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Cited by 2,216Nutritional Studies and DietNutrition, Health, and Society StudiesGlobal Public Health Policies and Epidemiology

Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review

Open access
Mozaffarian, Dariush·2016·Circulation
DOI 10.1161/circulationaha.115.018585PMC PMC4814348
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Abstract

Suboptimal nutrition is a leading cause of poor health. Nutrition and policy science have advanced rapidly, creating confusion yet also providing powerful opportunities to reduce the adverse health and economic impacts of poor diets. This review considers the history, new evidence, controversies, and corresponding lessons for modern dietary and policy priorities for cardiovascular diseases, obesity, and diabetes mellitus. Major identified themes include the importance of evaluating the full diversity of diet-related risk pathways, not only blood lipids or obesity; focusing on foods and overall diet patterns, rather than single isolated nutrients; recognizing the complex influences of different foods on long-term weight regulation, rather than simply counting calories; and characterizing and implementing evidence-based strategies, including policy approaches, for lifestyle change. Evidence-informed dietary priorities include increased fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed (eg, sodium-preserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat. More investigation is needed on the cardiometabolic effects of phenolics, dairy fat, probiotics, fermentation, coffee, tea, cocoa, eggs, specific vegetable and tropical oils, vitamin D, individual fatty acids, and diet-microbiome interactions. Little evidence to date supports the cardiometabolic relevance of other popular priorities: eg, local, organic, grass-fed, farmed/wild, or non–genetically modified. Evidence-based personalized nutrition appears to depend more on nongenetic characteristics (eg, physical activity, abdominal adiposity, gender, socioeconomic status, culture) than genetic factors. Food choices must be strongly supported by clinical behavior change efforts, health systems reforms, novel technologies, and robust policy strategies targeting economic incentives, schools and workplaces, neighborhood environments, and the food system. Scientific advances provide crucial new insights on optimal targets and best practices to reduce the burdens of diet-related cardiometabolic diseases.

AI snapshot

Written from the paper’s full text.

TL;DR

This comprehensive review argues that cardiometabolic disease prevention should prioritize food-based dietary patterns over single nutrients or calorie counting, with more fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains and fewer red/processed meats, refined grains, starches, added sugars, salt, and trans fat. It also emphasizes policy, health-system, and behavioral strategies to support these choices.

Key findings

  • Evidence-informed dietary priorities include increased fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat.
  • For long-term weight regulation, the average American adult gains only ~1 lb (0.45 kg) per year, consistent with excess energy intakes as small as ~50 kcal/day; refined grains, starches, and sugars appear to be primary culprits, while fruits, nonstarchy vegetables, nuts, yogurt, fish, and whole grains protect against chronic weight gain.
  • Sodium intake is estimated to account for 1.65 million annual global cardiovascular deaths, with optimal intake around ~2000 mg/d and possibly lower; sugar-sweetened beverages are estimated to account for 184,000 cardiometabolic deaths per year.
  • In PREDIMED, extra-virgin olive oil or mixed nuts with a Mediterranean-type diet led to significant reductions in cardiovascular events, including 30% lower risk of stroke, MI, or death compared with control; in contrast, the large WHI low-fat trial showed no benefits for major endpoints.

Methods

  • Design: comprehensive narrative review of the history, new evidence, controversies, and corresponding lessons for modern dietary and policy priorities for cardiovascular disease, obesity, and diabetes.
  • Data: existing literature, including metabolic studies, prospective cohorts, randomized clinical trials, and evidence on behavior change, health systems, and policy; no new primary data are reported.
  • Analysis: narrative synthesis with supporting tables and figures; not a systematic review or meta-analysis.

Limitations

  • Paper-stated: more investigation is needed on cardiometabolic effects of phenolics, dairy fat, probiotics, fermentation, coffee, tea, cocoa, eggs, specific vegetable and tropical oils, vitamin D, individual fatty acids, and diet-microbiome interactions; little evidence supports cardiometabolic relevance of local, organic, grass-fed, farmed/wild, or non-GMO priorities.
  • Paper-stated: compelling evidence is lacking to design personalized nutritional recommendations for cardiometabolic health based on genetic variation; non-genetic characteristics may be better determinants of dietary priorities.
  • Evident from the text: as a narrative review, it does not report a systematic search strategy, formal quality appraisal, or quantitative pooling; many conclusions rely on observational cohorts and surrogate outcomes, and some topics remain controversial (e.g., saturated fat, sodium J-shaped relationships).

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1161/circulationaha.115.018585

Cites

398 of 398 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 634 cited sources checked · 0 supported · 0 flagged

  • Interpretationreasoning

    Focusing on isolated nutrients often leads to paradoxical dietary choices and industry formulations.

    “Indeed, focusing on isolated nutrients often leads to paradoxical dietary choices and industry formulations.”
    Quote in the paperSubstantial claim
  • Premisecitation

    Specific foods and overall diet patterns, rather than single isolated nutrients, are important for cardiometabolic risk.

