There are many examples of people accused of a crime they didn’t commit. If we look at the movies, who doesn’t remember Andy Dufresne (Tim Robbins) sentenced to two life terms in the memorable movie Shawshank Redemption. Of course we knew that Andy was innocent, but there was a crime committed, although by another person.
What may be more intriguing is that people have also been accused of a crime that never took place. Those of you who saw the Danish movie The Hunt (Jagten) will know what I mean. Lucas (Mads Mikkelsen) is accused of a pedophilic act. Although he is innocent and no crime took place, he doesn’t stand a chance, and his world is shattered.
Here is a little story. I’ll let you decide for yourself whether it is true or not.
Lawrence C.H. Francesco (LCHF) was taken by the police and brought in to custody on a bright Sunday morning. Five days earlier he was seen arguing with a young lady by the name of Lucy D. Lapworth (LDL) outside a restaurant, not far away form his home. Nobody had seen or heard anything from LDL since then. She was considered missing and a crime could not be excluded. She was a very well known and influential person.
There was a lot of rumor going on about LCHF. He had been quite successful in life, but often a bit controversial. People were saying: “He was always so nice. But you could feel there was something underneath. He always looked like he was hiding something…”. “I always suspected he might be violent, but he did a good job of hiding it…” . “I knew they would never have a future together, they were always fighting. It was bound to end badly….”.
A few days later LDL resurfaced. She had stayed with an old friend in another town. She was fine and had not been harmed in any way. She admitted having had an argument with LCHF, which was the main reason she hadn’t been in touch. Going into hiding was a kind of a revenge. She knew it might get LCHF into trouble. There was no crime.
Following the incident LCHF noticed a change in his environment. He was sure his neighbors were avoiding him. Two months later he lost his job. He had to sell his house and move to a small apartment. His reputation was harmed.
Okay. Why this story? I’ll get to the point now.
LCHF (low carb high fat) on Trial – Prosecutor: The Formidable Five
A few days ago there was an article entitled “The popular high fat diets are threat to public health” published in Dagens Nyheter which is one of Sweden’s most respected newspapers. The paper was written by five highly respected Swedish doctors and medical authors. All of them are known for their contribution to medical science, particularly in the field of cardiovascular epidemiology. I’ll call them the Formidable Five, just for the sake of simplicity.
The article states that the incidence of heart attack and stroke among young women and men has increased in Sweden during the last few years. In Sweden, similar to many western countries, the death rate from heart disease and stroke has dropped dramatically in the last few decades. This is thought to be largely due to changes in lifestyle and eating habits leading to lowering of blood cholesterol, less smoking and lower blood pressure. This has been achieved despite overweight, obesity and type 2 diabetes becoming more common.
However, the Formidable Five state that according to a recent report from the Swedish Office of Public Health, there is now suddenly a negative trend. The number of heart attacks and strokes among women aged 35-44 years is increasing. This is primarily seen among women with low education.
The authors point out that during the 1980’s, consumption of fat decreased and more carbohydrates were consumed. Since 2005, the consumption of fats, primarily animal and dairy fats, has increased again in Sweden. This has lead to higher cholesterol levels. They authors believe this may be due to the popularity of LCHF diets in Sweden. Polls have shown that 25 percent of Swedes have tried such a diet to lose weight.
The message from the Formidable Five is quite clear:
Medical professionals and others advocating LCHF diets may have to take responsibility for an increased incidence of heart attacks and strokes among young Swedish men and women.
The Day After
The article written by the Formidable Five has caused quite a stir in Sweden. When highly respected specialists speak out in this manner, there must be something wrong. However, the article hasn’t been met with open arms by everyone.
Dr. Birgitta Strandvik Senior Professor at the Karolinska Hospitla in Stockholm responded two days later on the same newspaper’s website by pointing out that there are many different types of fats. She says that although dairy products contain saturated fats, they also contain fats that are considered healthy. She also points out that animal products may differ considerably, and that fats from grass fed animals may indeed be quite healthy. She asks the question whether the Formidable Five had access to data indicating that those people who suffered stroke or a heart attack at young age were on an LCHF diet. Of course they don’t have such data because it doesn’t exist.
Tore Person MD also reflects on Dagens Nyheter’s website on the Formidable Five’s article: “The fact that an increasing number of people – all over the world – choose to stay away from sugar, refined carbohydrates, and low-fat varieties, and instead revert to old, honest and well tested food, is made suspicious in their article, in an uncomfortable and challenging manner”.
