What you're describing is basically the same as what is called the "healthy user bias", where healthy behaviours or behaviours that are socially percieved as healthy tend to associate to each other, and the same happens with unhealthy behaviours. I agree it is probably the only explanation for the positive results of PUFA in obseravtional studies.
Posts made by Vapid Bobcat
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RE: Why is the epidemiological literature overwhelmingly in favor of PUFAs?
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RE: Why is the epidemiological literature overwhelmingly in favor of PUFAs?
@Kasper
Is there a reason to believe stress levels would be higher among people consuming less PUFAs? Because that's what you're implying here.If you have a large enough sample, there's no reason to assume stress levels would be significantly different between those at low vs high intakes of PUFA, thus it's pointless to account for chronic stress in such an analysis. The point of these studies is precisely to isolate the effect of PUFA specifically on health outcomes.
Ecological studies like the Israeli or Japanese ones are arguably far more confounded and less relevant than the meta analysis I posted. Is it the lack of PUFA that made Tokelauans healthy or the myriad of other factors that distinguishes them from the average westerner?
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RE: Why is the epidemiological literature overwhelmingly in favor of PUFAs?
Researchers obviously control for relevant variables such as energy intake, socioeconomic status etc. What reason is there to believe work stress or social life would significantly differ between thosa at low vs high PUFA intake?
I agree that looking at biomarkers such as cholesterol is not a reliable way of assessing a persons health. But studies looking at hard outcomes paint the same picture in favor of PUFA.
Ray Peat was against both omega 3 and 6...
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Benefits of completely eliminating starch and replacing it with simple sugars?
Did anyone try eliminating starch entirely and relying exclusively on simple sugars? Did it make a difference?
Also, did you experience problems with reintroducing starch?
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RE: Why is the epidemiological literature overwhelmingly in favor of PUFAs?
Thanks for sharing your thoughts. From what I gather, you seem to agree with me on healthy user bias being the main reason for the association.
"The healthy user effect is best described as the propensity for patients who receive one preventive therapy to also seek other preventive services or partake in other healthy behaviors.18 Patients who choose to receive preventive therapy may exercise more, eat a healthier diet, wear a seatbelt when they drive, and avoid tobacco. As a result, an observational study evaluating the effect of a preventive therapy (e.g., statin therapy) on a related outcome (e.g., myocardial infarction) without adjusting for other related preventive behaviors (e.g., healthy diet or exercise) will tend to overstate the effect of the preventive therapy under study. The healthy user effect has been widely cited as a likely source of bias in observational studies of HRT. Studies indicate that women who took HRT were more likely to engage in healthy behaviors such as regular exercise, a healthy diet, abstinence from alcohol, and maintenance of a healthy weight as compared to non-users.2 The apparent protective effect of HRT on cardiovascular disease likely reflects these unmeasured differences in patient characteristics."
In this case, the "preventive therapy" would be eating more PUFAs.
Underreporting alcohol and energy intake could be thought of as an extension of healthy (or in this case unhealthy) user bias
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RE: Why is the epidemiological literature overwhelmingly in favor of PUFAs?
@JulofEnoch Thanks for the elaborate answer. I will focus on the second study since it's more general.
I agree that food frecuency questionnaries are extremely limited, but they should probably be good enough to at least discriminate between those at the highest vs lowest perecentiles of PUFA intake.
By its very nature, I doubt MR is a valid way to assess the impact of dietary exposures. Serum omega 6 is not the same as tissue omega-6, and high omega-6 intake doesn't always lead to high serum omega-6.
We know that observational epidemiology cannot make causal inferences, but one has to wonder why high PUFAs, if they truly are the problem Ray Peat outlines them to be, rarely associate with worse health outcomes.
I agree that healthy user bias is probably explaining part or maybe all of the effect of PUFAs on different outcomes. Another possible explanation is over-adjustment for variables such as BMI.
But I still wonder if Peat or the community have found better explanations.
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RE: Why is the epidemiological literature overwhelmingly in favor of PUFAs?
@dan-saintdominic Isn't PUFA being the scourge of the modern diet a main tenet of the Ray Peat philosohpy?
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RE: Why is the epidemiological literature overwhelmingly in favor of PUFAs?
@thyroidchor27 I read the conclusion, obviously. What are you trying to state?
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RE: Why is the epidemiological literature overwhelmingly in favor of PUFAs?
@skylark How are the examples I provided not "real life"?
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Why is the epidemiological literature overwhelmingly in favor of PUFAs?
In pretty much every retrospective, cohort study or RCT I happen to take a look at, higher PUFA consumption, especially linoleic acid, almost always leads to better outcomes than lower PUFA consumption.
