Tcc501 720 Nutritionclaims En-Us

Confusing
Conclusions In this module, Dr. Campbell critiques the design of the Harvard Nurses Health Study.1 As you will recall from the lecture, researchers speculated that the nurses consuming less fat would have lower rates of breast cancer. However, breast cancer rates did not decrease among the study subjects consuming less fat. Researchers therefore stated that there was no evidence a lower intake of total fat or specific major types of fat was associated with a decreased risk of breast cancer. Dr. Campbell points out that although the women were divided into two groups (a high-fat group and a low-fat group), all of them were actually consuming very similar diets overallat least as far as their animal-to-plant food ratios were concerned. He points out that the design of the study overlooked this confounding factor, leading to erroneous conclusions that have promoted public confusion. An Alternate Interpretation Dr. Campbell interprets the results of the Nurses Health Study quite differently. When Americans on animal-food-based diets decrease their fat consumption, they actually tend to increase protein consumptionparticularly animal protein, because they tend to consume more skim milk, low-fat meats, etc. When the fat is removed, the percentage of protein in these products increases; as a result, a diet high in low-fat foods can raise the consumption of animal-based protein up to 80-85% of total protein intake. And if diets high in animal protein are associated with an increased risk of cancer, lowering fat intake by raising protein consumption may not lower cancer risk. But even if this explanation is illuminating, it raises questions for us as consumers. Most of us are more than accustomed to feeling confused by conflicting messages about what is good for us and what isnt. But how do we know if studies are well designed? And what should we bear in mind when interpreting media messages about nutrition? Making Sense of Media Messages Is There a Single-Nutrient Focus? First, note whether a report seems to be focused on single nutrients, chemicals, or drugs or whether it involves broader patterns of diet and disease. The single-nutrient study may provide useful information on a very specific function, but that information may not be
1 If you wish to find out more about the Nurse's Health Study, including study findings, you can do so at:
Module 7 Reading: Assessing the Science Behind Nutrition Claims
http://www.channing.harvard.edu/nhs/

For individual student use only: please do not copy or distribute. 2012, T. Colin Campbell Foundation and TILS
integrated into the bigger picture about diet and healthand it may not apply to the big picture in the manner suggested. If nutrients are being canonized or demonized, take note! All nutrients play a role in maintaining health, and the promotion of certain nutrients over others is misleading. Keep in mind too that there is no single mechanism that creates disease within the symphony of interactions. If conclusions suggest supplements or drug treatments rather than diet and lifestyle adjustments, be wary. What Kinds of Studies and What Kinds of Conclusions? If a report is based on an animal study, remember that results do not give us the full picture of multiple relationships among lifestyle factors and health results in context, and cannot provide practical evidence on diet and disease in humansfindings should be regarded as indications of what might be possible in humans. If the message is based on a human study, note whether it was done with Western subjects. The Nurses Health Study highlights a common difficulty in exploring the relationship between diet and disease: virtually all human studies are conducted on Westerners consuming Western diets. And although some studies may seem to be examining a wide range of factors (like the different levels of fat intake in the Nurses Health Study), scientists actually tend to study people consuming more or less the same diet: one that is rich in animal foods and likely to be related to Western diseases. Finally, human studies should not set forth conclusions about single nutrient effects. If they do, remember that conclusions like these actually lie outside the scope of these studies. Who Is Behind the Claim? If you find a message particularly compelling and wish to investigate further, you can also determine whether or not there is a serious paper behind a particular claim, and read it. Most authors of diet books, articles, and blogs are not scientists, do not publish studies, and therefore do not have to defend their assertions to their peers. However, you might search for evaluations of an author, message, or study by others whose opinions you respect. Where Are the Industry Connections? To evaluate further the claims set forth by a particular author, research paper, or organization, you may want to look for funding sources and associations: what institutions or industries have been involved, and what might their interests be? The funding for a particular study may or may not be mentioned in the published paper. Another way you might get a sense of a particular authors or researchers slant is to look up the researchers name online to discover the other papers, institutions, or funding sources with which he or she has been associated. If a researcher is connected to an educational institution, an online profile could provide additional information. Facts, Judgments, and Opinions Of course, it is also important to distinguish among three different types of assertions when you are evaluating information: facts, judgments, and opinions. Note that statements of
