User talk:RBut

Garth Davis

I am thinking about creating an article for Dr. Garth Davis. I found one book review, do you know of any good sources that discuss Davis? Psychologist Guy (talk) 09:58, 15 August 2021 (UTC)[reply]

@Psychologist Guy: Cannot find any overviews about him, most of these just quote him or include him for a bit, some are less reliable than others, you might be able to piece together a story from these:

1: https://eu.citizen-times.com/story/news/2021/01/27/side-effects-pandemic-weight-gain-struggle-many/6659842002/ and

2: https://www.news.com.au/finance/money/costs/i-dont-know-why-im-so-stupid-how-accepting-a-friend-request-cost-this-melbourne-mum-570000/news-story/2a9ba435274e1c8649c9f7ef8a689282 - In the second one, scammers used his profile and ripped somebody off for 575k. That makes for an interesting story.

3: https://abc13.com/farmacy-pharmacy-fruits-veggies/360916/

4: https://www.chron.com/entertainment/article/Big-Medicine-Extreme-makeover-1544513.php (might not be reliable, it just covers his practice).

5: https://abc13.com/surgeon-and-patient-doing-triathlon-together-200-pounds-joining-him-marathon/1397045/ - This can make for an interesting story.

6: https://abc13.com/proteinaholic-dieting-protein-diet-high/1025775/ (covers his book).

7: https://www.scmp.com/lifestyle/health-wellness/article/3015941/plant-based-meat-you-and-your-dog-nut-cheese-and-vegan

8: https://www.houstonchronicle.com/lifestyle/renew-houston/health/transformation/article/bariatric-surgery-ironman-triathlon-marcus-cook-14097434.php

9: https://www.prweb.com/releases/2014/09/prweb12194210.htm

10: https://www.chron.com/news/houston-texas/health/article/Bariatric-surgery-followed-by-skin-tightening-6275735.php

11: https://www.thetimes.co.uk/article/what-eating-too-much-meat-is-really-doing-to-your-health-89tmxnl9g63

12: https://www.newuniversity.org/2018/11/14/inside-the-socal-veg-fest/

13: https://abcnews.go.com/Health/Wellness/lap-band-surgery-half-patients-complications/story?id=13187452

14: https://eu.shreveporttimes.com/story/life/2016/08/05/triathlete-emerges-489-pound-body/88004030/

15: https://www.gulf-times.com/story/660401/Go-Vegan-in-Quarantine

The way you search on google is by using quotes. I used this: Dr. "Garth Davis" -"director" - you get this: https://www.google.com/search?q=Dr.+%22Garth+Davis%22+-%22director%22&client=firefox-b-d&tbm=nws&ei=YvIYYdnOBfGLhbIP0cC0qA8&start=50&sa=N&ved=2ahUKEwjZh-XD7rLyAhXxRUEAHVEgDfU4KBDy0wN6BAgHEEA&biw=1858&bih=995&dpr=1

There is a director named Garth Davis, so the minus before the director in quotes removes articles that preface Garth Davis with director. The quotes for "Garth Davis" are to only include articles that mention this exact name, otherwise articles will pop up on people with similar names. The Dr is to bias the search towards this preface but to not only include articles that mention Dr, because some articles might not while still talking about Dr. Garth Davis.

You can find quite a few of his replies to issues and topics covered by plant based news/report sites: https://www.google.com/search?q=Dr.+%22Garth+Davis%22+-%22director%22&client=firefox-b-d&biw=1858&bih=995&tbm=nws&ei=E-4YYeaRKoSM8gK39KKwDQ&oq=Dr.+%22Garth+Davis%22+-%22director%22&gs_l=psy-ab.3...12561.18493.0.19190.4.4.0.0.0.0.54.174.4.4.0....0...1c.1.64.psy-ab..0.0.0....0.ZceqB6w5T3s

I mainly know him from his Youtube interviews and presentations/lectures (whatever you wish to call them). He has many of those. He also has a blog. He was featured in several documentaries, Forks Over Knives and What The Health. Apart from his book and some of his positions, that is all I know about him. RBut (talk) 11:01, 15 August 2021 (UTC)[reply]

Thanks for the links some of those can definitely be used, I believe he would qualify for an article so I will go through these links soon. I am going to create it tonight or tomorrow. Psychologist Guy (talk) 13:49, 15 August 2021 (UTC)[reply]

@Psychologist Guy: Alright, I'll be on a lookout for it. RBut (talk) 23:21, 15 August 2021 (UTC)[reply]

Dr. Joel Kahn also might qualify for an article. Who is your favourite plant-based doctor? Do you know of any others that might qualify for wiki articles? Psychologist Guy (talk) 21:18, 30 August 2021 (UTC)[reply]

@Psychologist Guy: Caldwell Esselstyn for his ground breaking interventional studies. Dean Ornish does have the randomized controlled trials, but Essesltyn was given patients that were basically on death row, as any further medical intervention were not viable (already had many cardiac events, bypasses, stens and etc, and were still back in the hospital). With his intervention, he managed to keep all of these patients alive. The duration of the study with follow up was 12 - 14 years (it's been a while since I read them), with I believe 12 patients or so, and around 4 years in another with only a single stroke out of close to 200 patients. There was a group that did not take his advice, of around 10 - 20 people, it was used as a control group. These patients were given standard advice by their experts (e.g. further pharmaceutical, medical intervention and dietary intervention, particularly the DASH diet where they say eat more lean meats such as fish, less red meats, less salt, and etc). Esselstyn achieved a 99% success rate in preventing further events, while standard advice killed some, and achieved further cardiac events in many (and this is most impressive because the intervention group was that much larger). Even though it was not a randomized controlled trial, the results were still too impressive. I legitimately cannot wrap my head around the fact that this is not investigated by governments, particularly governments that have free healthcare. They could easily fund RCTs with up to a thousand patients or more. I also like Dr. Neal Barnard, but not only for his research, but his pioneering with PCRM. They do a lot. One of favorite moments were when they sued 2015 USDA guidelines for saying cholesterol was not a nutrient of concern (over half the panel that came up with the guidelines were funded by the Egg board). It was changed to "eat as little cholesterol as possible". The 2010 guidelines had a limit of 200 - 300 mg of cholesterol, changed to 0 being the most optimal after the lawsuit (which is exactly what the most strict methodologies such as metabolic wards show - aka, eat a little cholesterol as possible). RBut (talk) 07:10, 31 August 2021 (UTC)[reply]

