Talk:Saturated fat and cardiovascular disease/Archive 1

Initial comments

I think more detailed information regarding how the various health organizations arrived at their conclusions would be helpful. I haven't dug too far but for the American Heart Association I found Summary of the Scientific Conference on Dietary Fatty Acids and Cardiovascular Health from the year 2000 which seems to rely on Dietary Fat Intake and the Risk of Coronary Heart Disease in Women from November 1997. Are there more recent summaries laying out the thinking and science behind their advice? The studies forming the basis for their recommendations should be clarified.

I also see reference to the Framingham Heart Study and William Castelli in some of my searches. What studies or papers in particular from it are important. Also the classic studies by Ancel Keys (Seven Countries Study) and D. Mark Hegsted seem play a role as does the Nurses' Health Study and the Lyon Diet Heart Study (Mediterranean diet).

Among other names Walter Willett of the Harvard School of Public Health along with Frank Hu, Dariush Mozzafarian, George Blackburn, David Kritchevsky of the Wistar Institute, Jeremiah Stamler, Martijn Katan, Linda Van Horn, Alice Lichtenstein, Scott Grundy, Ronald Arky, KC Hayes, turn up. Any others?

Robert Atkins of Atkins Diet fame
Nathan Pritikin of Pritikin Diet fame
Dean Ornish
Uffe Ravnskov – The Cholesterol Myths
Michael Pollan writer of The Omnivore's Dilemma and In Defense of Food

Lambanog (talk) 10:55, 11 March 2011 (UTC)

It would be great to go through their citations and harvest all the systematic reviews and meta-analyses for the leading part of this page. I get frustrated by searching e.g. Web of Science and missing useful references because I've not used the right keywords. But building a citation map for each one and speculating about the relative weight of each of their references in the determination of their views sounds like WP:SYNTH. They have the privilege of WP:SYNTH but we do not. And juxtaposing primary sources with secondary sources to refute the secondary sources is just plain contradictory to WP:MEDRS. Eastsidehastings (talk) —Preceding undated comment added 16:17, 11 March 2011 (UTC).

Although it could be attempted, I don't think it is necessary to find or evaluate everything in text discussion. But I do think it would be very good if the most significant studies are available in the reference or further reading section so that anyone coming to this article can quickly evaluate the most pertinent material. Meta-analyses are the preferred source and I don't think giving a free pass to the various health associations based on their say so is satisfactory given the history. If nothing substantial can be found from the WHO since 2003 for example then that might be of interest to a person willing to dig a little into this subject. I believe in putting it all out there for the reader to make up their own mind on this issue.

That's another thing: should background information dealing with the trans fats merry-go-round be included? Or a history of how saturated fats became the enemy? Or how the preferred indicator has progressed from total cholesterol to LDL/HDL to ApoA/ApoB? Why the lipid hypothesis is the preferred explanation and why other potential theories are not in favor such as the link to bacteria? It would put the "scientific consensus" on this issue in context and support why this is an topic worth its own article. Lambanog (talk) 17:14, 11 March 2011 (UTC)

I, for one, would like to see as much of the top-grade evidence here as possible, and reduce the lower-grade material. But to be able to voice that material without it making the main Saturated fat page ridiculously cumbersome or having immediate reversions is a big part of why this page exists - there is plenty of history of editors wanting to include references to this particular primary study or that particular tertiary book. Putting all that material in order of precedence should help form the correct statement for the Saturated fat page.

I don't hold with Taubes' narrative assassination style at all. Either the best evidence (systematic review/meta-analysis) paints a picture or it doesn't. Either the medical authorities make statements consistent with that evidence or they don't. The reader should be able to look at each reference in order of importance and make up their own mind. The Saturated fat editor can find the right material to express the secondary source mainstream view. Trying to unpick a narrative of who thought what when makes for a good yarn, but it adds nothing at all to the quality or weight of evidence. The valuable victory that Taubes achieved was to prompt more careful analysis of replacement nutrients, and that analysis is now visible in the best evidence.

I've tried to avoid dealing with trans fat (call it X) or dietary cholesterol (call it Y) because they confound the question of whether or not saturated fat (call it A) contributes to CVD (call it C). Similarly, while there are many references on saturated fat (A) vs serum lipid profiles (call it B), and many references discussing serum lipid profiles (B) vs CVD (C), the references which directly discuss saturated fat vs CVD are much farther between. The Lipid hypothesis has its own page already; here I've tried to find A vs C sources without having to talk about A vs B and B vs C. Not that the discussion isn't pertinent, it's just an order of magnitude bigger to deal with. So, no, I'm not tempted to expand to X vs C, or Y vs C, or which bits of B are really important. I still feel a long way from the bottom of having found all the best sources on A vs C directly.

Eastsidehastings (talk) 22:08, 11 March 2011 (UTC)

All right, I'll try not to sidetrack the article from your aim then—at least until you're satisfied with the sources By the way are you approaching this from a professional or layman's perspective? Lambanog (talk) 22:17, 11 March 2011 (UTC)

I'd absolutely like the articles to read well for the lay audience. If you'd asked me 6 months ago, I'd have thought the keyword "Meta-Analysis" was code for "Don't Have Budget for Real Research". But I've been schooled. Some. Eastsidehastings (talk) 08:34, 12 March 2011 (UTC)

I'd like a clear layman-friendly article too but coming up with the correct format for logical exposition is one of the things that will need to be addressed. Don't know if this arrangement by quality of source is going to end up working but am willing to see it develop. Changes can be implemented later after there are sufficient sources for you. I might add some studies comparing low fat and low carbohydrate diets even though they are somewhat tangential because they present a stark contrast and upset the conventional wisdom. Lambanog (talk) 08:57, 12 March 2011 (UTC)

POV fork & fringe theories

I'm concerned that this is an improper WP:POVFORK as well as giving undue weight to WP:FRINGE theories. I've started a discussion at FTN to get some help. There's a lot that could possibly be done with this article, as Lambanog mentions above and Itsmejudith has already done at FTN. However, best to find sources first and see what can be done with them rather than hunting for sources with a certain pov. --Ronz (talk) 04:50, 12 March 2011 (UTC) Wikipedia:Fringe_theories/Noticeboard#Saturated_fat_and_cardiovascular_disease_controversy

After browsing the sources, I wonder why this article is called "controversy"? The only part that seems to indicate that saturated fat might not be unhealthy is the introduction, and that sounds more like "conspiracy" than "controversy". Ketil (talk) 10:48, 30 September 2011 (UTC)

I agree. The only citations in the article that oppose the idea that sat fat is bad for you are supported by dairy and meat interests. (I guess the tropical oils folks are underfunded or asleep.) If this was a truly controversial subject among scientists (as opposed to pop science and pop nutrition writers) 20 or 40 years ago, then there should be a History section describing the controversy. Otherwise the word Controversy should be dropped from the name of the article.-- Solo Owl 02:43, 19 August 2013 (UTC) — Preceding unsigned comment added by Eall Ân Ûle (talk • contribs)

