Ongoing Study Discussion Thread - Nutrition, Training, Health etc.

[AdamWW]

This was released today.

They used healthy non obese people here.

So those who eat at their TDEE or above are at a higher risk for cardiometabolic issues?


The Lancet link to the study works within this article

https://www.npr.org/sections/thesalt...-heart-healthy

The thing that confuses me about studies such as this and others which have historically found that caloric restriction improves health markers and/or extends lifespan is that you cannot be in a chronically energy deficient state. Eventually, you will simply reach a point where you can’t lose more weight, and a deficit is impossible or you die... I mean our bodies cannot be in a net energy deficit indefinitely.... eventually we’d have to regain body weight and thus be bumped out of whatever benefit the restriction was causing.... so in that case, any benefit would only ever be temporary.

I actually had the same confusion when I heard a while back that certain towns in rural Asia apparently consumed very low calorie diets despite being more active then usual, and the scientists studying them basically suspected that the caloric restriction was a big factor. Well... ok... but it’s impossible to be a net energy deficit for a prolonged period without simply wasting away unless you periodically gain the weight back.

But in this case, I could see why being in an energy deficit even when within a healthy weight range would cause improvements, mainly because they didn’t specify their body fat levels... so if someone is a BMI of 23 (healthy) but carries 20% BF or more and doesn’t exercise, losing body fat should definitely cause all the reported improvements. But if you were take someone who is, say, the same BMI of 23 and only 14% bodyfat and at least moderately active, I doubt the same improvements would show up.

I only read quickly through the summary but it’d be good to know what their body comp was and how active they were, as well as if their food choices changed while in a deficit.

[boo99]

The thing that confuses me about studies such as this and others which have historically found that caloric restriction improves health markers and/or extends lifespan is that you cannot be in a chronically energy deficient state. Eventually, you will simply reach a point where you can’t lose more weight, and a deficit is impossible or you die... I mean our bodies cannot be in a net energy deficit indefinitely.... eventually we’d have to regain body weight and thus be bumped out of whatever benefit the restriction was causing.... so in that case, any benefit would only ever be temporary.

I actually had the same confusion when I heard a while back that certain towns in rural Asia apparently consumed very low calorie diets despite being more active then usual, and the scientists studying them basically suspected that the caloric restriction was a big factor. Well... ok... but it’s impossible to be a net energy deficit for a prolonged period without simply wasting away unless you periodically gain the weight back.

But in this case, I could see why being in an energy deficit even when within a healthy weight range would cause improvements, mainly because they didn’t specify their body fat levels... so if someone is a BMI of 23 (healthy) but carries 20% BF or more and doesn’t exercise, losing body fat should definitely cause all the reported improvements. But if you were take someone who is, say, the same BMI of 23 and only 14% bodyfat and at least moderately active, I doubt the same improvements would show up.

I only read quickly through the summary but it’d be good to know what their body comp was and how active they were, as well as if their food choices changed while in a deficit.

Good insights as usual

The prolonged deficit is the big issue, I mean they were in one for 2 yrs, 25% I think under TDEE, I would find that personally tough. But the bigger issue would be what you said: wasting eventually if really prolonged I suppose.

So you get lower LDL, BP, etc but you have another issue.

So what long term practical applications would this prolonged deficit be useful for especially here they weren't obese, which I think would have been more applicable for the obese that usually have cardiometabolic issues?

[Mrpb]

Yeah what Adam said: someone dubbed as 'normal weight' was probably still 20% body fat. They benefit from reducing body fat.

And also: people went from their normal diet (probably shtty) to a diet that had vegetables, fruit, fiber etc. This was probably also important for the health effects.

If you're already 15% and already eating healthy, would you still get healthier from a calorie deficit? I highly doubt it.

[AdamWW]

Good insights as usual

The prolonged deficit is the big issue, I mean they were in one for 2 yrs, 25% I think under TDEE, I would find that personally tough. But the bigger issue would be what you said: wasting eventually if really prolonged I suppose.

So you get lower LDL, BP, etc but you have another issue.

So what long term practical applications would this prolonged deficit be useful for especially here they weren't obese, which I think would have been more applicable for the obese that usually have cardiometabolic issues?

