High protein diet increases likelihood of early death and cancer as much as smoking 20 cigarettes/day

[Seabird]

http://www.telegraph.co.uk/science/science-news/10676877/High-protein-diet-as-bad-for-health-as-smoking.html

 

Anyone care to share their thoughts on this new study?

[Douglas Wadle]

I'm by no means a high protein diet supporter, but this study is making grandiose claims based on very little human data.  This is mostly animal data, and mostly observational and based on extrapolation of hormonal alterations.  I think this kind of study adds to the science in that it helps direct other research in the future, but when the media or the authors make claims that aren't supported by the research, it just adds to why people are so confused about what to eat and how to exercise, etc.  It's similar to the claims made on another post that excessive endurance activities are bad for you.  Too much extrapolation from too little data. Here's a link to the actual study in case you want to read it.  I personally wouldn't change what I'm doing based on this research.  

 

http://download.cell.com/cell-metabolism/pdf/PIIS155041311400062X.pdf?intermediate=true

[Nicholas Dobson]

Aside from the fact The Telegraph is a terrible place to get news from?

 

The NHS have a nice little blog that takes a quick look at health-related news stories. The one for this story is: http://www.nhs.uk/news/2014/03March/Pages/high-protein-diet-may-be-harmful-for-middle-aged.aspx

[Alan Tseng]

I'd be interested to know exactly what animal protein was given?  Was it cage free, grass-fed, and organic?

[Douglas Wadle]

it wasn't a controlled study.  it was a survey of what people were eating, and those who at over 20%(if i remember correctly) of animal proteins were included in the high protein arm. 

[Josh Schmitter]

Having not read the study, my thoughts are:

 

Should I have the leftover veggies and free range chicken in the fridge, or maybe the hot dogs from the farm?

[Joshua Naterman]

There is no causal data at all. What I see is high protein + low carbs = not an ideal situation, which is something I will probably keep repeating until I die of very old age or a catastrophic traffic accident. There's no surprise there, but there's no data on vegetable intake, quality of various food sourcing, etc etc etc, physical activity, and so on.

 

In short, this study is a very poor model to try and make any real-world connections or decisions with. As was mentioned earlier, this is a decent starting point for more detailed and meaningful experiments to be designed from.

[Mikkel Ravn]

We can conclude with a fair amount of certainty that a high protein intake does not make you immortal. That goes for high carb too, and, probably, every other style of diet.

[Kelly Gage]

Several thoughts from looking the journal article itself not just the newspaper articles...

They showed NO difference in mortality for low middle or high protein groups when considered as a whole. Only when they broke out different age groups were they able to find a difference. The younger group w high protein correlating with higher mortality. Older group high protein correlating with LOWER mortality. Be very suspicious when studies do data mining like this.

They did ONE 24 hour dietary survey and used that as representative of the individual's diet over 18 YEARS

The average caloric intake reported was than 1900 calories a day. This is significantly less than the average calorie consumption in America.

I have also read that one of the authors of the study owns a nutricutical company that produces vegan meal replacements. I have not checked this.

For virtually any nutrition study you hear about remember that correlation does not demonstrate causation. In general all long term nutrition studies are pretty worthless for this reason.

Don't smoke. Maintain healthy weight (with whatever eating style works for you). Get plenty of exercise (but don't overdo it). Get plenty of sleep.

[Joshua Naterman]

For virtually any nutrition study you hear about remember that correlation does not demonstrate causation. In general all long term nutrition studies are pretty worthless for this reason.

 

That's not necessarily true, it depends on what they look at. For example, the section that suggests that higher protein diets actually improve mortality in the elderly is sound. They require a different protein distribution and (to some extent) intake in order to maintain muscle mass. Elderly mortality is highly correlated with fall risk status, which in turn is extremely highly correlated with the maintenance (or lack thereof) of muscle tissue, particularly in the legs. That, of course, is largely a dietary issue for the elderly. 

 

Keep in mind that scientific studies were NEVER meant for laymen to read. They are intended to be viewed and interpreted by people of comparable education to the authors.

 

Still, there are a lot of studies like this that (in my opinion) do not come close to properly partitioning the available data or covering the full range of confounds in discussion. I don't understand how articles like this even get published.

[Kelly Gage]

 

Keep in mind that scientific studies were NEVER meant for laymen to read. They are intended to be viewed and interpreted by people of comparable education to the authors.

First, I'm a physician.

 

Second, I disagree.  I believe that a reasonably intelligent person can learn enough to understand most clinically/personally relevant research in nutrition, medicine, and exercise physiology (not necessarily the basic science/molecular parts).  It certainly doesn't take a PhD to be able to analyze research better than the average newspaper article.  

[Joshua Naterman]

First, I'm a physician.

 

Second, I disagree.  I believe that a reasonably intelligent person can learn enough to understand most clinically/personally relevant research in nutrition, medicine, and exercise physiology (not necessarily the basic science/molecular parts).  It certainly doesn't take a PhD to be able to analyze research better than the average newspaper article.  

Sorry, this one is long. A throwback to days of yore, perhaps. I am trying to be complete since my schedule doesn't really permit an organic flow of conversation and I do not want to accidentally deliver an insult. I respect your analysis, your education, and your opinions.

 

To start with, I want you to know that I was not suggesting that you were, or were not, a layman. Based on your very good analysis of the article I assumed you were certainly familiar with properly dissecting research methods. I did not know you were a physician.

 

I was suggesting that unless one has a very comprehensive background in human nutrition, at least up to a master's degree level, that one would probably not be considered a peer for the purposes of evaluating the information in that article. Since there are specific areas of clinical nutrition that I would not be up to speed on protocol in, there are a huge number of nutrition articles that I would not be considered a "peer" in terms of knowledge base. 