What Does the Public Health Report Say?
In order to learn more about the crime, I decided to read the part of the report from the Swedish Office of Public Health that deals with cardiovascular disease. Here is a brief summary of what I found out.
- During the last decades, there has been a dramatic decrease in the death rate from heart attack and stroke in Sweden
- There has been a constant decline in the incidence of heart attack among men and women from 1995-2011 (see figure below)
- Among young Swedish women (age 35-44) there has not been a decline in the incidence of heart attack since 1995. At the same time, the incidence of heart attack among young men has declined significantly.
- Among women aged 35-44 years heart attacks are rare. Among women in this age group who have a low education, there is a slight increase in the number of heart attacks. However, this group is getting smaller all the time, because higher education is becoming more common.
- The incidence and mortality from stroke has declined constantly from 1995-2011 (see figure below).
- In the age group 35-44 years, the incidence of a first stoke has increased by 21 percent among women and 15 percent among men, since 1995. This increase is most prominent among those with low education.
In summary: There has been a constant decline in the incidence and mortality from heart attack and stroke since 1995. This decline has continued despite the recent popularity of LCHF diets. Among young women there has been a slight increase in the number of heart attacks since 1995. Among women and men there has been some increase in the numbers of strokes. The increase in heart attacks and strokes among young women and men is primarily found among those with lower education. Dietary habits were not addressed in the report, therefore no relationship was found between dietary changes and the frequency of heart attacks or strokes.
The Bottom Line
It is obvious from the public health report that there has been a constant decline in the incidence and death rate from heart attack and stroke in Sweden between 1995 and 2011. This is indeed a very positive finding. However, the slight increase in the number of heart attacks among young women, and the increase in stroke among young women and men raises some concern.
In fact, similar findings were reported last autumn from the French FAST-MI registry. The proportion of women with heart attack, younger than 60 years increased from 12 to 26 percent within fifteen years. The most prominent risk factors among these women were smoking and obesity. Most of them did not have raised blood cholesterol or high blood pressure. Nothing suggests they were on an LCHF diet.
The fact that the increase in cardiovascular events among young Swedes is primarily found among those with low education raises a few questions. Social isolation is a well known risk factor for heart disease. It is commonly associated with low education and so is smoking.
I wonder why the Formidable Five wrote their article. I know they believe in the diet-heart hypothesis. They strongly believe that blood cholesterol, LDL-cholesterol in particular, is of prime importance when it comes to reducing the incidence and mortality from cardiovascular disease. They know that LCHF diets often raise LDL-cholesterol. Therefore they believe that LCHF diets may be a threat to public health. The problem is that they lack scientific data to prove their point.
Scientific studies have not shown that reducing the total amount of fat in our diet will reduce the risk of death nor will it reduce the risk of dying from cardiovascular causes. If you cannot use scientific data to convince people that LCHF diets are dangerous, you will have to use other methods. Framing someone usually gets him into trouble. I am sure the Formidable Five believed the end justified the means.
The Formidable Five have brought LCHF to trial. But there is no crime. The recently published public health data indeed look quite good. Certainly, there is some concern regarding the youngest age groups. However, when it comes to explaining that, LCHF has a good alibi.
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As always, interesting post.
This whole area of low versus high carb becomes exhausting at some point. Both sides waves reams of data and present it how they want and I, for one, just end up scratching my head.
I tend to go by how I feel from what I eat. I know that carbs really affect me, like they are a trigger for cravings in some instances so I try to stick to the carbs that are universally accepted as good by both camps (fruits and vegetables). Although I tend to stick to lower fructose type fruits because the high fructose ones, again, act as craving triggers for me.
I throw in about a 1/2 cup of legumes, some nuts and seeds, and a piece of chicken or fish daily.
I guess it’s more of an ad hoc moderate carb, moderate fat, moderate protein for lack of a label (maybe modified DASH if anything)
I make sure I get around 30 mins of daily exercise, monitor my blood lipids and hope for the best.
About a year ago, I was eating horribly, drinking too much, although I was exercising. My numbers were:
TC: 6.6
LDL: 4.16
HDL 1.41
TRIG: 2.25
In other words, not great
Adopted a healthier lifestyle essentially via the above mentioned food choices and limiting alcohol to 1-2 glasses of wine a couple times a week.
