Time for another slide update….
We now live in an era where there is more disclosure of conflicts of interest, without necessarily more controls.
1: “Ketogenic Diet, Enthusiasm Outpaces Evidence”
(image at the top of this post)
Joshi S, Ostfeld RJ, McMacken M. The Ketogenic Diet for Obesity and Diabetes—Enthusiasm Outpaces Evidence. JAMA Intern Med [Internet]. 2019 Jul 15 [cited 2019 Jul 15];
This article, has incomplete references and factual errors, including the discussions of “blue zones,” fiber intake, and selenium cardiomyopathy just to mention a few. The piece also incorrectly assumes that the opposite of the ketogenic diet is a vegan diet.
The alternative is the low fat, high carbohydrate diet, now regularly eulogized/abandoned by even its most prominent supporters (see this recent paper as an example).
A low-carbohydrate or ketogenic diet can be vegan – ask Carrie Diulus, MD (@cadiulus) – about that.
2: Soho Forum Debate, Nina Teicholz and David Katz, MD
I happened to be in the audience for this debate. I recommend watching it.
Could this approach be driven by financial interest in numerous businesses?
4: A favorite – “Resist Agra-Food Industries, brought to you by certain other Agra-Food Industries”
These are funny, and at the same time they’re not. Many physicians don’t have time to read the disclosures, and they don’t see the impact of not reading them.
5: Comment from Salim Yusuf, OC, FRSC
Most people don’t read the whole paper, they read the abstract …(When I was at the NIH) … anything that came in that contradicted (low fat) was poo-poo’d.
I believe the biggest conflict of interest is your inherent belief system – Salim Yusuf, OC, FRSC, Food for Thought: the science and politics of nutrition – Day 2 – June 15, 2018’ – https://youtu.be/Yyhx3C1paA0?t=23130
Dr. Yusuf and the PURE study team are unconflicted (“we have no disclosures”). In comparison to the examples above, there’s a greater sense of credibility and interest in embracing their curiosity when they present.
I also recommend viewing his comments in context (link to time code here).
This has been going on for a long time
There’s a cohort of journalists, scientists, physicians, who are changing their views
Interestingly, Nina and a cohort of scientists and physicians around her have histories of dramatically changing their points of view after reviewing the data.
I’d call this the oppositite of dogma over data, hence the hashtag/protest sign, #DataOverDogma / #DataNotDogma.
It’s possible to be conflict free
I’ve linked to many other exmaples off of my official Disclosures page.
In terms of my inherent beliefs and makeup, I am
- Formerly Fat
- Eating a low carbohydrate, healthy fat diet
- Working to be an ally
- Interested in physicians meeting patients where they are instead of physicians deciding where patients should be
- From a generation of physicians trained during the most profound ethical crisis in the profession’s history
As usual, I welcome any comments.