Talk:Saturated fat

NPOV dispute - Research showing no link between saturated fat and CV risk is missing from this article

This paper was published September, 2022. It unfortunately does not fit popular opinion despite utilizing scientific rigor. I assume that's the reason for its exclusion. https://academic.oup.com/eurjpc/article-abstract/29/18/2312/6691821

It came to the same conclusion this meta-analysis did in 2014: https://www.acpjournals.org/doi/10.7326/M13-1788?articleid=1846638

Which came to the same conclusion this meta-analysis did in 2010: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824152/

(The point is to illustrate that this has been an ongoing debate for at least 12 years.)

Apparently the science is not so clear cut on the relationship between saturated fat and CV risk, but that's not the impression someone reading this article would get. Are we going to present all the scientific data, or are we taking sides? Agenda or no? 2600:4040:5012:7500:3000:9EF2:F8B5:125A (talk) 13:29, 26 March 2023 (UTC)

2014 is old, but the more recent paper might be worth mentioning. Or is it just an outlier? We cite WHO stuff which is more recent. Bon courage (talk) 13:56, 26 March 2023 (UTC)

The best sources on this are the World Health Organization (2023) [1], American Heart Association [2] (2017), UK Scientific Advisory Committee on Nutrition (2019), [3] and Cochrane review (2020) [4]. In total they have looked at hundreds of studies. The scientific consensus is clear on this, high saturated fat intake does increase CVD risk. Psychologist Guy (talk) 16:15, 26 March 2023 (UTC)

We have about 60 years research on this, it has been known for a long time since the research of D. Mark Hegsted and colleagues that palmitic acid increases LDL-c and total cholesterol. The debate has continued in recent years about specific saturated fatty acids on CVD risk. Long-chain saturated fatty acids increase CVD risk (palmitic and myristic acid for example) but stearic acid a medium-chain saturated fatty acid is neutral or may lower LDL. It's probably worth mentioning this on the article at some point. The World Health Organization have discussed it. Psychologist Guy (talk) 16:38, 26 March 2023 (UTC)

Yeah, Cochrane is a always a great source. Let’s see what it actually said:

“ We found little or no effect of reducing saturated fat on all‐cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate‐quality evidence.

There was little or no effect of reducing saturated fats on non‐fatal myocardial infarction (RR 0.97, 95% CI 0.87 to 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both low‐quality evidence), but effects on total (fatal or non‐fatal) myocardial infarction, stroke and CHD events (fatal or non‐fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI. There was no evidence of harmful effects of reducing saturated fat intakes.” Antisoapbox (talk) 21:41, 9 June 2023 (UTC)

Hopefully you have read that review, rather than just the abstract. Firstly, the trials in most cases were only two years long and they were on "participants at varying levels of risk of cardiovascular disease, men and women, with mean ages from 46 to 66 years". But you deliberately left out "There is a large body of evidence assessing effects of reducing saturated fat for at least two years. These studies provide moderate‐quality evidence that reducing saturated fat reduces our risk of cardiovascular disease" and "In this review, saturated fat reduction had little or no effect on all‐cause or cardiovascular mortality but did appear to reduce the risk of cardiovascular events by 17%". The conclusion is that reduction of saturated fat reduced risk of cardiovascular events in the participants that had or were at risk of cardiovascular disease by 17%. If you have any Cochrane reviews telling us the opposite that increased saturated fat consumption reduces cardiovascular events, let us know but no such finding has ever been published because saturated fat clearly increases CVD risk and yes it takes decades, not two years but those trials have shown us reducing CVD for around two years can reduce CVD events. Psychologist Guy (talk) 23:48, 9 June 2023 (UTC)

Here is a major study: [5]. The conclusion is: "In this cohort, substituting omega 6 linoleic acid for saturated fat did not provide the intended benefits, but increased all cause morality, cardiovascular death, and death from coronary heart disease." A recent meta-analysis -- included in the provided link -- addresses more recently raised concerns, and reaffirms the original result. Therefore exclusion of this result is an NPOV issue.

With every food investigated in nutrition there will always be an outlier study. There is no point in cherry picking 1 study or meta-analysis when every other meta-analysis and review says the opposite as you are ignoring consensus. The study you are quoting is from 2013. We since have many recent reviews published between 2014 and 2023 which conclude linoleic acid consumption lowers risk of CVD and mortality [6], [7], [8], [9]. Psychologist Guy (talk) 21:40, 6 June 2023 (UTC)

It is undeniable that the wikipedia article on saturated fat violates NPOV.

"Available evidence from adequately controlled randomised controlled trials suggest replacing SFA with mostly n-6 PUFA is unlikely to reduce CHD events, CHD mortality or total mortality. The suggestion of benefits reported in earlier meta-analyses is due to the inclusion of inadequately controlled trials. These findings have implications for current dietary recommendations.".