    “A second key lesson is the importance of specific foods and overall diet patterns, rather than single isolated nutrients, for cardiometabolic risk.8, 9”
    • Also stated in: § Nutrients, Foods, and Diet Patterns – a Historical Evolution · boosted
      “Rather, cardiometabolic diseases are largely influenced not by single nutrients, but by specific foods and overall diet patterns.19-21”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [8] Jacobs DR Jr. Tapsell LC Food, not nutrients, is the fundamental unit in nutrition. Nutr Rev 2007 65 439 450 17972438 source

      Not checked in the free run.

    • cites [9] Mozaffarian D Ludwig DS Dietary guidelines in the 21st century--a time for food. JAMA 2010 304 681 682 20699461 source

      Not checked in the free run.

    • cites [19] Mozaffarian D Appel LJ Van Horn L Components of a cardioprotective diet: new insights. Circulation 2011 123 2870 2891 21690503 PMC6261290 source

      Not checked in the free run.

    • cites [20] Mozaffarian D Mann DL Zipes DP Libby P Bonow RO Nutrition and Cardiovascular Disease and Metabolic Diseases. Braunwald's Heart Disease; A Textbook of Cardiovascular Medicine 2014 Elsevier/Saunders Philadelphia 10th Edition. Chapter 46

      Not checked in the free run.

    • cites [21] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015 Available at: http://www.health.gov/dietaryguidelines/2015-scientific-report/. March 25, 2015

      Not checked in the free run.

  • Interpretationreasoning

    In the long-term, counting calories may not be biologically nor behaviorally relevant.

    “Whereas short-term weight loss can be achieved by any type of calorie-reduced diet, in the long-term, counting calories may not be biologically nor behaviorally relevant.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Short-term weight loss can be achieved by any type of calorie-reduced diet.
  • Interpretationnone given

    Dietary habits influence diverse cardiometabolic risk factors, including not only obesity and LDL-cholesterol but also blood pressure, glucose-insulin homeostasis, lipoprotein concentrations and function, oxidative stress, inflammation, endothelial health, hepatic function, adipocyte metabolism, cardiac function, metabolic expenditure, pathways of weight regulation, visceral adiposity, and the gut

    “First, it is now evident that dietary habits influence diverse cardiometabolic risk factors, including not only obesity and LDL-cholesterol but also blood pressure (BP), glucose-insulin homeostasis, lipoprotein concentrations and function, oxidative stress, inflammation, endothelial health, hepatic function, adipocyte metabolism, cardiac function, metabolic expenditure, pathways of weight”
    Quote in the paperSubstantial claim
  • Interpretationnone given

    Little evidence to-date supports cardiometabolic relevance of other popular priorities: e.g., local, organic, grass-fed, farmed/wild, non-GMO.

    “Little evidence to-date supports cardiometabolic relevance of other popular priorities: e.g., local, organic, grass-fed, farmed/wild, non-GMO.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 132
  • Classified as probably not a substantial claim. 20

  • May combine two claims.

    Interpretationreasoning

    All calories are not equal for long-term adiposity: certain foods impair pathways of weight homeostasis, others have relatively neutral effects, and others promote the integrity of weight regulation.

    “Thus, all calories are not equal for long-term adiposity: certain foods impair pathways of weight homeostasis, others have relatively neutral effects, and others promote the integrity of weight regulation.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Short-term weight loss can be achieved by any type of calorie-reduced diet.

  • May combine two claims.

    Interpretationreasoning

    Evidence-informed dietary priorities include fewer red meats, processed (e.g., sodium-preserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat.

    “Evidence-informed dietary priorities include increased fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed (e.g., sodium-preserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Influences on dietary choices are complex, including individual-level, sociocultural, community, agricultural, industry, governmental, and global contributors.

    “Influences are complex, including individual-level, sociocultural, community, agricultural, industry, governmental, and global contributors.10”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Afshin A Micha R Khatibzadeh S Schmidt LA Mozaffarian D Brown GW Yamey G Wamala S Dietary Policies to Reduce Non-Communicable Diseases. The Handbook of Global Health Policy 2014 John Wiley & Sons, Ltd. West Sussex, UK First Edition. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Total calories matter in the short-term, which explains why people can initially lose weight on nearly any type of diet and why many fad diets initially seem to work.

    “Of course, total calories matter in the short-term, which is why people can initially lose weight on nearly any type of diet21 – and explaining why so many “fad” diets initially seem to work.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015 Available at: http://www.health.gov/dietaryguidelines/2015-scientific-report/. March 25, 2015

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    When sustained over many years, minor annual weight gain drives population obesity, leading to 10 lbs weight gain over 10 years, 20 lbs over 20 years, and so on.

    “Yet, when sustained over many years, this minor annual weight gain drives population obesity, e.g. leading to 10 lbs weight gain over 10 years, 20 lbs over 20 years, and so on.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Global dietary patterns have shifted in nearly every nation in the world.

    “In recent years, global dietary patterns have shifted in nearly every nation in the world.4”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Imamura F Micha R Khatibzadeh S Fahimi S Shi P Powles J Mozaffarian D Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessment. Lancet Glob Health 2015 3 e132 142 25701991 PMC4342410 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    A main benefit of both low-carb and paleo diets is reduced refined grains, starches, and added sugars, which represent the majority of total carbs and ultra-processed foods in modern diets.

