Henry Blackburn on Ancel Keys
I'm going to make an exception to the general rule here of not blogging on articles in the media. This is an important read and I don't want those who don't interact with me on social media to miss this.
Long time colleague of Ancel Keys, or A. Ben as I have nicknamed him (affectionately!) here, Henry Blackburn has apparently had enough of the Big Fat Smear Campaign masquerading about as "science journalism".
In defense of U research: The Ancel Keys legacy
The renowned scientist has become the target of a high-fat “smear” campaign. |
It begins:
(The article Blackburn is referring to is here: Chocolate milk in the schools and other products of expert opinion)
Recently, a number of writers identifying themselves as “health-science journalists” have been calling on Americans to “end the war on fat” as they promote a high-fat, low-carbohydrate diet (“Chocolate milk in the schools and other products of expert opinion,” June 22). What’s puzzling is that they draw attention to their arguments by using personal attacks on one of Minnesota’s premier scientists, Ancel Keys.
Keys was a University of Minnesota physiologist who spent most of his career conducting wide-ranging studies on the relationship of lifestyle — especially the foods we eat — to heart disease. He worked at the university from the late 1930s until his death at age 100 in 2004, and he carried out classic experiments of diet effects on blood-cholesterol levels in the laboratory and of diet associations with heart attacks among cultures with contrasting traditional eating patterns. “Contrasting” is the operative word here. ...Read on. It ends with:
In addition to finding — and exploiting for profit — a common villain in Keys, these writers use a number of devices to promote what Nina Teicholz, author of “The Big Fat Surprise,” advocates as a return to “tallow and lard.” Innuendo, distortions and accusations may be good for media attention and book sales, but they can do real damage — not only to the reputation of a pioneering researcher, but to public understanding of the scientific method and the evolving science of nutrition. It’s time to end the war on Ancel Keys.Teicholz tweeted recently that she will be correcting errors in her book for the paperback version. She even tweeted that she has read the "gratuitously mean spirited" critiques by Seth and myself and that she believes some fair points have been made. While I doubt she'll do much to correct her many transgressions as this would effectively gut her book, I do hope she'll reconsider her smears of Keys in future interviews and perhaps any newer editions of her book.
(The article Blackburn is referring to is here: Chocolate milk in the schools and other products of expert opinion)
Comments
You must realise that scientific research was much less specialised 50 years ago than it is now. That's is why many old papers are easier for a layperson to read.
Modern researchers are only writing papers for colleagues who work in the same extremely narrow and highly specialised research field. Outsiders are literally incapable of understanding their work properly.
It's funny because back then scientists were trained in science and they weren't necessarily supposed to be great communicators -- and yet they were. Nowadays a science education includes more and more "core" how to be a conscientious citizen of the world with an appreciation for the poetry of outer upper Podunk, and yet fewer and fewer are capable of communicating their message.
various food trends have both produced strong evidence suggesting that
(a) an increased intake of heat treated animal protein and (b), in some
countries, a decreased intake of vegetable protein, may both have played
an important part in causing the present increase in the incidence of
atherosclerosis."
See http://www.abc.net.au/catalyst/heartofthematter/download/Yudkinssugartheory.pdf
"...putting down all the information available from international statistics, I found that...the best relationship of all existed between the rise in the number of reported coronary deaths in the UK and the rise in the number of radio and television sets." [John Yudkin. Pure, White and Deadly (1972) Penguin; p.86]
Then, affluence → eating more meat, poultry, fish, eggs, cheese, fat, sugar etc. More cars, radios & TV meant moving less. CHD is multi-factorial. No single factor causes it.
Now, poverty → eating more heavily-subsidised crap-in-a-bag/box/bottle, instead of produce.
Whatever the recommendations, the food industry will always use them as an opportunity to increase profits.
Look at all of the low-carb crap-in-a-bag/box/bottle that was about, when the Atkins diet was all the rage.
But as the cheerleaders outnumber the critics, you should expect to be bashed here if you bash señor Keys for any lack of empirical rigor [speaking as an occaisional Keys-basher myself--at least with regard to the suspect campaign to demonize dairy fat--although I am in accord with his fondness for pasta & garlic & tomatoes & basil & red wine...]
CAD is a multivariate disease. Just because Keys did not foresee the current obesity epidemic, which also has multiple contributing factors, doesn't mean Keys was on the wrong track.
Since when do we expect pioneers to break ground AND solve the complete puzzle?