Source: doi.org/10.1186/s12937-017-0254-5 sbelknap (talk) 20:59, 9 September 2023 (UTC)

You already cited that paper before on the red meat talk-page. It's a bit silly to be talking about CHD mortality or total mortality from randomized controlled trials that are around a year and a half long. There is no long-term clinical data. Of course there will be no signifcant effect here. Total mortality is not something that can be studied within a year from a couple of short-term trials. The best evidence that we have for this are epidemiological studies that look at decades of data and show consistent results. Psychologist Guy (talk) 20:53, 10 September 2023 (UTC)

You have misstated the findings of the Hamley meta-analysis. Perhaps you have not read it. Is this one behind a paywall for you?

If you have access to the article, look at Figure 6.

Poor-quality RCTs show that switching satfat → PUFA *reduces* CHD mortality while the high-quality RCTs show switching satfat → PUFA *does not reduce* CHD mortality.

I propose that the findings of Hamley be included in this wikipedia article on Saturated Fat. sbelknap (talk) 22:21, 10 September 2023 (UTC)

Most controlled trials will not give us good results for CHD mortality or total mortality because nearly all of the controlled trials are short-term. Hopefully you realise this. We need long-term data, that is why we rely on epidemiological studies here.

Many of these short-term trials that the author you cite mentions are between 1 and 2 years. In a human lifetime that is a short time. It will not give us significant data about mortality. The paper you are talking about by Steven Hamley is online in full [10]. The review he is criticizing is the Hooper review [11]. The Hooper review reported that there was little or no effect of reducing saturated fat on all‐cause mortality or cardiovascular mortality. The reduction was in cardiovascular events. It is not our purpose here to be doing original research like Steven Hamley has been doing. The Hooper review is a high-quality source and is cited on the article. There is no reason to cite a weak source like Steven Hamley. If like Hamley you believe certain controlled trials are "inadequate" that is up to you, but this type of original research will not be put onto the article. It is not up to us to question reliable reviews here, we just report what they say. The Hooper review is cited on the article. Psychologist Guy (talk) 00:22, 11 September 2023 (UTC)

I've published two meta-analyses. I'm familiar with how this is done.

Hamley's meta-analysis is a separate analysis and is not a commentary on the Hooper review. He does critique prior meta-analyses, including Hooper. This is a routine part of a meta-analysis & systematic review. Hamley does a more comprehensive analysis than Hooper, as he studies how different types of studies compare.

In the methods section of Steven Hamley's meta-analysis, he states, "I followed the PRISMA (www.prisma-statement.org) guidelines [52] throughout the design, implementation, analysis, and reporting of this meta-analysis."

Hamley does follow the PRISMA guidelines. Hooper does not follow the PRISMA guidelines. For these and other reasons, the Hamley review is of higher quality than the Hooper review.

This article could be improved by including the points made by Hamley. sbelknap (talk) 04:02, 11 September 2023 (UTC)

Ramsen and Hamley both deal with the question whether SFA should be replaced primarily with omega 6. Ramsen concludes that

"RCT that substituted mixed n-3/n-6 PUFA in place of TFA and SFA reduced CHD risk. By contrast, n-6 specific PUFA interventions tended to increase CHD risk.".

Hamley concludes that

"By contrast, n-6 specific PUFA interventions tended to increase CHD risk."

Both authors are looking for the best way to replace SFA and conclude that a replacement with primarily omega 6 does not reduce risk. Based on these two studies it seems that replacing SFA with a mix of omega 3 and omega 6 is the best strategy to reduce CVD risk. CarlFromVienna (talk) 09:26, 11 September 2023 (UTC)

You are correct that Hamley & Ramsen have different conclusions. Thanks for sharing your original research. As you know, editors are not to cite their own original research for content in wikipedia articles. Neither Hamley nor Ramsen draw the conclusion you state, that "replacing SFA with a mix of omega 3 and omega 6 is the best strategy to reduce CVD risk."

The way ahead with this article is to cite Hamley's findings. sbelknap (talk) 11:40, 11 September 2023 (UTC)

Hamley seems to be using some subjective criteria about what he classifies as a "adequately controlled trial" and the ones which are "inadequate" in his view. The adequate trials all seem to support his POV. For example this 1965 trial that used corn oil [12] was using high-dose corn oil in supplement form. The conclusion of this trial is that there was no benefit. This is not surprising. The subjects were consuming corn oil capsules, not a healthy diet. This is in contrast to another trial he cited that involved a plasma-cholesterol-lowering diet that included soybean oil, fish and vegetables [13], the conclusion was "the cholesterol-lowering diet reduced the incidence of total CHD". Yet Hamley excludes this trial as "inadequate". Why would we cite an article by Hamley that does original research?

I would agree that replacing SFA with a mix of omega 3 and omega 6 is a good strategy to reduce CVD risk. The scientific consensus is telling people to consume a mixture of n-3/n-6 PUFA in place of SFA. The idea to include just n-6 or "mostly" n-6 is not the consensus view. Hamley seems to be misrepresenting scientific consensus. The consensus view is very clear, we do not need to add one opinion piece from Hamley challenging it. See WP:Fringe. Psychologist Guy (talk) 11:58, 11 September 2023 (UTC)

Here, you misstate Hamley's methods, describing his criterion for "adequately-controlled" as being subjective. You also mischaracterize Hamley's article as "an opinion piece." Hamley is conducting and reporting meta-research and review in his article. If one follows his process, one obtains the same meta-research result. Perhaps you are unfamiliar with PRISMA. The failure of the Cochrane group to distinguish RCT quality is a deviation from PRISMA, which perhaps accounts for why the Cochrane meta-analysis does not claim adherence to PRISMA.