    “A main benefit of both low-carb and paleo diets is reduced refined grains, starches, and added sugars, which represent the majority of total carbs and ultra-processed foods in modern diets (see Carbohydrate-rich foods, below).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The 2015 Dietary Guidelines Advisory Committee concluded that low-fat diets have no effect on CVD and emphasized the importance of healthful, food-based diet patterns.

    “Based on this evidence, the 2015 Dietary Guidelines Advisory Committee concluded that low-fat diets have no effect on CVD and emphasized the importance of healthful, food-based diet patterns.21”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015 Available at: http://www.health.gov/dietaryguidelines/2015-scientific-report/. March 25, 2015

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisenone given

    Paleo diets emphasize fruits, nonstarchy vegetables, nuts, and fish, each of which have health benefits.

    “Paleo diets also emphasize fruits, nonstarchy vegetables, nuts, and fish, each of which have health benefits.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    A vegetarian diet is not a guarantee of health, and a non-vegetarian diet can be rich in healthful foods.

    “Thus, a vegetarian diet is not a guarantee of health; while a non-vegetarian diet can be rich in healthful foods.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Both Mediterranean and DASH diet patterns improve a range of risk factors, reduce long-term weight gain, and are consistently associated with lower risk of clinical events.

    “Both Mediterranean and DASH diet patterns improve a range of risk factors, reduce long-term weight gain, and are consistently associated with lower risk of clinical events.19, 21, 27-29”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [19] Mozaffarian D Appel LJ Van Horn L Components of a cardioprotective diet: new insights. Circulation 2011 123 2870 2891 21690503 PMC6261290 source

      Not checked in the free run.

    • cites [21] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015 Available at: http://www.health.gov/dietaryguidelines/2015-scientific-report/. March 25, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [27] Djousse L Akinkuolie AO Wu JH Ding EL Gaziano JM Fish consumption, omega-3 fatty acids and risk of heart failure: a meta-analysis. Clinical nutrition (Edinburgh, Scotland) 2012 31 846 853 PMC3509256 22682084 source

      Not checked in the free run.

    • cites [28] Mozaffarian D Hao T Rimm EB Willett WC Hu FB Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011 364 2392 2404 21696306 PMC3151731 source

      Not checked in the free run.

    • cites [29] Smith JD Hou T Ludwig DS Rimm EB Willett WC Hu FB Mozaffarian D Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts Am J Clin Nutr 2015 101 1216 1224 25854882 PMC4441808 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Vegetarianism per se is neither necessary nor sufficient for a good diet; vegetarian foods can include harmful items such as french fries, soda, refined grains, starches, added sugars, sweets, trans fats, and sodium.

    “However, vegetarianism per se is neither necessary nor sufficient for a good diet: indeed, french fries and soda are vegetarian, as are other harmful factors such as refined grains, starches, added sugars, sweets, trans fats, and sodium.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    A cardioprotective diet pattern must be characterized by the healthful foods that are included, not simply specific items to be avoided.

    “A cardioprotective diet pattern must be characterized by the healthful foods that are included, not simply specific items to be avoided (Table 2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisereasoning

    Beneficial diets are higher in fiber, vitamins, antioxidants, minerals, phenolics, and unsaturated fats, and lower in glycemic index, glycemic load, salt, and trans fat.

    “Such diets are higher in fiber, vitamins, antioxidants, minerals, phenolics, and unsaturated fats, and lower in glycemic index, glycemic load, salt, and trans fat.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    RDAs were quickly recognized as methodologically and conceptually inappropriate for chronic diseases, leading to creation of new nutrient-based metrics (e.g., Adequate Intakes, AIs; Acceptable Macronutrient Distribution Ranges, AMDRs) which were limited by imprecise definitions and inconsistent usage.

    “RDAs were quickly recognized as methodologically and conceptually inappropriate for chronic diseases, leading to creation of new nutrient-based metrics (e.g., Adequate Intakes, AIs; Acceptable Macronutrient Distribution Ranges, AMDRs) which were limited by imprecise definitions and inconsistent usage.16”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16] Harper AE Evolution of recommended dietary allowances--new directions? Annu Rev Nutr 1987 7 509 537 3300745 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Focus on low-carb diets could paradoxically reduce intakes of healthful carb-containing fruits, legumes, and minimally processed whole grains; paleo guidelines often recommend liberal intakes of red meats, lard, and salt and avoidance of legumes and dairy.

    “However, focus on “low-carb” could paradoxically reduces intakes of other, healthful carb-containing fruits, legumes, and minimally processed whole grains; while “paleo” guidelines often recommend liberal intakes of red meats, lard, and salt and avoidance of legumes and dairy.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In many countries, the current obesity epidemic is a striking change from decades of prior relative stability; in the US, obesity began steeply rising only ~3 decades ago.