"after browsing the sources?" after living with the sources in the introduction and the table for several years, and reading those studies and their accessible references, and reading the early history of the controversy (e.g. Boyd, Mann, Yudkin, Stehbens in the 50s-70s as well as the lipidology literature etc) it is obvious that 1) non-funded scientists come to the same results as funded ones, with the exception of the AHA, who picked out only 4 studies, giving us a less rigorous analysis than the others, 2) there has always been, and continues to be, a controversy in the peer-reviewed scientific literature on this question across many fields, and most of it has no industry funding, 3) it is in the interests of the beef and dairy lobby to promote fat-free and lean value-added products, then sell the cream and butter to bakers, so their position on saturated fat itself is conflicted, 4) if scientists had found an unequivocal association between increased SFAs and increased CVD risk by 2009 it would not have been necessary to begin modelling the substitution of other foods and nutrients, which is of questionable validity to whether "more" of a specific thing is harmful, 5) there are several different classes of disease called CVDs, with different aetiologies, which this page does not consider at all.

I wish to submit that persons whose knowledge of the topic is limited to "browsing the sources" for any conflicts of interest that might differ from their own should not be editing pages on technical and historical topics with an extensive literature spanning decades. This page is a mess, and reading this talk has helped me to understand why that is.49.227.224.22 (talk) 00:10, 6 September 2019 (UTC)

National government recommendations - secondary or tertiary sources?

Is anyone certain about the right relative weight? WP:MEDRS doesn't quite cover the situation. They're reputable, and mainstream presumably, but are they authoritative in their own right? I've avoided them to date, but there's plenty of nice clear statements from a multitude of national governments, which could really help improve readability on this topic. Eastsidehastings (talk) 08:22, 12 March 2011 (UTC)

I included the section for more completeness but the advice seems like a direct copy of those given by the heart associations and in truth is redundant. Worse is that the recommendations seem out-of-date and biased. Both the government and heart association advice seem to stress how saturated fats raise total cholesterol and LDL, problem is that total cholesterol as a risk indicator is inferior and maybe even unreliable, and while saturated fats raise LDL they also raise HDL by a larger proportion with the end result of improving the LDL/HDL ratio which is considered a reliable risk measure. The silence on the beneficial influence of saturated fats on HDL that gets no mention in the discussion seems like willful blindness. If one is cynical one can also note that the US Department of Agriculture is a party to the US dietary guidelines and speculate on the possibility of conflict of interest or undue influence from vested interests from the U.S. agricultural sector. If you feel the U.S. dietary recommendations should be removed I wouldn't mind, even if I was the one to add it. Lambanog (talk) 08:48, 12 March 2011 (UTC)

Saturated fat improves the LDL/HDL ratio? My impression has been that the (I agree, willful) silence on the raised HDL from Saturated fat is because it raises LDL more, thus worsening, not improving the LDL/HDL ratio. But ah, how easy it is to devolve into speculation on mechanism when there should be direct "black box" evidence. (Is there a need for a "Saturated fat and dyslipidemia" section/article?) On the government bias side, if anyone has a vested interest, it's the Kiwis. They've got an economy built on fatty meat and dairy products, but their government still recommends reducing saturated fat content. But none of this helps us figure out what the right weight is... I'm itching to include the government material because it's so clearly-stated, but I don't know if it's appropriate. Eastsidehastings (talk) 09:02, 12 March 2011 (UTC)

From the studies I've seen saturated fats tend to raise all cholesterol levels, and HDL disproportionately so, leading to a more healthy LDL/HDL ratio. See: Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet and Comparative Study of Coconut Oil, Soybean Oil, and Hydrogenated Soybean Oil for example but they aren't review or meta-analysis studies so there's probably a more definitive study out there on this point. Edit: Adding these meta-analyses which probably should be included in the article to support this point Effect of dietary fatty acids on serum lipids and lipoproteins. A meta- analysis of 27 trials and Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Apparently one cannot assume what is left unsaid by the heart associations follows the logic of their argument, need to check the studies themselves. This is just another stake in the coffin that makes one lose trust in the general recommendations put out. Lambanog (talk) 09:37, 12 March 2011 (UTC)

"if anyone has a vested interest, it's the Kiwis. They've got an economy built on fatty meat and dairy products, but their government still recommends reducing saturated fat content."

Kiwi here - our govt doesn't fund much original research, but our dairy industry sells low-fat milk for the same price as full-fat then sells the butter separately - the meat industry sells low-fat meat and trimmed cuts at a higher price - it's called a "value-added" economy. In other words, the meat and dairy industry are well able to profit from the saturated fat phobia, and make only token efforts to fight it.49.227.224.22 (talk) 00:18, 6 September 2019 (UTC)

Userfy

May I suggest userfying this page until it is a little more developed? the empty headings look odd, as do heading titles like "secondary sources". WLU (t) (c) Wikipedia's rules:^simple/_complex 15:02, 12 March 2011 (UTC)

Basic associations patterns or conclusions from the data

Since we're looking at these studies I think we might be able to pick out some trends and make some generalizations. I see a couple of things that seem to be agreed upon. Correct me if you see different:

1. Polyunsaturated (PUFA) fats give better lipid profile than saturated fats.
2. Carbohydrate and monounsaturated fats are either roughly the same or unclear compared to saturated fats in producing a better lipid profile.

Is that consistent in the studies or not? Lambanog (talk) 07:35, 14 March 2011 (UTC)

The PUFA improvement seems really solid. Carbohydrates seem to be coming out badly, particularly for high-glycemic index. I'm still holding out hope for MUFA, but I agree there's doubt. I remain cautious about delving into serum lipids, though - the reference list is immense. Eastsidehastings (talk) 08:45, 14 March 2011 (UTC)

If a higher intake of SFA has the same association with risk as a much lower one , why was it necessary to replace it with PUFA? Doing so cannot prove that SFA is a causal factor in CVD. If PUFA has benefits, so be it, though the latest Cochrane says these are limited and restricted to middling doses. These doses - as if we were not eating them already - could replace anything. I can think of 8-10 separate macronutrient classes comparable to "SFA". Does anyone realize how many different combinations can be made with substitutions among 8-10 items? This hardly seems like a valid way of settling a controversy about a specific item.

All fats contain SFA, MUFA and PUFA, so if we increase fat as it comes to us in our food we increase all 3 - if the SFA isn't associated with harm and the PUFA is associated with benefit, wouldn't that seem to support carbohydrate restriction over fat restriction? This may seem facetious, but my point is that the substitution method for analysing epidemiological data is only 10 years old, has not been questioned or defended as a valid procedure in the literature, and seems to have an arbitrary fixation with one nutrient class.49.227.224.22 (talk) 00:35, 6 September 2019 (UTC)

Wrong study described?

