Nina Teicholz: Evidence for the American Heart Association's diet is....a single clinical trial (that was retracted)
Real science is never settled, and anyone who has certainty on such things is not qualified to discuss it.
Nutrition science is an oxymoron.
2023-02-06. Emphasis added.
The American Heart Association (AHA) considers its diet the ‘gold standard’ for fighting heart disease. But exactly how much gold lies in the vault to back up that ideal? ....
In sum, only a single part of the AHA/ACC diet, its ‘dietary pattern’ of fruits, veg, legumes, nuts, whole grains, and fish, is supported by “strong” evidence. And even that evidence was of only moderate quality. The rest of the AHA/ACC diet doesn’t even meet the AHA’s own standards for population-wide recommendations.
But let’s just pause here to observe that not a single news organization or even the medical press, to my knowledge, published an article questioning the strength or quality of this evidence when the AHA/ACC guideline came out in 2019, even though all these helpful graphics were in the paper for any reporter to see. Every article I can find trumpets the AHA/ACC ‘lifestyle guidelines’ as the unassailable truth. This tells you that health and nutrition reporters are either asleep at the wheel or too afraid to challenge conventional wisdom. Either way, it’s a sobering reality.
AHA buries its own evidence review
When the AHA/ACC first released their Guideline, the paper linked to the review on EPC’s website. I remember poring over the results and noting, to my surprise, that a single trial was cited to justify the AHA/ACC’s ‘dietary pattern.’ That trial, called PREDIMED, was a test of the Mediterranean diet, conducted in Spain.
A single trial, as we’ve seen, is insufficient for granting a rating of “strong” to a body of evidence, according to not just the AHA but the vast majority of guidelines standards. Also, this trial was published in 2013, so what was the evidence for the AHA diet for the 52 years before then?
...Worse, PREDIMED was actually retracted in 2018 due to serious protocol deviations including questions about whether it was properly randomized. The study was republished, yet scientists including Stanford’s world-famous evidence-based medicine expert John Ioannidis expressed strong lingering concerns about PREDIMED’s basic scientific rigor.
In any case, the fact of having only a single trial to support the AHA/ACC’s main dietary advice was presumably embarrassing, because the whole review disappeared from the EPC website, and the AHA/ACC then “corrected” its paper to erase even a mention of EPC’s name.
... The moral of the story is that if you’re following this group’s advice, dedicating yourself to a diet of fruits, whole grains, nuts, and fish while restricting saturated fat and red meat, you are resting your hopes on a single, once-retracted medical trial that didn’t even test the diet you’re following. Diet-wise, you’re wandering in the dark.
WIND: in summary, there is zero credible scientific evidence to support AHA dietary recommendations.