LUSTIG: Keys won the battle. Yudkin was thrown under the bus. And …
NARRATOR: In what way was he thrown under the bus?
LUSTIG: Well, he was discredited by numerous societies basically saying that he did not have the data to make his claims about the importance of sugar.
What's the matter with this science thing, having to have DATA! Sheesh!!!
The food industry has been manipulating the masses for yonks. People didn't buy the crap because they thought it was healthy - the food industry health-washed the crap.
Also: The plural of anecdote is not data.
Nobody is arguing that there is no connection between T2D and CHD. You are making strawman arguments.
In a later review, Keys again addressed Yudkin’s claims regarding sugar intake and coronary heart disease in international comparisons:4
In regard to international comparisons, there are countries with a high per capita consumption of sugar and of saturated fats; those countries tend to have high CHD death rates. And there are countries with low per capita sugar and saturated fat intakes; these have low CHD rates. When all these countries are put together, statistical calculation naturally shows CHD mortality is correlated with both sugar and fat intake. However, partial correlation analysis shows that when sugar is held constant, CHD is highly correlated with per capita saturated fats in the diet but when fat is constant there is no significant correlation between sugar in the diet and the CHD incidence rate. It should be noted, too, that Yudkin carefully avoids mentioning the fact that 2 countries with the highest per capita sugar consumption, Cuba and Venezuela, suffer low CHD mortality; it is notable that the dietary intake of estimated fats is low in both Cuba and Venezuela.
Another flaw in Yudkin’s hypothesis about sugar and coronary heart disease that Plant Positive addressed was the contradictory evidence from animal experiments of atherosclerosis. When diets rich in dietary cholesterol and saturated fat, such as egg yolks are used to induce atherosclerosis in non-human primates, the atherosclerosis process has actually been reversed when these atherogenic components are replaced with chow very rich in sugar.5 6 This does not suggest that sugar should be considered a heart healthy food, but does emphasize the fact that sugar alone cannot induce atherosclerosis in the absence of dietary cholesterol and elevated blood cholesterol, and therefore cannot not explain the coronary heart disease epidemic.
http://healthylongevity.blogspot.com/2012/12/plant-positive-strikes-back-nutrition.html?m=1
References:
4. Coronary heart disease--the global picture.
Ancel Keys
http://www.ncbi.nlm.nih.gov/m/pubmed/1103902/
5. Evidence of regression of atherosclerosis in primates and man
Mark L. Armstrong
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2496395/
6. The dietary prevention of coronary heart disease: dietary cholesterol and fat.
W. E. Connor
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2425963/
I gotta get me a copy of Michael Moss's Sugar, Salt, Fat from the library.
Someone on here put a link to it in their comment.
http://canceranddiet.nl/cardiovascular_disease/dietary-fat.html
http://canceranddiet.nl/cardiovascular_disease/saturated-fat.html
http://canceranddiet.nl/cardiovascular_disease/randomized-saturated-polyunsaturated-fat.html
haven't had red meat in two decades and incorrectly think their risk of
heart disease is very low because they've been led to believe that
saturated fat is the cause of heart disease'
I read this sentence twice and wondered where the sense of it lies.
'Plenty' (how many)
'haven't had red meat in two decades' (how many? where is this stated?)
'incorrectly think their risk of heart disease is very low' (your opinion? you're their doctor?)
'they've been led to believe that saturated fat is the cause of heart disease') 'Because they've been led to believe that saturated fat...'
Was that last an if-then statement? If so, what's the if part of it?
Plenty of people are walking around right now with nice bellies....because they have been led to believe that saturated fat...'
They haven't had read meat in two decades .... because they have been led to believe that saturated fat...'
'They incorrectly think their risk of heart disease is very low.. because they've been led to believe that saturated fat...'
I think that you mean to say that at two of the above statements are true (they might be, or not). But the fat bellies part leads me to ask again, how many people are there and are you really their doctor?
I'm guessing you're quite successful in your very very large medical practice.
Unless I'm thoroughly confused.