    “In many countries, the current obesity epidemic is a striking change from decades of prior relative stability; in the US, for instance, obesity began steeply rising only ~3 decades ago.41”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] Mozaffarian D Benjamin EJ Go AS Arnett DK Blaha MJ Cushman M de Ferranti S Despres JP Fullerton HJ Howard VJ Huffman MD Judd SE Kissela BM Lackland DT Lichtman JH Lisabeth LD Liu S Mackey RH Matchar DB McGuire DK Mohler ER 3rd Moy CS Muntner P Mussolino ME Nasir K Neumar RW Nichol G Palaniappan L Pandey DK Reeves MJ Rodriguez CJ Sorlie PD Stein J Towfighi A Turan TN Virani SS Willey JZ Woo D Yeh RW Turner MB Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation 2015 131 e29 322 25520374 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Pathways of benefit of Mediterranean and DASH diets appear diverse, including effects on BP, glucose-insulin homeostasis, blood lipids and lipoproteins, inflammation, endothelial function, arrhythmic risk, and possibly coagulation/thrombosis, paraoxonase 1 activity, and the gut microbiome.

    “Pathways of benefit appear diverse, including effects on BP, glucose-insulin homeostasis, blood lipids and lipoproteins, inflammation, endothelial function, arrhythmic risk, and possibly coagulation/thrombosis, paraoxonase 1 activity, and the gut microbiome.20, 21, 30”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [20] Mozaffarian D Mann DL Zipes DP Libby P Bonow RO Nutrition and Cardiovascular Disease and Metabolic Diseases. Braunwald's Heart Disease; A Textbook of Cardiovascular Medicine 2014 Elsevier/Saunders Philadelphia 10th Edition. Chapter 46

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [21] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015 Available at: http://www.health.gov/dietaryguidelines/2015-scientific-report/. March 25, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [30] Lou-Bonafonte JM Gabas-Rivera C Navarro MA Osada J PON1 and Mediterranean Diet. Nutrients 2015 7 4068 4092 26024295 PMC4488773 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Evidence-informed beneficial diet patterns share several key characteristics: more minimally processed foods (fruits, nuts/seeds, vegetables excluding russet or white potatoes, legumes, whole grains, seafood, yogurt, vegetable oils) and fewer red meats, processed meats, refined grains, starches, and added sugars.

    “These include more minimally processed foods such as fruits, nuts/seeds, vegetables (excluding russet or white potatoes), legumes, whole grains, seafood, yogurt, and vegetable oils; and fewer red meats, processed (sodium-preserved) meats, refined grains, starches, and added sugars.”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [19] Mozaffarian D Appel LJ Van Horn L Components of a cardioprotective diet: new insights. Circulation 2011 123 2870 2891 21690503 PMC6261290 source

      Not checked in the free run.

    • cites [21] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015 Available at: http://www.health.gov/dietaryguidelines/2015-scientific-report/. March 25, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [22] Perrin AE Simon C Hedelin G Arveiler D Schaffer P Schlienger JL Ten-year trends of dietary intake in a middle-aged French population: relationship with educational level. Eur J Clin Nutr 2002 56 393 401 12001009 source

      Not checked in the free run.

    • cites [23] Harvard Heart Letter Latest thinking on a “cardioprotective” diet 2011 Available at: www.health.harvard.edu. Accessed

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The mechanistic pathways underlying the observed benefits of fruits, vegetables, nuts, yogurt, fish, and whole grains are still being elucidated, but may partly reflect opposing, protective effects in comparison to rapidly digested, refined carbohydrates.

    “The mechanistic pathways underlying these observed benefits are still being elucidated, but may partly reflect opposing, protective effects in comparison to those of rapidly digested, refined carbohydrates.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The US National School Lunch Programs recently banned whole milk but allows sugar-sweetened chocolate skim milk.

    “For example, the US National School Lunch Programs recently banned whole milk, but allows sugar-sweetened chocolate skim milk.56”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [56] Food and Nutrition Service, US Department of Agriculture Nutrition Standards in the National School Lunch and School Breakfast Programs 2012 Available at: https://www.federalregister.gov/articles/2012/01/26/2012-1010/nutrition-standards-in-the-national-school-lunch-and-school-breakfast-programs. May 26, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Increased fruits, nonstarchy vegetables, nuts, yogurt, fish, and whole grains each appear to protect against chronic weight gain: the more these foods are consumed, the less the average weight gain.

    “Conversely, increased fruits, nonstarchy vegetables, nuts, yogurt, fish, and whole grains each appear to protect against chronic weight gain: the more these foods are consumed, the less the average weight gain.28, 29, 51, 55”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [28] Mozaffarian D Hao T Rimm EB Willett WC Hu FB Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011 364 2392 2404 21696306 PMC3151731 source

      Not checked in the free run.

    • cites [29] Smith JD Hou T Ludwig DS Rimm EB Willett WC Hu FB Mozaffarian D Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts Am J Clin Nutr 2015 101 1216 1224 25854882 PMC4441808 source

      Not checked in the free run.

    • cites [51] Wang H Troy LM Rogers GT Fox CS McKeown NM Meigs JB Jacques PF Longitudinal association between dairy consumption and changes of body weight and waist circumference: the Framingham Heart Study. Int J Obes (Lond) 2014 38 299 305 23736371 PMC3809320 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Intakes of low-fat milk and whole-fat milk appear relatively neutral for long-term weight control, suggesting they do not perturb normal homeostatic mechanisms.

    “In contrast, intakes of other foods, such as low-fat milk and whole-fat milk, appear relatively neutral, suggesting they do not perturb the normal homeostatic mechanisms for long-term weight control.29, 51”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [29] Smith JD Hou T Ludwig DS Rimm EB Willett WC Hu FB Mozaffarian D Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts Am J Clin Nutr 2015 101 1216 1224 25854882 PMC4441808 source

      Not checked in the free run.

