeta/image110.jpg # MONOCYTE CHEMOATTRACTANT PROTEIN-1 **Monocyte Chemoattractant Protein-1: Plant-based (vs Control)** ![][image111] -[image111]: /blog/plantbasedmeta/image111.png +[image111]: /blog/plantbasedmeta/image111.jpg **Monocyte Chemoattractant Protein-1: Plant-based (vs Baseline)** ![][image112] -[image112]: /blog/plantbasedmeta/image112.png +[image112]: /blog/plantbasedmeta/image112.jpg # INTERLEUKIN 6 **Interleukin 6: Plant-based (vs Control)** ![][image113] -[image113]: /blog/plantbasedmeta/image113.png +[image113]: /blog/plantbasedmeta/image113.jpg **Interleukin 6: Plant-based (vs Baseline)** ![][image114] -[image114]: /blog/plantbasedmeta/image114.png +[image114]: /blog/plantbasedmeta/image114.jpg **Interleukin 6: Plant-based by Duration (vs Control)** ![][image115] -[image115]: /blog/plantbasedmeta/image115.png +[image115]: /blog/plantbasedmeta/image115.jpg **Interleukin 6: Plant-based by Duration (vs Baseline)** ![][image116] -[image116]: /blog/plantbasedmeta/image116.png +[image116]: /blog/plantbasedmeta/image116.jpg # INTERLEUKIN 8 **Interleukin 8: Plant-based (vs Control)** ![][image117] -[image117]: /blog/plantbasedmeta/image117.png +[image117]: /blog/plantbasedmeta/image117.jpg **Interleukin 8: Plant-based (vs Baseline)** ![][image118] -[image118]: /blog/plantbasedmeta/image118.png +[image118]: /blog/plantbasedmeta/image118.jpg # INTERLEUKIN 10 **Interleukin 10: Plant-based (vs Control)** ![][image119] -[image119]: /blog/plantbasedmeta/image119.png +[image119]: /blog/plantbasedmeta/image119.jpg **Interleukin 10: Plant-based (vs Baseline)** ![][image120] -[image120]: /blog/plantbasedmeta/image120.png +[image120]: /blog/plantbasedmeta/image120.jpg # KIDNEY FUNCTION @@ -702,12 +702,12 @@ If you have enjoyed my work and want me to continue producing this sort of conte **Urea: Plant-based (vs Control)** ![][image121] -[image121]: /blog/plantbasedmeta/image121.png +[image121]: /blog/plantbasedmeta/image121.jpg **Urea: Plant-based (vs Baseline)** ![][image122] -[image122]: /blog/plantbasedmeta/image122.png +[image122]: /blog/plantbasedmeta/image122.jpg # LIPIDOLOGY @@ -716,332 +716,332 @@ If you have enjoyed my work and want me to continue producing this sort of conte **Low Density Lipoprotein Cholesterol: Plant-based (vs Control)** ![][image123] -[image123]: /blog/plantbasedmeta/image123.png +[image123]: /blog/plantbasedmeta/image123.jpg **Low Density Lipoprotein Cholesterol: Plant-based (vs Baseline)** ![][image124] -[image124]: /blog/plantbasedmeta/image124.png +[image124]: /blog/plantbasedmeta/image124.jpg **Low Density Lipoprotein Cholesterol: Plant-based by Duration (vs Control)** ![][image125] -[image125]: /blog/plantbasedmeta/image125.png +[image125]: /blog/plantbasedmeta/image125.jpg **Low Density Lipoprotein Cholesterol: Plant-based by Duration (vs Baseline)** ![][image126] -[image126]: /blog/plantbasedmeta/image126.png +[image126]: /blog/plantbasedmeta/image126.jpg **Low Density Lipoprotein Cholesterol: Plant-based by Weight Loss (vs Control)** ![][image127] -[image127]: /blog/plantbasedmeta/image127.png +[image127]: /blog/plantbasedmeta/image127.jpg **Low Density Lipoprotein Cholesterol: Plant-based by Weight Loss (vs Baseline)** ![][image128] -[image128]: /blog/plantbasedmeta/image128.png +[image128]: /blog/plantbasedmeta/image128.jpg # HIGH DENSITY LIPOPROTEIN CHOLESTEROL **High Density Lipoprotein Cholesterol: Plant-based (vs Control)** ![][image129] -[image129]: /blog/plantbasedmeta/image129.png +[image129]: /blog/plantbasedmeta/image129.jpg **High Density Lipoprotein Cholesterol: Plant-based (vs Baseline)** ![][image130] -[image130]: /blog/plantbasedmeta/image130.png +[image130]: /blog/plantbasedmeta/image130.jpg **High Density Lipoprotein Cholesterol: Plant-based by Duration (vs Control)** ![][image131] -[image131]: /blog/plantbasedmeta/image131.png +[image131]: /blog/plantbasedmeta/image131.jpg **High Density Lipoprotein Cholesterol: Plant-based by Duration (vs Baseline)** ![][image132] -[image132]: /blog/plantbasedmeta/image132.png +[image132]: /blog/plantbasedmeta/image132.jpg **High Density Lipoprotein Cholesterol: Plant-based by Weight Loss (vs Control)** ![][image133] -[image133]: /blog/plantbasedmeta/image133.png +[image133]: /blog/plantbasedmeta/image133.jpg **High Density Lipoprotein Cholesterol: Plant-based by Weight Loss (vs Baseline)** ![][image134] -[image134]: /blog/plantbasedmeta/image134.png +[image134]: /blog/plantbasedmeta/image134.jpg # TRIGLYCERIDES **Triglycerides: Plant-based (vs Control)** ![][image135] -[image135]: /blog/plantbasedmeta/image135.png +[image135]: /blog/plantbasedmeta/image135.jpg **Triglycerides: Plant-based (vs Baseline)** ![][image136] -[image136]: /blog/plantbasedmeta/image136.png +[image136]: /blog/plantbasedmeta/image136.jpg **Triglycerides: Plant-based by Duration (vs Control)** ![][image137] -[image137]: /blog/plantbasedmeta/image137.png +[image137]: /blog/plantbasedmeta/image137.jpg **Triglycerides: Plant-based by Duration (vs Baseline)** ![][image138] -[image138]: /blog/plantbasedmeta/image138.png +[image138]: /blog/plantbasedmeta/image138.jpg **Triglycerides: Plant-based by Weight Loss (vs Control)** ![][image139] -[image139]: /blog/plantbasedmeta/image139.png +[image139]: /blog/plantbasedmeta/image139.jpg **Triglycerides: Plant-based by Weight Loss (vs Baseline)** ![][image140] -[image140]: /blog/plantbasedmeta/image140.png +[image140]: /blog/plantbasedmeta/image140.jpg # APOLIPOPROTEIN B **Apolipoprotein B: Plant-based (vs Control)** ![][image141] -[image141]: /blog/plantbasedmeta/image141.png +[image141]: /blog/plantbasedmeta/image141.jpg **Apolipoprotein B: Plant-based (vs Baseline)** ![][image142] -[image142]: /blog/plantbasedmeta/image142.png +[image142]: /blog/plantbasedmeta/image142.jpg **Apolipoprotein B: Plant-based by Duration (vs Control)** ![][image143] -[image143]: /blog/plantbasedmeta/image143.png +[image143]: /blog/plantbasedmeta/image143.jpg **Apolipoprotein B: Plant-based by Duration (vs Baseline)** ![][image144] -[image144]: /blog/plantbasedmeta/image144.png +[image144]: /blog/plantbasedmeta/image144.jpg **Apolipoprotein B: Plant-based by Weight Loss (vs Control)** ![][image145] -[image145]: /blog/plantbasedmeta/image145.png +[image145]: /blog/plantbasedmeta/image145.jpg **Apolipoprotein B: Plant-based by Weight Loss (vs Baseline)** ![][image146] -[image146]: /blog/plantbasedmeta/image146.png +[image146]: /blog/plantbasedmeta/image146.jpg # APOLIPOPROTEIN A1 **Apolipoprotein A1: Plant-based (vs Control)** ![][image147] -[image147]: /blog/plantbasedmeta/image147.png +[image147]: /blog/plantbasedmeta/image147.jpg **Apolipoprotein A1: Plant-based (vs Baseline)** ![][image148] -[image148]: /blog/plantbasedmeta/image148.png +[image148]: /blog/plantbasedmeta/image148.jpg **Apolipoprotein A1: Plant-based by Duration (vs Control)** ![][image149] -[image149]: /blog/plantbasedmeta/image149.png +[image149]: /blog/plantbasedmeta/image149.jpg **Apolipoprotein A1: Plant-based by Duration (vs Baseline)** ![][image150] -[image150]: /blog/plantbasedmeta/image150.png +[image150]: /blog/plantbasedmeta/image150.jpg **Apolipoprotein A1: Plant-based by Weight Loss (vs Control)** ![][image151] -[image151]: /blog/plantbasedmeta/image151.png +[image151]: /blog/plantbasedmeta/image151.jpg **Apolipoprotein A1: Plant-based by Weight Loss (vs Baseline)** ![][image152] -[image152]: /blog/plantbasedmeta/image152.png +[image152]: /blog/plantbasedmeta/image152.jpg # LOW DENSITY LIPOPROTEIN PARTICLE COUNT **Low Density Lipoprotein Particle Count: Plant-based (vs Control)** ![][image153] -[image153]: /blog/plantbasedmeta/image153.png +[image153]: /blog/plantbasedmeta/image153.jpg **Low Density Lipoprotein Particle Count: Plant-based (vs Baseline)** ![][image154] -[image154]: /blog/plantbasedmeta/image154.png +[image154]: /blog/plantbasedmeta/image154.jpg **Low Density Lipoprotein Particle Count: Plant-based by Duration (vs Control)** ![][image155] -[image155]: /blog/plantbasedmeta/image155.png +[image155]: /blog/plantbasedmeta/image155.jpg **Low Density Lipoprotein Particle Count: Plant-based by Duration (vs Baseline)** ![][image156] -[image156]: /blog/plantbasedmeta/image156.png +[image156]: /blog/plantbasedmeta/image156.jpg # LOW DENSITY LIPOPROTEIN PARTICLE SIZE **Low Density Lipoprotein Particle Size: Plant-based (vs Control)** ![][image157] -[image157]: /blog/plantbasedmeta/image157.png +[image157]: /blog/plantbasedmeta/image157.jpg **Low Density Lipoprotein Particle Size: Plant-based (vs Baseline)** ![][image158] -[image158]: /blog/plantbasedmeta/image158.png +[image158]: /blog/plantbasedmeta/image158.jpg **Low Density Lipoprotein Particle Size: Plant-based by Duration (vs Control)** ![][image159] -[image159]: /blog/plantbasedmeta/image159.png +[image159]: /blog/plantbasedmeta/image159.jpg **Low Density Lipoprotein Particle Size: Plant-based by Duration (vs Baseline)** ![][image160] -[image160]: /blog/plantbasedmeta/image160.png +[image160]: /blog/plantbasedmeta/image160.jpg # LIVER FUNCTION **Alanine Aminotransferase (U/L) ![][image161] -[image161]: /blog/plantbasedmeta/image161.png +[image161]: /blog/plantbasedmeta/image161.jpg **Alanine Aminotransferase: Plant-based (vs Control)** ![][image162] -[image162]: /blog/plantbasedmeta/image162.png +[image162]: /blog/plantbasedmeta/image162.jpg **Alanine Aminotransferase: Plant-based (vs Baseline)** ![][image163] -[image163]: /blog/plantbasedmeta/image163.png +[image163]: /blog/plantbasedmeta/image163.jpg **Alanine Aminotransferase: Plant-based by Duration (vs Control)** ![][image164] -[image164]: /blog/plantbasedmeta/image164.png +[image164]: /blog/plantbasedmeta/image164.jpg **Alanine Aminotransferase: Plant-based by Duration (vs Baseline)** ![][image165] -[image165]: /blog/plantbasedmeta/image165.png +[image165]: /blog/plantbasedmeta/image165.jpg # ASPARTATE AMINOTRANSFERASE **Aspartate Aminotransferase: Plant-based (vs Control)** ![][image166] -[image166]: /blog/plantbasedmeta/image166.png +[image166]: /blog/plantbasedmeta/image166.jpg **Aspartate Aminotransferase: Plant-based (vs Baseline)** ![][image167] -[image167]: /blog/plantbasedmeta/image167.png +[image167]: /blog/plantbasedmeta/image167.jpg # GAMMA-GLUTAMYL TRANSFERASE **Gamma-Glutamyl Transferase: Plant-based (vs Control)** ![][image168] -[image168]: /blog/plantbasedmeta/image168.png +[image168]: /blog/plantbasedmeta/image168.jpg **Gamma-Glutamyl Transferase: Plant-based (vs Baseline)** ![][image169] -[image169]: /blog/plantbasedmeta/image169.png +[image169]: /blog/plantbasedmeta/image169.jpg # BILIRUBIN **Bilirubin: Plant-based (vs Control)** ![][image170] -[image170]: /blog/plantbasedmeta/image170.png +[image170]: /blog/plantbasedmeta/image170.jpg **Bilirubin: Plant-based (vs Baseline)** ![][image171] -[image171]: /blog/plantbasedmeta/image171.png +[image171]: /blog/plantbasedmeta/image171.jpg # THYROID FUNCTION **Triiodothyronine (ng/dL) ![][image172] -[image172]: /blog/plantbasedmeta/image172.png +[image172]: /blog/plantbasedmeta/image172.jpg **Triiodothyronine: Plant-based (vs Control)** ![][image173] -[image173]: /blog/plantbasedmeta/image173.png +[image173]: /blog/plantbasedmeta/image173.jpg **Triiodothyronine: Plant-based (vs Baseline)** ![][image174] -[image174]: /blog/plantbasedmeta/image174.png +[image174]: /blog/plantbasedmeta/image174.jpg # THYROXINE **Thyroxine: Plant-based (vs Control)** ![][image175] -[image175]: /blog/plantbasedmeta/image175.png +[image175]: /blog/plantbasedmeta/image175.jpg **Thyroxine: Plant-based (vs Baseline)** ![][image176] -[image176]: /blog/plantbasedmeta/image176.png +[image176]: /blog/plantbasedmeta/image176.jpg # FREE TRIIODOTHYRONINE **Free Triiodothyronine: Plant-based (vs Control)** ![][image177] -[image177]: /blog/plantbasedmeta/image177.png +[image177]: /blog/plantbasedmeta/image177.jpg **Free Triiodothyronine: Plant-based (vs Baseline)** ![][image178] -[image-45]: /blog/plantbasedmeta/image-4-45.png +[image-45]: /blog/plantbasedmeta/image-4-45.jpg # THYROXINE **Free Thyroxine: Plant-based (vs Control)** ![][image178] -[image178]: /blog/plantbasedmeta/image178.png +[image178]: /blog/plantbasedmeta/image178.jpg **Free Thyroxine: Plant-based (vs Baseline)** ![][image179] -[image179]: /blog/plantbasedmeta/image179.png +[image179]: /blog/plantbasedmeta/image179.jpg # THYROID STIMULATING HORMONE **Thyroid Stimulating Hormone: Plant-based (vs Control)** ![][image180] -[image180]: /blog/plantbasedmeta/image180.png +[image180]: /blog/plantbasedmeta/image180.jpg **Thyroid Stimulating Hormone: Plant-based (vs Baseline)** ![][image181] -[image181]: /blog/plantbasedmeta/image181.png +[image181]: /blog/plantbasedmeta/image181.jpg # ENERGETICS @@ -1050,32 +1050,32 @@ If you have enjoyed my work and want me to continue producing this sort of conte **Energy Expenditure: Plant-based (vs Control)** ![][image182] -[image182]: /blog/plantbasedmeta/image182.png +[image182]: /blog/plantbasedmeta/image182.jpg **Energy Expenditure: Plant-based (vs Baseline)** ![][image183] -[image183]: /blog/plantbasedmeta/image183.png +[image183]: /blog/plantbasedmeta/image183.jpg **Energy Expenditure: Plant-based by Duration (vs Control)** ![][image184] -[image184]: /blog/plantbasedmeta/image184.png +[image184]: /blog/plantbasedmeta/image184.jpg **Energy Expenditure: Plant-based by Duration (vs Baseline)** ![][image185] -[image185]: /blog/plantbasedmeta/image185.png +[image185]: /blog/plantbasedmeta/image185.jpg **Energy Expenditure: Plant-based by Weight Loss (vs Control)** ![][image186] -[image186]: /blog/plantbasedmeta/image186.png +[image186]: /blog/plantbasedmeta/image186.jpg **Energy Expenditure: Plant-based by Weight Loss (vs Baseline)** ![][image187] -[image187]: /blog/plantbasedmeta/image187.png +[image187]: /blog/plantbasedmeta/image187.jpg Thank you for reading! If you like what you've read and want help me create more content like this, consider pledging your [Support](https://www.uprootnutrition.com/donate). Every little bit helps! I hope you found the content interesting! diff --git a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SapienDiet.elm b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SapienDiet.elm index 67a138d..bd41a3b 100755 --- a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SapienDiet.elm +++ b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SapienDiet.elm @@ -41,7 +41,7 @@ This is just a post-hoc fallacy and a misunderstanding of the evidence being pre For example, there is a positive ecological association between smoking and life expectancy [[1](http://www.thefunctionalart.com/2018/07/visualizing-amalgamation-paradoxes-and.html)]. But, we wouldn't infer from this association that cigarette consumption increases longevity. Those sorts of inferences are what prospective cohort studies and randomized controlled trials are for, as they are actually equipped to assess individual-level exposure and outcomes. ![][image1] -[image1]: /blog/sapiendiet/image1.png +[image1]: /blog/sapiendiet/image1.jpg **Base Rate Fallacy** @@ -58,14 +58,14 @@ As an aside, it is also interesting to note that those in Hong Kong who followed The aggregated difference in the lowest to highest red meat intake in this pooled analysis was ~60g/day, which is approximately two bites [[4](https://pubmed.ncbi.nlm.nih.gov/23902788/)]. It's unclear how this is capable of informing our judgements about the health value of red meat in the context of something like a Sapien Diet™. Not only that, but the contrast is occurring primarily at lower levels of intake. ![][image2] -[image2]: /blog/sapiendiet/image2.png +[image2]: /blog/sapiendiet/image2.jpg Generally speaking, contrasts in red meat intake exceeding 80-100g/day are typically required on a per-cohort basis to reveal the increased risk of cardiovascular disease mortality or even all-cause mortality. Contrasts that fall below this threshold often do not provide for the statistical power that is necessary to obtain a statistically