A new study found that completely eliminating meat from one’s diet may significantly reduce the risk of developing cancer, with figures reaching up to 45% less risk for some cancers compared to those…
Background
Associations between vegetarian diets and risk of common cancers are somewhat understood, but such data on medium-frequency cancers are scarce and often imprecise.
Objectives
The objectives of this study was to describe multivariable-adjusted associations between different types of vegetarian diets (compared with nonvegetarians) and risk of cancers at different bodily sites.
Methods
The Adventist Health Study is a cohort of 95,863 North American Seventh-day Adventists established between 2002 and 2007. These analyses used 79,468 participants initially free of cancer. Baseline dietary data were obtained using a food frequency questionnaire and incident cancers by matching with state and Canadian provincial cancer registries. Hazard ratios (HRs) were estimated using proportional hazard regression. Small amounts of missing data were filled using multiple imputations.
Results
Overall cancers, all vegetarians combined compared with nonvegetarians, had HR: 0.88; 95% confidence interval (CI): 0.83,0.93; P < 0.001, and for medium frequency cancers, HR: 0.82; 95% CI: 0.76, 0.89; P < 0.001. Of specific cancers, colorectal (HR: 0.79; 95% CI: 0.66, 0.95; P = 0.011), stomach (HR: 0.55; 95% CI: 0.32, 0.93; P = 0.025), and lymphoproliferative (HR: 0.75; 95% CI: 0.60,0.93; P = 0.010) cancers, were significantly less frequent among vegetarians. A joint test that HR = 1.0 for all vegetarian subtypes compared with nonvegetarians was rejected for cancers of the breast (P = 0.012), lymphoma (P = 0.031), all lymphoproliferative cancers (P = 0.004), prostate cancer (P = 0.030), colorectal cancers (P = 0.023), medium frequency cancers (P < 0.001), and for all cancers combined (P < 0.001).
Conclusions
These data indicate a lower risk in vegetarians for all cancers combined, as well as for medium-frequency cancers as a group. Specific cancers with evidence of lower risk are breast, colorectal, prostate, stomach, and lymphoproliferative subtypes. Risk at some other sites may also differ in vegetarians, but statistical power was limited.
Compares only against the Standard American Diet [SAD]
Cannot inform on cause and effect
proportional hazard regression is just a fancy way of saying they tried to model out confounders by guessing
Food Frequency Questionnaire administered asking about 1 year of food administered once, in a study that has been running since 2002 - 23 years! 21 years since a FFQ
TLDR: It’s a interesting study, it is hypothesis generating and should be used for further science or to design a interventional study, it should not be used to inform on personal health choices, it simply does not have the power or the rigor
Don’t you think calling a proportional hazards model “guessing” is doing a disservice to Lemmy posters here? Not everyone has a background in statistics, and honestly quite a few people here struggle with highschool math. It’s not much different than linear regression. Its fancy linear regression, not fancy guessing.
At its most essential level - when you have a epidemiology dataset you don’t know the relationships until you analyze the data, in order to make controls for some factors in the data you have to assume some relationship for that factor. It’s typically assumed to be some linear relationship. If you knew the relationship between factors with certainty, you wouldn’t need a epidemiological dataset in the first place, but since we are trying to control for a confounder by definition we don’t know the relationship. It is a guess in colloquial terms, a educated guess to be sure, but still a guess.
the researchers should notice that wrong assumptions about the form of the relationship between confounder and disease can lead to wrong conclusions about exposure effects too.
This is a critical weakness of epidemiology when inferences are made about something not directly measured.
while all true, I’m taking issue with you calling it guessing, not that it’s a perfect method.
also, we use epidemiological data because it’s kind of hard to do a double blind study where you tell some group of people to eat meat for 20 years, and another group of people to not eat meat for 20 years, and then have them live exactly identical lives for that 20 years.
you’re kind of not mentioning that. it’s kind of dishonest when the audience (Lemmy) is full of layman who are definitely not reading your linked citations, I certainly don’t have time to. I’m not defending this study at all because I haven’t read it, I’m just taking issue with how you are presenting these (useful) techniques
These are useful techniques to generate hypothesis to test, absolutely!
The results from epidemiology, especially weak hazard ratios, and poor confounders, really have no business being publicized to lay people to get them to change any aspect of their life.
also, we use epidemiological data because it’s kind of hard to do a double blind study where you tell some group of people to eat meat for 20 years, and another group of people to not eat meat for 20 years, and then have them live exactly identical lives for that 20 years.
Sure, but that isn’t science. Science is a falsifiable hypothesis that can be tested, if we say we can’t test these things then we are not in the realm of empiricism but of theology. That is fine, but we should be clear that the message isn’t backed by science.
