Diet & MS Research

A board to discuss various diet-centered approaches to treating or controlling Multiple Sclerosis, e.g., the Swank Diet
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jimmylegs
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2017 study:whole vs refined grain->microbiota,immune markers

Post by jimmylegs » Thu Sep 13, 2018 10:46 am

Substituting whole grains for refined grains in a 6-wk randomized trial has a modest effect on gut microbiota and immune and inflammatory markers of healthy adults (2017)
fft: https://academic.oup.com/ajcn/article/105/3/635/4637852

ABSTRACT
Background: Observational studies suggest an inverse association between whole-grain (WG) consumption and inflammation. However, evidence from interventional studies is limited, and few studies have included measurements of cell-mediated immunity.

Objective: We assessed the effects of diets rich in WGs compared with refined grains (RGs) on immune and inflammatory responses, gut microbiota, and microbial products in healthy adults while maintaining subject body weights.

Design: After a 2-wk provided-food run-in period of consuming a Western-style diet, 49 men and 32 postmenopausal women [age range: 40–65 y, body mass index (in kg/m2) <35] were assigned to consume 1 of 2 provided-food weight-maintenance diets for 6 wk.

Results: Compared with the RG group, the WG group had increased plasma total alkyresorcinols (a measure of WG intake) (P < 0.0001), stool weight (P < 0.0001), stool frequency (P = 0.02), and short-chain fatty acid (SCFA) producer Lachnospira [false-discovery rate (FDR)-corrected P = 0.25] but decreased pro-inflammatory Enterobacteriaceae (FDR-corrected P = 0.25). Changes in stool acetate (P = 0.02) and total SCFAs (P = 0.05) were higher in the WG group than in the RG group. A positive association was shown between Lachnospira and acetate (FDR-corrected P = 0.002) or butyrate (FDR-corrected P = 0.005). We also showed that there was a higher percentage of terminal effector memory T cells (P = 0.03) and LPS-stimulated ex vivo production of tumor necrosis factor-α (P = 0.04) in the WG group than in the RG group, which were positively associated with plasma alkylresorcinol concentrations.

Conclusion: The short-term consumption of WGs in a weight-maintenance diet increases stool weight and frequency and has modest positive effects on gut microbiota, SCFAs, effector memory T cells, and the acute innate immune response and no effect on other markers of cell-mediated immunity or systemic and gut inflammation. This trial was registered at clinicaltrials.gov as NCT01902394.

"Study diets
All randomly assigned participants underwent a 2-wk run-in phase in which they were provided with a Western-style diet (high in saturated fats, red meats, simple carbohydrates, and processed or refined foods and low in fresh fruit and vegetables, WGs, seafood, and poultry). The purpose of the run-in period was to minimize the effect of habitual diet intake before starting the experimental diets. Total daily caloric intake of each participant was initially calculated with the use of the Harris-Benedict formula and was adjusted for physical activity when necessary to maintain the current body weights of subjects. Participants were instructed to maintain their current physical activity levels throughout the study. All meals were based on the USDA Dietary Guidelines 2010, which recommends that 50–55% of energy is derived from carbohydrates, 15–20% of energy is derived from protein, and 25–30% of energy is derived from fat (39). After completion of the run-in phase, participants were assigned to the following experimental diets: an RG diet (8 g/1000 kcal) and a WG diet (16 g/1000 kcal), respectively (Figure 1). The targeted fiber intake that was provided by the WG diet met the recommended Dietary Guidelines for Americans (35 g/d), whereas the fiber intake from the RG diet was slightly above the average intake in adults."

aww, why would you do that.

"The diets were similar in composition with the exception of the source of grain. The WG group received all grains from WG sources, and the RG group received all grains from RG-containing foods. Otherwise, the diets were matched for servings of fruit, vegetables, and protein (e.g., turkey meatloaf with 100% whole-wheat bread crumbs with mixed vegetables or turkey meatloaf with 100% white-bread crumbs with mixed vegetables). Six 240-mL glasses of water or calorie-free drinks were recommended daily. The study dietitian developed 3-d menu cycles at 3 caloric levels (2000, 2500, and 3000 kcal) that used commonly available ingredients and food items. Calories were adjusted (plus or minus) from these calorie amounts on the basis of participants’ weight fluctuations."

ok from wheat to flour to bread to crumbs in the whole grain diet. this is where i start to wonder about relative GI index type stuff.