The problem is that Esselstyn's results have not been replicated by others, the medical community at large basically dismiss his research for lacking support from clinical trials. As far as I know there is not any reliable clinical evidence as of 2021 that a plant-based diet can reverse CVD. There is a lot of evidence it can prevent CVD but prevention and reversal are not the same thing.

Esselsyn's diet is too restrictive, you can't eat nuts, seeds, olive oil or avocadoes on his diet. It is not a sustainable diet in my opinion. I would say two of my favourite plant-based doctors are Dr. Danielle Belardo who has been attacked by other vegans for her advocacy of olive oil and nuts in the diet [1] and Avi Bitterman. I also like Garth Davis and Robert Ostfeld. Danielle Belardo and Avi Bitterman explain here why a plant-based vegan diet has not been shown to reverse CVD but can reverse symptoms. I think a lot of people get confused with that [2] Psychologist Guy (talk) 19:38, 1 September 2021 (UTC)[reply]

@Psychologist Guy: Something cannot be replicated if it is not funded or if anyone is not attempting to get funding. And if he cannot garner funding for larger studies, you cannot expect him to be able to have access to equipment such as IVUS to undoubtedly prove reversal (very expensive, the machine is up to 200k with around 1k per disposable catheter. If you multiply that several times for a person, that's at least two extra thousands, and multiply that by two hundred people, that's four hundred k). And even so, he has still shown halting of disease that has progressed to late stage (no further cardiac events), not just prevention.

Esselstyn's motivation is to keep his patients alive, as I mentioned he had some of the sickest patients you could get. And I think his restrictions are very logical. None of these foods have been shown to be beneficial for cardiac health, while having many reasons to doubt. Another major issue is these industries (nuts, EVOO) have just as much tampering with the science as the AG studies. I've personally looked at the designs and data my self. They're just as shady. Esselstyn's advice is meant for people with diagnosed and late stage CHD. He hasn't claimed that you and I would have to be that restrictive with fat. I still completely disagree with olive oil. It's nothing but junk food. It's the sugar version of fat. While some avocados, nuts, and whole olives can definitely accommodate a healthy diet, seeds especially. (I also consider animal protein to be the sugar version of protein).

I also agree with the backlash that Danielle has gotten. Her demographic are the very same patients as Esselstyn. Yet, she promotes foods to sick people that will end up killing them. There are around 4 studies showing olive oil to harm the endothelium (how is that going to help, particularly patients with late stage CHD?). While nuts have only been shown to improve endothelial function in obese people (one of the shady tactics I have mentioned - they avoid healthy subjects or significant differences in control groups, yet they market their results for all populations).

Studies such as PREDIMED (the most touted study in support of the Mediterranean diet/olive oil/nuts that is used) have shown that a high fat diet even one with a high intake of extra virgin olive oil (or a high intake of olive oil with added nuts) is not healthy. They had three groups, a nuts group. The nuts group had as high of an EVOO intake as the control or what they called a low fat group. 17% total caloric intake (TCI) from EVOO in nuts group but further added 5% of TCI from nuts, an EVOO group (I call this group the EVOO group with extra EVOO, since they simply added 5 - 6% more TCI from EVOO than the other two groups), and a control group that were meant to reduce fat, but didn't to any significant extent to which you would see benefit. Unless you consider a 5% difference in fat intake as significant. From around 42% of TCI from fat in nuts and EVOO groups, to 37% in "low fat" group - and the "low fat" group also had an intake of 16% of TCI from EVOO, while EVOO group had a 22% of TCI from EVOO... - so the "low fat" group and the EVOO group had an 6% difference in TCI from EVOO. Did I mention the study was sponsored by these industries? I guess now we can understand why they did not use an actual low fat group - they would not be able to market their impressive results if an actual low fat group were used, of course unless the actual low fat group replaced the fat with processed carbohydrates). The PREDIMED study began with patients with no cardiac problems. By the end of the study there were hundreds of events related to cardiac health in all three groups, as well as deaths (related to cardiac health). Then the group that had the least events (around 10 - 30 difference in events in the control group versus the nuts and olive oil group), they marketed nuts and EVOO as health foods ("see, reducing fat will not help! nuts and EVOO actually reduce CVD!!").

In reality, they should have marketed it that the mediterranean diet with nuts or extra virgin olive oil will cause heart disease. So I 100% disagree with Danielle, this is also why I do not like Kahn, he also gives bad advice. During a debate he said you can get up to 30% of your calories from olive oil (it's been a while since I've watched it, I believe this is accurate). Why would you experiment with your patients versus do something that has been proven? Esselstyn had proven complete halting of disease, and had hundreds of adherent patients as well (thousands now), showing no issues with adherence to the diet or that it's too restrictive, some of these patients have done it for decades. While Ornish also had some very adherent patients in his RCTs, that had the same impressive results as Esselstyn. RBut (talk) 02:10, 2 September 2021 (UTC)[reply]

RBut, you will most likely disagree with everything I am about to say but olive oil has been shown to reduce LDL, there is a recent review of RCTs here [3]. I don't think even you would dispute this. It doesn't make much sense when you say olive oil causes heart disease. What mechanism are you claiming supports that view? I am guessing you will say the oxidized fatty acids from high cooking temperatures but this is only a potential problem with deep-frying not other cooking methods. How was the olive oil used in the PREDIMED study you mention? The cooking methods are very important here.