Good lord there should be a confirmation for the delete button.
Anyway,
The results from epidemiology, especially weak hazard ratios, and poor confounders, really have no business being publicized to lay people to get them to change any aspect of their life.
This is certainly a problem with science reporting.
if we say we can’t test these things then we are not in the realm of empiricism but of theology
I would like to know how you think we’ve established the link between smoking and cancer. Or air quality, etc. It’s just a tool, not something perfect.
theology
This is the key of my issue with your statements here. I am no vegetarian. When you are being hyperbolic like this, it makes everything else you say suspect.
I would like to know how you think we’ve established the link between smoking and cancer. Or air quality, etc. It’s just a tool, not something perfect.
Ah, Good question! I do cover this in my evidence standards post (i know, I know, no time to read, but I’ll quote the bits here) https://discuss.online/post/25820268
What about smoking? Smoking causes cancer and that was all observational epidemiology.
That epidemiology had hazard ratios of 6000 (far greater then 4), was consistent across different reputable studies, demonstrated in animal interventions… and most importantly there is no medical benefit to smoking… Giving up smoking is all upside, no real tradeoff. That being said… we actually don’t know that smoking causes cancer in all contexts - the health of the subject, their diet, their lifestyle, their genetics… there are smokers who die without lung cancer.
theology
This is the key of my issue with your statements here. I am no vegetarian. When you are being hyperbolic like this, it makes everything else you say suspect.
I’m not being hyperbolic, if the response to feedback about the rigor of something is that the thing is untestable, that is no longer science.
Depending on your lemmy interface there should be a undelete button too.
Yes, fine, this is what I am saying: Take issue with the findings of the model, not epidemiological data (edit: as a technique that is akin to theology). Focus on that.
I’m not being hyperbolic
It was theology before, but now that hazard ratio is fine, because the number is big? There’s big numbers in the bible too, friend. This is what I would call hyperbole. Either it’s theology or it’s not.
Yes, fine, this is what I am saying: Take issue with the findings of the model, not epidemiological data. Focus on that.
I totally agree with you, actually.
Under what circumstances would I personally look at a observational epidemiology study and consider it to modify my behavior?
Hazard Ratios greater then 4 (far greater honestly, but 4 is the floor)
Absolute Risk reported in the paper (not relative)
Clear signal across different studies
However, this is so rare, that it is exceptional.
It was theology before, but now that hazard ratio is fine, because the number is big? There’s big numbers in the bible too, friend. This is what I would call hyperbole. Either it’s theology or it’s not.
It does not prove causation, there is no downside to giving up smoking, so why not? Does smoking cause cancer in all circumstances, no. So, give up smoking, sure why not. Does smoking cause cancer? It hasn’t been proven.
There is more nuance here, in some contexts smoking is correlated with cancer. I have my own personal theories on the incidence of cancer increasing even though smoking has existed throughout documented history, but that is neither here nor there.
“science journalist” often incorrect or misunderstood understanding of things.
I think they understand perfectly, the study is just a talking point for some agenda. If the journalist was interested in science they would have mentioned some of the things I did.
Food Frequency Questionnaire administered asking about 1 year of food administered once
I don’t think you read that whole part of the study. The direct follow-up to that reads: “Validation of the dietary habits was primarily by comparison with 6 24-h dietary recalls administered by telephone in a representative validation subgroup (1100 participants).” (Per the methodology section.)
From there, I’m not going to discuss the other points because I know neither you nor I are qualified to interpret primary medical literature; we should leave that to the experts, and I’m not going to fan the flames of this by doing something I’m not qualified to do. But I can objectively point out that your last bullet point is highly selective and misleading. I can also point out for readers at home that “Compares only against the standard American diet*” isn’t necessarily true? You’re assuming omnivorous Seventh day Adventists generally follow that diet similar to the general population, and moreover, you subscribe to a pseudoscientific diet which is notoriously even less healthy somehow. There is no reason people should trust you to interpret primary medical literature when your qualifications are that you follow and advocate a diet which the medical community considers deeply unscientific and very unhealthy.
* I’m not sure where you got the term “SAD” from, but it’s generally called the “Western pattern diet”.
The direct follow-up to that reads: “Validation of the dietary habits was primarily by comparison with 6 24-h dietary recalls administered by telephone in a representative validation subgroup (1100 participants).”
Yup! But they were validating the globally administered FFQ, so that doesn’t change the rigor of the data, just the confidence in the FFQ.
I know neither you nor I are qualified to interpret primary medical literature; we should leave that to the experts, and I’m not going to fan the flames of this by doing something I’m not qualified to do. But I can objectively point out that your last bullet point is highly selective.