"In this study, we showed a modest effect of WGs on the composition of microbiota and stool SCFA concentrations. These observations were consistent with 2 (30, 31) of 3 (30, 31, 35) previous studies that investigated the effects of WGs on gut microbiota. We did not observe a difference in the bacterial diversity or phyla between groups, which was in agreement with the other intervention trials that used WG wheat as the main source of WGs (31, 67). In contrast, Martínez et al. (30) used WG barley and brown rice as the main sources of WGs and reported increases in gut microbial diversity and in the Firmicutes:Bacteroidetes ratio. Similar to the results that were reported by Martínez et al. (30) and Vitaglione et al. (31), we observed differences at the genus level whereby there was an increase in the SCFA producer Lachnospira and a decrease in proinflammatory Enterobacteriaceae."

interesting, thank you barley and brown rice for joining the fun

"Note that WG foods contain more micronutrients and phenolic compounds that are known to have various health benefits, including those on immune and inflammatory responses, and we could not determine the contribution of these components, as well as their interactions with fiber, to the final effects in our clinical trial. Therefore, future intervention studies should also consider the inclusion of a variety of grains... "

yes pls

"... because grains vary in types of fiber and compositions of phytochemicals and micronutrients. In particular, the WG in the current study was predominantly from wheat, whereas oats contributed <5%; however, oats are more prominent sources of soluble fiber, which are known to beneficially alter risk factors for diseases (71). Finally, genomic and epigenetic variations should be determined for the varied responses to WG intake in individuals in terms of changes in gut microbiota, inflammation status, and the immune response."
take control of your own health
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jimmylegs
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2014 meta analysis: Nuts&legumes: heart disease, stroke risk

Post by jimmylegs » Fri Sep 14, 2018 8:29 am

Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis (2014)
https://academic.oup.com/ajcn/article/100/1/278/4576571

ABSTRACT
Background:
Relations between the consumption of nuts and legumes and risk of ischemic heart disease (IHD), stroke, and diabetes have not been well established.

Objective: We systematically investigated and quantified associations of nut and legume consumption with incident IHD, stroke, and diabetes.

Design: We systematically searched multiple databases to identify randomized controlled trials or observational studies that examined the relations. Studies were excluded if they reported only intermediate physiologic measures, soft cardiovascular outcomes, or crude risk estimates. Data were extracted independently and in duplicate. We assessed pooled dose-response relations by using a generalized least-squares trend estimation, and prespecified sources of heterogeneity were assessed by using metaregression. The potential for publication bias was explored by using funnel plots, Begg’s and Egger’s tests, and Duval and Tweedie trim-and-fill methods.

Results: Of 3851 abstracts, 25 observational studies (23 prospective and 2 retrospective studies) and 2 trial reports met inclusion criteria and comprised 501,791 unique individuals and 11,869 IHD, 8244 stroke, and 14,449 diabetes events. The consumption of nuts was inversely associated with fatal IHD (6 studies; 6749 events; RR per 4 weekly 28.4-g servings: 0.76; 95% CI: 0.69, 0.84; I2 = 28%), nonfatal IHD (4 studies; 2101 events; RR: 0.78; 0.67, 0.92; I2 = 0%), and diabetes (6 studies; 13,308 events; RR: 0.87; 0.81,0.94; I2 = 22%) but not stroke (4 studies; 5544 events). Legume consumption was inversely associated with total IHD (5 studies; 6514 events; RR per 4 weekly 100-g servings: 0.86; 0.78, 0.94; I2 = 0%) but not significantly associated with stroke (6 studies; 6690 events) or diabetes (2 studies; 2746 events). A meta-regression did not identify the effect modification by age, duration of follow-up, study location, or study quality. Mixed evidence was seen for publication bias, but analyses by using the Duval and Tweedie trim-and-fill method did not appreciably alter results.

