Kevin Klatt, PhD, RD

The prestigious Mayo Clinic regularly gets itself into hot water across evidence-based medicine and skeptics circles (see here ) for its heavy promotion of questionable science; Mayo is particularly entrenched in the complementary/alternative/integrative/functional medicine (CAM/IFM) movement that is taking academic medical centers by storm (it even has a peer reviewed publication about its CAM use). Mayo, like other famous clinics, seems more than happy to promote its clinic with low-to-no evidence modalities that have been re-branded under the CAM/IFM movement. There's a nutrition video that Mayo has produced and is circulating around the social media spheres. I've seen it before but today it made me particularly annoyed so here we are. The video covers the role of a whole foods plant-based diet as 'powerful medicine' with a focus on cancer. You can see the video embedded below. A link to their tweet with the video can be found here   and its also up on their YouTub...

The PURE macronutrients studies were published in the Lancet journals today and the headlines / commentaries are reminding us that everything we thought we think we were told we knew about nutrition is wrong/misguided, etc. Below is my non-epidemiologist's run down of what happened in PURE. A couple papers came out related to PURE, but the one causing the most buzz is the relationship of the macronutrients to mortality. With a median follow up of 7.4 years, 5796 people died and 4784 had a major cardiovascular event (stroke, MCI). The paper modeled the impacts of self reported dietary carbohydrate, total fat, protein, monounsaturated (MUFA), saturated (SFA), and polyunsaturated (PUFA) fatty acid intakes on cardiovascular (CVD), non-CVD and total mortality; all macros were represented as a percentage of total self reported energy intakes and reported/analyzed in quintiles (energy intakes between 500-5000kcals/day were considered plausible..). All dietary data was determined by a ...

The American Heart Association (AHA) released it's Presidential Advisory on Dietary Fats and Cardiovascular Disease this week and the responses have been all over the place (see medscape ,  science-based medicine , HNR , Gary Taubes , Cardiobrief ). Here's my summary/take: There's nothing terribly new about this advisory; it's relatively the same line of thinking/evidence that the AHA has used to support it's recommendations in the past, so regular followers of the field will not read this report and be too shocked. The most novel aspect of it is an updated meta-analysis of 4 diet-heart trials which the AHA generated. The new meta analysis comes about because there have been multiple meta-analyses which have attempted to address this issue over the past several years, and they don't all align nicely - see here , here , here . Why? Because the study inclusion criterion that are used are often not the same. Shorter term trials have consistently shown that satu...

My thoughts on Nutrition in 2017 - hopes, concerns, expectations and things to look out for: 1. The National Academies of Medicine (NAM) - NAM is making moves on laying a framework for addressing chronic diseases within the context of the dietary reference intakes. It'll be interesting to see what directions NAM moves in and how actionable this framework will be. Nutrition has a long history of relying on variable qualities of evidence to achieve its recommendations that's led to a lot of talk about how to make nutrition policy. When it comes to addressing chronic disease, we have very few validated surrogate outcomes (e.g. LDL) to link nutrient intakes to, and major parts of the field of medicine are moving away from these due to their limitations . Nutrition has a really poor history of conducting large randomized controlled trials with meaningful, interpret-able outcomes (e.g. MRFIT, WHI, PREDIMED), especially when brought together in seemingly endless variations of m...