Medscape posted the study and the response so far has been 100% negative, calling attention to various sources of invalidity.
“Someone has slipped a cog. Two self-reported dietary recall responses in 2003, assumed to have validity over a 20 year span. Really!”
If you know the causes of heart disease, you know it is impossible for IF to increase RR by 1.91 as there is no possibility for that within the rules set by the simulation 
.
There are only a few dials on heart disease risk. Once AI becomes better more people will understand this.
Interesting article:
Awww, they chopped the best part off the headline. This chart sums it up pretty well:
LPIR stands for lipoprotein insulin resistance, which is measured by NMR technology. Don’t ask what it costs.
Surprising similarity to what @John_Hemming just posted in an article about “Strengths And Weaknesses Of Longevity Biomarkers”.
https://www.rapamycin.news/t/strengths-and-weaknesses-of-longevity-biomarkers-vitadao/12857?u=ng0rge
There it’s a blood measure called 2-hour post-challenge blood glucose (2h-BG) test. Here’s a comparison:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136064/
Your article says “Meanwhile, the LPIR Score can be obtained with a single fasting blood sample and it is relatively affordable.”
While the other article says " a number of techniques such as euglycemic clamp technique, insulin tolerance test, insulin sensitizing test, i.v./oral glucose tolerance test, fasting insulin levels, and fasting glucose to insulin ratio have been devised by several investigators. However, all these techniques are time consuming, expensive, stressful to the patients. Besides, the high cost and nonavailability of newer technologies is also a hindrance. Recently, “2-hour post-glucose insulin levels” has been recognized as a possible indicator of IR. Therefore, a single “2-hour post-glucose insulin level” appears to be a reliable indicator of IR in PCOS patients. "
Just pulled this up: $33
https://www.walkinlab.com/products/view/glucose-two-hour-post-prandial-blood-test
And for LP-IR there’s this:
https://www.findlabtest.com/lab-test/general-wellness/lp-ir-score-labcorp-result-code-884314
Yeah, that was kind of click bait. I had to look up what NMR even is (nuclear magnetic resonance) and on wikipedia it showed a pic of a huge machine and talked about the physics of the thing. I couldn’t find the actual blood test.
This is the best explanation out there about the Kraft curves and that would be the $33 one.
Life extension offers the LP-IR test economically as part of a detailed cholesterol panel. I added it once to their Elite Comprehensive panel. I need to do it again. The price has been dropping steadily over the past few years.
The Latest
You may have seen the headlines: “Intermittent fasting linked to 91 percent increase in risk of death from heart disease”; “The intermittent fasting trend may pose risks to your heart.”
The news came from an abstract presented Monday at an American Heart Association conference in Chicago. The study has not yet been published in a peer-reviewed journal, and experts cautioned that it had many limitations. Here’s what we know.
The Limitations
Since the study has not been published or peer-reviewed, it’s challenging to fully evaluate it, Dr. Varady said.
A “major limitation” is that they used just two diet questionnaires to accurately represent people’s typical eating pattern, Dr. Varady said; and the study did not seem to evaluate what kinds of foods people ate.
Dr. Dariush Mozaffarian, a cardiologist and professor of medicine at Tufts University, called the study “very problematic.” The eight-hour eating group may have included many people who were very busy, or faced other challenges that forced them to miss meals or eat erratically, he said.
The group also could have included people who were already in poor health — those with eating disorders or illness that reduced their appetite, for instance, which may have resulted in them eating during a shorter window, said Satchidananda Panda, a professor at the Salk Institute for Biological Studies in San Diego.
And if intermittent fasting is really harmful, it’s not clear why that might be. Dr. Zhong said that his study was not designed to answer that question.
There is only one correct response to the dozens of recent news reports and articles written in the past few days claiming that time-restricted dieting (compressing eating into eight or so hours each day) leads to a 91% increase in fatal heart attacks: ignore it.
These articles are based on a recently released American Heart Association report. The research behind the claim is a 2003-2018 self-report dietary recall survey project. The comparison groups this report was based on were created by dividing those who responded to at least two surveys in the first year of the study. The assumption was made that the recall information was accurate and remained valid for years.
There are several methodological and statistical reasons why the claims in this report are exceptionally weak. I won’t go into them here but I believe reporting and titling the article and press releases as they did is an irresponsible act because the AHA knew full well how the press would respond to it. (These days, many research report titles are written to attract attention; major universities have a research clearinghouse dedicated to that process.)
There is no way to be certain about what, if anything, this report means. One possibility is that the groups created for the analysis reflect the longer term outcomes of people who, in 2003, were concerned enough about their glucose metabolism and cardiovascular health to adopt what was at that time a fringe diet plan.