The claim that extra virgin olive oil (EVOO) harms the endothelium is found on vegan websites like forksoverknives [4] but it is not true if you look at the medical literature, it is only true for oils that are used in deep-frying for hours so the studies you mention were on deep-frying. The forksoverknives website says "Other studies report similar findings, showing that EVOO damages endothelial function just like its ‘regular’ olive oil counterpart." On the word "studies" it links to just one study on pubmed [5]. The first thing that needs to be noted here is that this study is on deep-frying only but forkesoverknives do not mention that, they are cherry-picking studies and misrepresenting them on purpose. We have access to the full paper [6]. Now, read the paper in full, nowhere in the paper does it mention EVOO. The study was not on EVOO, so that is a deliberate lie from forksoverknives. This is why vegan websites sometimes get a bad reputation for putting out misinformation.

The paper concluded "In conclusion, our results have demonstrated that the deep-frying process causes a comparable change in the biochemical characteristics of palm, olive or soybean oils." Nobody is going to dispute this. It also says "The repeated deep frying process has a proven deleterious effect on the sta-bility of PUFAs and other biochemical parameters of vegetable oils (such as acidity, presence of polar compounds and peroxide index), and has been linked to an increase in the presence of free radi-cals" Again nobody is going to dispute this, we all know deep frying for long periods of time with oils is bad! You should look up the definition of deep-frying, this is VERY different than sautéing. Now here is the important finding of the study "Our results showed that 10 and 20 deep-fry levels (80 and 160 minutes of deep frying, respectively), caused a change in the biochemical parameters of the oils." Right, deep frying for 80 and 160 minutes?! Crazy. Of course that is going to be bad. But nowhere in the Mediterranean Diet is this usually done. In the Mediterranean diet the EVVO is put straight on salads uncooked or put into a pan i.e. sautéing or stir-frying lightly, not for 80 or 160 minutes deep-fried!

Because olive oil is used usually for sautéing only for a few minutes or at a stable moderate heat (roasting) its unlikely its smoking point will be reached but its now been proven that EVOO has great oxidative stability and produces lower levels of polar compounds than other oils when it hits smoking point, so it is safe. [7], this has now been proven [8]. So it is not bad for the heart unless the food is deep-fried for hours. There are also countless studies showing that extra virgin olive oil is rich in antioxidant compounds such as polyphenols, carotenoids, squalene and tocopherols. Olive oil polyphenols are anti-inflammatory and have potential anti-cancer effects [9] [10] Olive oil as you know is rich in oleic acid [11] which has been associated with antitumoral effects and has been shown to reduce cancer risk [12]. Claiming olive oil is a "junk food" and comparing it to processed sugar for me is very odd to believe. I have been consuming it for 25 years and people in the Blue Zones who live the longest on earth all use large amounts of oils (usually olive oil). [13]. I am always interested in how people come to different conclusions about things. You have said it is a junk food but from what I have read it is a health food. If you look online for recent studies about olive oil they are all positive there are no recent studies claiming it causes heart disease. I don't get this anti-olive oil thing in the vegan community, it makes no sense. Olive oil can be a beneficial food to add to a vegan diet. As for the study you mentioned I will try and download the PREDIMED, I cannot find it in full. As for Dean Ornish his regime includes eggs and low-fat dairy. I am confused about that, it was never fully plant-based. It seems to be octo-lacto vegetarian. Psychologist Guy (talk) 23:57, 2 September 2021 (UTC)[reply]

Maybe you can direct me to the study you were talking about, but I suspect this is it [14]. I will take a look at it tomorrow when I get full access. Psychologist Guy (talk) 01:03, 3 September 2021 (UTC)[reply]

@Psychologist Guy: Two sections to this reply, 1 for replying to you, and 2 for mechanisms. 1. The meta analysis shows it reduces ldl by 4 mg/dl. One. If you were to put this on a risk calculator, you would find your CVD risk to decrease by an insignificant amount (even if you add the small changes in tri's and hdl). Two. If the olive oil is replacing something like saturated fat, the drop is predictable. Which it almost definitely is. Therefore, these finding do not apply to everyone. You're not going to get a decrease in triglycerides as a healthy person by consuming oil. This is completely preposterous to suggest. It'd be the equivalent of saying that you can decrease your glucose levels by eating glucose. But I can agree that if you have a high triglyceride level and replace sat fat with olive oil, you will drop your tris. Three. If you were to use actual olives, you would find a more significant drop due to the fiber. Arguing that olive oil drops ldl (which I'm almost certain are the effects of replacing sat fat) while at the same time agreeing with getting rid of the fiber from the olive doesn't make sense to me if that's your goal since you can further drop your ldl by just eating whole olives. Four. In the conclusion it says "This meta-analysis suggested that OO consumption decreased serum TC, LDL-c, and TG less but increased HDL-c more than other plant oils." - So it decreases ldl less than other oils. Five. If the subjects are obese or heavily overweight, you could do anything with any food and it would improve their biomarkers.

It does make sense to say that olive oil causes heart disease. Because 1) The same Meditteranean diet studies you use, I can use for my argument. Because those same studies show that people who did not have CVD, develop it after following the diet. The bluezone studies have a reduced CVD risk, not zero risk. And since the reduced risk is around 50%, some dietary pattern from the bluezones is causing a massive amount of cardiac events. 2) There is evidence supporting this position. Which I'll mention at the end. I think it's harder for you to defend your position, then it is for me. The studies in support of your position are not completed on the population you're trying to say will benefit.