Example of a study I came upon by chance: https://pubmed.ncbi.nlm.nih.gov/35170737/
Higher n-6 PUFA consumption cuts the risk of dying by half in newly diagnosed head/neck cancer patients.
Example 2:
https://pubmed.ncbi.nlm.nih.gov/34434952/Highest vs lowest PUFA quartile associated with 20% decreased all-cause mortality
Is healthy user bias enough to explain this?
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RE: Cold hands & feet – discuss causes & remedies
Has anyone improved cold hand and feet?
Despite having improved my core temperatures (I'm usually in the 98.6 - 99°F range), my hands and feet become freezing after the smallest drop in room temperature.
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RE: Is Ray Peat Legit? My thoughts:
@honest_skeptic Maybe you should spend some time digging into Peat's work before making these half-assed assumptions about him
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Why does epidemiology show a benefitial role of PUFAs?
I assume the Ray Peat community or even Peat himself has a perfectly rational explanation for why PUFAs, including linoleic acid, appear to be protective against death and a multitude of diseases in epidemiology.
* Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association (2017):
Total and cause-specific mortality. Hazard ratio (95% confidence interval) for substituting energy from saturated fat by the same energy from specific types of fat. Nurses’ Health Study and Health Professionals Follow-up Study.
* Association of Specific Dietary Fats With Total and Cause-Specific Mortality (2016):
During 3 439 954 person-years of follow-up, 33 304 deaths were documented. After adjustment for known and suspected risk factors, dietary total fat compared with total carbohydrates was inversely associated with total mortality (hazard ratio [HR] comparing extreme quintiles, 0.84; 95% CI, 0.81-0.88; P < .001 for trend). The HRs of total mortality comparing extreme quintiles of specific dietary fats were 1.08 (95% CI, 1.03-1.14) for saturated fat, 0.81 (95% CI, 0.78-0.84) for polyunsaturated fatty acid (PUFA), 0.89 (95% CI, 0.84-0.94) for monounsaturated fatty acid (MUFA), and 1.13 (95% CI, 1.07-1.18) for trans-fat (P < .001 for trend for all). Replacing 5% of energy from saturated fats with equivalent energy from PUFA and MUFA was associated with estimated reductions in total mortality of 27% (HR, 0.73; 95% CI, 0.70-0.77) and 13% (HR, 0.87; 95% CI, 0.82-0.93), respectively. The HR for total mortality comparing extreme quintiles of ω-6 PUFA intake was 0.85 (95% CI, 0.81-0.89; P < .001 for trend). Intake of ω-6 PUFA, especially linoleic acid, was inversely associated with mortality owing to most major causes, whereas marine ω-3 PUFA intake was associated with a modestly lower total mortality (HR comparing extreme quintiles, 0.96; 95% CI, 0.93-1.00; P = .002 for trend).
Dietary intake of SFA, when substituted for total carbohydrates, was associated with slightly higher cancer mortality (HR comparing extreme quintiles, 1.07; 95% CI, 0.98-1.17; P = .02 for trend), whereas PUFA intake, especially linoleic acid intake, was associated with modestly lower cancer mortality (HR comparing extreme quintiles of PUFA intake, 0.93; 95% CI, 0.87-0.99;P = .02 for trend) (eTables 13 and 14 in theSupplement). Other Major subclasses of dietary fat generally were not associated with cancer mortality except that α-linolenic acid intake was associated with a slightly elevated risk for cancer mortality (eTables 13 and 14 in the Supplement). However,this association was not significant when recent α-linolenic acid intake was analyzed (eTable 7 in the Supplement). We observed inverse associations of PUFA and MUFA intakes and strong positive associations of TFA intake with neurodegenerative (eTable 15 in the Supplement) and respiratory (eTable 16 in the Supplement) disease mortality. Higher SFA intake was associated with a substantial increase of mortality due to respiratory disease (HR comparing extreme quintiles, 1.56; 95% CI, 1.30-1.87;P < .001 for trend). Among Major PUFAs, ω-3 PUFA intake, primarily α-linolenic acid,was inversely associated with neurodegenerative disease mortality (eTable 17 in the Supplement). Marine ω-3 PUFA intake was inversely associated with respiratory disease mortality (eTable 18 in the Supplement). Sensitivity analyses minimally changed these results for causespecific mortality."
If PUFAs are the scourge Ray Peat claims they are, shouldn't we expect to see people at the highest percentiles of PUFA intakes get sick more and die more than the ones with the lowest PUFA intakes?