Comment by matthewkayin
2 days ago
I wonder if this is because it has less to do with fat and carbs and more to do with processed foods.
The Mediterranean diet is regarded as quite healthy by many health professionals but, it is also high in carbs and fat. But these are healthy, unprocessed carbs and fats. Whole grains and olive oil.
People going for high fat, low carb / low fat, high carb are usually doing so while also sticking to real foods.
When people say "fat" is bad for you, they mean saturated fat. Mediterranean diet is quite low on saturated fat, while still having the good fats.
Cochrane systematic reviews should make you seriously question whether the Mediterranean diet really is much good at all - hard data is inconclusive and low quality [1].
In general we really even barely have enough nutritional knowledge to say if the term 'good fats' even makes much scientific sense, but broad and vague things like "Mediterranean diet" are just total nonsense, from the standpoint of serious nutrition science.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC6414510/
That seems to be searching for RCT's, which, I'm not surprised would struggle to replicate. Most of these had a duration of less than 5 years, while dietary related health outcomes are the result of decades of following a pattern. It's possibly also unethical, in some cases (i.e. the existence of effective LDL lowering medication would likely complicate things).
Many people seem to disregard epidemiology, especially when it comes to nutrition (I think because it tends to support unpopular positions). But epidemiology has performed some excellent feats in the name of public health: cholera, smoking, pfao.
It is unfortunate that the large time-lines on these things make more rigor difficult, but I wouldn't throw out the epidemiology.
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