I get the feeling there are comments that are not describing the right study. The following if I understand it correctly should be remarking on the Siri 2010 study below it, but due to its placement Stamler's comments seem to be referring to the Skeaff New Zealand study.

Some meta-analyses have found a significant relationship between saturated fat and serum cholesterol levels,[7][8] and serum cholesterol levels and cardiovascular disease,[9] yet 11 of the 15 studies that measured the relationship between saturated fat and coronary heart disease in this meta-analysis were adjusted for serum lipids or other dietary lipids. The remaining 4 studies found a significant relationship between saturated fat and coronary heart disease.[10] Furthermore, a positive relationship between saturated fat and fatal coronary heart disease was found despite an over-adjustment for serum lipids.[10]

Which meta-analysis is referred to needs to be clarified. Lambanog (talk) 17:37, 14 March 2011 (UTC)

I agree. Are the comments sourced properly? I haven't look at them too hard. Eastsidehastings (talk) 01:59, 15 March 2011 (UTC)

Moved the following criticism by Stamler here. I believe it is a response to the 2010 Krauss study and was placed inappropriately in the body of the article.

yet 11 of the 15 studies that measured the relationship between saturated fat and coronary heart disease in this meta-analysis were adjusted for serum lipids or other dietary lipids. The remaining 4 studies found a significant relationship between saturated fat and coronary heart disease. Furthermore, a positive relationship between saturated fat and fatal coronary heart disease was found despite an over-adjustment for serum lipids.

Lambanog (talk) 22:05, 19 March 2011 (UTC)

Wow, yes, that had no business being there. On the other hand, it does speak to the controversy very well. I'm dropping it back into the "Editorial etc..." section. Eastsidehastings (talk) 05:44, 20 March 2011 (UTC)

Other studies to possibly include

• Walker C, Reamy BV. (April 2009). Diets for Cardiovascular Disease Prevention: What Is the Evidence?. Am Fam Physician 79 (7): 571-578. PMID 19378874.

Lambanog (talk) 08:17, 18 March 2011 (UTC)

It's a very interesting paper, but I don't see any attempt to control for the effects of weight loss on serum lipids, or, indeed, observed CVD outcomes. It assumes changes in outcomes based on changes in serum lipids. It doesn't discuss SFA, except by implication. Eastsidehastings (talk) 06:58, 21 March 2011 (UTC)

• Hu FB, Manson JE, Willett WC. (February 2001). Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr 20 (1): 5-19.

All sorts of great material here. Not in the "systematic" category, though, I think. Good for "Editorial..."? Eastsidehastings (talk) 18:38, 22 March 2011 (UTC)

• Ravnskov, Uffe. (June 1998). The Questionable Role of Saturated and Polyunsaturated Fatty Acids in Cardiovascular Disease. Journal of Clinical Epidemiology 51 (6): 443-460.

Unpopular guy, from his citation map. Proper journals, though. I like the long reference list with this paper, but I wish he'd attributed "It is important to note, for instance, that several meta-analyses have shown diet and most cholesterol-lowering drugs to be ineffective as a means of preventing CVD," so we could have mined them out. I didn't find any meta-analyses in his reference list, let alone several. Do you think this is "Systematic Review" or just "Review"? I'm unclear on selection criteria, weighting, etc. Eastsidehastings (talk) 20:11, 22 March 2011 (UTC)

• Hu, Frank B. (April 2010). Are refined carbohydrates worse than saturated fat?. American Journal of Clinical Nutrition 91 (6): 1541-1542. doi:10.3945/ajcn.2010.29622

Lambanog (talk) 17:32, 21 March 2011 (UTC)

• Something new just coming out: The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010?

Looks like another good read for the Editorial section? Could be considered as a consensus statement? Eastsidehastings (talk) 15:35, 27 March 2011 (UTC)

• This Japanese cohort study from October 2010 shows an inverse correlation: Dietary intake of saturated fatty acids and mortality from cardiovascular disease in Japanese: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study

Primary study? Eastsidehastings (talk) 15:37, 27 March 2011 (UTC)

• A Dutch cohort study involving milk: Dairy consumption and 10-y total and cardiovascular mortality: a prospective cohort study in the Netherlands

Primary study? Eastsidehastings (talk) 15:37, 27 March 2011 (UTC)

Lambanog (talk) 15:58, 23 March 2011 (UTC)

An egg study and one on saturated fats, both are extrapolations from the Nurses' Health Study:

• Hu FB, Stampfer MJ, Rimm EB; et al. (1999). "A prospective study of egg consumption and risk of cardiovascular disease in men and women". JAMA. 281 (15): 1387–94. doi:10.1001/jama.281.15.1387. PMID 10217054. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)

Primary study? Doesn't explicitly deal with SFA? Eastsidehastings (talk) 15:46, 27 March 2011 (UTC)

• Dietary fat intake and the risk of coronary heart disease in women

Primary study? Eastsidehastings (talk) 15:49, 27 March 2011 (UTC)

Low carb vs. low fat:

• Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities

Excellent reference for the Diets page, but it doesn't deal with SFA? Eastsidehastings (talk) 15:43, 27 March 2011 (UTC)

Lambanog (talk) 14:08, 26 March 2011 (UTC)

Okay I think I'm seeing a pattern here...primary studies. Won't put them in that meta section but there seem to be a few primary studies with some heft even on their own. I'll continue to place them here if only to help organize any future edits I might make. No need to comment.

• The "Rolls Royce" study: Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial

• Smaller but longer prospective study on dairy intake indicating inverse relationship: Dairy consumption and patterns of mortality of Australian adults

• A review calling for reappraisal from diabetes researchers: Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal

• Letter to the editor commentary from a prominent diabetes researcher: Saturated Fat and Health: Recent Advances in Research

Lambanog (talk) 17:25, 27 March 2011 (UTC)

• Review of dairy prospective studies The consumption of milk and dairy foods and the incidence of vascular disease and diabetes: an overview of the evidence

Lambanog (talk) 11:40, 28 March 2011 (UTC)

Enig Published and Self-Published Works

I see that 'Eat Fat, Lose Fat' is under a Penguin imprint. What about 'Nourishing Traditions'? Does 'Eat Fat, Lose Fat' make the same beneficial statements about SFA? Eastsidehastings (talk) 07:09, 21 March 2011 (UTC)

Eat Fat, Lose Fat seems to make the same claims [1]. Lambanog (talk) 09:41, 21 March 2011 (UTC)

Delete Primary studies section?

