Slide Update: If you’re tied to dogma, what’s your interest in data?

2019.07.15 Low Carb and Low Carbon, Washington, DC USA 196 04012 (View on Flickr.com)

Time for another slide update….

We now live in an era where there is more disclosure of conflicts of interest, without necessarily more controls.

These are some examples, along with advice from Salim Yusuf, OC FRSC, Distinguished University Professor of Medicine, McMaster University, lead investigator of the PURE study.

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

See: My Debate with David Katz | Nina Teicholz (view on flickr.com)

I happened to be in the audience for this debate. I recommend watching it.

2019.05.13 The Soho Forum Debate, New York City, NY, USA 02508 (View on Flickr.com)

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”

Grant JD, Jenkins DJA. Resisting influence from agri-food industries on Canada’s new food guide. Can Med Assoc J [Internet]. CMAJ; 2018 Apr 16 [cited 2018 Apr 25];190(15):E451–2.

Brands mentioned in competing interests include Unilever, Barilla, Almond Board, Kellogg’s, Proctor and Gamble, Bayer, Pepsi/Quaker, Soy Foods Association, Coca-Cola, Canola Council, Walnut Council, Dean Foods, California Strawberry Commission, and more…

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

Source: Food for Thought: the science and politics of nutrition – Day 2 – June 15, 2018’ – https://youtu.be/Yyhx3C1paA0?t=23130

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

See: Physicians’ 20th Century Nutrition Education: via Medical Journal Advertisements (Food Has Always Been Medicine).

Physicians’ 20th Century Nutrition Education: via Medical Journal Advertisements (Food Has Always Been Medicine)

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

2018.11.07 Low Carb and Low Carbon 583 (View on Flickr.com)

2018.11.07 Low Carb and Low Carbon 584 (View on Flickr.com)

I’ve linked to many other exmaples off of my official Disclosures page.

In terms of my inherent beliefs and makeup, I am

• Normoglycemic
• Normotensive
• 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

2019.07.15 Low Carb and Low Carbon, Washington, DC USA 196 01010 (View on Flickr.com)

As usual, I welcome any comments.