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    • Some say we should tax sugary drinks and snacks and use that to subsidize the aforementioned. We'll see what Chris thinks but I say we just need more educational campaigns to teach people about the benefits of eating properly - whatever that is.

    • Education is important for sure. But someone who is lower income is probably going to make a rational decision to buy food they can afford which is almost never the healthiest option. How do overcome that?

    • I think that there are healthy, fast options out there. I can't help but think that kids not taking home economics is making things worse. My mom didn't teach me these skills. She was a 16 year old runaway who never learned them herself!

      But my point is, with better information and training we can make better decisions. That includes about food.

    • Lack of money for healthy food is always a concern even with people who aren't poor - me for example. One thing we have to realize is that even with our 'unhealthy' western diets even the majority of poor people are still getting the vitamins and minerals they need for maximum growth. Athletic performance isn't even that affected by our diets as long as it isn't too extreme. I've done plenty of 'research' on my own when eating McDonalds food while on bicycle training holidays in California and have gotten plenty of KOM segment times or top finishes on big mountain climbs against friends who eat very strict diets. As long as I don't consume too much sugar or fat I find there's little if any detectable difference in my performance. And remember athletes consume sugar drinks and gels regularly while on rides. Other serious scientific studies have shown that people who ate McDonalds food for recovery had no discernible level of recovery from people who had eaten specialty recovery drinks or food created for that purpose. Just like for example chocolate milk being the best recovery drink.

      Long term health may be a concern if we're eating tons of fat or sugar but it's not as big of a factor in the short term as we might think so long as people are eating some reasonably healthy meals on occasion. Where it's of the biggest concern is with developing children. Some places are starting to realize that giving a young mother or family food for their child will actually be cheaper in the long term than supporting that child when they get older and become an adult. Any development that is impeded due to lack of nutrition will eventually mean a cost to society. What is of the biggest concern in my mind is weight gain but here again eating sugary and high fat foods does not mean you will end up fat or overweight. I could go on a McDonald's 'diet' and lose weight. Calories in vs calories out still holds in the larger scientific community. Yeah there are triggers with eating certain foods that cause you to not be satiated, blah blah blah, but we have to be cautious when we come to conclusions because there is so much misinformation and pseudoscience out there in the diet sector.

      So how does wealth affect people's likelihood of being overweight or obese?
      "Suspecting that men and women pay different  prices for being obese, a group of researchers  at George Washington University recently attempted to quantify the economic impact by gender. They found that obesity costs women nearly twice as much as it does men, and that the vast majority of this difference can be traced  to the hit obese women take to their wages. The economic impact is only the beginning. Obese women in the U.S. are less likely to get married than their normal-weight peers, and about half as likely to attend college. They’re also twice as likely to become ill or depressedas obese men. Given these incentives, is it any wonder that women with more resources tend to use them to avoid the fate of being fat and female in America?"

      Maybe we need an education program that talks not just about how eating affects your short and long term health but how it may be costing you real money, reduce your chances of finding a mate and so on. The problem here again is that it's taboo to talk disparagingly about people's weight - especially of women's weight. Our society has gone too far at times in promoting overly thin women and now there are unrealistic fitness models that women aspire to be like (men too actually and they don't realize that many of the guys with ripped abs and muscles are on drugs). So how do you tell people they shouldn't be fat (and that eating better will help them) but not offend anyone? Participaction was a huge educational program promoted by the Canadian government years ago but new scientific research shows that exercise is NOT what makes most people lose weight. It certainly helps then become more fit and healthy but it's not the road to getting thinner.

      Some scientists recently found that parents are feeding their babies too much because of a misunderstanding on children's growth milestons and that this is a huge factor in their future chances of becoming obese as adults. It seems people or rather parents think of their child's weight milestones as an important indicator of their child's health but not interpreting it properly. They are wanting their child to be above the 50th percentile of children at each age milestone and think that it's better to be above the 50th percentile in weight.

      This isn't an article that discusses parents misinterpretation of the weight milestones but does talk about parents feeding their kids too much

      There's good news here. Parents can be educated about not feeding their kids too much and have the milestones explained to them better. They can be taught to understand the risks of feeding their child too much and greatly reduce the chances of their child becoming overweight as an adult.