I am trained in the maths, so I can speak to the weakness of the signal here.
Did you happen to look at my post on standards of evidence? I welcome feedback, and I know you do care about data and science even if we disagree on diets, so I would appreciate your thoughts. https://discuss.online/post/25820268
Jet, I can’t honestly take you seriously when you follow a carnivore diet. I’m sorry. It’s like someone who believes in autistic enterocolitis trying to debunk a study about vaccine safety. That’s the heart of the matter: your interpretation of scientific literature is so asinine and filled with disinformation that I honestly believe you believe this but also have to acknowledge that talking with someone on a carnivore diet about nutrition science is pigeon chess. “It’s not me who’s wrong! It’s the entirety of medical academia and all of the health institutes who are wrong!”
your interpretation of scientific literature is so asinine and filled with disinformation that I honestly believe you believe this but also have to acknowledge that talking with someone on a carnivore diet about nutrition science is pigeon chess.
Shouldn’t our divergent views be manifest in our standards of evidence? We might be stuck in a loop of pre-selecting a conclusion before examining the data, hence our inability to be empathetic to the others conclusions.
I don’t need you to agree with me, but if you can speak to my consistency of evidentiary standards we could have a productive discussion.
“It’s not me who’s wrong! It’s the entirety of medical academia and all of the health institutes who are wrong!”
Jet, linking me to the SMHP this would be like me linking you to the PCRM in a reality where the broader scientific community supports an animal-based diet. “Not all doctors believe that! Check out the PCRM!” in a world where an exclusive carnivore diet reduces the rates of major chronic diseases by double digits, and you’d tell me I’m cherry-picking like the far-right cherrypicks climate scientists who don’t believe in man-made climate change.
Closing the loop on soliciting feedback on my evidentiary standards process: You can’t look at it because you know you disagree with my conclusions. That seems rather circular
A document which answers many of the critiques you brought up in your post edits above (wrt SAD).
I’m simply providing counter evidence to the blanket statement that “the entirety of medical academia and all of the health institutions that are wrong”
I’m reading what you wrote, and responding to it as written, I’m taking you seriously, which I hope you do for me as well.
you’d tell me I’m cherry-picking like the far-right cherrypicks climate scientists who don’t believe in man-made climate change
Okay, to be fair, that’s what I’m hoping you would say to me in that reality. Even with animal ethics at stake in that alternate reality, I would hope you’d call me out. When I say the entire biology community believes in evolution, the entire climatology community believes in man-made climate change, and the entire medical community believes vaccines do not cause autism, that isn’t a literal mathematical universal qualification; it’s saying that the support is so overwhelming that any dissent is absolutely negligible and not even worth considering.
Hey no fair updating your post with insults after I responded nicely to you.
can also point out for readers at home that
Your just grand standing, you don’t want to talk to me about what I wrote at all… That is a bit rude.
There is no reason people should trust you to interpret primary medical literature when your qualifications are that you follow and advocate a diet which the medical community considers deeply unscientific and very unhealthy.
That is just an appeal to consensus fallacy, anyone who wants to learn more is welcome to discuss, ask question, etc at !carnivore@discuss.online but that has nothing to do with this post at all. My analysis of the posted study does not rely on my personal dietary choices.
90k people, only one FFQ administered at the 2-3 year mark, no FFQ followup. The study started in 2002-2007; So we are 23ish years into the study and the last FFQ was done 21 years ago.
It is a confounder that really does need to be highlighted when examining the publications.
The actual study Longitudinal associations between vegetarian dietary habits and site-specific cancers in the Adventist Health Study-2 North American cohort
abstract
Background Associations between vegetarian diets and risk of common cancers are somewhat understood, but such data on medium-frequency cancers are scarce and often imprecise.
Objectives The objectives of this study was to describe multivariable-adjusted associations between different types of vegetarian diets (compared with nonvegetarians) and risk of cancers at different bodily sites.
Methods The Adventist Health Study is a cohort of 95,863 North American Seventh-day Adventists established between 2002 and 2007. These analyses used 79,468 participants initially free of cancer. Baseline dietary data were obtained using a food frequency questionnaire and incident cancers by matching with state and Canadian provincial cancer registries. Hazard ratios (HRs) were estimated using proportional hazard regression. Small amounts of missing data were filled using multiple imputations.