I honestly don't know... in fact that's kind of my big gripe with the conclusions they drew:

"2 years of moderate calorie restriction significantly reduced multiple cardiometabolic risk factors in young, non-obese adults. These findings suggest the potential for a substantial advantage for cardiovascular health of practicing moderate calorie restriction in young and middle-aged healthy individuals, and they offer promise for pronounced long-term population health benefits."


I completely disagree with this statement. I think that is a massive leap to claim that ONLY the calorie reduction would have caused the benefits, and at least from what they included in the methodology summary I see so few controls or considerations for the aspects of Bodyfat, Lifestyle, Stress, Nutrient Content of the foods...

Additionally, it sounds like most of this is all about 'targeted' deficits in energy.

In reality, they simply told people what to do, and tried to measure adherence over a long period but this wasn't actually a warded environment.

Finally, some of their exclusion criteria (https://clinicaltrials.gov/ct2/show/NCT00427193) really hits home as to WHY simple calorie restriction would have caused these benefits:

- Engaged in a regular program of physical fitness involving some kind of heavy physical activity (e.g., jogging, running or riding fast on a bicycle for 30 minutes or more) five or more times per week over the past year
- Practice a vegan dietary lifestyle


So basically, you had to be between in the upper-middle range of normal BMI OR near the top end of the overweight BMI, and you cannot have followed an exercise program which amounts to any more than 150minutes per week...

Essentially you need to be an average fat American... and I didn't even see them say what the average BMI was.. it could have been like 27 with a bodyfat of 28%...

[Strawng]

Yeah what Adam said: someone dubbed as 'normal weight' was probably still 20% body fat. They benefit from reducing body fat.

And also: people went from their normal diet (probably shtty) to a diet that had vegetables, fruit, fiber etc. This was probably also important for the health effects.

If you're already 15% and already eating healthy, would you still get healthier from a calorie deficit? I highly doubt it.

This. If you're single digits, I'd be willing to bet the opposite happens for all-cause mortality. Speaking for myself, if I'm in a deficit around 10% BF or less, I tend to get sick far more often than normal and don't recover as well. I'd imagine that the suppressed immune system caused by a caloric deficit in lean individuals may increase disease risk with age unless some benefit occurs due to the reduced metabolic rate and cellular division that somehow outweighs the negative impacts of less lean mass and impaired immune function. Also, studies show that older adults often do better at slightly higher or even overweight BMI's, even with regards to things like cognitive impairment:https://journals.plos.org/plosone/ar...l.pone.0148908. I'd be fascinated to know at what point exactly a caloric deficit is more harmful than beneficial.

[boo99]

I honestly don't know... in fact that's kind of my big gripe with the conclusions they drew:

"2 years of moderate calorie restriction significantly reduced multiple cardiometabolic risk factors in young, non-obese adults. These findings suggest the potential for a substantial advantage for cardiovascular health of practicing moderate calorie restriction in young and middle-aged healthy individuals, and they offer promise for pronounced long-term population health benefits."


I completely disagree with this statement. I think that is a massive leap to claim that ONLY the calorie reduction would have caused the benefits, and at least from what they included in the methodology summary I see so few controls or considerations for the aspects of Bodyfat, Lifestyle, Stress, Nutrient Content of the foods...

Additionally, it sounds like most of this is all about 'targeted' deficits in energy.

In reality, they simply told people what to do, and tried to measure adherence over a long period but this wasn't actually a warded environment.

Finally, some of their exclusion criteria (https://clinicaltrials.gov/ct2/show/NCT00427193) really hits home as to WHY simple calorie restriction would have caused these benefits:

- Engaged in a regular program of physical fitness involving some kind of heavy physical activity (e.g., jogging, running or riding fast on a bicycle for 30 minutes or more) five or more times per week over the past year
- Practice a vegan dietary lifestyle


So basically, you had to be between in the upper-middle range of normal BMI OR near the top end of the overweight BMI, and you cannot have followed an exercise program which amounts to any more than 150minutes per week...

Essentially you need to be an average fat American... and I didn't even see them say what the average BMI was.. it could have been like 27 with a bodyfat of 28%...

Jeesh

Yea, true the % could be way up there

So if up there then likely had issues that possible deficit and/or losing weight might bring favourable results to

Now watch the USA media etc start plugging to eat in an energy deficit indefinitely.

[Heisman2]

Nice quick read on the inadequacy of a lot of nutrition research: https://undark.org/2019/07/18/science-of-eggs/

[necon76]

Anyone experimenting with the low volume approach have any observations to report?