significant estimate. Brian's own reference also confirms that meat intake in Asian populations is generally quite a bit lower than the United States. ![][image3] -[image3]: /blog/sapiendiet/image3.png +[image3]: /blog/sapiendiet/image3.jpg >_Per capita beef consumption has decreased to some degree in the past decade in the United States but still remains substantially higher than that in Asian countries. Beef consumption increased in China, Japan, and Korea from 1970 to 2007._ @@ -76,7 +76,7 @@ In actuality, when we select Asian populations with the widest contrasts in red Additionally, Brian has [stated publicly](https://twitter.com/FoodLiesOrg/status/1419347985935257601?s=20&t=_2uz8-vTlkgxnFPP4DCqtg) that steak is a good source of iron and can protect against iron deficiency. This claim is in accord with the available evidence on red meat consumption and iron deficiency anemia, with unprocessed red meat associating with a 20% decreased risk of anemia in the UK Biobank cohort [[7](https://pubmed.ncbi.nlm.nih.gov/33648505/)]. Interestingly, unprocessed red meat was also associated with a statistically significant increase in the risk of many other diseases as well. ![][image4] -[image4]: /blog/sapiendiet/image4.png +[image4]: /blog/sapiendiet/image4.jpg If the methods were sensitive enough to detect the inverse association with iron deficiency anemia, why not also conclude that the methods were also sensitive enough to detect the effect on heart disease as well? Why form differential beliefs about the causal nature of these associations? @@ -85,7 +85,7 @@ Furthermore, the association between red meat intake and heart disease is observ Almost all of the most highly powered studies found positive associations between heart disease risk and red meat. Altogether, those studies also had the highest contrast in red meat, with Asian countries having the lowest contrast, as mentioned earlier. The majority of the included studies included adjustments for diet quality, used validated food frequency questionnaires, and had adequate follow-up time. The greatest increase in risk was found among studies with follow-up times exceeding 10 years. Removing all of the more poorly powered cohorts leaves us with a remarkably consistent relationship overall. ![][image5] -[image5]: /blog/sapiendiet/image5.png +[image5]: /blog/sapiendiet/image5.jpg This one change results in a 38.3% attenuation in the I², going from 41.3% to 13%. Which suggests that of the variance that was attributable to heterogeneity, poor statistical power could explain about 68% of it. @@ -94,12 +94,12 @@ Lastly, when cohort studies from around the world are meta-analyzed, we see the However, Whiteman, et al. also had one of the shortest follow-up times, one of the youngest populations (and thus one of the lowest death rates), and used a very poor adjustment model (only adjusting for three confounders). If a leave-one-out analysis is performed that excludes Whiteman, et al., a different picture is painted. ![][image6] -[image6]: /blog/sapiendiet/image6.png +[image6]: /blog/sapiendiet/image6.jpg Anybody who wishes to complain about this reanalysis is free to try to explain to me why increasing the potential for bias with poor multivariable adjustment is a desirable thing. But, it probably doesn't matter anyway. This meta-analysis was published in 2014, and more cohort studies have been published since then. If we add those results to the original forest plot conducted by Larsson et al., we would still get significant results. ![][image7] -[image7]: /blog/sapiendiet/image7.png +[image7]: /blog/sapiendiet/image7.jpg **Claim #3 (**[**5:22**](https://youtu.be/VYTjwPcNEcw?t=322)**):** @@ -112,7 +112,7 @@ It's unclear what this means. As per the Duhem-Quine thesis, all scientific find In 2021, Shwingshakl et al. published an enormous meta-analysis that compared the results of 950 nutritional randomized controlled trials to results from 750 prospective cohort studies [[11](https://pubmed.ncbi.nlm.nih.gov/34526355/)]. In the aggregate, results from nutritional epidemiology are consistent with results from nutritional randomized controlled trials approximately 92% of the time when comparing intakes to intakes (omitting supplements). ![][image8] -[image8]: /blog/sapiendiet/image8.png +[image8]: /blog/sapiendiet/image8.jpg Across 23 comparisons of meta-analytically summated findings from both bodies of evidence, only 2 comparisons showed discordance. This means that nutritional epidemiology tends to replicate in randomized controlled trials in the supermajority of cases. @@ -135,7 +135,7 @@ I'm not sure why we should care. If this isn't cashing out into some sort of hea This is just whacky, and it seems to be based on data from a 1950s textbook to which I cannot get access. However, we don't really need to in order to address this claim. Let's take a look at this table that Brian has generated. ![][image9] -[image9]: /blog/sapiendiet/image9.png +[image9]: /blog/sapiendiet/image9.jpg First of all, if these two foods are weight-standardized, then the protein content of navy beans only makes sense if the navy beans were considered raw. Navy beans can't even be consumed raw because they're hard as fucking rocks. So, immediately this table is potentially misleading, having possibly presented an unrealistic comparison between these two foods. But, that's not the most egregious part of Brian's table. It's actually completely unnecessary to consider digestibility and biological value separately as Brian has [[12](https://pubmed.ncbi.nlm.nih.gov/26369006/)]. @@ -144,12 +144,12 @@ First of all, if these two foods are weight-standardized, then the protein conte Biological value is inherently captured by both of the standard protein quality scores, the protein digestibility-corrected amino acid score (PDCAAS) and the digestible indispensable amino acid score (DIAAS). This means that if you want to represent all the things that matter for a given protein in isolation (such as digestibility, biological value, and limiting amino acids), all you need is either a PDCAAS or DIAAS value for the proteins in question. But, the DIAAS is probably better. ![][image10] -[image10]: /blog/sapiendiet/image10.png +[image10]: /blog/sapiendiet/image10.jpg Aggregating DIAAS data across multiple protein foods paints a completely different picture than the one that Brian cobbled together [[13](https://pubmed.ncbi.nlm.nih.gov/28748078/)][[14](https://pubmed.ncbi.nlm.nih.gov/33333894/)][[15](https://pubmed.ncbi.nlm.nih.gov/34476569/)][[16](https://onlinelibrary.wiley.com/doi/full/10.1002/fsn3.1809)]. Some plant proteins actually do quite well. But what are these numbers really representing? Ultimately the scores are going to be truncated by limiting amino acids more than any other parameter, and pairing complementary proteins will increase the DIAAS value [[17](https://pubmed.ncbi.nlm.nih.gov/34685808/)]. In fact, this is also true of the PDCAAS, as combining different lower-scoring plant proteins will often result in perfect scores [[18](https://www.2000kcal.cz/lang/en/static/protein_quality_and_combining_pdcaas.php)]. ![][image11] -[image11]: /blog/sapiendiet/image11.png +[image11]: /blog/sapiendiet/image11.jpg If beef is awesome in virtue of it getting a perfect score for protein digestibility, biological value, and limiting amino acids, then navy beans and wild rice must also be awesome too. If not, then I don't know what the hell Brian is talking about, or why he even brings the point up. It's also worth pointing out that certain animal foods, like collagen, actually score a zero on the PDCAAS as well. @@ -180,7 +180,7 @@ Again, the IARC had very strict inclusion-exclusion criteria, and of the studies Brian then goes on to claim that the results are a toss-up simply because there were 15 studies ostensibly showing that red meat was "good" and 14 studies ostensibly showing that red meat was "bad". To imply that this is necessarily a "toss up" is just pure confusion. Even if you have double the studies showing that red meat is "good", that doesn't necessarily mean there is a lower probability that red meat is "bad". It depends on the strength of the studies included. Consider this forest plot. ![][image12] -[image12]: /blog/sapiendiet/image12.png +[image12]: /blog/sapiendiet/image12.jpg Here we see that despite the fact that there is a 2:1 ratio of studies that show a decreased risk with red meat to studies that show an increased risk with red meat, the summary effect measure still points toward a statistically significant increase in risk. This is because not every study has equal power or precision. Some findings are just less certain than others. @@ -197,7 +197,7 @@ This is truly bizarre. It's incredibly unclear what Brian is trying to say here, Firstly, this appears to be just a straight up equivocation of cancer types. Colorectal cancer and lung cancer are two different diseases, and the prevalence of these diseases are different in the general population. If Brian's criticism is that the relative risk of lung cancer from smoking is higher than the relative risk of colorectal cancer from red meat, then he's just confused. Massive differences in the magnitude of those effect estimates are expected, as the prevalence of a given disease will determine the maximum possible relative risk [[22](https://pubmed.ncbi.nlm.nih.gov/21402371/)]. ![][image13] -[image13]: /blog/sapiendiet/image13.png +[image13]: /blog/sapiendiet/image13.jpg Let's take a look at the prevalence of these diseases in Canada [[23](https://cancer.ca/en/cancer-information/cancer-types)]. The prevalence of lung cancer among Canadian non-smokers is 1 in 84 (1.19% prevalence). Prevalence of colorectal cancer, assuming red meat has nothing to do with colorectal cancer, is 1 in 16 (6.25% prevalence). The baseline prevalence of lung cancer is much smaller than the baseline prevalence of colorectal cancer, so comparing the two is dubious. @@ -208,7 +208,7 @@ For this reason, it's best that we do an apples to apples comparison. In a massi However, they also included an analysis on smoking, which found a statistically significant 16% increase in the risk of colorectal cancer with smoking as well. Yes, that is right— there was a slightly stronger association between red meat and colorectal cancer than there was between smoking and colorectal cancer. But the two were likely non-inferior. Huxley et al. also found around the same magnitude of effect for many other exposures. ![][image14] -[image14]: /blog/sapiendiet/image14.png +[image14]: /blog/sapiendiet/image14.jpg What's the symmetry breaker? Why form a causal belief with regards to smoking or physical inactivity or obesity and not red meat? If Brian argues that he doesn't infer causality for any of the exposures with non-inferior effect sizes to red meat, then the appropriate thing to do is honestly just to laugh at his absurdity and move on. @@ -225,7 +225,7 @@ Why should we be using anthropological data about ancestral diets to inform best Favouring whole foods is heuristic, and not a rule. There are plenty of examples of processed foods being superior to whole foods, even foods that we could identify as ancestral. In fact, there are been specific analyses investigating the differential contributions of animal-based foods (red meat, poultry, fish, dairy, and eggs) and ultra-processed foods to disease risk within the context of a health-conscious population [[25](https://pubmed.ncbi.nlm.nih.gov/35199827/)]. ![][image15] -[image15]: /blog/sapiendiet/image15.png +[image15]: /blog/sapiendiet/image15.jpg Overall, ultra-processed foods and animal foods are non-inferior to one another for CVD mortality and cancer mortality risk. Animal based foods also seem to associate with the risk of endocrine disorders like T2DM, whereas ultra-processed foods did not. Once again, we require symmetry-breakers. Why form the belief that ultra-processed foods increase the risk of these diseases and not animal foods? @@ -246,7 +246,7 @@ This study isn't actually investigating temporal changes in soil carbon at all. Even just ignoring the fact that this methodology creates mathematically atrocious pigs and chickens in terms of carbon balance in their model, the data provided suggests that 20 years worth of carbon sequestration are roughly equal to three years of plant composting. In second figure of the publication, they show a cross-sectional analysis of seven different degraded lands (previously used for crops) that are in the process of being restored over a varied number of years. ![][image16] -[image16]: /blog/sapiendiet/image16.png +[image16]: /blog/sapiendiet/image16.jpg >_In years 1–3, these fields are minimally grazed and receive 1 cm of compost ha−1 yr−1. After year 3, exogenous inputs (hay and compost) were ceased, and the regeneration strategy shifted toward an animal-only approach, whereby animals were the primary mechanism of improving the land._ @@ -257,7 +257,7 @@ If composting can increase soil carbon sequestration that much, why are they eve It's convenient that the time scale of the investigation by Rowntree, et al. caps out at 20 years, because current literature suggests that there is a soil carbon saturation point at around 20 years, after which pasture grazing systems will yield diminishing returns. ![][image17] -[image17]: /blog/sapiendiet/image17.png +[image17]: /blog/sapiendiet/image17.jpg Here we see three different scenarios for soil carbon sequestration rates from grazing agriculture. Even under the most generous estimates (the larger black hashed line), soil carbon sequestration plateaus at around 20 years. @@ -266,12 +266,12 @@ However, current estimates suggest that if we switch to more plant-predominant d If we switch to plant-predominant diets by 2050 we could sequester -14.7 GtCO2 per year by reforesting pasture land, compared to other agricultural methods that make use of grazing land for pasture. Merely the introduction of pasture grazing increases land use by almost double compared to a vegan agricultural system [[28](https://experts.syr.edu/en/publications/carrying-capacity-of-us-agricultural-land-ten-diet-scenarios)]. ![][image18] -[image18]: /blog/sapiendiet/image18.png +[image18]: /blog/sapiendiet/image18.jpg In fact, there are stepwise decreases in the per-person carrying capacity of different agricultural scenarios as more pastureland is included in the model. However, vegan agricultural scenarios were largely comparable to both dairy-inclusive and egg-inclusive vegetarian models. ![][image19] -[image19]: /blog/sapiendiet/image19.png +[image19]: /blog/sapiendiet/image19.jpg As mentioned earlier in this article, there are plant agriculture methods that are also touted as "regenerative", that also may have greater soil carbon sequestration potential per hectare than current "regenerative" grazing livestock methods [[29](https://www.nature.com/articles/ncomms6012)]. It would be interesting to see a head-to-head comparison of wheat versus meat, using "regenerative" methodology, on soil carbon sequestration overall. @@ -287,7 +287,7 @@ It has been calculated that even if all grasslands were repurposed for grazing, The remaining two scenarios encounter some issues when we think of what would be required to sustain people on meat-heavy diets, because 80g of protein from the fattiest beef still would not provide enough calories per person. We would appear to need multiple planets. But we should use a grass-fed example to do the calculations, so I've chosen White Oak Pastures' ground beef as the example meat. We'll also be multiplying the results by 2.5 to account for the extra land used by rotational grazing and/or holistic management [[26](https://www.frontiersin.org/articles/10.3389/fsufs.2020.544984/full)]. ![][image20] -[image20]: /blog/sapiendiet/image20.png +[image20]: /blog/sapiendiet/image20.jpg Under no plausible scenario (calculable from the 'Grazed