My most recent numbers a month ago:
TC 5.1
LDL 3.49
HDL 1.12
TRIG: 1.06
So my numbers seem to be in the right direction, I wish I could get HDL a bit higher.
So I’m going to keep at it my way and let the two camps keep throwing punches at each other!
Thanks for the comment Bill. You´re absolutely right, the battling can be tiresome. But I assume it will continue because there is seldom a right or wrong. Everybody has to find their own way, just like you are trying to do.
Simply a case of attempting to grab headline by using phrases that thrill (or scare as in this case). But when you pull it completely apart, as you just did and daylight shines, you can see clearly how those not-fantastic five are twisting the words to suit their own agendas. I recently (5 months to be precise) ago commenced LCHF and am thrilled to be able to tell your readers that my Blood Glucose levels are back into the normal range and my reflux (of 15 years duration) vanished overnight! I am living this way to manage T2DM which was recently diagnosed after ten + years of symptoms – not brought together and diagnosed by various medical people. I say to all out there be very careful of those sugar/insulin spikes that silently gnaw away at you vascular system, doing untold serious damage. You can (If I can) control it with lifestyle choices rather than radical surgery, heart attacks and lifelong medications which do nothing to treat the cause and only mask the symptoms.
Another great article. Thank You Doc.
Thanks for the kind words JustMEinT. I appreciate your comment and your interest in my writing. Hope you continue visiting the site.
A really well wriiten post, with the strong foundation you have on the subject. I am not in the trade, but pretty well educated on lchf, and I came to the same conclusion regarding the statistics, and also why these doctors and scientists are trying to scare ppl, using falsified data. They have a position to defend, often sponsored by companies like Pfizer etc. Luckily, we have brave ppl that stick out their neck and oppose to the ludicracy. Nobody knows exactly how low carbdiets work in the body, and if saturated fat is bad or good, and what amount we can eat, but I’m 57 and I don’t have the time to wait, I have to listen to my body. I feel great, my bp and cholesterol is perfect, so I’ll take my chances 😉
I have a personal history of deliberate high saturated fat intake and inadvertent excessive omega-6 intake. Fortunately, 3-1/2 years ago (I was 62 at the time) I figured out that excessive peanut butter consumption was slowly doing me in. I stopped eating peanut butter sandwiches for lunch, switching to thin-sliced ham. This was only significant dietary change I made. As noted by Dr. Bill Lands, “…peanuts have 4,000 milligrams of omega-6 in each 28 gram, one ounce serving of peanuts…” When I heard these words, I realized my mistake.
The consequences of giving up peanut butter? Within 2 months my leg pains were gone. I have since regained considerable strength and stamina. My gingivitis cleared up. And my cholesterol and blood pressure normalized.
Thanks for the comment Ann-Kristin. I agree that listening to your body and how you are feeling is a key issue. It will tell you a lot about whether you are doing the right thing. This is actually very important to keep in mind because we are all different and there is no exact diet formula for everybody.
Wonderful post!
I have been into the Swedish LCHF-diet since 2009 and gained so much healthy benefits except loosing excess weight, its simply like magic. And when i suceeded to help a friend with diabetes type 2 to be a type “zero” and and cut of all his medicins plus helping another two type 1 to cut their insulin dozez by more than half, i felt like i had become a “superdoctor”… 🙂
Thanks for the comment Majoren. I agree that carbohydrate restriction can be very useful in type 2 diabetes and should be used much more often.
Great post! Very creative. It always amazes me how quick and vehemently the medical industry protects it’s tradition despite scientific research, or lack thereof.
Treating “medical industry” and low carb diets as opposites and/or implying that only one of these two “sides” has interests to protect isn’t accurate at all. Low carb diets are often promoted by people who have financial interests, just like many other diets.
About Sweden and low carb: epidemiological evidence concerning possible health risks is inconclusive. In some studies there seems to be increase in CVD risk/mortality
https://www.bmj.com/content/344/bmj.e4026
https://www.ncbi.nlm.nih.gov/pubmed/17391111
but not in others
https://www.ncbi.nlm.nih.gov/pubmed/22333874
nor in cancer
https://www.nutritionj.com/content/12/1/58
I’d say that at the very least the results indicate that low carb diets aren’t the semi-magical solution they were triumphed to be.
