Just as nutritional controversy cannot be discussed without getting into the Cholesterol Wars, so can the Cholesterol Wars not be discussed without confronting The Lipid Hypothesis (LH). Plant Positive provides a great entry point for jumping into the fray. He’s a heavyweight combatant, coming from the left in the top three bullet’d areas of contention I mention in Cholesterol Wars 1, with 137 voice-over slide videos to his credit, both on YouTube and his blog.
His series, The Primitive Response Playlist is a set of 22 videos responding to attackers from the right. He begins the series with Vegan Propaganda, addressing the apparent desire from those on the right (who he calls “confusionists”) to dismiss what he has to say as “vegan propaganda”. If you actually listen to it, you’ll get a good sense of the vitriolic tension between the sides.
Here’s my review; bolded numbers are video frame times:
Vegan Propaganda, 1:00:
Appropriately enough, the video starts with the following definition of the lipid hypothesis (LH) from page 37 of Daniel Steinberg’s 2007 book, The Cholesterol Wars: The Skeptics vs the Preponderance of Evidence:
Vegan Propaganda, my summary of 1:00 – 7:48:
The claim is made that in challenging LH, “confusionists” like Anthony Colpo & Denise Minger are in a battle that simply cannot be won. Overturning LH would be nearly impossible. The credentials, dedication, honesty, tactics, integrity of the critics are sarcastically impugned. We are also reminded to beware of “wikiality“.
Vegan Propaganda, 7:49:
Quotes Weston A Price Foundation (WAPF), Myths & Truths About Nutrition :
“Myth: Vegetarianism is healthy.
Truth: The annual all-cause death rate of vegetarian men is slightly more than that of non-vegetarian men (.93% vs .89%); the annual death rate of vegetarian women is significantly more than that of non-vegetarian women (.86% vs .54%) (Am J Clin Nutr 1982 36:873).”
Wow! Look at that! Vegetarian women are dying in droves compared to omnivores. I didn’t know that. How did WAPF get these numbers? Well, turns out it was simple division. I went to the journal ref, put the raw numbers for study size and deaths into a spreadsheet and, voila, here’s what I got (compare the last 4 orange numbers with the WAPF 4 numbers above):
The yellow numbers are the raw data from the journal article; the orange are my simple arithmetic: divide to get total death rate for the seven year study and then divide by 7 to get average annual death rate.
Vegan Propaganda, 8:32:
The 1982 study that WAPF is interpreting at 7:49 above is from the journal article by Burr and Sweetnam, Vegetarianism, dietary fiber, and mortality. I found the journal PDF and here’s the abstract (bold in abstract is mine):
“ABSTRACT A prospective study was set up to test the hypotheses that the risk of death from various diseases is reduced by a high intake of dietary fiber or by vegetarianism. A simple screening questionnaire was distributed among persons with a special interest in health foods, and 10,943 subjects were recruited and followed-up. Their mortality was ascertained by flagging their National Health Service records, and analyzed after 7 yr. A significant negative association was found between vegetarianism and mortality from ischemic heart disease which was especially marked among the men and did not seem to be due to a confounding effect of smoking. No significant associations were found with fiber, although persons who habitually ate wholemeal bread had a lower mortality from cerebrovascular disease. These findings confirm other evidence of a lower mortality from heart disease among vegetarians. “
Yep, that’s the same study alright, but from the abstract, the study authors (B/S, no slur intended) reached entirely different conclusions than did WAPF. So, OK, who’s right, WAPF or B/S? Here’s a screenshot from the journal PDF table 5 where we will find the source data for the dispute:
The Table 5 numbers can’t be directly compared to the simple WAPF calculations in my spreadsheet above, because Standardized Mortality Ratio (SMR) is a computation that requires knowing the ages of everyone in the samples and the journal separates “wholemeal” eaters from processed grain eaters to give eight groups, not just four. But, looking at the numbers, in every one of the eight groups, the vegetarians have lower mortality in every single group! If WAPF is right, how can this be? What’s going on here?
So how does SMR work? Let’s break it down. To get the expected deaths, B/S used actuarial tables giving average death rates for people by year of birth, so it’s an age-adjusted calculation. [To get the expected deaths for any collection of people, just break them into groups by birth year, and for each of the study years, multiply the number of people in each birth year by the actuarial table average death rate for people born that year and add them all together. The point being that it’s just additive; the wholemeal can be combined with the non-wholemeals.]