and Confused?' report) would either continuous grazing or rotational grazing be tenable on a global scale. Even if the calorie allotment for animal foods in the EAT Lancet diet was occupied only by grass-fed beef, we'd still be exceeding the carrying capacity of the Earth by 70% for continuous grazing and 325% for rotational grazing. As for Brian's pet diet, the Sapien Diet™, we'd need over 10 Earths in the optimistic plausible scenario. @@ -295,21 +295,21 @@ Under no plausible scenario (calculable from the 'Grazed and Confused?' report) Essentially, we would need to figure out a way to extend the pasturable land beyond the available land on Earth. Perhaps we could do this by terraforming Mars or ascending to a type 2 civilization on the Kardashev scale by building a megastructure in space, such as a Dyson sphere or an O'Neill cylinder. But, those options don't sound very ancestral at all. ![][image21] -[image21]: /blog/sapiendiet/image21.png +[image21]: /blog/sapiendiet/image21.jpg We're not even scratching the surface, though. The authors of 'Grazed and Confused?' likely did not consider the suitability of each grassland in their calculation, because current suitability thresholds are set for crop production, rather than livestock. The issue is that grass itself could be considered a crop, so it's unclear why suitability considerations that have been established for crop production wouldn't also apply to pasture-raised animal production. The IIASA/FAO define the suitability of a given grassland as a threshold of a 25% ratio of actual yield per acre and potential yield per acre [[31](https://pure.iiasa.ac.at/id/eprint/13290/)]. Had these suitability criteria been considered by the authors of 'Grazed and Confused?', their models likely would have produced much smaller estimates. This is because much of the available grassland is either unsuitable or poorly suitable to begin with. ![][image22] -[image22]: /blog/sapiendiet/image22.png +[image22]: /blog/sapiendiet/image22.jpg These suitability criteria have been used by livestock agriculture advocates to argue against the scalability of crop agriculture and for the scalability of grazing-based livestock agriculture [[32](https://www.sciencedirect.com/science/article/abs/pii/S2211912416300013)]. However, [Avi Bitterman](https://twitter.com/AviBittMD) demonstrated on his [Discord server](https://discord.gg/YtfQNPnk) that these individuals are not symmetrically applying this standard and it would actually turn out that current "regenerative" grazing systems wouldn't be likely to even meet the suitability standards themselves. According to figures produced by White Oak Pastures, their "regenerative" grazing system is far less efficient than conventional feedlot approaches [[33](https://blog.whiteoakpastures.com/hubfs/WOP-LCA-Quantis-2019.pdf)]. Overall, White Oak Pastures uses 150% more land than conventional approaches to yield only about 20% of what a conventional farm can produce, and only 90% of the average slaughter weight. ![][image23] -[image23]: /blog/sapiendiet/image23.png +[image23]: /blog/sapiendiet/image23.jpg This would give us a "suitability" estimate of around 7%, which would likely drastically reduce the amount of grassland that would be considered suitable for "regenerative" grazing agriculture as well. It would be doubly important to adhere to this standard when critiquing "regenerative" plant agricultural methods, in order to ensure an apples-to-apples comparison [[29](https://www.nature.com/articles/ncomms6012)]. @@ -326,7 +326,7 @@ As with the issues for this narrative that were entailed from the land requireme > _"Increases in cattle population, placements, and slaughter rates are demonstrated in figure 2. The increased slaughtering and placement numbers would also require a 24% increase in the size of the national beef cow-calf herd, proportional to the increased annual grass-finishing placement rate, in order to provide additional cattle to stock the grass-finishing stage. Increases in both the cow-calf herd and the grass-finishing population together would result in a total increase to the US cattle population of an additional 23 million cattle, or 30% more than the current US beef cattle population as a whole"_ ![][image24] -[image24]: /blog/sapiendiet/image24.png +[image24]: /blog/sapiendiet/image24.jpg If Brian wants to criticize vegans for indulging idealized pie-in-the-sky fantasies, what in the sweet holy blue fuck is this shit? The United States can't maintain their current demands for beef with the system that Brian is proposing. This is doubly problematic if you consider that the White Oak Pastures model for which Brian advocates probably requires even more land than the conventional grazing methods included in the above model. This means that 30% could very well be an underestimate. @@ -349,7 +349,7 @@ Furthermore, during [my debate](https://www.youtube.com/watch?v=S8p39Gwct1Y) wit In 2020, Tucker et al. published a comprehensive comparative analysis of mammalian populations across a number of human-modified areas, such as cropland and pastureland [[36](https://onlinelibrary.wiley.com/doi/full/10.1111/ecog.05126)]. Overall, their findings suggest that there is higher taxonomic diversity with increasing pastureland as opposed to increasing cropland. ![][image25] -[image25]: /blog/sapiendiet/image25.png +[image25]: /blog/sapiendiet/image25.jpg In the absence of countervailing data, this actually counts against the hypothesis that pastureland entails less animal death than cropland. This is because increasing taxonomic diversity implies a higher number of trophic strata. A higher number of trophic strata implies higher levels of predation. Higher levels of predation thus imply higher levels of animal death. The land with the lesser carrying capacity should probably be assumed to entail less death. @@ -370,7 +370,7 @@ This proposition is simple to address. If Brian believes that we are ethically j During my debate with Brian, I submitted to him an argument for the non-exploitation of animals, which is essentially just a rephrasing of [Isaac Brown](https://twitter.com/askyourself92)'s [Name the Trait](https://drive.google.com/drive/folders/1tAjU2Bv1tsGbNLA2TfJesgbIh8JKh9zc) argument. ![][argument1] -[argument1]: /blog/sapiendiet/argument1.png +[argument1]: /blog/sapiendiet/argument1.jpg This argument for non-exploitation simply requires one to identify the property that is true of humans that also is untrue of animals, that if true of humans, would cause humans to lose sufficient moral value, such that we’d be justified in slaughtering them for food as well. Brian rejected P3, stating that "consciousness" was the property true of humans, but untrue of animals, such that animals were ethical to exploit for food but humans were not. This fails and entails a contradiction on Brian's part, because consciousness is not a differential property between humans and the animals he advocates farming for food. diff --git a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SeedOils.elm b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SeedOils.elm index 297ac04..63724f4 100755 --- a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SeedOils.elm +++ b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SeedOils.elm @@ -39,24 +39,24 @@ It is also suggested that saturated fatty acids (SFA) are resistant to this sort As it turns out, we've thoroughly investigated the effects of altering the fatty acid composition of the diet on LDL oxidation rates in humans. For example, Mata et al. (1996) explored this question with one of the most rigorous studies of its kind. No statistically significant differences between the effects of high-SFA diets and high-PUFA diets on the lag time to LDL oxidation were observed [[2](https://pubmed.ncbi.nlm.nih.gov/8911273/)]. ![][image1] -[image1]: /blog/seedoils/image1.png +[image1]: /blog/seedoils/image1.jpg However, diets high in monounsaturated fat (MUFA) diets might actually increase the lag time to LDL oxidation more than either SFA-rich or PUFA-rich diets. It would appear as though this effect could be explained due to the fact that MUFA might be better than SFA at replacing LA in LDL particles. So, it seems as though the implication that SFA could offer unique protection against LDL oxidation is less straightforward than originally suggested. ![][image2] -[image2]: /blog/seedoils/image2.png +[image2]: /blog/seedoils/image2.jpg When comparing LDL that were enriched with PUFA to LDL that were enriched with MUFA, Kratz et al. (2002) observed a stepwise decrease in LDL lag time to oxidation with increasing PUFA, specifically linoleic acid (LA) [[3](https://pubmed.ncbi.nlm.nih.gov/11840183/)]. These results cohere with the results of Mata el al., suggesting that MUFA increases the lag time to LDL oxidation more than SFA or PUFA. ![][image3] -[image3]: /blog/seedoils/image3.png +[image3]: /blog/seedoils/image3.jpg In short, it would at least seem to be true that vegetable oil consumption, when investigated in isolation, increases the susceptibility of LDL to oxidize. But, don't get too excited. As we will discuss, these are paltry changes compared to what can be accomplished with antioxidants. Despite Kratz et al. claiming that vitamin E doesn't mask the effects of dietary fatty acids on LDL susceptibility to oxidation, their reference for this claim does not clearly support this conclusion. The work of Reaven et al. (1994) was their supporting reference for this claim and it actually paints a slightly different picture [[4](https://pubmed.ncbi.nlm.nih.gov/8148354/)]. The Lag time to LDL oxidation with vitamin E supplementation was more than double that which was observed in the previous study (or nearly any other random population sample from any other study that I've seen for that matter). ![][image4] -[image4]: /blog/seedoils/image4.png +[image4]: /blog/seedoils/image4.jpg Reaven et al. discovered that the lag time to LDL oxidation was enormously high in all groups after a run-in diet that included 1200mg/day of vitamin E for three months before randomization. Compared to the previous study by Kratz et al. (2002), the LDL lag time to oxidation was 150% higher (~60 minutes to ~150 minutes). This is consistent with other research showing that the vitamin E content of LDL particles linearly increases the lag-time to LDL oxidation [[5](https://pubmed.ncbi.nlm.nih.gov/1985404/)]. @@ -67,14 +67,14 @@ All three studies used the same copper sulfate solution methodology to measure t Which brings me back to the trial by Kratz et al. (2002), which compared olive oil (OO) versus sunflower oil (SU). Despite the fact that all diet groups were receiving roughly the same amount of vitamin E, the OO group ended up with significantly higher vitamin E status compared to the SU group. This is consistent with the observations that MUFA increases the lag time to LDL oxidation to a greater degree than SFA or PUFA. Which leads to higher vitamin E representation in the end. ![][image5] -[image5]: /blog/seedoils/image5.png +[image5]: /blog/seedoils/image5.jpg It is well understood that higher PUFA intakes increase vitamin E requirements in humans [[7](https://pubmed.ncbi.nlm.nih.gov/26291567/)]. However, the OO group also started with much higher status to begin with, which likely contributed to the effect. Lastly, the run-in diet was high in SFA. Such a diet is almost assuredly to be lower in vitamin E, which could exaggerate the effects of high-PUFA diets. As discussed earlier, SFA is not vulnerable to lipid peroxidation in any way similar to that of PUFA. However, SFA being less vulnerable to lipid peroxidation typically means that sources of SFA contain very low amounts of antioxidants [[8](https://pubmed.ncbi.nlm.nih.gov/14100992/)]. For example, both coconut oil and butter contain negligible vitamin E and have minimal polyphenols. The potential importance of polyphenol antioxidants in protecting LDL from oxidation has been demonstrated in research investigating OO [[9](https://pubmed.ncbi.nlm.nih.gov/15168036/)]. ![][image6] -[image6]: /blog/seedoils/image6.png +[image6]: /blog/seedoils/image6.jpg Figure 2 from Marrugat et al. (2004) shows that virgin OO increases the lag time to oxidation to a greater degree than that of refined OO, with the primary differences between these different OOs being their polyphenol content. Many polyphenols act as antioxidants once they're inside our bodies, so these results are not particularly surprising. @@ -83,7 +83,7 @@ It is likely that the overall dietary pattern matters more than PUFA, or even LA For example, in a trial by Aronis et al. (2007), diabetic subjects were placed on either a fast food diet that was formulated to be "Mediterranean diet-like" or assigned to follow their usual diet. There was also a third arm of non-diabetics placed on the Mediterranean-style fast food diet. Lag time to LDL oxidation was measured according to the same methodology as described above, with a copper sulfate solution. ![][image7] -[image7]: /blog/seedoils/image7.png +[image7]: /blog/seedoils/image7.jpg It should be noted that the foods were specifically formulated to increase the lag time to LDL oxidation. However, what makes these results more impressive is that the fast food groups (groups A and B) were consuming twice as much PUFA than they were at baseline. Despite this we see some of the longest lag times to LDL oxidation observed in the literature in a population that has not been primed with megadoses of vitamin E for three months. @@ -98,7 +98,7 @@ For example, it may be the case that when you expose LDL particles to copper sul One particularly long crossover-style RCT by Palomäki et al. (2010) compared the effects of butter to that of canola oil (CAO) on oxLDL [[14](https://pubmed.ncbi.nlm.nih.gov/21122147/)]. Overall the butter diet resulted in higher LDL and higher oxLDL. I wasn't able to find many PUFA-SFA substitution trials that measured oxLDL beyond this one study, unfortunately. ![][image8] -[image8]: /blog/seedoils/image8.png +[image8]: /blog/seedoils/image8.jpg Again, I speculate that this is likely the result of SFA being a poor source of antioxidants. Or perhaps it's because baseline diets could have been higher in PUFA, and reducing vegetable oil intakes might just be cutting off robust sources of antioxidants and increasing LDL oxidation. There are not many studies investigating this, so it's not clear at the moment. @@ -107,7 +107,7 @@ But, just for the sake of argument let's assume that high-PUFA diets do increase Lastly, while we have established that vegetable oil consumption does appear to have an independent impact on LDL oxidation (though the effect is dwarfed by the effect of antioxidants), it is also true that oxLDL isn't actually a robust risk factor for CHD. Wu et al. (2006) discovered that the association between oxLDL and CHD does not survive adjustment for traditional risk factors like apolipoprotein (ApoB) or TC/high density lipoprotein cholesterol (HDL-C) [[16](https://pubmed.ncbi.nlm.nih.gov/16949489/)]. ![][image9] -[image9]: /blog/seedoils/image9.png +[image9]: /blog/seedoils/image9.jpg Essentially this means that after accounting for ApoB or TC/HDL, risk is more closely tracking ApoB or TC/HDL-C, and is not particularly likely to be tracking oxLDL at all. So even if it were the case that diets high in vegetable oils simply increased oxLDL, it wouldn't appear that it moves the needle for risk in the real world. It would also suggest that the hypothetical detriments of increasing LDL oxidation aren't significant enough to offset the LDL-lowering benefits of a high-PUFA diet. As we will discuss later in this section. @@ -130,7 +130,7 @@ Because lipid peroxidation of the LDL particle's phospholipid membrane is not re This is relevant because the immune cells that mediate the formation of atherosclerotic plaques only tend to take up maximally