PURE Bullshit



I tried to ignore this.

The Prospective Urban Rural Epidemiology (PURE) study. I cringed all week long as people everywhere were just delightfully sharing the good news! You can boil all the breathless headlines down to:

Carbohydrates Will Kill You!!!

Saturated Fat Will Save Your Life!!!

We’ve Got It All Wrong Again!!!

But We’re Right This Time!!!

Only, that’s not really what the study actually said… But it doesn’t matter; it’s just stupid from the get-go and what frustrates me is that the exact same people who would be crawling out of woodwork to laugh themselves silly—had the “news” folk decided to highlight other “findings” in the study (e.g., starches and legumes and raw vegetables = good)—are getting all giddy about this enormous waste of time, money, and mind space.

And…Zimbabwe? Bangladesh? Palestinian Territories? Iran? Pakistan? India?

Are you shitting me…places where they routinely spend 60-70% of their income on food (compared with about 10% in the 1st World)?

And did you know that in this study of participants from age 35-70 looking epidemiologically at the relationships between macronutrients and cardiovascular events, in particular, they excluded 7,365 (5%) due to a “history of cardiovascular disease? (source)

How does that make any sense at all?

Well, I’ve seen a lot of breathlessness, but let me pick on just one: Nina Teicholz. The Facebook posts begin here.

PURE study continues to resound: higher total fat (45% of cals) linked to longest life, lowest rates of death from heart disease […]

Lowest carb intake associated with lowest rates of cardiovascular mortality (but not total mortality) […]

PURE: saturated fat intake < 10% associated with highest rates of mortality, stroke, cardiovascular death […]

Now, here’s the doozie of all doozies:

These are associations ONLY, yet important info. where they contradict official guidelines (eg. sat fat)

Shorter Teicholz: It’s bullshit, but it’s nice bullshit so I like it.

Let me sell you a clue, Nina. It’s kinda like two wrongs don’t make a right…you don’t contradict one steaming pile of odorous bullshit (official guidelines) with another steaming pile of odorous bullshit (diet questionnaire epi study) and claim it’s coming up smelling like roses. You just have twice as much steaming, odorous bullshit.

Hell, even the stopped-clock axiom comes into play when Dr. Joel Kahn, a plant pusher, has some fun with Teicholz.

Ms. Teicholz analyzed the claims made in that movie, a film that is motivating thousands if not millions of people to eat more fruits and vegetables and less dairy and meats. She introduced her analysis with comments on the science presented in the movie. Those comments would appear to pertain to the PURE study as well as PURE data was based on a single food frequency questionnaire obtained to describe the diet of individuals over more than 7 years. In a matter of tit for tat, her criticisms about the type of science presented in What the Health were:

1. The extreme unreliability of food frequency questionnaires

2. The impossibility of fully adjusting for confounding variables.

3. Epidemiologists cross-calculating hundreds of food and lifestyle variables against death rates from different ailments, resulting in a huge number of associations. Just as a matter of probability, some of the positive results will be spurious.

4. Scientists in most fields (except nutrition) agree that small associations — with “risk ratios” of less than 2 — are not reliable.

These 4 points she made were offered to invalidate the health claims of What the Health. They seem equally appropriate for an interpretation of the PURE study wherein all of the risk ratios in Table 2 of the paper on macronutrients and outcomes were <2.

Well, what can you say, Nina? You’re kinda caught here being duplicitous, aren’t you, and ought that not cast skepticism and doubt on everything you put out? After all, one thing a reputation for honesty and integrity buys you in this sphere is that people will enjoy gaining trust in you because it saves them time in fact and reference checking—not to mention checking you on fairness and consistency in your arguments…that your confirmation bias is at least checked by a healthy amount.

So, you just took a crap on all that trust.

Join My New Facebook Group: “Richard Nikoley’s Ketotard Chronicles

I’ve seen one good news piece on this whole thing, so far, in The Atlantic: New Nutrition Study Changes Nothing …Why the science of healthy eating appears confusing—but isn’t, James Hamblin

Neophilia is a problem for science, though. And especially the sort of science pertaining to nutrition. Demand for newness leads writers and publishers to focus on narratives that upend conventional wisdom. If new research doesn’t change or challenge the way readers think about the world, why is it a story worth publishing? Eggs are in, and now they’re gone. Butter? It’s back. Every six weeks, The New York Times is legally obligated to tell us either that breakfast isn’t important or that skipping it causes death.

The effect of all this, day after day, year after year, is a perception that all kinds of contradictory evidence is coming up every day—and that each bit is roughly equally valid.

Of course, it’s not. […]

The practically important findings were that the healthiest people in the world had diets that are full of fruits, beans, seeds, vegetables, and whole grains, and low in refined carbohydrates and sugar.

As a writer and a reader, though, this is very boring. If I pitched that to my editor, he would laugh at me. What is new here? Why is this interesting? You know what would be novel? You getting fired! Now get out there and find me a story, dammit!