The PREDIMED used the Mediterranean diet and 4 tablespoons of EVOO per day. Patients were allowed to cook with it, or use it in salad dressing. All deep fried stuff was discouraged, and they used frequent questionnaires to monitor. Predictably, the industries sponsoring this study made sure the subjects are compliant so they could get the most impressive results to market. As you have mentioned cooking with olive oil does not create any of these negative effects as does deep frying, so I've no idea how you're going to explain the cardiac events caused by a Mediterranean diet.

Forks over knives did not misrepresent the study. The 5th study you have referenced says in the method section: "To evaluate the acute effect of the ingestion of large amounts of olive, soybean and palm oils, fresh and at two different deep-fry levels, on the glucose and lipid profiles and the endothelial function.". They found no difference in endothelial dysfunction with deep fried or fresh olive oil (they both had the same negative effect, a large negative effect). Forks over knives also didn't say it was on EVOO, the study you referenced is headlined under the section "olive oil" and under that section it follows "what about EVOO". I think you're taking this as a personal attack and hence missing these details. You should have further quoted the study, after "in conclusion, our results have". It says this: "Moreover, all the high-fat meals prepared with fresh or cooked oils produced a similar detrimental acute effect in the endothelial function independently of the type of oil used or its deep-fry level." (they used potato soup and added whichever oil they were testing - the soup provided 10% of the kcal of the meal, while the oil 90% - those were the high fat meals).

Using olive oil for its antioxident/phytochemical doesn't make sense. You could get that amount with like 1/10th of the calories from something like cabbage. So if you associate olive oil with the benefits from these compounds, you can literally associate any other whole plant food with these same benefits. They just happened to pick olive oil because that's what they're looking to promote. Same with ldl drop. If you're arguing for ldl drop you can pick any whole plant food and get superior results, e.g. broccoli.

I disagree that olive oil is beneficial to add to a vegan diet. That's how you make a healthy diet into an unhealthy one. This is why the Mediterranean diet cannot reproduce a cardiac event free diet like Esselstyn. I'll argue why at the end.

If you cannot access full studies, simply paste the DOI into SciHub (if you cannot access that, look for proxy websites - I cannot paste the one I use, it does not let me). Here's the predimed study: https://www.nejm.org/doi/full/10.1056/nejmoa1800389 - click the supplementary appendix for in depth detail on the methodology, or click here: https://www.nejm.org/doi/suppl/10.1056/NEJMoa1800389/suppl_file/nejmoa1800389_appendix.pdf

Dean Ornish allowed for low fat dairy, egg whites and omega 3 supplements in his early research. Not anymore though, or at least that's what he has said.

2. The mechanisms: One, it is 14% saturated fat. 1 tablespoon of EVOO = 2 grams of saturated fat. 4 tablespoons recommended in the predimed study (you probably consume more than that?) = 8 grams of saturated fat. You might think 8g of saturated fat, pfft, that's nothing. But for someone with heart disease, multiply that for a week. 8 x 7 = 56g of saturated fat per week. Multiply that by a year. 56g x 52 = 2912g. Now multiply that by a decade 2912 x 10 = 29,120g, and by 3 more decades (this is when the atheroma has progressed to a significant stage, it the stage where the possibility to experience a cardiac event is high) = 29,120 x 3 = 87,360g of extra saturated fat just from oil, that did not need to be consumed or to have affected your system over your lifetime. That can easily be the difference between developing a heart attack and not over the decades. You cannot argue in favor of consuming saturated fat, it is not an essential fatty acid. It'd be the equivalent of arguing for a cholesterol intake. You do not need to have one. And saturated fat has just as many negatives. The lower, the better.

Two: The kcal. 1 tablespoon of olive oil = 14g of fat x 9 kcal = 126 kcal per tablespoon x 4 = 504 kcal. If your diet consists of 2.5k kcal, 1/5th is coming just from oil with this diet. And if it's 2k (in the study it was around that amount 2 - 2.2k), then 1/4th of your kcal are coming just from oil. Ridiculous. If you were to replace those kcals with something healthy like sweet potato, you would get far superior benefits from antioxidant content to phytochemical content, and reduction in ldl. And those foods would not impair the function of your endothelium. If the subjects are overweight and are not losing weight (which many people are that have CVD), this can further compound onto unfavorable health effects contributing to a heart attack. Without the oil, these subjects could easily lose a lot more fat, improving health outcomes. That's another reason why Esselstyn's diet has superior outcomes and why it should be the one recommended to people with CVD, and why you yourself shouldn't gulp down 1/5th to 1/4th of your calories from oil.

Three: Diabetes risk. Oil increases intramycocellular lipid concentration. Even if you are not diabetic, this slows the absorption of glucose into your cells. It now spends more time flowing around your blood, and that's a consequence because glucose oxidizes easily. Combined with constant endothelial dysfunction, and you're in a low but constant progressive state of atheroma. Especially if somebody is fat. This then further compounds and these biochemical reactions add up over time.

Four: Omega 6 to omega 3 ratio, it is 14:1 with olive oil. The recommended ratio is 4:1. Even if the oil is not deep fried, there are many pathways that can affect the omega 6 e.g. it easily oxidizes, LA can be converted into AA. If you will look for studies that do not use healthy subjects then simply using something less worse improves health. It's a massive confounding factor which is almost never controlled for in meta analysis. And this is also why the public health message is what it is. They're ok with promoting something that is less unhealthy. If they were to follow the body of science that we have, they would 100% have to recommend at minimum, a vegetarian diet.