oxidized LDL particles, not minimally oxidized LDL particles [[20](https://pubmed.ncbi.nlm.nih.gov/6838433/)][[21](https://pubmed.ncbi.nlm.nih.gov/24891335/)]. Maximally oxidized LDL have to be disposed of through scavenger receptor-mediated pathways, rather than LDL receptor-mediated pathways. ![][image10] -[image10]: /blog/seedoils/image10.png +[image10]: /blog/seedoils/image10.jpg If minimally oxidized LDL likely contribute as little to foam cell formation as native LDL, why favour measures of minimally oxidized LDL such as the E06 antibody assay over measures of maximally oxidized LDL such as the 4E6 antibody assay? @@ -143,7 +143,7 @@ Nevertheless, if merely having more LA in your body meant that you would increas It’s important to note that there was not a single statistically significant increase in risk observed in any of the included cohorts when comparing the lowest tissue LA to the highest tissue LA. One of the more interesting findings was from a regression analysis of the Scottish Heart Health Extended Cohort by Wood et al. (1984), which found a strong inverse correlation between adipose LA and CHD incidence [[24](https://pubmed.ncbi.nlm.nih.gov/6146032/)]. ![][image11] -[image11]: /blog/seedoils/image11.png +[image11]: /blog/seedoils/image11.jpg This certainly isn't what we would expect if the chain of causality is LA -> OxLDL -> CHD. However, as we'll discuss in the next section, this is what we'd expect if the chain of causality is SFA -> LDL -> CHD. So, let's go ahead and dive into that data next. @@ -156,26 +156,26 @@ Let's start with the epidemiological evidence, being sure to keep the original q The relationship between SFA and CVD is nonlinear, and significantly influenced by the degree of replacement with PUFA. As such, the linear summation of prospective cohort studies can hide the nonlinear effect. For example, let's have a look at one of the most heavily-cited meta-analyses by Siri-Tarino et al. (2010), which investigated the relationship between SFA and CVD in prospective cohort studies [[25](https://pubmed.ncbi.nlm.nih.gov/20071648/)]. ![][image12] -[image12]: /blog/seedoils/image12.png +[image12]: /blog/seedoils/image12.jpg As we can see, the aggregated results are null (P = 0.22). However, the I² (a measure of heterogeneity) is 41%, and no attempt was made to investigate the source of that heterogeneity. If we take the time to calculate the intake ranges of each cohort study (when possible), we can test for nonlinearity. ![][image13] -[image13]: /blog/seedoils/image13.png +[image13]: /blog/seedoils/image13.jpg After stratifying the included studies by intake range, we see a statistically significant 30% increase in risk in subgroup one (~25±15g/day) and null results for subgroups two and three (35±15g/day and 45±15g/day, respectively). This is precisely what we'd expect to see if the risk threshold presupposed by the Dietary Guidelines was correct. McGee et al. (1984) needed to be removed for this analysis because SFA intake ranges could not be determined from the provided data. But perhaps this is an isolated finding. There are many other meta-analyses on this subject [[26](https://pubmed.ncbi.nlm.nih.gov/27697938/)][[27](https://pubmed.ncbi.nlm.nih.gov/30954077/)][[28](https://pubmed.ncbi.nlm.nih.gov/32307197/)][29](https://pubmed.ncbi.nlm.nih.gov/19752542/)]. Maybe the other meta-analyses on this subject would find something different? Let's find out. ![][image14] -[image14]: /blog/seedoils/image14.png +[image14]: /blog/seedoils/image14.jpg Applying the same methodology to all of the available meta-analyses yields the same result. This time subgroup two is representing the intake threshold presupposed by the Dietary Guidelines (~25±15g/day). We see similar increases in risk in the same subgroup across all published meta-analyses investigating the relationship between SFA and CVD (RR 1.14 [1.07-1.22], P<0.0001). You may be asking why subgroups one, three, and four are null, whereas subgroup two is not. The answer is quite simple. It's because those ranges are not crossing the threshold of effect. The range of intake represented in subgroup one exists below the threshold of effect, whereas subgroups three and four exist above the threshold of effect. As such, comparing lower intakes to higher intakes within those ranges does not show an additional increase in risk. The relationship between SFA and CVD is sigmoidal. ![][image15] -[image15]: /blog/seedoils/image15.png +[image15]: /blog/seedoils/image15.jpg Comparing intakes that exist on either the floor or ceiling of the risk curve will typically produce null results. Only when the middle intake range is investigated is the increase in risk observable. @@ -219,7 +219,7 @@ Drag-netting the literature yielded a total of 74 studies. 20 studies were exclu Altogether there were 21 studies that met all of the inclusion criteria [[30](https://doi.org/10.1161/01.atv.3.2.149)][[31](https://doi.org/10.1194/jlr.M044644)][[32](https://doi.org/10.1016/j.jacc.2006.03.001)][[33](https://doi.org/10.1161/CIRCULATIONAHA.118.038908)][[34](https://doi.org/10.3945/ajcn.115.116046)][[35](https://doi.org/10.3945/ajcn.2009.27725)][[36](https://doi.org/10.1136/bjsports-2016-096550)][[37](https://doi.org/10.1186/s12944-019-1035-2)][[38](https://doi.org/10.1016/j.clnu.2020.03.028)][[39](https://doi.org/10.1159/000229002)][[40](https://doi.org/10.1371/journal.pone.0000377)][[41](https://doi.org/10.3945/jn.112.161661)][[42](https://doi.org/10.1161/CIRCRESAHA.118.314038)][[43](https://doi.org/10.1159/000175862)][[44](https://doi.org/10.3945/ajcn.115.116046)][[45](https://doi.org/10.1093/aje/kwh193)][[46](https://doi.org/10.1136/bmj.i5796)][[47](https://doi.org/10.1136/hrt.78.5.450)][[48](https://doi.org/10.1017/S0007114517003889)][[49](https://doi.org/10.1097/HJR.0b013e3282a56c45)][[50](https://doi.org/10.1093/oxfordjournals.aje.a009047)]. Cohorts were stratified across four subgroups, based on absolute grams-per-day intakes of SFA. Total pooled results across all subgroups showed a non-significant increase in risk (RR 1.07 [0.97-1.18], P=0.16). Subgroup two was the only subgroup to reach statistical significance (RR 1.24 [1.10-1.40], P=0.0005). ![][image16] -[image16]: /blog/seedoils/image16.png +[image16]: /blog/seedoils/image16.jpg Again, we see the exact same thing. The increase in risk occurs in the same subgroup, in the same intake range— the same intake range presupposed by the Dietary Guidelines to increase risk. @@ -228,26 +228,26 @@ Again, we see the exact same thing. The increase in risk occurs in the same subg Altogether there were 10 studies that met all of the inclusion criteria. In order to preserve the PUFA to SFA ratio, cohorts were stratified across four subgroups, based on absolute grams-per-day intakes of SFA. Total pooled results across all subgroups showed a statistically significant reduction in CVD risk (RR 0.91 [0.83-1.00], P=0.04). Subgroup two was the only subgroup to reach statistical significance (RR 0.87 [0.80-0.93], P=0.0002). ![][image17] -[image17]: /blog/seedoils/image17.png +[image17]: /blog/seedoils/image17.jpg This second forest plot was not stratified by PUFA intake. As mentioned above, it was instead stratified by SFA intake. This way the ratio of SFA to PUFA would be better preserved. This is important for understanding the relationship between these two dietary fats. ![][image18] -[image18]: /blog/seedoils/image18.png +[image18]: /blog/seedoils/image18.jpg Both SFA and PUFA have inverse sigmoidal relationships with CVD. The more PUFA you replace with SFA, the higher your risk. The more SFA you replace with PUFA, the lower your risk. This is exactly the same relationship we see in the RCTs as well [[51](https://pubmed.ncbi.nlm.nih.gov/32827219/)]. Recently, Hooper et al. (2020) published an enormous meta-analysis and meta-regression analysis for the Cochrane Collaboration, which investigated CVD-related outcomes of many PUFA-SFA substitution RCTs. ![][image19] -[image19]: /blog/seedoils/image19.png +[image19]: /blog/seedoils/image19.jpg Their analysis shows that substituting SFA for PUFA, and crossing the 10% of energy threshold as SFA, increases CVD risk in the aggregate. Especially for CVD events, CVD mortality, CHD mortality, and non-fatal acute myocardial infarction (AMI). Cochrane also performed multiple meta-regression analyses on the included data. Meta-regression is a tool used to investigate the relationship between two variables when they are controlled by a moderator variable. In this case, the two variables in question are SFA intakes (or PUFA-SFA substitution) and CVD. Multiple moderator variables were modeled. ![][image20] -[image20]: /blog/seedoils/image20.png +[image20]: /blog/seedoils/image20.jpg The only statistically significant moderator variable was total cholesterol (TC) (P=0.04). This suggests that the chain of causality is SFA -> TC -> CVD. This therefore suggests that to the extent that a dietary modification reduces TC, reductions in CVD should follow. This is confirmed in their exploratory analysis later on in the paper. @@ -260,7 +260,7 @@ Both trials achieved significant differences in TC during the course of both of Neither trial saw a statistically significant difference in either CVD mortality or total mortality. ![][image21] -[image21]: /blog/seedoils/image21.png +[image21]: /blog/seedoils/image21.jpg However, in the aggregate, there is a significant increase in CVD mortality between the two trials. This is concerning, seeing as though these two trials are often touted as the best designed trials that have been conducted in the investigation of this research question, aside from the LA Veterans Administration Hospital Study (LAVAT) by Dayton et al. (1969) [[54](https://www.ahajournals.org/doi/10.1161/01.CIR.40.1S2.II-1)]. However, the MCE's design ended up allowing participants to enter in and exit out of the trial at their leisure, and this ended up resulting in a mean follow-up time of around 1.5 years. Which is abysmal. @@ -275,7 +275,7 @@ First, we can harden oils through hydrogenation or through emulsification. Howev TFAs are associated with an increased risk of many diseases, including CVD. However, TFAs are the only known fatty acid subtypes that have been associated with increased CVD mortality when replacing SFA on a population-level [[57](https://pubmed.ncbi.nlm.nih.gov/30636521/)]. ![][image22] -[image22]: /blog/seedoils/image22.png +[image22]: /blog/seedoils/image22.jpg Basically, TFAs are fucking dangerous— more dangerous than SFA. The CO-based margarine used in the SDHS was "Miracle" brand margarine [[58](https://pubmed.ncbi.nlm.nih.gov/23386268/)]. According to Dr. Robert Grenfell of the National Cardiovascular Health Director at the Australian Heart Foundation and the Deputy Chairman of the Sydney University Nutrition Research Foundation, Bill Shrapnel, Miracle brand margarine was up to 15% TFA at the time the study was conducted [[59](https://www.ausfoodnews.com.au/2013/02/11/heart-foundation-takes-swipe-at-butter-and-new-study-on-margarine.html)]. @@ -284,17 +284,17 @@ Basically, TFAs are fucking dangerous— more dangerous than SFA. The CO-based m If Woodhill et al. (1978) truly fed the subjects in the vegetable oil group (group F) as much of that margarine as they seem to be claiming to in their publication, that could be around 5.7g/day of TFA. ![][image23] -[image23]: /blog/seedoils/image23.png +[image23]: /blog/seedoils/image23.jpg The margarine used in the MCE was likely to be Fleischmann's Original, due to the availability and popularity at the time of the intervention. As well as the fact that the product was developed in direct response to pro-PUFA research that was being conducted at the time. ![][image24] -[image24]: /blog/seedoils/image24.png +[image24]: /blog/seedoils/image24.jpg The only other two margarines that were potentially available in the region at the time the MCE was conducted were Imperial margarine and Mazola margarine. Some Imperial products remained high in TFA until very recently [[60](https://abcnews.go.com/Business/story?id=8182555&page=1)]. Mazola was pretty much the only non-hydrogenated margarine on the market at the time. ![][image25] -[image25]: /blog/seedoils/image25.png +[image25]: /blog/seedoils/image25.jpg The answer to the question of which margarine was used in the MCE is anybody's guess at this point. But if I were generous, I'd say that based on the margarines that were available (and most likely to be used) at the time the MCE was conducted, there is roughly a 67% chance that the trial was potentially confounded by TFA in the vegetable oil diet. Though Ramsden et al. (2016) remain skeptical that confounding such as this was likely [[61](https://pubmed.ncbi.nlm.nih.gov/27071971/)]. @@ -305,7 +305,7 @@ Ramsden et al. have argued at length that the control group was likely confounde Fully hydrogenated oils contain very little TFA [[62](https://pubmed.ncbi.nlm.nih.gov/26048727/)]. However, partially hydrogenated oils such as most soft margarines of the period contain high levels of TFA. Here is a selection of SOs taken from the USDA's SR28 Nutrient Database [[63](https://www.ars.usda.gov/northeast-area/beltsville-md-bhnrc/beltsville-human-nutrition-research-center/methods-and-application-of-food-composition-laboratory/mafcl-site-pages/sr11-sr28/)]. ![][image26] -[image26]: /blog/seedoils/image26.png +[image26]: /blog/seedoils/image26.jpg As you can see, a tablespoon of partially hydrogenated SO margarine contains 2200% more TFA than a tablespoon of fully hydrogenated SO shortening. @@ -322,7 +322,7 @@ The trial did achieve statistically significant differences in LA intake between So, why did the trial see such a massive reduction in risk? Likely because, as far as multifactorial interventions go, this trial did its best to knock the ball out of the park. Just take a look at the diets. ![][image27] -[image27]: /blog/seedoils/image27.png +[image27]: /blog/seedoils/image27.jpg Firstly, the groups achieved a difference of 10g/day in SFA and the between-group differences in SFA cross the 25g/day threshold that we discussed earlier. Secondly, the intervention group was consuming significantly fewer foods that are positively associated with CVD, such as whole meat, processed meat, and butter. Lastly, the intervention group was consuming significantly higher amounts of fruit and vegetables (considered together), as well as unsaturated fats, which are strongly inversely associated with CVD. @@ -335,7 +335,7 @@ The study methods of MR also assume that genes are randomly distributed in the p Even though MR data doesn't really need to be mentioned, because we have actual RCT data on this subject. However, it's worthwhile to add it in here just to hammer home how utterly consistent this evidence actually is. This time the data is being sourced from the UK Biobank, which is a massive prospective cohort study that also leverages a repository of biological samples from over 500,000 subjects [[66](https://pubmed.ncbi.nlm.nih.gov/33924952/)]. ![][image28] -[image28]: /blog/seedoils/image28.png +[image28]: /blog/seedoils/image28.jpg Here we see that Park et al. (2021) observed the same relationship yet again. Genetically elevated serum LA was inversely associated with AMI, whereas genetically elevated serum AA was positively associated with AMI. The gene variants that were investigated were related to the function of fatty acid desaturase (FADS) enzymes. @@ -356,7 +356,7 @@ It's important to preface this discussion with an acknowledgment that the trial Essentially, the concern that increasing vegetable oils in the diet increases cancer risk originates from the following figure. Figure 1 from the original analysis by Pearce at al (1971) clearly shows that the cumulative deaths due to carcinoma rise faster in the vegetable oil group than in the control group after around two years into the study. ![][image29] -[image29]: /blog/seedoils/image29.png +[image29]: /blog/seedoils/image29.jpg I must admit that the graph looks pretty scary, and narratives surrounding the findings of this study had me convinced for a while too. However, this graph is incredibly misleading when taken out of context. @@ -373,40 +373,40 @@ This basically means that the excess cancer deaths seen in the vegetable oil gro Pearce et al. also included a table that stratifies cancer outcomes by the degree of adherence per group. ![][image30] -[image30]: /blog/seedoils/image30.png +[image30]: /blog/seedoils/image30.jpg As mentioned above, the vegetable oil group had significantly more low adherers. As we can see, about 33% of the excess cancer was occurring among low adherers in the vegetable oil group. Let's see what happens when we not only remove the low adherer subgroup, but also compare the between-group difference in carcinoma risk among the highest adherers. ![][image31] -[image31]: /blog/seedoils/image31.png +[image31]: /blog/seedoils/image31.jpg Removing the low adherers nullifies the effect of the vegetable oil diet on cancer outcomes. There are also other plausible explanations for the effect as well. For example, the vegetable oil group contained many more moderate smokers than the animal fat group. Moderate smokers were defined as those smoking 0.5-1 packs of cigarettes per day. As you can see, observed cancer among moderate smokers was 3x higher in the vegetable oil group, and this is where all the excess cancer risk is accumulating. ![][image32] -[image32]: /blog/seedoils/image32.png +[image32]: /blog/seedoils/image32.jpg This means that low adherers in the vegetable oil group were likely to be smokers, and the smokers were likely to get more cancer. As we would expect [[70](https://pubmed.ncbi.nlm.nih.gov/22943444/)]. To suggest that the results of the LAVAT demonstrate a higher cancer risk for those consuming vegetable oils is just to misunderstand or misrepresent the data that Pearce et al. reported. The study did not actually divulge an independent effect of vegetable oil intake on cancer mortality. In fact, if we only look at high adherers, there are no statistically significant differences in cancer. ![][image33] -[image33]: /blog/seedoils/image33.png +[image33]: /blog/seedoils/image33.jpg As the authors reported, if the increase in cancer risk was actually a consequence of the vegetable oil diet, we would see more cancer risk among higher adherers. But we don't. We see no statistically significant differences. Overall, there is insufficient evidence to declare higher vegetable oil intakes to be an independent risk factor for cancer. The available data suggests that, at worst, higher vegetable oil intakes likely have a neutral effect compared to high animal fat intakes. But, the LAVAT was not the only trial to report cancer as a secondary endpoint. Three other trials that substituted vegetable oils for SFA also reported cancer outcomes. ![][image34] -[image34]: /blog/seedoils/image34.png +[image34]: /blog/seedoils/image34.jpg When considering all of the studies in the aggregate (subgroup 2.1.1), we see that the effect of substituting vegetable oils for SFA on cancer is null. But, the LAVAT is still boasting its (dubiously) large effect size. When we remove the moderate smokers, the increased risk is nullified (subgroup 2.1.2). However, further excluding all regular smokers pushes the aggregated results to a non-significant decrease in cancer risk with substituting vegetable oils for SFA (subgroup 2.1.3). The direction of effect that we see is actually consistent with the wider epidemiology investigating the relationship between LA biomarkers and cancer mortality. Here we see a strong inverse association between tissue LA representation and cancer risk overall [[71](https://pubmed.ncbi.nlm.nih.gov/32020162/)]. ![][image35] -[image35]: /blog/seedoils/image35.png +[image35]: /blog/seedoils/image35.jpg However, this is total cancer. There is still some controversy surrounding whether or not vegetable oils may increase the risk of other cancers. So, let's dive into that literature next. @@ -415,17 +415,17 @@ However, this is total cancer. There is still some controversy surrounding wheth There is a meta-analysis by Ruan et al. (2020) investigating the limited epidemiological research on the subject. The results suggest that higher intakes of PUFA could also increase the risk of skin cancer in prospective cohort studies [[72](https://pubmed.ncbi.nlm.nih.gov/31298947/)]. However, if we take a look at the author's data, we have some troubling findings. ![][image36] -[image36]: /blog/seedoils/image36.png +[image36]: /blog/seedoils/image36.jpg Increasing PUFA intake seems to increase the risk of squamous cell carcinoma (SCC). However, a single study by Park et al. (2018) is contributing 92.6% of the weight [[73](https://pubmed.ncbi.nlm.nih.gov/29636341/)]. ![][image37] -[image37]: /blog/seedoils/image37.png +[image37]: /blog/seedoils/image37.jpg This could be due to the fact that the study's adjustment model lacked several important covariates that may have plausibly changed the association. For example, the multivariate adjustment model adjusted for hair colour rather than skin tone. This is problematic because hair colour does not sufficiently capture the differential effects of skin tone on skin cancer [[74](https://pubmed.ncbi.nlm.nih.gov/23107311/)]. ![][image38] -[image38]: /blog/seedoils/image38.png +[image38]: /blog/seedoils/image38.jpg In at least one of the included prospective cohort studies by Ibiebele et al. (2009) that investigated the relationship between LA and skin cancer included adjustments for skin colour, and their results were null [[75](https://pubmed.ncbi.nlm.nih.gov/19462452/)]. This further casts doubt on the veracity of the findings reported by Park et al. (2018). @@ -434,17 +434,17 @@ In fact, when tissue representation of LA was investigated by Wallingford et al. There is also one study by Harris et al. (2005) that investigates the relationship between red blood cell cis-LA content and squamous cell carcinoma [[77](https://pubmed.ncbi.nlm.nih.gov/15824162/)]. While it is a case-control study and lacks the temporal component that is necessary to establish causality, it is some of the only human outcome data we have on the subject, and the results are null. ![][image39] -[image39]: /blog/seedoils/image39.png +[image39]: /blog/seedoils/image39.jpg If one still believes that higher intakes of LA increases the risk of skin cancer, I have a treat for them. Do you remember the LAVAT we mentioned in the cancer section? It turns out that skin cancer was actually one of their secondary endpoints. ![][image40] -[image40]: /blog/seedoils/image40.png +[image40]: /blog/seedoils/image40.jpg In table II from the post-hoc analysis by Pearce et al. (1971), we see that in the vegetable oil group, there were ten cases of skin cancer, whereas in the animal fat group there were 21. This produces a statistically significant increase in skin cancer risk for the animal fat group, whether or not we exclude or include the post-diet period (RR: 2.11 [1.01-4.43] and 2.09 [1.07-4.11], respectively). ![][image41] -[image41]: /blog/seedoils/image41.png +[image41]: /blog/seedoils/image41.jpg As we discussed earlier, there were no statistically significant differences in cancer risk among heavy smokers, of which there were only two cases in the animal fat group. However, there was a non-significant increase in cancer risk among moderate smokers, of which there were 19 cases in the vegetable oil group. @@ -453,12 +453,12 @@ This suggests that the increase in skin cancer seen in the animal fat group is n Additionally, the methods of MR have also been used by Seviiri et al. (2021) to investigate the relationship between elevated plasma LA and skin cancer [[78](https://pubmed.ncbi.nlm.nih.gov/34088753/)]. Data was collected for two different keratinocyte cancers, which were BCC and SCC, and the results are consistent with those found in the LAVAT. ![][image42] -[image42]: /blog/seedoils/image42.png +[image42]: /blog/seedoils/image42.jpg There was a statistically significant 6% reduction in BCC risk with genetically elevated plasma LA, whereas AA showed a statistically significant 4% increase in risk. Oddly, the effect size of eicosapentaenoic acid (EPA) was actually larger than that of AA, which would seem to be at odds with the RCT data on the subject [[79](https://pubmed.ncbi.nlm.nih.gov/24265065/)]. ![][image43] -[image43]: /blog/seedoils/image43.png +[image43]: /blog/seedoils/image43.jpg For SCC, the only statistically significant relationship between genetically elevated plasma PUFA was a 4% increased risk with plasma AA. The results for all other PUFA were null. @@ -473,14 +473,14 @@ The notion that vegetable oils are responsible for the obesity epidemic is extre Indeed, this mechanism does appear to work— in mice [[81](https://pubmed.ncbi.nlm.nih.gov/22334255/)]. In this study by Alvheim et al. (2012), mice were fed two different diets with varying fatty acid compositions. Essentially, mice were randomized to two diets that contained either moderate fat (35% of energy) or high fat (60% of energy). Within each diet group there were three distinct diet conditions. One of the diet conditions was low in LA (1% of energy), and the two remaining diet conditions were "high" in LA (8% of energy), with one of which also being supplemented with long-chain omega-3s. ![][image44] -[image44]: /blog/seedoils/image44.png +[image44]: /blog/seedoils/image44.jpg By the end of the study, the mice receiving 8% of their energy from LA had consistently higher body weight, with a slightly mitigating effect of supplemented omega-3s in the mice fed a high-fat diet (chart e). The increases in body weight in the mice that were fed high-LA diets was commensurate with increases in 2-AG. Ergo, consuming a high-LA diet will increase 2-AG and facilitate obesity— in mice. But what about humans? A study by Blüher et al. (2006) involving 60 subjects explored the correlation between body fatness and a number of markers related to the endocannabinoid system. There ended up being significant correlations between circulating 2-AG and obesity [[82](https://pubmed.ncbi.nlm.nih.gov/17065342/)]. ![][image45] -[image45]: /blog/seedoils/image45.png +[image45]: /blog/seedoils/image45.jpg However, there is an issue. Unlike mice, circulating levels of the 2-AG precursor, ARA, did not differ between lean and obese subjects. For this reason, the authors go on to express skepticism toward the hypothesis that 2-AG synthesis is driven passively by the supply of precursors in humans. Instead, they point out that there is more evidence that obesity itself acts to inhibit the degradation of 2-AG. @@ -493,7 +493,7 @@ This would not be surprising, considering that the impaired clearance and/or deg While somewhat tangential to the point, it is interesting to note that we have tested the effects of selective CB1-antagonism in humans with a pharmaceutical called Rimonabant [[84](https://pubmed.ncbi.nlm.nih.gov/17054276/)]. Overall, this drug does appear to reduce energy intake and result in weight loss that is equal to just over a quarter-pound per week. ![][image46] -[image46]: /blog/seedoils/image46.png +[image46]: /blog/seedoils/image46.jpg The reason this is tangential is because CB-antagonists such as Rimonabant are not specifically targeting LA metabolism. All this research tells us is that the endocannabinoid system is involved with the regulation of body weight in humans, but it does not tell us what independent contributions are being made by 2-AG, or even dietary LA for that matter. @@ -504,14 +504,14 @@ If we wish to explore the effects of dietary LA on appetite, there have been a n Of the trials that actually reported ad libitum energy intake in response to diets of varying fatty acid composition, no consistent effects are observed [[86](https://www.ncbi.nlm.nih.gov/pubmed/14694208)][[87](https://pubmed.ncbi.nlm.nih.gov/26331956/)][[88](https://pubmed.ncbi.nlm.nih.gov/10953671/)][[89](https://pubmed.ncbi.nlm.nih.gov/11040181/)][[90](https://pubmed.ncbi.nlm.nih.gov/23328113/)][[91](https://pubmed.ncbi.nlm.nih.gov/28760423/)]. All together, the short-term evidence is largely a wash. In fact, this was remarked upon by Strik et al. (2010) in table 4 of one such publication, and they included the aggregated findings across a number of different trials investigating the relationship between fatty acid saturation, satiety, and energy intake [[92](https://pubmed.ncbi.nlm.nih.gov/20492735/)]. Overall, when there was an effect of LA, it tended to decrease energy intake. ![][image47] -[image47]: /blog/seedoils/image47.png +[image47]: /blog/seedoils/image47.jpg In one particularly well-done trial by Strik et al., participants in the three groups were given unlimited access to muffins made using either SFA, MUFA, or PUFA. They would consume these muffins ad libitum one variety at a time, with a washout period between different muffin types. By the end, all three groups experienced all three muffin types. Each time researchers collected subjective data on satiety and the general satisfaction of the food experience. No differences in any parameters reached statistical significance. ![][image48] -[image48]: /blog/seedoils/image48.png +[image48]: /blog/seedoils/image48.jpg There were no statistically significant differences in hunger, fullness, satisfaction, or prospective consumption (how much more subjects suspected they could eat at that moment). It appeared as though SFA trended toward a decrease in fullness, perhaps. There were also no observed differences in ad libitum energy intake. @@ -524,19 +524,19 @@ I have also heard it proposed that in order to study this effect, researchers ma This difference in LA intake produced an enormous increase in adipose LA in the vegetable oil group. It's probably safe to say that these people reached a maximal saturation point, as evidenced by the hyperbolic curve in adipose LA representation over time. ![][image49] -[image49]: /blog/seedoils/image49.png +[image49]: /blog/seedoils/image49.jpg The median LA representation in adipose tissue increased from around 8-11% of total fatty acids to over 30% of total fatty acids across the eight year study. The baseline levels are consistent with levels found in traditional populations like the Tsimane, Inuit, and the Navajo aboriginals [[93](https://pubmed.ncbi.nlm.nih.gov/22624983/)][[95](https://onlinelibrary.wiley.com/doi/10.1002/cphy.cp050117)]. While the data published by Martin et al. (2012) is representing the fatty acid composition of breast milk in the Tsimane, it is also true that the LA contents of both breast milk and adipose tissue correlate extremely tightly [[96](https://pubmed.ncbi.nlm.nih.gov/16829413/)][[97](https://pubmed.ncbi.nlm.nih.gov/8237871/)][[98](https://pubmed.ncbi.nlm.nih.gov/9684741/)]. ![][image50] -[image50]: /blog/seedoils/image50.png +[image50]: /blog/seedoils/image50.jpg There were no statistically significant differences between the baseline tissue LA presentation in the LAVAT and measurements taken from either the Navajo or Tsimane (SD estimated for Navajo). However, tissue LA was statistically significantly higher among Inuit when compared to the baseline measurements observed in the LAVAT. From this, we can likely infer that the subjects in the LAVAT were largely starting from ancestral levels of tissue LA, and increasing tissue LA to approximately threefold higher levels over the eight year trial period. So how did this threefold increase in tissue LA affect their body weight over time? Long story short, it didn't. ![][image51] -[image51]: /blog/seedoils/image51.png +[image51]: /blog/seedoils/image51.jpg Some may speculate that perhaps the 10.8g of LA being consumed in the control group was simply too high, and that the hyperphagic effects of the LA could have been masked by both