I'm not sure it's adding to either the current state of evidence, or to describing the various views in the controversy. We'd be into 4 figures, I expect, if we wanted to create a neutral coverage of all the primary work. Eastsidehastings (talk) 07:36, 21 March 2011 (UTC)

Understood. Delete if you find it necessary. This topic should be covered well enough by secondary sources, but if there are gray areas I personally would not rule out the use of primary sources and would not be dogmatic about it. Lambanog (talk) 09:41, 21 March 2011 (UTC)

Parked:

Primary studies in reputable medical journals

Studies of dietary customs of certain ethnic groups may be confounded by other cultural customs. For example, Fulani of northern Nigeria get around 25% of energy from saturated fat, yet their lipid profile is indicative of a low risk of cardiovascular disease. However, this finding may be due to their high activity level and their low total energy intake.

An evaluation of data from Harvard Nurses' Health Study found that "diets lower in carbohydrate and higher in protein and fat are not associated with increased risk of coronary heart disease in women. When vegetable sources of fat and protein are chosen, these diets may moderately reduce the risk of coronary heart disease."

In a 2008 study published in The New England Journal of Medicine three diets were compared: a low-carbohydrate diet, a low-fat diet, and a Mediterranean diet. The low-carbohydrate and Mediterranean diets were seen as "effective alternatives" to low-fat diets that resulted in greater weight loss and more favorable lipid profile (for the low-carbohydrate diet) or better glycemic control (for the Mediterranean diet).

Pacific island populations who obtain 30-60% of their total caloric intake from fully saturated coconut fat have low rates of cardiovascular disease.

A study published in the Lancet in 1994 found that how long-term dietary intake of essential fatty acids affects the fatty-acid content of aortic plaques is not clear.'These findings imply a direct influence of dietary polyunsaturated fatty acids on aortic plaque formation and suggest that current trends favouring increased intake of polyunsaturated fatty acids should be reconsidered.'

Eastsidehastings (talk) 18:27, 21 March 2011 (UTC)

May be off the topic of this parked section, but:

There seem to a small number of ethnic groups whose traditional diets are "unbalanced" by "Western" medical standards. The Inuit, Maasai, and (according to the reference above) Fulani peoples are heavily or exclusively carnivores -- the Inuit because few plants grow in the homelands, the others for cultural reasons. And here we have certain Pacific Islanders who get a great deasl of their energy from coconut oil (necessity or culture?) (do they also eat a lot of fish?). I'll bet there are others, too. Perhaps there should be a section on traditional ethnic diets that defy current medical norms, but the people are healthy nevertheless (with a warning not to try this at home).-- Solo Owl 03:12, 19 August 2013 (UTC) — Preceding unsigned comment added by Eall Ân Ûle (talk • contribs)

Sandboxing evidence table

Systematic Review	CVD/SFA Relationship
Mozaffarian D, 2010	19% reduction by substituing PUFA
Siri-Tarino,2010	insignificant
Mente, 2009	insignificant
Skeaff, 2009	reduced events by substituting PUFA
Jakobsen, 2009	5% exchange of SFA for PUFA: 13% decrease events, 26% decrease deaths
Van Horn, 2008	25-35% fats but <7% SFA and TFA reduces risk
Chanu, 2003	significant in longer term
Hooper, 2001	reducing total fat, SFA or cholesterol intake reduced events by 16% and deaths by 9%. Longer-term trials led to 24% reduction
Hu, 1999	exchanging SFA for nuts gave 45% reduction
Bucher, 1999	insignificant
Truswell, 1994	decrease SFA and cholesterol intake, partial replacement with PUFA: 6% reduced deaths, 13% reduced events

Eastsidehastings (talk) 16:32, 21 March 2011 (UTC)

Eastsidehastings (talk) 16:54, 21 March 2011 (UTC)

Eastsidehastings (talk) 17:04, 21 March 2011 (UTC)

Other implications?

Just wanted to ask if after summarizing there seem to be clear implications, should other possible implications also be stated? For example if PUFAs seem to be beneficial for CVD, should criticism about PUFAs being possibly bad for cancer be mentioned? I seem to recall reading about PUFA concerns in the early 2000s both for CVD and other diseases but the newest studies may refute the CVD implications. Lambanog (talk) 15:44, 21 March 2011 (UTC)

So, for example: "The best evidence regarding the relationship between SFA and CVD suggests that isocalorically substituting PUFA for SFA reduces CVD. For more detail on the health role of these fatty acids, see PUFA"? Or maybe lifting the leader section from the PUFA page? Hmmm. Better to just link, I think, in case the PUFA page is in flux. Eastsidehastings (talk) 16:32, 21 March 2011 (UTC)

Drat. I should have guessed the Polyunsaturated Fat page would be in a bad state. Primary mice studies? And I wonder why there's separate page for PUFA? Nevertheless, sorting out the health implications of increasing PUFA intake is PUFA's problem to sort out. Eastsidehastings (talk) 16:41, 21 March 2011 (UTC)

Problematic areas identified

• Some meta-analyses have found a significant relationship between saturated fat and serum cholesterol levels, and serum cholesterol levels and cardiovascular disease.

Upon reading Mensink et al. 2003 it would seem to say the reverse of what is implied in the statement's later clause. Furthermore, some of the more recent studies contradict the relationship between total serum cholesterol and CAD and I don't think that was stated in the description of those meta-analyses for example Mente 2009. This sentence does not follow the general pattern of the rest of the section. The studies should be broken off from the sentence and each study and what it says should probably be described in its own paragraph. Lambanog (talk) 02:44, 22 March 2011 (UTC)

• Two of the references to the WHO are of poor quality and little more than captions:

1. World Health Organization Risk factor: lipids
2. World Health Organization Prevention: personal choices and actions

I think those references should be removed. If there is no objection I will remove them. Lambanog (talk) 02:44, 22 March 2011 (UTC)

Agreed, both on the lipids part and on the WHO pamphlets. Would you mind keeping the serum lipids references parked here, though? I get the sensation that this article will come around to lipids eventually. Just I've been avoiding it, searching for the direct A vs C studies. I think I'm running out of sources, now, though. Eastsidehastings (talk) 05:57, 22 March 2011 (UTC)

I took out the WHO pamphlets but have kept the more detailed report in the article. I leave it to you to decide what to do with it if anything. Although I might come back to it later myself. Lambanog (talk) 10:31, 22 March 2011 (UTC)

Historical perspective SFA vs CVD

For entertainment, I followed a reference to a 1961 statement from the AHA:

"The reduction or control of fat consumption under medical supervision, with reasonable substitution of poly-unsaturated for saturated fats, is recommended as a possible means of preventing atherosclerosis and decreasing the risk of heart attacks and strokes."