In the methods section, Hamley describes the criterion he used:

"Clinical trials were identified from earlier meta-analyses. Relevant trials were categorised as ‘adequately controlled’ or ‘inadequately controlled’ depending on whether there were substantial dietary or non-dietary differences between the experimental and control groups that were not related to SFA or mostly n-6 PUFA intake, then were subject to different subgroup analyses."

Hamley excludes the Oslo Diet Heart study because of a dietary difference between the experimental and control groups that was unrelated to SFA or (mostly) ω-6 PUFA intake—trans fatty acids: that is, in the Oslo Diet Heart study, "only the experimental group (the high n-6 PUFA group) received advice to avoid major sources of industrial trans fatty acids (TFA), such as common/hard margarines, shortenings and/or hydrogenated oils." This info is presented by Leren et al in the primary source. There is nothing subjective or original about Hamley's exclusion of the Oslo Diet Heart study. In fact, this critique of the Oslo Diet Heart study is well-known.

These objections to inclusion of Hamley's meta-analysis in this wikipedia article on saturated fat are without merit. Hamley is more careful in his meta-analysis than other authors, he adheres to PRISMA & he reaches conclusions that are important and relevant here. Hamley's work is a high-quality secondary source. Inclusion of Hamley's work would improve this article. sbelknap (talk) 12:26, 11 September 2023 (UTC)

The title of this discussion is „no link between SFA and CVD“. Both studies you brought up do not deal with this question but with the question if SFA should be replaced with primarily omega 6. That is a different discussion. Do you have any study that actually deals with the question at hand and supports that there is no link between SFA and CVD? If not this discussion can be closed. CarlFromVienna (talk) 15:30, 11 September 2023 (UTC)

Have you read these studies? They compare a control diet to a diet that substitutes PUFA for SatFat. The PUFA diet was high in ω-6 fat and was not pure ω-6 fat. Thus, the intervention diet reflects standard diet recommendations at the time these studies were done. It is still routine to prescribe a PUFA diet high in ω-6. That is what happens when one eats grains, legumes, and many other plant-based foods as these foods contain PUFAs high in ω-6 fats.

A reduction in satfat *requires* an increase in some other macronutrient: carbohydrate, fat, or protein. For purposes of this line of inquiry, protein & carbohydrate is kept reasonably constant, it is the fat component of diet that is manipulated. To maintain constant total fat intake, some type of dietary fat is increased and someother type of dietary fat is decreased. It is not possible to satisfy your demand for a study that *only* manipulates satfat. That's not a thing.

I propose including discussion of Hamley's meta-analysis in this wikipedia article on saturated fat. sbelknap (talk) 18:15, 11 September 2023 (UTC)

Hamley's criteria for "adequately-controlled" and "inadequately-controlled" is indeed subjective. He just made up reasons to exclude certain trials as "inadequate", when such trials were actually reliable. For example he put the LAVAT trial (Los Angeles Veterans Administration Trial) [14] on the "inadequately-controlled" list based on his bizarre reason that there was insufficient vitamin E intake in the control group. The trial is one of the most rigorously controlled trials performed on the subject (they commissioned food companies to design foods to keep the subjects blinded). It's well known that vegetable oils contain higher vitamin E than animal foods so subjects consuming vegetables oils are going to have higher Vitamin E levels. There is no way round this. It's ridiculous to exclude the trial for this reason. He has other stupid reasons for dismissing other trials.

Steven Hamley is a conspiracy theorist who delivered his paper at the Low Carb Down Under event. He spends a lot of time attacking the American Medical Association. I doubt you are going to gain a consensus here by getting other users to agree with you. I am not convinced by Hamley's methods. This is not the place to promote fringe science. He is not a reliable medical source. You should also disclose here that you have had interaction with Steven Hamley which is an obvious conflict of interest. Psychologist Guy (talk) 20:25, 11 September 2023 (UTC)

The criterion for defining adequacy of control used by Hamley is objective and adequately described in the methods section of his meta-analysis. The lack of sufficient vitamin E constitutes an instance of a "substantial dietary or non-dietary difference between the experimental and control groups that were not related to SFA or mostly n-6 PUFA intake." Assuring adequacy of all essential nutrients in the control group is essential to excluding deficiency of a nutrient as a confounding variable. The scientists who designed LAVAT erred in this way. Excluding LAVAT from his meta-analysis meets his objective exclusion criteria for an adequately-controlled trial. Hamley was not the first one to critique the excluded trials for these design flaws. Many of these critiques were made by others.

Your ad hominem ("conspiracy theorist", "fringe science") against Hamley is hard to take seriously. Hamley gives enough detail in his paper that any competent meta-researcher could duplicate his results.

I don't know Hamley, never met him. I've never had any private exchange with Hamley. I don't recall any public exchange on twitter with Hamley. As Twitter (now X) is a public forum, this is possible, of course. Regardless, this does not constitute a COI. I have no other COI.