groups exceeding a particular threshold. This is difficult to reconcile with the fact that the LA intake of the animal fat group was perfectly within bounds when compared to all known estimates of preagricultural LA intakes, as mentioned above [[99](https://pubmed.ncbi.nlm.nih.gov/20860883/)]. Also, this was an ad libitum trial in normal weight subjects and body weight remained within 2% of baseline. @@ -545,7 +545,7 @@ The LA intakes in the vegetable oil group universally overshoot the upper bounds This wasn't the only RCT that substituted vegetable oils for animal fat to measure body weight over time. According to the secondary endpoint analysis done by Hooper et al. 2020 with the Cochrane Collaboration, Olso Diet-Heart saw a 2.5kg reduction in body weight during their study period, whereas the Medical Research Council saw no change in body weight as well [[100](https://pubmed.ncbi.nlm.nih.gov/2607071/)][[101](https://pubmed.ncbi.nlm.nih.gov/4175085/)]. ![][image52] -[image52]: /blog/seedoils/image52.png +[image52]: /blog/seedoils/image52.jpg Altogether, it does not appear as though vegetable oils uniquely increase body weight in humans. So, while vegetable oils may increase 2-AG and induce obesity in mice, this does not appear to pan out in humans. Large scale RCTs in humans do not support the hypothesis that vegetable oils lead to weight gain over time in humans. @@ -554,21 +554,21 @@ Altogether, it does not appear as though vegetable oils uniquely increase body w The effect of varying PUFA and SFA in the diet on measures of energy expenditure (EE) have been tested numerous times and show unambiguously consistent results [[102](https://pubmed.ncbi.nlm.nih.gov/24363161/)]. Overall, diets higher in PUFA and lower in SFA tend to increase EE in humans [[103](https://pubmed.ncbi.nlm.nih.gov/1556946/)][[104](https://pubmed.ncbi.nlm.nih.gov/9467221/)]. ![][image53] -[image53]: /blog/seedoils/image53.png +[image53]: /blog/seedoils/image53.jpg Here is an example from that body of literature. In this study by Lichtenbelt et al. (1997), we can clearly see a consistent effect across all six subjects with higher PUFA intakes increasing postprandial EE. The same trend was also observed for resting metabolic rate (RMR). Ultimately, high-SFA, low-PUFA diets tend to lower EE and RMR compared to high-PUFA, low-SFA diets. This finding is incredibly consistent, though PUFA and MUFA seem to trade blows in some studies, the overall trend of SFA being least thermogenic is clear. The effects of high-PUFA feeding on fat oxidation have also been studied by Casas-Agustench et al. (2009) as well [[105](https://pubmed.ncbi.nlm.nih.gov/19010571/)]. When using the respiratory quotient to compare the effects of diets that are high in PUFA, MUFA, and SFA on EE and fat oxidation, we see a similar trend emerge once again. ![][image54] -[image54]: /blog/seedoils/image54.png +[image54]: /blog/seedoils/image54.jpg High-PUFA feeding resulted in higher postprandial EE as well as a higher thermic effect of feeding (TEF). Though the differences in the rate of fat oxidation did not reach significance between groups, there was an obvious trend that reflected the degree of fatty acid saturation. PUFA was the most thermogenic, SFA was the least thermogenic, and MUFA was somewhere in between. The same results were observed by DeLany et al. (2000), only this time different dietary fats containing labeled carbon isotopes are used [[106](https://pubmed.ncbi.nlm.nih.gov/11010930/)]. You can measure these isotopes in the breath in order to measure how much of the dietary fat a subject has consumed was burned in the time after a meal. ![][image55] -[image55]: /blog/seedoils/image55.png +[image55]: /blog/seedoils/image55.jpg Using this methodology, we see that there is one type of SFA that is preferentially oxidized over all other FAs that were tested, and that is lauric acid. However, lauric acid might have ketogenic properties, so interpret with caution. Looking over the rest of the tested FAs, we see that PUFA once again has the highest oxidation rate, followed by MUFA, and SFA once again comes in last place. @@ -579,7 +579,7 @@ Vegetable oils don't appear to make you fat. But even if they did, it does not a The idea that vegetable oils are the primary driver of obesity and/or type 2 diabetes mellitus (T2DM) has deep roots in many diet communities. However, the evidence cited to support this assertion is typically animal research investigating the effects of LA on hypothalamic function and energy intake. Not to mention that, as we discussed earlier, altering the fatty acid saturation of the diet has no discernable effect on ad libitum energy intake. So, let's investigate the effects on insulin sensitivity. ![][image56] -[image56]: /blog/seedoils/image56.png +[image56]: /blog/seedoils/image56.jpg When the relationship between tissue LA and insulin sensitivity was investigated by Iggman et al. (2010), the results are null for leaner individuals. However for overweight individuals, adipose LA is associated with a statistically significant increase in insulin sensitivity [[107](https://pubmed.ncbi.nlm.nih.gov/20127308/)]. @@ -588,14 +588,14 @@ This study into T2DM incidence is the closest thing I've been able to find inves Again, we can turn our attention to well-conducted crossover RCTs for clearer answers to these sorts of questions. Fortunately, we have one such trial by Heine et al. (1989), investigating the effects of altering fatty acid saturation on measures of insulin sensitivity and glucose homeostasis [[108](https://pubmed.ncbi.nlm.nih.gov/2923077/)]. Subjects were placed on either a high-LA diet (10.9% of energy) or a low-LA diet (4.2% of energy) for 30 weeks, after which measures of plasma insulin and glucose clearance were taken. ![][image57] -[image57]: /blog/seedoils/image57.png +[image57]: /blog/seedoils/image57.jpg While there were no statistically significant differences between groups in most ways, the high-LA group has a significantly higher glucose clearance rate during the first infusion test. Overall, there was an obvious trend toward a benefit with the high-LA diet. Another trial by Zibaeenezhad et al. (2016) compared 15g of walnut oil (containing approximately 8g of LA) to no intervention, and measured a number of endpoints relevant to T2DM [[109](https://pubmed.ncbi.nlm.nih.gov/28115966/)]. Presumably, randomization balanced baseline LA between groups, so we can assume that the trial is effectively testing the effects of adding a tablespoon of walnut oil to the diet. ![][image58] -[image58]: /blog/seedoils/image58.png +[image58]: /blog/seedoils/image58.jpg By the end of the trial, the walnut oil diet improved both HbA1C and fasting blood glucose. There were also no statistically significant changes in body weight or BMI. Which suggests that these effects were independent of weight loss. This is not what we'd expect if the vegetable oils were increasing the risk of developing T2DM. @@ -606,14 +606,14 @@ There are a few more studies that do not adjust for many T2D mediators. In this Ultimately, it appears that neither LA biomarkers nor intake associate with negative outcomes with regards to insulin sensitivity, obesity, T2D, or liver function. These results are pretty consistent with existing meta-analyses on this question (which I combed through to find minimally adjusted data) [[112](https://pubmed.ncbi.nlm.nih.gov/29032079/)]. ![][image59] -[image59]: /blog/seedoils/image59.png +[image59]: /blog/seedoils/image59.jpg These are not at all the results that we would expect to see if merely having more LA in either your body or your diet increased the risk of T2DM. Although, there are some who would claim that associations between LA biomarkers and diseases are unreliable. Essentially, the idea is that LA can oxidize for various reasons and potentially skew the biomarker in different directions. For example, if higher tissue representation of LA is inversely associated with a disease, but the disease itself predisposes LA to oxidation (and thus creates the potential for the LA biomarker to appear artificially lower), the data could be confounded. However, there is fascinating data that would seem to contradict this [[113](https://pubmed.ncbi.nlm.nih.gov/30987358/)]. ![][image60] -[image60]: /blog/seedoils/image60.png +[image60]: /blog/seedoils/image60.jpg In analysis of a prospective cohort study by Yepes-Calderón et al. (2019), levels of the LA peroxidation products, malondialdehyde (MDA), was strongly and inversely associated with new onset T2DM after kidney transplant. Even after applying seven different multivariate adjustment models, no adjustment succeeded in nullifying the effect. @@ -622,12 +622,12 @@ Perhaps the reason LA is inversely associated with T2DM is _because_ it undergoe Lastly, in a multinational MR study of almost a million participants by Chen et al. (2017), there was an inverse association between elevated plasma LA levels and incidence of T2DM [[114](https://pubmed.ncbi.nlm.nih.gov/28032469/)]. ![][image61] -[image61]: /blog/seedoils/image61.png +[image61]: /blog/seedoils/image61.jpg Once again, we see the same thing that we saw in the MR studies investigating CVD. Genetically higher plasma LA is inversely associated with lower fasting blood glucose and T2DM incidence, whereas genetically higher plasma AA is positively associated with both higher fasting blood glucose and T2DM incidence. We also see in their subgroup analysis that the conversion of LA to AA through FADS is once again mediating. ![][image62] -[image62]: /blog/seedoils/image62.png +[image62]: /blog/seedoils/image62.jpg When excluding gene variants affecting the function of FADS, the association between genetically elevated plasma LA and T2DM is null. However, when FADS gene variants are considered, the association is statistically significant. This once again suggests a causal relationship between the conversion of LA to AA and disease incidence. Strangely, long chain omega-3s are positively associated as well, which is in contrast to the RCT data on the subject [[115](https://pubmed.ncbi.nlm.nih.gov/31434641/)]. @@ -644,7 +644,7 @@ However, within this body of literature, the primary hypothesis that has been pu Because it would be unethical to truly test the effects of IVLE overfeeding in humans, we have to rely on animal models to provide us with insights. In one well-designed mouse study by Ksami et al. (2013), both SO- and FO-IVLEs were fed to mice with intestinal injuries [[121](https://pubmed.ncbi.nlm.nih.gov/24107776/)]. Except there were additional groups that were fed FO-IVLEs that also contained SO-derived phytosterols. Markers of liver pathology were comparable between phytosterol-containing FO-IVLEs and controls fed SO-IVLEs. ![][image63] -[image63]: /blog/seedoils/image63.png +[image63]: /blog/seedoils/image63.jpg When tested in humans at matched, eucaloric dosages, there are no clinically meaningful differences between SO-IVLEs and FO-IVLEs [[122](https://pubmed.ncbi.nlm.nih.gov/23770843/)][[123](https://pubmed.ncbi.nlm.nih.gov/22796064/)]. Across all of the markers investigated by Nehra et al. (2014), the only significant changes were increases in alkaline phosphatase, but they occurred in both groups. @@ -661,21 +661,21 @@ There is just a tiny little problem, though. They actually weren't testing the e Ultimately, they likely did not significantly alter the LA content of the diet itself, as evidenced by the fact that tissue LA went largely unchanged throughout the duration of the trial. ![][image64] -[image64]: /blog/seedoils/image64.png +[image64]: /blog/seedoils/image64.jpg Fortunately, we do have better, more direct experiments investigating the effects of dietary fatty acid composition and fatty acid saturation on measures of liver fat in humans [[126](https://pubmed.ncbi.nlm.nih.gov/22492369/)]. First is an isocaloric feeding study by Bjermo et al. (2012) that largely found non-inferiority between LA and SFA on measures of visceral adipose tissue (VAT). However, the high-LA diet resulted in a greater overall improvement in the subjects' metabolic profile. The high-LA diet did result in lower waist circumference, PCSK9, cholesterol, serum insulin, and ALT, though it did not necessarily result in a difference in VAT compared to the high-SFA diet. The results are slightly different when looking at human overfeeding [[127](https://pubmed.ncbi.nlm.nih.gov/24550191/)]. In this trial by Rosqvist et al. (2014), which compared hypercaloric diets that were either high-LA or high-SFA, the high-LA diet did appear to be protective against VAT accumulation. ![][image65] -[image65]: /blog/seedoils/image65.png +[image65]: /blog/seedoils/image65.jpg The high-LA diet seemed to be uniquely protective against liver fat accumulation in particular. Additionally, the high-LA diet seemed to be associated with a greater increase in lean body mass (LBM) when compared to the high-SFA diet. But not only that, the high-LA diet seemed more resistant to fat gain overall compared to the high-SFA diet. These are not the results we'd expect if LA was uniquely causal in NAFLD. These human experimental finding are perfectly consistent with the observational evidence on the subject as well, which typically shows that either high-PUFA or high-LA diets protect against NAFLD at the population level as well [[128](https://pubmed.ncbi.nlm.nih.gov/22209679/)][[129](https://pubmed.ncbi.nlm.nih.gov/27618908/)]. ![][image66] -[image66]: /blog/seedoils/image66.png +[image66]: /blog/seedoils/image66.jpg Overall there is an inverse association between high-PUFA intake and measures of hepatic lipid concentrations. There is, however, an association between high-SFA diets, just like the experimental literature. There is also evidence from Wehmeyer et al. (2016) that suggests that the effect of total energy intake on NAFLD is greater than either high-PUFA or high-SFA diets [[130](https://pubmed.ncbi.nlm.nih.gov/27281105/)]. Regardless, there does not appear to be any clear or persuasive evidence that LA is uniquely causal of NAFLD. @@ -688,14 +688,14 @@ If you've spent any amount of time in any low carb or vegan diet community or bl There is an analysis of the Epidemiological Investigation of Rheumatoid Arthritis cohort by Lourdudoss et al. (2018) that investigated the relationship between dietary fatty acids and RA pain [[131](https://pubmed.ncbi.nlm.nih.gov/28371257/)]. As per the recurring theme throughout much of the dietary fat literature, a high O6:O3 ratio is associated with an increased risk of both unacceptable pain and refractory pain (RR 1.70 [1.03-2.82] and 2.33 [1.28-4.24], respectively. ![][image67] -[image67]: /blog/seedoils/image67.png +[image67]: /blog/seedoils/image67.jpg However, if we look at omega-3 we see that there is a statistically significant decrease in both unacceptable pain and refractory pain (RR 0.57 [0.35-0.95] and 0.47 [0.26-0.84], respectively). Whereas for omega-6, results for all three endpoints are null. If we do a little math (1/0.54 and 1/0.47), we see that the risk increase when going from the highest to lowest intakes of omega-3 for both unacceptable pain and refractory pain are pretty much the same as the risk ratios for the lowest to highest O6:O3 ratio. Which are 1.75 and 2.12, respectively. When considered together, this likely means that the effect of a high O6:O3 ratio has more to do with insufficient omega-3 than it has to do with excessive omega-6, which is consistent with the experimental literature on the subject [[132](https://pubmed.ncbi.nlm.nih.gov/29017507/)][[133](https://pubmed.ncbi.nlm.nih.gov/28067815/)]. However, these results are not consistent across all measures of RA, such as bone marrow lesions in those without RA at baseline [[134](https://pubmed.ncbi.nlm.nih.gov/19426478/)]. ![][image68] -[image68]: /blog/seedoils/image68.png +[image68]: /blog/seedoils/image68.jpg In an analysis of this