[Mrpb]

Anyone experimenting with the low volume approach have any observations to report?

Yup. Seems to be working quite well now. I'm doing 8 sets per week for chest, shoulders and back. Basically 4 sets per workout, twice per week. Every set is very close to failure. I'm getting stronger, while my body weight is staying the same. Seems like I'm breaking through a previous plateau now, but may be too early to tell.

Higher volume did work quite well for me in the shorter term, but longer always stalled and burned out.

[Heisman2]

Anyone experimenting with the low volume approach have any observations to report?

I'm making tremendous progress with weighted dips. Key portions of my pressing workouts:

Saturday: weighted dips x 3 sets, incline dumbbell bench press x 2 sets

Thursday: machine chest press x 3-5 sets, standing barbell shoulder press x 2 sets

Then doing 1 sets of laterals, bent over laterals, and 1-2 sets of tricep work each session

Taking everything to true failure, which I've never done. It makes a difference for the dips. My chest is still sore 2 days after my last dip workout and I'm getting much stronger each workout.


However, I haven't made any progress with my back during the same time frame. I think it's the pushing to failure that is helping more with the dips, and the lower volume allows me to recover from this. By true failure I mean I keep pushing until the weight starts moving backwards. I will give it a few more sessions to see if my back starts responding well.

[Mrpb]

>300.000 people observational data.

Findings In this systematic review and meta-analysis of prospective observational studies assessing the association between plant-based dietary patterns and risk of type 2 diabetes among adults, higher adherence to plant-based dietary patterns was associated with a lower risk of type 2 diabetes; this association was strengthened when healthy plant-based foods, such as fruits, vegetables, whole grains, legumes, and nuts, were included in the pattern. Findings were broadly consistent in several prespecified subgroups and in sensitivity analyses.

Meaning Greater adherence to plant-based dietary patterns, especially those rich in healthful plant-based foods, is associated with lower risk of type 2 diabetes.

https://jamanetwork.com/journals/jam...oo3Y1rE9YWMoxI

[necon76]

Yup. Seems to be working quite well now. I'm doing 8 sets per week for chest, shoulders and back. Basically 4 sets per workout, twice per week. Every set is very close to failure. I'm getting stronger, while my body weight is staying the same. Seems like I'm breaking through a previous plateau now, but may be too early to tell.

Higher volume did work quite well for me in the shorter term, but longer always stalled and burned out.

I'm making tremendous progress with weighted dips. Key portions of my pressing workouts:

Saturday: weighted dips x 3 sets, incline dumbbell bench press x 2 sets

Thursday: machine chest press x 3-5 sets, standing barbell shoulder press x 2 sets

Then doing 1 sets of laterals, bent over laterals, and 1-2 sets of tricep work each session

Taking everything to true failure, which I've never done. It makes a difference for the dips. My chest is still sore 2 days after my last dip workout and I'm getting much stronger each workout.


However, I haven't made any progress with my back during the same time frame. I think it's the pushing to failure that is helping more with the dips, and the lower volume allows me to recover from this. By true failure I mean I keep pushing until the weight starts moving backwards. I will give it a few more sessions to see if my back starts responding well.

Interesting. I guess if you're truly pushing yourself, and putting maximal demand on the muscle with every set the body is simply forced to adapt. Seems kinda obvious if you think about it. There's a routine from Paul Carter I'd been wanting to try, but I'd thought it looked like too little work. This is making me reconsider.

[AdamWW]

Interesting. I guess if you're truly pushing yourself, and putting maximal demand on the muscle with every set the body is simply forced to adapt. Seems kinda obvious if you think about it. There's a routine from Paul Carter I'd been wanting to try, but I'd thought it looked like too little work. This is making me reconsider.

I’ve been finding similar improvements by recently cutting my volume back as well. Originally I was doing about 16 sets per week for primary leg movements, about 15 for chest, about 15 for back, etc.

Now, I’m doing about 10 working sets for each, and not only am I recovering faster but progress is coming quicker. I suspect there is a highly individualized response to volume, but also a chance it comes down to how intense each person perceives their workouts. People who do 20 sets a week for one group might simply not train at the same intensity level on working sets.

[boo99]

I’ve been finding similar improvements by recently cutting my volume back as well. Originally I was doing about 16 sets per week for primary leg movements, about 15 for chest, about 15 for back, etc.