Five: Endothelial dysfunction. 1 (EVOO - 31% decrease in FMD and around 30% raise in triglycerides) 2 (OO - the 5th study you linked from the FOV article - 32% decrease in FMD and 27% raise in tris - independent of oil consumed, whether it was fresh or deep fried). 3 - They tested several times, a high carb muffin (218g carbs) vs a high monounsaturated fat milkshake (38g oleic acid) - it reduced FMD and increased triglycerides while the high carb muffin improved it and did not increase triglycerides. This goes hand in hand with:

Six: Postprandial lipemia (the consequence of removing fiber, or consuming fat without fiber (e.g. saturated fat, trans fat), or consuming a fat predominant diet). A direct mechanism for how olive oil can contribute to atheroma. https://pubmed.ncbi.nlm.nih.gov/27885367/ - In the section: "Postprandial hyperlipemia and atherosclerosis" - "The greater the magnitude and duration of the postprandial TRL response, the greater the exposure of the arterial wall to postprandial TG-rich lipoproteins (TRLs) (and their remnants) and the greater the likelihood that TGs will replace CEs (chylomicrons) in LDL-C and HDL-C particles. Postprandial TRLs can penetrate the arterial wall and can reach the subendothelial space (Figure 5), causing endothelial lipid (notably TG) deposits, attraction of monocytes, production of inflammatory markers, and oxidative stress.34-37 The role of TGs in atherosclerosis-mediated inflammation not only depends on their direct vascular effects, but it is also related to profound changes in the functionality of HDL-C that include protection against vessel inflammation or disorders of immune response."

https://pubmed.ncbi.nlm.nih.gov/8399091/ - If you go to table 6, titled: "Postprandial Plasma Lipid Response to Three Meals Plus One Snack at the End of Each Diet Phase" - it shows the triglyceride raise (postprandial lipemia) with a NCEP diet (National Cholesterol Education Program) enriched with specific oils, such as olive oil - this is what the guidelines were based on. From 111 mg/dl baseline (fasted) to 246 mg/dl by the 3rd meal (dropped to 117 after 24hr, aka fasted next day). Large time period for the tri's to be able to do a ton of damage every single day. Previous studies I referenced in endothelial dysfunction section showed a 30% postprandial raise with a meal, while this is around a 140% raise for 3 meals. "Mean postprandial plasma triglyceride concentrations (5-, 8-, and 10-hour time points) were approximately two fold higher than fasting values"

Seven: The phenol benefits are exaggerated: https://www.nature.com/articles/1601917 "Conclusion: Although phenols from olive oil seem to be well absorbed, the content of olive oil phenols with antioxidant potential in the Mediterranean diet is probably too low to produce a measurable effect on LDL oxidisability or other oxidation markers in humans. The available evidence does not suggest that consumption of phenols in the amounts provided by dietary olive oil will protect LDL against oxidative modification to any important extent." - Again, simply pick any whole plant food, get superior benefits in this area.

Eight: https://pubmed.ncbi.nlm.nih.gov/2407875/ - This study actually tested whether new lesions would form. They do. "Each quartile of increased consumption of total fat and polyunsaturated fat was associated with a significant increase in risk of new lesions. Increased intake of lauric, oleic, and linoleic acids significantly increased risk."

Nine: https://pubmed.ncbi.nlm.nih.gov/9989963/ - a study just like Esselstyn's (people that have suffered cardiac events) but the intervention was a Mediterranean diet that is high in olive oil. What'd they find? 25% suffered another major cardiac event which was either a stroke, a heart attack, or death. Is oil and whatever else, fish and eggs, worth dying for? This is nowhere close the .6% cardiac event rate as with Dr. Esselstyn's study, and he had around 10 - 20 patients on this diet for up to 12 - 14 years, with the same result (no more cardiac events). Clearly this is what needs to be investigated, as we almost definitely have a cure for CHD.

Ten: As I have previously mentioned the PREDIMED study. They also showed the Mediterranean diet causes CVD. This again, was industry sponsored, so everything was in their favor.

Eleven: Better outcomes than a Mediterranean diet: traditional Okinawa - no oil, sweet potato heavy diet, most centenarians, nonexistent CVD (or other chronic disease). The point? oil is not needed to live long or to be healthy, and it definitely isn't needed to improve your health if you consume a healthy diet.

Twelve: I know I mentioned this a bunch of times, but just to reiterate as the second last point: the studies that use olive oil on subjects are not evidence of the benefits of olive oil for everyone. You will undoubtedly, 1 trillion % get a benefit from consuming olive oil if you replace saturated fat. Where I disagree is that this would further benefit somebody that does not consume oil or a high SFA diet. This is also what the consensus is, e.g. the consensus of the AHA: They never said olive oil is healthy in all circumstances. Their review states that it must replace saturated fat. And to end this point: There are no studies on healthy people that have shown positive effects with oil consumption, only negative effects (the olive oil studies that reduced postprandial FMD reported that they used healthy subjects).

Not saying eat no fat. I'm just saying oil is heavily processed, it objectively is the sugar version of fat. You're extracting a single macronutrient, and your body can now absorb it effortlessly, unlike when it is bound to fiber. You do not need oil to consume fat. And it will not improve your health if you eat a healthy diet. Or prevent cardiac events. It will only cause them. RBut (talk) 14:48, 4 September 2021 (UTC)[reply]

I believe this is a perfect example of why we need to follow the highest evidence available from evidence-based medicine. People are doing these diet debates and wars all over the internet but they are pointless because people often ignore what high-quality evidence is when it comes to clinical nutrition. As you know amongst the highest and most reliable evidence is a meta-analysis or systematic review of RCTs [15]. So much of the content we have been talking about apart from the meta-analyses of RCTs I cited are irrelevant. The forksoverknives.com website piece on olive oil is not relying on high-quality evidence-based medicine it is relying on a just a few studies. When you make an extraordinary claim such as extra virgin olive oil (EVOO) harms the endothelium they need to back that up with high-quality evidence. They have not done that.

