Guest guest Posted March 19, 2011 Report Share Posted March 19, 2011 Q- Where is the focus of our 5 minute cardiac diet education? What is the makeup of our hospital cardiac diets? The logic in this article carries over for me regarding cardiac health diet guidelines. The accepted truth has always been that a low fat diet will lower cholesterol which correlates with a reduce risk of heart disease. Is this evidence based? Current research showing 30% fat diets that are high in O-3 fats, high in MUFA, moderate in naturally occurring saturated fats, low in O-6 and trans fats are associated with higher levels of HDL and lower levels of oxidized LDL which is associated with reduced risk of heart disease. Old school- eggbeater omelet, smart balance margarine, skim milk, dry chicken breast w Lipitor therapy = cardiac diet. Current research- Have a real egg. Add some avocado, hold the fake margarine and go for real butter. Add Grass feed beef, add olives, and organic 2% milk for some folks. Manipulate your fat intakes, recheck labs, then look into meds if necessary. Anyone teaching cardiac folks anything other than a low fat diet? Osowski MS, RD, LD Registered Dietitian Sent from my iPhone On Mar 19, 2011, at 7:02 AM, ne wrote: > An interesting excerpt from " The Truth Wears Off " -- an examination of > research studies on today's drugs. Some of these drugs influence > appetite and/or weight change and may be of interest to RDs. - ne > > " On September 18, 2007, a few dozen neuroscientists, psychiatrists, and > drug-company executives gathered in a hotel conference room in Brussels > to hear some startling news. It had to do with a class of drugs known as > atypical or second-generation antipsychotics, which came on the market > in the early nineties. The drugs, sold under brand names such as > Abilify, Seroquel, and Zyprexa, had been tested on schizophrenics in > several large clinical trials, all of which had demonstrated a dramatic > decrease in the subjects' psychiatric symptoms. As a result, > second-generation antipsychotics had become one of the fastest-growing > and most profitable pharmaceutical classes. By 2001, Eli Lilly's Zyprexa > was generating more revenue than Prozac. It remains the company's > top-selling drug. > > " But the data presented at the Brussels meeting made it clear that > something strange was happening: the therapeutic power of the drugs > appeared to be steadily waning. A recent study showed an effect that was > less than half of that documented in the first trials, in the early > nineteen-nineties. Many researchers began to argue that the expensive > pharmaceuticals weren't any better than first-generation antipsychotics, > which have been in use since the fifties. 'In fact, sometimes they now > look even worse,' , a professor of psychiatry at the > University of Illinois at Chicago, told me. > > " Before the effectiveness of a drug can be confirmed, it must be tested > and tested again. Different scientists in different labs need to repeat > the protocols and publish their results. The test of replicability, as > it's known, is the foundation of modern research. Replicability is how > the community enforces itself. It's a safeguard for the creep of > subjectivity. Most of the time, scientists know what results they want, > and that can influence the results they get. The premise of > replicability is that the scientific community can correct for these flaws. > > " But now all sorts of well-established, multiply confirmed findings have > started to look increasingly uncertain. It's as if our facts were losing > their truth: claims that have been enshrined in textbooks are suddenly > unprovable. This phenomenon doesn't yet have an official name, but it's > occurring across a wide range of fields, from psychology to ecology. In > the field of medicine, the phenomenon seems extremely widespread, > affecting not only antipsychotics but also therapies ranging from > cardiac stents to Vitamin E and antidepressants: has a forthcoming > analysis demonstrating that the efficacy of antidepressants has gone > down as much as threefold in recent decades. > For many scientists, the effect is especially troubling because of what > it exposes about the scientific process. If replication is what > separates the rigor of science from the squishiness of pseudoscience, > where do we put all these rigorously validated findings that can no > longer be proved? Which results should we believe? Francis Bacon, the > early-modern philosopher and pioneer of the scientific method, once > declared that experiments were essential, because they allowed us to > 'put nature to the question.' But it appears that nature often gives us > different answers. ... > > " [ph Banks Rhine, a psychologist at Duke, came to call this trend > toward a reduction in the strength of proof for a theory he had > developed in the early nineteen-thirties] the 'decline effect.' > > " According to Ioannidis, an epidemiologist at Stanford University, > the main problem is that too many researchers engage in what he calls > 'significance chasing,' or finding ways to interpret the data so that it > passes the statistical test of significance - the ninety-five-per-cent > boundary invented by Fisher. 