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Most of these emails have contained dialogue along the lines of “Hey Anthony, I’m sure you’ll like this!”, presumably because I’ve previously highlighted the cardiovascular dangers of ketogenic low-carb diets and now this study allegedly does the same. Yeah, I guess I could use this epidemiological study as further ‘proof’ that ketogenic low-carb diets are bad for your heart, but I won’t. Stop for a moment and let that methodology sink in.  This study relies on self-reported data, renowned for its unreliability, taken from women with no training in food intake data collection except for whatever brief (if any) instructions came with the survey form that was mailed to them.
The second major reason I won’t be citing this study in any future discussion of the detrimental CVD effects of ketogenic diets is because, in my opinion, it’s a complete load of bollocks.
Firstly, it would appear – from the self-reported data of highly questionable validity – that none of the women in this study even consumed a ketogenic diet. But I think it’s somewhat retarded to use a study that didn’t involve Atkins-style diets or even true low-carb diets to claim anything about Atkins-style diets or low-carb diets. Take for example a ward study involving young (23-29 years) and aged (61-73 years) men examined the effect of various protein intakes on nitrogen balance. So in clinical trials, low-protein diets routinely produce quick and significant declines in a wide variety of health markers, yet we’re supposed to believe from a sloppy epidemiological study that they in fact decrease CVD risk? In other words, after adjusting for caloric intake, determining the CVD effects of individual macronutrients is impossible.
This kind of nonsense, folks, is where most of your research-designated taxpayer dollars go. Oh, another point of interest regarding protein: This study will no doubt be embraced by the truth-twisting “plant-based diet” crowd, but take a look at the figures for vegetable protein in Table 2.
So to all of you nasally, effeminate, Youtube vegan pseudoscientists: If you’re going to believe this big epidemiological wank, you have to embrace the whole study, not just the bits that support what you want to believe. Aside from the highly questionable quality of self-reported data, another huge problem with epidemiological studies is the inability to control for confounding factors.
Epidemiological studies simply do not have the ability to determine this with any degree of certainty.
My favourite example is the plethora of studies showing that whole grain cereals reduce the incidence of cardiovascular disease, diabetes, cancer, and so on. But when you look at the baseline data included in the whole-grain studies, something quickly becomes apparent: The whole-grain eaters live overall healthier lifestyles. So how do we know if it’s their whole-grain consumption or other aspects of their generally healthier diet and lifestyle that are truly responsible for any beneficial health outcomes? The answer to that comes from randomized controlled clinical trials where these confounding factors are largely removed due to the randomization process that occurs prior to the trials.
In these studies, subjects follow a whole-grain diet and a diet similar in every other respect except the cereal foods are refined.
These studies find that whole grains offer no health advantage and in fact usually produce worse health outcomes. One terribly sad and regrettable development in modern nutritional science is the belief by researchers that they can impart the same kind of accuracy seen in controlled clinical trials to completely uncontrolled epidemiological research by performing what are known as “multivariate analyses”.

