Review of 2018
A year ago, a review was published called “21st century science overload“. It reported that 2009 was the year when the total number of science papers passed the 50 million mark. The same Canadian research calculated that approximately 2.5 million new scientific papers are published each year. The number of journals publishing papers has increased exponentially to approximately 30,000. With authors paying a few thousand dollars to put an article on open view, or readers paying $30-40 to read one article, academic publishing is big business.
These papers cover many fields from archaeology to zoology, but the subject area of most interest is medical and health sciences, closely followed by biological sciences. Within the field of medical and health sciences, tens, if not hundreds, of thousands of papers are published each year. The ones that rise to the top tend to be the ones that are press released by the journals. These are not necessarily the best, or the ones that advance knowledge the most; they tend to be the topics that are most likely to interest readers of printed and on-line newspapers. Anything to do with food, drink and health seems to fall into this category.
The following review of the year captures the 56 articles/topics that I have researched and written about during 2018:
What motivates people? There are only two fundamental drivers of change. Human beings move away from pain and/or towards pleasure. As people commit to New Year Resolutions, I took a look at their chance of success.
Type 2 diabetes will get worse without lifestyle change. A very interesting study from Glasgow set out to examine: (i) whether a sustainable non-surgical weight management intervention helps patients achieve a long-term 5% to 10% weight loss; (ii) whether such weight loss improves glycaemic control; and (iii) whether such weight loss reduces anti-glycaemic medication use. The title of this post captured the real finding.
Saturated fat. A short and sweet post with a slide about saturated fat that I share at conferences.
Statins for children. A paper recommended that tens of thousands of children (in the UK alone) should be on statins. I went through the vital role of cholesterol to show why I was horrified by this proposal.
Food to help you live longer. The UK Daily Mail ran a series featuring a vegan diet book. I went through the recommended daily diet to point out the nutritional deficiencies. Amusingly, a blog was subsequently posted attacking me for not pointing out that the vegan book author recommends taking (and sells) supplements. I rest my case!
LCHF & Butter. I upset a few people in the LCHF world with this post, but I stand by it. There are particular circumstances in which it’s OK to add butter to normal food, but people still battling obesity should be thinking very seriously before doing this.
Low carb diets & birth defects. I ended up having to submit a paper to the journal to ask some questions about this article. Read the post and you’ll see why.
Diet for Type 2 Diabetes (DiRECT). What evidence currently exists for putting T2D into remission? The DiRECT study (published December 2017) offered evidence for the very low calorie option. I gathered more information from the researchers about the ongoing diet that would need to be followed to continue remission.
Protein – by Kevin Handreck. An octogenarian researcher shared with me his incredible forensic on academic articles reviewing protein. He kindly allowed me to post it as a blog to help anyone researching in this area.
Diet for Type 2 Diabetes (DiRECT) Part 2. I went into more detail about the diet required to maintain remission with Type 2 Diabetes using the very low calorie approach. It turned out to be fascinating.
Low carb vs low fat. This post reviewed the much covered Gardner paper looking at a healthy low fat diet vs. healthy low carb diet. But how low in either were the diets?
Processed food & cancer. It seems incredible that it was February 2018 before a paper on processed food and cancer was published. Surely processed food should have been a subject to study for some time?
Britain needs to go on a diet says Public Health England. Public Health England (PHE) has become more and more calorie obsessed and then they went full on eating disorder by announcing that Britain needs to go on a diet.
The US Dietary Guidelines. The U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) asked for public comments on scientific questions to inform the development of the 2020-2025 Dietary Guidelines for Americans. Saturated fat was one of the nutrients for which input was requested. This open post contains my submission to the USDA and HHS.
Gary Taubes in London. I had the pleasure of attending a weekend conference where Gary Taubes was the key presenter. These were the notes I took related to his research on obesity.
The 5:2 diet and heart disease. Some media headlines on March 19th 2018 declared: “5:2 diet could cut the risk of heart disease.” I think that this may be the first time I have seen a national newspaper undertake proper journalism on a diet/health story and not simply take the press release as fact. The UK Independent newspaper led with “5:2 diet does not reduce risk of heart disease, despite study’s claims.” This post takes a look at why The Independent was right.
