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Dr. Garth Davis, Surgeon: I Warned You….

Dr. Garth Davis, after having—probably blissfully confident—posted comments in the original Forks Over Knives thread I blogged about (Doctor FAIL: Garth Davis, Bariatric Surgeon (and China Study Balderdash)) basically did the same blissfully confident, dismissive commenting on that post. Such as this:

This is one of the funniest yet saddest commentaries I have ever seen. You guys are ridiculous. Actually I started as a big time meat eater. I wrote a book in 2007 called “The Experts Guide To Weigh Loss”. In that book I actually wrote a section on diet that basically supported a zone diet. My thought was patients need as high protein as possible. My diet for patients was eggs for breakfast. Turkey and veggies for lunch. Chicken and veggies for dinner. Problem was after reviewing thousands of patients I was finding problems with cholesterol levels and weight gain over time.... [it goes on, devoid of proper paragraph breaks]

"Funniest." Nice, lazy dismissal. Well, we'll just see who brought it and who didn't. Read on, if you want to see pure, unadulterated doctor/surgeon impotence.

....Oh, "as high protein as possible?" Wow. And you wrote a book recommending that? Hmm. He goes on in his comment to basically use the old "been there done that" shtick, without being willing to explain himself or qualify (Campbell does similarly...grew up on a dairy farm...where I guess dairy famers and their children drop like flies). For example, he conflates Blue Zones with 7th Day Adventists—not even conceding that one of the longest living Blue Zone populations—the Okinawans—eat more meat than the traditional Japanese...which would be pork, and that their traditional cooking fat is lard.

...One commenter even felt sorry for him over my treatment in the post. But she proved to be irredeemably irredeemable, in spite of all efforts. The thing is, comments on my blog are both devastating and fucking brutal if you don't have your shit strait, or can't defend your ideas. Intentional. No place in the Paleosphere even comes close. We put Socrates to shame and Hegel in short pants, here. There's no catechismal dispensation here on Free the Animal. You put up, or...

"This is one of the funniest yet saddest commentaries I have ever seen. You guys are ridiculous."

And why, exactly, are we ridiculous?

"Unlike you guys who get your science from blogs I go to the source sitting through lectures and reading journals."

Ah yes, the whole tired old bloggers don’t know real science and mathematics schtick. Because no paleo-type bloggers have ever read or wrote about any scientific papers or understand that correlation does not equal causation, or have any sort of inkling of what real Science is, right Doc?

"I will never be set in my ways. If there is some ground breaking science that shows me there is a different way then so be it."

I find your self assessment of open-mindedness pretty difficult to take seriously, coming from someone who repeatedly uses appeal to authority as an argument.

Dr. Doug McGuff (stating the facts, and only the facts, ma'am):

“Taking a statistics course does not make you a statistician” - ad hominem attack

“The actual china study was printed in Nature, one of the premier scientific journals….” - argument from authority

“Her opinions were published on her blog, not a journal” - argument from authority

“The problem is that lay people just cannot understand the difficulty of statistical significance and therefore will believe anything anybody tells them.” - Nice combo of argument from authority and slippery slope analogy.

“The Weston Price Foundation is one of the least scientific organizations I have studied.” - Unsubstantiated, narcissistic ad hominem attack.

“Why would people believe Minger over physicians and epidemiologists?” - Oh, the same people that gave us heart healthy margarin? - argument from authority.

“You cannot take raw data and make conclusions like she does.” - But you can use the raw data to show how epidemiologists are manipulating statistics to support their pre-determined beliefs. The entire basis of evidence based medicine is an emphasis on raw data as opposed to statistically derived data.

There's tons there, 115 Comments as of now. After a bit, I began pounding him, including his incomplete and false information about the Masai, not to mention cholesterol and other stuff, including the Okinawans.

While he didn't address anything I wrote, he did come in with another comment.

I can’t believe all the inflammatory words. You guys are an angry bunch. Doug I can’t believe your comments especially. What kind of doctor are you? I spend my whole life studying diet. I run a very big weight management clinic where we do medical and surgical weight loss and research into the cause and treatment of disease. Denise may be intelligent but any scientist who reads her work can tell she does not know how to analyze data properly. She made huge errors in her critique that even a junior med student should notice....

I had explained to him that Denise did exactly what Campbell did in The China Study in terms of isolated variables (to be more accessible), but that her formal critique included all the multivariate analysis she'd already done from the outset.

“The ridiculous commentary by the Minger is laughable to anybody who understands statistics. You cannot look at raw data and make conclusions, as Denise did, without controlling for confounding variables.”