      Canada is currently redoing its Canada Food Guide and I'm guessing that other countries are considering or doing similar things. We aren't going to get people back in the kitchen cooking but there is a concerted effort to get food processing companies to reduce sodium and sugar in their products. There was in fact some government and industry agreement on this a while back but industry failed to live up to their part of the agreement and government hasn't pressed their case. Money, money, money.

    • A few years ago I started to research why the curve of mortality from heart disease looks like it does among endurance athletes. Sedentary people have the highest risk, the risk drops precipitously for people who do 30-60 minutes of aerobic exercise/day, but then increases again until the people who do 3+ hours/day have risk factors approaching sedentary people. This got personal for me when fit athletes I knew started dying of coronary disease much too young.

      One of my favorite athletes, Steve Larsen, died suddenly at 39 of atherosclerosis. He was something like twice world mountain bike champion, on Lance's Tour de France teams, was an incredible triathlete. He left behind 5 young children.

      The evidence seems to point to them believing they burn off whatever they eat. They train so hard they have to eat 5,000+ calories/day. That's a lot of material that inflames your arteries and builds up plaque to flush through your circulatory system. Since they don't notice a diff in recovery between eating MacDonalds and eating a bowl of oatmeal or beans and brown rice, they eat the MacDonalds, not realizing what is happening to their arteries. If they get a calcium scan done, they are usually shocked.

      Bad screen capture from James O'Keefe's TEDx talk:

    • Fruit and vegetables can be expensive in food deserts like Detroit, but beans, brown rice, sweet potatoes, oatmeal...are pretty much the cheapest foods. The reason heart disease plummeted during WWII in Europe was because animal foods became scarce due to poverty. The reason poor countries have such low rates of heart disease, type II diabetes, and bowel cancer is they eat a lot of beans, rice, roots, etc. (Or they do until their markets fill up with cheap refined food like sugar, pastries and shortening.)

      I don't think 1 in 1,000 Americans know that heart disease is a food-borne illness, almost completely preventable and reversible. Clinton knows it and preaches it, but still no one knows. Same with type II diabetes. I'm not aware of a case that wasn't reversible in 30 days through a cheap diet alone.

    • I've read numerous articles on the risks of serious endurance athletes who continue to train seriously well into old age. The findings show that competitive endurance athletes live longer than the average person IF they reduce the amount they train after they retire from professional sport. Yes they have found increased levels of calcium in people who have trained for many years as an endurance athlete and while increased amounts of calcium in the arteries of sendentary people is considered a bad thing it is not necessarily so in trained athletes. At this point in time it's not known for sure if an increased amount of calcium in athletes is a bad thing and could even be a good thing. It's definitely something doctors and scientists are interesting in determining so the studies continue. I have some friends in California who are very serious cyclists and one of them had some heart concerns. We started doing all kinds of reading on endurance athletes and reduced lifespans and determined from the studies that we were okay so long as we weren't crazy ultra endurance athletes that kept up that level of training for decades. My one friend who first brought up his concern with me is a firefighter and developed lung challenges due to a particularly bad fire. He also had some heart issues but it was determined that it was a genetic thing. I've recently had my heart checked in a few tests to make sure things were okay. Another friend of mine who is a good cyclist but doesn't train quite as much as I do has also recently had his heart checked. We have another friend who trains a lot and has had a stent put in his heart. The findings show that people who exercise at such extreme rates or high levels as we do will expose a faulty heart sooner than the average person. My doctor told me though that if I had that kind of fault that I'd have died long ago considering how hard I push myself. That's a different thing from long term damage done however. Fortunately I've never been an extreme athlete, I have taken over a decade off from serious training and my heart has checked out fine. That is of course no guarantee that I won't die of a heart attack tonight. I carry low dose aspirin with me on most of my rides just in case someone has a heart attack.

      I'd like to see some study that claims eating excesive amounts of food as an athlete causes a calcium build up in their arteries. I think some suggest the build up of calcium may be the body's response to inflamation. It's still unknown at this time but I'd sure like to see a peer reviewed study. Also keep in mind that over 50% of peer reviewed studies end up being wrong after further follow up studies. That's a serious problem with scientific studies and the method they are using to report their findings. There's currently lots of serious discussions about how to address the numerous issues that are plaguing science journal articles right now.

