Is Doctor McDougall aware of this?

[John McDougall]

A mean joke is the position about the lack of strength of evidence that proves "It's the Food." This is a side effect free therapy; reducing food costs by as much as 80%. The evidence is overwhelming concerning its effectiveness and overall health benefits.

However, studies (many large and randomized) consistently show heart surgeries (angioplasty and CABG) do not save lives, and cause harm as serious as permanent brain damage and immediate death.

Read my May 2016 newsletter and read the original papers (links) free.
https://www.drmcdougall.com/misc/2016nl/may/160500.htm

Consider the biases created by money and personal eating habits. Your cardiologist or bypass surgeon is often one bite from a fatal heart attack and/or surgery himself/herself. Would you listen to a financial advisor who is bankrupt?


John McDougall, MD

[bbq]

Broker: They're Broker than You Are
http://www.freemoneyfinance.com/2008/03/broker-theyre-b.html

"Broker" is another word for "salesperson." In the world of money there are brokers for stocks, bonds, real estate, mortgages, insurance, businesses, etc. One of the problems today is that most people are getting financial advice from salespeople, not rich people.

Warren Buffett once observed, "Wall Street is the place people drive to in their Rolls Royce to take advice from people who ride the subway."

Rich dad said, "The reason they are called brokers is because they are broker than you."

[wade4veg]

Many doctors and RDs base their argument that since there has (not) been large scale RCT on Dr. Ornish's or Dr. Esselstyn's diet, it shouldn't be seriously considered, especially since no one is willing to eat that rabbit food diet anyway.

I think it unlikely there will ever be a large RCT of the diet vs the SAD diet.... Because if you are looking at 1,000 people who are willing to follow the true 10% low fat plant based diet for say, 4 years... then when you select people open to the intervention option, you still have perhaps 500 willing to do the 10% plant based diet, but told they are in the SAD arm of the study and they'll just have to eat poorly to make the study viable.
But if you just take 1,000 average people, then I think it nearly impossible to find more than a 50 to 100 or so that will follow the low-fat plant based diet for the full 4 years. So it will always be hugely difficult to conduct the study on normal people assigned at random to one or the other arm of the trial.

More possible would be to do two arms of a trial where each ate the 10% low-fat plant based diet, but one arm also took statins of varying strength. The trial might also include those with and without existing CAD.
Such a study might happen, but even then many wouldn't accept the results.
The problem is in the RCT process. Not enough willing and 'durable' participants in the 10% low-fat arm.

[patty]

It was interesting this morning I caught on TV a doctor who was promoting less vs more, was suggesting for the doctor to be a coach:) She was saying early detection of cancer doesn't have to be aggressive as the cancer might be meaningless. She was sharing about breast cancer. She of course used prostate cancer as a example where the male would age and die from other causes. And the side effects of surgery could be infection or loss of sexual desire. The point of course teaching the doctor to be a coach opens the door to the changing the conversation between doctor and patient where acknowledgment of chronic illness is food borne. The 190 degree turn would be a given as with Dr McDougall.

Aloha, patty

[Jeff the Chef]

We do have lot's of data on statins and their contribution to people eating the typical diet. We also have the Ornish data that used no statins. It's not a lot of data but something to build with.
No one has shown reversal with statins alone. We have studies showing reversal with ans without statins. It's not hard to figure out the real contributing factor in reversal. There are no negative side effects with a plant based diet. The same can't be said for statins. We all make the best choices we can for ourselves.
Since it's consider standard of care to include statins I really don't see much new data coming forward without the use of stains.
f1jim

There is the case of Tim Russert. He was taking a megadose of statin to treat his heart disease. He died. That's not to say that statins don't save lives. I am told that statins are helpful. But I think the results that Dr. Esselstyn obtained in his studies are much better than the results people get from adopting a "mainstream diet" and taking a statin.

This conservation reminds me of the book Heart 411. It was written by 2 doctors at the Cleveland Clinic.

They explicitly rejected "low-fat diets" and specifically mentioned Dr. Esselstyn's diet as one they would not recommend.

Many doctors and RDs base their argument that since there has been large scale RCT on Dr. Ornish's or Dr. Esselstyn's diet, it shouldn't be seriously considered, especially since no one is willing to eat that rabbit food diet anyway.

I don't understand the last paragraph. Ornish and Esselstyn shouldn't be taken seriously because there have been large scale RCT on their diets?

Esselstyn maybe got much better results than the SAD+statins, but he used statins too.

Here is criticism of Esselstyn. The blogger also refers to the China Study as "completely discredited."

https://theskepticalcardiologist.com/20 ... ased-diet/

[wade4veg]

I don't understand the last paragraph. Ornish and Esselstyn shouldn't be taken seriously because there have been large scale RCT on their diets?

Esselstyn maybe got much better results than the SAD+statins, but he used statins too.

Here is criticism of Esselstyn. The blogger also refers to the China Study as "completely discredited."

https://theskepticalcardiologist.com/20 ... ased-diet/

I think you are reading a typo.. missing word.... "there have NOT been large scale RCT on their diets"

As to the Skeptical Cardiologist, I think you might conclude that he is a advocate of a entirely different dietary plan.
He says the following about his personal diet...

"I now consume full fat milk, yogurt and cheese as much as I desire and my omelettes contain egg yolks.
Oh, and I slather butter (really good butter, from grass fed , pasture raised cows) on food at the drop of a hat."

Still I"m glad you gave us the link. I'm always open to reading other points of view. Though I am very hesitant to change until those offering the alternative diet have some evidence to prove their plans will help those with existing CAD.
Its easy to just knock Esselstyn and Ornish for the imperfections in their studies, but you have to give me other studies showing your approved diet is better.
I doubt this doctor has such proof, but I'll look around his site when I get time.