scientific fact are largely judgments that can be evaluated as to quality of thinking and the research underlying them. Facts, Judgments, and Opinions Scientific Facts Objective, verifiable observations that are not relative to the speaker; our best articulations of natural laws. For example: Humans need protein to survive. Judgments Judgments are assertions that may be well reasoned or poorly reasoned, and based on more or less evidence. Most information and advice we hear about nutritionalthough it may be stated as factactually falls into this category! Examples of judgments include: Theories: Principles that are confirmed by available evidence and can be used to predict phenomena. Theories are intended to explain certain aspects of the way the world works; however, theories do not become facts, but describe facts. In science, the term theory connotes ample evidence and a high degree of confidencethat is, its just a theory, is not a valid dismissal of scientific theory. For example: Plant-based foods, as a class, promote health, whereas animal-based foods, as a class, carry health risks. Hypotheses: Formally (as it is used to describe a part of the scientific method, for instance), a hypothesis is a specific, testable prediction about the relationship between two or more variables. More generally, however, we can think of a hypothesis as a proposed explanation for a phenomenon (based on evidence). For example: Higher levels of dietary protein will lead to greater tumor severity over a rats lifetime, and if we alter the level of dietary protein during tumor formation, we will influence the development of the tumors. Speculation: An explanation or proposal constructed without fully supporting data. For example: After learning about the best-fed Filipino childrens developing primary liver cancer, Dr. Campbell speculated that their greater protein intake was associated with more cancer. Opinions Beliefs, judgments, or views that are not necessarily based on knowledge or evidence. Example: People like eating meat, so they wont go for a vegetarian diet. A Note on Researcher Intent As you examine the study design, reasoning, and industry involvement behind particular nutrition claims, you may find yourself wondering what these factors reveal about researcher intent. Please bear in mind that the answer may be nothing at all. Single-
nutrient studies and studies done on Western subjects are accepted parts of scientific practice in our current paradigm, and the role of industry in our socioeconomic system often includes funding research. Industry backing does not necessarily indicate intent to deceive or manipulate the public. Indeed, the vast majority of scientists working within our system have the best of intentions about discovering how best to promote human health. How to Analyze Nutrition Claims Use the tool below to help you analyze specific claims you may hear about nutrition. Weve provided two completed examples to show you how to use it, each preceded by the brief article on nutrition to which it refers. Critical Questions for Analyzing Nutrition Messages The science- and nutrition-related messages we get from the media often focus on study conclusions or recommendations without giving us much information about who arrived at those conclusions, or how. As a result, we seem to be bombarded with confusing, contradictory assertions. How can we become more confident, critical consumers of the messages we receive? Here are some questions we can ask ourselves to critique what we hear and identify where we might need more information. 1. What is the message recommending or promoting? 2. What problem is this recommendation intended to solve? Is it, in your opinion, an important problem? 3. What questions are being asked about this problem (by the author, or in the research cited)? What questions are not being asked? 4. What kinds of evidence are being used to answer these questions? How does it relate to other evidence on this topic, if you know? 5. What kinds of assumptions are being made about the problem? (An assumption is a belief that may be unstated or taken for granted without evidence.) 6. What can you tell about the authors approach to nutrition science? What might be missing? 7. Are the conclusions well reasoned and warranted by the evidence? Explain. 8. What might be some important consequences of accepting these conclusions (for society, the environment, etc.)?