    • cites [51] Wang H Troy LM Rogers GT Fox CS McKeown NM Meigs JB Jacques PF Longitudinal association between dairy consumption and changes of body weight and waist circumference: the Framingham Heart Study. Int J Obes (Lond) 2014 38 299 305 23736371 PMC3809320 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The 2015 Dietary Guidelines Advisory Committee Report emphasizes food-based, healthful diet patterns as the primary recommendation to address obesity.

    “Consistent with this modern science, the 2015 Dietary Guidelines Advisory Committee Report emphasizes food-based, healthful diet patterns as the primary recommendation to address obesity.21”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015 Available at: http://www.health.gov/dietaryguidelines/2015-scientific-report/. March 25, 2015

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisereasoning

    Major foods in the refined grain/starch/sugar group include potatoes, white bread, white rice, refined breakfast cereals, crackers, sweets, soda, and other ultra-processed foods high in starches or sugars.

    “Major foods in this group include potatoes, white bread, white rice, refined breakfast cereals, crackers, sweets, soda, and other ultra-processed foods high in starches or sugars.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    When consumed over years, certain foods may interfere with long-term weight homeostasis, others have relatively neutral effects, and others promote healthy weight regulation.

    “Based on these influences, when consumed over years, certain foods may interfere with long-term weight homeostasis, others have relatively neutral effects, and others promote healthy weight regulation (Figure 5).19, 21”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [19] Mozaffarian D Appel LJ Van Horn L Components of a cardioprotective diet: new insights. Circulation 2011 123 2870 2891 21690503 PMC6261290 source

      Not checked in the free run.

    • cites [21] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015 Available at: http://www.health.gov/dietaryguidelines/2015-scientific-report/. March 25, 2015

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Lower sleep duration and altered circadian rhythms alter hunger and food preferences.

    “For example, lower sleep duration and altered circadian rhythms predict greater weight gain and obesity, alter hunger and food preferences, and influence leptin, ghrelin, insulin, and gut-peptide concentrations.28, 67”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [28] Mozaffarian D Hao T Rimm EB Willett WC Hu FB Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011 364 2392 2404 21696306 PMC3151731 source

      Not checked in the free run.

    • cites [67] Gonnissen HK Hulshof T Westerterp-Plantenga MS Chronobiology, endocrinology, and energy- and food-reward homeostasis. Obes Rev 2013 14 405 416 23387351 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Children who habitually drink low-fat milk gain more weight, and those who drink whole-fat milk gain less weight, over time.

    “that children who habitually drink low-fat milk gain more weight, and those who drink whole-fat milk gain less weight, over time.62-66”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [62] Scharf RJ Demmer RT DeBoer MD Longitudinal evaluation of milk type consumed and weight status in preschoolers. Arch Dis Child 2013 98 335 340 23508869 PMC4439101 source

      Not checked in the free run.

    • cites [63] Noel SE Ness AR Northstone K Emmett P Newby PK Associations between flavored milk consumption and changes in weight and body composition over time: differences among normal and overweight children. Eur J Clin Nutr 2013 67 295 300 23031848 source

      Not checked in the free run.

    • cites [64] Huh SY Rifas-Shiman SL Rich-Edwards JW Taveras EM Gillman MW Prospective association between milk intake and adiposity in preschool-aged children. J Am Diet Assoc 2010 110 563 570 20338282 PMC3229928 source

      Not checked in the free run.

    • cites [65] Berkey CS Rockett HR Willett WC Colditz GA Milk, dairy fat, dietary calcium, and weight gain: a longitudinal study of adolescents. Arch Pediatr Adolesc Med 2005 159 543 550 15939853 source

      Not checked in the free run.

    • cites [66] Noel SE Ness AR Northstone K Emmett P Newby PK Milk intakes are not associated with percent body fat in children from ages 10 to 13 years. The Journal of nutrition 2011 141 2035 2041 21940511 PMC3192461 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The gut microbiome appears increasingly important; probiotics in yogurt appear to interact with microbiota to reduce weight gain.

    “The gut microbiome also appears increasingly important; e.g., probiotics in yogurt appear to interact with microbiota to reduce weight gain.28, 29, 51-54”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [28] Mozaffarian D Hao T Rimm EB Willett WC Hu FB Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011 364 2392 2404 21696306 PMC3151731 source

      Not checked in the free run.

    • cites [29] Smith JD Hou T Ludwig DS Rimm EB Willett WC Hu FB Mozaffarian D Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts Am J Clin Nutr 2015 101 1216 1224 25854882 PMC4441808 source

      Not checked in the free run.

    • cites [51] Wang H Troy LM Rogers GT Fox CS McKeown NM Meigs JB Jacques PF Longitudinal association between dairy consumption and changes of body weight and waist circumference: the Framingham Heart Study. Int J Obes (Lond) 2014 38 299 305 23736371 PMC3809320 source

      Not checked in the free run.

