18 Responses to “Can Atkins diet raise heart attack risk for women?”

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  1. avatar Entri says:

    re. my above comment, I should have written: So you chance of not having an event “during the long study” is 97%, not 99.81%.

  2. avatar Entri says:

    Zoe, I think your calculations are awry. You write:
    “Table 3 shows that the overall incident number for 43,396 women over 680,745 study years (women times average follow up period) was 1,270. Not deaths, please note, but medically diagnosed cardiovascular disease. This puts the overall incident rate for the women in the study at 0.19%. This means that all the women in the study had a 99.81% chance of NOT suffering any cardiovascular events whatsoever during the long study.”

    If 1,270 of 43,396 women had an cardio-vascular event over a 15.7 year period, that means there was a 3% chance of having an event over the period of study, NOT 0.19%. So you chance of not having an event “during the long study” is 97%, not 0.19%. You’re mixing two things up: the risk of having a CV event PER STUDY YEAR (0.19%) and the risk of having an event over the duration of the study (3%). That’s statistics 101

  3. avatar Hazel says:

    I understand why you disregard this study, and you make a convincing argument, pointing out all the reasons why it shouldn’t scare people away from the low carb diet.

    But you make one critical mistake that weakens your argument. You don’t consider the archaeological evidence for our ancient diet. Many others Paleo/low carb bloggers make the same mistake, and as a Paleo/low carb dieting archaeologist, this really frustrates me.

    You state quite clearly in the introduction we should be “going back to eating what we evolved to eat – the meat, eggs and dairy products from grass living animals”. Dairy products have been in the human diet for at MOST 9,000 years. (See: Earliest date for milk use in the Near East and southeastern Europe linked to cattle herding; http://www.nature.com/nature/journal/v455/n7212/full/nature07180.html).

    You then turn around and say “carbohydrates – the macro nutrient that has only been in our food chain, in any great quantity, for the blink of an eye in terms of evolution”. But people were gathering and eating grains for at least 12,000 years, and possibly as long as 22,000 years. (See: Processing of wild cereal grains in the Upper Palaeolithic revealed by starch grain analysis; http://www.nature.com/nature/journal/v430/n7000/full/nature02734.html)

    That’s several thousand years longer than people were eating dairy products, but you seem to not know, or not be troubled by this fact. Many other Paleo supporters make this same error.

    You can eat however you want, and disregard as many studies as you want. But you cannot claim that we evolved to eat dairy in 9,000 years, but not to eat grains after 12,000+ years. My problem is not with your opinion or your evidence. It’s with the way you use that evolution as the basis for your argument, when the archaeological evidence clearly refutes you.

    • avatar Zoë says:

      Hi Hazel – fair point – I should have been more accurate and said meat and eggs. I’m so used to saying “meat, eggs and dairy from grass grazing animals” in terms of what is good to eat today (for those OK with dairy, which is by no means everyone) that the dairy must have slipped in to the first bit.

      22,000 years is still the blink of an eye in evolution terms – if you accept we go back to Australopithecus Lucy c. 3.5 million years ago and many trace us back even further.

      So hopefully we can agree on meat and eggs!
      Very best wishes – Zoe

  4. This is hands down the worst published study I have ever seen, but a casual read by a non-scientist might infer that it is all scientific and statistical ‘n’ stuff. As I read beyond the headlines, I kept asking myself, “what were they thinking????” They “corrected” for satfat and also for non-satfat in their model, but didn’t include a table showing how that ended up. Why would they do this and then not show any results?
    Also, the food questionnaire was even worse than you have shown here. Participants were asked AT THE VERY BEGINNING what they ate. Like you, I have trouble remembering what I ate 6 months ago, but 10-20 years ago, I ate completely differently.

  5. avatar Jessica says:

    THANK YOU ZOE!!!! I was worried about the study, particularly as I think that I actually eat less carbs than you recommend. What these studies don’t realise is that if I eat ‘normal’ amounts of carbs, my BGs go up and I am at extreme risk of….cardio vascular disease. If I eat normal carbs, my weight goes up and I am then at risk of…..wait for it, I know this one….oh yes, cardio vascular disease.
    I’d be interested to know if The Sun ran this story, since they ran one a few weeks back highlighting someone who HAD to get all his energy from fat, not carbs. I hope they warned him by letting him know he would soon be reading a story which would inform him he was due to have a ‘slight’ heart attack risk. Or do I suppose he was completely forgotten about?

  6. Instead of “controlling for” all the “confounding” variables, I’d like to take their data and see how strongly these factors are correlated with diet. For instance:

    Are people eating a low-carb diet more likely to exercise?

    Are people eating a high-protein diet more likely to be tall?

    Are people eating a high-fat diet more likely to be highly educated?

    Then, of course, you would have to do some actual controlled studies to figure out cause vs. effect vs. correlation.

  7. I have lost trust in the medical doctors. Their reccommedations about food and medication have given me dibetes II, obisity and a stroke, just to mention a few ailments. Finally I “cracked the code” in January and I am now down 20 kg since last October. Two weeks ago I also read Owen Fonorow’s book “Practicing Medicine without a Licence?” about the discoveries of two times Nobel Prize winner Linus Pauling. I encourage you to read it and find out for yourself Who has your best interest in mind. After starting the suggested regime, suddenly my rotten body started to work after only three days! Beforehand I had dumped Lipitor and a blod thinning agent, drastically reducing my insulin use also the last 5 months. Today my bloodpressure is starting to look better also, so this weekend I will start reducing my medication for hypertension :-)
    Best of luck, regards Bjørn in Norway.