The Big Fat Surprise: Why Butter, Meat & Cheese Belong in a Healthy Diet Since he cites only my book (albeit at the end), one could assume that these accusations are directed at my work. He calls portrayals of Keys' dietary work "false and misleading." This is untrue. 1. That Keys rejected hundreds of dietary surveys can easily be seen in his reported, published numbers (Kromhout et. al, American Journal of Clinical Nutrition, 1989, 49, page 891--this is the most detailed analysis of diet for the Seven Countries Study). And 2. I write that one of the three dietary surveys on Crete was conducted during Lent, not all of them. Other matters: I describe the reasons for the selection of countries in the same way that Blackburn does (I merely add that none of the 7 countries challenged the diet-heart hypothesis and therefore could be seen as an example of selection bias). I also identify his study conclusion in the same way (that low animal fat consumption was linked to lower risk of heart attacks) However, I add that this association did not hold up in follow-up analyses and also that it was only an association that did not prove causation. I never imply that Keys alone was responsible for the endurance of this hypothesis (I describe at length how his idea was institutionalized). My point is that Keys launched this hypothesis in 1961; after that, many other actors were involved in the following 50+ years.
Here's the study she mentioned
http://ajcn.nutrition.org/content/49/5/889.full.pdf+html
Food consumption patterns in the 1960's in seven countries
Read and decide if NT is right.
Opportunism by the food industry was rampant then as it is now. Anyone who doesn't think the meat/dairy/egg boards are behind the current sugar causes heart disease, not saturated fat media blitz is naïve. Throw in Atkins, too, while you're at it.
Follow the money.
SO - what causes insulin resistance? What causes metabolic syndrome? Does saturated fat consumption have any effect on these? Why would they cause heart disease?
"Here's a page or so (p163-4) from John Yudkin's book "Pure White and Deadly", 1972 edition. Yudkin begins the chapter with an apology for talking about such uncomfortable disagreements in public. But he liked the truth.
This quote covers opinion from Prof John Yudkin and Dr Meyer Friedman. You can hear their dislike of Keys. Keys was the architect of what has become the current world obesity epidemic and never one to let the truth get in the way of a good idea, as with his six nations "fat causes heart disease" study. Unfortunately Meyer's listof those easily misleddid not include gullible politicians who set food policy. Keys was a very successful politico, with intense conviction of his own correctness. Fine if he had been right, which he
wasn't.
Yudkin begins:
I have already mentioned Dr Ancel Keys and his pioneer work in relation to diet and heart disease. A year or so ago he wrote a memorandum which he sent to a large number of scientists working in this field and which with very few changes has now been published in a medical journal 'Atherosclerosis'. It consists entirely of a strong criticism - I nearly said virulent criticism - of the work I have published from time to time on the theory that sugar is the main dietary factor involved in causing heart disease.
The publication contains a number of quite incorrect and unjustified statements; for instance; that we had never tested our method for measuring sugar intake; that no one eats the amounts of sugar that we and others have used in our experiments; that it was absurd of me in 1957 to use intemational statistics of 41 countries as evidence for the
relationship between sugar and heart disease (exactly the same statistics that Dr Keys had previously used for only 6 selected countries to show the relationship between fat and heart disease).
He ends by triumphantly pointing out that both sugar and fat intakes are related to heart disease, but that the cause must be fat, not sugar, because he had just found in 1970 that fat intake and sugar intake are themselves closely linked. You will remember my own discussion of this link in Chapter 5, based on the fact that, as far back as 1964, I had shown this relationship to exist between fat intake and sugar intake. Let me thereforequote from a recently published book Pathogenesis Of Coronary Artery Disease written by Dr Meyer Friedman, another distinguished worker in this field:
"It is sad, for example, to observe that essentially honourable investigators omit published data (including some of their own data obtained earlier) which refute or call into question their contemporary data and the interpretations they have made of them. It is even sadder to observe how these same observers eagerly and indiscriminately collect studies (no matter how poorly or incompletely performed) supporting their respective hypotheses but peruse with the most "nit-picking" and distrustfuI eye other studies which tend to subvert the interpretive verity of their own. But this is not really a very important cause of our present confusion because only a few investigators indulge in these practices and their foibles are quite well known to their scientific peers. They essentially succeed in
misleading only themselves and those physicians and laymen who can not be expected to know of the self-imposed enslavement of these investigators to their respective concepts"
Hmm, Friedman on Keys sounds like Ravnskov on Keys' modern followers.
Plus ça change (plus c'est la même chose)
Peter"
I don't disagree that people without T2D genetics, tobacco use, hypertension, or familial hyperlipidemia are at low risk (not no risk) for CHD. That's not a controversial point and yes, they are not statistically likely to benefit from sat fat restriction (or carb restriction for that matter). OTOH, the genetics for T2D are very widely spread, ranging from 1 in 3 to 1 in 2 by population and there is yet no screening test.