    • cites [52] Poutahidis T Kleinewietfeld M Smillie C Levkovich T Perrotta A Bhela S Varian BJ Ibrahim YM Lakritz JR Kearney SM Chatzigiagkos A Hafler DA Alm EJ Erdman SE Microbial reprogramming inhibits Western diet-associated obesity. PLoS One 2013 8 e68596 23874682 PMC3707834 source

      Not checked in the free run.

    • cites [53] Park DY Ahn YT Park SH Huh CS Yoo SR Yu R Sung MK McGregor RA Choi MS Supplementation of Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032 in diet-induced obese mice is associated with gut microbial changes and reduction in obesity. PLoS One 2013 8 e59470 23555678 PMC3605452 source

      Not checked in the free run.

    • cites [54] Power SE O'Toole PW Stanton C Ross RP Fitzgerald GF Intestinal microbiota, diet and health. Br J Nutr 2014 111 387 402 23931069 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Many healthful foods are minimally processed, whereas several classes of processed foods are harmful.

    “Many healthful foods are minimally processed (e.g., fruits, nuts, seafood), whereas several classes of processed foods are harmful (e.g., refined grains and cereals, preserved meats and other high sodium foods, food made with partially hydrogenated oils).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    The massive, rapid shifts in cardiometabolic disease demonstrate the crucial importance of population approaches to address them, including improved nutrition.

    “Overall, although a promise of “precision medicine” has been promoted,96 the massive, rapid shifts in cardiometabolic disease occurring across nations and within populations over time97 demonstrate the dominant influence of environmental risk factors and the crucial importance of population approaches to address them, including improved nutrition.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [97] Capewell S O'Flaherty M Rapid mortality falls after risk-factor changes in populations. Lancet 2011 378 752 753 21414659 source

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  • May combine two claims.

    Premisecitation

    Several groups reviewing the evidence for health hazards of genetic modification have found no evidence for harms, but methods for such evaluation remain heterogeneous.

    “Several groups reviewing the evidence for health hazards of genetic modification have found no evidence for harms;130-134 however, methods for such evaluation remain heterogeneous.135-139”
    Quote in the paperNot a substantial claim0 of 10 sources checked
    • cites [130] American Medical Association AMA Report on Genetically Modified Crops and Foods 2001 Available at: https://www.isaaa.org/kc/Publications/htm/articles/Position/ama.htm. July 16, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [131] Key S Ma JK Drake PM Genetically modified plants and human health. J R Soc Med 2008 101 290 298 18515776 PMC2408621 source

      Not checked in the free run.

    • cites [132] American Association for the Advancement of Science Statement by the AAAS Board of Directors On Labeling of Genetically Modified Foods 2013 Available at: http://www.aaas.org/sites/default/files/AAAS_GM_statement.pdf. July 16, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [133] World Health Organization Frequently asked questions on genetically modified foods 2014 Available at: http://www.who.int/foodsafety/areas_work/food-technology/Frequently_asked_questions_on_gm_foods.pdf?ua=1. July 16, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [134] Van Eenennaam AL Young AE Prevalence and impacts of genetically engineered feedstuffs on livestock populations. J Anim Sci 2014 92 4255 4278 25184846 source

      Not checked in the free run.

    • cites [135] Domingo JL Gine Bordonaba J A literature review on the safety assessment of genetically modified plants. Environ Int 2011 37 734 742 21296423 source

      Not checked in the free run.

    • cites [136] Hammond B Kough J Herouet-Guicheney C Jez JM Toxicological evaluation of proteins introduced into food crops. Crit Rev Toxicol 2013 43 Suppl 2 25 42 24164515 PMC3835160 source

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    • cites [137] Bartholomaeus A Parrott W Bondy G Walker K The use of whole food animal studies in the safety assessment of genetically modified crops: limitations and recommendations. Crit Rev Toxicol 2013 43 Suppl 2 1 24 24164514 PMC3833814 source

      Not checked in the free run.

    • cites [138] Nicolia A Manzo A Veronesi F Rosellini D An overview of the last 10 years of genetically engineered crop safety research. Crit Rev Biotechnol 2014 34 77 88 24041244 source

      Not checked in the free run.

    • cites [139] Devos Y Aguilera J Diveki Z Gomes A Liu Y Paoletti C du Jardin P Herman L Perry JN Waigmann E EFSA's scientific activities and achievements on the risk assessment of genetically modified organisms (GMOs) during its first decade of existence: looking back and ahead. Transgenic Res 2014 23 1 25 23963741 source

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  • May combine two claims.

    Interpretationnone given

    Many bioactive compounds have demonstrated effects on cardiovascular risk pathways in animal and human studies; effects on blood lipids have been most often studied.

    “Many of these bioactive compounds have demonstrated effects on cardiovascular risk pathways in animal and human studies; effects on blood lipids have been most often studied.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationnone given

    Use of dietary supplements, often at high or pharmacologic doses, is commonplace, despite absence of convincing evidence for health benefits.

    “Use of dietary supplements, often at high or pharmacologic doses, is commonplace, despite absence of convincing evidence for health benefits.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Compared with conventionally grown foods, organically grown foods can contain higher concentrations of phenolic compounds and fewer pesticide residues, but have similar nutrient profiles in many other respects.