  8. avatar Catherine says:

    I can see it now! “The All-New Sucrose Diet! Backed by scientific research, eat as much sugar as you possibly can! No weighing or calorie counting! No points! Just pack in that sugar! Yes, you CAN eat as much chocolate as you like, as much cake and pastry – no limits!The diet the world’s been waiting for!” Isn’t that what they’re saying? Perhaps they should do another experiment whereby the participants really DO eat nothing but processed carbohydrate foods for 15 years. I suspect, though, that they would end up being sued!!

    Zoe, your shredding of that totally pathetic “study” was wonderful. Basically, we all stand more chance of being run over by a bus than we do of acquiring CVD from Atkins-ing or Dukan-ing.

  9. avatar Diane Smith says:

    There’s a lot of money tied up in low fat, high carb, meat, eggs and butter will kill you dogma. A huge industry of low fat, high sugar and starch foods that are being marketed to us all as ‘healthy’. Not to mention the huge diet industry and the drug industry thriving on the back of the dietary misinformation. This industry does not want the truth to come out about the benefits of a low carbohydrate diet as it would destroy their market. No wonder there are so many studies designed and manipulated to make low carb look dangerous. Sweden is a prime target for these studies as the high fat, low carb diet has become a very popular movement there and must be raising major alarm bells with the low fat, high carb dependant industries.

    This whole scenario is the most astounding real life example of the emperor’s new clothes and nutritionists like yourself Zoe, are the child crying out ‘but he is wearing nothing at all(and actually, he is looking very fat and sick)!’

  10. avatar Les Carey says:

    Hi Zoe,
    I knew you would take this latest story apart, just like the meat study back in March, you dissected so admirably (pardon the pun).
    You know the old saying “Too many cooks spoil the broth”. That’s what is happening in the field of dietary research. So many researchers around the world are carrying out these observational studies, which rely on the answers to questionnaires. Like you say, these are notoriously unreliable, as anybody knows if they have filled in a survey form of any kind. You can’t always remember the answers, or you’re too busy, so you end up ticking any old box.
    Trouble is the media jump on stories like this with attention grabbing headlines and before you know it it’s gospel. These people ought to know better.
    The result is confusion. How will we ever sort out the obesity epidemic until they are all working together and doing proper clinical studies?
    No wonder the public are confused and they end up ignoring even the good advice too. (Daily Mail & Guardian readers, this means you). We can hardly expect the Government to get the dietary guidelines right either, when they are receiving so much conflicting information. After all, they are not doctors or scientists, they can only go by the information they are given, but when they get the report, they bury the news they don’t like.
    One survey we can do is to fill in the Department for Health’s Food Labelling Consultation. It’s on their website now. I would like to see carbohydrate content listed on labels and the nutrition panels made bigger on packaging. I need a magnifying glass to read some of them. If I can’t read it, I don’t buy it, simple as that. The closing date for this is 6th August. Here’s the link:

  11. avatar jake3_14 says:

    Thanks for such a detailed and insightful analysis, Zoe.

    In the US, we’ve had to cope with a study, which in every way, showed the superiority of a low-carb diet, except that it was deliberately designed to be so short (4 weeks), that it also showed markers of detoxification, one of which, elevated CRP, were deliberately made into the headlines by the researchers. When one digs into the study data, though, the absolute CRP levels were negligible, so the researchers tortured the data with statistical manipulation and made the issue seem much more important than it was.

    How do we, as the low-carb lay public, insist on nutrition science that is worthy of the name?

  12. Of all journals to rely on RR and not address the minute absolute risk (along with the inane scoring system and 1-shot diet journal), BMJ astounds me. I also wonder why the presence/absence of diabetes was not accounted for in the final multivariate analysis.

    I trust you are publishing a response – at least online?

  13. avatar George Henderson says:

    This really does make you wonder, who is training these “scientists”?
    for people who say that epidemiology is a pseudoscience, here is more evidence.
    Epidemiology had a huge hit many decades ago with “smoking causes lung cancer” but since then this band has failed to set the charts on fire and it is time their record company pulled the plug.
    Perhaps they should take another look at what they did right on that occasion; saw the link appear repeatedly in case histories BEFORE undertaking the epidemiology; found a VERY strong correlation, TESTED it in the laboratory, discovered a MECHANISM, tested the effect of smoking-cessation INTERVENTIONS etc.
    There were giants on the earth in those days.

  14. avatar Sharon Jamieson says:

    Fantastic Zoe, as always you have have debunked these silly “studies” that come out in the press. I don’t understand how they can be so blind to the truth.

  15. avatar NM says:

    Very good article.

    I couldn’t actually believe what I was reading with regard to their scoring system. I assumed I was just a bit tired, because, obviously, I thought, it couldn’t actually be *that* useless. But no, it really is that useless.

    It’s as if the scoring system has been designed to be as ambiguous and compromised as possible! I genuinely don’t think that a GCSE Science student could get away with such rubbish.

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