No one is making the claim that sat fat causes diabetes or obesity.
"Seventy-one foods from the United States were examined (23); a
positive association was found between the amount of fat and the ratio
of zinc to copper (P < 0.001)."
In other words, the problem with fat is that foods high in fat are low in copper. This is well supported by data and therefore not bullshit.
One of Charles Grashow's many interesting finds tells us that "Yudkin, who carried out an epidemiological survey for the year 1952
involving 15 countries, recorded that animal protein gave at least as
good a correlation [with atherosclerosis] as both animal and total fat."
So meat and dairy are both implicated in cardiovascular disease. Both have a high zinc-copper ratio. I expect you know that zinc and copper antagonise one another. Klevay found that a high zinc-copper ratio caused hypercholesterolemia and cardiovascular disease in lab animals.
If you have other problems with Klevay's work, please say so. I have never come across any criticisms of it, and Stephan Guyenet says this about it.
http://wholehealthsource.blogspot.co.uk/2010/04/copper-and-cardiovascular-disease.html
If your problem is with phytic acid, here's what Don Matesz says.
http://donmatesz.blogspot.co.uk/2011/10/phytate-facts.html
Foods high in fat are low in a lot of things. Carbs just for example... Trying to deduce whatever causal association out of that is BS so long as you can't describe a plausible pathomechanism. This IS POSSIBLE for fat, or to be more precise for saturated fatty acids, or to be EVEN MORE pricise, especially for myristic acid.
It is at the same time not possible to prove any cardiovascular consequences of a lack of copper. If anything the opposite is true!
http://aje.oxfordjournals.org/content/151/12/1182
Considering the antagonistic and competitive uptake relationship between copper and zinc. What are your thoughts on this extreme plant-based diets where copper is known to quite effectively upstage zinc in the nutrition supply department. Are there any problems associated with the *other* side of this balance?
Also, as I understand it, organ meats actually have a very high copper to iron and zinc ratio, higher than most plant-options, granted, we're dealing with non-haem iron, but high copper nonetheless.
Leslie M. Klevay, M.D., S.D. in Hyg.
Am J Clin Nutr July 1975 vol. 28 no. 7 764-774
"The ratio of zinc to copper has been associated with the risk of coronary heart disease. Because this association with risk is closer
than for any other agent EXCEPT, PERHAPS, CHOLESTEROL, the ratio of zinc to copper may be the preponderant factor in the etiology of coronary heart disease."
SO - it still comes back to cholesterol!
Evelyn, among others, does so regularly. On the internet. Right here at this website. Alas, I'm not able to include your own recent contributions in this category.
Jumping to conclusions [see above] can later prove to have been unwise. [LEAPING to them can't be any better].
So every internet crank's argument needs to be addressed de novo?
This guy just uses a hodge-podge of data. He doesn't explain his methods and there's no peer-review so no one else has looked at his work to even determine whether he made an arithmetic error. He doesn't say how he corrected for data quality between countries, life expectancies or confounding factors (cigarette consumption, HIV burden, poverty, parasite burden, etc.). In fact, he doesn't give us any idea about his statistical methods at all. He just stirs together a bunch of estimates that are wildly different in their quality and says "my data set was bigger, so I win." Why should anyone take that seriously? This is UN diplomat with a money problem level of work.
You are of course entitled to your opinions.
But do not be upset if they don't happen to carry universal weight.
Obesity researchers everywhere! Drop everything and address the claims from supplement salesman Mark Sisson who tells us weight gain is "all about insulin".
Of course it's possible to prove cardiovascular consequences of copper deficiency. You just look at the heart and arteries of copper deficient rats. What's the problem?
There is indeed a 'plausible pathomechanism', and I can describe it to you if you like. I don't mind if you call it bullshit.
Your "interpretation" of data and publications can be called different than whishful thinking at best. You are making a fool of yourself by such a margin that it's not even funny anymore.
atherogenesis or is a marker of inflammation associated with atherosclerosis remains to be established.'
They call it a 'marker' of inflammation. They may not realise it's there for a purpose: copper gets released into the blood during inflammation because it's needed for tissue repair.
"Digging out all the information he needs to exonerate whole grains and legumes takes a lifetime. I know, I’ve spent a lifetime (well, 30 years) doing it.
