REattempt
Recycles dryer sheets
- Joined
- Feb 27, 2010
- Messages
- 293
To keep this simple, let's take this one thing, and look at it. There are two problems with what you have said.
First, you are not understanding the meaning of "controlled." <SNIP> The experiment was controlled.
So, to say that the experiment was not controlled is incorrect.
Second, just because he didn't do the experiment you wanted to see, doesn't mean that it was damning or bad science.
<SNIP>
That's all he set out to do, and he did it following the best principles of science.
No one can do this experiment testing cardiovascular results over 20 years. That would be nice, but it's not feasible. The best we can do is look at marker that correlate with CVD.
In summary, it was a randomized, controlled experiment that looked at how different diets would affect subjects' weight and health markers in the real world. It was excellent science.
1) I Agree with you on the controlled study. I misspoke..it was a controlled study. I might even agree with you on the damning or poor science. He did, however, have poor compliance (see below).
2) I wasn't arguing with the loss of weight on Atkins. It may well be the best diet for people to lose weight "in the real world." In fact, it did demonstrate that people who reduced carb intake lost more weight. That's about all the study demonstrated.
3) I do believe that it is a mis-representation. The article published in Jama was Comparison of the Atkins, Zone, Ornish, and LEARN Diets for change in Weight and related risk factors among overweight premenopausal women. It was not a comparison of the diets. It was a comparison of a poorly executed study that got no where near the compliance of well run studies and DOES NOT REFLECT THE ACTUAL RESULTS OF THE DIETS WHEN FOLLOWED.
Ok, with that out, I understand your point about "which diet will work, given my inability to follow directions, for me?" Fair point.
It is OK science, however poorly executed...biggest mistake was in the execution:
What happened in this study that subjects weren't able to follow the basic guidelines of their diets during the period of intense teaching and support? This was an NIH funded study - so, how did a $2-million trial fail to achieve measurable compliance? Other studies note good to excellent compliance, check it out:
ScienceDirect.com - The American Journal of Cardiology - Comparison of Coronary Risk Factors and Quality of Life in Coronary Artery Disease Patients With Versus Without Diabetes Mellitus Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets
Low-Fat Dietary Pattern and Risk of Cardiovascular Disease, February 8, 2006, Howard et al. 295 (6): 655
Low-Fat Dietary Pattern and Weight Change Over 7 Years, January 4, 2006, Howard et al. 295 (1): 39
One thing is clear to me: those tasked with instructing participants about their assigned diets knew the rules of the dietary approach well and were able to communicate, clearly, how to implement the necessary dietary changes to participants in the studies.
In this study (AtoZ): "[t]he same dietitian taught all classes to all groups in all 4 cohorts."
and per the video, the follow-up support was "thank you for your input, goodbye."
It's clear to me, from this study's method of instruction compared with other studies with better compliance, that it is not just knowledge of a diet that is necessary to teach someone how to follow a diet, but actual expertise of the dietary approach is critically important. The enthusiasm and understanding of the approach. Compliance is driven by the quality of the instruction and the follow-up and support.
Compliance stunk across the board...even the Atkins group had poor compliance.
These are not the best principles of Science. They are sloppy execution.
I get that they took the "public health" approach, but then name it something different..."Dietary results for AtoZ based on real world compliance....."
Finally, I agree that we need a 20 year time horizon to truly "know." However, I disagree with the assertion that looking at the markers are "the best we can do." I believe that looking at outcomes (CVD, CHD, blood flow) are better measure of cardiac impact than simply the markers.