As you fellas are anons, there is no way to independently assess your COIs.

Regardless, my proposal stands. So far, the objections raised to inclusion of Hamley in this wikipedia article range from specious to laughable. I've countered each one fully. Enough of this. Lets craft some text on the Hamley article to put in the article. sbelknap (talk) 20:53, 11 September 2023 (UTC)

The criteria Hamley uses is laughable, nobody else would use criteria like this. The LAVAT trial involved commissioning food companies to create entirely new products with vegetable oils in them to keep subjects entirely blinded. This isn't a design flaw. Show me another trial that went this far, the methodology and control was top notch. That trial is one of the most well controlled that we have on this subject. If vegetable oil is going to be used in a trial, the Vitamin E content will always be higher than that of an animal-based diet. I don't know how you would get round this, you would have to invent and alter a vegetable oil which would be very hard to do, almost impossible. If you want to believe Hamley is an objective researcher that is up to you, but it is obvious he isn't. This is very much WP:Fringe. He never published a Meta-regression. The Hooper 2020 meta-analysis includes a meta-regression and is does not employ outrageous criteria [15]. It is a much more reliable source. Nobody outside of the low-carb community takes Hamley seriously. We shouldn't be promoting him on Wikipedia. Psychologist Guy (talk) 21:21, 11 September 2023 (UTC)

To be sure, a near order-of-magnitude difference in dietary vitamin E in LAVAT is no small thing! FTFA:

Vitamin E: in LAVAT, α-tocopherol intake in the con- trol group was 9.4-fold lower than the experimental group (22.6 mg vs. 2.4 mg) [48] and only 16.0% of the current RDA (15 mg) [49]. Based on the average energy intake of the control group reported in the vitamin E paper (2400 kcal) [48] and the estimated energy intake (3150 kcal) and vitamin E (11.54 mg of α-tocopherol equivalents) per capita in the United States food supply between 1959–1968 [50], the vitamin E intake of the control group would be expected to be about 8.79 mg of α-tocopherol equivalents. This was not discussed by any of the meta-analyses.

sbelknap (talk) 21:11, 11 September 2023 (UTC)

And how do you suggest that could be modified? Vegetable oils are higher in Vitamin E than animal fats. Of course a diet high in animal fat will be lower in Vitamin E. This isn't a control issue. There is no way round this. It's ridiculous for this reason alone for Hamley to discount the trial as "inadequate". It is not a valid reason. I have read a lot of meta-analyses and I have never seen any nutritional researcher dismiss a trial as "inadequate" based on the reason cited here. The Hooper meta-analysis is a much better source. Psychologist Guy (talk) 21:44, 11 September 2023 (UTC)

Seriously?

The issue isn't that the PUFA diet had more Vitamin E. Instead, it is that the control diet was *deficient* in vitamin E at 16% of the RDA. Thus, the effect of vitamin E deficiency serves as a confounder. Vitamin E deficiency is relevant to the effect variable, as glycemia drives atherosclerosis. The deficiency of vitamin E in the control group is a serious design flaw. nutritionj.biomedcentral.com/articles/10.1186/s12937-023-00840-1

Hamley was correct in excluding LAVAT from his meta-analysis. sbelknap (talk) 22:22, 11 September 2023 (UTC)

It isn't a design flaw. It is just a consequence of a diet being based on animal fats. Like I said, there is no way round this. Any control diet with high amounts of animal fat will be low in vitamin E. This doesn't mean the trial is inadequately controlled. Even if you disagree with this, hopefully you agree that the Hamley meta-analysis does not show anything significant. Take a look at figure 2 [16]. Look where the summary point is for total CHD events for Hamley's adequately controlled trials. The risk ratio is 1.02 with a p value of 0.84. This is non significant. There is a clear noninferiority in the treatment effect. The difference between the diets is non-significant in Hamley's meta-analysis. Psychologist Guy (talk) 00:51, 12 September 2023 (UTC)

The control diet in LAVAT was the domiciliary diet at the Los Angeles Veterans Administration Center. This was not a diet "based on animal fats" — the domiciliary diet at that time was only 40% total fat, as described in the primary source articles.

The adequately-controlled trials showed that the PUFA-enriched diet did not reduce CHD events compared to placebo. That is the point. This is why citing Hamley would improve this wikipedia article. sbelknap (talk) 02:13, 12 September 2023 (UTC)

As all major nutritional societies recommend swapping SFA for PUFAs, can you point to one that has reflected Hamley in their research? If not, Hamley is only a primary source with no impact. Why then would we allow him to make an impact here if he cannot even make one in nutritional science? CarlFromVienna (talk) 06:18, 12 September 2023 (UTC)

Here on wikipedia, we are to rely on high-quality secondary sources.

Hamley is a high-quality secondary source. It has > 150 citations in the peer-reviewed literature.

According to the two United States National Academies of Science review, the Dietary Guidelines for Americans are not evidence-based.

In its most recent iteration, the Dietary Guidelines for Americans no longer presents the conclusion that saturated fat is harmful. There is a diversity of views and this article would be improved if it reflected that.