We're at 13 systematic reviews / meta-analyses and counting, and it all adds up to pretty much the same statement as from 1961. Eastsidehastings (talk) 04:18, 25 March 2011 (UTC)

Not really. The improvement switching saturated fat to polyunsaturated fat does not decrease mortality. With one study referenced the change is 14% for 7% of the study participants for a single measurement. That's not really anything to hang your hat on. If anything it should tell researchers they are still looking in the wrong place. — Preceding unsigned comment added by 174.52.58.40 (talk) 19:16, 4 September 2011 (UTC)

Also, it's sad that all of these meta-studies have so many aspects of cardiovascular disease to try to make associations with. The only thing statistically significant they can come up with is cardiovascular events, which seem to effect less than 10% of people in these studies. So with at most a 20% reduction in risk, affecting less than 10% of the study, we're talking about at most a 2% absolute reduction. With this 2% reduction they think they don't have to backpedal from the recommendation to reduce saturated fat intake. The real kicker is that there is no statistically significant difference in mortality! If the authors and research communities weren't so biased against saturated fat, the tone of these studies would be completely different. — Preceding unsigned comment added by 174.52.58.40 (talk) 00:27, 12 September 2011 (UTC)

Comments

I'm thinking of including the Japanese study but was wondering if there are reasons that caused you not to include it.

If you'd like to restart the Primary studies section, that'd be the right place. Eastsidehastings (talk) 16:03, 27 March 2011 (UTC)

Also the dairy study and egg study would seem similar to the nut study, would it be okay to include them or better to take the nut study out or not?

That was included by some author way back in the mists of time. I don't have access to the original, so I can't be certain on the systematic/meta classification. From the abstract, I'd have guessed the nut study warrants demotion to Primary or Editorial. Do you have access to the full text? Eastsidehastings (talk) 16:03, 27 March 2011 (UTC)

I don't have full access to this one but from what I can tell it is based mainly on the Nurses' Health Study and four others. Technically not primary but I'm not sure how much more significant it is than one of the larger primary prospective cohort studies. I might start a primary study section but attempt to limit it to some of the higher quality studies. Nut study staying where it is should probably be okay then. Lambanog (talk) 17:25, 27 March 2011 (UTC)

Another study based on the Nurses' Study may be more directly associated to the topic. Also the I'm not sure the Bucher study is about saturated fats and am unsure whether it belongs. Lambanog (talk) 13:48, 26 March 2011 (UTC)

Drat. I think I conflated Bucher and Truswell when I found them. I can't find anything in Bucher directly about the dietary advice, although the references are listed. But that'd be synth. I'm demoting it. Eastsidehastings (talk) 16:27, 27 March 2011 (UTC)

Zelman

I'm wending my way through the Great Fat Debate articles, but one definite take-home message isn't "saturated fat is good for you". It's that substituting refined carbohydrates for saturated fat doesn't seem to reduce your risk of CVD (but substituting P/MUFA for SFA does). The "best" scenario for SFA is that it's health-neutral, and that's assuming you don't pay attention to what you're substituting. I've put in a fairer summary of Zelman, 2011 based on a fuller discussion of SFA. WLU (t) (c) Wikipedia's rules:^simple/_complex 19:26, 31 August 2011 (UTC)

Newly published (BMJ)

I found this article on the issue of SF/CVD interesting, http://www.bmj.com/content/347/bmj.f6340

Perhaps it can be added to the page in a meaningful way?

Many of the same things that brought up above on the talk page calling for "fringe theory"-status are discussed in detail with many references in this article. IMHO ... peer-reviewed articles in British Medical Journal are not a very common source of fringe theories ... — Preceding unsigned comment added by 83.248.187.123 (talk) 17:07, 23 October 2013 (UTC)

Chowdhury study challenged

Hi,

The summary table now gives the imperession the Chowdhury study clearly paints a picture, whereas key findings of the study are now being re-assessed (source). Should the description be fine-tuned? Cheers, --Dailycare (talk) 16:44, 27 April 2014 (UTC)

I agree, and this was my motivation for expanding the paper's summary in 'Review details'. As per my suggestion below, I think the description column in the table is unhelpful. Panther306 (talk) 20:39, 18 May 2014 (UTC)

Removal of summary table.

The summary table is in danger of misleading the casual reader, as it displays a select choice of evidence and the description column is reliant on too few words to accurately reflect the findings in context. May I suggest developing the 'Review details' section by introducing a more thorough and balanced summary of relevant articles.

Panther306 (talk) 16:24, 17 May 2014 (UTC)

I agree with this, since this table is not a comprehensive list of reviews and is therefore misleading. If there are tables with review papers, they should be divided into reviews of clinical trial data vs. reviews of observational data to reflect the differing rigor of this data. Truthinnutrition (talk) 12:43, 24 July 2017 (UTC)

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Title: Is it a controversy?

I'm surprised the title of this page is called "Saturated fat and cardiovascular disease controversy". The article states that medical, scientific, heart-health, governmental and intergovernmental, and professional authorities are in agreeance that saturated fat is a risk factor for cardiovascular disease. And that "some hold contrary beliefs". It seems the term "controversy" is a overstatement of what is actually some criticism and different views. I recommend removing the term "controversy" from the title. Kind regards, Timelezz (talk) 19:59, 27 December 2016 (UTC)

Non-secondary opposing views

The section below does not contain WP:SECONDARY sources. They are one-person opinions, i.e., WP:PRIMARY or WP:OR, that have low weight as sources and may be seen as WP:UNDUE. --Zefr (talk) 23:06, 11 January 2017 (UTC)

Opposing views

Gary Taubes, a science writer and three-time winner of the Science in Society Award of the National Association of Science Writers, has stated, "Dietary fat, whether saturated or not, is not a cause of obesity, heart disease, or any other chronic disease of civilization."

Author and journalist Michael Pollan, a two-time James Beard Foundation Award winner, in his book In Defense of Food – An Eater's Manifesto states "The amount of saturated fat in the diet probably may have little if any bearing on the risk of heart disease, and evidence that increasing polyunsaturated fats in the diet will reduce risk is slim to nil."

Mary G. Enig, a nutritionist who is a member of the International Network of Cholesterol Skeptics states "there is very little evidence to support the contention that a diet low in cholesterol and saturated fat actually reduces death from heart disease."

Author and science journalist Nina Teicholz, in the international and New York Times bestseller, "The Big Fat Surprise" (Simon & Schuster 2014), wrote the first book to present the scientific evidence showing that saturated fats are not bad for health. The book was named a best book of 2014 by the Economist, the Wall Street Journal, Forbes, Mother Jones, Library Journal, and Kirkus Reviews. "This book should be read by every nutrition science professional," said the American Journal of Clinical Nutrition. The book's arguments were subsequently published as cover articles in TIME magazine and the New Scientist, among many other publications. A summary of her investigation and an interview are also available on the website of the BMJ journal.

References

Where is the controversy...

