Thank You, American Heart Association (Sincerely)

Once again, I’m apparently having a very different reaction than everyone else.

Last week the American Heart Association (AHA) put out a Presidential Advisory statement online warning against the use of saturated fats and in favor of polyunsaturated fats.

Lead author Frank Sacks, MD was quoted by Medscape:

We want to set the record straight on why well-conducted scientific research overwhelmingly supports limiting saturated fat in the diet.

Later in the article, he goes on to say:

This advisory is based on careful scientific review — it has been organized in a very systematic way, involving experts from a wide range of fields who have looked very carefully at the literature. Then the recommendations have been thoroughly vetted and questioned through multiple levels of peer review and scientific advisory committees across the entire AHA.

Okay, without question, I considered this excellent news for several reasons. Let me explain with an analogy….

Trial of The Century

Imagine saturated fat was a defendant on trial for murder. The trial stretched into years, then decades, and now approaches a century. The prosecution side is well funded with lots of resources and has been flooding the trial with mountains of papers and studies. The defense keeps finding issues with the evidence presented and starts to bring around many studies of its own, appearing to look better and better up to this point. The jury seems to be slowly moving more and more in the direction of the defense.

Like me, you might be a juror that is coming in late and feel overwhelmed by how much homework you’ve been given and how much material you have to sift through to have any idea of what to think.

But then, out of nowhere, the prosecution says, “Alright, alright — nevermind all these things. There are really just four studies that matter. Four studies that meet the standards necessary to judge this entire case on.”

You, me, and the rest of the jury look up in both surprise and relief. Everything just got easier for all of us!

Why This is Great

The AHA (whether it meant to or not) has now told us several things by this release:

1. People are starting to believe saturated fat is okay or even healthy to the point where the AHA feels the need to act. This isn’t a study itself or a new guideline — this is a full-throated message to the masses.
2. The AHA is insisting we narrow this down to just four studies. Four!!!
   1. Obviously, this means The Big Four presented must stand up to scrutiny in their methodology and data. And to be sure, I don’t know myself all the ins and outs of these studies to have a strong opinion — but I definitely will eventually. After all, I only have this tiny list now instead of the thousands in front of me before.
   2. Likewise, this implies every other study besides The Big Four is clearly unfit to meet the criteria set forth by the AHA. This too must be examined closely.
3. The selection criteria itself is now something we can look at. When you announce you have used an objective, categorical set of standards — you have to be prepared to defend it.

The Debate is Consolidated

There have been many, many voices of opposition that have sprung up in the last week, but I’m going to point to two in particular.

On the public prominence front, Gary Taubes delivers an impressive critique that outlines approach, bias, and the overall politics regarding the science and studies chosen.

Of sources on the biochemical front, no one comes close to Chris Masterjohn’s very methodical breakdown of each of the Big Four. He exposes both the problems with these studies and the inconsistencies with the AHA’s selection criteria.

If I could get you to read/listen to just two – make it these two.

Will They Address Criticism Directly?

This is an extremely relevant question.

We can determine a lot by the next actions of the AHA with regard to defending their release — or ignoring arguments altogether. Is this about science or politics?

If this is about the science:

• They will rightly defend their selection criteria and address comments about this process itself.
• They will likewise rebut issues with the studies directly and why they believe each is worthy of the standard they set.

If this is about politics:

• They may ignore critiques of this advisory entirely, insisting their release adequately addressed all possible concerns.
• They may set up a false dichotomy with regard to response effort — “Hey, we can’t answer every criticism of this work.” In other words, if we have to answer even one, then we’d have to answer all. Therefore the prudent thing would be to answer none.
• They may employ political tactics such as singling out an extremist voice in order to set up a Weak Man Argument. This hasn’t happened yet, but let me go on record now to say it is a very, very common practice in politics of the modern era.

Thanks!

I’m being sincere here – I’m genuinely happy the AHA took this action as I can now observe how much of the institution is acting on science vs politics.