Results Overall cancers, all vegetarians combined compared with nonvegetarians, had HR: 0.88; 95% confidence interval (CI): 0.83,0.93; P < 0.001, and for medium frequency cancers, HR: 0.82; 95% CI: 0.76, 0.89; P < 0.001. Of specific cancers, colorectal (HR: 0.79; 95% CI: 0.66, 0.95; P = 0.011), stomach (HR: 0.55; 95% CI: 0.32, 0.93; P = 0.025), and lymphoproliferative (HR: 0.75; 95% CI: 0.60,0.93; P = 0.010) cancers, were significantly less frequent among vegetarians. A joint test that HR = 1.0 for all vegetarian subtypes compared with nonvegetarians was rejected for cancers of the breast (P = 0.012), lymphoma (P = 0.031), all lymphoproliferative cancers (P = 0.004), prostate cancer (P = 0.030), colorectal cancers (P = 0.023), medium frequency cancers (P < 0.001), and for all cancers combined (P < 0.001).
Conclusions These data indicate a lower risk in vegetarians for all cancers combined, as well as for medium-frequency cancers as a group. Specific cancers with evidence of lower risk are breast, colorectal, prostate, stomach, and lymphoproliferative subtypes. Risk at some other sites may also differ in vegetarians, but statistical power was limited.
I’ve ranted about my Standards for Nutritional Evidence before, but here are the major issues
TLDR: It’s a interesting study, it is hypothesis generating and should be used for further science or to design a interventional study, it should not be used to inform on personal health choices, it simply does not have the power or the rigor
Don’t you think calling a proportional hazards model “guessing” is doing a disservice to Lemmy posters here? Not everyone has a background in statistics, and honestly quite a few people here struggle with highschool math. It’s not much different than linear regression. Its fancy linear regression, not fancy guessing.
Does their model not fit or something?
At its most essential level - when you have a epidemiology dataset you don’t know the relationships until you analyze the data, in order to make controls for some factors in the data you have to assume some relationship for that factor. It’s typically assumed to be some linear relationship. If you knew the relationship between factors with certainty, you wouldn’t need a epidemiological dataset in the first place, but since we are trying to control for a confounder by definition we don’t know the relationship. It is a guess in colloquial terms, a educated guess to be sure, but still a guess.
This is a good overview of cause and effect in inferential statistics, and confounders (start at the 5 minute mark) https://www.youtube.com/watch?v=n4YV7tEtg3I
If you prefer something written with more rigor: https://pmc.ncbi.nlm.nih.gov/articles/PMC4017459/
This is a critical weakness of epidemiology when inferences are made about something not directly measured.
while all true, I’m taking issue with you calling it guessing, not that it’s a perfect method.
also, we use epidemiological data because it’s kind of hard to do a double blind study where you tell some group of people to eat meat for 20 years, and another group of people to not eat meat for 20 years, and then have them live exactly identical lives for that 20 years.
you’re kind of not mentioning that. it’s kind of dishonest when the audience (Lemmy) is full of layman who are definitely not reading your linked citations, I certainly don’t have time to. I’m not defending this study at all because I haven’t read it, I’m just taking issue with how you are presenting these (useful) techniques
These are useful techniques to generate hypothesis to test, absolutely!
The results from epidemiology, especially weak hazard ratios, and poor confounders, really have no business being publicized to lay people to get them to change any aspect of their life.
Sure, but that isn’t science. Science is a falsifiable hypothesis that can be tested, if we say we can’t test these things then we are not in the realm of empiricism but of theology. That is fine, but we should be clear that the message isn’t backed by science.
Good lord there should be a confirmation for the delete button.
Anyway,
This is certainly a problem with science reporting.
I would like to know how you think we’ve established the link between smoking and cancer. Or air quality, etc. It’s just a tool, not something perfect.
This is the key of my issue with your statements here. I am no vegetarian. When you are being hyperbolic like this, it makes everything else you say suspect.
Ah, Good question! I do cover this in my evidence standards post (i know, I know, no time to read, but I’ll quote the bits here) https://discuss.online/post/25820268
I’m not being hyperbolic, if the response to feedback about the rigor of something is that the thing is untestable, that is no longer science.
Depending on your lemmy interface there should be a undelete button too.
Yes, fine, this is what I am saying: Take issue with the findings of the model, not epidemiological data (edit: as a technique that is akin to theology). Focus on that.
It was theology before, but now that hazard ratio is fine, because the number is big? There’s big numbers in the bible too, friend. This is what I would call hyperbole. Either it’s theology or it’s not.
I totally agree with you, actually.
However, this is so rare, that it is exceptional.
It does not prove causation, there is no downside to giving up smoking, so why not? Does smoking cause cancer in all circumstances, no. So, give up smoking, sure why not. Does smoking cause cancer? It hasn’t been proven.
