After reading the following I wonder if it would it influence the way you might consider the credentials of this man and his work?
Ronald M. Krauss, M.D., is Senior Scientist and Director of Atherosclerosis Research at Children’s Hospital Oakland Research Institute, Adjunct Professor in the Department of Medicine at UCSF and in the Department of Nutritional Sciences at UC Berkeley, and Guest Senior Scientist in the Department of Genome Sciences of Lawrence Berkeley National Laboratory. He received his undergraduate and medical degrees from Harvard University with honors and served his internship and residency on the Harvard Medical Service of Boston City Hospital. He then joined the staff of the National Heart, Lung, and Blood Institute in Bethesda, Maryland, first as Clinical Associate and then as Senior Investigator in the Molecular Disease Branch. Dr. Krauss is board-certified in internal medicine, endocrinology and metabolism, and is a member of the American Society for Clinical Investigation, a Fellow of the American Society of Nutrition and the American Heart Association (AHA), and a Distinguished Fellow of the International Atherosclerosis Society. He a member of the U.S. National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, founder and past Chair of the AHA Council on Nutrition, Physical Activity, and Metabolism, and a National Spokesperson for the AHA. Dr. Krauss has also served on both the Committee on Dietary Recommended Intakes for Macronutrients and the Committee on Biomarkers of Chronic Disease of the Institute of Medicine of the National Academy of Sciences. He has received numerous awards including the AHA Scientific Councils Distinguished Achievement Award and the Centrum Center For Nutrition Science Award of the American Society for Nutrition, and he is listed in Who’s Who in America and the World. Dr. Krauss is on the editorial boards of a number of journals, and is Associate Editor of Obesity. Dr. Krauss has published nearly 400 research articles and reviews on genetic, dietary, and drug effects on plasma lipoproteins and coronary artery disease. In recent years Dr. Krauss’ work has focused on interactions of genes with dietary and drug treatments that affect metabolic phenotypes and cardiovascular disease risk.
The overall objective of the Krauss Laboratory are:
To investigate genetic and metabolic determinants of the prevalent atherogenic dyslipidemia (high triglyceride, low HDL, and increase in small, dense LDL particles) that is associated with obesity and insulin resistance in humans.
To identify genetic influences on response to dietary and drug treatment of atherogenic dyslipidemia.
The above was to spark your interest - here’s the link to where I took it from:
You might then wonder what the results of his research might be? Well, published in the January 13, 2010 issue of The American Journal of Clinical Nutrition was this:
There is a full PDF of the study you can read for free should you be of the studious type. But just for fun have a look at the conclusion of the abstract where it says...'specific nutrients'... Would it be mischievous of me to substitute ...‘carbohydrate’... Or even...‘healthy whole grains’...?
Mike Pollard
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Scientific theories are adjusted all the time as new evidence is discovered. Maybe the evidence for this one stacks up and the medical establishment will adjust its opinion. However, until that time I believe that we should follow the advice which has been developed by the mainstream scientists. I am afraid that just because a scientist is eminent it doesn’t stop them having wacky opinions, sometimes further evidence proves that they were right as in plate tectonic theory but many times they are proved to be wrong, such as the MMR vaccine debacle which has damaged thousands of children.
Unfortunately the science of food and its effects on the body is still fairly new and to a certain degree our generation are all guinea pigs as more and more people around the world abandon their traditional diet and take up the Western one. What is known is that the burger, fries and cola diet with excess fat, sugar and salt is exceptionally unhealthy and the Mediterranean diet of fruit and veg, whole grains and modest amounts of protein from meat and and oily fish plus exercise is very healthy. Each of us has to decide how far we move on the spectrum between the two while the scientists continue their experiments to find out why that is.
I used to be an academic and most of that list just means he's good at making friends!
He's "board-certified"? What board? Do internal medicine, endocrinology and metabolism as defined by that board directly relate to whatever you're looking to him for?
I thought there was an AMA like our BMA, but it's not mentioned above. Any reason why not?
The most interesting bit of that description is the 400 research papers and reviews. I'd love to see the review and citation profiles for those. On the AJCN one linked above, at least some of them were him citing himself and others didn't have free full text so could have been disagreeing.
Looking at the paper, I'm almost certain the results line "Intake of saturated fat was not associated with an increased risk" is an incorrect description of the result. I feel that should have been caught at review, but there appears to be all medics and no statistician on the board of that journal. Basically, it doesn't show an association, but the experiment's design doesn't let it show there is no association, if you see what I mean. The line in the conclusion "there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk" is the correct description of this meta-analysis.
Basically, he struck out and found nothing. It's null evidence. That's slightly interesting, because some people would expect it to show something, but nothing guarantees it. In an ideal world, if the link does exist but we ask for a signficance level of 5%, about 1 in 20 random experiments will show nothing significant.
And finally, that paper analyses the general population, not an FH population, so its application to most HEART UK members may be limited.
You could try this one. Only shows a small increase in risk and does conclude more work is required - I suspect due to the very long periods needed to show a result (this was 2001)
Below is a 2010 study about replacing Saturated Fat with Polyunsaturated Fat. Again, seems to indicate that replacing 'fat' with something else non-fat (for example carbs) has no science behind it. As the opening line states:
Reduced saturated fat (SFA) consumption is recommended to reduce coronary heart disease (CHD), but there is an absence of strong supporting evidence from randomized controlled trials (RCTs) of clinical CHD events and few guidelines focus on any specific replacement nutrient.