'The scientists are so eager to pass > this magical test that they start playing around with the numbers, > trying to find anything that seems worthy,' Ioannidis says. In recent > years, Ioannidis has become increasingly blunt about the pervasiveness > of the problem. One of his most cited papers has a deliberately > provocative title: 'Why Most Published Research Findings Are False.' > > " The problem of selective reporting is rooted in a fundamental cognitive > flaw, which is that we like proving ourselves right and hate being > wrong. 'It feels good to validate a hypothesis,' Ioannidis said. 'It > feels even better when you've got a financial interest in the idea or > your career depends upon it. And that's why, even after a claim has been > systematically disproven' - he cites, for instance, the early work on > hormone replacement therapy, or claims involving various vitamins - 'you > still see some stubborn researchers citing the first few studies that > show a strong effect. They really want to believe that it's true.' ... > > " The disturbing implication of a study [conducted in the late > nineteen-nineties by Crabbe, a neuroscientist at the Oregon Health > and Science University] is that a lot of extraordinary scientific data > are nothing but noise. The problem, of course, is that ... dramatic > findings are ... the most likely to get published in prestigious > journals, since the data are both statistically significant and entirely > unexpected. Grants get written, follow-up studies are conducted. The end > result is a scientific accident that can take years to unravel. > > " This suggests that the decline effect is actually a decline of > illusion. While Karl Popper imagined falsification occurring with a > single, definitive experiment - Galileo refuted Aristotelian mechanics > in an afternoon - the process turns out to be much messier than that. > Many scientific theories continue to be considered true even after > failing numerous experimental tests. Verbal overshadowing might exhibit > the decline effect, but it remains extensively relied upon within the > field. The same holds for any number of phenomena, from the disappearing > benefits of second-generation antipsychotics to the weak coupling ratio > exhibited by decaying neutrons, which appears to have fallen by more > than ten standard deviations between 1969 and 2001.... > > " Such anomalies demonstrate the slipperiness of empiricism. Although > many scientific ideas generate conflicting results and suffer from > falling effect sizes, they continue to get cited in the textbooks and > drive standard medical practice. Why? Because these ideas seem true. > Because they make sense. Because we can't bear to let them go. And this > is why the decline effect is so troubling. Not because it reveals the > human fallibility of science, in which data are tweaked and beliefs > shape perceptions. (Such shortcomings aren't surprising, at least for > scientists.) And not because it reveals that many of our most exciting > theories are fleeting fads and will soon be rejected. (That idea has > been around since Kuhn.) The decline effect is troubling because > it reminds us how difficult it is to prove anything. We like to pretend > that our experiments define the truth for us. But that's often not the > case. Just because an idea is true doesn't mean it can be proved. And > just because an idea can be proved doesn't mean it's true. When the > experiments are done, we still have to choose what to believe. " > > Author: Jonah Lehrer > Title: " The Truth Wears Off " > Publisher: The New Yorker > Date: December 13, 2010 > Pages: 52-57 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 19, 2011 Report Share Posted March 19, 2011 We have been teaching DASH principles with fish (Omega-3) & high fiber along with traditional " low fat cooking " attachments.  Holly ---------- Holly Lee Brewer, MS RD CDE Pediatric Dietitian, Diabetes Educator Medical Nutrition Therapist, Las Vegas, NV Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com 301st MDS, NAS JRB Fort Worth (Carswell), TX Joint Base Balad, Iraq (Jan-Jul 2009) ________________________________ To: " rd-usa " <rd-usa > Cc: " Nutrition_Reports " <Nutrition_Reports > Sent: Sat, March 19, 2011 12:10:22 PM Subject: Re: Drug research and 'significance chasing,' in today's medical field  Q- Where is the focus of our 5 minute cardiac diet education? What is the makeup of our hospital cardiac diets? The logic in this article carries over for me regarding cardiac health diet guidelines. The accepted truth has always been that a low fat diet will lower cholesterol which correlates with a reduce risk of heart disease. Is this evidence based? Current