There is more nuance here, in some contexts smoking is correlated with cancer. I have my own personal theories on the incidence of cancer increasing even though smoking has existed throughout documented history, but that is neither here nor there.
deleted by creator
deleted by creator
Thanks for the leg work of getting to the actual study instead of “science journalist” often incorrect or misunderstood understanding of things.
I think they understand perfectly, the study is just a talking point for some agenda. If the journalist was interested in science they would have mentioned some of the things I did.
I don’t think you read that whole part of the study. The direct follow-up to that reads: “Validation of the dietary habits was primarily by comparison with 6 24-h dietary recalls administered by telephone in a representative validation subgroup (1100 participants).” (Per the methodology section.)
From there, I’m not going to discuss the other points because I know neither you nor I are qualified to interpret primary medical literature; we should leave that to the experts, and I’m not going to fan the flames of this by doing something I’m not qualified to do. But I can objectively point out that your last bullet point is highly selective and misleading. I can also point out for readers at home that “Compares only against the standard American diet*” isn’t necessarily true? You’re assuming omnivorous Seventh day Adventists generally follow that diet similar to the general population, and moreover, you subscribe to a pseudoscientific diet which is notoriously even less healthy somehow. There is no reason people should trust you to interpret primary medical literature when your qualifications are that you follow and advocate a diet which the medical community considers deeply unscientific and very unhealthy.
* I’m not sure where you got the term “SAD” from, but it’s generally called the “Western pattern diet”.
Yup! But they were validating the globally administered FFQ, so that doesn’t change the rigor of the data, just the confidence in the FFQ.
I am trained in the maths, so I can speak to the weakness of the signal here.
Did you happen to look at my post on standards of evidence? I welcome feedback, and I know you do care about data and science even if we disagree on diets, so I would appreciate your thoughts. https://discuss.online/post/25820268
Jet, I can’t honestly take you seriously when you follow a carnivore diet. I’m sorry. It’s like someone who believes in autistic enterocolitis trying to debunk a study about vaccine safety. That’s the heart of the matter: your interpretation of scientific literature is so asinine and filled with disinformation that I honestly believe you believe this but also have to acknowledge that talking with someone on a carnivore diet about nutrition science is pigeon chess. “It’s not me who’s wrong! It’s the entirety of medical academia and all of the health institutes who are wrong!”
Shouldn’t our divergent views be manifest in our standards of evidence? We might be stuck in a loop of pre-selecting a conclusion before examining the data, hence our inability to be empathetic to the others conclusions.
I don’t need you to agree with me, but if you can speak to my consistency of evidentiary standards we could have a productive discussion.
Not the entirety! https://thesmhp.org/
Jet, linking me to the SMHP this would be like me linking you to the PCRM in a reality where the broader scientific community supports an animal-based diet. “Not all doctors believe that! Check out the PCRM!” in a world where an exclusive carnivore diet reduces the rates of major chronic diseases by double digits, and you’d tell me I’m cherry-picking like the far-right cherrypicks climate scientists who don’t believe in man-made climate change.
Closing the loop on soliciting feedback on my evidentiary standards process: You can’t look at it because you know you disagree with my conclusions. That seems rather circular
A document which answers many of the critiques you brought up in your post edits above (wrt SAD).
I’m simply providing counter evidence to the blanket statement that “the entirety of medical academia and all of the health institutions that are wrong”
I’m reading what you wrote, and responding to it as written, I’m taking you seriously, which I hope you do for me as well.
Now your just putting words in my mouth.
Okay, to be fair, that’s what I’m hoping you would say to me in that reality. Even with animal ethics at stake in that alternate reality, I would hope you’d call me out. When I say the entire biology community believes in evolution, the entire climatology community believes in man-made climate change, and the entire medical community believes vaccines do not cause autism, that isn’t a literal mathematical universal qualification; it’s saying that the support is so overwhelming that any dissent is absolutely negligible and not even worth considering.
If that is your worldview on things you believe no wonder you always end up attacking me and my character.
Hey no fair updating your post with insults after I responded nicely to you.
Your just grand standing, you don’t want to talk to me about what I wrote at all… That is a bit rude.
That is just an appeal to consensus fallacy, anyone who wants to learn more is welcome to discuss, ask question, etc at !carnivore@discuss.online but that has nothing to do with this post at all. My analysis of the posted study does not rely on my personal dietary choices.
I think it was based on AHS-2 - https://adventisthealthstudy.org/studies/AHS-2
90k people, only one FFQ administered at the 2-3 year mark, no FFQ followup. The study started in 2002-2007; So we are 23ish years into the study and the last FFQ was done 21 years ago.
It is a confounder that really does need to be highlighted when examining the publications.