The current version of this article gives the position of the nutritional societies. It does not reflect the state of the relevant scientific literature, including Hamley. Lets fix that. sbelknap (talk) 14:34, 12 September 2023 (UTC)

Most recent Dietary Guidelines for Americans [17] says "Chapter 1 explains the importance of limiting intakes of saturated fat to support healthy dietary patterns. Staying within saturated fat limits and replacing saturated fat with unsaturated fat is of particular importance during the adult life stage" (page 102), also "For those 2 years and older, intake of saturated fat should be limited to less than 10 percent of calories per day by replacing them with unsaturated fats, particularly polyunsaturated fats." (page 44). Guideline 4 is to "Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages". Your claim that "the Dietary Guidelines for Americans no longer presents the conclusion that saturated fat is harmful", is odd because they are telling people to limit saturated fat to support health. You dislike scientific consensus I get that but this isn't the place to challenge medical consensus. These sorts of discussions are not productive (a vote may be better). The Hamley source is unlikely to be included on the article because it is unreliable. Psychologist Guy (talk) 15:55, 12 September 2023 (UTC)

Going over the history of this topic, the Hamley source has been mentioned before on Wikipedia in two places. The consensus was to not include it as it is unreliable. I have raised this issue at WikiProject Medicine to gain a new consensus. Hopefully there will be input from other editors so this can finally be resolved. Psychologist Guy (talk) 17:01, 12 September 2023 (UTC)

The way wikipedia works is that engaged editors decide how to proceed.

Now that I've addressed every objection that has been raised here among engaged editors, lets craft some text and add it to the saturated fat article.

Unless there is some other objection? sbelknap (talk) 18:15, 12 September 2023 (UTC)

I am puzzled by the claim that the Hamley article is unreliable. No engaged editor has presented any plausible reason why they hold this opinion. Each objection raised has been shown to be wrong. What is going on here?

AFAIK, this is the best meta-analysis that has been done so far on substituting PUFA for satfat. sbelknap (talk) 20:11, 12 September 2023 (UTC)

These are the recommendations, not the conclusions of the analysis of satfat in DGA. In previous revisions, DGAAC ignored high-quality data and concluded that satfat was harmful. This has been removed from the 2020 DGAs. sbelknap (talk) 03:51, 13 September 2023 (UTC)

Hamley is a paleo low-carber who, at the time he wrote his paper, wasn't even a PhD. His paper doesn't have co-authors. He is a single voice following a fad diet. Weighting this in the article against international nutritional societies would be false balance. CarlFromVienna (talk) 09:31, 13 September 2023 (UTC)

Unfortunately he has also been taking his information about the Dietary Guidelines for Americans from Gary Taubes, Nina Teicholz, James DiNicolantonio etc who are all well noted for conspiracy theories about nutrition. Add Hamley into the bag. The outcome is nutritional misinformation from the low-carb diet crowd. Psychologist Guy (talk) 21:26, 13 September 2023 (UTC)

Whatever the merits of these ad hominem attacks on Hamley, they are original research presented by engaged wikipedia editors. This oft-cited meta-analysis in a quality peer-reviewed journal stands on its own merits. A wikipedia article is improved when important minority POV is included. It seems relevant that there were lengthy delays in publication of the research results of several of the RCTs. The current wikipedia satfat article omits mention of secondary sources that present a POV that *differs* from the current draft of the satfat wikipedia article.

I propose that we proceed with crafting text covering the matters raised by Hamley. sbelknap (talk) 11:28, 14 September 2023 (UTC)

Dietary Guidelines for Americans

Above, Sbelknap has made the claim that "the Dietary Guidelines for Americans no longer presents the conclusion that saturated fat is harmful". He goes on to say "In previous revisions, DGAAC ignored high-quality data and concluded that satfat was harmful. This has been removed from the 2020 DGAs."

I want to point out why these claims are completely wrong. Firstly, as the recent DGA guidelines say "The 2020-2025 edition of the Dietary Guidelines builds from the 2015 edition, with revisions grounded in the Scientific Report of the 2020 Dietary Guidelines Advisory Committee" (page vii) [18]. Nowhere are they challenging the older conclusions, they build upon them.

The Dietary Guidelines for Americans have not changed their recommendations on saturated fat, nor do they dispute the conclusions from the 2020 Scientific Report or DGA 2015-2020 [19]. There was indeed more science about the saturated fat research in the DGA 2015-2020, this was not included in the 2020-2025 version. This doesn't mean they have changed their conclusions about saturated fat. They don't need to reprint the Scientific Report, they link to it.

The Scientific Report can be found online [20]. There is about 4 pages in DGA 2020-2025 which gives some background about the Scientific Report, "The use of a Federal advisory committee is a commonly used best practice to ensure the Federal Government seeks sound, external scientific advice to inform decisions. The Committee’s work concluded with its scientific report submitted to the Secretaries of USDA and HHS in June 2020. This report was not a draft of the Dietary Guidelines; it was a scientific document that detailed the Committee’s evidence review and provided advice to USDA and HHS." (page 8). The DGA 2020-2025 is not challenging the Committee’s evidence review.