On the forksoverknives website on the section on extra virgin olive oil it says "In a cohort study designed to measure the effects of a Mediterranean diet as the primary prevention of cardiovascular disease, extra virgin olive oil (EVOO) was shown to be better than regular olive oil, but neither significantly reduced heart attack rates. Other studies report similar findings, showing that EVOO damages endothelial function just like its ‘regular’ olive oil counterpart." Firstly why would we draw such a definite conclusion from a single cohort study that the website did not even link to? Is this good reporting for you? I am afraid it is not. And On the word "studies" it does indeed link to the study I cited above but that study does not mention EVOO. This is a minor point not worth fussing over we all make mistakes but I am not convinced this website is reading over the studies in full they are citing. Just to clarify again this is the study [16], it is not on EVVO. Olive and EVVO are different but I agree with you, the study did conclude "Moreover, all the high-fat meals prepared with fresh or cooked oils produced a similar detrimental acute effect in the endothelial function independently of the type of oil used orits deep-fry level". So this study even though it is not on EVVO does support your position, not mine. So you are correct on that. You are correct there are studies that support your position and you have a valid case when it comes to a few studies. But this is essentially the problem with citing a minority of single studies which boils down to obvious cherry-picking which anyone can do, we are all guilty of it. I could cite studies then you could cite some which refute mine or vice versa. This is why we shouldn't be citing individual studies like this. We need a meta-analysis and review of controlled clinical trials to rule out this kind of bias.

It is obvious that there are contradictory and inconsistent studies on this topic (olive oil on endothelial function) so we should not make an absolute definite statement if we are only citing a few studies. This study which cites one of studies that the forksoverknives website links to actually noted this

"There is inconsistent evidence about whether diets high in oleic acid have a beneficial [5, 18–20], neutral [9, 15, 21] or negative [14, 16, 22] impact on markers of endothelial function, and few of the previously published studies were conducted in patients with diabetes... In contrast to previous reports of FMD impairment following consumption of olive oil [14], we showed that FMD was not reduced following a meal containing 50 g of fat, including ∼30 g of oleic acid from high-oleic safflower oil. Our results confirm the findings of Williams et al. [15], who administered 64 g of olive oil or safflower oil, and found that neither source of unsaturated fatty acids had any acute effect on FMD, even after the oils were oxidised by heat. Given the mixed, and somewhat contradictory information about the effects of olive oil [14, 15], oleic acid [15, 16], and a Mediterranean diet [18, 21] on endothelial function, more work in this area is clearly needed." [17]. That is not compatible with the forksoverknives viewpoint so they ignore studies like this.

So you see when you make the bold claim that olive oil has been proven to damage the endothelial function this isn't an accurate statement because although some studies would support that position others do not like the study I just cited and this one [18] which reported that endothelial function was normal after meals rich in olive oil were consumed. Here is another study [19] that showed that a 4-weeks period of consumption of Mediterranean diet rich in EVOO improved endothelial function, there are many others which could be cited. These are all old studies that I would not normally mention but they seem to be mentioned by forksoverknives and yourself. Forksoverknives do not mention any of these other studies though, do they? They only support material that supports their viewpoint that olive oil is bad. Here is a study from 2014 that concluded that "Olive oil polyphenols revert endothelial dysfunction" [20], I am sure you and forksoverknives would disagree with that! But why is that not on their website? See anyone can go on Google or pubmed and find an individual study to support their point of view. It's pointless in doing that. I can cherry-pick studies to support my bias and so can you. This is not the way evidence based medicine works. Nothing you have cited has actually been strong evidence-based (where are the meta-analysis of controlled trials?!). So yes you can cite individual studies or a single RCT but you have not cited any high-quality reviews of RCTs, we need to look at many not just a handful. We need to rule out biases not promote them. A review from 2019 in the European Journal of Clinical Nutrition [21] concluded that EVOO has no negative effects on the endothelial function. This review paper cited 18 studies on that very topic. Why would you ignore this evidence for single studies from 1999 or 2000?

This is why we need to refer to high-quality evidence based material and not just a handful of cherry-picked studies. You have found some studies that support your view but you have jumped the gun like the forkesoverknives website has done by claiming it causes heart disease. The forksoverknives website is bad because it is not reporting the totality of evidence and it is not reporting what the highest-quality studies say. We can't call that evidence-based. It is fanaticism.

As for nuts. We have a meta-analysis of 32 RCTs [22] "This systematic review and meta-analysis of the effects of nut consumption on inflammation and endothelial function found evidence for favourable effects on FMD, a measure of endothelial function". As I understand it you have not argued against consumption of nuts but this is high quality evidence, they do not damage the endothelial function. I can't find a single meta-analysis or review that has concluded olive oil causes heart disease or damages the endothelial function. I do not believe in the conspiracy theories that scientists are being funded by big olive oil etc or its all industry funded. You have written a lot of valid material above that I have not commented on but I only wanted to comment on the endothelial function specifically. I can reply to your other material later. Psychologist Guy (talk) 22:32, 4 September 2021 (UTC)[reply]

Forksoverknives linked to one other study from 1999 to "prove" that olive oil damages the endothelial function. The forksoverknives website says "A 1999 study measuring FMD after the ingestion of high-fat meals reported a “three-hour decline in FMD after subjects ingested a traditional meal of a hamburger and fries or cheesecake. Olive oil was found to have the same impairment to endothelial function as the rest of these high-fat meals." So yes this study supports what you were saying. But I got access to the full paper and found that it also says this:

"Olive oil was also found to have the same impairment to endothelial function as the rest of these high-fat meals. This impairment, however, was also totally eliminated when vitamins C and E were given. As with antioxidant vitamin supplementation, olive oil, eaten with vinegar on a salad, did not impair endothelial function. Some societies that use the Mediterranean diet may have learned to provide the natural antioxidants which buffer the oxidative stress of these fatty meals. An exception to fats that impair endothelial function is fish oil. Salmon (50g) does not confer any impairment on endothelial function; it also results in half the rise in triglycerides. Other studies show that Omega-3 fatty acids improve endothelial function."[23]