    “Compared with conventionally grown foods, organically grown foods can contain higher concentrations of phenolic compounds and fewer pesticide residues; yet, they also have similar nutrient profiles in many other respects.124-126”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [124] Dangour AD Dodhia SK Hayter A Allen E Lock K Uauy R Nutritional quality of organic foods: a systematic review. Am J Clin Nutr 2009 90 680 685 19640946 source

      Not checked in the free run.

    • cites [125] Smith-Spangler C Brandeau ML Hunter GE Bavinger JC Pearson M Eschbach PJ Sundaram V Liu H Schirmer P Stave C Olkin I Bravata DM Are organic foods safer or healthier than conventional alternatives?: a systematic review. Ann Intern Med 2012 157 348 366 22944875 source

      Not checked in the free run.

    • cites [126] Baranski M Srednicka-Tober D Volakakis N Seal C Sanderson R Stewart GB Benbrook C Biavati B Markellou E Giotis C Gromadzka-Ostrowska J Rembialkowska E Skwarlo-Sonta K Tahvonen R Janovska D Niggli U Nicot P Leifert C Higher antioxidant and lower cadmium concentrations and lower incidence of pesticide residues in organically grown crops: a systematic literature review and meta-analyses. Br J Nutr 2014 112 794 811 24968103 PMC4141693 source

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  • May combine two claims.

    Interpretationcitation

    Based on first principles, genetic modification should be considered a tool, not an endpoint; its potential effects on human health will relate to the specific compositional changes in the food, not the method itself.

    “Based on first principles, genetic modification should be considered a tool, not an endpoint: its potential effects on human health (positive, neutral, negative) will relate to the specific compositional changes in the food, not the method itself.140”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [140] Institute of Medicine. Safety of Genetically Modified Foods: Approaches to Assessing Unintended Health Effects. Washington DC: The National Academies Press 2004 25009871

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    Both the type of food and its processing are relevant to health.

    “Consequently, both the type of food and its processing are relevant.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Functional foods attempt to improve health by incorporating bioactive compounds that may alter lipid, vascular, and other metabolic pathways, microbiome composition and function, and digestive and inflammatory systems.

    “Similar to dietary supplements, functional foods attempt to improve health by incorporating bioactive compounds that may alter lipid, vascular, and other metabolic pathways, microbiome composition and function, and digestive and inflammatory systems.114-121”
    Quote in the paperNot a substantial claim0 of 8 sources checked
    • cites [114] Basu A Rhone M Lyons TJ Berries: emerging impact on cardiovascular health. Nutrition Reviews 2010 68 168 177 20384847 PMC3068482 source

      Not checked in the free run.

    • cites [115] Huang WY Davidge ST Wu J Bioactive natural constituents from food sources-potential use in hypertension prevention and treatment. Crit Rev Food Sci Nutr 2013 53 615 630 23627503 source

      Not checked in the free run.

    • cites [116] Gylling H Plat J Turley S Ginsberg HN Ellegard L Jessup W Jones PJ Lutjohann D Maerz W Masana L Silbernagel G Staels B Boren J Catapano AL De Backer G Deanfield J Descamps OS Kovanen PT Riccardi G Tokgozoglu L Chapman MJ Plant sterols and plant stanols in the management of dyslipidaemia and prevention of cardiovascular disease. Atherosclerosis 2014 232 346 360 24468148 source

      Not checked in the free run.

    • cites [117] Mirmiran P Bahadoran Z Azizi F Functional foods-based diet as a novel dietary approach for management of type 2 diabetes and its complications: A review. World J Diabetes 2014 5 267 281 24936248 PMC4058731 source

      Not checked in the free run.

    • cites [118] Mehta N Ahlawat SS Sharma DP Dabur RS Novel trends in development of dietary fiber rich meat products-a critical review. J Food Sci Technol 2015 52 633 647 25694673 PMC4325053 source

      Not checked in the free run.

    • cites [119] Bhat ZF Kumar S Bhat HF Bioactive peptides of animal origin: a review. J Food Sci Technol 2015 52 5377 5392 26344955 PMC4554628 source

      Not checked in the free run.

    • cites [120] Ryan PM Ross RP Fitzgerald GF Caplice NM Stanton C Functional food addressing heart health: do we have to target the gut microbiota? Curr Opin Clin Nutr Metab Care 2015 18 566 571 26406391 source

      Not checked in the free run.

    • cites [121] Sharma S Puri S Prebiotics and Lipid Metabolism: A Review. Altern Ther Health Med 2015 21 Suppl 3 34 42 26348612

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    This rapid digestion may induce multiple adverse effects, potentially stimulating reward/craving areas in the brain, activating hepatic de novo lipogenesis, increasing uric acid production, and promoting visceral adiposity.

    “This rapid digestion may induce multiple adverse effects, potentially stimulating reward/craving areas in the brain, activating hepatic de novo lipogenesis, increasing uric acid production, and promoting visceral adiposity.49, 162-166”
    Quote in the paperSubstantial claim0 of 6 sources checked
    • cites [49] Lennerz BS Alsop DC Holsen LM Stern E Rojas R Ebbeling CB Goldstein JM Ludwig DS Effects of dietary glycemic index on brain regions related to reward and craving in men. Am J Clin Nutr 2013 98 641 647 23803881 PMC3743729 source

      Not checked in the free run.

