Comment by themk
3 days ago
Notably, the epidemiological study people like to dump on the most, largely did use natural experiments (i.e. they chose regions, that, at the time, had very traditional diets, without the convenience of supermarkets to mess it all up). They also didn't rely solely on food surveys, but actually measured the meals.
But all that aside, I don't actually follow a Mediterranean diet, and agree that one has to be careful here, because it is not well defined (or, it might be in some circles, but that differs from what the general population might expect).
The only reason I mentioned it was in response to
> The Mediterranean diet is regarded as quite healthy by many health professionals but, it is also high in carbs and fat.
Where I was pointing out that the fats in the Mediterranean diet (by pretty much every measure of what it means to be a Mediterranean diet), are not saturated, and it is usually saturated fats that are considered "bad".
That is, all I was trying to do was clear up the (common!) confusion about fats (they are not all the same).
Fair, the term may have been well-defined and measured in the original study, or in some specific circles. I was definitely thinking of the meaningless general thing "Mediterranean diet" has metastasized into today.
I also think it is better, rhetorically, to not draw support for the badness of saturated fats / differences of different fats by referencing the Mediterranean diet, since this rather looks like drawing upon narrow / weak science to support something that is in fact much more broadly supported by a larger variety of more careful work.
But yes, it is very important that people recognize there are huge differences here!
There are so many differences in lifestyle between the regions that they studied and other places that it is absurd to attribute the outcomes confidently to the diet. Especially when stress is a well known CVD risk in itself.
This sounds like they didn't think about it at all. Of course they did, and sure, their techniques were not as sophisticated as today. But there have been plenty of follow-up studies that have controlled more rigorously for those things, and it turns out they were probably right?
Also, the 7 countries study didn't just compare the regions, they also did intra-regional comparisons. Not that I think this particular study is what you should base all your evidence on, but, most others back it up.
The people who run these studies actually know what they are doing. They know the limitations of their methods, and, they have thought about confounding variables. This _always_ comes up in internet debate, like, "ahh, but there are confounding variables so the study must be trash!". It's literally their job to take those confounding variables into account. They don't just grab random people of the street to run these things. And I assure you, they know about the details.