    • Unfortunately sweet potatoes are $1.50 a pound here (I still eat them) but beans and the rest of the food you've mentioned are inexpensive. I'm not aware of the science on WWII heart disease deaths and their cause but I agree with you on diet helping diabetes, obesity a huge factor in diabetes prevalence and that junk food's growing ubiquity is a worldwide concern. Education, education, education. But we'll also need to somehow pressure companies that create all that refined food.

      On a bit of a separate note, one concern of mine is that people automatically assume all processed foods are bad and that's simply not true. Flash frozen vegetables can be healthier than raw vegetables if the raw vegetables have sat out for a long time. The frozen vegetables are frozen when fresh and that saves many of their nutrients.

      There's no simple answer to all of these problems but one thing is for sure and that's that it'll take a multipronged approach to addressing this concern in a way that's going to stop and then reverse the obesification of the world's population.

    • Chris - When considering whether calcium in sedentary people is possibly different from trained athletes we can look to the enlarged heart. In sedentary people an enlarged heart is usually considered a sign of heart disease and requires intervention with medications. An athlete's large heart is generally considered a good thing. See article:
      The jury is still out on that one though I would be concerned if I was an ultra marathoner for years.

    • My understanding is we look for calcium buildup in arteries because calcium provides a hard, reflective layer that shows up in scans, not because it poses the danger of blockage that plaque does. The calcium is an indirect measure of risk because it's correlated with coronary disease, not because it's the cause of heart attacks like blockage from plaque is.

      The trouble with plaque is it's hard to detect without an expensive MRI or angioplasty. Studies show that when you change someone's diet who has calcium and plaque buildup, the plaque recedes along with their risk of a heart attack, but the calcium rarely does.

      Retired athletes who have heart attacks are very common even when they cut back on their exercise as they age. For example, the great marathoner Alberto Salazar was only 48 when he had his massive heart attack and he had remained slender and kept jogging 25-30 miles/week. As in almost every case I'm aware of, he had no structural damage to his heart from his years of being a champion marathoner and ultrarunner. He simply had plaque build-up because he enjoys MacDonald's.

      It's true, former elite athletes are more at risk of heart attacks as they age, but so is the rest of the population. Plaque buildup is cumulative over the years.

      There are people with major structural damage to their hearts from past heart attacks or infections (that's me, Rheumatic fever as a child). They far exceed any damage a pro athlete sees to their hearts. But as the Cleveland Clinic Prevention Center has so dramatically demonstrated, it's a rare patient (less than 1 in 100) who experiences heart disease after a change in diet, even if they are sedentary or old. Their prevention center sees the worst of the worst, patients who've had stents, heart attacks, strokes, and bypass operations. Their surgeons referred them to the prevention center because they had become so weak or old that surgical interventions are no longer an option.

      The main artifact from heart attacks and infections that a change in diet won't help is permanent damage to the nerves that carry electrical signals, but that only represents a small percentage of patients whose heart problems arise from plaque buildup.

    • If I understood you correctly you're saying you can change your diet and your chance of getting a heart attack falls pretty quickly? Is that what you were saying more or less? What is the diet change?

    • Here's a good article that talks about Salazar and the extreme exercise hypothesis as per the 2012 Tedtalk. It says his hypothesis and reasoning then says:

      I suspect, though, that part of what sustains the “too much exercise can kill you” myth is the widespread recognition of the so-called exercise paradox. That is, while consistent exercise decreases the likelihood that you will have a heart attack, if you are destined to have one it is more likely to happen while you are exercising.

      Even if it does turn out that extreme exercise increases people's chance of getting a heart attack by 1% I'm really not worried about it because I'm not an extreme endurance athlete. Very interesting research however. Just for the record I don't normally eat at McDonald's ;) That stuff tastes like crap and fortunately for me my girlfriend is a cook and is asian. Asian food is my favourite though I like almost anything and everything. I'm not picky. Basically I try to stay fit, rest lots, eat lots of fruit and vegetables, grains, some meat and milk products and avoid junk food unless I'm doing some crazy bike ride and need some quick energy. Hopefully I have good genetics and don't get unlucky with cancer before my body is thoroughly worn out :) I'll continue to read all the great diet, food, exercise and lifestyle conversations on Cake to try to pick up a few tips on how to live healthier and happier.