On page 23 it says "The science supporting the Dietary Guidelines is extensively documented in the Scientific Report of the 2020 Dietary Guidelines Advisory Committee, which describes the state of the science on key topics related to diet and health. Outcomes with Strong or Moderate evidence are provided in Figure 1-3. The report is available at DietaryGuidelines.gov" [21]. It's obvious that the DGA have not changed their view about saturated fat and like all other guidelines are telling people to limit their consumption.

Sbelknap seems to be claiming that because all the saturated fat research cited in DGA 2015-2020 or the Scientific Report is not included or updated in DGA 2020-2025 they have changed their mind about their former saturated fat conclusions. This is clearly not the case. I have disproven that above, they are not challenging their older conclusions but building upon them. This is one of the oddest claims I have come across.

Currently there is no mention of DGA 2020-2025 on the article, this can be added. Psychologist Guy (talk) 20:52, 13 September 2023 (UTC)

That's a lot of text to dodge the point I made!

The USDA blocked use of outside meta-analyses by the DGAC preparing the 2020 guidelines, instead requiring the DGAC to rely on internal reviews by staff memebers at USDA. This was a change from the prior 2015 cycle. As there had been a big change in the views of some scientists on saturated fats since the previous cycle, outside experts attempted to introduce the external meta-analyses into consideration by DGAC but were rebuffed. This matter was discussed in the 2020 cycle by DGAC in a public meeting. Here's the transcript for that meeting:[22] There was no action taken by USDA or DGAC on this matter.

In the 2020 cycle, the DGAC ignored the available RCTs on cardiovascular deaths and considered only the observational studies. I consider this decision to be the most serious error made by DGAC in the 2020 cycle.

Thus, the 2020 cycle DGAC drew a conclusion that was not based on the best available information. And that is my point. Something is seriously amiss at USDA & DGAC. There are many peer-reviewed secondary sources that discuss these points. There is a lack of consensus in the scientific community and in the medical literature regarding the harmfulness of saturated fat. That lack of consensus belongs in this wikipedia article. sbelknap (talk) 23:38, 16 September 2023 (UTC)

This appears to be a conspiracy theory, this is the sort of thing that low-carbers like Nina Teicholz and Gary Taubes have been claiming. It is clear that the DGA guidelines on saturated fat have not changed. They are telling people to lower consumption just as all the other governmental and nutritional guidelines across the world are doing.

Your claim that there is lack of consensus about the harmfulness of saturated fat is not true. Just go to any governmental, dietetic or medical authority and they all say the same thing that high saturated fat consumption increases CVD risk. This is not disputed by anyone apart from those in the low-carb community. I am not aware of any medical textbooks claiming what you are saying. We do not need to create a false balance here. The medical consensus is very clear on this.

Here is a medical textbook "Saturated fats increase health risk if consumed in large amounts over a long period of time. They can raise total blood cholesterol and low-density lipoprotein (LDL) or "bad cholesterol", thus increasing the risk of cardiovascular disease and stroke. Saturated fats may also increase the risk of type 2 diabetes and cholesterol cancer." (Gerard J. Tortora, Bryan H. Derrickson (2020). Principles of Anatomy and Physiology. Wiley. p. 49). Show us one medical or nutritional textbook claiming that high saturated fat consumption does not increase CVD or cancer risk. None exist. Show us a reliable medical textbook telling us saturated fat consumption decreases CVD risk. None exist. The opposite is true and there is decades of evidence to support it. Let's stick with the science and not promote conspiracy theories on here. Psychologist Guy (talk) 11:30, 17 September 2023 (UTC)

The controversy regarding the toxicity of dietary saturated fat is discussed in current textbooks.

For example, here is the abstract for the relevant chapter in Clinical Lipidology, 3rd Edition (2023) by Christie M. Ballantyne

The Chapter Title is "Saturated Fat Intake and the Prevention and Management of Cardiovascular Disease in Adults: An Academy of Nutrition and Dietetics Evidence-based Nutrition Practice Guideline"

Abstract:

Cardiovascular disease (CVD) is the leading cause of death in the United States and globally and is largely attributable to atherosclerosis. Evidence indicates that multiple dietary components contribute to the complex causes of CVD and associated events and mortality. Public health authorities and scientific organizations have recommended reduced saturated fatty acid (SFA) intake for decades to promote cardiovascular health, which is linked to favorable impacts on established and emerging atherosclerotic CVD risk factors. Recently, a debate has emerged about whether SFA intake should be reduced for CVD prevention, which has contributed to confusion among health care professionals, including registered dietitian nutritionists (RDNs), and the general public, and necessitates the critical evaluation of the evidence. The objective of this evidence-based nutrition practice guideline is to provide health care and public health professionals, particularly RDNs, with evidence-based recommendations on how to address SFA intake in adults within an individualized healthy dietary pattern. Moderate evidence supports the reduction of SFA intake for CVD event reduction, low- to moderate-certainty evidence supports prioritization of replacement of SFAs with polyunsaturated fatty acids, and low-certainty evidence supports focusing on reducing the total amount of SFA rather than specific food sources of SFA. Guideline implementation should include consideration of individual preferences; principles of inclusion, diversity, equity, and access; and potential nutritional deficiencies that may occur with reduced SFA intake. Future research is needed to address gaps that were identified and provide high-quality evidence to support stronger future recommendations based on the relationship between SFA and CVD. sbelknap (talk) 11:58, 17 September 2023 (UTC)