Example 1 Nutrient Found in Dark Meat of Poultry, Some Seafood, May Have Cardiovascular Benefit ScienceDaily (a popular science news website at www.sciencedaily.com)
Article:
Source: ScienceDaily (Mar. 1, 2012) A nutrient found in the dark meat of poultry may provide protection against coronary heart disease (CHD) in women with high cholesterol, according to a study by researchers at NYU Langone Medical Center. The study, published online in the European Journal of Nutrition, evaluated the effects of taurine, a naturally-occurring nutrient found in the dark meat of turkey and chicken, as well as in some fish and shellfish, on CHD. It revealed that higher taurine intake was associated with significantly lower CHD risk among women with high total cholesterol levels. The same association was not seen in women with low cholesterol levels, however. There is very little information available about taurine, said principal investigator Yu Chen, PhD, MPH, associate professor of epidemiology at NYU School of Medicine, part of NYU Langone Medical Center. While there have been some animal studies that indicate taurine may be beneficial to cardiovascular disease, this is the first published prospective study to look at serum taurine and CHD in humans, she explained. "Our findings were very interesting. Taurine, at least in its natural form, does seem to have a significant protective effect in women with high cholesterol." Coronary heart disease is the leading killer of American men and women, causing one in five deaths. Also known as coronary artery disease, it is caused by the buildup of plaque in the arteries to the heart. Large prospective epidemiologic studies have provided evidence that nutritional factors are important modifiable risk factors for CHD. Dr. Chen and colleagues conducted their study using data and samples from the NYU Women's Health Study. The original study enrolled more than 14,000 women, 34 to 65 years of age, between 1985 and 1991 at a breast cancer screening center in New York City. Upon enrollment, a wide range of medical, personal and lifestyle information was recorded and the data and samples continue to be utilized for a variety of medical studies. For the serum taurine study, funded by the American Heart Association, the researchers measured taurine levels in serum samples collected in 1985 before disease occurrence for 223 NYUWHS participants who developed or died from CHD during the study follow-up period between 1986 and 2006. The researchers then compared those samples to the taurine levels in serum samples collected at the same time for 223 participants who had no history of cardiovascular disease. The comparison revealed serum taurine was not protective of CHD overall. However, among women with high cholesterol, those with high levels of serum taurine were 60 percent less likely to develop or die from CHD in the study, compared to women with lower
serum taurine levels. If future studies are able to replicate the findings, taurine supplementation or dietary recommendations may one day be considered for women with high cholesterol at risk for CHD. "It is an interesting possibility," she said. "If these findings are confirmed, one day we might be able to suggest that someone with high cholesterol eat more poultry, specifically dark meat." Dr. Chen explained that Caucasian women comprised more than 80 percent of the study population and, therefore, the results may not at this time be generalized to men or other races, but suggested that future studies should be conducted in these populations. In addition, she explained, it is unclear whether synthetic taurine as an additive in food and drink products will have the same benefit observed in this study, and health effects of these products should be investigated separately. "We studied taurine found in the blood that originated from natural sources," Dr. Chen said. "The nutrient being added to energy drinks or supplements is human-made and is added in unstudied amounts. These products also often contain not only very high amounts of taurine, but a multitude of other ingredients as well such as caffeine and ginseng that may influence CHD risk." The researchers are currently using NYUWHS data to evaluate the effect of taurine on the occurrence of stroke in another study funded by the National Heart, Lung, and Blood Institute (NHLBI). Co-authors on the European Journal of Nutrition paper are: Oktawia P. Wojcik, PhD, Karen L. Koenig, PhD, Anne Zeleniuch-Jacquotte, MD, Camille Pearte, MD, and Max Costa, PhD, all of NYU School of Medicine.
