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Show 1200: Making Sense of Changing Nutritional Guidelines

Is fish oil helpful or useless? Does eating red meat make any difference for heart health? Can you keep up with changing nutritional guidelines?
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Making Sense of Changing Nutritional Guidelines

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Why is nutrition advice so controversial? Often, it seems as if food fights are the fiercest disagreements in medicine. Have you had trouble making sense of changing nutritional guidelines?

Changing Nutritional Guidelines:

For years, nutrition scientists have been telling us that people who eat red meat are putting their health in danger. Then a few months ago, researchers published a handful of articles reviewing the literature on red meat and concluding that meat-eaters are not running much risk, if any at all. (Processed meats such as bacon or hot dogs do appear to be linked to some risk.) What is the bottom line? How do smart people use the same data to come to different conclusions? The papers were published in the Annals of Internal Medicine.

Understanding Risk:

When we discuss studies that are supposed to show whether or not eating red meat will put you in danger, we need to understand the difference between relative risk and absolute risk. Dr. Aaron Carroll explains this and discusses how nutritional guidelines might change with new data.

Vitamin D and Fish Oil:

Numerous studies have shown that people who have low levels of vitamin D are more vulnerable to a range of health problems. It makes sense that vitamin D supplements would reverse that, but many clinical trials have produced disappointing results. We talk with Dr. JoAnn Manson about the VITAL study she led and what we should conclude from the results.

VITAL tested fish oil as well as vitamin D supplements. The findings on fish oil suggest that, at the appropriate dose, omega-3 fatty acids in fish oil can help protect the heart.

How Are Changing Nutritional Guidelines Shaped by Research?

Dr. Manson has served on panels that offered nutritional guidelines. She shares how they may change as new data from studies become available.

This Week’s Guests:

Aaron Carroll, MD, is Regenstrief Foundation Professor of Pediatrics and Associate Dean for Research Mentoring at Indiana University’s School of Medicine. He is also Director of the Center for Pediatric and Adolescent Comparative Effectiveness Research. His research focuses on the study of information technology to improve pediatric care, health care policy, and health care reform.

In addition to his scholarly activities, he has written about health, research, and policy for CNN, Bloomberg News, the JAMA Forum, and the Wall Street Journal.

He has co-authored three popular books debunking medical myths, has a popular YouTube show called Healthcare Triage, and is a regular contributor to the New York Times’ The Upshot.

Dr. Carroll’s most recent book is The Bad Food Bible: How and Why to Eat Sinfully.

The photo of Dr. Carroll is by Marina Waters.

JoAnn Manson, MD, DrPH, is Chief of the Division of Preventive Medicine at Brigham and Women’s Hospital. She is also Professor of Medicine and the Michael and Lee Bell Professor of Women’s Health at Harvard Medical School. Dr. Manson is the c0-principal investigator of the VITAL trial. Here is a description of the VITAL trial. Results were recently published in JAMA Oncology (Nov. 21, 2019) and Circulation Research (Jan. 3, 2020)

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99.

Buy the CD

Download the mp3

Previous Interviews:

Both Dr. Carroll and Dr. Manson have been interviewed on The People’s Pharmacy before. Look for Show 1112, Show 1153, Show 1160  and Show 1124.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Citations
  • Johnston BC et al, "Unprocessed red meat and processed meat consumption: Dietary guideline recommendations from the Nutritional Recommendations (NutriRECS) Consortium." Annals of Internal Medicine, Nov. 19, 2019. doi: 10.7326/M19-1621
  • Song M et al, "Effect of supplementation with marine ω-3 fatty acid on risk of colorectal adenomas and serrated polyps in the US general population: A prespecified ancillary study of a randomized clinical trial." JAMA Oncology, Nov. 21, 2019. DOI: 10.1001/jamaoncol.2019.4587
  • Manson JE et al, "Vitamin D, marine n-3 fatty acids, and primary prevention of cardiovascular disease Current evidence." Circulation Research, Jan. 3, 2020. DOI: 10.1161/CIRCRESAHA.119.314541
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The headline drew me in but then I found little substance. Still don’t know what to believe.

Hope you had a chance to listen, Leila.

I suspect that the vitamin D anomaly could be due to co-occurring effects of UV exposure. UV destroys dioxins and other persistent organic compounds. People with low UV exposure could have low vitamin D and high POP load. Vitamin D supplementation would correct the former but not the latter. Has anyone looked into this?

so far as we know, that research has not been done.

Does the omega effect extend to flax seed omegas or only fish oil?

Still, a whole wheat veg diet is best I’ve found and think it’s the best because I hurt the least from eating it.

I understand the confusion on these issues, and a dramatic headline grabs attention and sells books & papers. There are many in various parts of the industry that have a lot to gain and lose. So I would be curious as to who pays for Dr. Carrol’s research? The various lobbying groups for the food industry have a LOT to gain by fueling these nutritional conflicts. So, I would ask you as hosts to try to identify who & where the bulk of each speaker’s research funding is derived, before I or others can really take them seriously. Wouldn’t you agree?

* Be nice, and don't over share. View comment policy^