The serious flaws in the DGAC/USDA process is a matter of public record. Senator Grassley has issued a letter regarding these serious flaws. His letter is here: [23]

sbelknap (talk) 12:12, 17 September 2023 (UTC)

A letter by Senator Grassley is not good evidence. Firstly, he was lobbied by Nina Teicholz and you know this [24], [25]. You are taking all your information from Nina Teicholz's low-carb group "Nutrition Coalition" website, it is not a reliable source. They have Mark Hyman on their board of directors [26]. Psychologist Guy (talk) 12:51, 17 September 2023 (UTC)

The paper you linked is a reliable source but has not been published yet in full [27] so most users here will not be able to read what it says but it doesn't dispute the evidence that saturated fat increases CVD risk. The paper was published by the Academy of Nutrition and Dietetics. According to the conclusion of the paper "Based on the highest-quality available evidence, the Expert Panel found moderate certainty evidence to support reducing SFA intake for reduced risk of CVD and CVD events but was unable to recommend a specific percentage of SFA reduction or intake." [28]. From the conclusion this paper doesn't support what you have been claiming, it seems to come to a similar conclusion to the Hooper review that there is moderate evidence from trial data that reducing saturated fat intake reduces CVD events. Psychologist Guy (talk) 12:51, 17 September 2023 (UTC)

You asked for a textbook account of this controversy. The abstract of that textbook chapter includes this statement, "Recently, a debate has emerged about whether SFA intake should be reduced for CVD prevention, which has contributed to confusion among health care professionals, including registered dietitian nutritionists (RDNs), and the general public, and necessitates the critical evaluation of the evidence."

It is clear that there are conflicting views among experts on the toxicity of saturated fats. These conflicting views are not reflected in the current draft of this wikipedia article. sbelknap (talk) 06:36, 18 September 2023 (UTC)

This article is not about the USDA but about saturated fat. All major nutritional societies worldwide recommend to cut back on it. The discussion above is too American-centric and does not belong here. CarlFromVienna (talk) 08:48, 18 September 2023 (UTC)

With all due respect, you are not the arbiter of what belongs & what does not belong in this discussion. The USDA/DGAC position on saturated fat is the most influential government agency worldwide on this issue. Most other countries take the US DGAs into consideration when formulating their own policies.

Regardless, the controversial USDGAC behavior reflects disagreement in the scientific community in toto; textbooks, peer-reviewed literature are part of science, not part of one country. The point here is that tertiary sources reflect a current controversy among scientists on the matter of saturated fat safety. Given the vehemence of this disagreement, this wikipedia article will be improved when it reflects both views presented in the secondary literature.

Various absurd objections to a more balanced discussion have been raised by engaged editors. When these objections are shown to be in error, objections of an even more absurd nature are raised.

There is something wrong here. This is not good stewardship of wikipedia. sbelknap (talk) 21:26, 18 September 2023 (UTC)

You say that „the serious flaws in the DGAC/USDA process is a matter of public record“ and that „most other countries take the US DGAs into consideration when formulating their own policies“. And still these other countries recommend to cut back on SFA. So clearly they don’t see any issue in what you try to frame as „serious flaws“. You have argued against your own case. CarlFromVienna (talk) 09:34, 19 September 2023 (UTC)

The National Academies have determined that the process used by the USDA and by the USDGAC is flawed. Most countries consider the USDGAs in determining their own recommendations. Thus, the dietary guidelines of other countries is also based on a flawed process.

This wikipedia article does not consider the high-quality secondary research that has been published.

There is a serious problem with this article. Something is wrong here. sbelknap (talk) 19:05, 4 October 2023 (UTC)

There is an overwhelming strong consensus in the medical community that high saturated fat consumption increases CVD risk. The view is accepted by all of the leading medical organizations around the world that study heart disease. For example, World Health Organization, American Medical Association, British Dietetic Association, National Heart Foundation of Australia, European Society of Cardiology, British Heart Foundation, Canadian Cardiovascular Society, Heart Research UK, American College of Cardiology, National Lipid Association, British Cardiovascular Society, Heart and Stroke Foundation of Canada, Indian Heart Association etc all support this view and it is very easy to look up these organizations and view articles and leaflets on their websites about saturated fat. They are all telling people to limit consumption of saturated fat, not increase it.

Wikipedia talk-pages are not the place to promote your conspiracy theories. If you believe all the medical organizations are wrong in the world and you are right then that is up to you but according to your Twitter profile you also promote global warming denialism and the pseudoscientific carnivore diet. My advice is to stop trolling these talk-pages, otherwise you may be blocked again like you were on the red meat article. We will not promote WP:Fringe theories on here regarding health. Psychologist Guy (talk) 13:08, 5 October 2023 (UTC)

Engaged editors on this saturated fat page are failing to respect WP:NPOV.