    • I think one of the most astounding demonstrations ever done was Caldwell Esselstyn's first human diet intervention for patients with severe heart disease.

      He's a great guy, olympic gold medalist, bronze star surgeon during the Vietnam war, renowned surgeon at the world's most prestigious heart clinic, I could go on for paragraphs. What he noticed after tens of thousands of surgeries is when you do open heart surgery, the same mechanism that caused your arteries to clog in the first place, cause them to clog again in an average of 10 years. Eventually, you can't keep having open heart surgeries, so you are sent to home hospice care, same as terminal cancer patients.

      He took 21 of them for an experiment of only dietary intervention. They couldn't exercise because they were not ambulatory (couldn't get out of bed). They were the worst of the worst with a long history of heart attacks, strokes, and genetic pre-disposition to heart disease. All were on heavy meds.

      One died of a heart attack from arrhythmia caused by damaged nerves from multiple heart attacks, at the very beginning of the trial (none of them were expected to live more than 6 months). He put the others on a diet of no animal or refined foods, just beans, vegetables, fruit and whole grains.

      5 of them said doc, that's a fate worse than death, we need pizza and burgers. Those 5 died shortly after. The remaining 15 stuck to the program and were able to get out of bed, play golf, run marathons, and live full lives. 13 are still alive 20 years later, 2 died of old age. One guy had another minor heart attack 2.5 years after the program started because he decided moderation was okay and had a little birthday cake during social occasions, etc. That scared him back on the program and he had no further problems.

      Dr. Esselstyn wrote a very respected book and has given many great lectures, including this TEDx talk.

    • Wow that sounds...well too good to be true. I'll definitely do some digging. Thanks for the info!!!

      I start with the assumption that it’s not true and that
      there are problems with his study. I also look for replication of the study if
      it does show promising results. I ask myself what is the predominant view of
      the experts in the field and if I find they are at odds with the person then I
      want to know why. As soon as you started saying he is some authority I’m
      concerned about the argument from authority fallacy so I become even more
      skeptical - though interested.

      The first thing I find is this:

      It leaves me with concerns about Esselstyn’s study and lack
      of very tight controls, limited study, lack of replication, failure to be
      followed up and no publication in a credible peer reviewed journal. So far at
      least. I also ask myself what Esselstyn has to gain from promotion of this and
      think book sales but don’t look any further into his possible motives. I keep
      looking and find this:

      More concerns about his study and it further reinforces that
      his controls are not very tight, his claims are extraordinary and the people in
      the study were even on medication. Now I still haven’t discounted his argument
      but I’m finding the evidence really preliminary. His study is what scientists
      would call preliminary and not something that we should make strong claims on,
      certainly not a slam dunk as he would claim. 
      When I hear of Bill Clinton following this I am brought further home to
      another famous and hugely respected person who may have fallen victim to claims
      of alternative medicine and that’s Steve Jobs. No matter how famous, successful
      or brilliant you are in one subject or area you are not infallible especially
      if you don’t know the rules of logical thinking and aren’t aware of logical

      So the search continues and I remain a skeptic.

      What is likely so far: Good things – eating lots of fruits
      and vegetables, reducing red meat intake when they have nitrates, eating whole
      grains, eggs, cheese, nuts, avocado…

      There’s no such thing as super foods but rather vitamins and
      nutrients that our bodies need and foods that can provide us with them. Fiber
      is also something that helps keep us regular and whatever else it does that
      appears to be beneficial.

      Bad or concerns – milk is not some magical nutrient (I drink
      whole milk), soy could possibly be a concern if men drink too much, almond milk
      and other alternatives to milk have tons of sugar and often not much in the way
      of nutrients, nitrates in red meat eaten in large quantities, not getting
      enough exercise, not getting sunlight, hormones in meat could be a problem, too
      much sugar, bioaccumulation of mercury if you eat too much fish from certain
      places… Too much sodium? Science keeps going back and forth on that but it’d
      probably be a good idea to avoid too much anyway. Moderation…

    • This is the darkside of the Internet: someone like Harriet Hall can brand herself as The Skeptical Cardiologist when she's never been one, has never done a scientific study, has never had a paper published in a respected publication, was let go from Oprah Magazine after a few contributing columns that they had to heavily edit because she wasn't factual.