If the "Conflicting views" section has been excised? A pair of recent edits by Zefr have removed the entire section from this article about a controversy. The first edit, [2] states the reason WP:NOTSOAPBOX.The second edit [3] reverts another editor's reversion [4] of the first edit. According to "Wikipedia is not a soapbox or means of promotion", the following are not allowed: advocacy, propaganda, recruitment, opinion pieces, scandal mongering, self-promotion, advertising, marketing or public relations. I don't find any of those attributes in the excised section, including advocacy and opinion presented as fact.

I don't know the mind of the editor who excised the section, so in the absence of any reply here, I'll revert their last excisional edit.--Quisqualis (talk) 03:09, 12 January 2017 (UTC)

See the Talk section immediately above this one. The content of references 1-5 removed is clearly a fringe view expressed by authors presenting opinions per WP:SOAP not confirmed by any credible major organizations or systematic reviews. Reference 6 above, published in BMJ, is also an op-ed by an American journalist who has published in a British journal, with some points that may warrant being part of the controversy discussed in the article. Overall, the section removed represents undue weight given to fringe authors and their theories. In the article under Views, there are contrary positions discussed versus the majority, mainstream scientific evidence. Since there are no authoritative reviews presented to proclaim that saturated fats have no untoward effects on CVD, I felt it was warranted to remove it. Perhaps we should focus on the BMJ article citations to consider adding further controversial positions to the article. --Zefr (talk) 03:36, 12 January 2017 (UTC)

I would have appended my above comment to the comment in section 22 , but the editor of that section was using a pseudonym (Timelezz), rather than the name used to make the excisional edit (Zefr). This editor may be a foot glove--Quisqualis (talk) 04:34, 12 January 2017 (UTC)

I restored this section as at least three of the four views given are those of authors of secondary sources; their writings "(provide) an author's own thinking based on primary sources". As noted in the article text, their publications, by mainstream publishers, have been positively discussed by at least some reputable scientific bodies, as well as major non-scientific magazines. Their views may be in a minority and their conclusions may be debated but, characterising these as fringe views is plainly incorrect. Please restore the material. Mutt Lunker (talk) 23:21, 12 January 2017 (UTC)

As this is an article about human disease, it requires a higher standard for sourcing per the MEDRS guideline, particularly the sections under Books and Popular press (WP:MEDPOP) which encompass the above references 1-5. As I indicated yesterday, there may be value retrievable to discuss the controversy based on select citations used by these authors – and/or those from the BMJ article by Teicholz – but the deleted content should be rewritten with briefer content. I would like to hear from other editors before we rewrite this section. --Zefr (talk) 23:48, 12 January 2017 (UTC)

I still maintain that WP:SOAP is not applicable here; still, I prefer a squeaky-clean Wikipedia. The popular press authors used studies, published by peer-reviewed sources, in order to come to their conclusions. There should be secondary sources, including review articles, mentioning these studies, which we can cite. It will look cleaner if those sources are listed, with less likelihood of sectional excision.--Quisqualis (talk) 00:17, 13 January 2017 (UTC)

Quisqualis, let me tell that I am no foot clove of Zefr. I don't even know who s/he is, neither did I make any edits to the article. Please, have reservations before drawing discrediting assumptions. Kind regards, Timelezz (talk) 22:50, 24 January 2017 (UTC)

This is a very strange page. It represents almost zero of the actual controversy going on. What it does instead is provide one side of the controversy, and any edits that show the "other" side are being deleted. Even peer-reviewed articles authored by multiple authors, as I have just tried to insert, were just deleted by an editor. I was told by an editor that I could not include any of the peer-reviewed journal entries that I inserted, and I was not allowed to include magazine or newspaper pieces. Yet in another part of the page, a report from a TV program is cited. These are not consistent standards and reflect a bias on the part of the dominant editors. The piece in the BMJ by the American journalist is a good example. This was not an op-ed. It was published as a critical investigation by The BMJ, not as an op-ed (even though that might be the opinion of an editor here, but that is not accurate, per The BMJ). Her critiques were peer reviewed and withstood a major retraction effort. Therefore, they are accurate. The critiques on the review of saturated fat documented in this article, and the enormous controversy around this paper, should absolutely be on this page. I just tried to insert them, and an editor deleted them. Please explain. They are most certainly pertinent. If the dominant editors of this page believe there is no controversy or that anyone on the other side of the controversy is "fringe," then the whole page should be deleted. There is a controversy, documented in many journal articles, magazines, newspapers, etc., but if these are not allowed to be posted, then the page serves no purpose. TruthinNutritionTruthinnutrition (talk) 12:38, 24 July 2017 (UTC)

definition of "gained attention"

Saturated fat and cardiovascular disease - section: "The notion that saturated fat has a detrimental effect on human health gained attention for the first time in the 1950s.[15] "

This statement is 1: unclear (is it the attention of the englsh-speakng world, or the internatnal medical communty, or both, or what); 2: sounds odd after just following the previous sections description of some dutch guy focusing (at least his own attention) at saturated fats' effects at an international conference in 1935.

im gonna add "wider international attention" to that, not that it is any more substantial, but at least somewhat narrows downn the object of the statement. 80.98.79.37 (talk) 13:13, 22 July 2017 (UTC).

Original research

If indeed there is a "controversy" then this article should be based on sources which discuss that controversy directly. What this article seems to be is a "controversy" in which Wikipedia editors (not RS) has decided what is controversial and synthesized the topic. I am wondered if AfD might might be appropriate? Alexbrn (talk) 11:05, 24 July 2017 (UTC)

If this is true, then most of this page should be deleted, as it is just a list of authorities on one side of the controversy. If this is allowed, then the "other" side of the controversy should also be allowed. TruthinNutrition Truthinnutrition (talk) 12:41, 24 July 2017 (UTC)

Can somebody please explain what the supposed controversy is supposed to be. I can't see it at all!!! Editor Truthinnutrition please explain why you think most of the page should be deleted? It is well sourced, and accurate, and reliable sources do not report a controversy. Please Explain. -Roxy the dog. bark 13:33, 24 July 2017 (UTC)

This page is supposed to reflect a controversy over the hypothesis that saturated fats cause CVD. Yet the vast majority of the page, including the introduction, only represents one view, namely that these fats DO cause CVD, which is the view of the establishment. All these establishment sources are cited. However, the page is supposed to document a "controversy." In order to have a controversy, you must show that there is another point of view. There are many, legitimate sources in peer-reviewed journals, magazines, newspapers, and books documenting another point of view (namely, that the evidence shows that saturated fats have not been demonstrated to cause heart disease); however, when users attempt to include this other point of view, these edits are deleted. Hence, there is no representation of controversy. Either this page should document the true existing controversy or cease to exist as a page. How about I suggest some edits, and all the users here can agree upon whether they are justified and should be included? Truthinnutrition (talk) 15:12, 24 July 2017 (UTC)

