Oddbean

I also think heart disease and gout are potential problems in the carnivore diet. But also cancer and malnutrition - there are a lot of nutrients proven to protect against cancers that are found in vegetables and fruits (e.g. berries), and also many are produced by gut bacteria when they are feed indigestable fibers (which are counted as carbohydrates) This is what I think I know (I could be wrong of course, apparently I need to add disclaimers to everything I say now-a-days even though it should be obvious): This data comes from dozens of sources I could not easily cite at this point. Much of the expert opinions come from thousands of studies, careful evaluation of which ones are good (only about 15%) and which ones matter most (maybe only 2%). Anybody can "find a study" that says anything they want to hear, so be extremely careful about making conclusions from just 1 or 2 studies. Many studies show LDL lowering reduces mortality, here is one just for kicks, but do not just accept single studies like this or any other: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812424/ Heart disease ------------- Heart disease seems to be caused by: 1. Unmodifiable factors: Age, maleness, family history and other genetic components 2. The concentration of ApoB lipoprotein in your bloodstream, integrated over time (high concentrations for short time periods don't add much to this integral) 3. Modulated by hypertension (higher blood pressure increases the rate) 4. Modulated by inflammation (reducing inflammation in the endothelial lining reduces the rate) 5. Made worse by other things that may damage your endothelial lining (smoking, elevated glucose for a long time, etc). Most people don't get their ApoB measured, but LDL is a close proxy for it. The carnivore diet raises LDL. In some people (hyperresponders) it raises LDL massively. Also it has been around forever - Egyptian Pharoahs had heart disease. The 'ice man' had heart disease. It's not caused by modern diets or "bread" it has been with us forever and not weeded out by evolution because it is a late-stage disease of aging. Modern medicine has good solutions for preventing this disease which target LDL cholesterol. In particular: 1. If you are a hyper-producer of cholesterol, statin drugs very sigificantly lowers your LDL. 2. If you are a hyper-absorber of cholesterol, ezetimibe very sigificantly lowers your LDL. 3. Baby aspirin significantly lowers your inflammation (but may make gout worse) 4. Multiple drugs significantly lower your blood pressure (ACE inhibitors, ARBs, calcium channel blockers, beta blockers, diuretics). Diet can also have a significant effect: 1. Lots of PUFAs (I know it's unpopular, but Canola oil is magically powerful against atherosclerosis), you can use nuts and seeds for these if you don't want seed oils. 2. Low saturated fat (which causes cholesterol), which lowers the level of ApoB 3. Low simple carbs (which raise triglycerides which also have an impact) Weight loss has a significant positive effect, no matter how you do it. If you lose weight on carnivore, the weight loss part of what you did was protective against atherosclerosis. Exercise is also proven to have a sigificant effect, independent of any weight loss it may also provide. Your body has a lot of ways to deal with atheromas in a "safe" way: they tend to develop hard fibrous caps which protects you (they won't break and spill out and form a clot when they have a firm cap). Also, your blood vessels will form new tiny capillaries to carry blood around any narrowings. And your blood vessels will expand to make more room when there is a narrowing. So the lifetime buildup isn't really much of a worry as your body adapts to it. Exercise helps to maximize this adaptation. The real worry is when a fresh atheroma with a soft cap bursts. If you keep your inflammation and blood pressure down and your diet good, you can avoid these fresh atheromas and live a long life, even if you can't "reverse" heart disease (some doctors claim they can revese it, but most professionals have reason to doubt that. I also doubt it is reversable). Gout ---- This is a simple disease. You have too much uric acid, which has gotten to a high enough level that it crystallizes out into monosodium urate crystals. Your immune system can attack these crystals once they get into the wrong places (tiny areas in your joints, often your big toe). They aren't attacked right-off-the-bat and by the time you have a gout attack you usually have quite a lot of crystal build-up. The cause is either (1) Too much uric acid production, either (a) too many purines in your diet, or (b) too much break down of your body's tissues, or (2) your kidneys aren't filtering out the uric acid fast enough. Some people turn over cellular material rapidly (1b) or don't have good kidney function (2), but eating a high purine diet can cause it all on it's own. Purines are essentially from DNA. The amount of purines you eat are proporational to the number of cells you eat. Baby spinich has high purines compared to adult spinach because the cells are smaller. Same with baby fish vs adult fish. Organ meat has more smaller cells. Yeast is tons of tiny cells. Eggs are one giant cell with essentially no purines. Milk isn't cellular and has no purines. Gout isn't dangerous and is reversible (modulo any joint damage it caused that persists), but it is painful and best avoided.