research showing 30% fat diets that are high in O-3 fats, high in MUFA, moderate in naturally occurring saturated fats, low in O-6 and trans fats are associated with higher levels of HDL and lower levels of oxidized LDL which is associated with reduced risk of heart disease. Old school- eggbeater omelet, smart balance margarine, skim milk, dry chicken breast w Lipitor therapy = cardiac diet. Current research- Have a real egg. Add some avocado, hold the fake margarine and go for real butter. Add Grass feed beef, add olives, and organic 2% milk for some folks. Manipulate your fat intakes, recheck labs, then look into meds if necessary. Anyone teaching cardiac folks anything other than a low fat diet? Osowski MS, RD, LD Registered Dietitian Sent from my iPhone On Mar 19, 2011, at 7:02 AM, ne wrote: > An interesting excerpt from " The Truth Wears Off " -- an examination of > research studies on today's drugs. Some of these drugs influence > appetite and/or weight change and may be of interest to RDs. - ne > > " On September 18, 2007, a few dozen neuroscientists, psychiatrists, and > drug-company executives gathered in a hotel conference room in Brussels > to hear some startling news. It had to do with a class of drugs known as > atypical or second-generation antipsychotics, which came on the market > in the early nineties. The drugs, sold under brand names such as > Abilify, Seroquel, and Zyprexa, had been tested on schizophrenics in > several large clinical trials, all of which had demonstrated a dramatic > decrease in the subjects' psychiatric symptoms. As a result, > second-generation antipsychotics had become one of the fastest-growing > and most profitable pharmaceutical classes. By 2001, Eli Lilly's Zyprexa > was generating more revenue than Prozac. It remains the company's > top-selling drug. > > " But the data presented at the Brussels meeting made it clear that > something strange was happening: the therapeutic power of the drugs > appeared to be steadily waning. A recent study showed an effect that was > less than half of that documented in the first trials, in the early > nineteen-nineties. Many researchers began to argue that the expensive > pharmaceuticals weren't any better than first-generation antipsychotics, > which have been in use since the fifties. 'In fact, sometimes they now > look even worse,' , a professor of psychiatry at the > University of Illinois at Chicago, told me. > > " Before the effectiveness of a drug can be confirmed, it must be tested > and tested again. Different scientists in different labs need to repeat > the protocols and publish their results. The test of replicability, as > it's known, is the foundation of modern research. Replicability is how > the community enforces itself. It's a safeguard for the creep of > subjectivity. Most of the time, scientists know what results they want, > and that can influence the results they get. The premise of > replicability is that the scientific community can correct for these flaws. > > " But now all sorts of well-established, multiply confirmed findings have > started to look increasingly uncertain. It's as if our facts were losing > their truth: claims that have been enshrined in textbooks are suddenly > unprovable. This phenomenon doesn't yet have an official name, but it's > occurring across a wide range of fields, from psychology to ecology. In > the field of medicine, the phenomenon seems extremely widespread, > affecting not only antipsychotics but also therapies ranging from > cardiac stents to Vitamin E and antidepressants: has a forthcoming > analysis demonstrating that the efficacy of antidepressants has gone > down as much as threefold in recent decades. > For many scientists, the effect is especially troubling because of what > it exposes about the scientific process. If replication is what > separates the rigor of science from the squishiness of pseudoscience, > where do we put all these rigorously validated findings that can no > longer be proved? Which results should we believe? Francis Bacon, the > early-modern philosopher and pioneer of the scientific method, once > declared that experiments were essential, because they allowed us to > 'put nature to the question.' But it appears that nature often gives us > different answers. ... > > " [ph Banks Rhine, a psychologist at Duke, came to call this trend > toward a reduction in the strength of proof for a theory he had > developed in the early nineteen-thirties] the 'decline effect.' > > " According to Ioannidis, an epidemiologist at Stanford University, > the main problem is that too many researchers engage in what he calls > 'significance chasing,' or finding ways to interpret the data so that it > passes the statistical test of significance - the ninety-five-per-cent > boundary invented by Fisher. 