She addressed this. She actually did numerous MV regressions before publishing her first critique, but wanted to keep it simple and basic for readers (just as in The China Study book). In her formal critique of 30 pages or so, she includes the MV analysis.

http://rawfoodsos.com/2010/08/06/final-china-study-response-html/

Also, it’s as though you didn’t read this post you’re commenting on. I included a number of links to Ned Kock, a statistician who performed a number of MV regressions on the same and different data sets (China Study II) and came to the same findings as Minger.

Alright, as I said, there's a lot there and I wish I had space to highlight all commenters who added value. But as I said in the title, I warned him. Indeed I did.

Memo to Dr. Garth Davis:

Cat still got your tongue, sir? Well, here. Find me a study that contradicts any of this and factors in the nutritional cost of avoiding or eliminating whole animal foods from the diet.

Grains, Vegetarians, Vegans and Nutritional Density

An excerpt:

Again, look at the numbers at the tops of the bars that are off the chart in order to judge the real relative comparison. As with our other nutritional comparisons, here’s how these meals stack up:

  • 850 Cal (5 pounds) Mixed Raw Fruit: 127% USRDA (4 of 21 nutrients over 100%)
  • 850 Cal (about 8-10 oz) Omivorous Meal: 440% USRDA (12 of 21 nutrients over 100%)

Yes, indeed, in the fruit meal there are only 4 of the 21 nutrients that provide 100% or more of the RDA, but 3 of those 4, just barely (vitamin C being the only one off the scale). So in essence, a single nutrient at 1,500% of the RDA skews the whole analysis pretty badly. If we were to take vitamin C out of the equation and just average the other 20 nutrients, the fruit meal provides only 57% of the RDA. As you can see, however, we do not have nearly this same problem with the omnivorous meal, because 12 of the 21 nutrients are over 100% and of those, 5 are off the scale. Just removing vitamin C as we did in the fruit meal changes nothing at all, because the general nutrition is excellent and widespread.

No response, as we had already been accustomed to for days. My notice to him:

Dr. Garth. Well, what do you think? Inn’t interesting that pure layman are quoting studies to you? You’ve yet to respond to mine, or any of the others.

You stepped in shit. Didn’t you? You should very well know that I am going to blog your comments and your total failure to respond to valid responses if you don’t—and when I do, it’ll be far more Googlishly devastating than this post. I take no prisoners, but I’m a sucker for redemption.

…Yep. You did. You thought everyone would run and hide because you read studies all the time (but have yet to cite one—perhaps you’re afraid of how we’ll tear it to shreds?). We do too (and a number have been cited by myself and others).

Isn’t it wonderful? You have zero power. You have to earn your respect and you know what? You suck in this thread, compared to what others have posted….and everybody knows it. This blog gets over 100,000 visits per month. Thousands of people over years who are curious enough to look at comments are going to see who you relly are. Authoritarian. That’s about it.

And here’s another thing. OK, I can accept that a surgeon with an interest in nutrition eventually tires of the debate. But that’s only because there’s no real debate. This is clearly not the case, here. Very clearly. You have been challenged by your own standards, and you are silent, which of course speaks volumes.

At a point, I debated with myself whether my treatment of you in this post was justified.

Now I know that it was. I’ve been at this for a long time. My judgment of character is pretty spot on.

I remain a sucker for redemption.

Nothing.

Alright, so I kinda had let my warning to to the good Doktor slide; back of my mind and...back of my mind. Enter Stabby! Long time commenter, always keeping me honest, but always being honest himself. Comment from him last night.

Hey Richard, haven't seen you in a while, just dropping in.

I can’t believe he would reference the EPIC trial. The other trials he cited are inane too, but the EPIC trial didn’t even show that vegetarians lived longer. They had a moderately lower risk of cardiovascular disease, although correlation isn’t causation. But there was no difference in all-cause mortality.

So yes he is a moron about The China Study but he is also a moron about the EPIC trial. And even if vegetarians were significantly healthier than omnivores, that wouldn’t mean much because then we would have to discuss the potential reasons why—and it wouldn’t look pretty for the “meat kills you” side. But oh no, let’s just cherry-pick epidemiology instead of having a real conversation. We just want a “gotcha”...hey, my correlation says this.

And if he’s going to cherry-pick like a knave he should at least learn how to be a good knave.

So there you go. Thanks for the resurrection and motivation, Stabby.

Comments

  1. Recently I told you that you were my 2nd fave irritant behind Mencken and posts like this are the reason why. Honestly, my view on meat is more environmental than health now. Atheist, yet in church of Salatin. Plants need herbivores need predators need plants. Only totalitarian agriculture differs. And veganism is the logical endpoint of that.