Australian cohort by Wang et al. (2009), neither omega-3, omega-6, nor the O6:O3 ratio had a statistically significant effect on the incidence of bone marrow lesions. However, intakes of saturated fat were associated with a statistically significant increase in risk in both multivariate models (RR 2.62 [1.11-6.17] and 2.56 [1.03-6.37], respectively). @@ -710,7 +710,7 @@ Next up is evening primrose oil (EPO), which contains approximately 72% LA by we However, EPO trials using this design have been criticized by Horrobin (1989) for having a number of potential methodological errors [[141](https://pubmed.ncbi.nlm.nih.gov/2688567/)]. In another trial by Belch et al. (1988) using more robust methodology and more complex comparisons, EPO seems to do quite well in moderate doses [[142](https://pubmed.ncbi.nlm.nih.gov/2833184/)]. In this trial, 49 subjects with RA, managed with nonsteroidal anti-inflammatory drugs (NSAID), were randomized to three groups. One group had 12g/day of EPO, another group received 12g/day of EPO+FO, and the final group was placed on a placebo. ![][image69] -[image69]: /blog/seedoils/image69.png +[image69]: /blog/seedoils/image69.jpg While EPO alone resulted in significant reduction in the use of NSAIDs, the largest reductions in NSAID usage was seen when EPO was paired with FO. Not only does this detract from the notion that LA increases RA, this also lends further credibility to the beneficial effects of increasing dietary omega-3. @@ -737,7 +737,7 @@ Not only that, but there was no multivariable adjustment to ascertain whether or Puzzlingly, in stark contrast to these findings, other cross-sectional data seems to suggest that LA has either a neutral or beneficial effect on SLE, at least once people are diagnosed [[148](https://pubmed.ncbi.nlm.nih.gov/31074595/)][[149](https://pubmed.ncbi.nlm.nih.gov/26848399/)]. In the first paper by Charoenwoodhipong et al. (2020), it was observed that LA had no association with worsening SLE-related symptoms. ![][image70] -[image70]: /blog/seedoils/image70.png +[image70]: /blog/seedoils/image70.jpg As you can see in Figure 3, there is no consistent relationship between LA and SLE-related symptoms in either direction. However, a consistent trend toward favourable outcomes was observed with higher omega-3, and the inverse of which was observed with a high O6:O3. This suggests that while a high O6:O3 is a correlate for worse outcomes, it does not appear to be a function of LA, but rather a function of insufficient omega-3. This is a consistent trend in the literature so far. @@ -748,14 +748,14 @@ However, this correlation may be spurious considering that people diagnosed with Again, at the risk of sounding like a broken record, the inverse of this has been suggested in additional research by Lourdudoss et al. (2016) investigating the relationship between LA and the risk of increasing glucocorticoids [[152](https://pubmed.ncbi.nlm.nih.gov/26848399/)]. ![][image71] -[image71]: /blog/seedoils/image71.png +[image71]: /blog/seedoils/image71.jpg This is particularly odd since LA was associated with systemic inflammation in the previous study. Like I said in the beginning, the data is a mess. Nothing seems congruent, because most of it is either cross-sectional or completely uncontrolled or unadjusted. However, there are a few prospective studies investigating SLE and vegetable oil intake. First up is a study by Shin et al. (2017) involving 82 subjects which aimed to explore the differences in plasma fatty acids between those with SLE and those without [[153](https://pubmed.ncbi.nlm.nih.gov/30830319/)]. Ultimately, they discovered that plasma SFAs are more likely to be elevated in those with SLE, whereas plasma PUFA— particularly LA— was more likely to be reduced. ![][image72] -[image72]: /blog/seedoils/image72.png +[image72]: /blog/seedoils/image72.jpg At first glance, this may seem like a win for PUFA, or LA more specifically, but there are some interpretive challenges here. For example, PUFA concentrations in tissue could plausibly reduce in the presence of lipid peroxidation cascades, and there is evidence from Shah et al. (2014) that lipid peroxidation metabolites are higher in subjects with SLE [[154](https://pubmed.ncbi.nlm.nih.gov/24636579/)]. @@ -768,7 +768,7 @@ However, echoing the sentiments toward antioxidants that have been discussed in Much to my surprise, the relationship between both SLE and RA have been investigated using MR. In this MR study by Zhao and Schooling (2019), three different statistical tests across two gene variant subgroups were performed [[161](https://pubmed.ncbi.nlm.nih.gov/30409829/)]. ![][image73] -[image73]: /blog/seedoils/image73.png +[image73]: /blog/seedoils/image73.jpg Generally speaking, statistically significant inverse associations between genetically elevated plasma LA and both RA and SLE were consistently found. The only inconsistency was when the Egger MR or the MR PRESSO methods were applied. The application of the Egger MR method seemed to nullify the effect in all cases, and the application of the MR PRESSO method only seemed to nullify the effect for RA in the second subgroup analysis. @@ -794,7 +794,7 @@ So, as I do, I decided to gather all the data I could and compile a meta-analysi Altogether, 10 prospective cohort studies were included in the analysis. With respect to the exposures specified in the inclusion criteria, Delcourt et al. (2007) reported only on PUFA [[164](https://pubmed.ncbi.nlm.nih.gov/17299457/)]. Whereas Seddon et al. (2003) investigated both PUFA and vegetable fat [[165](https://pubmed.ncbi.nlm.nih.gov/14662593/)]. Chong et al. (2009), Chua et al. (2006), Cho et al. (2000), and Tan et al. (2009) all explored LA, PUFA, and TFA in their analyses [[166](https://pubmed.ncbi.nlm.nih.gov/19433719/)][[167](https://pubmed.ncbi.nlm.nih.gov/16832021/)][[168](https://pubmed.ncbi.nlm.nih.gov/11157315/)][[169](https://pubmed.ncbi.nlm.nih.gov/19433717/)]. Parekh et al. (2009) additionally included vegetable fat in their analysis, but did not investigate TFA [[170](https://pubmed.ncbi.nlm.nih.gov/19901214/)]. Similarly, Sasaki et al. (2020) reported on LA and PUFA, but did not report on TFA or vegetable fat [[171](https://pubmed.ncbi.nlm.nih.gov/32181798/)]. Both Christen et al. (2011) and Mares-Perlman et al. (1995) studied associations pertaining to both LA and PUFA [[172](https://pubmed.ncbi.nlm.nih.gov/21402976/)][[173](https://pubmed.ncbi.nlm.nih.gov/7786215/)]. There was significant heterogeneity across all investigated exposures, and no single exposure reached statistical significance. ![][image74] -[image74]: /blog/seedoils/image74.png +[image74]: /blog/seedoils/image74.jpg Among the studies with the longest follow-up time, largest cohort size, best adjustment models, and the widest exposure contrasts, the results tended to be null. For example, Chong et al. (2009) adjusted for lutein, zeaxanthin, and sources of omega-3, which are inversely associated with late AMD [[174](https://pubmed.ncbi.nlm.nih.gov/21899805/)][[175](https://pubmed.ncbi.nlm.nih.gov/18541848/)]. Their results were null for every exposure. @@ -837,7 +837,7 @@ Altogether 43 studies were obtained from a PubMed and Google Scholar literature **Alzheimer's Disease:** ![][image75] -[image75]: /blog/seedoils/image75.png +[image75]: /blog/seedoils/image75.jpg For Alzheimer's disease, results across all exposures were null. However, there were not many studies per subgroup. When the subgrouping is removed the results still don't reach statistical significance (RR 0.74 [0.43-1.26], P=0.26). There is also decently high heterogeneity between the included studies. For example, Rönnemaa et al. (2012), saw a non-significant increase in Alzheimer's risk with increasing LA intake, but Morris saw a statistically significant decrease in Alzheimer's risk with increasing vegetable oil intake. @@ -850,7 +850,7 @@ Given that the two datasets that were investigated in these two studies were pri **Dementia:** ![][image76] -[image76]: /blog/seedoils/image76.png +[image76]: /blog/seedoils/image76.jpg Again, we see null findings across all of the investigated exposures. The only statistically significant study, Beydoun et al. (2007), found a 23% reduction in the risk of cognitive decline (RR 0.77 [0.65-0.91], P=0.002). What sets this study apart from most of the others was its robust multivariate adjustment model. In fact, the adjustment model was so comprehensive, it was given its own section in the paper. @@ -861,7 +861,7 @@ However, the cohort study had half as much follow-up time and used different met **Total Dementia:** ![][image77] -[image77]: /blog/seedoils/image77.png +[image77]: /blog/seedoils/image77.jpg Results are slightly different when Alzheimer's disease, cognitive decline, and general dementia are all considered together, however. It is noteworthy to point out that when all of the studies are aggregated, vegetable fat associates with a statistically significant 58% reduction in total dementia (RR 0.42 [0.21-0.84], P=0.01). Though, to be clear, more than two thirds of the weight are derived from a single study, so interpret with caution. @@ -894,27 +894,27 @@ I scoured the literature for as many LA substitution trials as I could find. Alt Four studies met the inclusion criteria and were included in the analysis [[195](https://pubmed.ncbi.nlm.nih.gov/11246548/)][[196](https://pubmed.ncbi.nlm.nih.gov/15168040/)][[197](https://pubmed.ncbi.nlm.nih.gov/26016869/)][[198](https://pubmed.ncbi.nlm.nih.gov/25319187/)]. The LA intakes in the high-LA diets ranged from 22.2g/day with Vafeiadou et al. (2015) to 50.8g/day with Junker et al. (2001), with an average of 33.5g/day, across all included studies. The LA intakes in the low-LA diets ranged from 4.8g/day with Iggman et al. (2014) to 7.8g/day with Junker et al. (2001), with an average of 6.4g/day, across all included studies. The average contrast in LA intake was 27g/day across all included studies. ![][image78] -[image78]: /blog/seedoils/image78.png +[image78]: /blog/seedoils/image78.jpg There were 12 studies that were captured by the exclusion criteria and had to be excluded from the analysis. ![][image79] -[image79]: /blog/seedoils/image79.png +[image79]: /blog/seedoils/image79.jpg **Results:** ![][image80] -[image80]: /blog/seedoils/image80.png +[image80]: /blog/seedoils/image80.jpg Altogether, high-LA diets yielded a non-significant increase in CRP when compared to control (P=0.15). The results are ultimately null. However, it may still be possible that the true effect of LA on CRP is hidden. It's plausible that high-LA diets do increase CRP, but they don't tend to increase CRP much more than control. ![][image81] -[image81]: /blog/seedoils/image81.png +[image81]: /blog/seedoils/image81.jpg When the effects of high-LA diets are compared to baseline, the results are almost squarely null (P=0.62). Even Junker, 2001, which saw the widest contrast in LA intake ultimately had a null result. But, we're not out of the woods yet. There are still other possibilities to consider. What if the subjects' usual diets are already high in LA that dosing more in an intervention trial doesn't actually do anything to CRP? Perhaps the comparator diets could still prove to be anti-inflammatory in some way. ![][image82] -[image82]: /blog/seedoils/image82.png +[image82]: /blog/seedoils/image82.jpg Comparing the effects of low-LA diets to baseline yielded a non-significant decrease in CRP (P=0.21). Again, the results are ultimately null. So, at present it does not appear as though low-LA diets are terribly protective compared to high-LA diets on measures of CRP. @@ -925,7 +925,7 @@ But there is one last thing to discuss. Junker et al. (2001), saw the widest con As described in the Statistical Analyses section, the Mann-Whitney-Wilcoxon test was used to test for statistical significance when distributions were non-normal. This test is specifically designed for non-normal distributions, and applying this test is also best practice in this case. ![][image83] -[image83]: /blog/seedoils/image83.png +[image83]: /blog/seedoils/image83.jpg Here we see that CRP is actually reported as median and range, because the distributions of CRP were non-normal. We can also see that all three groups saw non-significant decreases in median CRP from baseline, falling from 0.9 (0.17-5.9) to 0.75 (0.17-7.7). However, the upper bounds for CRP during the starting week of the trial are unusually high in the OO group. This means that estimating the mean and standard deviation will actually yank the variance and the mean much higher than it rightfully should be. @@ -957,7 +957,7 @@ To test this, I scoured the literature for any randomized controlled trials (RCT Altogether, five studies were included in the analysis. The vast majority of data was collected from Freese et al. (2008), which included data for 8-oxodG, GR, GPx, and CAT [[200](https://pubmed.ncbi.nlm.nih.gov/17671440/)]. Whereas Jenkinson et al. (1999) additionally investigated SOD and LO2 in their investigation [[201](https://pubmed.ncbi.nlm.nih.gov/10452406/)]. Exploration of MDA was contributed by both de Kok et al. (2003) and Södergren et al. (2001) [[202](https://pubmed.ncbi.nlm.nih.gov/12504167/)][[203](https://pubmed.ncbi.nlm.nih.gov/11641740/)]. Lastly, Parfitt et al. (1994) contributed data for CD [[204](https://pubmed.ncbi.nlm.nih.gov/8181259/)]. ![][image84] -[image84]: /blog/seedoils/image84.png +[image84]: /blog/seedoils/image84.jpg **Results:** @@ -966,72 +966,72 @@ Normally when I see a bunch of null results I feel like I may have wasted my tim **8-oxo-7,8-dihydro-20-deoxyguanosine (8-oxodG) vs Control** ![][image85] -[image85]: /blog/seedoils/image85.png +[image85]: /blog/seedoils/image85.jpg **8-oxo-7,8-dihydro-20-deoxyguanosine (8-oxodG) vs Baseline** ![][image86] -[image86]: /blog/seedoils/image86.png +[image86]: /blog/seedoils/image86.jpg **Glutathione Reductase (GR) vs Control** ![][image87] -[image87]: /blog/seedoils/image87.png +[image87]: /blog/seedoils/image87.jpg **Glutathione Reductase (GR) vs Baseline** ![][image88] -[image88]: /blog/seedoils/image88.png +[image88]: /blog/seedoils/image88.jpg **Glutathione Peroxidase (GPx) vs Control** ![][image89] -[id]: /blog/seedoils/image89.png +[id]: /blog/seedoils/image89.jpg **Glutathione Peroxidase (GPx) vs Baseline** ![][image90] -[image90]: /blog/seedoils/image90.png +[image90]: /blog/seedoils/image90.jpg **Superoxide Dismutase (SOD) vs Control** ![][image91] -[image91]: /blog/seedoils/image91.png +[image91]: /blog/seedoils/image91.jpg **Superoxide Dismutase (SOD) vs Baseline** ![][image92] -[image92]: /blog/seedoils/image92.png +[image92]: /blog/seedoils/image92.jpg **Malondialdehyde (MDA) vs Control** ![][image93] -[image93]: /blog/seedoils/image93.png +[image93]: /blog/seedoils/image93.jpg **Malondialdehyde (MDA) vs Baseline** ![][image94] -[image94]: /blog/seedoils/image94.png +[image94]: /blog/seedoils/image94.jpg **Catalase (CAT) vs Control** ![][image95] -[image95]: /blog/seedoils/image95.png +[image95]: /blog/seedoils/image95.jpg **Catalase (CAT) vs Baseline** ![][image96] -[image96]: /blog/seedoils/image96.png +[image96]: /blog/seedoils/image96.jpg **Conjugated Dienes (CD) vs Control** ![][image97] -[image97]: /blog/seedoils/image97.png +[image97]: /blog/seedoils/image97.jpg **Conjugated Dienes (CD) vs Baseline** ![][image98] -[image98]: /blog/seedoils/image98.png +[image98]: /blog/seedoils/image98.jpg The only statistically significant finding was a reduction in 8-oxodG with high-PUFA diets (P=0.02). Which is interesting, because 8-oxodG is a marker of DNA damage, and as such its implications extend far beyond oxidative stress. I thought PUFA was supposed to destroy your DNA with all of those highly reactive, toxic byproducts they create when they oxidize? Well, apparently, like most mechanistic reasoning, that shit just doesn't pan out in the real world. diff --git