Regards
Jane Karlsson PhD
Oxford, UK "
Are you open to the possibility that someone could end up with a zinc deficiency? Accepting the idea that most are able to excrete excess copper, that might still create the odd exception where zinc balance is lost.
This is how Colpo began his post.
'Recently, I received an
email from one Jane Karlsson, PhD, vigorously asserting that whole
grains were wonderfully healthy foods that could immensely benefit
humankind.'
This is not true. I said nothing of the kind. There wasn't anything I could do, because he had blocked all further emails from me and doesn't allow comments. I just had to hope people would read the conversation and see I hadn't said it. I suspect they didn't, because it was very long and very boring. So all they know about me is that I said something rather silly about whole grains. Colpo is very clever.
This isn't about you or me, this thread is about Ancel Keys and the people who criticize him. You think that this particular "study" is "fantastic". Why? I think it is "nonsense" and I stated why. Poor quality raw data (the WHO criticizes its own data), massaged with unknown statistical methods, and no attention to possible confounders does not produce useful information. Can you explain to me what you see in this study that causes it to rise to the level of "fantastic"?
Stella--we are closer than you think: I also remember that New Yorker cartoon. [fantastic, wasn't it?!!]
"Ancel Keys Had A Tiny One"
http://www.fathead-movie.com/index.php/2014/07/22/ancel-keys-had-a-tiny-one/
Tom's such a comedian!
"It turns out before Keys arrived on Crete he had been preceded by another epidemiologist, named Leland G. Allbaugh, who was employed by the Rockefeller Foundation in New York to improve its understanding of "underdevelopment." Crete was selected for its pre-industrialized economy, which had suffered gravely during the war. Allbaugh, seeking to understand the human toll of these recent hardships, conducted a thorough study of the Cretan diet, and like Keys, found that their fare "consisted chiefly of foods of vegetable origin, with cereals, vegetables, fruits, and olive oil predominating," with only "small amounts" of meat, fish, and eggs. Yet far from adoring this perfect example of the Mediterranean Diet, Allbaugh reveals a startling reality: the Cretans were openly miserable with their daily fare. "We are hungry most of the time," said one. When asked how their diet could be improved, "Meat alone or with cereal was mentioned as a 'favorite food' by 72% of the families questioned." They had evidently eaten more meat before the war and were now suffering without it."
Question - how much meat had they eaten before the war? NT offers no documentation to prove her statement.
If you keep labouring a point, you'll either be ignored, or written-off as a crank. Just trying to be helpful.
Cardiovascular Disease from Copper Deficiency—A History
Leslie M. Klevay
J. Nutr.
February 1, 2000vol. 130 no. 2 489S-492S
"The copper deficiency theory on the etiology and pathophysiology of ischemic heart disease has been developed in a series of papers over two decades; the most important or recent include Klevay 1990a, 1990b, 1998 and 2000). The theory has evolved, has been modified and has attempted to incorporate newer concepts and findings such as aspirin, beer, homocysteine, iron overload and oxidative damage. It is offered as the simplest and most general explanation of ischemic heart disease, the leading cause of death in the industrialized world."
http://www.freewebs.com/stopped_our_statins/IHD-%20Deficiency%20Disease.pdf
SCHEMIC HEART DISEASE AS DEFICIENCY DISEASE
"The concept that ischemic heart disease is a disease of intoxication is tenable no longer. Too much negative data have accumulated, only some of which are mentioned here. Also excessive amounts of the wrong type of fat cannot explain newer facts about heart disease risk such as fetal programming or the effect of low paraoxonase. Just as cholesterol was an important focus for heart disease as
intoxication, homocysteine can become an excellent focus for a paradigm shift to heart disease as deficiency because supplementation with several nutrients can alter homocysteine metabolism, decrease its plasmaconcentration and, presumably, decrease risk."
'Statins normalize vascular lysyl oxidase down-regulation induced by proatherogenic risk factors'
http://www.ncbi.nlm.nih.gov/pubmed/19406911
Just type the following keyboard characters:-
semi-colon, hyphen, close parenthesis
It should look like this:-
;-)
Or are you joking again? I can't tell!
OK, I did it. It looks really boring. I don't think I'll use it much.
I can't discern "tone" from text on a screen. Can you?
Or were you bluffing? I never know.
Anyway, I've got some "nuts" that need "roasting".
Evelyn know what this means :-D
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