Carbohydrates & cardiovascular disease. This was an impressive piece of research. A team of researchers had looked at which foods correlated with cardiovascular risk using data for 158 Countries! I summarised the findings in this post.
Red meat & cancer. Every year some non-sense is published about red meat and cancer and every time it happens, I do a post rebutting it. Sadly the facts don’t stop the non-sense continuing to be published. There may be an association between processed meat (indeed processed food full stop) and cancer, but not un-processed meat, let alone pasture fed ruminants, which is what real food proponents favour.
A new 3,500 calorie formula? Professor Kevin Hall and I are both fascinated by the 3,500 formula. We share the view that the 3,500 formula is inaccurate in the extreme. Hall’s paper (examined in this post) showed that he continued to seek a formula to use instead of the 3,500 calorie formula. I don’t consider this to be possible or helpful. Anything that ‘promises’ that a specific calorie deficit sustained for a specific period of time will elicit a specific weight loss is a) a lie b) a cruel lie and c) a driver of unhelpful and unsustainable behaviour.
The diet-heart hypothesis & plant sterols. I summarised the findings from my PhD, one of which was that a fall in cholesterol levels had no impact on heart disease. In this, first of two posts, I explored why this might be the case.
Plant sterols lower cholesterol but increase the risk of heart disease. In this second of two posts on heart disease, cholesterol and plant sterols, I explained why certain foods have cholesterol lowering claims and assessed whether or not this is a good thing.
Jamie Oliver, Hugh Fearnley-Whittingstall & Childhood Obesity. Two British chefs sent a letter to the Prime Minister setting out their recommended strategy for obesity.
SACN report on saturated fat. This note (combined with the one in July) took longer than any other I have done. The UK ‘Scientific’ Advisory Committee on Nutrition was tasked with coming up with a review of saturated fat. The committee produced a 233 page report. I focused on the following: 1) the background to and remit of the panel; 2) the aspects of health under consideration (and why this is interesting); 3) saturated fats and cardiovascular disease (and why this is the only relevant factor); 4) where the panel went wrong; and 5) why the panel might have gone wrong – also known as “conflicts of interest.”
PHC conference 2018. This post presented the key points from the presentation I gave at the 2018 Public Health Collaboration conference.
High protein diets & heart failure. Dr Peter Brukner sent me this paper to review. It turned out that the researchers were trying to claim that “borderline significant” is a significant finding. It isn’t and it never will be.
The HPCSA vs. Professor Noakes: Tim wins again! Professor Tim Noakes won the original trial brought against him by the Health Professions Council of South Africa. This post was all about the fact that he won the appeal. Having had the privilege to be part of this piece of history, I have written several posts on the whole saga. To close the case, this final post looked at the judgement that had just been delivered. What did the appeal committee think were the key points to be addressed? What conclusions did the committee members make? And what did they make of a counter claim lodged by Tim’s legal team?
Scientific Advisory Committee Nutrition (SACN) Declarations of Interest. This post addressed a Q&A at a conference where I mentioned declarations of interest among the SACN committee (see the post above on SACN and saturated fat in May).
SwissRe & BMJ Nutrition Conference. This post summarised the key points made by Dr Fiona Godlee at the end of the Food for Thought nutrition conference hosted by SwissRe and the BMJ in Zurich.
Antidepressants & weight gain. A useful study quantified the gain arising from different medications and it noted differences between medications – I summarised the findings, as they will be useful to patients and doctors alike.
Saturated fat consultation (SACN) – My response. This is a copy of the full response that I sent as a submission to the SACN committee to say where I thought they had erred with their draft report on saturated fat.
The Eatwell Guide is nutritionally deficient. When the ‘Eatwell’ Plate was relaunched as the ‘Eatwell’ Guide, I did a lot of analysis on the nutritional content of the recommended intake. This post presented the findings of that analysis.