a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SweetDeception.elm b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SweetDeception.elm index 3e01037..d385716 100755 --- a/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SweetDeception.elm +++ b/packages/website/frontend/src/Config/Pages/Blogs/MainBlog/SweetDeception.elm @@ -32,12 +32,12 @@ The IMCL hypothesis attempts to highlight the potential impact of IMCL accumulat The mechanistic case for the IMCL hypothesis was first outlined in the late 1990s with two small studies by Jacob, et al. and Perseghin, et al., which discovered relationships between IMCL and insulin resistance in T2DM-free subjects who were born of parents with T2DM [[1](https://pubmed.ncbi.nlm.nih.gov/10331418/)][[2](https://pubmed.ncbi.nlm.nih.gov/10426379/)]. In these experiments, the offspring of those with T2DM were subjected to the gold-standard measure of whole-body insulin sensitivity, the hyperinsulinemic-euglycemic clamp test (HEC). It was discovered that there was an inverse association between IMCL and insulin sensitivity, which led researchers to suspect that perhaps this biomarker was relevant to the pathophysiology of T2DM. ![][image1] -[image1]: /blog/sweetdeception/image1.png +[image1]: /blog/sweetdeception/image1.jpg Fast forward to 2004, and another small study from van Loon, et al. would introduce the hypothesis' first paradox [[3](https://pubmed.ncbi.nlm.nih.gov/15165998/)]. In this experiment, muscle biopsies and less precise (but still adequate) measures of insulin sensitivity were deployed in an investigation of subjects who were either sedentary, afflicted with T2DM, or who were trained athletes. The study found that the IMCL concentrations of IMCL were actually statistically significantly higher in athletic subjects compared to either sedentary or T2DM-afflicted subjects. Yet, the athletic subjects did not suffer from impaired insulin sensitivity or the hyperglycemia that is characteristic of T2DM. ![][image2] -[image2]: /blog/sweetdeception/image2.png +[image2]: /blog/sweetdeception/image2.jpg Researchers Coen and Goodpaster attempted to reconcile the findings in 2012 [[4](https://pubmed.ncbi.nlm.nih.gov/22721584/)]. They hypothesized that IMCL behaves differently in the context of T2DM, and that while IMCL serves as a fuel source in athletic subjects, in sedentary subjects with T2DM the IMCL seems to produce more disruptive mediators like ceramides and diacylglycerols. However, the authors tend to play fast and loose with their causal inferences, often citing animal research to buttress clear implications about what holds true in human beings. In fact, the majority of their supporting evidence is derived from mice, despite mice generally being poor facsimiles for human subjects [[5](https://pubmed.ncbi.nlm.nih.gov/31307492/)]. @@ -62,19 +62,19 @@ The mechanisms, epidemiological, and experimental evidence for this hypothesis w The author first refers to literature they themselves conducted, including three primary human trials demonstrating disturbances to energy expenditure, markers of liver function, as well as measures of IHL accumulation [[10](https://pubmed.ncbi.nlm.nih.gov/26376619/)][[11](https://pubmed.ncbi.nlm.nih.gov/21952692/)][[12](https://pubmed.ncbi.nlm.nih.gov/22828276/)]. The first trial discovered that isocaloric feeding of fructose compared to glucose over a ten-week period significantly increased hepatic fat. ![][image3] -[image3]: /blog/sweetdeception/image3.png +[image3]: /blog/sweetdeception/image3.jpg However, it's unclear what the clinical significance of this finding is, considering that the fructose-based intervention resulted in significant overfeeding and only increased fasting glucose by 5% compared to the glucose-based control. Seems like the authors tried pretty damn hard to induce a T2DM phenotype feeding fructose to subjects, and were ultimately unable to achieve that. In fact, they weren't really able to get close. Even the oral glucose tolerance test results, though far from ideal, showed an altogether normal blood glucose curve for the fructose group. ![][image4] -[image4]: /blog/sweetdeception/image4.png +[image4]: /blog/sweetdeception/image4.jpg The second trial was unremarkable, and suggested that fructose consumption may decrease energy expenditure over time when isocalorically compared to glucose. Again, it's interesting, but it's far from demonstrating a cause and effect relationship between T2DM and sugar. The third trial is a bit more complicated to unpack. Basically, subjects were split into two groups, 25% of calories as either fructose or glucose as parts of eucaloric diets over 10 weeks, with the primary endpoints beings measures of liver function. Overall, the results of the trial suggest a significantly detrimental effect of fructose compared to glucose on a number of markers related to liver function. However, it's slightly more complicated than that. While it's true that the treatment effect showed a benefit of glucose over fructose, it's also true that the marker of liver function that was negatively perturbed was gamma-glutamyl transferase (GTT). The change in GGT was also barely statistically significant compared to baseline, while markers such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT) showed a non-significant decrease. Glucose showed greater reductions that were barely statistically significantly different from that of fructose. ![][image5] -[image5]: /blog/sweetdeception/image5.png +[image5]: /blog/sweetdeception/image5.jpg Other than that, fructose did seem to increase uric acid levels to a statistically significant degree, making fructose a potential aggravating factor for conditions such as gout. But again, this is a far cry from causally linking fructose consumption to the development of T2DM, especially since fructose seemed to do nothing particularly interesting to markers of liver function. It is true that sugar intake is severely negatively associated with health outcomes [[13](https://pubmed.ncbi.nlm.nih.gov/34444794/)]. However, while this is a consistent finding, clinical trials on sugar consistently fail to demonstrate a connection between sugar intake and the development of T2DM. @@ -87,7 +87,7 @@ Suffice it to say, there would be little, if any, room for sugar while on such a Despite these improvements, recidivism continued to climb. As of two years, the CCI group had crept back into the diabetic range on average [[15](https://pubmed.ncbi.nlm.nih.gov/31231311/)]. By, 3.5 years, the CCI group was once again firmly within the diabetic range on average, having regained a significant amount of weight [[16](https://www.hsrd.research.va.gov/publications/esp/virtual-diet-brief.pdf)][[17](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7208790/)]. ![][image6] -[image6]: /blog/sweetdeception/image6.png +[image6]: /blog/sweetdeception/image6.jpg To be clear, there was a clear distinction between remission and reversal, as defined by the authors. Remission was a much more robust measure of traction against T2DM than reversal, even though it sounds like the latter is stronger than the former. Remission was defined in two parts; partial remission and complete remission. Partial remission was defined as "sub-diabetic hyperglycemia of at least 1 year duration, HbA1c level between 5.7-6.5%, without any medications (two HbA1c measurements)" and complete remission was defined as "Normoglycemia of at least 1 year duration, HbA1c below 5.7%, without any medications (two HbA1c measurements)". Reversal was defined more loosely, as "sub-diabetic hyperglycemia and normoglycemia (HbA1c below 6.5%), without medications except metformin" (Athinarayanan, et al., (2019), Supplement Table 2). @@ -104,12 +104,12 @@ The underlying premise is that PUFAs, particularly omega-6 fatty acids found in Since I've already covered how the human outcome data flies in the face of this hypothesis in a previous article [[18](https://www.the-nutrivore.com/post/a-comprehensive-rebuttal-to-seed-oil-sophistry)], I won't rehash all of it here. But, essentially there is no human outcome data supporting this effect across multiple cohort studies and multiple RCTs. In the epidemiology, tight markers of seed oil consumption show a consistent inverse association with T2DM [[19](https://pubmed.ncbi.nlm.nih.gov/29032079/)]. ![][image7] -[image7]: /blog/sweetdeception/image7.png +[image7]: /blog/sweetdeception/image7.jpg Additionally, there have been several interventions feeding large amounts of PUFA to subjects, to the exclusion of SFA, and measuring long term effects on insulin sensitivity [[20](https://www.sciencedirect.com/science/article/abs/pii/0163782781900709)][[21](https://pubmed.ncbi.nlm.nih.gov/1347091/)]. In both Houtsmuller, et al. (1979) and Watts, et al. (1992), long term feeding of PUFA was associated with improvements in insulin sensitivity. In the case of the former trial, the insulin sensitivity measure, an oral glucose tolerance test (OGTT), showed improvement to glucose tolerance among diabetics over time. These results were aggregated by Hooper, et al. back in 2020 in an exploratory analysis [[22](https://pubmed.ncbi.nlm.nih.gov/32428300/)]. ![][image8] -[image8]: /blog/sweetdeception/image8.png +[image8]: /blog/sweetdeception/image8.jpg Additionally, we can also see that Ley, et al. (2004) showed an improvement in OGTT results, but with the substitution of CHO for SFA, rather than PUFA for SFA (which is kinda funny) [[23](https://pubmed.ncbi.nlm.nih.gov/14739050/)]. @@ -130,22 +130,22 @@ Now that we have a clear understanding of the model, let's discuss the overwhelm For the first study by Ravikumar, et al., a single-arm trial of 10 subjects, the drug pioglitazone was investigated for its effects on markers of T2DM, particularly postprandial endogenous glucose production (EGP) using isotope labeled glucose, as well as IHL. After 16 weeks of treatment, the pioglitazone group experienced an increase in total body weight equal to +6.2kg on average. Yet, the pioglitazone group also experienced a decrease in IHL. ![][image9] -[image9]: /blog/sweetdeception/image9.png +[image9]: /blog/sweetdeception/image9.jpg However, to be fair, the pioglitazone group also experienced a significant decrease in IMCL as well, however there was no significant correlation between decreases in IMCL and EGP. There was however, a direct association between IHL and EGP. Although this trial was not controlled, it certainly doesn't produce results expected on the IMCL hypothesis, and it lends further credence to the TCH. Additionally, many markers of T2DM subsequently improved, such as plasma glucose, hemoglobin A1c (HbA1c), and even TGs, with the changes being -2.3mmol/L, -1.9%, and 0.4mmol/L, respectively. ![][image10] -[image10]: /blog/sweetdeception/image10.png +[image10]: /blog/sweetdeception/image10.jpg It can also be inferred that there was a meaningful increase in insulin sensitivity, given the fact that plasma glucose dropped despite the same amount of insulin being produced by subject. Essentially, glucose disposal per unit insulin went up, implying that insulin signalling had improved. ![][image11] -[image11]: /blog/sweetdeception/image11.png +[image11]: /blog/sweetdeception/image11.jpg In the second study by Petersen, et al., eight subjects with T2DM were compared to 10 healthy volunteers in a non-randomized weight loss trial over an average of seven weeks. Essentially, subjects were followed up until normoglycemia was achieved, so not every subject was subjected to the same amount of weight loss for the same time period. In this time, body weight dropped by an average of 8kg in the T2DM group. This was marked with commensurate drops in plasma glucose, plasma insulin, and TG, at -2.4mmol/L, -108pmol/L, and -0.3mmol/L, respectively. ![][image12] -[image12]: /blog/sweetdeception/image12.png +[image12]: /blog/sweetdeception/image12.jpg The most interesting and surprising finding was that there was no significant change in IMCL despite weight loss. But, subjects did end up achieving normoglycemia and near normal insulin sensitivity as determined by a HEC. However, much like the previous study, insulin sensitivity was directly associated with IHL reduction. Once again, this flies in the face of the IMCL hypothesis, and offers further support for the TCH as the T2DM approached nearly normal levels of IHL. Although neither of these papers directly test for evidence of the sugar or oxidation hypotheses, it should be noted that both of these trials involve the consumption of both sugar and most likely animal products. @@ -154,12 +154,12 @@ In light of this evidence, Steven and Taylor conducted another preliminary human In terms of other T2DM markers, such as plasma glucose, the response to the diet was heterogeneous among participants with long-term T2DM. Some showed similar responses to those in the short-term group and some responded slowly. By the end of the study, 87% of the short-term group and 50% of the long-term group achieved non-T2DM fasting plasma glucose levels. HbA1c levels also decreased in both groups, with a more significant reduction observed in the short-term group. However, there was an unforeseen result— about half of subjects did not respond to the treatment at all, which was not expected given nearly all previous research. ![][image13] -[image13]: /blog/sweetdeception/image13.png +[image13]: /blog/sweetdeception/image13.jpg Given these results and Prof. Taylor's previous characterization of the PFT concept, the most likely hypothesis seemed clear— these people just needed to lose more weight, which we'll get to later. For now, there was enough evidence of the effectiveness of weight loss for T2DM treatment that Prof. Taylor and his colleagues decided it was time to test the efficacy of the treatment in a real-world outpatient scenario. A cluster-randomized experiment was designed and undertaken, and would come to be known as the Diabetes Remission Clinical Trial (DiRECT) [[31](https://pubmed.ncbi.nlm.nih.gov/29221645/)]. ![][image14] -[image14]: /blog/sweetdeception/image14.png +[image14]: /blog/sweetdeception/image14.jpg The DiRECT trial involved 298 subjects across 49 primary care practices (or clusters) randomized two groups, a control group receiving the standard of care for T2DM management, and the treatment group receiving a three stage program: stage one, total diet replacement; stage two, food reintroduction; phase three, weight maintenance. For the first stage, the treatment group received a liquid diet consisting of four packets of meal replacement formula, which totaled around 825-853 kcal/day for three to five months (depending on patient-specific goals). For the second stage, after subjects completed the first weight loss phase of the trial, food was gradually reintroduced over a period of two weeks to two months. During the last stage, patients were followed up over the course of around a year. The results were encouraging. diff --git a/packages/website/frontend/src/Pages/Donate.elm b/packages/website/frontend/src/Pages/Donate.elm index 4e20df5..71a634e 100755 --- a/packages/website/frontend/src/Pages/Donate.elm +++ b/packages/website/frontend/src/Pages/Donate.elm @@ -467,10 +467,10 @@ featureToString : Maybe Bool -> { src : String, description : String } featureToString maybeBool = case maybeBool of Just True -> - { src = "donate/checkmark.png", description = "" } + { src = "donate/checkmark.jpg", description = "" } Just False -> - { src = "donate/ex.png", description = "" } + { src = "donate/ex.jpg", description = "" } Nothing -> - { src = "donate/question.png", description = "" } + { src = "donate/question.jpg", description = "" } diff --git a/packages/website/frontend/static/arguments/abortion.jpg b/packages/website/frontend/static/arguments/abortion.jpg new file mode 100644 index 0000000..b3588ce Binary files /dev/null and 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