Why are they citing a study from 1999? In regard to the quote it says if you add olive oil with vinegar or vitamin C it does not impair endothelial function. They do not mention this! Olive oil is not consumed by itself. The Mediterranean diet is well-balanced. Also the above quote notes that salmon does not impair the endothelial function. Forksoverknives are totally silent about that and are happy to leave that off their website? Hopefully you understand what biased, selective and downright dishonest reporting the forksoverknives website is doing. The Forks Over Knives website based on the film is a die-hard advocate of low-fat food so I was not expecting them to be neutral in regard to olive oil but their selective reporting is the worst I have seen. Psychologist Guy (talk) 23:33, 4 September 2021 (UTC)[reply]

@Psychologist Guy: It goes beyond data. You further need a logical framework. There are several issues: 1. Meta analysis can easily be misleading if the individual studies that make it up, are not of sound methodology. Studies can be manipulated by specifically designing the study in such a way, as to get the required and predictable result to be able to market the product. To then compile these studies, without a logical framework and give them equal value does not make sense to me.

2. A meta analysis only answers the questions that it does, it does not mean you can use its results to answer every other question that it did not (e.g. a meta analysis shows endothelial function improves via oil consumption, you open individual studies and find that subject BMI is high on average, and saturated fat was displaced, and that postprandially their endothelial function worsened but fasted endothelial function improved over time due to replacing saturated fat - this does not answer the question whether a healthy person would benefit from oil). Therefore to use it in such a way would be fallacious.

I can point to a series of articles that came out in 2018 or 2019 challenging the red meat and processed meats cancers and other chronic disease association. They were published in the Annals of Internal Medicine. There was a massive backlash by scientists because the meta analysis used a GRADE system, which is not a suitable framework for this question, therefore it was misleading. There are many of these examples of meta analysis being misused to promote a product. I can also point to the meta analysis of prospective cohorts on saturated fat and it's connection to CVD. In this instance, they're being abused for the purpose of promoting saturated fat (evidenced by most of those meta analysis having industry sponsors, as well as the fact that it is not possible to find a statistical relationship due to genetic randomness in ldl levels, unless the question is modified, e.g. "what if saturated fat is replaced with polyunsaturated fat?"). So right now, do I mindlessly accept the conclusion of these meta analysis? or should I use any sort of logical framework to determine what was answered and what wasn't?

I don't know why you brought forks over knives into this. I'm not relying on their article or arguments for my position. I'm not going to argue for them. Yes, they made a few mistake and could've created a better article.

In the study: "Normal endothelial function after meals rich in olive or safflower oil previously used for deep frying" - I cannot find their DOI, therefore I cannot find their in depth methodology. The one listed in the abstract is not in depth. Measuring endothelial function is challenging and I'm not willing to accept the results without being able to investigate. And I would like to know their definition of healthy. Are the healthy subjects they used old? do they exercise? and etc. This is the only study that you have referenced that might apply to me, but I cannot read it to determine whether it does.

"Here is another study [19] that showed that a 4-weeks period of consumption of Mediterranean diet rich in EVOO improved endothelial function" - They did not use healthy patients. My whole argument is that they do not use healthy subjects, you cannot use studies on patients with hypercholesterolemia and etc and apply it to all populations. By using unhealthy subjects, you can make any food look good, including steak. The other study you have cited, uses patients with type 2 diabetes. Just to give one example of why you cannot use data studies on one population (e.g. hypercholesterolemic people), and apply it to everyone (e.g. healthy people, that do not consume diets that would cause hypercholesterolemic issues). in previous meta analysis you have cited where ldl dropped by 4 points is not evidence that this would happen to me. If I were to use this oil with my 50 mg/dl ldl, the complete opposite would happen. It would go into the 70s or 80s over time due to the saturated fat content. So, context matters. A logical framework matters. We're not meant to apply this data to any more than it has answered. Again, I completely agree with this data, if it were to be used on an average person, the people it were studied on, the people that have to change this to this (e.g. saturated fat into polyunsaturated fat). It would 100% improve their health. But it does not apply to people that eat low saturated fat and no oil. So the studies you reference where oil improves endothelial function is not evidence that the same will happen on my population.

The 2014 study "Olive oil polyphenols revert endothelial dysfunction" is in vitro, not in vivo.

"A review from 2019 in the European Journal of Clinical Nutrition [21] concluded that EVOO has no negative effects on the endothelial function. This review paper cited 18 studies on that very topic. Why would you ignore this evidence for single studies from 1999 or 2000?" And that's awesome for the population it was studied on. However, an alternative conclusion would be that if replacing saturated fat with EVOO had no effects on endothelial function, that's not an actual benefit. That would go to show that replacing sat fat with EVOO will not improve your endothelial function. Again, a logical framework matters.

"As I understand it you have not argued against consumption of nuts but this is high quality evidence, they do not damage the endothelial function" - I searched the whole study. There is no averaging of BMI, none of the important confounding factors. I've looked at some individual studies, so yes, with a BMI of around 30 had improvements in endothelial function, good for them. Not evidence of benefit for everyone other populations. You can do the exact same thing with steak. "see!! steak improves endothelial function!! it's a health food now!". And yes, I'm not against consumption of whole food fats, unless you completely go overboard and get 30 - 40% of your calories from them, or have CHD. But I am definitely against liquid fat. Stripping everything beneficial away from a food, extracting a single macronutrient and calling it healthy? it's far too obvious why it's unhealthy.

Supplements of C and E having the ability to blunt negative responses to oil are not good enough evidence for me that it is not harmful. It is not evidence of it's harmless nature over time either.