There are common responses to my postings, such as the first two above:
‘I’m happy with the experts and their advice, so will continue with my current thinking: therefore I shall not be changing.’
That’s all very well, but perhaps that attitude might be worth a coat of looking at:
In 1847 Ignaz Semmelweis made the link between puerperal fever (childbed fever) and surgeons not washing their hands (often after dissecting a cadaver in the teaching of students). His findings conflicted with current medical opinions and he was subject to much ridicule by the establishment. In spite of his spectacular results in lessening postpartum deaths by simple hygiene. His findings were never acted upon, as the germ theory had not been established as fact. He died in an insane asylum.
It seems so silly now doesn’t it, but that’s the problem with current thinking - it always moves on! But if perhaps, if you are a patient you’d prefer to cling to the ‘gentlemen don’t need to wash their hands’ theory?
In 1888 Charles Louis Alphonse Laveran discovered the parasite that caused malaria.
The germ theory of disease had by now been enthusiastically embraced by the medical community who wanted to attribute it to every pathological disease. Briefly his findings conflicted with current medical opinions and he was subject to much ridicule by the establishment.
It seems so silly now doesn’t it, but that’s the problem with current thinking - it always moves on!
Perhaps you might be going on holiday to East Africa this year, and if you are you might still be clinging to the ‘night air’ theory of malaria (when mosquitos are active) and will be taking your prophylactic ‘miasma’ pills.
In 1998 Barry Marshall made the link (he wasn’t the first by the way) between Helicobacter Pylori and stomach ulcers. His findings conflicted with established medical opinions and he was subject to much ridicule by the establishment.
He and Robin Warren were awarded the Nobel Prize for Medicine in 2005.
It seems so silly now doesn’t it, but that’s the problem with current thinking - it always moves on!
But if you are a sufferer perhaps you’d prefer to cling to the then theory of ulcer causation and treatment and go on a stress management course!
Now we come to Ronald Krauss.
Perhaps a more careful perusal of his CHORI overview might have flagged up the following:
‘...founder and past Chair of the AHA Council on Nutrition, Physical Activity, and Metabolism, and a National Spokesperson for the AHA...’
The American Heart Association (AHA) is big - very big! Since 1949 it has spent $3.3 billion on heart research - in the field of heart research I don’t think you’ll find any bigger!
Notice who the chairman was? That’s right, dodgy Ron!
Now, speaking of other characters of dubious qualifications, you might to go back and see who else might have been a major mover and shaker in the AHA.
In 1960 six people made up the committee of the AHA. Was one Ancel Keys. I wonder how many backs this man this man scratched? His credentials included:
BA in economics and political science. MS in zoology. Phd in oceanography and biology and a second Phd in physiology.
Pretty impressive don’t you agree? But among those qualifications I don’t see anything that would qualify the man to analyse statistics, let alone publish the statistics he did and get them accepted as gospel and in the face of much contemporary scepticism. Anyone with half an eye could see the man was a faker with an ego the size of a planet!
So what are your conclusions of the study I posted?
In 2000 Ronald Krauss, as chairman of the AHA endorsed:
‘Limit the intake of foods with a high content of saturated
fatty acids and cholesterol.’
In 2010 he said this:
‘A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.’ (questioning the role of carbohydrate? - my parenthesis)
The man, like the best of scientists has re-evaluated his paradigm and changed his mind when the ‘facts’ changed.
The following is a quote by Max Planck:
‘A scientific truth does not triumph by convincing its opponents and making them see the light but rather because its opponents eventually die and a new generation grows up that is familiar with it.’
My conclusions of the study you posted are above: "Basically, he struck out and found nothing. It's null evidence. That's slightly interesting, because some people would expect it to show something, but nothing guarantees it."
Stop trying to make this black-and-white. It ain't.
Also, the US Republican Party and the Chinese Communist Party are both really really big and they can't both be correct. The size of the AHA tells us almost nothing.
No, I'm intent on not just accepting a blurb as a reason to take this chap as the new messiah. And if you bothered to read what I wrote, I'll accept his actual conclusion - his meta-analysis did not find a significant link - but that is not evidence that there is no link.
The clinical studies are well-known and they don't demonstrate it conclusively, else the lipid hypothesis would not be a hypothesis any longer - it would be the lipid fact! Often they are looking at multiple diet factors and not only saturated fat, but here are three interesting meta-analyses from the NHS evidence bank:
# Brunner, E.J., Thorogood, M., Rees, K. and Hewitt, G. (2007) Dietary advice for reducing cardiovascular risk (Cochrane Review). The Cochrane Library. Issue 4. John Wiley & Sons Ltd. thecochranelibrary.com [Free Full-text]
# Hooper, L., Summerbell, C.D., Higgins, J.P. et al. (2000) Reduced or modified dietary fat for preventing cardiovascular disease (Cochrane Review). The Cochrane Library. Issue 2. John Wiley & Sons, Ltd. thecochranelibrary.com [Free Full-text]
# Howell, W.H., McNamara, D.J., Tosca, M.A. et al. (1997) Plasma lipid and lipoprotein responses to dietary fat and cholesterol: a meta-analysis. American Journal of Clinical Nutrition 65(6), 1747-1764. [Abstract] [Free Full-text]
I think there is currently a problem with testing that lipid hypothesis is wrong because the most conclusive way would be to deliberately elevate saturated fat intake and, on balance, that is considered unethical because most would expect the treatment group to die sooner. So inconclusive is a disappointing but not unsurprising outcome.
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