Now, I’m doing about 10 working sets for each, and not only am I recovering faster but progress is coming quicker. I suspect there is a highly individualized response to volume, but also a chance it comes down to how intense each person perceives their workouts. People who do 20 sets a week for one group might simply not train at the same intensity level on working sets.

Exactly. Intensity and volume.

Inversely related.

Intensity up
Volume goes down

Intensity down
Volume goes up


Mike Mentzer, one of the greats of the Golden Era stressed that lifts need to be brief and intense. Even had a book about it called High Intensity Training which I had and lost somewhere over the years.

Today I had a client who claimed he squats regularly 15-20 sets. I said if you can do that many sets with normal rest intervals you simply aren't working at YOUR full intensity level.

[AdamWW]

Exactly. Intensity and volume.

Inversely related.

Intensity up
Volume goes down

Intensity down
Volume goes up


Mike Mentzer, one of the greats of the Golden Era stressed that lifts need to be brief and intense. Even had a book about it called High Intensity Training which I had and lost somewhere over the years.

Today I had a client who claimed he squats regularly 15-20 sets. I said if you can do that many sets with normal rest intervals you simply aren't working at YOUR full intensity level.

Yup, precisely.

I also noticed much better joint health and recovery when I limited accessory movements which caused undo burn/strain to a reasonable level. I used to follow Squats with heavy leg presses, but now I just do a few sets after my squats while focusing primarily on glute activation but with less weight, and everything improved in terms of post training fatigue. In fact, I treat the leg presses as optional depending on what happens with my squats... if I hit a large increase or PR on squats I might skip the presses altogether depending on how my body feels afterward... allows me to avoid the added CNS fatigue carrying over to my upper body day, etc.

[boo99]

Yup, precisely.

I also noticed much better joint health and recovery when I limited accessory movements which caused undo burn/strain to a reasonable level. I used to follow Squats with heavy leg presses, but now I just do a few sets after my squats while focusing primarily on glute activation but with less weight, and everything improved in terms of post training fatigue. In fact, I treat the leg presses as optional depending on what happens with my squats... if I hit a large increase or PR on squats I might skip the presses altogether depending on how my body feels afterward... allows me to avoid the added CNS fatigue carrying over to my upper body day, etc.

So intuitive eating + intuitive lifting FTW

Good points on limiting burn, strain and CNS fatigue because I remember multiple times being at that stage and simply going to the gym wasn't fun anymore; it became like going to a job I hated.

For some reason over these 25 yrs of going to a gym, I tend to leave there with the thought that I haven't done enough but I've been there 60 mins+ which I need to reevaluate my intensity to make the sessions brief and intense. I'm kinda a volume whore now lol.

[AdamWW]

So intuitive eating + intuitive lifting FTW

Good points on limiting burn, strain and CNS fatigue because I remember multiple times being at that stage and simply going to the gym wasn't fun anymore; it became like going to a job I hated.

For some reason over these 25 yrs of going to a gym, I tend to leave there with the thought that I haven't done enough but I've been there 60 mins+ which I need to reevaluate my intensity to make the sessions brief and intense. I'm kinda a volume whore now lol.

I know what you mean... there’s a kind of stagnant feeling when you don’t feel worked to the point of pretty heavy exhaustion because you develop a high threshold for it. That’s why being a seasoned gym goer requires a lot of change and fine tuning.

As for intuitive eating and lifting, it’s only intuitive to a point.

I always set minimums for both, but the maximum is intuitive. I have a base volume of training I know I need to be effective, and if my body feels OK at the time, I will add some other things only if I’m sure it will yield some return, even if only some added activity and form mastery.

Same with food: I know I have a baseline need, but if I hit that ‘planned’ surplus (while I’m bulking now) goal and am still hungry, i eat to satisfaction because feeling hungry while building strength makes no sense to me... but its never to the point of force feeding, just making sure I’m 100% satiated, energized, and not thinking about food. Sometimes it’s only like an additional banana, and other times it’s and entire added meal plus some dark chocolate afterward... just depends.

[necon76]

Exactly. Intensity and volume.

Inversely related.

Intensity up
Volume goes down

Intensity down
Volume goes up


Mike Mentzer, one of the greats of the Golden Era stressed that lifts need to be brief and intense. Even had a book about it called High Intensity Training which I had and lost somewhere over the years.

Today I had a client who claimed he squats regularly 15-20 sets. I said if you can do that many sets with normal rest intervals you simply aren't working at YOUR full intensity level.