The NPOV policy says nothing about objectivity. In particular, the policy does not say that there is such a thing as objectivity in a philosophical sense—a "view from nowhere" (to use Thomas Nagel's phrase), such that articles written from that viewpoint are consequently objectively true. That is not the policy, and it is not our aim! Rather, to be neutral is to describe debates rather than engage in them.

I've cited many high-quality secondary (and tertiary) sources supporting the alternative POV that high saturated fat consumption does not increase risk of atherosclerotic vascular disease. Wikipedia is not the place to express your opinions. The current version of the saturated fat article has been corrupted by a biased point of view that does not consider the range of prominent findings in the literature. This article is flawed because it suppresses an alternate POV that is presented in high quality sources from peer-reviewed medical literature. Here at Wikipedia, editors are obliged to rely on high-quality secondary/tertiary sources and not on position statements of organizations, clinical practice guidelines, government policies, etc. Something is very wrong here. What is going on? sbelknap (talk) 13:23, 5 October 2023 (UTC)

It is hard to assume good faith when you repeatedly ignore scientific consensus and keep typing the same thing over and over. Your behaviour is not acceptable. You disrupted the red meat talk-page before, now you have disrupted this and the taurine talk-page. I have taken this to WP:ANI [29]. Psychologist Guy (talk) 14:36, 5 October 2023 (UTC)

We are encouraged to assume good faith.

The point here is that there is *not* a scientific consensus on the health effects of saturated fat. There are many hundreds of primary source peer-reviewed articles and dozens of secondary source articles that contradict the POV in the current saturated fat wikipedia article.

Again, according to NPOV "to be neutral is to describe debates rather than engage in them"

I am not "typing the same thing over and over." I have presented many separate high-quality secondary sources that present an alternate point of view regarding the health effects of saturated fat.

In your complaint at WP:ANI you made multiple misstatements regarding me. For example, I did not start making edits on September 9 to the saturated fat article. I have no connection to Nina Teicholz. Today, I added a POV tag to the article, as per discussion here on this talk page.

Other editors have expressed the same objection to the current content of the saturated fat article.

There is something very wrong here. The behavior of some engaged editors is not consistent with good stewardship of wikipedia. sbelknap (talk) 14:48, 5 October 2023 (UTC)

We have been here before many times. You did the same on the red meat article and got blocked for it, you did the same on taurine now you are back for round 3. You started editing this year on this article on September 9. As for Nina Teicholz we can all read her conversations with you on Twitter, she even re-tweeted you a few times.

You have not learnt anything after your block which leads to me to believe you are not assuming good faith. 1000s of words have been exchanged here and on other talk-pages with you but you do not listen, it gets to be point of being tiresome. It is the same thing every-time, you believe you correct and all the dietary guidelines and medical organizations are wrong. The World Health Organization, American Medical Association, European Society of Cardiology do not support what you are claiming, no medical organization in the world does. This isn't the place to promote fringe views about health. Psychologist Guy (talk) 15:07, 5 October 2023 (UTC)

I have made thousands of good faith edits to wikipedia that have stood.

It is absurd to claim that engaging in discussion with somebody that I've never met on a public forum is any sort of connection.

You claimed that I have been making edits on the saturated fat article since September 9. AFAICT, this is false. Please stop making false claims. Instead, I have engaged in good faith discussions here on this talk page.

Here on wikipedia, editors are to "describe debates rather than engage in them." Some engaged editors are not doing this here on the saturated fat article. There is debate on the healthfulness of saturated fats in the secondary literature. High-quality sources present a POV that differs from what is in this wikipedia article. This is poor stewardship of wikipedia.

My understanding is that wikipedia articles are to rely on secondary sources. Primary sources, tertiary sources, etc. may inform content but the primary cites are to be secondary sources.

The reason we have talk pages is to engage in discussion so as to achieve consensus. Please stop making threats. Please stop making false statements about me and my edits. sbelknap (talk) 15:37, 5 October 2023 (UTC)

• My sense of the sourcing landscape is that the WP:BESTSOURCES say saturated fat is harmful, to the point where it is a consensus, but there is a legit minority position questioning this (leaving aside whack stuff like Teicholz etc. which is not legit). What would be ideal is a source offering a overview of this. Bon courage (talk) 15:44, 5 October 2023 (UTC)

  Now why would we rely on a source offering an overview of the controversy?

  WP:MEDRS states that "Biomedical information must be based on reliable, third-party published secondary sources, and must accurately reflect current knowledge."

  I've presented some high-quality peer-reviewed systematic reviews & meta-analyses that were rejected for specious reasons. What I see here is ad hominem attacks on Hamley, false statements about me, and obstruction of NPOV by multiple engaged editors. Several other editors have also raised the same point that I am raising here. The current wikipedia article on saturated fat does not present a NPOV. All sorts of exceptional reasons are being raised in justification of resisting attempts to achieve a NPOV on this article.

  Something here is rotten. sbelknap (talk) 16:06, 5 October 2023 (UTC)