Thanks Mie. These are important references in relation to the topic. Of course these are epidemiological data, therefore we cannot draw any conclusions about a causal relationship. I included a reference to the Cochrane Library in my article that summarizes results of interventional studies on the effect of reducing or modifying the fat we eat. In short there was no effect of reducing or modifying fat consumption on total or cardiovascular mortality. However, replacing saturated fats by unsaturates appeared beneficial in terms of reducing the number of cardiovascular events, although as mentioned, there was no effect on mortality.
Axel, you’re talking about somewhat different thing. Low carb diets and their potential benefits/harms cannot be reduced to saturated fat intake per se since issues like fibre intake, protein intake, red meat consumption etc. etc. matter too. Therefore referencing the Cochrane meta-analysis doesn’t have direct relevance in this case.
I get your point Mie. Of course you´re right. However carbohydrate restriction usually implies increased fat and/or protein consumption, at least in relative terms. “The Formidable Five´s major ” concern in their DN article was the increased fat consumption associated with LCHF. Therefore the Cochrane analysis is of interest. But you´re absolutely right, LCHF diets may vary very much depending on fiber consumption, the amount of red meat etc. This may indeed be important when it comes to cardiovascular disease prevention.
Ok. For the record: I don’t consider these “outbursts” such as the FF article to have much importance in scientific sense. Of course they’re entitled to their opinions just like everyone else, but I’d rather be careful with extrapolations of ecological data.
Of course, they have a point in the sense that low carb diet advice should stress avoiding excess (processed) red meat and increasing the intake of unsaturated fatty acids at the expense of saturated ones.
Doc & Mie,
you both seem to confuse public health with pharmacology. Almost all forms of scientific inquiry uses mathematical modelling: economics/econometrics, meteorology, etc. Public Health is certainly not an exception.
I find the FF putting the highest form of evidence to the table. They show that CHD mortality has almost halved in Sweden and large part of this is explained by reduction in serum cholesterol levels. The numbers don’t lie.
Based on all evidence available, there’s fairly good reason to extrapolate, after all these people are into saving lives, not pleasing the online cranks with their divine belief for the hierarchy of evidence: “In RCT & Mozzafarian we trust”.
The public health measure to limit the consumption of SFA and eggs have been immensely successful, and nowhere has it been as successful as in Northern Europe, Iceland included (Pedersen et al 2011). Unfortunately this positive trend is now history thanks to LCHF which have mediated the increased consumption of SFA. Consumption of potatoes and oatmeal has plummeted.
Modelling the decreasing coronary heart disease mortality in Sweden between 1986 and 2002.
https://www.ncbi.nlm.nih.gov/pubmed/19141562
Richard.
You are right about the great results that have been achieved in reducing the death rate from coronary heart disease, not least in the Nordic countries. Studies indicate that these results may largely be due to changes in risk factors, such as less smoking, lower blood cholesterol and better blood pressure.
This does not imply that carbohydrate restriction, which is an effective tool to treat overweight, obesity, metabolic syndrome and type 2 diabetes, is harmful, although it may in some cases raise plasma cholesterol. At the same time LCHF will likely induce weight loss, increase HDL-cholesterol, lower triglycerides and LDL-particle count, and improve glycemic control. There isn´t any proof that this is harmful. On the contrary, most studies indicate it´s beneficial.
I live in Sweden since 2008 and what I mainly see here is no LCHF, but more like HCHF! Sausages with a lot of crap in it, beer, booze, lots of creations containing white flour and sugar and to my biggest surpise hardly no vegetables! I bet that causes more health issues then anything else!
A sausage is a vegetable in Sweden
Excellent article. What surprises me is that intelligent people like the Five mentioned above forget the elements of evidence based science. There has never been any test done that shows a link between HF and increase in heart disease and yet fat continues to be vilified!
Read Gary Taubes’ book and follow it from there. Try it for yourself and in most cases the lchf diet is quite amazing!
Thanks for the comment Jean. I was also quite surprised by the unscientific approach.
Doc,
we know for a fact that that younger women in Northern Sweden were amongst the first portion of the population to change their diet to one lower in carbohydrates and higher in fat, especially for butter used in cooking.
https://www.nutritionj.com/content/11/1/40
Anyways, Sweden has not been consuming a LCHF diet for long enough to contribute significantly to an increased risk of cvd (ie. time lag hypothesis), especially considering the apparently high quality cardiovascular care in Sweden. Moreover, LCHF-diet has been popular among the young and people in their pre-midlife. (Those at the highest risk of dying with previous heart events are usually in the typical “low cholesterol, low saturated fat” -diets and are in the age where they are less keen on following popular trends).