Source: NYU Langone Medical Center/New York University School of Medicine (2012, March 1). Nutrient found in dark meat of poultry, some seafood, may have cardiovascular benefits. ScienceDaily. Retrieved March 24, 2012, from http://www.sciencedaily.com- /releases/2012/03/120301113353.htm

Using the Critical Questions Tool: Example 1 Article or media piece: Nutrient Found In Dark Meat of Poultry, Some Seafood, May Have Cardiovascular Benefits (from ScienceDaily) 1. What is the message recommending or promoting? Its not quite a recommendation yet, but Dr. Yu Chen thinks that if her findings are confirmed, we might one day recommend that people with high cholesterol eat more poultry, specifically dark meat (and, perhaps, seafood). 2. What problem is this recommendation intended to solve? Is it, in your opinion, an important problem? Coronary heart disease is the problem. It is indeed an important one to address because its the leading killer of American men and women, causing 1 in 5 deaths. 3. What questions are being asked about this problem (by the author, or in the research cited)? What questions are not being asked? What is the impact of the single nutrient taurine on CHD? The researchers do not seem to be looking at the impact of whole foods (or classes of foods) on CHD. 4. What kinds of evidence are being used to answer these questions? How does it relate to other evidence on this topic, if you know? Dr Chen and her colleagues used data and samples from the NYU Womens Health Study. They measured taurine levels in serum samples collected in 1985 (before disease occurrence) for 223 NYUWHS participants who developed or died from CHD between 1986 and 2006. They compared these data with taurine levels in serum samples collected at the same time for 223 participants with no history of CHD. They noted that higher taurine intake was associated with significantly lower CHD risk among women with high cholesterol. They also noted that there have been some animal studies suggesting that taurine may be beneficial to CHD. They dont appear to be looking at any studies on the impact of whole animalbased foods on CHD.
5. What kinds of assumptions are being made about the problem? (An assumption is a belief that may be unstated or taken for granted without evidence.) The researchers seem to assume that higher serum taurine levels are due to higher taurine intake from consuming certain types of meat (rather than that synthesized in the human liver), and that food-source taurine can be differentiated from supplemental taurine in these samples. Dr. Chen and colleagues also seem to assume that high levels of a single nutrient (taurine) can be expected to have a consistent impact on CHD (in women with high cholesterol), and that this impact may be achieved by eating more poultry, without regard to the rest of the diet. They also seem be assuming that health outcomes can be optimized within the context of the Western diet, and that women with high cholesterol can only make dietary adjustments within the context of that diet.
6. What can you tell about the authors approach to nutrition science? What might be missing? See above. Dr. Chen and her team seem to be approaching this issue by examining the relationship of a single nutrient with a particular disease, absent the total context of the diet. They do not seem to have a wholistic approach to nutrition science.
7. Are the conclusions well reasoned and warranted by the evidence? Explain. I would say the evidence is insufficient and there are too many assumptions in play for me to believe conclusions are well founded. Dr. Chen and her colleagues found that among women with high cholesterol, those with high levels of serum taurine were 60% less likely to develop or die from CHD. They suggest that if future studies replicate these findings, taurine supplementation or dietary recommendations might be considered for women with high cholesterol who are at risk for CHD. However, these recommendations seem ill conceived without confirming evidence that women with the lowest risk for CHD are consuming diets high in poultry!
The approach is also focused on dealing with symptoms of health issues, rather than causesserum taurine was not protective of CHD overall, but only in women with high cholesterol.
8. What might be some important consequences of accepting these conclusions (for society, the environment, etc.)? Given such recommendations, women with high cholesterol may be less likely to take measures to actually lower their cholesterol levels. Instead they may be more likely to consume poultry and seafood (thus increasing their risk of chronic degenerative diseases), and even to supplement taurine. And there might be an increased market for taurine supplements and even taurine-spiked food productsIm not sure what the health consequences of that would be!