That excess consumption of saturated fat causes CVD in people is the mainstream views and Wikipedia is going to reflect that. The "controversy" wrt sugar - insofar that there is any - is that there may have been an over-focus on fat's role and an under-appreciation that other kinds of excess intake (e.g. of sugar) are just as harmful. This has been fuelled by suspicions that historically, "sugar industry" influence skewed the scientific view. But all this is a lot more nuanced that the silly "sugar bad; fat good" nonsense that is now being promoted in some quarters. PMID 27900447 is a good source on this. I think we could just removed the word "controversy" from this article's title and have a brief "Controversy" section, sourced to scholarly works (not popular books) like the source I mentioned. Alexbrn (talk) 15:23, 24 July 2017 (UTC)

I agree the article would be clearer if "controversy" was removed from the title, and we covered (or renamed) the controversy in the subsection, "Opinion contradictory to the mainstream". --Zefr (talk) 16:18, 24 July 2017 (UTC)

Ah, so it seems that the controversy as described here is just bollocks, I see. I would support a change of page name to drop the bollocks. -Roxy the dog. bark 16:40, 24 July 2017 (UTC)

review details

removed the text that was redundant (no need to repeat it twice: "A 2015 systematic review of randomized control trials by the Cochrane Library found that reducing saturated fat intake resulted in a 17% reduction in cardiovascular events, and that replacing saturated fats with cis unsaturated fats in particular is beneficial. It concluded: "Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturated fats. ref: 29.

A 2015 systematic review of randomized control trials by the Cochrane Library found that reducing saturated fat intake resulted in a 17% reduction in cardiovascular events, and that replacing saturated fats with cis unsaturated fats in particular is beneficial. It concluded: "Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturated fats. ref: 35." ) 80.98.79.37 (talk) 08:20, 31 July 2017 (UTC).

Teicholz book

I added the following book in a "Further reading" section:

• Nina Teicholz (2015). The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet. Simon & Schuster. ISBN 978-1451624434.

Zefr removed this with the edit summary "Spam, non-expert opinion source." That was really surprising to me, given that I'm not affiliated with the author, it's on-topic, and that Teicholz is actually already cited in the article. I'm not sure why you'd think she's a non-expert, given that citation actually shows she's published in BMJ on the topic. Her book explores topics like whether old recommendations were ever really supported by rigorous science, whether recommendations are keeping up with new science, and how they have been influenced by non-scientific factors like business interests and politics. Seems like an interesting tertiary source for readers to learn more about the topic than the BMJ article says. -- Beland (talk) 22:51, 1 July 2018 (UTC)

Interestingly, the cited article has been corrected, and criticized to the extend that over 180 scientists requested that it be retracted. [5] -- Beland (talk) 22:55, 1 July 2018 (UTC)

Due respect, Beland, but there is discussion above under "Where is the controversy" that gives background on previous discussions about Teicholz. She has no scientific qualifications to comment on fat and cardiovascular disease, and her op-ed in BMJ was just scam and spam to promote her book and blog here. This article has substantial high-quality WP:MEDRS sources; including her book as valid reading gives it WP:UNDUE credibility that misleads the unscientific or unsuspecting visitor to the page. Numerous Google examples like this CBC-physician review refute her views. --Zefr (talk) 23:05, 1 July 2018 (UTC)

@Zefr: What evidence is there that Teicholz is perpetrating a scam or is discussing this topic just to make money, as opposed to holding genuine beliefs based on legitimate criticisms of scientific methodology? It's unclear to me that not having scientific "qualifications" is a good reason not to listen to a source, if that source applies the methods of the scientists who work in that field. That seems a bit snooty and strongly favors orthodox views, which is problematic given that this is to some degree criticism of the orthodox science. Given she's been published in BMJ, it seems like she's been vetted by the scientific community as someone worth listening to, even if she's a journalist by profession rather than a front-line researcher. From what I've heard of Teicholz explaining her views, she looks at both primary studies and meta-review studies and interprets their claims, and happens to come to a non-orthodox conclusion. I read that as a tertiary source, not a primary source as you've claimed in previous discussions. Some meta-reviews cited by the article apparently agree with her, so she's not coming completely out of left field. It's also unclear to me that the CBC article successfully refutes Teicholz. Sometimes Labos is talking about fat, sometimes saturated fat, and sometimes overall calories. I don't think the two authors really disagree on the good and bad of most of those things. There are good things about fat, and it seems like there is general agreement that unsaturated fat is satiating and not bad for heart health. It would be more convincing if the article addressed Teicholz's criticisms of specific scientific studies, and went through different health claims point by point. Where there is not a scientific consensus, it's not Wikipedia's job to pick one side in the debate and remove all mention of the other side, and I'm not taking a position as to which side is correct in this case. I agree it would be good to have books representing the orthodox view in the "Further reading" section to balance out non-orthodox books; I'm open to suggestions if you have any. Given that this was a New York Times bestseller, it's probably worth actually going into criticisms of the Teicholz book rather than not mentioning it at all, since many readers will be familiar with it. As it is, it's unclear why anyone who reads that book and agrees with its conclusions would have reason to trust this article, given that book is criticizing the scientific basis for the mainstream claims. Sometimes unorthodox views turn out to be correct, even if many times they don't; I generally want to see Wikipedia explaining the controversy until such time as it can sort itself out. As to the specific edit, at the very least the book should be included as a footnote so that readers can get more information about the specific view of this author, until we can come up with a more balanced reading list if we want to do that. -- Beland (talk) 02:00, 2 July 2018 (UTC)

Beland, my objection to use of the BMJ-Teicholz source in the article lede is that she is not a qualified WP:MEDASSESS source, is a blogger and pseudoscientific author of op-ed positions like the disgraced Dr. Oz or Joseph Mercola, and is WP:UNDUE weighted in the article as having a voice equal to high-quality systematic reviews and meta-analyses of completed clinical trials -- even those that support the position of saturated fat being acceptable in diets, despite overwhelming evidence to the contrary, as the article presents. She has "legitimacy' resulting from one controversial editorial decision by the BMJ, contrary to the demands for retraction by 180+ scientists and counterweight of dozens of professional medical organizations and publications, further supporting WP:UNDUE. It is obvious that her book and the BMJ article coincided, and that she is promoting her book via her website. It is irrelevant that her book is "best-selling", as there are numerous op-ed non-expert publications that attract public attention. The unorthodox views you discuss are adequately represented by literature in the Opinion contradictory to the mainstream section where her non-expert opinion belongs, not in the lede. --Zefr (talk) 15:07, 2 July 2018 (UTC)

Opinions contradictory to the mainstream

So can Zefr please explain why he thinks the three scientific articles with dissenting opinion I just tried to add are supposedly not reliable sources? Here are the links: https://www.sciencedirect.com/science/article/pii/S0958694615001624 https://www.sciencedirect.com/science/article/pii/S0899900711003145 https://openheart.bmj.com/content/3/2/e000409?itm_content=consumer&itm_medium=cpc&itm_source=trendmd&itm_term=0-A&itm_campaign=oh In fact the last one from Harcombe et al is not new, it is already in the table on the saturated fat page.