Let’s look at the internet. The coverage of the study was mostly fine, but the headlines alone promise novelty. Stat ran “Huge New Study Casts Doubt on Conventional Wisdom About Fat and Carbs.” Reuters ran “Study Challenges Conventional Wisdom on Fats, Fruits, and Vegetables.” Medscape ran “PURE Shakes Up Nutritional Field: Finds High Fat Intake Beneficial.” Even the editors at The Lancet used the headline “PURE Study Challenges the Definition of a Healthy Diet.”

Yeah, you know, it’s pretty simple: Meat, fish, fowl, fruits, vegetables, tubers, legumes, nuts, seeds, whole grains…minimally processed…prepare yourself most of the time…eschew lots of added or cooking fats…eschew processed foods…and don’t eat too much, too often. Move your ass every day. Pick up some heavy things and move those too, every day. Take walks and hikes that include ascent and descent. Get regular sunshine on unprotected skin. Sleep well. Develop loving and mutually respectful relationships. Engage in meaningful work.

And one more thing, for fuck’s sake, already: Stop pretending that The Blue Zones don’t exist. It’s not perfect, but you could do a lot worse than simply picking a few micro-cultures you like where people tend to live long in good health, observe what they eat and do, and model some of it for yourself and yours and stop being so fucking stupid with your utterly ridiculous and insane hyper-restrictive diets—and that goes for everyone…from vegan hyper-restrictive morons to zero-carb hyper-restrictive morons and all the assholes in-between.

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Still, sell-outs happen regularly, so order now to avoid a waiting list.

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  1. hap on September 2, 2017 at 21:11

    Understanding Richard.

    See comments on Relationships

    This guy came late to the game……but he figured it out.

  2. thhq on September 3, 2017 at 04:21

    The study recommends 35% fat and 55% carbs being the best diet for longevity. This is the Med Diet, not HFLC. The high carb diets are associated with poverty, which has other risk factors. HFLC is a diet associated with affluence, which has better medical care.

    Americans already eat over 40% dietary fat, and have not eaten below that for 20 years. We should lead the world in longevity.

    Correlation is not causation.

    • thhq on September 3, 2017 at 05:31
    • Shameer M. on September 3, 2017 at 14:10

      The KIND of dietary fat is extremely important. Here’s an excellent post on the damaging effects of the increased use of seed oils

      Here’s a follow-up podcast going in-depth on the same topic:

      There’s more and more evidence coming out showing that seed / omega6 oils are the leading cause (although not the only cause) of most modern health issues

    • Nocona on September 3, 2017 at 12:01

      And what KIND of dietary fat do these people eat? It’s like saying people need to lose weight, instead of saying people need to lose fat.

    • thhq on September 4, 2017 at 06:00

      I’d argue that from the standpoint of the Lancet study the TYPE of fat didn’t matter. Agreed that there are better and worse fats to eat. But the people in Zimbabwe and other targeted poor populations aren’t getting enough fat of any kind. This isn’t a suboptimization study.

    • thhq on September 4, 2017 at 08:49

      The USDA historic consumption is very instructive on fat type consumed for Americans. Saturated fat is unchanged over decades at 60 grams per day, which works out to about 12% of daily calories. Cholesterol consumption is similarly steady. It’s not like we’re starved for sat fat. The increases have been in PUFA and MUFA, mostly from vegetable sources, though meat, especially poultry, contains a lot of MUFA too. MUFA is now much higher than either sat fat or PUFA.

      Granted, we could cut out some of that PUFA. But 70% of our daily fat is MUFA and sat. That’s not a bad profile at all. We could drop all the PUFA and still have dietary total fat over 35%.

    • Bret on September 5, 2017 at 07:46

      As long as we’re not increasing SFA and MUFA to account for the PUFA removal, KT style.

      Can’t imagine why anyone would want to eat concentrated PUFAs (vegetable oils), unless they were starving and had no other options.

      How canola oil is made

  3. Nocona on September 2, 2017 at 15:12

    I’d consider some of the Weston Price cultures he studied, who were vigorous and healthy, were some of the older Blue Zones. They also had a huge difference in range of diets. We also know he studied some pre-industrial cultures that were not healthy at all. If I’m not mistaken, one of the underlying variables of the healthy peoples were that they were getting plenty of the fat soluble vitamins.

  4. Lute Nikoley (dad) on September 2, 2017 at 17:24

    Richard, im disappointed in you. Where the hell is the bullshit horn?

    • Richard Nikoley on September 2, 2017 at 17:27

      Hahaha. Dead battery, long ago.

    • Jo tB on September 7, 2017 at 06:39

      I agree with you dad, I’m missing the bullshit horn as well. Richard doesn’t sound right when he isn’t blowing his bullshit trumpet. He sounds TOO polite.

  5. Shameer M. on September 2, 2017 at 19:00

    “eschew lots of added or cooking fats”

    Smart advice but unfortunately I’ve got a weakness for butter & ghee (grassfed, of course).