      I think one of the most damaging skeptical fallacies is if it sounds too good to be true, it probably is. That's neither logical nor scientific. The world is filled with thousands of scientific advances that seem way too good to be true.

      Yes, Esselstyn did a follow-up study with 198 patients he published in 2014. Unlike Harriet, he has almost 200 publications in the most prestigious journals. Page 2.

      Esselstyn's study is so easily replicable, it's been done thousands of times across the nation. There is Dean Ornish's landmark study published in the Lancet. There is the President of the American College of Cardiology. Then there is William Roberts, who has written over 1300 scientific publications, a dozen cardiology textbooks, and has been editor in chief of the American Journal of Cardiology for a quarter of a century who has stated repeatedly that animal and refined foods are the cause of atherosclerosis. He was my cardiologist when I lived in Texas.

      The nightmare for some doctors I know (including my son-in-law) is to have a patient walk in with a printout of Harriet Hall's web posting about heart disease being caused by your genes. They have to explain that ignores half the world's population and hundreds of their own patients and the most respected cardiologists in the world.

    • Thanks for taking the time to respond. This conversation is getting even more interesting. The first thing I’ll say is that I start off with a skeptical view when someone (in this case Esselstyn) is
      trying to convince me of something that is not the generally accepted viewpoint
      of most experts in the field of research his is talking about. He’s making an
      extraordinary claim and therefore requires extraordinary evidence. The
      preliminary study was not sufficient to override that view. So now you’ve
      provided some follow up studies so I’ll have to check those. In other words I
      didn’t simply think if it sounds too good to be true it probably isn’t true.

      Oprah promotes pseudoscience and woo and her Dr. Oz is notorious for promoting
      quackery and alternative medicine of all kinds. That makes me think it is very
      unusual indeed that her magazine would edit her because she wasn’t factual. I
      remain a skeptic of that though not sure either way at this point. Steven
      Novella works hand in hand with her so at this point I’m leaning towards
      Harriet and not Oprah. I have no factual evidence either way but just a he said
      she said. I’ll have to check that out later.

      His study has been done thousands of times across the nation? Really? So there would be a
      meta analysis done on the subject and there’s no reason to even look at any
      individual study. If in fact it’s been done thousands of times. Or do you mean
      to refer to each person who has a special diet to be a study in and of

      Harriet is a medical doctor and not a cardiologist. That gives Esselstyn the edge on her
      but it in no way excludes her from potentially being a valuable and credible
      person to attack his work. I am not a specialist of any kind other than
      teaching and I can make a legitimate attack on people who make poor studies
      even if they are scientists or doctors. I’ve studied statistics and understand
      things like controlling variables, and not being an expert does not exclude me
      from being able to criticize chiropractors and naturopaths for example. Again,
      the edge goes to Esselystyn, though his study was preliminary and at least at
      first he was overstating and overselling his results. We have to be extremely
      careful that we don’t fall into the observation bias problem. That is, we pick
      a side and once our mind is made up we look for every piece of evidence to
      support out view and exclude those opposing it. The best approach again is to
      ask ourselves “what evidence would convince me otherwise?”  What would it take me to change my mind? Me for example I want the replicated studies. I want the meta-analysis. I want
      experts who are starting to change their opinions and supporting Esselstyn’s

      Is Esselstyn’s view the prevailing view among cardiac disease causality

      Oh, one more thing – I read those two brief criticisms but didn’t take a side on the
      issue it merely made me aware of some of the overstatements and preliminary
      nature of Esselstyn’s first study. I love digging for more answers.

      **This Cake thing totally changed the formatting of what I wrote in Word :( I fixed it a bit...

    • It was true and he admits to his first study being a small preliminary study and he set about doing a follow up study. I was making the right call on that so far. Harriet’s
      criticism was posted on November 23, 2010 and his follow up was printed in July
      2014. She criticized the strictness of the adherent’s diet and I see his follow
      up study addressed that by “considered participants adherent if they
      eliminated dairy, fish, and meat, and added oil.”(

      Their article states: “Major cardiac events judged to be recurrent disease totaled one stroke in the adherent cardiovascular participants—a recurrent event rate of .6%, signicantly
      less than reported by other stud- ies of plant-based nutrition therapy.” That’s concerning to me. I hope they address why that is. (I later read other studies didn’t eliminate oils completely or food products that may contain even small amounts of oil) I’m
      glad to see that they are arguing that they feel their approach should be
      tested more widely among a broader population to see if it can be sustained. The
      study has a lot of diet changes and although they didn’t require exercise they
      encouraged it. A number of people lost weight too.