What is a healthy diet? The obvious follow-up to last week’s note is to present a diet that would deliver recommended intakes of micronutrients. This post does that.
Fewer babies with high cholesterol? This post was a review of an article in the BMJ Open entitled “Women’s pre-pregnancy lipid levels and number of children: a Norwegian prospective population-based cohort study.” Because cholesterol is needed to make babies, the article title was counter-intuitive. I took a look at it.
Cereals spike blood glucose. A small study inspired this post. The senior advisor to the study, Dr Michael Snyder, gave his view of their findings: “We saw that 80 percent of our participants spiked after eating a bowl of cornflakes and milk. Make of that what you will, but my own personal belief is it’s probably not such a great thing for everyone to be eating.”
Whole grains, CVD, cancer & mortality. A couple of supporters had emailed to ask if I would look at a particular article, so that’s what this post was about. The study is from May 2016 and it has been cited 168 times, so it has had a significant impact. The study is called “Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies” (Dagfinn Aune). It was a great article to use to illustrate the limitations of epidemiology.
Men, women & dieting. This post came from some research which reported “men are more successful than women at dieting.” This was one of the study findings. However, it was by no means the only finding and the reasons for observed differences were interesting.
Low, moderate or high carbohydrate. This was possibly the most talked about study of 2018. Seidelmann et al wrote a paper called “Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis.” It was so bad, most people trying to review it hardly knew where to start. There were several letters sent to the journal in response: mine; Nina Teicholz’s; Angela Stanton; Marc Bellemare & Amelia Finaret; and Jocelyn L Tan-Shalaby.
Keto diet, mice and diabetes. This was one of the most difficult articles of the year to unpack. I enlisted the support of biochemistry research assistant Isabella Cooper and between us we got to the bottom of some headlines that didn’t make sense.
Low carb diets could shorten life (really?) Every claim made by this study (and the media headlines) was wrong from the outset. This study did not even review low carb diets. The average carbohydrate intake of the lowest fifth of people studied was 37%. That’s a high carb diet to anyone who eats a low carb diet.
A new miracle diet pill? I took a look at the claims, the evidence, the side effects and the cost of the drug with some troubling findings.
Red meat: the evidence. In preparation for the Chris Kresser vs. Joel Kahn debate on the Joe Rogan Experience, I posted the full evidence related to red meat from the Nutrition Evidence Library, which was used by the Dietary Guidelines Advisory Committee. There turned out to be no evidence against red meat.
Food in the Canary Islands. Andy and I spent a week in the Canary Islands in September and made a detailed observation of the local diet.
Type 1 diabetes and gluten. This week’s interesting paper was genuinely attention grabbing for the simple reason that it reported an association of double. That makes causation more likely according to the Bradford Hill criteria.
Heme iron. This was a follow-up post to the red meat one – inspired by the Joe Rogan Experience debate. What is heme iron? Non-heme iron? What are the recommended intakes? Where do we find it? Is there a connection between heme iron and heart disease?
Vitamin D supplements. The headlines reported that ”Vitamin D Supplements Don’t Help Bone Health, According To Huge Study.” This didn’t appear to make sense at first sight, but it did subsequently make sense when I took a considered look at the article.
World Obesity Day. October 11th is World Obesity Day. Who started World Obesity Day? Why? What have the themes of previous days been? Will it make any difference to obesity?
Fiber: An umbrella review. What is fiber? How much do we need? What are the recommended dietary intakes for fiber? How could we consume this amount? What is the evidence for fiber?
Fiber: A plausible mechanism. IF fiber is supposed to be good for us (and see the previous post for my conclusion on this) – what is the mechanism by which it supposedly bestows benefit?
Plant based diet and diabetes. A paper was published claiming that plant based diets were better for the well-being of people with diabetes. This claim turned out to be based on one study involving 74 people, which reported: “Quality of life increased in both groups, but more in the experimental group.” That’s hardly “hold the front page”!
World Diabetes Day. This is the third World Diabetes Day note on my site. This one looked at the dietary advice for diabetics issued by the UK and the US official organisations for diabetes.