    • Gene, I think I remember that but being a Mencken fan myself, that’s a bit embarassing.

      On the other hand, it does give me much to shoot for and I would hate to ever dissapointed you.

  2. Don’t fuck with a logician!

  3. My favorite by Garth Davis: “You say my arguments are illogical and have no data”

    You are not allowed to point out illogical arguments unless you post some random scientific data to go along with it? What?

  4. Woop Woop, git em, Ricardo

  5. Well done. This guy really is an ugly little charlatan.

  6. Dr. Garth Davis, Surgeon: “Denise may be intelligent but any scientist who reads her work can tell she does not know how to analyze data properly. ”

    I am a scientist and would say that Denise study was sufficient to show that the analysis of Campbell was not rigorous. Denise did not proof that meat is healthy, just that the analysis of Campbell was insufficient to draw clear conclusions. I did not read The China Study itself yet. Thus Campbell and Davis may still claim that Denise did not quote the study honestly, but reading the discussion between Denise and Campbell, I am not expecting this.

    • Campbell’s responses are really to damage his credibility in my eyes. However they appear to have been enough to convince his victi (ahem) believers.

  7. Yes Colpo has long used the epic study to show that vegetarianism is no healthier than omnivorism, I just assumed that Dr Davis had access to further data as he called it the Epic Europe trial (or similar) instead of the Epic Oxford study. Yes I am ashamed to say I assumed he knew more becaause he is a doctor….shame!
    The epic oxford is a devestating study for healthy vegetarians, why do vegetarians and vegans have higher rates of colon cancer if we have colons designed for eating plants? Twats!
    Dr Davis wrote this…..
    ” My thought was patients need as high protein as possible. My diet for patients was eggs for breakfast. Turkey and veggies for lunch. Chicken and veggies for dinner. Problem was after reviewing thousands of patients I was finding problems with cholesterol levels and weight gain over time… ”

    is this even possible?

    • Galina L says:

      I think eating pattern of paleo and “balanced” diet suppose to be different, meat overeating is still overeating and still possible, paleo food is pretty dense in nutrition. For example, I used to have 3 square meals a day + at least 3 snacks on regular diet (I have been eating self-cooked food all my life), while eating LC paleo diet, I eat 2 times a day, no snacks. There are some bloggers, who struggle with a weight problem . Jimmy Moore is a good example. His wife told in comments on Tom Naughton blog, that JM couldn’t control his weight after 180 lb lost Atkins diet due to the excess of protein he was eating. So yes, you can overeat good food, even though it is more difficult than overeating on junk. Recommending people to eat as much protein as possible is not a good idea.

  8. “Dr. Davis graduated Phi Beta Kappa from the University of Texas in Austin where he was the Student Government President. He was also recognized as the most outstanding student at UT. Dr. Davis went on to attend medical school at Baylor College of Medicine and graduated in the top 10 percent of his class. In addition, he was inducted to the Alpha Omega Alpha Medical Honor Society. Dr. Davis completed his surgical residency at the prestigious University of Michigan in Ann Arbor where he was elected to the position of Chief Administrative Resident. While in Michigan, Dr. Davis underwent extensive training in general surgical disciplines, specializing in laparoscopic procedures. He is certified by the American Board of Surgery and is a Fellow of the American College of Surgeons and a Fellow of the American Society for Metabolic and Bariatric Surgery. Dr. Davis is a recognized expert in initial bariatric procedures as well as revisional bariatric surgery, and is frequently asked to give lectures to both patient and physician audiences alike.”

    Call me naive, but please, someone tell me how is it that such an academically distinguished person can demonstrate such poor critical thinking and writing skills?

    • It’s commonly know in academia as the “BS Factor”, or how to get through institutes of higher learning with good bull shitting skills.

  9. Elenor says:

    “Dr. Davis is a recognized expert in initial bariatric procedures as well as revisional bariatric surgery”

    Meaning what? He does the first surgery AND the corrective surgery when the first surgery goes wrong?!

    You have to go searching for the information — but some ridiculous number of folks who have this surgery are readmitted with various problems shortly after they go home. However, the “shortly after” is often not counted as morbidity related to the surgery; it’s treated/listed/counted as a NEW admittance/’injury’ not related to the bariatric surgery that… you know.. actually MADE them ill enough to need “admittance” — actually RE-admittance!

