It doesn't look like they had a control group, did they?
Not exactly a control group, but among the group of 22 patients who did not follow the diet, 13 or 62% had some sort of adverse event (stroke/heart-attack etc), compared with just 1 out of the group of 177 (0.6%) who did follow the diet. That seems to be pretty compelling evidence that the approach is effective.
It's not. For all we know, those that were unable to follow the diet were those who had the worst cases and/or least healthy diets.
It doesn't look like they had a control group, did they?
Not exactly a control group, but among the group of 22 patients who did not follow the diet, 13 or 62% had some sort of adverse event (stroke/heart-attack etc), compared with just 1 out of the group of 177 (0.6%) who did follow the diet. That seems to be pretty compelling evidence that the approach is effective.
One immediate issue is that conscientiousness, e.g. the ability to maintain a difficult diet for an extensive period of time, is quite correlated with longevity.
This is a very commonly known effect, which makes me more than a bit suspicious of this particular study.
This is also why a control group with random assignment is necessary, particularly in the social sciences. There are simply too many confounding factors to make epidemiology useful in basically any way.
It doesn't look like they had a control group, did they?
I'm not trying to quibble, but am genuinely curious: What would a control group consist of? There were plenty of patients who didn't receive the trial program, at large in the general population. And it couldn't have been a blind study, because the patients knew what they were eating.
> What would a control group consist of?
It would be an equivalent population who weren't asked to change their diets.
There are multiple reasons the patients in this study might not be comparable to participants in other studies or to the general population. Age, gender, average disease severity all need to be controlled for. And if nothing else the simple fact the patient knows they're being monitored could have an impact on all sorts of behaviors.
Yeah, these are interesting results, but without a control group you can't say for certain what is causing an effect or, actually, if an effect exists.
While interesting this is a highly flawed study. It should be considered preliminary with more properly controlled followup studies. 1. No control group You need to have a control group that continues eating a standard healthy diet that includes animal products. The 11% who were non-adherent could have been eating unhealthy diets which contributed to their instances of CAD. Without a control it could have just been e…
"This study had several limitations. First, it included self-selected, very deter- mined patients. Without a control group, it is challenging to establish causality and as- sess how much of the observed changes are specifically due to the diet. Only some of the observed beneficial outcomes may have been due to the diet. This study was not pro- spectively randomized. Nevertheless, this fact does not detract from proof of concept that major cardiovascular events occurred in probably The past several decades have witnessed a substantial and sustained reduction in CAD. Nevertheless, CAD remains the number one killer of women and men in this country. Thousands of stable patients having stents experience no reduction in major cardiac events.6 While drugs have some effects on disease initiation and progression, these in- terventions do not address disease causation. Not surprisingly, most patients experience disease progression, more drugs, more im- aging, repeat interventions, progressive dis- ability, and, too often, death from a disease of western malnutrition, the cause of which has been largely left untreated. We have in press several patient experiences that exemplify the repeated failure of present-day cardiac drugs and procedural interventions, and that confirm the capacity of whole-food plant- based nutrition to restore health in “there is nothing further we can do” situations.36
In summary, the present cardiovascular medicine approach tested beyond 40 years can neither cure the disease nor end the epi- demic and is financially unsustainable. The safety, diminished expense, and prompt, powerful, and persistent results in treating the cause of vascular disease by whole-food plant-based nutrition offer a paradigm shift from existing practice. We think the time is right for a controlled trial. But in the mean- time, the data are sound and strong enough that patients should be informed of this option."
This was some years ago now, but I saw the PI of the Nurses's Health Study [0] (I don't remember if it was Speizer or Willett; probably Willet) give a talk at Harvard. This was just after I read The China Study [1] -- a book recommended by Prevent and Reverse Heart Disease, which was given to participants of this study. The recommendations of the NHS [2] seem to disagree with the more extreme diets of TCS and this study. I asked about this in the Q&A. The speaker dismissed TCS, saying that the their data did not in fact support their conclusions. It seems Willett and Campbell have had an ongoing exchange [3] in the literature.
[2] "A Mediterranean-type diet reduces risk of incident CHD and stroke. Fish intake reduces risk of stroke. Nut and wholegrain consumption reduces risk of CHD. Refined carbohydrates and trans fats increase risk.", see:
While interesting this is a highly flawed study. It should be considered preliminary with more properly controlled followup studies. 1. No control group You need to have a control group that continues eating a standard healthy diet that includes animal products. The 11% who were non-adherent could have been eating unhealthy diets which contributed to their instances of CAD. Without a control it could have just been e…
"This study had several limitations. First, it included self-selected, very deter- mined patients. Without a control group, it is challenging to establish causality and as- sess how much of the observed changes are specifically due to the diet. Only some of the observed beneficial outcomes may have been due to the diet. This study was not pro- spectively randomized. Nevertheless, this fact does not detract from proof…
Thanks for including that.
> These data convey a strong message of patients accepting empowerment to be the locus of control to arrest their disease and confirm that patients will adopt a significant lifestyle transition to plant-based nutrition to halt and regress what we believe is a largely food- borne illness.
In other words, they conclude that diet can impact CAD and some people will be willing to change their diet. No surprise there. The fact that the study was for plant-based nutrition holds very little relevance since there was no control group. It could simply be that people transitioned to a healthy diet. We can't know for sure without proper controls.
While interesting this is a highly flawed study. It should be considered preliminary with more properly controlled followup studies. 1. No control group You need to have a control group that continues eating a standard healthy diet that includes animal products. The 11% who were non-adherent could have been eating unhealthy diets which contributed to their instances of CAD. Without a control it could have just been e…
I don't know if it's highly flawed, though it does have the flaws you mention. The numbers may be true, but they don't smell right to me. 90% adherence for a significant change in diet for the long-term of three and a half years? Even for people who've had close shaves with death and those who have 'every intention' of following through, this seems absurdly high.
Similarly the marked difference in effects between the groups - two thirds of the non-adherent group versus a single case in the 177 adherents, in terms of having another event? It's not like the benefits of vegetarianism all arrive the following day - I would have thought there'd likely be a few more in the adherents group that had an event while they were still 'in transition'.
It may all very well be true, but it does smell a little funny.
While interesting this is a highly flawed study. It should be considered preliminary with more properly controlled followup studies. 1. No control group You need to have a control group that continues eating a standard healthy diet that includes animal products. The 11% who were non-adherent could have been eating unhealthy diets which contributed to their instances of CAD. Without a control it could have just been e…
This post needs to be higher. Note the weasel-words about this being an adjunct to normal cardiovascular care:
>These patients with established cardiovascular disease (CVD) were interested in transitioning to plant-based nutrition as an adjunct to usual cardiovascular care.
In other words, this study cannot establish that the statins these patients were already taking didn't account for their perceived health benefits.
Link to PDF of full article: http://www.jfponline.com/fileadmin/qhi/jfp/pdfs/6307/JFP_063...
Thank you for that!
Seconded. We've changed the url to that from http://www.jfponline.com/articles/editor-s-pick/article/a-wa.... We've also reverted the title. The submitted title ("A 99.4% effective way to reverse Coronary Artery Disease (CAD).") seemed pretty editorialized.