Just gave it a test run. Full body, but two work sets for everything, pushed to the point that I didn't think I could get another rep. Got some good results on the first sets, and a surprisingly good pump too. To be continued...

[boo99]

I know what you mean... there’s a kind of stagnant feeling when you don’t feel worked to the point of pretty heavy exhaustion because you develop a high threshold for it. That’s why being a seasoned gym goer requires a lot of change and fine tuning.

As for intuitive eating and lifting, it’s only intuitive to a point.

I always set minimums for both, but the maximum is intuitive. I have a base volume of training I know I need to be effective, and if my body feels OK at the time, I will add some other things only if I’m sure it will yield some return, even if only some added activity and form mastery.

Same with food: I know I have a baseline need, but if I hit that ‘planned’ surplus (while I’m bulking now) goal and am still hungry, i eat to satisfaction because feeling hungry while building strength makes no sense to me... but its never to the point of force feeding, just making sure I’m 100% satiated, energized, and not thinking about food. Sometimes it’s only like an additional banana, and other times it’s and entire added meal plus some dark chocolate afterward... just depends.

Yes true, always need to change it up and try to be ahead of the body's adaptations

Just gave it a test run. Full body, but two work sets for everything, pushed to the point that I didn't think I could get another rep. Got some good results on the first sets, and a surprisingly good pump too. To be continued...

I think this is the first time I got to reply to you in a while outta that other misc thread

Interested to see how it continues for you

Bringing most sets to failure needed me to be more aware of that, cause I tend to be locked up with my reps and stopping before failure

Honestly I didn't have great success with lower volume though I don't think I did my full intensity so that's likely why

[Mrpb]

Today I had a client who claimed he squats regularly 15-20 sets. I said if you can do that many sets with normal rest intervals you simply aren't working at YOUR full intensity level.

That's true, but it's not certain what is better. Doing more volume with lower intensity can also work.

[Mrpb]

Design
In a cross-sectional design, long-term (n = 44, > 1 year) self-reported followers of a Paleolithic diet (PD) and controls (n = 47) consuming a diet typical of national recommendations were recruited. Diets were assessed via 3-day weighed diet records; 48-h stool for short chain fatty acids using GC/MS, microbial composition via 16S rRNA sequencing of the V4 region using Illumina MiSeq. TMAO was quantified using LC–MS/MS.

Results
Participants were grouped according to PD adherence; namely excluding grains and dairy products. Strict Paleolithic (SP) (n = 22) and Pseudo-Paleolithic (PP) (n = 22) groups were formed. General linear modelling with age, gender, energy intake and body fat percentage as covariates assessed differences between groups. Intake of resistant starch was lower in both Paleolithic groups, compared to controls [2.62, 1.26 vs 4.48 g/day (P < 0.05)]; PERMANOVA analysis showed differences in microbiota composition (P < 0.05), with higher abundance of TMA-producer Hungatella in both Paleolithic groups (P < 0.001). TMAO was higher in SP compared to PP and control (P < 0.01), and inversely associated with whole grain intake (r = − 0.34, P < 0.01).

Conclusions
Although the PD is promoted for improved gut health, results indicate long-term adherence is associated with different gut microbiota and increased TMAO. A variety of fiber components, including whole grain sources may be required to maintain gut and cardiovascular health.

https://link.springer.com/article/10...94-019-02036-y

[Heisman2]

https://link.springer.com/article/10...94-019-02036-y

That looks extremely interesting and potentially quite an important finding. One of the big things anti-egg people say is that it leads to too much TMAO. I need to read that in full.

[Mrpb]

New study on training to failure in well trained guys: https://www.mdpi.com/2075-4663/7/7/169/htm

From what I heard better results by not going to failure (haven't read the study myself yet).

Edit: just had a read. Really hard to draw conclusions because not only was there a difference in training to failure, the non failure group also had a light day. Are the better results really caused by not training to failure or did they have better recovery because of the light day. Impossible to tell I think. (ofc a combination of both is possible too).

For anyone that wants an easier read: https://mennohenselmans.com/skeletal...ive-intensity/

Be careful though because Menno frames this completely as not training to failure is superior but this study isn't exactly a clean setup to come to that conclusion.

[Heisman2]

Yeah, I would be interested in the failure group only training 2x/week. I'm getting great gains now but definitely would not recover enough if I was training 3x/week.