      When they go one to say why their results are favorable I have some
      concerns. First they assume certain things are responsible for the outcome but
      they can’t be sure of this. They’d have to do more studies that isolate various
      foods, oils and so on. It could turn out there very few things are causing the
      problem. That’d sure be great. I can see where this is heading though as each
      meat, cheese, egg, dairy, poultry, shell fish and oil producer will lobby to
      see this information is presented as preliminary and not yet fact. While they
      are true in a way it’s certainly starting to look that way and while no one can
      say with certainty what is causing the disease we seem to be on the right
      track. This is big. Really big. Huge. I want to see more studies!!

    • Ornish's study that you gave me a link to is a very small one with only 28 people on his lifestyle change that includes a low-fat vegan diet. Those same people also stopped smoking, had stress management training, and exercised moderately. That is a small study with other potentially important factors that aren't controlled for. Or rather we can't be sure it was certain diet changes alone that are responsible for the improved results. A preliminary study at best.


      This final link basically has the same concerns I had. Very promising but more follow up is required to isolate the variables or factors responsible for the improvements. There are simply too many variables that have been changed between the control group and those who received the treatment. Certainly makes you think twice before you buy certain food products and it has to be scary to various food producers.

      I now have a big but separate yet related concern and that's that many vegan people are very susceptible to product sellers nonsense. They are often anti GMO when not even knowing what it is, they are often anti vaccers, promote misinformation about organic food and take suppliments that have been shown to be pseudoscientific nonsense. They're more likely to take homeopathic remedies for example. So while they are generally a subset of the population that takes their health very seriously and has a generally higher education, they are also very easily duped into believing stuff that is not true. So why am I concerned about them? Because it causes good people to waste their money needlessly. Not on vegan food in general but on foods, suppliments and so on that are not in fact healthier for them or for the planet but they think they are because producers take advantage of their ignorance on sciece.

    • There's a book called What's Your Dangerous Idea. I'd guess you would say your dangerous idea is that meat should be taxed for the betterment of society :)

    • many vegan people are very susceptible to product sellers nonsense. They are often anti GMO when not even knowing what it is, they are often anti vaccers, promote misinformation about organic food and take suppliments that have been shown to be pseudoscientific nonsense.

      Is this a popular perception? I know hundreds of vegans and I've never met an anti-vaxxer in my life. Your friend VilTri on Cake? Brian and Gorudy here? The doctors who are in the most prominent positions in cardiology?

      It reminds me of Harriet Hall's central argument against vegan diets: they are too extreme and people won't adhere to them. Does she have some science to back that up? The evidence she provides is she enjoys meat. People like me and VilTri don't find the diet extreme at all. We find it delicious and energizing.

      I think Esselstyn had the best quote about that:

    • Maybe it's because people like David Wolfe promote all kinds of woo and is an anti-vaxxer. As a cyclist it's hard to miss the vegan Harley Johnstone's (Durianrider) crazy posts. There are lots of vegans on Youtube that are very popular and unfortunately many of them are also quacks. Extreme raw veganisms isn't supported by the science.

      I should probably add that I had never heard of Harriet Hall until I found her post the other day. I see that her article has annoyed the heck out of you in the past. If someone brings her article into a doctors office then the doctor could simply say "well he is a large longitudinal follow up study and here is what has been found".

      About 5 years ago I was in a Planet Organic store and wandered over to the pamphlet section to have a look at the literature they were offering. I was aghast at all the pseudoscience nonsense they were promoting. The health food sector is rife with marketers that are taking advantage of the ignorance of people who are intelligent but believe whatever nonsense they are selling.

