Studies to give your doctor

Fresh research showing no link between increased saturated fat (particularly animal fat) and cardiovascular disease:
(published 27.9.2016)

http://www.foodandnutritionresearch.net/index.php/fnr/article/view/31694

ORIGINAL ARTICLE

FOOD CONSUMPTION AND THE ACTUAL STATISTICS OF CARDIOVASCULAR DISEASES: AN EPIDEMIOLOGICAL COMPARISON OF 42 EUROPEAN COUNTRIES

Pavel Grasgruber*, Martin Sebera, Eduard Hrazdira, Sylva Hrebickova and Jan Cacek

Faculty of Sports Studies, Masaryk University, Brno, Czech Republic

ABSTRACT

Background: The aim of this ecological study was to identify the main nutritional factors related to the prevalence of cardiovascular diseases (CVDs) in Europe, based on a comparison of international statistics.

Design: The mean consumption of 62 food items from the FAOSTAT database (1993–2008) was compared with the actual statistics of five CVD indicators in 42 European countries. Several other exogenous factors (health expenditure, smoking, body mass index) and the historical stability of results were also examined.

Results: We found exceptionally strong relationships between some of the examined factors, the highest being a correlation between raised cholesterol in men and the combined consumption of animal fat and animal protein (r=0.92, p<0.001). The most significant dietary correlate of low CVD risk was high total fat and animal protein consumption. Additional statistical analyses further highlighted citrus fruits, high-fat dairy (cheese) and tree nuts. Among other non-dietary factors, health expenditure showed by far the highest correlation coefficients. The major correlate of high CVD risk was the proportion of energy from carbohydrates and alcohol, or from potato and cereal carbohydrates. Similar patterns were observed between food consumption and CVD statistics from the period 1980–2000, which shows that these relationships are stable over time. However, we found striking discrepancies in men’s CVD statistics from 1980 and 1990, which can probably explain the origin of the ‘saturated fat hypothesis’ that influenced public health policies in the following decades.

Conclusion: Our results do not support the association between CVDs and saturated fat, which is still contained in official dietary guidelines. Instead, they agree with data accumulated from recent studies that link CVD risk with the high glycaemic index/load of carbohydrate-based diets. In the absence of any scientific evidence connecting saturated fat with CVDs, these findings show that current dietary recommendations regarding CVDs should be seriously reconsidered.

Keywords: prevention; BMI; smoking; food consumption

Citation: Food & Nutrition Research 2016, 60: 31694 - http://dx.doi.org/10.3402/fnr.v60.31694
Copyright: 2016 Pavel Grasgruber et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.
Received: 22 March 2016; Revised: 12 July 2016; Accepted: 9 August 2016; Published: 27 September 2016
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Jefferson said:
Fresh research showing no link between increased saturated fat (particularly animal fat) and cardiovascular disease:
(published 27.9.2016)

http://www.foodandnutritionresearch.net/index.php/fnr/article/view/31694
Click to expand...

Great find Jefferson! I haven't gone through it in detail but it looks to be an excellent and very large study with p values less than .001 - I have some good uses for this data.
 
This last epidemiological study mentioned by Jefferson is a good one I agree due to the sheer size of it.
When wanting to have a conversation about Evidenced Based Medicine with a doctor it is worth knowing abit about "hierarchy of evidence".
Small studies are often considered exploratory, so if there are only eight people being monitored your doctor is not likely to take it seriously.

Large randomised controlled trials or large epidemiological studies are high up on the evidence list. Large being number (n) of participants in the thousands.
Smaller studies contribute to "evidence" when the results are pooled together with other similar studies in a "systematic review" which has a "meta-analysis" of the results. This will rate highly in the evidence hierarchy. The Cochrane database of systematic reviews is a good resource. In New Zealand the government pays for all citizens to access the Cochrane database but I do not know what the situation is in other countries. (Incidently the Cochrane SR's on the flu vaccine in older adults and another SR for young children are good ones to have on hand to show your GP. They conclude that flu vaccine safety is unknown and also there is no evidence for it's effectiveness)

Worth mentioning however that much has also been written about the limitations of large studies that tend to predominantly generalise and categorise the participants creating wash out effects. The idiosynchrises of individuals is lost.

Here is a link to a pubmed article about levels of evidence, for anyone who is interested.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124652/
 
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