Conclusion: This systematic review supports inverse associations between eating nuts and incident IHD and diabetes, and eating legumes and incident IHD.
take control of your own health
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ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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Re: 2014 meta analysis: Nuts&legumes: heart disease, stroke

Post by ElliotB » Fri Sep 14, 2018 9:09 am

Omega-3 Fatty Acids, Especially DHA, offer numerous Cardiovascular Benefits:

https://www.drsinatra.com/enjoy-DHA-omega-3-benefits

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jimmylegs
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2012 meta analysis: Omega-3s & heart disease

Post by jimmylegs » Fri Sep 14, 2018 9:34 am

Association Between Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events - A Systematic Review and Meta-analysis (2012)
https://jamanetwork.com/journals/jama/a ... .2018.2498

Abstract
Context Considerable controversy exists regarding the association of omega-3 polyunsaturated fatty acids (PUFAs) and major cardiovascular end points.

Objective To assess the role of omega-3 supplementation on major cardiovascular outcomes.

Data Sources MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials through August 2012.

Study Selection Randomized clinical trials evaluating the effect of omega-3 on all-cause mortality, cardiac death, sudden death, myocardial infarction, and stroke.

Data Extraction Descriptive and quantitative information was extracted; absolute and relative risk (RR) estimates were synthesized under a random-effects model. Heterogeneity was assessed using the Q statistic and I2. Subgroup analyses were performed for the presence of blinding, the prevention settings, and patients with implantable cardioverter-defibrillators, and meta-regression analyses were performed for the omega-3 dose. A statistical significance threshold of .0063 was assumed after adjustment for multiple comparisons.

Data Synthesis Of the 3635 citations retrieved, 20 studies of 68 680 patients were included, reporting 7044 deaths, 3993 cardiac deaths, 1150 sudden deaths, 1837 myocardial infarctions, and 1490 strokes. No statistically significant association was observed with all-cause mortality (RR, 0.96; 95% CI, 0.91 to 1.02; risk reduction [RD] −0.004, 95% CI, −0.01 to 0.02), cardiac death (RR, 0.91; 95% CI, 0.85 to 0.98; RD, −0.01; 95% CI, −0.02 to 0.00), sudden death (RR, 0.87; 95% CI, 0.75 to 1.01; RD, −0.003; 95% CI, −0.012 to 0.006), myocardial infarction (RR, 0.89; 95% CI, 0.76 to 1.04; RD, −0.002; 95% CI, −0.007 to 0.002), and stroke (RR, 1.05; 95% CI, 0.93 to 1.18; RD, 0.001; 95% CI, −0.002 to 0.004) when all supplement studies were considered.

Conclusion Overall, omega-3 PUFA supplementation was not associated with a lower risk of all-cause mortality, cardiac death, sudden death, myocardial infarction, or stroke based on relative and absolute measures of association.

maybe they should have re-worked the title...

would need to dig in to full text to find out how they assessed supplementation and whether they looked at total intake (doesn't sound like it)
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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jimmylegs
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Re: 2012 meta analysis: Omega-3s & heart disease

Post by jimmylegs » Fri Sep 14, 2018 9:39 am

Seafood Long-Chain n-3 Polyunsaturated Fatty Acids and Cardiovascular Disease: A Science Advisory From the American Heart Association (2018)
https://www.ahajournals.org/doi/abs/10. ... 0000000574