    Mayo Clinic has posted:
    Longer term risks and complications of weight-loss surgery vary depending on the type of surgery. They can include:
    Bowel obstruction
    Dumping syndrome, causing diarrhea, nausea or vomiting
    Gallstones
    Hernias
    Low blood sugar (hypoglycemia)
    Malnutrition
    Stomach perforation
    Ulcers
    Vomiting
    Death (rare)

    In 2003 G. Wesley Clark, MD, bariatric surgeon, San Diego, CA wrote:
    “The most commonly cited mortality rate for bariatric surgical operations, across the United States, is 0.5%. That looks pretty good, till you do the math and realize that means about 1 out of 200 patients will experience a fatal result. ”

    CBS news posted: “A recent study by researchers at the University of Washington found that 1 in 50 people die within one month of having gastric bypass surgery.”

    Bariatric surgery is a real knife’s edge decision. Is the risk of morbidity and mortality worth the benefits that many patients get? I’m not sure this doc isn’t like the famed (and disgustingly dishonorable!) Dr Oz: a specialist within his very limited field – - giving (bad) advice way outside his knowledge and skills! Wonder what his clinic’s success is with NON-surgical weight loss?

  10. Note that Japanese men do not live longer than Icelandic men, The overall Japanese life expectancy is given a major lift by female longevity.

    • p.s. from the comments
      “What that paper doesn’t mention is the famine situation Okinawa was dealing with in 1949.”
      I have met and been friends with many okinawans I would agree that relative to the mainland Japanese they appeared to be in far better health.

  11. Seems to me that if you live on an island and you are only eating 3 ounces of fish a week, you fail at life.

  12. I didn’t read the whole paper, Charles (thanks for that), but I don’t think it means a lot. Their primary focus seems to be on CR as a possible explanation for longevity and as such, they are looking primarily at total energy intake decades back (when the old folks were younger). That in itself is dubious enough—and it’s probably sufficient to assume that factors like non-industrialization, world economic depression, world war resulted in situations were food was a lot scarcer.

    “Archived dietary data are used to estimate energy balance and potential CR status in Okinawan septuagenarians at younger ages. Okinawan data were derived from the Office of the Civil Administrator of the Ryukyu Islands (Okinawa) for the year 1949, when the current septuagenarians were aged approximately 30 years,24 and approximately every 5–10 years thereafter by the Okinawa prefectural government.25 Studies relied on 3-day food records of usual dietary intake to estimate caloric intake in conjunction with dietitian interviews.”

    So, not only is that dubious, but then breaking it down by all different types of food in the post WWII era, a conflict, incidentally where:

    “The Battle of Okinawa, codenamed Operation Iceberg,[3] was fought on the Ryukyu Islands of Okinawa and was the largest amphibious assault in the Pacific War of World War II.[4][5] The 82-day-long battle lasted from early April until mid-June 1945. After a long campaign of island hopping, the Allies were approaching Japan, and planned to use Okinawa, a large island only 340 mi (550 km) away from mainland Japan, as a base for air operations on the planned invasion of Japanese mainland (coded Operation Downfall). Four divisions of the U.S. 10th Army (the 7th, 27th, 77th, and 96th) and two Marine Divisions (the 1st and 6th) fought on the island while the 2nd Marine Division remained as an amphibious reserve and was never brought ashore. The invasion was supported by naval, amphibious, and tactical air forces.

    “The battle has been referred to as the “Typhoon of Steel” in English,[6] [7][8] and tetsu no ame (鉄の雨[9]) (“iron rain”[10]) or kou no kaze (鋼の風[9]) (“steel wind”[10]) in Japanese. The nicknames refer to the ferocity of the fighting, the intensity of kamikaze attacks from the Japanese defenders, and to the sheer numbers of Allied ships and armored vehicles that assaulted the island. The battle resulted in the highest number of casualties in the Pacific Theater during World War II. Japan lost over 100,000 soldiers, who were either killed, captured or committed suicide, and the Allies suffered more than 65,000 casualties of all kinds. Simultaneously, tens of thousands of local civilians were killed, wounded, or committed suicide. The atomic bombings of Hiroshima and Nagasaki caused Japan to surrender just weeks after the end of the fighting at Okinawa.”

    So we bombard an island with 1,200 ships, kill 100,000 of their soldiers, tens of thousands of citizens, destroy their livelihoods and a mer 4 years later are doing a food survey to see what they eat and projecting that six decades into the future to gain insight on a proper diet?

    I’m pretty certain they would have been eating a lot more pork and fish in those years had their herds of pigs and fishing fleets been fully recovered.