Example 2 Article: Source: Low-Fat Diet Not a Cure-All The Nutrition Source (a website maintained by the Department of Nutrition at the Harvard School of Public Health, accessible at http://www.hsph.harvard.edu/nutritionsource)
Results from large, long Women's Health Initiative Dietary Modification Trial shows no effect on heart disease, breast cancer, colorectal cancer, or weight. The low-fat, high-starch diet that was the focus of dietary advice during the 1990s as reflected by the USDA food guide pyramid is dying out. A growing body of evidence has been pointing to its inadequacy for weight loss or prevention of heart disease and several cancers. The final nail in the coffin comes from an eight-year trial that included almost 49,000 women. Although the media have made much of the "disappointing" results from the Women's Health Initiative (WHI) Dietary Modification Trial, it would be a serious mistake to use these new findings as reason to load up on sausage, butter, and deep-fried fast food. The trial and its findings The Women's Health Initiative Dietary Modification Trial was started back in 1993, at a time when dietary fat was seen as a dietary evil and the low-fat diet was thought to be a straightforward route to preventing heart disease, some cancers, and the epidemic of obesity that was beginning to sweep the country. With funding from the National Heart, Lung, and Blood Institute, researchers recruited almost 50,000 women between the ages of 50 and 79 years. Of these, 19,541 were randomly assigned to follow a low-fat diet. Their goal was to lower their fat intake from almost 38% of calories to 20%. They were helped in this effort by a series of individual and group counseling sessions. Another 29,294 women were randomly assigned to continue their usual diets, and were given just generic diet- related educational materials. After eight years, the researchers looked at how many (and what percentage) of women in each group had developed breast cancer or colorectal cancer. They tallied up heart attacks, strokes, and other forms of heart disease. They also looked at things like weight gain or loss, cholesterol levels, and other measures of health. The results, published in the Journal of the American Medical Association, showed no benefits for a low-fat diet. Women assigned to this eating strategy did not appear to gain protection against breast cancer,(1) colorectal cancer,(2) or cardiovascular disease.(3) And after eight years, their weights were generally the same as those of women following their usual diets.(4) The researchers saw a trend toward a lower risk of breast cancer among women in the
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low-fat group. This trend was not statistically significant, meaning it could have been due to chance. It could also have been due to the very small weight loss during the early years of the study among women in the low-fat group, who received intensive dietary counseling. There is strong evidence from many studies that being overweight increases the risk of breast cancer after menopause, and that staying slim after menopause is an effective way to reduce risk of breast cancer, along with many other diseases. Limitations of the study Some nutrition experts say that the WHI Dietary Modification Trial doesn't really lay to rest the low-fat hypothesis because the women in the study only modestly lowered their fat, from 38% to 29%. Had they reached the trial's target of 20%, benefits from the low-fat approach may have become more apparent, these nutritionists suggest. It is possible that the participants in the low-fat group may have actually overstated how much they reduced their fat intake. This has happened in other studies, as shown by comparisons between self-reported changes and biochemical measures of dietary change. Significant reductions in fat intake are usually reflected in a decrease in HDL (good) cholesterol and an increase in triglycerides. Yet in the WHI trial, there were no differences in blood levels of HDL cholesterol or triglycerides between the low-fat and usual diet groups. This casts doubt on the degree of fat reduction achieved in this study. Two other limitations of the trial are the study population and duration. The trial included women who were aged 50 to 79 years at the beginning of the trial. By this time in life, it may be too late for changes in diet to reduce risks of cancer and other chronic conditions. In addition, it takes years for the effects of dietary change to be seen, and so it is possible that eight years wasn't enough time to see the true impact of a low-fat diet. The debate will likely continue as to why the WHI observed little benefit for a low-fat diet. Was it because reducing the intake of dietary fat truly has little benefit? Was it because the women in the trial didn't lower fat intake enough? Or had the study focused on a younger population, or lasted longer, would it have revealed a benefit? In any case, the dietary intervention didn't work, even though the WHI trial was, by far, the most expensive study of diet ever conducted (costing many hundreds of millions of dollars) and even though the women in the low-fat group received intensive dietary counseling from some of the best nutritionists and dietitians in the country. Change was already in the air The dietary fat reduction arm of the WHI (it also has a hormone replacement therapy component and a calcium and vitamin D component) was controversial from the beginning.