Abstract
Since the 2002 American Heart Association scientific statement “Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease,” evidence from observational and experimental studies and from randomized controlled trials continues to emerge to further substantiate the beneficial effects of seafood long-chain n-3 polyunsaturated fatty acids and cardiovascular disease. A recent American Heart Association science advisory addressed the specific effect of n-3 polyunsaturated fatty acid supplementation on clinical cardiovascular events. This American Heart Association science advisory extends that review and offers further support to include n-3 polyunsaturated fatty acids from seafood consumption. Several potential mechanisms have been investigated, including antiarrhythmic, anti-inflammatory, hematologic, and endothelial, although for most, longer-term dietary trials of seafood are warranted to substantiate the benefit of seafood as a replacement for other important sources of macronutrients. The present science advisory reviews this evidence and makes a suggestion in the context of the 2015–2020 Dietary Guidelines for Americans and in consideration of other constituents of seafood and the impact on sustainability. We conclude that 1 to 2 seafood meals per week be included to reduce the risk of congestive heart failure, coronary heart disease, ischemic stroke, and sudden cardiac death, especially when seafood replaces the intake of less healthy foods.

dammit can't just put seafood *on* the doritos? (KIDDING - i never eat that kind of pseudo food)
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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Re: 2012 meta analysis: Omega-3s & heart disease

Post by jimmylegs » Sat Sep 15, 2018 6:10 am

Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks - Meta-analysis of 10 Trials Involving 77 917 Individuals (2018)
https://jamanetwork.com/journals/jamaca ... 81015207=1

"Key Points
Question Does supplementation with marine-derived omega-3 fatty acids have any associations with reductions in fatal or nonfatal coronary heart disease in people at high risk of cardiovascular disease?

Findings This meta-analysis of 10 trials involving 77 917 participants demonstrated that supplementation with marine-derived omega-3 fatty acids for a mean of 4.4 years had no significant association with reductions in fatal or nonfatal coronary heart disease or any major vascular events.

Meaning The results provide no support for current recommendations to use omega-3 fatty acid supplements for the prevention of fatal coronary heart disease or any cardiovascular disease in people who have or at high risk of developing cardiovascular disease.

Abstract
Importance Current guidelines advocate the use of marine-derived omega-3 fatty acids supplements for the prevention of coronary heart disease and major vascular events in people with prior coronary heart disease, but large trials of omega-3 fatty acids have produced conflicting results.

Objective To conduct a meta-analysis of all large trials assessing the associations of omega-3 fatty acid supplements with the risk of fatal and nonfatal coronary heart disease and major vascular events in the full study population and prespecified subgroups.

Data Sources and Study Selection This meta-analysis included randomized trials that involved at least 500 participants and a treatment duration of at least 1 year and that assessed associations of omega-3 fatty acids with the risk of vascular events.

Data Extraction and Synthesis Aggregated study-level data were obtained from 10 large randomized clinical trials. Rate ratios for each trial were synthesized using observed minus expected statistics and variances. Summary rate ratios were estimated by a fixed-effects meta-analysis using 95% confidence intervals for major diseases and 99% confidence intervals for all subgroups.

Main Outcomes and Measures The main outcomes included fatal coronary heart disease, nonfatal myocardial infarction, stroke, major vascular events, and all-cause mortality, as well as major vascular events in study population subgroups.

Results Of the 77 917 high-risk individuals participating in the 10 trials, 47 803 (61.4%) were men, and the mean age at entry was 64.0 years; the trials lasted a mean of 4.4 years. The associations of treatment with outcomes were assessed on 6273 coronary heart disease events (2695 coronary heart disease deaths and 2276 nonfatal myocardial infarctions) and 12 001 major vascular events. Randomization to omega-3 fatty acid supplementation (eicosapentaenoic acid dose range, 226-1800 mg/d) had no significant associations with coronary heart disease death (rate ratio [RR], 0.93; 99% CI, 0.83-1.03; P = .05), nonfatal myocardial infarction (RR, 0.97; 99% CI, 0.87-1.08; P = .43) or any coronary heart disease events (RR, 0.96; 95% CI, 0.90-1.01; P = .12). Neither did randomization to omega-3 fatty acid supplementation have any significant associations with major vascular events (RR, 0.97; 95% CI, 0.93-1.01; P = .10), overall or in any subgroups, including subgroups composed of persons with prior coronary heart disease, diabetes, lipid levels greater than a given cutoff level, or statin use.