I wish it were not true but in today’s reporting environment, it is likely that reportage on health, exercise, and nutritional “research” will be misleading or outright incorrect.
It says nothing about drinking sugar contain drinks, it’s not intermittent fasting. It’s just eating over 8 hour window. It’s logic if you start and end your day with sugar containing drinks that you become more unhealthy. It’s even logical that eating small bites over a longer time period is more healthy since this doesn’t spike your sugar so much.
It’s scientific fact that fasting activates AMPK and inhibits mTOR as well as dozens of other longevity genes and pathways. But drinking sugar containing drinks does the exact opposite.
Furthermore they are speaking about American people, you can not take the average American diet seriously in any investigation related to time restricted eating.
This information was also in the Dutch news, I hate it when they use news like this to justify there own lack off discipline.
This is such a blatantly stupid case of a respected organization doing something that even the stupidest person in the room might say “I wouldn’t endorse and release that to the mainstream media and general public.” It undermines science in the worst way and although in a different category is right in there with David Sinclair in making the general public say “you just can’t trust those people” (about science and scientists). The science community in general needs to be more careful about policing themselves and building trust with the general public. They can’t keep releasing statements that bounce around like a yoyo on topics important to public health.
I’m not a conspiracy theorist but it does make you wonder if there isn’t a plot to undermine trust in all of our institutions.
I agree. Trust in science, which is behind most of the benefits we enjoy including most likely the fact that we are alive to enjoy them, has suffered under the anti-authority, anti-logic populist movement. However some of that destruction occurred much earlier at the hands of the university grant management offices which, as early as the 1980’s, became sources of shady PR to promote the university’s image and secure more grants the overhead for which fattened their coffers. I am out of touch now but several decades ago, they became involved as influencers (read: controllers if you wanted to get along) in writing article titles. I can’t imagine any such office would have written this title, however. The AHA takes the prize on that. The AHA is perhaps lower on my list than it is on yours. While acknowledging its many contributions, I have also witnessed it clinging to disproven explanatory models and criticising newer, better supported ones, while quietly backing away from the old views and hoping no one would notice. The association’s open distaste for leading edge thinking has at times been unscientific.
Trust is a critical element of a functional society. We can’t just stand by and watch it be trampled into the dirt. This won’t end well. Some ethical system of public funding has to be found.
The model that doesn’t adjust have 6.40 HR for LPIR and 1.89 for apoB.
Once you adjust for “physical activity, smoking, BMI, systolic blood pressure, diabetes, parental MI<60 years, and baseline treatment for hypertension or for high cholesterol”
HR for LPIR decreases to 3.85 and 1.56 for apoB.
LPIR is just a fancy way of measuring apoB and TG:
We could resolve this question of which explains which and what proportion of variance each accounts for in short order if we had the raw dataset. Does anyone know what, where, etc.?
When I look at the above visuals, I see a multi-factor issue with some components accounting for more variance in benefit but less in harm and the reverse.
In a small colloquium at Oxford (around 1972) a prize winning biologist observed that the then US funding system was in many areas perverse to scientific exploration.
This said, I think the public issue takes priority. We need to do a better job of educating the public, especially the populist types, to the fact that almost everything they value owes to the work of scientists and their findings. From this it follows that we need to police better. We have our share of charletains. Some benign but charlatans nonetheless.
Jason Fung weighs in… with an emphasis on “stupid”
https://drjasonfung.medium.com/the-aha-says-fasting-increases-cardiac-risk-by-91-are-they-really-that-stupid-f8ee453ad77c
I was talking to my Dad last night - he is a top notch researcher with 300+ articles in the peer reviewed literature - in the area of Cardiology and Longevity (was the principle investigator on the Adventist Health Study until last year - since 1977).
He is similarly surprised that ACC allowed this to get a press release and pretend to be science, when it is rubbish. Really a serious disservice. Also not good for my patients - to have them undermine what is generally part of a healthy lifestyle.
The claims made are completely unsupported by the evidence.
Thank you for the article. While Dr. Fung is correct in decrying the validity of the AHA paper, his focus on the publically obvious problem with implying causation from association misses the most fundamental logical flaw which is expecting an independent variable based on self-reported eating behavior in 2003 to remain valid across the years to be used in a retrospective analysis in 2015 and beyond. There are other design and methodological weaknesses that limit the validity of claims such as this but they are mostly meaningful only to design experts.
I agree with your father. It is quite surprising that this was published given its obvious unreliablity.