This is where researchers attempt to adjust for such factors as smoking, overweight, alcohol consumption, and activity levels by mathematically factoring them into their risk factor equations.
Controlled clinical trials control confounding factors, while epidemiological researchers attempt to adjust for them.
The next best thing we can do is put our Sherlock Holmes caps on, and take a look at Table 1, which lists numerous non-dietary factors and their relationship to CVD risk.
Hypertension is not caused by protein or carbohydrate intake (although high refined carbohydrate intakes may increase blood pressure). Given that all these factors were shown to increase CVD risk, and that the researchers are claiming protein and lower carbohydrate intakes were also associated with increased risk, it appears we are faced with the same old scenario that plagues epidemiological research.
A few months back I reported on a study which was being loudly touted as proof that red meat caused cancer.
Because, if taste, discernment and self-respect are factors, doing the wild thing is not so much about numbers as it is about quality. Well, a Pubmed slut I ain’t.  As far as I’m concerned, the BMJ paper merely adds to a long, long, l-o-n-g line of epidemiological studies that constitute little other than a massive waste of taxpayer funds and do little to add anything of substance to the pool of nutritional knowledge.
Anthony Colpo is an independent researcher, physical conditioning specialist, and author of The Fat Loss Bible and The Great Cholesterol Con. Disclaimer: All content on this web site is provided for information and education purposes only. Food labels contain a wealth of nutritious facts that most consumers overlook or do not take the time to read.
The data was obtained from a single questionnaire at the start of the study, and it was assumed that it was representative of the subjects’ daily diets for the following 15.7 years (the average length of follow-up). Not only is 123.7 g miles above the ketogenic threshold of 50g of carb daily, it’s also well clear of the commonly cited 100g cut-off for non-ketogenic low-carb diets.
The subjects in the low-protein group experienced significant losses in lean tissue, immune response, and muscle function. But if we group high-protein and low-carbohydrate intakes together, we somehow magically get an understanding of the effects of “most low carbohydrate diets” – even though the lowest carbohydrate centile in this study was far higher than that seen in most low-carbohydrate diets…?!
They rose in step with animal protein, therefore also allegedly imparting an increased “risk score”. When researchers detect an association between a dietary factor and the incidence of a particular disease, how do we know for sure the dietary factor is actually the causal factor? It could well be that other factors, such as an overall unhealthier diet or lifestyle accompanying the pinpointed dietary factor, are the real cause. These studies are then used by health authorities, dopey dieticians, and clueless ‘health’ writers to claim whole grain cereals alleviate everything from heart disease to jock itch. It also comes from crossover clinical trials in which each individual subject serves as their own control by following both diets. We see, not surprisingly, that smoking, low physical activity, body mass index and high blood pressure are all associated with a significantly higher CVD risk.

Namely, that in this study population, higher protein intakes and lower carbohydrate intakes were in all likelihood associated with overall unhealthier lifestyles. But those who bothered to read the paper for themselves quickly saw that the folks who ate the most protein also ate the most calories, smoked the most cigarettes, and did the least exercise. To the contrary, studies like this just further contribute to the mass of confusion and ignorance that constitutes the modern-day nutritional arena. Comparative nitrogen balance study between young and aged adults using three levels of protein intake from a combination wheat-soy-milk mixture.
Elderly women accommodate to a low-protein diet with losses of body cell mass, muscle function, and immune response.
The Recommended Dietary Allowance for Protein May Not Be Adequate for Older People to Maintain Skeletal Muscle. Synthesis of hepatic secretory proteins in normal adults consuming a diet marginally adequate in protein. Individuals wishing to make changes to their dietary, lifestyle, exercise or medication regimens should do so in conjunction with a competent, knowledgeable and empathetic medical professional. Those in the higher-protein group lost no lean tissue and experienced improvements in immune response and muscle function[2]. As evinced by the manner in which they screw up in spectacular fashion on a daily basis, humans do not have god-like powers. But we were nevertheless supposed to believe the claim that it wasn’t their shitty, sedentary, gluttonous lifestyle and fondness for cancer sticks that killed them – it was the damn round steak they were eating!
A lot of dietary sectarians take the drunken player approach to research – they never met a supportive study they didn’t like. Anyone who chooses to apply the information on this web site does so of their own volition and their own risk. The National Institutes of Health reviewed 34 randomized controlled trials to determine the effectiveness of low-calorie diets.
96,000 women were randomly selected, invited by mail to participate, and asked to fill in a questionnaire and return it in a pre-paid envelope. You can go out tonight, pick up some aesthetically challenged drunken floozy, then excitedly tell all your friends tomorrow how you were up all night doing the horizontal hula. The owner and contributors to this site accept no responsibility or liability whatsoever for any harm, real or imagined, from the use or dissemination of information contained on this site. Attempting to adjust something mathematically after the fact and then acting like this produces the same kind of quality data as clinical trials in which confounding is largely removed in the first instance by randomization or crossover assignment is absolutely ridiculous. In other words, the RDA for protein mostly failed to maintain a muscle-preserving environment even in sedentary subjects.

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