 

In this particular area of human nutrition I can claim to understand it as well as most graduating master's students (I do not claim to have a Ph.D.'s level of understanding) at my school since I have had a number of interactions about these things with them over the past 3 years at school. It would not surprise me at all if you did as well, I certainly do not think I'm the only one who can, or does, pick up this stuff. Personally, I don't think one requires as much education for this particular article, and you clearly picked it apart nicely, so again I hope you do not get the impression that I was, or am, talking down to you. I honestly thought "awesome, that guy is pretty solid."

 

I agree that at this point, as a physician, you know how to identify good science and research design, and that you have an incredibly detailed understanding of a huge number of organ systems in terms of normal and abnormal function, but I do not know whether you have a sufficient background in human nutrition to really be considered the target audience of nutritional studies. I am not saying that you do, or that you do not. I know nothing about your educational background other than that you have gone through medical school at some point.

 

My apologies if you take this next statement as condescending, it is not meant as such. It is a comment on physicians and nutrition in general, a group that with some luck I will be a part of 4 years from now, and if that is so it will apply equally to me as well. I do not intend to imply anything about you or any other particular individual one way or the other. I do not know you, and I am not making a statement about you in particular. This statement is based on the physicians I have interacted with face to face:

 

I can say with some confidence that it has been my experience that the average physician does not know enough about nutrition to be considered a peer in the world of nutritional research. I certainly think that they know enough to make good general dietary recommendations to nearly all (if not all) patients.

 

As background information, my experiences are based on interactions with my father's team of doctors (he is not in the best of health, and I attend appointments with him when I can) and  30-40 physicians who work at the CDC, through the EIS fellowship (now graduated from that), who I interact with fairly often since my girlfriend is a physician who works there as well and they all hang out together in various combinations pretty frequently. They are, at least academically, far above average. EIS is highly competitive. Most of them have finished residencies and now hold board certifications in various specialties, and a fair number hold MPH degrees. and I would not say that they have enough general nutrition knowledge to consult on nutritional research like this article. I think it is fair to say that 30-40 is not a huge number, and can't be made to be wholly representative of the nation's doctors, but they are academically superior and I do think that counts for something when forming an opinion. They have also been out of medical school for several years, and the education is constantly being updated, so for all I know comprehensive nutrition is being taught now (though a look at medical school curriculums does not reflect this on the schedule, but Harvard seems to be moving towards integrating nutrition and exercise into their medical program).

 

I do think that they would easily and quickly be able to say "This paper doesn't really mean much" but I have had enough discussions with them to know that they really don't understand how this all comes together. That's why they occasionally ask me questions about things like this... they know that this happens to be an area where I am very well educated. I would trust their opinions on nutrition articles regarding conditions within their fields of medical specialization more than I trust my own opinion of such specific articles. They are all brilliant, and to date have much more impressive academic credentials than I do, but they respect my opinion on these areas (general human metabolism as it relates to body composition, performance, common chronic disease, and mortality observed across the human lifespan and how diet and exercise interact to affect these areas) because I have proven to them a number of times that I have a pretty solid background in this particular area. I have been steeped in it, very specifically, for a number of years. I cannot make the same claim for medical research.

 

There are certain realms within nutrition where I know that I have that background and a LOT more realms where I do not. I can identify blatantly bad science and methodological problems, but would not be able to consider myself sufficiently knowledgeable to judge the actual content value in many, many areas if there are not basic science errors. The same is true of all professionals in all scientific disciplines. 

I also agree that at this point in time just about any intelligent person CAN learn enough to be a good judge of  most research in the areas you mentioned without holding a degree, but let's be honest: We're talking about an extremely small minority of the population that actually puts the time in to develop this background. Having said that... scientific research, even when open for public access, is not written with the general public in mind. It is also not written for people outside the area of expertise examined. I do think that without understanding the basic science it is hard to make a connection with the full meaning and implications of an article, but that's just my opinion. I am a perfectionist, and I do tend to believe that understanding the details as well as additional bodies of research relating to the populations being studied can make a huge difference in what a study's implications are and what the reader takes away from said study. 

 

That doesn't mean someone can't learn to understand it, I mean Daniel Burnham understands this stuff pretty darn well also and he's an electrical engineer by training. He regularly brings things to my attention that I would otherwise not see or learn about, and I am extremely grateful for that.Having a network like this is incredibly helpful to me!

 

The GB community has a disproportionate number of both highly educated professionals and self-educators who really work hard at developing well-rounded knowledge, and that is part of the reason I love this place. You guys are awesome.

 

It definitely doesn't take an advanced degree to interpret that article better than that media outlet did, to be sure! I wish the news was still based on actual information instead of hype and buzz words... now it seems more like a shameless competition for site hits.

 

If you read all of this, thanks for reading. It was a lot to type, too, and I hope my message didn't get too muddled.

[Kelly Gage]

Message was clear.  Since you and I basically agree on the article and I pretty much agree with your previous post (and probably no one else cares about this thread by now)…  I'll clarify one point I made which may have been unclear:

 

I believe that a reasonably intelligent person can learn enough to understand most clinically/personally relevant research in nutrition, medicine, and exercise physiology (not necessarily the basic science/molecular parts).  It certainly doesn't take a PhD to be able to analyze research better than the average newspaper article.  

I think most of the mainstream news coverage of nutrition revolves around epidemiological research which takes much less education and effort to understand (though certainly some effort). The basic science research is MUCH more complex and requires more education to understand, but gets less media attention and (in my mind) should have much less influence on the lifestyle decisions that people make (based on the huge gaps between test tube/bench top science and organism level outcome).