“What the health” – a partial review

I was recently recommended to watch the film “What the health”,  available on netflix: https://www.netflix.com/watch/80174177

Bias:  I’m starting from a position skepticism so I will be looking to pick holes in everything and figure out if it’s reasonable what the directors / writers (Kip Andersen and Keegan Kuhn) are intending to convey. When I hear something that I don’t understand, doesn’t fit with my existing understanding of biochemistry / limited medical knowledge I will try to be as objective as possible in assessing it.

Method:  I will use their data, assess it’s provenance, try to take into account any biases I think they may have and known biases I have and unknown ones I may have. I will try to evaluate their data / observations and those of others as objectively as possible.

[UNASSESSED] Point 1: @~15:40 heterocyclic amines are mentioned as being ?bad? [recheck this].  [Are they?]

[UNASSESSED] Point 2: [follow up on paper and see if it supports what they’re claiming] @~16:13 “Intake of meat, fish, poultry and eggs and risk of prostate cancer progression” -> Richman … et al… Chan

[UNASSESSED] Point 3: [follow up and see if you can find paper to support their claim that] “consuming 1 egg a day is the same as smoking 5 cigarettes per day” [in terms of what, CVD, stroke, cancer?]

[UNASSESSED] Point 4: [follow up and see if you can find paper to support their claims that] Cholesterol and fat “coat” red blood cells and muscle cells.  This:

  • stops muscles cells uptaking sugar
  • changes hormone levels [-> I’d hope it does… you’re levels of Leptin might rise, that’d be good.  But if not Leptin, which hormones?  And is this bad?]
  • Makes blood viscous… [So what?, increases change of Heart attack, stroke?]

[Assessed: NEUTRAL] Point 5: @~18:03 It shows the title for “Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease” doi: 10.3945/ajcn.2009.27725. He correctly claims it was supported by “National Dairy Council” though it’s not clear from the paper what that means.  From the paper it does say it was:

Supported by the National Dairy Council (PWS-T and RMK) and made possible by grant UL1 RR024131-01 from the National Center for Research Resources, a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research (PWS-T and RMK). QS was supported by a Postdoctoral Fellowship from Unilever Corporate Research. FBH was supported by NIH grant HL60712.

So there’s clearly scope for definite bias in their work and findings, but I’d prefer it’s stated as if it’s unstated then you have no idea.

[Assessed: DAMAGING] Point 5: @~18:03 He goes on to quote from another paper: 10.1016/j.ijcard.2003.11.028 “Egg consumption and endothelial function: a randomized controlled crossover trial” which states that:

Subjects first presented for baseline brachial artery reactivity studies (BARSs), lipid panel and weight measurements following an overnight fast. Subjects then returned
for 3 consecutive weeks and underwent BARS following oatmeal ingestion, egg ingestion and ingestion of a sausage and cheese sandwich (comparable to McDonald’s Sausage McMuffink) [15] high in saturated fat, in random sequence.

But he said:

The egg industry similarly funds studies that confuse consumers by making claims that eggs don’t negatively effect heart function.  That is, only when compared to eating a McDonald’s Sausage McMuffin? [exclamation]

So what they’re really saying is eating eggs is just as bad as eating a McMuffin.

Let’s analyse this:

  1. The paper does not compare eating eggs to “eating a McDonald’s Sausage McMuffin”.  It compares the difference between eating oats and eating eggs over 6 weeks.
  2. It finds (according to their statistical analysis and I’ve done stats so I know you can fudge stuff but this paper actually finds) that there is statistically significant a drop in LDL and cholesterol when eating oats vs eating eggs.  Though there is no statistically significant change in flow-mediated vasodilation (FMD) in the brachial artery… which apparently supports the statement that “that eggs [consumed over the short term] don’t negatively effect heart function”… but he doesn’t say that.
  3. Finally he says “So what they’re really saying is eating eggs is just as bad as eating a McMuffin” which is like saying eating eggs is as bad as eating eggs… which is what you’d hope as the McMuffin is meant to have egg in it.  What’s he actually doing is playing off our gut reaction (perhaps correctly) that anything McDonald’s is bad for you… these are weasel words.  He’s not the side of rigorous debate.  He’s a very effective politician.

[Assessed: SEEMINGLY DAMAGING] Point 6: @~18:18 Dr. Michelle McMacken M.D. who it seems is presented as another expert seems to be saying that along with things that sounds bad the first thing she mentions is “heme iron”.  Now everything is toxin in the wrong quantity, even water, but this is not the most obvious of things to highlight.  Are they mis quoting her, did she make a mistake, is she actually an idiot, is heme iron… which is sold as a supplement and present in all your red blood cells in enormous quantity actually bad for you as a supplement?  Who knows.  I thought it was weird to mention it though.

[Assessed: DAMAGING] Point 7: @~23:00 Mike Ewall, Energy Justice Network, Executive Director states:

Dioxins being the most toxic, man-made chemicals known to science

Wrong.  Simply completely wrong. What about VX, or a huge host of other brutal chemical weapons.  Counter: perhaps he doesn’t mean per volume or per weight.  Perhaps he means the effective contamination? i.e. there are millions or billions more tonnes produced so even if it’s 100 thousand times less toxic then when you multiple by a huge volume becomes a big number.

[Assessed: NEUTRAL] Point 8: Mike Ewall continues:

… cause all sorts of things.  They cause endometriosis,

Cynic in me says he’s just chosen a long sounding word.  It’s actually the growth of womb tissue in the wrong place.  Which although potentially very unpleasant / horrific for females… endometriosis is not the first thing to mention when discussing the effects of dioxins on humans and isn’t even mentioned on the WHO site directly.

[Assessed: SEEMINGLY DAMAGING] Point 9: Mike Ewall continues:

… they cause cancers, they cause endocrine disruptions problems. [says stuff about incinerators, doesn’t mention “global” food supply chains are / are hopefully heavily monitored for dioxin levels].  Men have no way in their bodies to get rid of dioxins, but, women have two ways.  They’re both involving having a baby.  One is that dioxin crosses the placenta into the growing infant and the other is that it comes out of the breast milk.

From my limited research it seems true that dioxins have a frightening long half life in the human body.  Obviously we have had limited exposure to these chemicals in our evolutionary history so have no / poor mechanisms to deal with them.  It seems they come from forest fires in huge amounts so I wonder why we’re so bad (biologically) at dealing with them. But if it was true that dioxins were never lost then they would have an infinite half life.  But they don’t.  They have a finite, although long half life in the order or 1 to 10 years according to: http://www.dioxinfacts.org/potency.html  Interesting also according to the same site, the emission of dioxins is predominantly from forest fires now with the reduction due to regulations and technology.  [TODO: cross reference this]

[Stopped at 18:24]: TODO watch the rest.

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