Special Interests by Scientists, Publishers, Media and Nutrition Guidance on Fats
According to headlines, dietary fat doesn’t play a role in cardiovascular disease (CVD). What is happening? Is everything we thought we knew wrong? No, but there are factors at play. 1) Scientists are promoted and rewarded for publishing in peer review journals. 2) Managing Boards of scientific journals want higher citation ratings and subscription sales. 3) Media conglomerate revenues depend upon the number of viewers/readers they attract.
The convergence of these 3 agendas creates media storms that are not necessarily aligned with public interest. How? Scientists promote their results to obtain future research funding. Research institutes and journals promote their research to build brand reputation. Media outlets use headlines to increase sales.
Let’s discuss science first. Research scientists need to publish. Their job is to ask questions, conduct research and publish the results. For example, Dr Mozaffarian has published many papers on dietary fat and CVD. Here are three papers he has co-authored with very different conclusions:
·Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats. (Chowdhury et al, 2014)
·In contrast, the association between country (Japan vs USA) and incident coronary artery calcification was attenuated following adjustment for serum n-3 PUFA. The authors conclude that n-3 PUFA may have antiatherosclerotic effects at levels observed in Japan. (Wu & Mozaffarian, 2014)
·Both dietary and circulating eicosapentaenoic acid and docosahexaenoic acid, but not alpha-linolenic acid or n-6 PUFA, were inversely associated with CVD incidence. These findings suggest that increased consumption of n-3 PUFA from seafood may prevent CVD development in a multiethnic population. (de Oliviera et al, 2013)
Publishers of scientific journals want their research publications to be number one. Mentions in the news increase visibility and prestige of their brands. The concept of giving journalists access to embargoed scientific information prior to presentation or publication was initiated in 1921. Indeed, many scientific publishers release embargoed summaries to facilitate media coverage. Annals of Internal Medicine sent out embargoed summaries of the Chowdhury et al (2014) manuscript which has effectively stimulated media coverage.
Media outlets want an exclusive story or perspective. As Editor of the New England Journal of Medicine, Dr Franz Ingelfinger decreed that an article to be published in JAMA could not have previously appeared elsewhere. This requirement, known as the Ingelfinger rule, began a mutually-beneficial symbiosis between scientific institutions, publishers and media. The shared goal is to increase awareness of the impact of a singular report.
So what should a consumer do? Understand that nutrient efficacy cannot be assessed based as a yes/no question on dietary supplement use. Regardless of dietary source (food, beverage or supplement), people with grossly suboptimal micronutrient levels will be deficient. History confirms that nutrient-health associations exist between suboptimal and optimal nutrient concentrations. Finally, excessive intakes will not confer supper human status or health benefits.
Chowdhury, Mozaffarian and associates clearly show a significant reduction in coronary outcome risk when circulating EPA and DHA concentrations are higher (Figure 2). They also report increase CVD risk when total trans fatty acid concentrations are elevated. These facts are consistent with the findings of Wu & Mozaffarian (2013), De Oliveira et al (2013), and many other studies.
As always, nutrition advice should be guided by the totality of the evidence. The fact is that most people are not consuming adequate amounts of EPA+DHA and they would benefit by eating less saturated and trans fatty acids.
Chowdhury R, Warnakula S, Kunutsor S, Crowe F, Ward HA, Johnson L, Franco OH, Butterworth AS, Forouhi NG, Thompston SG, Khaw K-T, Mozaffarian D, Danesh J, Angelantonio ED. Association of dietary, circulating and supplemental fatty acids with coronary risk: A systematic Review and meta-analysis. 2014 Ann Intern Med doi:10.7326/M13-1788
Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray CJL, Ezzati M. The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors. 2009 PLoS Med doi:10.1371/journal.pmed.1000058
Wu JHY, Mozaffarian D. ω=3 fatty acids, atherosclerosis progression and cardiovascular outcomes in recent trials: new pieces in a complex puzzle. 2013 Heart doi 10.1136/heartjnl-2013-305257
De Oliveira OMC, Wu JH, Baylin A, Vaidya D, Rich SS, Tsai MY, Jacobs Jr DR, Mozaffarian D. Circulating and dietary omega-3 and omega-6 polyunsaturated fatty acids and incidence of CVD in the Multi-Ethnic Study of Atherosclerosis. 2013 J Am Heart Assoc doi: 10.1161/JAHA.113.000506