    • Nocona on September 3, 2017 at 11:57

      Enjoy the vitamin K. Don’t worry.

    • Bret on September 4, 2017 at 12:59

      Shameer, butter/ghee with fat soluble vitamins are fine and dandy. Just don’t make them the core basis of your diet #KTstyle. A few tablespoons a day is a reasonable amount. Not a couple of sticks a day.

    • JP on September 7, 2017 at 07:55

      There are better ways of getting Vitamin K that don’t cost your hundreds of calories.

  6. hap on September 2, 2017 at 21:08

    Taleb….doesn’t call it neophilia….but neomania….which I think has more punch.

    • thhq on September 4, 2017 at 05:54

      Neophilia, neomania, whatever. These mono mindsets drive sales for Nora, The Sun, and People. You can pick up a ten year old People in a waiting room and get the same frantic advice.

      Neotardism’s singular focus ignores decades of focused population studies on our own situation, not Zimbabwe’s. Studies such as Wing’s NWCR. It’s as if it’s always a new day out there and we have just now discovered that the sun comes up.


  7. Sassysquatch on September 3, 2017 at 09:00

    You hit the nail on the head about neglecting the Blue Zones. Excellent writing here!

  8. Steven on September 3, 2017 at 10:39

    Guess who’s in ketosis right now? Me

    Guess what I had for food yesterday? I ate two apples, a bunch of oatmeal, a couple of cups of raw whole milk, several carrots, some corn, a bunch of sweet peas, figs, and of course several high protein sources like salmon and tuna.

    In other words a whole hell of a lot of carbs. I stopped eating last night at around 7 and went dancing. I just finished my second cup of coffee and am about to work out and all I can taste are ketone.

    I guess my metabolism is broken.

  9. Jared on September 3, 2017 at 10:59

    You’re being unfair to Techoltz.

    Her point is that you can’t have a health guideline that doesn’t match observations (e.g. limit saturated fat to <10% of calories). That is, there can be no causal relationship if there is no correlation.

    Or did you not learn that in Statistics 101?

    • Richard Nikoley on September 3, 2017 at 12:24

      Shut your fucking cock holster, Jared.

    • May on September 3, 2017 at 12:50

      Trumped by blue zones.

    • Jared on September 3, 2017 at 13:57

      You got me there. I was foolish enough to try to have a chat with a shit-flinging Orangutan and come out clean. I don’t know what I expected..

    • Richard Nikoley on September 3, 2017 at 16:30

      Not the way one “tries to have a chat” with me.

  10. Sidney on September 4, 2017 at 06:42

    It is amazing that people would get dietary advice from journalists such as Teicholz and Taubes, who have no scientific training at all, and ignore the advice of respected M.D.’s (McDougall, Ornish, Esselstyn, Barnhard, etc.) who do have the rigorous training and observe patients in clinical practice. I do not trust health recommendations from any American organization, as all of them are under control of lobbyists and special interests, e.g. the meat and dairy industries. I trust the World Health Organization guidelines, as they are completely independent and base their recommendations on evidence based research. Here are the current guidelines: http://www.who.int/mediacentre/factsheets/fs394/en/

    • Richard Nikoley on September 4, 2017 at 07:56

      Meh, any governmental organization is going to be influenced by monied interests and ideology, etc.

      The only “guidelines” worth following are eat whole food, not too much, too often, and in a way that promotes your general health and happiness. If that seems to hard, then look to Blue Zones and model one or a few.

    • Steven on September 4, 2017 at 08:12

      So, use Canola oil over butter. Great idea.

      Use less salt to reduce Diabetes??? How about no. Salt is critical and don’t eat that iodized shit they recommend.


      “changing how you cook – remove the fatty part of meat; use vegetable oil (not animal oil); and boil, steam or bake rather than fry;”

      Fucking retards.

    • hap on September 4, 2017 at 12:32

      Agree with Richard…..various associations with special interests know they are targets for bias criticisms. Subsequently the morph into more ambiguously named groups with more difficult to follow audit trails.

      Since political power is more and more centralized……how is it an epiphany that groups Ie monies interests aggregate as political sponsors and policy advocates? Now there has been an uncoupling of political power transitionin from politicos to bureaucrats……who have engineered their career positions and contribute far more to policy and regulationthan politicians who are forever expending their life essence on getting re elected…..a circular process in conjunctionwith monies interests, although the bureaucracy is the primary target.

      Ie…THE SWAMP

      the WHO….like many other international organizations have been similarly hi jacked

  11. Bret on September 5, 2017 at 07:55

    Can’t say I respect McDougall a whole hell of a lot, Sidney. He’s bitten by the vegan snake and goes pushing that nonsense in a decidedly unscientific way.

    Never take advice from anyone (whether you respect them or not) without a healthy grain of salt. And go test it in your own life first.

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