What is your assessment of the 2020 Hooper, et al review in Cochrane?
The systematic reviews done by Hooper, et al in Cochrane (in 2001, 2011, 2016 and then 2020) all report no association between modification or reduction of saturated fat intake with cardiovascular mortality, total mortality, non-fatal MI. The only significant effect reported was a relative risk reduction in combined cardiovascular events. Danny and Alan have frequently and strongly supported the idea that dietary replacement of saturated fat with PUFA and healthy carbs improves cardiovascular outcomes. But this Hooper study seems to consistently show that the only effect is on combined events. How should we - meaning non-experts - interpret these reviews, and can you point us to any other data that more strongly demonstrates a direct impact of saturated fat intake on cardiovascular risk outside of its impact on ApoB (the authors of the review specifically state increase in ApoB alone would not explain their findings for various outcomes). Thanks for all your great content. This podcast has changed my life.
Homocysteine
In the alternative health space it is quite popular to say that Homocysteine is causal for atherosclerosis while ApoB/LDL-P is not. There are some studies showing association with Homocysteine but also that reducing Homocysteine does not reduce risk (but were trials long enough or happened at too late a stage to make a statistically significant difference? ). Would be interested to find out more about the current science on this.
Recommended serves of fruit and vegetables
Around the world, there are different government recommendations for serves of fruit/veg per day. Australia recommends 2 fruit and 5 veg, yet less than 10% of the population achieve this. Is the target too high? What would happen if the target was reduced to something like the UK guidelines? What is the evidence around setting these guidelines to make sure that they are realistic enough for people to achieve them, without being so unrealistic that they discourage people from eating fruit/veg?