Lots of views out there... many from people with MD and other credentials. We need to be at least as skeptical of the Skeptical Cardiologist as we are with anyone else. There are kooks with impressive degrees and training and they all can have websites these days. Buyer beware.

[f1jim]

I encourage everyone to read the "criticisms" of both the Esselstyn original study and of the China Study. It provides a great deal of insight as to what is required to try to discredit either work. It's almost embarassing to see what passes for critiquing of these works. If that's the criticims they offer we are in great shape.
f1jim

[Jeff the Chef]

I don't understand the last paragraph. Ornish and Esselstyn shouldn't be taken seriously because there have been large scale RCT on their diets?

Esselstyn maybe got much better results than the SAD+statins, but he used statins too.

Here is criticism of Esselstyn. The blogger also refers to the China Study as "completely discredited."

https://theskepticalcardiologist.com/20 ... ased-diet/

I think you are reading a typo.. missing word.... "there have NOT been large scale RCT on their diets"

As to the Skeptical Cardiologist, I think you might conclude that he is a advocate of a entirely different dietary plan.
He says the following about his personal diet...

"I now consume full fat milk, yogurt and cheese as much as I desire and my omelettes contain egg yolks.
Oh, and I slather butter (really good butter, from grass fed , pasture raised cows) on food at the drop of a hat."

Still I"m glad you gave us the link. I'm always open to reading other points of view. Though I am very hesitant to change until those offering the alternative diet have some evidence to prove their plans will help those with existing CAD.
Its easy to just knock Esselstyn and Ornish for the imperfections in their studies, but you have to give me other studies showing your approved diet is better.
I doubt this doctor has such proof, but I'll look around his site when I get time.

Lots of views out there... many from people with MD and other credentials. We need to be at least as skeptical of the Skeptical Cardiologist as we are with anyone else. There are kooks with impressive degrees and training and they all can have websites these days. Buyer beware.

I thought it was a typo.

I agree to looking at other POV. And Ornish and Esselstyn's studies have limitations--what story doesn't? I really laughed when he said TCS had been completely debunked. By Minger and Mastermohn, who I used raw data? But people like him can keep us on our toes.

[John McDougall]

Recall our Diet / MS study was RCT and done by OHSU without conflict of interest,.


See: http://www.msard-journal.com/article/S2211-0348(16)30100-6/pdf

John McDougall, MD

[Spiral]

Recall our Diet / MS study was RCT and done by OHSU without conflict of interest,.


See: http://www.msard-journal.com/article/S2211-0348(16)30100-6/pdf

John McDougall, MD

Thanks.

Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial

Vijayshree Yadav, Gail Marracci, Edward Kim, Rebecca Spain, Michelle Cameron, Shannon Overs, Andrew Riddehough, David K.B. Li, John McDougall, Jesus Lovera, Charles Murchison, Dennis Bourdette

[Jeff the Chef]

Recall our Diet / MS study was RCT and done by OHSU without conflict of interest,.


See: http://www.msard-journal.com/article/S2211-0348(16)30100-6/pdf

John McDougall, MD

Yes. This should make the debate more interesting. What will the low carb advocates on the one hand and Messina on the other had have to say now?

[Helpinghands]

In the ongoing saga of a vegan low fat poster and Ginny, he asked her if she knew of ANY studies regardless of whether they included exercise, statins or stress control that showed regression of heart disease other than those done by whole food, low fat, no oils doctors? I'm guessing he figured she'd be trapped and have to admit there weren't any. Surprise, she came up with one. I then googled any articles on this study done in Israel and found a CNN article that detailed not only the study referenced by Ginny, but a prior study that actually used Atkins as one of the diet protocols. For those interested I'll post the url to the article.

http://www.cnn.com/2010/HEALTH/03/01/weight.loss.reverse.artery.clogs/index.html?hpt=Sbin

Shock and surprise that all show lesion regression if the subject lost a certain amount of weight regardless of diet, The more they lost the greater the regression.

[f1jim]

I can't find this study in Pubmed or any of the usual peer reviewed journal overviews.
Got any links to the actual study?
f1jim

[GlennR]

I can't find this study in Pubmed or any of the usual peer reviewed journal overviews.
Got any links to the actual study?
f1jim

Shai I, [/url]Spence DJ, Schwarzfuchs D, Henkin Y, Parraga G, Rudich A,[/url][/url] Fenster A, Mallett C, Cohen NL, Tirosh A, Bolotin A, Thiery J, Fiedler GM, Bl?her M, Stumvoll M, Stampfer MJ. Dietary intervention to reverse carotid atherosclerosis. Circulation 2010

Here's a link to her publication listing. http://fohs.bgu.ac.il/research/profileBrief.aspx?id=dVMMtsdV

And a link to the study: http://circ.ahajournals.org/content/121/10/1200.short

[pundit999]

The study's low-fat group had 26% calories from fat. Not low fat as we know it here.

Dr Esselstyn, Dr Ornish and Dr McDougall as well as Dr T Colin Campbell advise a whole food plant based diet with no added oil: may be 10% fat or lower.

And why were low-fat people consuming 174mg of Cholesterol? This was not a vegan, plants only diet.

But I guess the point is that the study did show reversal with diets that are not compliant with this way of eating. But whether you have a heart attack is a totally different matter, even if your arteries are less clogged.

Food diaries obtained from a subset of participants during the weight loss phase12 showed distinct differences between low-carbohydrate and low-fat diet in fat intake (41% versus 26% in the low-fat diet), carbohydrate intake (28% versus 48% in the low-fat diet), and dietary cholesterol intake (358 versus 174 mg/d in the low-fat diet).