Science Based Medicine review of McDougall

[bhami]

In one of her regular posts on the Science Based Medicine blog, Harriet Hall gives a cursory review of the McDougall program, which I think substantially misrepresents it (largely by omission, given the brief nature of that blog post). You might want to reply there.
https://sciencebasedmedicine.org/the-mcdougall-diet/

--Bruce

[barryoilbegone]

Cursory for sure. We can notice she skipped the journal article in Nutrition, the Newsletter archive, the other books, and all the testimonials - not to mention the continuing similar programs from Ornish, Esselstyn, Barnard also published in the scientific literature, the Blue Zones findings etc.

She too either (a) doesn't seem to have realised the book was written in 1991, judging by the way she talks about referencing dates, or (b) is trying to pretend that it's using deliberately outdated references for the time.

The consensus of clinical and scientific evidence is critical, but she tends to cherry pick particular statements only in this one text here - statements taken out of context for the most part I noticed as well. The overall understanding of the politics of science as well in the way she writes is lacking as well.

We can guess people will always be apt to pull this stuff, if it involves changes they dislike emotionally and /or they're loyal to another school of practise, but that's their right I guess. Can lead the horse to water and all that...

[QubitBob]

We can guess people will always be apt to pull this stuff, if it involves changes they dislike emotionally and /or they're loyal to another school of practise...

No, I don't think that is the case, here. Anyone who visits the Science Based Medicine Web site on a regular basis knows that all of the authors are very consistent: They are heavily critical of any medical treatment or diet if there aren't randomized, controlled studies backing them up. Period. Unfortunately, due to cost and logistical difficulties, one rarely finds randomized, controlled studies with diets. The thousands of patients whom Dr. McDougall helped during his 40+ years of practice don't count in their eyes. Fortunately, we McDougallers found Dr. McDougall on our own, thought his advice was sound, and tried it ourselves, to our everlasting benefit. So, I really don't care if the folks at SBM are critical of Dr. McDougall's plan--they are like the kid Mikey on the old Life cereal commercial: They hate everybody!

[barryoilbegone]

They are heavily critical of any medical treatment or diet if there aren't randomized, controlled studies backing them up. Period.

I'm not a follower of that site, but appreciate this being pointed out. Pro RCT bias and dogma in certain areas is becoming a big problem now - very problematic as you say, when it comes to areas like nutrition. RCTs are an appropriate methodology more for single drug trials as we know, not nutrition - this flawed thinking is still so powerful, and pushed by universities still today.

The irony in case control studies is (as Dr Kempner pointed out decades ago with the Rice Diet) patients act effectively as their own controls, provided that the measures used to chart changes and progress are valid and reliable - which they have been, in the case of McDougall and the related programs.

[michaelswarm]

Are randomized controlled trials even appropriate for diets? Their nature is short term. You don’t wait until you have cancer or a heart attack to apply science to your diet. By then it may very well be too late. Ideally you want to teach this to your children. Food is neither drugs nor surgery, and the tools developed to prove drugs and surgery work may be inappropriate to nutrition science. Science has plenty of other tools outside of medicine to prove things.

[Hal]

There must be a lot of empirical evidence in restored lives to assume that a controlled randomized study would show the benefits of the WOE, for all, and there will be more people and data to come. Some kind of virtual convention with a few thousand healthy restored lives might spark enough interest for publicly funded randomized controlled studies of the WOE.

[michaelswarm]

Given what science already knows about WFPB diets, would assigning people to the SAD control group even be ethical?

[John McDougall]

"I would rather be hated than ignored" is a motto I have lived by. Just keep talking about me and my work; the truth should rise to the top. I am happy to know that I am worthy enough to gain the attention of detractors these days, looking for a break in their own careers.

I am, however, unwilling to give these newcomers a ride on my back to my level of respect and notoriety by debating them and defending myself on their schedule. My accomplishments have taken me over 50 years of hard work. The same can be said about Ornish, Campbell, and Esselstyn, my colleagues, who have also been dedicated to spreading the truth for decades These doctors are under similar attacks. Conflict and criticism, warranted or not, are part of the job.