You can read the discussion above where contradictions to mainstream publications have been discussed at length before, and the article section under Views. The Harcombe source could be included in this article under the Views section, but the Hoenselaar and Parodi sources are outdated opinions published in non-medical, non-MEDRS sources. Their information is redundant with the content already existing in the section. --Zefr (talk) 19:07, 23 February 2019 (UTC)

I had already read the discussion, the article section and the MEDRS page. I've read through them again but still fail to see why anything from there would apply to this case. Please be more specific. These are not primary sources nor non-expert opinions. They are secondary sources published in peer-reviewed journals. I don't see why the fact that they are published in journals specialised in nutrition rather than medical ones should be an issue. After all, this isn't a purely medical topic, it is about how an aspect of our nutrition affects our health. Seems kind of arbitrary to want to exclude those articles published in nutrition journals. Besides, if you really wanted to do that then you would also have to remove the reviews by Hamley, Schwab, Ramsden 2010, Jakobsen, Siri-Tarino, Van Horn and Skeaff. We can't have double standards! I also don't believe you can argue that their information is redundant. Firstly, shouldn't the length of the section reflect the amount of disagreement from within the scientific community? Second, the Hoenselaar one does add something new, because he examines the reports of three dietary advisory committees and details exactly how they misrepresent the science and ignore aspects that don't suit them. Oh and the papers were published in 2012 and 2015, I would hardly call that outdated. There are several older reviews included in the tables. 2001:690:2100:1:0:0:0:7 (talk) 16:25, 24 February 2019 (UTC)

Good arguments, although needing clarification and better focus. 1) WP:MEDREV and WP:MEDSCI encourage a high standard for medical content sources. The International Dairy Journal and the journal Nutrition do not have acceptable impact factors or standing in the field of medicine (searchable here). They are not journals where rigorous reviews on cardiovascular disease are published, and do not meet WP:MEDSCI. 2) the dates of publications are important (WP:MEDDATE; within 5 years), especially where a view contradictory to the established mainstream of reducing or replacing dietary saturated fat is concerned. The literature cited in the table is the background for reaching the mainstream view. 3) I raised the issue of redundancy - what new information by your proposed sources, particularly the Harcombe article, is suggested over what the article states now? --Zefr (talk) 16:05, 25 February 2019 (UTC)

Other modern systematic reviews

@Zefr:, @Alexbrn: Is there any chance you can help add this A systematic review of the effect of dietary saturated and polyunsaturated fat on heart disease to the table? It was published in 2017 and the journal looks ok and is used on other articles on Wikipedia. Psychologist Guy (talk) 16:00, 8 August 2020 (UTC)

Why is this page allowed to exist?

Sock evading block.

This is a really biased overview that ignores a lot of science to present and argument against saturated fats written by editors that are in the Vegan Wiki group and are either employed by vegan interest groups or are doing it for free: Proof for Psychologist Guy, his quote: "I have had people contact Greger, he knows nothing about this. ". https://en.wikipedia.org/w/index.php?title=Talk:Michael_Greger&diff=1002388477&oldid=1000888854 This is clearly written by someone who is on Wikipedia not to write it but to promulgate an agenda. He works with Zefr, AlexBrn to edit nutrition articles and vegan pages to promote their agenda. — Preceding unsigned comment added by 93.141.106.103 (talk) 17:19, 15 April 2021 (UTC) Unfortunately you are the same banned user JustANameInUse that also used an abusive IP on the Atkins diet talk-page [6] accusing and attacking multiple users of being vegans including myself. It seems you show up every few months and mention my account and others and accuse us of being vegans. Just last week I was heavily attacked in an email by a vegan because I edited the John A. McDougall article. It seems I get it from both sides. If the vegans are not attacking me then it is the carnivore dieters. I get it, your agenda was to promote the carnivore diet on Wikipedia, but you were indefinitely blocked because you kept making personal attacks. Like I said before there really is no conspiracy theory or some secret vegan group employed to edit articles. The mainstream scientific consensus held by medical authorities is that a diet high in saturated fat is a risk factor for heart disease. Please read WP:MAINSTREAM and WP:FRINGE. I am well aware there is still an ongoing debate in the medical community about how much saturated fat is harmful and that debate is very interesting. There are conflicting metanalyses on this but fad dieters promoting the Low-carb/keto/carnivore diet thing like to claim that saturated fat has no relation to cardiovascular disease at all. That is an extreme fringe view. We do not give equal weight to fringe views on Wikipedia. The scientific consensus remains that saturated fat is a risk factor, so that is what the article reflects. I agree that the article should be updated as much more could be added but when you keep turning up on IPs promoting conspiracy theories and complaining about vegans you are really not doing yourself any favours. You will most likely be reported or blocked. Psychologist Guy (talk) 19:04, 15 April 2021 (UTC) And now you are even lying. How can you be so shameless. Are you going to accuse this IP of sockpuppeting as you do with everyone who confronts you? https://www.jacc.org/doi/full/10.1016/j.jacc.2020.05.077 Your lying and vegan propaganda on wikipedia is clear to see to anyone who goes trough your contributions, as shown with the upper link in my first message, you just need to make yourself look like the aggravated party because that is the only argument you have. I get it, you are involved and probably paid in and by an ideology that needs to promote itself, but at least have the courtesy to be clever about it and not go around posting stuff about having people contacting a vegan activist about a rumor. You outed yourself. Nice job. BTW, nice fake email [email protected] with a nice fake story about someone sending you a email. Your timed contributions put you in the US timezone. Stop lying. — Preceding unsigned comment added by 93.141.106.103 (talk) 19:54, 15 April 2021 (UTC) You are not very good at this. When you use Wikipedia from an IP address you realise it is visible right? You were using the IP 93.141.106.212 [7] to attack "vegans" and me specifically. You are now doing the same on your IP 93.141.106.103 which traces exactly to the same geographic location and is in exactly the same IP range. It would be silly if you deny that IP was yours. Let's also not forget you use exactly the same writing style and are saying the same things about vegans. Its impossible you are another person. You have been banned from this website. Stop wasting our time coming back on IPs trying to stir up trouble on talk-pages. These vegan conspiracy theories of yours are ridiculous and you are personally attacking users here. The talk page is to suggest improvements for the article. What you are typing is not productive for the article. Psychologist Guy (talk) 20:35, 15 April 2021 (UTC) Wow, you really need to make this about someone else so your dietary activism can continue. You do understand that all edits here are archived and that you can't delete nor remove your own words of having people in contact with a known vegan activist to straighten out a rumor about him? You outed yourself out and no talking will ever erase that.