Edit: I'll add that I wish studies like this posted how much the weights changed during the workouts and between workouts. If the issue with the failure group was lack of recovery then the weights should have gotten lighter throughout the sessions as opposed to heavier. They do not comment on if this occurred.

[boo99]

"Plant‐Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All‐Cause Mortality in a General Population of Middle‐Aged Adults"


This was released August 7th

Didn't read as of yet, but will, just posting it if anyone's interested


https://www.ahajournals.org/doi/10.1161/JAHA.119.012865

[AdamWW]

"Plant‐Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All‐Cause Mortality in a General Population of Middle‐Aged Adults"


This was released August 7th

Didn't read as of yet, but will, just posting it if anyone's interested


https://www.ahajournals.org/doi/10.1161/JAHA.119.012865

The keto and carnivore crew ain’t gunna like this ;-)

[boo99]

The keto and carnivore crew ain’t gunna like this ;-)

Haha word

Cheers to ketosis

Hehe

[Mrpb]

"Plant‐Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All‐Cause Mortality in a General Population of Middle‐Aged Adults"


This was released August 7th

Didn't read as of yet, but will, just posting it if anyone's interested


https://www.ahajournals.org/doi/10.1161/JAHA.119.012865

Thanks. interesting.

Good to read how they're improving observational studies nowadays.

Although prior studies have characterized participants’ diets using a relatively simple classification method based on frequency of animal food consumption,4, 5, 6 there have since been more comprehensive attempts to assess an individual's diet using plant‐based diet indexes.10, 11, 12, 13 These indexes give higher scores for higher consumption of plant foods and lower consumption of animal foods, allowing researchers to examine whether the degree of adherence to an overall plant‐based diet is associated with health outcomes. Studies that used such indexes (ie, an overall plant‐based diet index [PDI] or a provegetarian diet index) found that greater adherence to these diets was associated with a lower risk of type 2 diabetes mellitus, coronary heart disease, and all‐cause mortality.10, 11, 12 In addition, some plant‐based indexes separately scored healthful (whole grains, vegetables, and plant proteins) and unhealthful (refined carbohydrates and sugar) plant sources of food. Healthful plant‐based diets, which scored higher intakes of only healthful plant foods higher, were more strongly inversely associated with type 2 diabetes mellitus and coronary heart disease than the overall plant‐based diets.11, 12 In contrast, greater adherence to less healthful (unhealthful) plant‐based diets, which scored higher intakes of only less healthful plant foods higher, were associated with a higher risk of these conditions.11, 12

Dietary Assessment

At baseline and visit 3, participants’ usual intake of foods and beverages was assessed by trained interviewers using a modified version of the 66‐item semiquantitative Willett food frequency questionnaire.15 Participants indicated the frequency with which they consumed foods and beverages of a defined serving size in the previous year. Visual guides, such as glasses and measuring cups, were provided for participants to estimate portion size. The reliability of the food frequency questionnaire was assessed in a random sample of ARIC study participants (n=419) from all 4 study sites at visit 2.15 Nutrient and total energy intakes were derived through multiplying consumption of food by nutrient content of each item in the food frequency questionnaire.

[deano110]

"Plant‐Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All‐Cause Mortality in a General Population of Middle‐Aged Adults"


This was released August 7th

Didn't read as of yet, but will, just posting it if anyone's interested


https://www.ahajournals.org/doi/10.1161/JAHA.119.012865

A very detailed study indeed, there is often a bit of a self-selection bias when looking at plant based diet vs other diets. By that I mean people that choose to follow a plant based diet are generally more health conscious and as such make other decisions which will positively affect their all-cause mortality, in comparison to the standard Western diet.

The strongest and most consistent significant associations were observed for PDI and provegetarian diet index, with all 3 outcomes in all 3 models (Figures S1 and S2). After adjusting for sociodemographic characteristics (age, sex, race‐center, and education), dietary factors (total energy intake and margarine consumption), and health behaviors (smoking, physical activity, and alcohol consumption), those in the highest versus lowest quintiles of PDI and provegetarian diet index had a 16% and 16% lower risk of incident cardiovascular disease, a 32% and 31% lower risk of cardiovascular mortality, and a 25% and 18% lower risk of all‐cause mortality, respectively (Table 3).

[boo99]

But who was micronutrients?







https://news.google.com/articles/CAI...S&ceid=US%3Aen