(5-8) Members of the HSPH Department of Nutrition argued that the hypothesis that a reduction in total fat intake would have major health benefits was not supported by existing data. It also noted that maintaining a contrast in diets between two groups over many years was difficult, and for this reason the study might not provide a clear answer
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even if the hypothesized benefits were true. Such a study had failed in the past. The Multiple Risk Factors Intervention Trial (MRFIT, often called Mister Fit) aimed to decrease risk of coronary heart disease by a program aimed at controlling key risk factors for the disease. Some of the participants received intensive counseling to stop smoking, control high blood pressure, and reduce their intake of saturated fat. At the end of the trial, there was no significant difference in rates of coronary heart disease.(9) Even so, the investigators argued that their hypotheses were still correct because the members of the control group had, on their own, began to stop smoking and eat less saturated fat, making differences in smoking rates and diet between the two randomized groups very small.(10) The results of the WHI add further evidence that clear answers to questions about the long term effects of diet on risks of cancers and other major diseases may not be obtainable by large randomized intervention trials, no matter how much money is spent conducting them. Type trumps percentage The findings from the Women's Health Initiative Dietary Modification Trial came as a surprise to many Americans who have been hearing for years that reducing fat is important for long-term health. Yet long-term follow-up studies such as the Nurses Health Study have consistently found little relation between the percentage of calories from fat and risks of breast cancer, colon cancer, or coronary heart disease. Such studies are one reason why major reviews of diet and health during the last five years, including those conducted by the U.S. Institute of Medicine and the U.S. Dietary Guidelines Committee, have moved away from advocating low fat intake to an emphasis on the type of fat. Many lines of evidence indicate that the type of fat is very important to long-term health. Replacing saturated and trans with natural vegetable oils can greatly reduce the risk of heart disease and diabetes. In the Nurses' Health Study II we have seen that women who consume high amounts of red meat and high-fat dairy foods during their early adult years are at increased risk of developing breast cancer. Making good dietary choices does really matter, but it is the type of fat, not the amount, that is most important. And keep in mind that too many calories from both fat and carbohydrate will lead to weight gain, which will increase risks of breast cancer, colon cancer, and heart disease. References 1. Prentice RL, Caan B, Chlebowski RT, et al. Low-fat dietary pattern and risk of invasive breast cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006; 295:629-42. 2. Beresford SA, Johnson KC, Ritenbaugh C, et al. Low-fat dietary pattern and risk of colorectal cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006; 295:643-54.
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3. Howard BV, Van Horn L, Hsia J, et al. Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006; 295:655-66. 4. Howard BV, Manson JE, Stefanick ML, et al. Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial. JAMA. 2006; 295:39-49. 5. Michels KB, Willett WC. The women's health initiative: will it resolve the issues? Recent Results in Cancer Research. 1996; 140:295-305. 6. Prentice RL, Sheppard L. Dietary fat and cancer: consistency of the epidemiologic data, and disease prevention that may follow from a practical reduction in fat consumption. Cancer Causes and Control. 1990; 1:81-97; discussion 99-109. 7. Prentice RL, Sheppard L. Dietary fat and cancer: rejoinder and discussion of research strategies. Cancer Causes and Control. 1991; 2:53-8. 8. Willett WC, Stampfer MJ. Dietary fat and cancer: another view? Cancer Causes and Control. 1990; 1:103-109. 9. Multiple risk factor intervention trial. Risk factor changes and mortality results. Multiple Risk Factor Intervention Trial Research Group. JAMA. 1982; 248:1465-77. 10. Willett W. Nutritional epidemiology. New York: Oxford University Press, 1998.