      Since that eye opening experience at Planety Organic years ago I've noticed that people who buy organic food also fall victim to the marketing nonsense of alternative medicine, extreme diets (I would not include Esselstyn's under that category though it is strict in comparison to the average diet) anti GMO messages, anti-vax and other assorted quackery. When I say many vegan people are susceptible to product sellers nonsense that does not mean ALL vegans but rather more vegans than the average person. I'd go farther and guess that the average vegan is more intelligent than the average person but then again studies have shown that the average organic food buyer is a little smarter than the average population. People who are smarter it appears are trying to be healthy and spend the time to read literature on being healthy. The problem is that there is a plethora of misinformation and scams out there. The diet industry is a multibillion dollar industry and why not focus on those who have the money to buy your products? Once people get into that whole stream or group they are exposed to a set of information much like someone who is a Republican. Now I am generalizing but it's fairly common and reasonable to take an average strongly supporting Republican and fairly regularly predict where they stand on a wide assortment of issues. Now this isn't true for all Republicans but is a well supported fact. My argument for a third party system in the usa would I think reduce how much Americans are being influenced by their political party association.

      Chris you and your friends are well above average intelligence, education and level of being informed. Just because you aren't an anti-vaxxer doen't mean vegans in general aren't more often anti-vaxxers than the regular population. How many of your friends are organic food eaters? How many are anti GMO? Regardless of the answer we have to keep in mind that general group statistics say nothing about an individual within that group only that they have a higher chance of being a certain way.

      I wonder if you've finished reading my other posts and see that I'm coming around to Esselstyn's diet recommendations and that while correlation doesn't equate to causation it would probably be good if people acted like it was in this case.

      So what diet recommendations would you make? Start with the most important and finish with the least important. Thanks for your time and insight into all of these very interesting topics :)

    • Oh, point taken on the crazy raw food vegans on YouTube. Come to think of it, my old boss Steve Jobs could be pretty wacked out about it, even though he was very bright. We'd get dinner and he'd have a small green salad and about 6 big cookies. 🤢

      You're right that Harriet makes me crazy. The backstory is Esselstyn's research comes on the heels of The China Study, the largest, most distinguished, best study of nutrition ever conducted in my opinion. I bought the $200 book and obsessed over it for weeks as if my life depended on it (it did). Pic of my copy below. The study authors were Colin Campbell, who headed the department of human nutrition at Cornell, fellow in the National Academy of Sciences, and the giant of the field; Sir Richard Pieto of Oxford University, the most respected cancer epidemiologist in the world whom the queen knighted for his distinction; and the Chinese Ministry of Health. It was funded by the NIH, American Cancer Society, yada--the most respected sources with the fewest conflicts.

      The researchers didn't depend on questionnaires of what they ate. They visited people's homes and took urine, blood and stool samples, and inspected their kitchens. They open-sourced all the data. I could go on about how amazing this study is, but guess who trashed it as thoroughly debunked and linked to conspiracy websites about it? I'm pretty sure she never got her hands on the data or understood the study like the people like me who spent days poring over the data. But what do you think the masses read on the Internet? The fat in-depth book I have or her emotion and personal bias-based blog that isn't peer-reviewed?

      Anyway, you mention many factors wrt to the Esselstyn study and correctly point out that Ornish had other variables like meditation, yada. That's the brilliant simplicity of Esselstyn's study. He, in conjunction with Colin Campbell, narrowed it to one factor: a diet of whole (not refined) plants. Not exercise, not medication, not stress relief, just one factor.

      You also point out the studies are small: 24 in the first and 198 in the second. That's one reason I trust them. Unlike 99% of nutrition studies that are based on questionnaires where people fill them out and can't remember and don't want to remember what they ate and how they cheated, Esselstyn's studies involved blood tests every two weeks, MRIs to see if arteries were opening, etc. I don't think Harriet understood any of that. The questionnaire studies take thin and bad data, but spread them over 6,000 people. Does that make the data trustworthy?

      The other brilliance of what Esselstyn and Campbell did is make it so my son-in-law and his clinic of 6 physicians can save thousands of lives/year by telling people it's about one thing: eating foods with the fiber in place. Apples, not apple juice. Brown rice, not white. Olives, not olive oil. And he points them to whole foods cookbooks.

      It takes 4 days for a patient's angina to subside on whole plant foods. It takes two weeks for their blood pressure and cholesterol to normalize. It may take up to 30 days for patients to get over their type II diabetes. It all sounds too good to be true but it's something you can try at home and with your friends or chronically ill relatives. My wife and I have done it many dozens of times.