Comment by didibus

This is one of those where you need to be able to discern nuances in your brain as multiple things are happening.

First, identifying cause and effect of CVD is super hard, and there are lots of studies with various level of indications and in reality we're still far from understanding most of it. Even just the effects of fat and sugar on it isn't clear, and our understanding of fat itself, and all its types, and of sugars and all its types, even that's incomplete. And this makes it a perfect battle ground for grift and financial interests, because you can paint various narratives and cleverly build a case for it, since in reality so many possibilities are still on the table.

I think the conclusions that are on the stronger side are those that relate to medication and surgery. Blood pressure pills, statins, antiplatelet, coronary artery bypass, aortic valve replacement, etc.

When it comes to nutrition and other lifestyle changes, things are muddy. So instead you have "school of thoughts" and belief systems forms that often tie up with personal identity.

Second, you have financial interests meddling with research and messaging. A financial interest might want to mingle even if the research supports them, just not to take any chances. And if we found two cases of it, that's just those that were caught and proven, it's likely there's many more mingling then just that. Even if it doesn't end up proving things their way, you can assume all this mingling slows things down and makes figuring out the truth much harder and slower, which maintains the state of uncertainty for longer and that state is good for financial interests.

Lastly, it's not that we know nothing at all, and everything is just beliefs. There are a few things that have strong evidence repeatedly. We know that smoking, high blood pressure, plaque buildup, high lifetime LDL, clots, and diabetes/insulin resistance are all bad and lead to increase risks of CVD. And avoiding or lowering those, no matter how, helps reduce that risk. But it's not enough for most people that want to feel in control and believe they're living in a way that CVD won't happen to them. Which makes them vulnerable to grifters and various influencers.