"Why are they citing a study from 1999?" - Science doesn't suddenly become invalid after a certain time period has passed. Today saturated fat increases my cholesterol, after a few decades it doesn't?

All the points you have attacked, are not relevant to the mechanisms I talked about apart from endothelial function. No idea why you brought up forks over knives and then argued against them. RBut (talk) 12:02, 5 September 2021 (UTC)[reply]

"My whole argument is that they do not use healthy subjects, you cannot use studies on patients with hypercholesterolemia and etc and apply it to all populations. By using unhealthy subjects, you can make any food look good, including steak." I don't agree with you but I understand what you are saying, I see this criticism a lot about clinical trials. There was a low-carb/carnivore diet guy on the saturated fat talk-page who dismissed the cochrane review of RCTs on saturated fat because he said they were done on people with heart disease and not healthy people. I told him none of the trials on that topic are done on healthy people and he did not reply. I don't think it is a very good criticism for many reasons but if you go down this route you have to dismiss about 70% or 80% of the research from clinical medicine, you will end up a denialist. Most of the trials when it comes to diet (excluding drug-based) are not done on perfectly healthy subjects, of course some are but the majority of them are not. Most subjects who are ill join the clinical trials to either receive the experimental treatment that might help them or they do it to receive additional medical care or attention. It is a bit different for healthy people who volunteer. Obviously there are ethical considerations as well. A lot of healthy people out there would not want to take risks doing trials. You seem to have accepted Caldwell Esselstyn's results but they were all on CVD patients not a large diverse population but you will not accept studies on olive oil.

It's true that many of the studies (in this case olive oil) are being done on patients with diabetes or hypercholesterolemia etc. I have looked for studies done examining the relationship between endothelial function and diet. Most of the studies have been done on CVD or hypercholesterolemic patients but there are positive and negative results from such studies that fit a reliable pattern of data. It is clear from the evidence that processed meats, high-fat dairy, refined grains, deep-friend foods, sweets etc damage the endothlial function, there was a little review on that here [24]. There is no evidence from non-industry funded studies that foods can be made to look good like steak. I have not seen any positive studies for butter or steak. There was a recent RCT that looked at EVVO on patients with CVD [25] which concluded " Mediterranean diet better modulates endothelial function compared with a low-fat diet and is associated with a better balance of vascular homeostasis in CHD patients, even in those with severe endothelial dysfunction." I don't think we should dismiss studies like this because they were done on CVD patients. I don't see how this sort of study design would work on healthy subjects.

I think you would agree that butter is one of the worst foods for the endothlial function. These were saved on my computer so I will cite them [26], [27], but they are done on diabetes patients. I don't know why you will dismiss everything not done on healthy subjects. In a nutshell what I am trying to say is there is consistent data on this topic, once we have so much consistent data from so many studies it is rational to make a judgement. We know which foods damage the endothlial function and from all the recent studies done on this, it is not olive oil, it is foods high in saturated or trans fat. It seems that low-fat dairy products do not damage the endothlial function [28] compared to high-fat dairy. The high-saturated fat content is the problem, I am not convinced the issue is cholesterol but we could discuss that another time. Olive oil is not high in saturated fat. You will probably disagree with this but egg whites do not damage the endothlial function (they contain no saturated fat) [29].

As for Dean Ornish, he seems to have been misrepresented by some, because he was never vegan, he does support a low-fat plant-based diet but it includes egg whites he has not changed his view on this. You can easily email his team and they will confirm this. And this is on his website which is live "The Dr. Dean Ornish Program for Reversing Heart Disease has demonstrated that heart disease can be reversed through a four-element approach that includes a lacto-ovo vegetarian style of eating. The diet, however, only allows eggs whites and nonfat dairy products and excludes added fats such as nuts, seeds, oils, avocados and coconut (see Ornish Lifestyle Medicine Guidelines)." [30]. There is no saturated fat in egg whites so that is why he recommends them they are not bad for the heart. He recommends a low-fat diet but it is different than Esselstyn's.

This is slightly off topic but I think you would enjoy this [31]. It is the first ever umbrella review that examines the effects of foods on LDL. The worst is solid fats and unfiltered coffee. You can see what the good foods for lowering LDL are, all the usual healthy foods such as nuts, tomatoes, unsaturated oils, avocado, oats etc. There is too much consistent data from clinical trials and diet. I don't believe any food can be made to look good, definitely not processed meats or full fat dairy. When you look at non-industry funded research we can see which foods are healthy and which ones increase disease. There is a clear pattern of data. It is robust. I am not going to ignore data done on diabetic or hypercholesterolemic patients. Even you have accepted Esselstyn's results which were not done on healthy patients. I think you and me are on the same page about many things just not the olive oil. You are one of the most knowledgeable people I have seen discuss some of these topics.

As for the forksandknives the reason I argued against it at length is because it is very likely you took your arguments from there or something similar, they cited the same points as you and it is always the same studies they cite. You did not become anti-olive oil yourself, you read Esselstyn who seems to have influenced Greger, Ornish and other plant-based doctors. I would be interested in knowing if you were influenced by Esselstyn to become anti-oil or someone else. The anti-olive oil seems to have spilled out into the vegan community. There are not many anti-olive oil articles on the internet but I did read Dean Ornish's article on the subject earlier today. I will respond to some of your other points later. Psychologist Guy (talk) 21:19, 7 September 2021 (UTC)[reply]

Ethan Brown

Hi RBut, thanks for your help with the Beyond Meat edit request. Do you mind taking a look at my recent request at Talk:Ethan_Brown_(executive) as well? Could really use a fresh pair of eyes. Thanks again for your time, S at Beyond (talk) 23:08, 9 September 2021 (UTC)[reply]