Plant-based diet or plant-biased research. The plant based diet and diabetes article was so bad that I wrote a rapid response to the journal. It was rejected, so I posted it on my site.
Diet for weight maintenance. This was my take on another much discussed study from 2018 – the Ludwig study from the NuSi funding camp. This study made an important discovery about the maintenance of weight loss. That, in a world where maintenance eludes so many people, is its significant contribution.
Where do calories go? The diet for weight maintenance post was my 400th Monday note! This week, I shared the first Monday note. It was interesting to see that the same themes were attracting my interest back in 2011.
Lowering LDL: It makes a lot of money, but no sense. This post generated more replies than any other throughout the year. Cholesterol is such a hot topic, with so many people angry at having been duped by the cholesterol hypothesis. This post makes eight points about cholesterol and lipoproteins and stresses the importance of being clear which of these is being talked about. It argues that cholesterol can’t be the issue. One lipoprotein (LDL) might be an issue (but such a belief requires an explanation) and Dr Malcolm Kendrick has closed down the possibility of LDL being the root cause.
Statins. A statin-industry funded study concluded that people should take statins regularly and at the highest dose possible. I asked a simple question while reading the paper (who is the control group?) and discovered a stunt had completely misrepresented results. The UK newspaper, the i, ran the story of my findings.
Weight gain over Christmas. The outcome of a randomised controlled trial – intended to avoid weight gain over the festive period – was published. The advice given wasn’t great and thus nor were the results.
Who knows what next year will bring? More attacks on red meat, more attacks on saturated fat and more raving about carbohydrates – of these things, I have no doubt.
Thank you so much for your support to allow me to tackle a few of the papers that need countering. We can’t let the starchy food promoting public health advisors get away with murder!
All the best – Zoë
4 thoughts on “Review of 2018”
I thought of you this morning when I read an article in the Guardian (I still usually glance at the headlines, scratching an itch) by someone called Nadja Hermann entitled “I lost 13 stone – now I know the truth about obesity.” The lady’s favourite food was a mixed salad with salmon. She thought this contained 500 calories, but my goodness, what with oily salad dressing and salmon and mozzarella, each salad really contained 1500. So by carefully counting calories to keep her intake under 1000 a day she managed to lose weight. She is basically advising people to starve themselves. To show willpower. And not to cheat. Which is what calorie-controlled diets have always done. Yet she has got a book out of this tired subject and the chance to blow her trumpet in a very long article in the Guardian. The Guardian seems to have allowed you to say a few words in May 2014, but nothing since. Poor fat people.
Many thanks for the tip off – I missed this one – sounds like a good thing that I did!
Best wishes – Zoe
Regarding article on Heme iron:
Is there a relationship between nutritional iron and the ability to give blood?
I haven’t had my iron levels explicitly tested. But I pass the test for giving blood.
Presumably passing the test (men: 135 grams / litre of haemoglobin) indicates something good.
But I’m not sure precisely what all the relationships are.
Can I simply safely assume my nutritional (etc) iron is OK, or might I need a separate test?
The blood donation services says “Choose foods rich in iron such as:
pulses and beans; nuts; wholemeal grains (brown rice, pasta and bread); leafy green vegetables like curly kale, broccoli and spinach; lean red meats, fish, turkey and chicken”.
That sounds as thought it is based on conventional flawed advice, not what I can rely on.
This was an interesting one as my hubby has his gold donations blood badge (over 50 donations!) The normal haemoglobin levels are 135 to 180 g/l for a man. Your helpful sharing of the test marker (135g/l) suggests that they set the bar quite low at the bottom end of normal – not a bad idea as they always need blood. Passing the test confirms that you’re in the normal range and not anaemic. Probably not a surprise with your diet!
That advice is shocking – it should start with red meat/offal, as the best source of the most absorbable (heme) iron. This promotion of far less nutritious whole grains and legumes, at the expense of the really nutritious foods, continues to be shockingly ignorant and consistent.
Happy New Year!
Best wishes – Zoe