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Fleming on huijari:
"What about Richard Fleming, the Omaha, Nebraska cardiologist who obtained Atkins' death report under such highly dubious circumstances? Fleming is an outspoken critic of high-protein, low-carbohydrate diets, and just happens to be the author of the only published study to have ever found greater weight loss in individuals randomized to follow a high-carbohydrate, low-fat diet than individuals following a low carbohydrate diet.
If legitimate, Fleming's study is indeed a landmark, for every other published randomized clinical trial has found either greater weight loss among those assigned to follow low carbohydrate diets, or statistically insignificant differences (the non-significant difference, by the way, invariably favoring the low carbohydrate dieters). In addition to being the only trial in which high-carbohydrate dieters reportedly lost more weight than low carbohydrate dieters, Fleming's paper reported some truly unique blood-test findings. While Fleming's high-carbohydrate dieters recorded marked triglyceride reductions, the low-carbohydrate dieters experienced an initial modest decrease, which then reversed itself and ended up slightly higher than baseline levels by the end of the study. If these results are genuine, then Fleming's study is again a milestone in nutrition research history, as every other relevant study has found low-carbohydrate diets to produce either similar or greater reductions in blood triglycerides than calorie-restricted high-carbohydrate diets.
A close look at Fleming's paper, which was published in a lesser-known journal called Preventive Cardiology, suggests that it may be more than mere co-incidence that the only non-supportive low carbohydrate weight-loss study comes from someone who just happens to be an avid critic of high-protein, low-carbohydrate diets.
Fleming claims that one hundred men and women were placed on one of four diets (a low carbohydrate diet, one of two low-fat, high-carbohydrate diets, or a "high-fat" diet) then followed for one year. This would make Fleming's trial one of the largest and longest-running - and hence, most expensive - high- versus low-carbohydrate diet trials ever conducted. As any clinical investigator will tell you, conducting randomized intervention trials is a costly, difficult, and time-consuming task. Even small trials can easily cost hundreds of thousand dollars; as a recent example, recruitment for the Diabetes Prevention Program, a randomized, controlled trial designed to test whether diet and exercise or medication can prevent or delay the onset of type 2 diabetes in susceptible individuals, was estimated to cost $1,075 for each participant. This figure was purely for recruitment, and did not include staff costs! In addition to enlistment, clinical trials employing dietary interventions and regular blood testing require substantial manpower in the form of investigators, nurses, dietitians, and technicians.
Despite the significant number of participants and the extended duration of Fleming's trial, his paper does not list a single source of funding, even though funding acknowledgement is standard procedure in any respected, peer-reviewed journal article. The Preventive Cardiology paper also lists no co-authors, nurses, dietitians, or technicians who may have assisted in the trial which, again, is par for the course in published papers. Fleming identifies himself as the "Medical Director of Preventive Cardiology, The Camelot Foundation at The Fleming Heart & Health Institute", but a visit to his web site indicates that this Institute has one lone member - Fleming! How did Fleming fund such an expensive undertaking? And how did he manage to conduct such a time-consuming project with so little, if any, assistance? Your guess is as good as mine...
Science reporter Gary Taubes has little doubt as to the validity of the Omaha cardiologist's findings; "Frankly, I think Fleming made it [the data] up," he told a Washington Post reporter (an accusation hotly denied, of course, by Fleming). In addition to the aforementioned anomalies, Fleming wrote that the participants "were randomly assigned to one of the four dietary regimens based upon dietary preferences." Such a description is a contradiction in terms if ever there was one. As Taubes pointed out; "If patients were assigned to diets based on their dietary preferences, then they weren't randomly assigned. If they were randomly assigned, then their preferences must be irrelevant. The two methods are incompatible. If this paper was peer-reviewed, it was done poorly. If this constitutes high-quality research in this field, then I suggest even more skepticism is necessary."
Call me a hopeless skeptic, but any information originating from the likes of the PCRM or Richard Fleming should be met with extreme caution."
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