'The scientists are so eager to pass > this magical test that they start playing around with the numbers, > trying to find anything that seems worthy,' Ioannidis says. In recent > years, Ioannidis has become increasingly blunt about the pervasiveness > of the problem. One of his most cited papers has a deliberately > provocative title: 'Why Most Published Research Findings Are False.' > > " The problem of selective reporting is rooted in a fundamental cognitive > flaw, which is that we like proving ourselves right and hate being > wrong. 'It feels good to validate a hypothesis,' Ioannidis said. 'It > feels even better when you've got a financial interest in the idea or > your career depends upon it. And that's why, even after a claim has been > systematically disproven' - he cites, for instance, the early work on > hormone replacement therapy, or claims involving various vitamins - 'you > still see some stubborn researchers citing the first few studies that > show a strong effect. They really want to believe that it's true.' ... > > " The disturbing implication of a study [conducted in the late > nineteen-nineties by Crabbe, a neuroscientist at the Oregon Health > and Science University] is that a lot of extraordinary scientific data > are nothing but noise. The problem, of course, is that ... dramatic > findings are ... the most likely to get published in prestigious > journals, since the data are both statistically significant and entirely > unexpected. Grants get written, follow-up studies are conducted. The end > result is a scientific accident that can take years to unravel. > > " This suggests that the decline effect is actually a decline of > illusion. While Karl Popper imagined falsification occurring with a > single, definitive experiment - Galileo refuted Aristotelian mechanics > in an afternoon - the process turns out to be much messier than that. > Many scientific theories continue to be considered true even after > failing numerous experimental tests. Verbal overshadowing might exhibit > the decline effect, but it remains extensively relied upon within the > field. The same holds for any number of phenomena, from the disappearing > benefits of second-generation antipsychotics to the weak coupling ratio > exhibited by decaying neutrons, which appears to have fallen by more > than ten standard deviations between 1969 and 2001.... > > " Such anomalies demonstrate the slipperiness of empiricism. Although > many scientific ideas generate conflicting results and suffer from > falling effect sizes, they continue to get cited in the textbooks and > drive standard medical practice. Why? Because these ideas seem true. > Because they make sense. Because we can't bear to let them go. And this > is why the decline effect is so troubling. Not because it reveals the > human fallibility of science, in which data are tweaked and beliefs > shape perceptions. (Such shortcomings aren't surprising, at least for > scientists.) And not because it reveals that many of our most exciting > theories are fleeting fads and will soon be rejected. (That idea has > been around since Kuhn.) The decline effect is troubling because > it reminds us how difficult it is to prove anything. We like to pretend > that our experiments define the truth for us. But that's often not the > case. Just because an idea is true doesn't mean it can be proved. And > just because an idea can be proved doesn't mean it's true. When the > experiments are done, we still have to choose what to believe. " > > Author: Jonah Lehrer > Title: " The Truth Wears Off " > Publisher: The New Yorker > Date: December 13, 2010 > Pages: 52-57 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2011 Report Share Posted March 20, 2011 Old school 1970s teaching: real eggs limit 3 x week, nuts fine, avacado fine, olives fine, butter fine, fortified margarine was used by some due to economics and what their MD suggested but there were always healthy choices in fat group, even bacon for those who were allowed a slice now and then, lots of fruits and veggies and foods high in vit a c d e and k all fortified whole grains and fiber we had no such thing as lipitor, extra niacin for those with high cholesterol, limit meat and poultry to 2 / 2-3 oz servings, fortified vit d skim milk and milk, yogurt products, eat fish, avoid salt cured and salty products, na 2-4g day, those that used salt used iodized, just the right calories, fats, carbohdrates and protein. Meet dv for all vit & min.. Walk 30 minutes 3-4 times a week and it worked:) BTW, elementary kids had healthy school lunch, recess and PE in schools. There were no vending machines in our elementary schools! I love Dash! People eat alot of healthy ethnic foods that were encouraged. Southerns diets had become too high in animal fat dur to the addition of adding large meat servings and they used crisco and margarine and trans fat due to problem in the 1960s with limited electricity and refrigeration...especially on rural areas! Sent from my iPhone > We have been teaching DASH principles with fish (Omega-3) & high > fiber along > with traditional " low fat cooking " attachments. > > Holly > ---------- > Holly Lee Brewer, MS RD CDE > Pediatric Dietitian, Diabetes Educator > Medical Nutrition Therapist, Las Vegas, NV > > Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com > 301st MDS, NAS JRB Fort Worth (Carswell), TX > Joint Base Balad, Iraq (Jan-Jul 2009) > > ________________________________ > > To: " rd-usa " <rd-usa > > Cc: " Nutrition_Reports " <Nutrition_Reports > > > Sent: Sat, March 19, 2011 12:10:22 PM > Subject: Re: Drug research and 'significance chasing,' in > today's > medical field > > > Q- Where is the focus of our 5 minute cardiac diet education? > What is the makeup of our hospital cardiac diets? > > The logic in this article carries over for me regarding cardiac > health diet > guidelines. The accepted truth has always been that a low fat diet > will lower > cholesterol which correlates with a reduce risk of heart disease. > Is this evidence based? > Current research showing 30% fat diets that are high in O-3 fats, > high in MUFA, > moderate in naturally occurring saturated fats, low in O-6 and trans > fats are > associated with higher levels of HDL and lower levels of oxidized > LDL which is > associated with reduced risk of heart disease. > > Old school- eggbeater omelet, smart balance margarine, skim milk, > dry chicken > breast w Lipitor therapy = cardiac diet. > > Current research- Have a real egg. Add some avocado, hold the fake > margarine and > go for real butter. Add Grass feed beef, add olives, and organic 2% > milk for > some folks. > Manipulate your fat intakes, recheck labs, then look into meds if > necessary. > Anyone teaching cardiac folks anything other than a low fat diet? > > Osowski MS, RD, LD > Registered Dietitian > Sent from my iPhone > > On Mar 19, 2011, at 7:02 AM, ne <fivestar@... > > > wrote: > > > An interesting excerpt from " The Truth Wears Off " -- an > examination of > > research studies on today's drugs. Some of these drugs influence > > appetite and/or weight change and may be of interest to RDs. - > ne > > > > " On September 18, 2007, a few dozen neuroscientists, > psychiatrists, and > > drug-company executives gathered in a hotel conference room in > Brussels > > to hear some startling news. It had to do with a class of drugs > known as > > atypical or second-generation antipsychotics, which came on the > market > > in the early nineties. The drugs, sold under brand names such as > > Abilify, Seroquel, and Zyprexa, had been tested on schizophrenics in > > several large clinical trials, all of which had demonstrated a > dramatic > > decrease in the subjects' psychiatric symptoms. As a result, > > second-generation antipsychotics had become one of the fastest- > growing > > and most profitable pharmaceutical classes. By 2001, Eli Lilly's > Zyprexa > > was generating more revenue than Prozac. It remains the company's > > top-selling drug. > > > > " But the data presented at the Brussels meeting made it clear that > > something strange was happening: the therapeutic power of the drugs > > appeared to be steadily waning. A recent study showed an effect > that was > > less than half of that documented in the first trials, in the early > > nineteen-nineties. Many researchers began to argue that the > expensive > > pharmaceuticals weren't any better than first-generation > antipsychotics, > > which have been in use since the fifties. 'In fact, sometimes they > now > > look even worse,' , a professor of psychiatry at the > > University of Illinois at Chicago, told me. > > > > " Before the effectiveness of a drug can be confirmed, it must be > tested > > and tested again. Different scientists in different labs need to > repeat > > the protocols and publish their results. The test of > replicability, as > > it's known, is the foundation of modern research. Replicability is > how > > the community enforces itself. It's a safeguard for the creep of > > subjectivity. Most of the time, scientists know what results they > want, > > and that can influence the results they get. The premise of > > replicability is that the scientific community can correct for > these flaws. > > > > " But now all sorts of well-established, multiply confirmed > findings have > > started to look increasingly uncertain. It's as if our facts were > losing > > their truth: claims that have been enshrined in textbooks are > suddenly > > unprovable. This phenomenon doesn't yet have an official name, but > it's > > occurring across a wide range of fields, from psychology to > ecology. In > > the field of medicine, the phenomenon seems extremely widespread, > > affecting not only antipsychotics but also therapies ranging from > > cardiac stents to Vitamin E and antidepressants: has a > forthcoming > > analysis demonstrating that the efficacy of antidepressants has gone > > down as much as threefold in recent decades. > > For many scientists, the effect is especially troubling because of > what > > it exposes about the scientific process. If replication is