Conclusions and Relevance This meta-analysis demonstrated that omega-3 fatty acids had no significant association with fatal or nonfatal coronary heart disease or any major vascular events. It provides no support for current recommendations for the use of such supplements in people with a history of coronary heart disease."

i'm searching using very vague search terms. since the research seems to be zeroed in on cardiovascular issues, i wonder what else if anything could stand to be examined.
perhaps, again, not just supplementation but total intakes. not just 4.4 years. i don't have time to really dig in but am curious
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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Re: 2012 meta analysis: Omega-3s & heart disease

Post by ElliotB » Sat Sep 15, 2018 6:19 am

'Conclusion: omega-3 fatty acids had no significant association with fatal or nonfatal coronary heart disease or any major vascular events'


Not everyone would agree with their conclusion (see link below for a cardiologists perspective).

Also consider that there are different types of Omega 3 fatty acids (primarily EPA and DHA) and for heart health, Omega 3 with higher levels of DHA than EPA may be a better choice (most Omega 3 supplements have higher levels of EPA than DHA).

Another potentially very important consideration, there are numerous sources of Omega 3 fatty acids and this study does not seem to take that into account either (some are considered better than others). It is possible/likely that the source of the Omega 3 fatty acids could have an effect on the effectiveness of it and ultimately effect the results.


A lot of good info here:

Cardiovascular Benefits of Omega-3 Fatty Acids

https://www.drsinatra.com/enjoy-DHA-omega-3-benefits

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Re: 2012 meta analysis: Omega-3s & heart disease

Post by jimmylegs » Sat Sep 15, 2018 6:33 am

isn't it nice that i don't make you click and sift through who knows what to access my point?

without taking the clickbait above, i wonder what n is represented by 'not everyone' 's opinion?

from the studies above, the other position is at n = 68 680 + 77 917 = 146,597 and counting (see how i did the math for you ;) ).
take control of your own health
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2018 paper: In Defense of Sugar: A Critique of Diet-Centrism

Post by jimmylegs » Sat Sep 15, 2018 6:53 am

well, from what i recall physical activity does sit at the base of the food pyramid... but i guess that's no reason not to start a good argument lol

In Defense of Sugar: A Critique of Diet-Centrism (2018)
https://www.sciencedirect.com/science/a ... 2018300847
Abstract
"Sugars are foundational to biological life and played essential roles in human evolution and dietary patterns for most of recorded history. The simple sugar glucose is so central to human health that it is one of the World Health Organization's Essential Medicines. Given these facts, it defies both logic and a large body of scientific evidence to claim that sugars and other nutrients that played fundamental roles in the substantial improvements in life- and health-spans over the past century are now suddenly responsible for increments in the prevalence of obesity and chronic non-communicable diseases. Thus, the purpose of this review is to provide a rigorous, evidence-based challenge to ‘diet-centrism’ and the disease-mongering of dietary sugar. The term ‘diet-centrism’ describes the naïve tendency of both researchers and the public to attribute a wide-range of negative health outcomes exclusively to dietary factors while neglecting the essential and well-established role of individual differences in nutrient-metabolism. The explicit conflation of dietary intake with both nutritional status and health inherent in ‘diet-centrism’ contravenes the fact that the human body is a complex biologic system in which the effects of dietary factors are dependent on the current state of that system. Thus, macronutrients cannot have health or metabolic effects independent of the physiologic context of the consuming individual (e.g., physical activity level). Therefore, given the unscientific hyperbole surrounding dietary sugars, I take an adversarial position and present highly-replicated evidence from multiple domains to show that ‘diet’ is a necessary but trivial factor in metabolic health, and that anti-sugar rhetoric is simply diet-centric disease-mongering engendered by physiologic illiteracy. My position is that dietary sugars are not responsible for obesity or metabolic diseases and that the consumption of simple sugars and sugar-polymers (e.g., starches) up to 75% of total daily caloric intake is innocuous in healthy individuals."

and so to a contradictory? complementary? point: i've seen other research suggesting a far greater proportion of people are actually sedentary, than would account for overall incidence of overweight and obesity. might moderation be the key? again???
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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Re: 2012 meta analysis: Omega-3s & heart disease

Post by ElliotB » Sat Sep 15, 2018 7:15 am

There are so many dissenting opinions on the conclusion of this study on the web, too many to list. So to summarize Dr. Sinatra's opinion, the conclusion of the study is totally wrong.