Once our critics have worked as hard as we have and gained worthy reputations for themselves then the stakes may be great enough to enter a competition, one I believe we will easily win. Until then, I refuse to offer these detractors a "free ride," especially when their current efforts have the potential to do real harm to people (including my patients).

In the meantime, consumers will have to look at the well documented, valuable, and accurate evidence I have provide and make judgements for themselves. Or better yet, follow different gurus; and personally appreciate the benefits and harms from respective advice on your own health.

PS: You are welcome to republish these two comments from me anywhere.


John McDougall, MD

[John McDougall]

BTW: my OHSU Diet/MS study was a one-year, controlled, randomized study performed by professional and experienced medical doctors and research scientists from a major medical center/university. Furthermore, my involvement in this study was limited a one-time educational experience for the study participants/patients (My 10-day residential program in Santa Rosa, CA). Study design, choosing subjects, randomization, testing, follow-up visits, data collection, analysys, reporting and publication were performed entirely independent of me and The McDougall Center; These research duties were solely the responsibility of the university, OHSU (Oregon Health & Science University).

See:

The Randomized Controlled Trial of the McDougall Diet:

Independent Research from OHSU (Medial School in Portland) on One Year: (Diet/MS study
MS and Related Disorders) http://www.msard-journal.com/article/S2211-0348(16)30100-6/pdf

Findings after one-year included (but were not limited to):
Average weight loss was 19.1 pounds while eating unrestricted amounts of food
Average cholesterol reduction was 19 mg/dL
Reduction in blood insulin and fatigue levels
An 85% compliance rate over 12-months

Important Observational Studies:

Data for 10 Years on 1615 participants at the Residential Santa Rosa Program:
(Nutrition Journal) http://nutritionj.biomedcentral.com/art ... 2891-13-99

Findings in 7-days included (but were not limited to):
Average weight loss was 3.1 pounds while eating unrestricted amounts of food
Average cholesterol reduction was 22 mg/dL
An average decrease of 18/11 mmHg in blood pressure in patients with hypertension (140/90 or greater)
Nearly 90% of patients were able to get off blood pressure and diabetic medications


Independent Research, One Year, Community-based Study, from New Zealand: (Nutrition & Diabetes)
https://www.nature.com/articles/nutd20173

Findings after one-year included (but were not limited to):
Participants lost an average of 11.5 Kg (25.3 pounds) at one year, with no limit of energy intake or mandate for regular exercise
Cholesterol reduction at month 12 was 0.55 mmol/L (20.9 mg/dl)
Medication usage decreased from 94 to 67 over 12 months: a 29% decrease
Quality of life showed significant improvements in both the ”physical component summary” and the “mental component summary”
Average attendance for intervention evening sessions was 79%


John McDougall, MD

PS: You are welcome to republish these two comments from me anywhere.

[colonyofcells]

For people who have doubts about the nutrition of vegan and vegetarian diets can send them: https://www.eatrightpro.org/media/press ... -dietetics

There is also the diet book of magician and skeptic Penn Jillette. It is not easy to convince skeptics but it is possible.

My impression is the diet guide for americans is becoming more and more vegetarian and vegan friendly.

[C.R.MacDonald]

An important and exciting point to pay attention to (as Dr. McDougall has pointed out) is that the results from his body of work is achieved not with the inclusion of scheduled exercise or portion control, but rather just to eat within the guidelines ad libitum. To give patients that kind of simplicity and freedom makes this lifestyle truly remarkable.and sustainable long-term. It's actually quite impressive.

[sligg1]

Are there any populations that eat the McDougall diet? I can't find any.

I watched on YouTube the people of Ikaria, one of the Blue Zone countries. Many of them live long lives past 100. None of them eat the McDougall diet. Mostly, they eat a plant-based diet but they also drink wine, they eat meat, the pasta is white flour, the rice is white, occasionally they eat cake. I don't know if their younger generation has been corrupted by the Western diet?

It seems to me that as long as humans continue to brutalize and murder animals for food, the virus Pandemics will eventually consume the world.

I'm a McDougaller going on 95, hoping to make 100.

Sal Liggieri

[sligg1]

The Ikarians also use a lot of olive oil.