In some countries the rates of lung cancer kept on climbing for two decades after smoking prevalence declined before the rates of lung cancer finally declined.
https://en.m.wikipedia.org/wiki/Smoking
I am curious about is to whether young women are least likely to be prescribed cholesterol lowering medication (in amounts sufficient to significantly lower cholesterol) compared to the rest of the population. These factors may explain why younger women were among the first to show increases in stroke and heart attacks. Any ideas Doc?
It has been demonstrated that elevated serum cholesterol and the feeding of dietary cholesterol and saturated fat accelerates the development of atherosclerosis in virtually all vertebrates (including nonhuman primates) that have been sufficiently challenged (so long as a way is found to raise serum cholesterol high enough for a sufficient period of time), very compelling evidence is required in order to safely say that this does not apply to humans. Therefore, based on the Darwinian foundation of our biomedical research paradigm, it’s extremely likely that LCHF induced elevation of LDL cholesterol will result in increased rates of heart events among Swedes in the future.
Richard. The French FAST-MI registry has also shown an increase in heart attacks (ST elevation myocardial infarction) among young women, as mentioned in my article. There is low prevalence of high cholesterol among these women. It appears that their strongest risk factors are smoking and obesity.
The link with low education in the Swedish data does not suggest that cholesterol plays a major role. Social isolation, often associated with low education, is asssociated with an increased risk of heart attack. Smoking could also play a role. Usually smoking is more prevalent among individuals with low education, and so is indeed obesity.
I think that “Low-fat Richard” who seems to like using a different anonymous alias everywhere he posts (and even sometimes several on the same site) is really a vegan ideologue (as is Dr Greger) and also goes by the (also anonymous) pseudonym Plant Positive (or Pee Pee for short). Check out his hour upon hour (upon hour) or smarmy, nauseating drivel on YouTube 😛
“Early on, the ecological Seven Countries’ Study claimed that a substantial proportion of the regional variation in CVD mortality was explained by differences in intake of saturated and monounsaturated fatty acids, and they pointed out that mean levels of total cholesterol correlated with mean intakes of saturated fatty acids [12,13]. However, a recent review on the role of fats and fatty acids on human health concluded that the relationship is more complex [14]. Trans fatty acids increase the risk, fish or n-3 long-chain polyunsaturated fats decrease the risk, but the data are conflicting or insufficient to convict or free total fat intake or other fat fractions with respect to CVD risk. Thus, further research is needed, especially focusing on long-term dietary intake.” https://www.nutritionj.com/content/11/1/40
“Traditional Mediterranean, rural Japanese, and other populations with very low CHD risk have uniformly low LA intakes [26,32]. Two US prospective cohort studies have reported inverse associations between LA intake and CHD risk [41,66]. However, because LA intake was uniformly high, several fold higher than evolutionary intakes and those
of modern groups with very low CHD rates [32], these studies provide little insight into optimal LA intakes. Moreover, both studies relied on food frequency questionnaires, which have well-known limitations [67] and may not be able to disentangle the effects of LA and n-3 ALA. Controlled trials in which high-LA oils replaced TFA- and SFA-rich fats have shown conflicting results [38,68–72], despite the fact that LA was accompanied by large amounts of medium-[38,70] and long-chain n-3 PUFAs [38]. A single small trial testing the specific effects of LA without n-3 PUFAs found increased CHD risk [71]. The only long-term trial that reduced n-6 LA intake to resemble a traditional Mediterranean diet (but still higher than preindustrial LA intake) reduced CHD events and mortality by 70% [31]. Although this does not prove that LA intake has adverse consequences, it clearly indicates that high LA intake is not necessary for profound CHD risk reduction.” https://www.ncbi.nlm.nih.gov/pubmed/19627662
“Was there a specific effect from saturated fat?