For anyone interested, simply type
"Are omega 3 fatty acids good for heart health"
in your Dr. Google search engine for almost 19 million results
with a variety of opinions, many contrary to the conclusion of the study.

Of course, you can always also try a search for opposing views by typing:
"are omega 3 fatty acids bad for heart health"

According to this article:
https://www.sciencedaily.com/releases/2 ... 194558.htm
"Omega 3 supplements have little or no heart or vascular health benefit'

As with the study you posted, there is no information on the type or characteristics of the Omega 3 used.


AND As with every topic, there are always differences of opinion and I have learned never to trust 1 source. And one thing is for sure, clinical trials are easy to manipulate to skew the results based on the result the sponsor wants and I always seek additional opinions. And of course just because something is found on the web, does not mean it is accurate.

From a source you like to rely on, The Harvard Medical School, their conclusion:

"Omega-3s and your heart
There are three main forms of these unsaturated fats, which play an essential role in human health (see "Three key omega-3s"). The so-called marine fatty acids, EPA and DHA, have several potential cardiovascular benefits. They might help

ease inflammation

ensure the heart maintains a steady beat, which may guard against potentially deadly, erratic rhythms

prevent the formation of dangerous clots in the bloodstream

lower levels of triglycerides, the most common type of fat-carrying particle in the bloodstream."


Here is a link to the complete Harvard article:
https://www.health.harvard.edu/heart-he ... et-deliver



My conclusion: The vast majority of opinions/research on this topic is contrary to the conclusion of the study. That does not mean that the study is wrong, but it is likely we just cannot determine the results of what Omega 3s can do with certainty at this time.

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Re: 2012 meta analysis: Omega-3s & heart disease

Post by jimmylegs » Sat Sep 15, 2018 7:22 am

better :)
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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Re: 2018 paper: In Defense of Sugar: A Critique of Diet-Cent

Post by NHE » Sat Sep 15, 2018 10:51 pm

Yes. Glucose is vital to the health of every cell. That's a red herring though. The problem is sucrose with its 50% mix of fructose and the lack of fiber in processed foods. High intakes of fructose without the fiber normally found in whole fruit is toxic to the liver and causes non-alcoholic fatty liver disease which is indistinguishable from liver cirrhosis due to alcohol.

Are these authors out for an ignoble? Who's paying them?

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Re: 2012 meta analysis: Omega-3s & heart disease

Post by NHE » Sat Sep 15, 2018 10:57 pm

jimmylegs wrote:Conclusions and Relevance This meta-analysis demonstrated that omega-3 fatty acids had no significant association with fatal or nonfatal coronary heart disease or any major vascular events. It provides no support for current recommendations for the use of such supplements in people with a history of coronary heart disease."
It doesn't matter. I have less fatigue and more cognitive energy when I take my fish oil.

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Re: 2012 meta analysis: Omega-3s & heart disease

Post by jimmylegs » Sun Sep 16, 2018 3:13 am

jimmylegs wrote:i'm searching using very vague search terms. since the research seems to be zeroed in on cardiovascular issues, i wonder what else if anything could stand to be examined.

perhaps, again, not just supplementation but total intakes. not just 4.4 years. i don't have time to really dig in but am curious
yep
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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jimmylegs
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Re: 2018 paper: In Defense of Sugar: A Critique of Diet-Cent

Post by jimmylegs » Sun Sep 16, 2018 3:23 am

who knows. think it's just one person, and i don't have time to dig in any further atm, but there are so many opportunities to call bs right in the abstract.
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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