So, repeating the simple arithmetic I did for the WAPF number above above:
Now, on the right in the bright yellow, is my simple sum combining the B/S journal data for expected deaths from 8 groups into four and, in orange, is the same simple calcs for the age-adjusted expected death rates for people with a similar age distribution as the 4 experimental groups. Now it becomes apparent that the group of vegetarians selected for this study happen to have a higher expected death rate than the group of omnivores selected: for males 2.10% vs 1.84%, for females 1.65% vs 0.99%!! But this is not because they don’t eat meat; it’s because, on the average, they’re older! DUH!! What’s more, they may be older because they’ve outlived the omnivores. But I’m not qualified to make that assertion; I’m just speculating out loud.
Bottom line? Plant Positive is right!! At best, the unknown WAPF author is an idiot, falling prey to thinking oneself to be smarter than a trained statistician and that simple math will yield a superior result. Really, all it shows is that the WAPF author didn’t understand the journal article. But at worst, the WAPF author of this article (with 29,744 hits!) did understand and shamefully, deliberately and willfully intended to mislead, misrepresent, obfuscate and distort the truth.
I know, “Now, Dan, tell us what you really think, LOL.” Of course, in the name of humility, maybe I’m the one being simplistic (along with B/S, the pHD scientists that wrote the journal article and all the equally highly trained peer reviewers) and there’s some vital consideration that we’ve all missed. But then, why didn’t the WAPF article give us at least a footnote, pointing out the B/S mistake and explaining at what point we’ve all deviated from correctness?
Nope, I don’t think so. Round one is clearly awarded to Plant Positive.
But, wait! Not so fast there. It looks like WAPF is in the process of removing that link that Plant Positive called out with something more correct. Being the borderline OCD’r that I am, I feel compelled to search WAPF for something better and look what I found: Twenty-Two Reasons Not to Go Vegetarian by Sally Fallon (Morell). Here’s a screenshot from the “Sidebar” section at the end:
These are the same misleading, fraudulent numbers as the recently-gone-missing first WAPF article. But this time we have a name and a face for it: Sally Fallon (Morell) is the WAPF idiot author who wrote this. Her credentials are an MS in English, so maybe it wasn’t intentional. Maybe she just didn’t understand. That’s excusable. At one point in my training, I studied actuarial science and got half way through the program to becoming an actuary (I quit because the insurance company I worked for engaged in practices that I found ethically disgusting.) But, I do understand enough to know it’s a bit more complicated than an Engish-studying-kinda-gal would appreciate.
Fallon is exonerated from intentional wrongdoing, but Round one still goes to Plant Positive.
Vegan Propaganda, 10:48 – 13:53, my summary:
This is the start of a stunningly great example of wikiality in action! A long, long, long list of bloggers, books and websites are presented: YouTube – Big Fat Lies, Dr Atkins, wiki, Jonny Bowden, Hurt Harris MD, Ernest Curtis MD, Mark Sisson, Chris Masterjohn, Evelyn (CarbSane), Petro D. (Hyperlipid), Dr. Mercola, Donald W Miller, Jr MD, Gary Taubes, Modern Dietary Fat Intakes in Disease Promotion (a textbook), to which I would also add the books of Uffe Ravnskov and Dr. Malcolm Kendrik, not mentioned in the video.
Q. What do all these “cholesterol deniers” have in common?
A. Firstly, the libelous claim that Ancel Keys falsified the data from the 22 Country Study and only presented the data from countries that fit his vegetarian agenda and, secondly, that this falsification is one of the cornerstones of the Lipid Hypothesis.
Vegan Propaganda, 13:53 – end, my summary:
TaDa!! Here is where the Ancel Keys wikiality is refuted. We are shown some slides, the first describing the actual Ancel Keyes history (credited to Frederick Epstein, MD), followed by a very short synopsis of others’ contributions to uncovering the epidemiological association of dietary saturated fat with CHD mortality.
I tentatively award round 2 to Plant Positive as well. I haven’t verified the information contained in the wikiality refutation. I will update this post if I can catch Plant Positive in a lie or distortion.
Meanwhile, the score so far is Plant Positive 2, opposition 0. Kudos to Plant Positive for coming down out of the ivory tower to set the record straight.
… to be continued.