If you want to dig into this to find out who is right (some people say cholesterol doesn't matter), this is one of the sources I like: https://www.youtube.com/@NutritionMadeSimple This guy so far, I can't tell what his biases are, except that he reads lots of studies, has a skeptical mind, and hones very close to the science. He explains clearly WHY he is saying what he is saying and he shows you the studies. Almost everybody else has some bias, even people who I think are great. This guy so far is unimpeachable from my point of view. Here are some of his videos on the topic: https://www.youtube.com/watch?v=hfztSGyBf_s - Cardiac surgeon says: Cholesterol doesn't matter!!?! https://www.youtube.com/watch?v=ntD4eN-9t-Q - Atherosclerosis | Cholesterol, LDL, HDL, Triglycerides https://www.youtube.com/watch?v=CxX51n2Z0vc - LOW cholesterol increases death? | New study https://www.youtube.com/watch?v=a3lHHnOHyr8 - Cholesterol & Risk of Death | New Evidence Emerges https://www.youtube.com/watch?v=6dCEcsWYL94 - Low carb Cardiologist on Saturated Fat, Cholesterol & ApoB | Dr. Ethan Weiss

wow, thanks Mike! This is a lot to go through, will keep my nights busy for a while! Great to hear multiple perspectives and I do recognize that no one should trust one study alone (like you said, you can find a study to fit any narrative). Man.. this is freaking complicated just due to sheer contradictory claims!

I know. I'm still sorting this stuff out too. The claims about seed oils, about inflammation caused by high blood sugar, about oxidized oils. about keto... they are "alternative" and I'm still trying to find out how much evidence there is on both sides. It seems that the evidence is against these notions, but the notions are very very popular in common culture now, and new ideas won't have a lot of evidence yet.. unless they are directly contrary to established evidence (which some of these are). So anyhow, if you find a good source and I'd benefit from it please pass it on. I remain open-minded, while maintaining a current view.

Actually that was a great resource. I looked up all the names of people who promote this diet to find out when they died, so I could calculate all-cause mortality of people promoting carnivore versus people promoting any one of (mediterranean, vegetarian or vegan). Most are still alive (and young). This "study" of mine suffers from selection bias. I have to pick people who are known, known to have strongly promoted and followed the diet, and who died, and we know what age they died at (the reason they died is not included because that is too easy to fake or lie about or requires us to investigate uncertain causal links -- even when we know it was a car accident for example). I'm happy to add more people if they are famous and the data for them is published, it's an open ongoing study. To counteract my selection bias, I encourage you to point me to more Carnivore people who lived long, or more Vegetarian people who died young. But they have to be famous known people who publicly promoted the diet. I added my ancestors to the vegetarian list even though they don't fit the criteria, because their data doesn't actually change the number much (makes it slightly lower) and it just makes it more certain for me that this isn't some mistake. Carnivore (this group just started with your data, thank you): Owsley Stanley: 76 Vilhjalmur Stefansson: 83 Barry Groves 77 Walter L Voegtlin 71 Blake F Donaldson 73 Atkins 72 Dr. Alfred W Pennington 56 Charles Poliquin 57 Average: 70.625 Mediterranean, Vegetarian or Vegan: Dame Harriette Chick 102 Caldwell Esselstyn 90 Blackburn, Henry 97 John Harvey Kellogg 91 Ancel Keys 100 Jack Lalanne 96 Nathan Pritikin 69 Jeremiah Stamler 102 Ellen G White 87 My G. Great Grandma Gass 99 (SDA vegetarian) My Great Grandma Paxton 89 (SDA vegetarian) My Grandma 79 (SDA vegetarian) Average: 91.75 Seems like the carnivore people die 20 years younger.

There are studies with half a million people that show higher mortality rates for red meat consumers. Been around for a while. My problem with those studies is that they don't mention anything about sugar consumption.

It is not practical to do an RCT on long-term diseases. We know the reverse causation hypothesis is not true: that dying young causes people to eat meat earlier in their life. So the only other hypothesis that I'm aware of is that some third factor causes people to both eat less meat and to live longer. That is called a confounder. And epidemiologists have nightmares about the confounders that they didn't think of. There are always unknown unknowns, so we can always be wrong. But proof isn't what we should be looking for because science doesn't give that anyways. We should look at the weight of the evidence and decide what seems most likely. My read of the evidence is that it is highly likely that high meat consumption causes shorter lives, and even probably because of the saturated fat and not from something else. That is, I believe it is highly likely that coconut oil would do the same thing. BTW: in studies on atherosclerosis in animal models, do you know what the standard method is to create a rat or mouse with atherosclerosis is so you can do an experiment on an atherosclerotic animal? It is to feed them coconut oil.

However, unlike all the other studies you don't have to trust the researcher on this one. Some people are hyper-skeptical of science. So by having a study they can check for themselves, it might actually mean more to them.

All pre industrial tribes passed their genes thanks to animal products. Price went on an expedition upon the invention of modern air travel to find and study primitive peoples, their diets, and the effect of modernized foods (i.e. 100% non animal foods). Price hypothesis was that in some corner of the Earth there is a superior vegan diet. https://m.media-amazon.com/images/I/91I7wBR067L._SL1500_.jpg

Same, I am very open minded and could care less who is correct, as long as there are facts there. I am doubly skeptical of meat only claims simply because there's a meat lobby and they could have their tentacles influencing all sorts of people and possibly studies. I don't see why anyone would try to influence anti-meat claims as that entails the rest of the food. But still, I remain open.

From my very limited to no education on this, what I've briefly understood, is it's less an issue with the cholesterol itself, and more about how sugar invokes an inflammatory response, triggering damage and then a build up of cholesterol causing blockages.