what > > separates the rigor of science from the squishiness of > pseudoscience, > > where do we put all these rigorously validated findings that can no > > longer be proved? Which results should we believe? Francis Bacon, > the > > early-modern philosopher and pioneer of the scientific method, once > > declared that experiments were essential, because they allowed us to > > 'put nature to the question.' But it appears that nature often > gives us > > different answers. ... > > > > " [ph Banks Rhine, a psychologist at Duke, came to call this > trend > > toward a reduction in the strength of proof for a theory he had > > developed in the early nineteen-thirties] the 'decline effect.' > > > > " According to Ioannidis, an epidemiologist at Stanford > University, > > the main problem is that too many researchers engage in what he > calls > > 'significance chasing,' or finding ways to interpret the data so > that it > > passes the statistical test of significance - the ninety-five-per- > cent > > boundary invented by Fisher. 'The scientists are so eager > to pass > > this magical test that they start playing around with the numbers, > > trying to find anything that seems worthy,' Ioannidis says. In > recent > > years, Ioannidis has become increasingly blunt about the > pervasiveness > > of the problem. One of his most cited papers has a deliberately > > provocative title: 'Why Most Published Research Findings Are False.' > > > > " The problem of selective reporting is rooted in a fundamental > cognitive > > flaw, which is that we like proving ourselves right and hate being > > wrong. 'It feels good to validate a hypothesis,' Ioannidis said. 'It > > feels even better when you've got a financial interest in the idea > or > > your career depends upon it. And that's why, even after a claim > has been > > systematically disproven' - he cites, for instance, the early work > on > > hormone replacement therapy, or claims involving various vitamins > - 'you > > still see some stubborn researchers citing the first few studies > that > > show a strong effect. They really want to believe that it's > true.' ... > > > > " The disturbing implication of a study [conducted in the late > > nineteen-nineties by Crabbe, a neuroscientist at the Oregon > Health > > and Science University] is that a lot of extraordinary scientific > data > > are nothing but noise. The problem, of course, is that ... dramatic > > findings are ... the most likely to get published in prestigious > > journals, since the data are both statistically significant and > entirely > > unexpected. Grants get written, follow-up studies are conducted. > The end > > result is a scientific accident that can take years to unravel. > > > > " This suggests that the decline effect is actually a decline of > > illusion. While Karl Popper imagined falsification occurring with a > > single, definitive experiment - Galileo refuted Aristotelian > mechanics > > in an afternoon - the process turns out to be much messier than > that. > > Many scientific theories continue to be considered true even after > > failing numerous experimental tests. Verbal overshadowing might > exhibit > > the decline effect, but it remains extensively relied upon within > the > > field. The same holds for any number of phenomena, from the > disappearing > > benefits of second-generation antipsychotics to the weak coupling > ratio > > exhibited by decaying neutrons, which appears to have fallen by more > > than ten standard deviations between 1969 and 2001.... > > > > " Such anomalies demonstrate the slipperiness of empiricism. Although > > many scientific ideas generate conflicting results and suffer from > > falling effect sizes, they continue to get cited in the textbooks > and > > drive standard medical practice. Why? Because these ideas seem true. > > Because they make sense. Because we can't bear to let them go. And > this > > is why the decline effect is so troubling. Not because it reveals > the > > human fallibility of science, in which data are tweaked and beliefs > > shape perceptions. (Such shortcomings aren't surprising, at least > for > > scientists.) And not because it reveals that many of our most > exciting > > theories are fleeting fads and will soon be rejected. (That idea has > > been around since Kuhn.) The decline effect is troubling > because > > it reminds us how difficult it is to prove anything. We like to > pretend > > that our experiments define the truth for us. But that's often not > the > > case. Just because an idea is true doesn't mean it can be proved. > And > > just because an idea can be proved doesn't mean it's true. When the > > experiments are done, we still have to choose what to believe. " > > > > Author: Jonah Lehrer > > Title: " The Truth Wears Off " > > Publisher: The New Yorker > > Date: December 13, 2010 > > Pages: 52-57 > > > > > > Quote Link to comment Share on other sites More sharing options...
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