    There’s this Japanese study:

    http://ci.nii.ac.jp/naid/110000220190/en

    “In Okinawa, the local and regional hog markets play a very important role compared with the national hog market. Therefore, in this study the market economic conditions for the local and regional hog markets in Okinawa were made clear. The hog marketing in Okinawa was chosen as the subject of the study of the following reasons : Hog production is one of the most important income sources for the agriculture in Okinawa and also pork is the most popular and has the most important position among meat. While the hog market in other areas is characterized by the national market, that in Okinawa depends mainly on the local and regional markets traditionally. The outline of the discussion of this study is as follows : 1. Consumption structure The quantity of pork consumption per person a year in Okinawa is larger than that of national average. For example, the quantity of pork consumption per person a year in Okinawa in 1979 was 7.9 kilograms which exceeded about 50% that of national average. And the percentage of the quantity of pork consumption in the whole meat of national average is 47% while that in Okinawa is 57%. 2. Production structure The percentage of hog farmers in the whole farmers in Okinawa is larger than that of national average, however hog numbers on a farm in Okinawa are smaller than those of national average.”

    So when I see that and then I see all these grass grazers going on and on about Okinawa and never even whisper the fact that it has a been pork culture, well, you know.

    This too:

    http://www.okinawaindex.com/index/?tid=2&cid=250&id=2

    “Pork is the Basis for Many Local Delicacies

    “A large percentage of Okinawan meals utilize pork as an essential ingredient. Pork meat contains plenty of vitamin B1, which is a non-saturated fatty acid that helps the body break down cholesterol and proteins. Many scientists suggest that the Okinawan diet is one of the primary secrets to Okinawan longevity.

    “In Okinawa, just about every part of the pig is used for food except for its squeal. If you drop by the Heiwa Dori food market in Naha, or any of the other markets on island, you’ll be able to see for yourself all the parts of the animal that are for sale and available for use in meals. You can even purchase pig face, which is used in soup or as decoration on special occasions, as well as the feet, stomach, tongue and ears.

    “Typical, less extreme, pork dishes can be found in almost every restaurant on island; they are also popular in packed lunches called bento.”

    Jesus I fucking hate vegetarians and their continual misleading lies. They just can’t deal with facts. I can. Here: the sweet potato is a crucial staple of the Okinawan diet. There. But see, that in no way compromises my ideology, and that’s because I don’t have one. I’m just simply an omnivore with the audacity to recommend natural omnivorous sources of all nutritional real foods.

    • There’s two problems, Charles. First that’s an average across the entire population—so some people eat even less, some more. Second, from what I gather, they consume pork in a huge number of dishes and they eat the entire animal (everything but the squeal, or tooth to hoof). That means they are eating the most nutritious parts. Having lived in Japan for 5 years (and a few trips to Okinawa in that time) I have a good sense how they use animal products. It’s small amounts, but they use it in everything, for flavor.

      My point is that this completely undercuts the vegetarian and vegan arguments that plant exclusive diets are a priori more healthful and promote greater longevity. I have no qualms with populations that eat real food but with minimal animal products in there. They are so greater in nutrition on average it’s the fact that they’re there.

      BYW, sweet potatoes, though low in protein at 5-10% depending on variety, have a very good amino acid profile. Complete protein I gather, so one can truly live on them.

  13. Also, just Googling around, appears there was a lot of famine and even starvation in Okinawa in the 1st half of the 20th century and many Okinawans fled the island for a better life elsewhere.

    And to answer the final question:

    “SO – is the Traditional Okinawan Diet really that meat heavy??”

    Oh, not at all and I didn’t say that nor mean to imply it. I meant to show the fact that pork is a huge part of their diet in terms of regular consumption (small amounts in soups and other dishes of all kinds for flavor). I have never once seen this acknowledged one single time by anyone touting Blue Zones or the longevity of Okinawans—or the meat consumption of any other people’s. It’s always about the fruit, vegetables, starch & legumes. Always.

    It may very well be that the best diet in general is one either high in starch, low in fat & protein, or high in fat, low in starch & protein with relatively less protein being optimal. Or, maybe it’s that lower protein diets are more often associated with lower caloric intake and that’s the largest factor. CR seems to be a promising means of increased longevity that works across many species.

    But again, it appears Okinawan CR was forced, not by choice.

  14. Even if those numbers would be right and the Okinawan diet contained only a little meat and fish (don’t forget other animal products), it would still be an enormous leap of faith to a vegan diet without any animal products.

  15. “Problem was after reviewing thousands of patients I was finding problems with cholesterol levels and weight gain over time….”

    As soon as I hear “problems with cholesterol” I know the speaker is an idiot. When will the lipid hypothesis die and supposedly intelligent physicians quit spouting the dangers of a TC >200. I think his credibility ends at that sentance.

  16. Wow, where did they find some many idiots in one place? When he wants you to drink his poison koolaid, you do it, huh? :)

    Enjoy your heart attacks, mindless lemmings:)