Because intakes of both saturated- and unsatured fats changed in the dietary interventions, it is impossible to assess which change is responsible for the effects found. To examine this, the researchers made an additional analysis, shown in the table below. None of the effects was significant. None of the different types of fat could be held responsible for the effects found.” https://dietanddisease.blogspot.com/2012/06/replacing-saturated-fat-by-unsaturated.html
“The modern, ‘westernized’ diet is rich in fat (well over 30 percent of calories), particularly saturated fatty acids due to the intake of animal foods (including dairy fats) and tropical oils (coconut and palm). It also is rich in omega-6 fatty acids, due to the high intake of corn and soy oils, compared to omega-3 fatty acids. This has many nutritionists worried because omega-6 fatty acids tend to be pro-inflammatory, compared to omega-3 fatty acids, which have a reputation of being anti-inflammatory. Omega-9 fatty acids tend to be neutral. However, recent research is pointing to health benefits associated with omega-9s.” https://www.foodprocessing.com/articles/2013/wf-omega9-fatty-acids.html
Obviously, where heart disease is concerned, there is serious confusion as to which fats do what. Meanwhile, the edible oils industry, through selective breeding, has substantially increased the oleic acid content of soybean, Canola, sunflower, and corn seeds. Saturated fat content of the new seeds (already low) was lowered slightly. The big change in the fatty acid profile, however, is in the reduction in the linoleic acid (LA) content of the new seeds. If LA is indeed a problem, the new oils should help lower the LA content of the food supply. The lower LA content of new corn varieties should lower the LA content of animal products if animal feed use becomes widespread. https://www.ars.usda.gov/is/ar/archive/aug03/corn0803.htm
Richard:
“you both seem to confuse public health with pharmacology.”
A strawman.
“I find the FF putting the highest form of evidence to the table. They show that CHD mortality has almost halved in Sweden and large part of this is explained by reduction in serum cholesterol levels.”
Err, I don’t think anyone was contesting the idea that cholesterol levels explain reduction in CHD mortality. Certainly not me nor Axel. Axel already replied to you in more detail concerning your misunderstanding.
“Based on all evidence available, there’s fairly good reason to extrapolate, after all these people are into saving lives, not pleasing the online cranks with their divine belief for the hierarchy of evidence: “In RCT & Mozzafarian we trust”.”
Once again, you know nothing of the things that you speak of:
1) Unless we know that precisely low carb diets in Sweden have significantly increased serum cholesterol levels, there’s no reason to extrapolate on the effects. And as Axel pointed out, since specific dietary habit weren’t studied, we have no certain way of knowing.
2) Hierarchy of evidence is the current scientific framework. If you had any relevant criticism against it, you’d have shown it by now. Instead, you resort to childish bitching since your personal heroes & lifestyle interventions you favor don’t rank highly in it. Don’t blame the mirror.
Mie,
I defend the rules of logic, not any arbitrary (belief) systems nor a religion (methodolatry: the profane worship of the randomized clinical trial as the only valid method of investigation).
There will never be a a study that will show an exact impact of a given diet to public health. Requesting such study and refusing to consider what we already have is simply put a form of denialism. A fact is that serum cholesterol levels are on the surge in Northern Sweden for the first time in many decades. It doesn’t require a huge leap of faith to assume that the trend is similar in rest of the Sweden. Another fact is that young women in Northern Sweden were the first to change plant-based cooking fats to butter. Hmmm….err….I wonder where they got the idea from, could it be that perhaps the best selling LCHF diet book on the Swedish market is written by an ex-pin up and targeted directly to young women like her, those without much schooling, that is. And, it’s not like these books have not received hefty amounts of coverage in magazines read by young women.
https://www.adlibris.com/fi/product.aspx?isbn=9174611119
I don’t blame the mirror. The logic and reasoning I use is no different than that of the best & most respected authorities in Swedish cardiology are using. I am not the one with a problem.
Richard:
“I defend the rules of logic, not any arbitrary (belief) systems nor a religion (methodolatry: the profane worship …”
… which isn’t taking place here. No one has claimed that RCTs are the only valid type of studies.
“There will never be a a study that will show an exact impact of a given diet to public health.”
… which is a nonsensical statement. No one’s claiming that a single study could do that.
“A fact is that …”
… we don’t know what’s the relation between increase in heart attacks & strokes & cholesterol levels and dietary changes among Swedish women, unless there’s data to indicate that heart attacks & strokes among these women are indeed connected to low carb diets. That is, it needs to be shown that low carb women have experienced more of the CHD events and that the cause can indeed be narrowed down to diet.
That was way too weak, even from you. Keep up the monologue from now on.