Source: Low-Fat Diet Not a Cure-All. The Nutrition Source. Harvard School of Public Health. Web. March 2012. http://www.hsph.harvard.edu/nutritionsource/nutrition-news/low-fat/
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Using the Critical Questions Tool: Example 2 Article or media piece: Low-Fat Diet Not a Cure-All (from The Harvard school of Public Health Nutrition Source) 1. What is the message recommending or promoting? Recommendations: Pay attention to type of fat consumed (it is more important than amount) Replace saturated and trans-fat with natural vegetable oils Avoid red meat and dairy foods Keep in mind that calories will lead to weight gain, which will increase risks of breast cancer and colon cancer 2. What problem is this recommendation intended to solve? Is it, in your opinion, an important problem? Chronic diseases like heart disease and cancer What to make of the surprising NHS findings I think both of these problems are worthwhileheart disease and cancer are serious diseases, and we should certainly try to understand why the NHS findings turned out as they did. 3. What questions are being asked about this problem (by the author, or in the research cited)? What questions are not being asked? The authors were mostly focused on why the NHS findings contradicted expectations. Specifically, the article asks: 1. Did women in the low-fat group not lower their fat intake enough? 2. Did study participants not report their consumption of fat accurately? 3. Was the study focused on a population too old for dietary changes to make a significant difference to their health? 4. Did the study not last long enough for us to see results? 5. Was it too difficult to maintain a contrast in diets between the two groups over many years? It is notable that all these questions relate to study methodology as opposed to the studys central hypothesis! Authors do not ask if researchers were asking the wrong question, if perhaps fat alone is not responsible for disease outcomes
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(that is, they do not look at the larger dietary context), or if perhaps neither group of women was consuming a diet likely to protect against cancer.
4. What kinds of evidence are being used to answer these questions? How does it relate to other evidence on this topic, if you know? The article merely comments that some nutritionists are asking question no. 1. It gives a little more explanation about questions 3 and 4. It looks in slightly more detail at question 2 by citing a previous study wherein subjects self-reports didnt match biomedical measures. For question 5, it suggests that researchers in a previous study believed subjects werent able to maintain dietary differences over many years. However, authors mainly seem to be saying all these questions could be correctthey dont really answer any of them. They dont examine any studies that look at the impact of the total diet on cancer (e.g., The China Project). 5. What kinds of assumptions are being made about the problem? (An assumption is a belief that may be unstated or taken for granted without evidence.) They assume that fat alone might be responsible for cancer and heart disease (not diet in the larger sense). They assume study methodology is at fault, not study design (i.e., investigating the impact of a single nutrient). They also assume a study on Western subjects can provide us with enough data to draw meaningful conclusions. 6. What can you tell about the authors approach to nutrition science? What might be missing? These authors do seem to assume or believe that science is best practiced when researchers examine the impact of single nutrients on disease. They do not seem to see disease formation as multi-mechanistic, nor to be examining the big picture, including the full complement of nutrient intakes. 7. Are conclusions well reasoned and warranted by the evidence? Explain. At the end of the article, the writers seem to give up on trying to explain the NHS findings, and suddenly conclude that it must be the type of fat that matters, not the amount of fat. They suggest this is so because we know that replacing saturated and trans fats with vegetable oils can reduce the risk of heart disease and diabetes; they also comment that the Nurses Health Study II
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showed that women who consume lots of red meat and high-fat dairy foods during early adult years are more at risk for breast cancer. In addition, they comment that too many calories from carbohydrates can cause weight gain and cancer/heart disease. In a way, these conclusions are reasonable, as far as they go. They do pull in information from other studies. But they arent putting the big picture together, in which the NHS findings AND the other data they cite would make sense without our assuming major flaws in NHS methodology. They arent going far enough. 8. What might be some important consequences of accepting these conclusions (for society, the environment, etc.)? If we accept these conclusions, its likely well go on trying to reduce fat consumption (but not consumption of animal products), and perhaps even try to reduce the consumption of carbohydrates to some extent (perhaps embracing the low-carb philosophy in part?). We would certainly go on counting calories and worrying about fat, and possibly trying to change the specific types of fat we eat. Traditional dieting would continue.
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Tcc501 720 Nutritionclaims En-Us

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Module 7 Reading: Assessing the Science Behind Nutrition Claims

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