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Home › Education › Diet Matters

Diet Matters

Jul 29, 2020 | Bradley Tanner

Recently, a new research article came out on the relationship between diet and several major diseases in the U.S.:

  • Micha Renata, Peñalvo Jose L, Cudhea Frederick, Imamura Fumiaki, Rehm Colin D, Mozaffarian Dariush. Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States. JAMA. March 7, 2017;317(9):912-924. doi:10.1001/jama.2017.0947.

This study was attached to a warning in multiple publications.

  • New York Times (2/3, O’Connor). In a study, researchers “analyzed data on a diverse group of thousands of people who were followed for an average of three decades” and “found that people who had the highest intakes of red meat, processed meat and poultry had a small but increased risk of developing cardiovascular disease.”
  • CNN (2/3, Lamotte). The study of 30,000 people published in JAMA Internal Medicine “found a small but significant risk of death from any cause tied to eating two servings of processed meat or unprocessed red meat each week.” Moreover, a 3% to 7% increase in risk for cardiovascular disease was “found for those eating two servings a week of processed meat, unprocessed red meat or poultry – although that last category might be due to frying or the consumption of skin, researchers said.” Meanwhile, “there was no association for eating fish, the study found.”
  • Newsweek (2/3, Gander), Reports the risk for all-cause mortality was 3% higher in “people who ate red and or processed meat – excluding fish – twice a week.” A serving “of meat was defined as 4 ounces.” Data from the study was collected between 1985 and 2002 and then participants were followed-up with in 2019.

What the study actually concludes is this.

Among individual dietary components, the largest estimated mortality was associated with suboptimal [excess] sodium (9.5%), followed by:

  • [too low of ] nuts/seeds
  • [high] processed meats, [not hamburger] – Processed meat refers to choices such as bacon, sausage, ham, hot dogs and bologna
  • [low] seafood omega-3 fats
  • [low] vegetables, fruits
  • [high] sugar-sweetened beverages (SSBs)
  • [low] whole grains (each between 5.9%-8.5%)
  • [low] polyunsaturated fats (2.3%)
  • [low] unprocessed red meats (0.4%)

Estimated deaths related to processed meats and SSBs were higher among men than women. By age, SSBs were the leading estimated factor associated with cardiometabolic mortality between ages 25 and 64 years and excess sodium at age 65 years or older.

Disparities were evident by race, especially for high SSBs among blacks and insufficient nuts/seeds among Hispanics, and by education, especially for low nuts/seeds and fruits and high SSBs among less-educated adults. Income-related disparities in current levels and trends over time of national consumption of nuts/seeds, fruits, and SSBs have been reported, which likely contribute to the disparities in diet-associated mortality by race and education identified in the present investigation.

Several other dietary factors were evaluated and not included because of insufficient evidence for causal relationships, including monounsaturated fats, vitamin D, magnesium, calcium, antioxidant vitamins, dairy products, cocoa, coffee, and tea.


So the real take-home is:

  • Liquids:
    • No one still wants to mention the easily avoidable risks of SSBs since we don’t need sugar (and protein is pretty useful). SSBs are a disparity issue.
    • Coffee and tea continue to get a pass.
    • They didn’t ask about alcohol strangely enough. Isn’t alcohol a part of many people’s diets? Doesn’t it have calories? Doesn’t it replace other calories?
    • They missed the fact that the more water you drink, the healthier you are.
  • Nuts are great.
  • Processed meats are bad for you.
  • Unprocessed meats are no doubt bad for the environment and an inefficient use of resources, but the connection of low unprocessed meats with poor health is weak, really weak.
  • Excess salt is a problem. But is it the combination of hypertension and salt?
  • Fats continue to win the day.

We are slowly learning that all that “old” nutrition research was garbage (fat is bad, sugar is fine, eggs are bad, meat is bad, chemicals are GRAS [Generally recognized as safe]). To the list of “corrections”, we can add eggs are fine now.

  • Dehghan Mahshid, Mente Andrew, Rangarajan Sumathy, et al. Association of egg intake with blood lipids, cardiovascular disease, and mortality in 177,000 people in 50 countries. Am J Clin Nutr. January 21, 2020. doi:10.1093/ajcn/nqz348.

In 3 large international prospective studies including ∼177,000 individuals, 12,701 deaths, and 13,658 CVD events from 50 countries in 6 continents, we did not find significant associations between egg intake and blood lipids, mortality, or major CVD events.

Beware the past results/publications from the industry-compromised researchers with a need for fame who used tiny and biased study populations and bad statistics.

Category: Education Tagged: nutrition

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Bradley Tanner

Bradley Tanner, MD, ME is a psychiatrist and Studio Head of HealthImpact.studio. In this role, he guides the development and evaluation of novel technological solutions to address health challenges including burnout, stress, and depression seen in medical students, residents, and practicing physicians in their early and later careers. You can reach Dr. Tanner at bradtanner@gmail.com. Personal health concerns and concerns related to suicidality should be addressed with your health professional.

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