    • cites [162] Le KA Bortolotti M Role of dietary carbohydrates and macronutrients in the pathogenesis of nonalcoholic fatty liver disease. Curr Opin Clin Nutr Metab Care 2008 11 477 482 18542010 source

      Not checked in the free run.

    • cites [163] Gower BA Goss AM A lower-carbohydrate, higher-fat diet reduces abdominal and intermuscular fat and increases insulin sensitivity in adults at risk of type 2 diabetes. The Journal of nutrition 2015 145 177S 183S 25527677 PMC4264021 source

      Not checked in the free run.

    • cites [164] Basaranoglu M Basaranoglu G Sabuncu T Senturk H Fructose as a key player in the development of fatty liver disease. World J Gastroenterol 2013 19 1166 1172 23482247 PMC3587472 source

      Not checked in the free run.

    • cites [165] Stanhope KL Sugar consumption, metabolic disease and obesity: The state of the controversy. Crit Rev Clin Lab Sci 2015 1 16 PMC4822166 26376619 source

      Not checked in the free run.

    • cites [166] Malik VS Hu FB Fructose and Cardiometabolic Health: What the Evidence From Sugar-Sweetened Beverages Tells Us. J Am Coll Cardiol 2015 66 1615 1624 26429086 PMC4592517 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Refined grains such as white bread, corn flakes, and rice; starchy foods such as russet or white potatoes; and pure table sugar all produce brisk rises in blood glucose and insulin.

    “Consequently, refined grains such as white bread, corn flakes, and rice; starchy foods such as russet or white potatoes; and pure table sugar all produce brisk rises in blood glucose and insulin (known as their glycemic index; or, when multiplied by portion size, as their glycemic load).161”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [161] Atkinson FS Foster-Powell K Brand-Miller JC International tables of glycemic index and glycemic load values: 2008. Diabetes Care 2008 31 2281 2283 18835944 PMC2584181 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Harms of poor quality carbohydrates appear to be larger in women and others predisposed to insulin resistance and atherogenic dyslipidemia, and smaller in men and in younger, lean individuals with high physical activity.

    “Harms appear to be larger in women89, 167 and others predisposed to insulin resistance and atherogenic dyslipidemia, and smaller in men and in younger, lean individuals with high physical activity.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [89] Mirrahimi A de Souza RJ Chiavaroli L Sievenpiper JL Beyene J Hanley AJ Augustin LS Kendall CW Jenkins DJ Associations of glycemic index and load with coronary heart disease events: a systematic review and meta-analysis of prospective cohorts. J Am Heart Assoc 2012 1 e000752 23316283 PMC3541617 source

      Not checked in the free run.

    • cites [167] Fan J Song Y Wang Y Hui R Zhang W Dietary glycemic index, glycemic load, and risk of coronary heart disease, stroke, and stroke mortality: a systematic review with meta-analysis. PLoS One 2012 7 e52182 23284926 PMC3527433 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Nonstarchy vegetables are associated with protection against weight gain and diabetes.

    “in contrast to nonstarchy vegetables which are associated with protection against weight gain and diabetes.28, 55, 146, 147”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [28] Mozaffarian D Hao T Rimm EB Willett WC Hu FB Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011 364 2392 2404 21696306 PMC3151731 source

      Not checked in the free run.

    • cites [55] Bertoia ML Mukamal KJ Cahill LE Hou T Ludwig DS Mozaffarian D Willett WC Hu FB Rimm EB Changes in Intake of Fruits and Vegetables and Weight Change in United States Men and Women Followed for Up to 24 Years: Analysis from Three Prospective Cohort Studies. PLoS Med 2015 12 e1001878 26394033 PMC4578962 source

      Not checked in the free run.

    • cites [146] Halton TL Willett WC Liu S Manson JE Stampfer MJ Hu FB Potato and french fry consumption and risk of type 2 diabetes in women. Am J Clin Nutr 2006 83 284 290 16469985 source

      Not checked in the free run.

    • cites [147] Heidari-Beni M Golshahi J Esmaillzadeh A Azadbakht L Potato consumption as high glycemic index food, blood pressure, and body mass index among Iranian adolescent girls. ARYA Atheroscler 2015 11 81 87 26261454 PMC4530659

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In recent work, among major vegetables consumed in the US, potatoes, corn, and peas were each associated with long-term weight gain, whereas other vegetable subtypes were each associated with weight loss.

    “In recent work, among major vegetables consumed in the US, potatoes, corn, and peas were each associated with long-term weight gain, whereas other vegetable subtypes were each associated with weight loss.55”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [55] Bertoia ML Mukamal KJ Cahill LE Hou T Ludwig DS Mozaffarian D Willett WC Hu FB Rimm EB Changes in Intake of Fruits and Vegetables and Weight Change in United States Men and Women Followed for Up to 24 Years: Analysis from Three Prospective Cohort Studies. PLoS Med 2015 12 e1001878 26394033 PMC4578962 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Potatoes have been cross-sectionally linked to greater diabetes, higher blood glucose, and lower HDL-C.

    “Potatoes have also been cross-sectionally linked to greater diabetes, higher blood glucose, and lower HDL-C;148”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [148] Khosravi-Boroujeni H Mohammadifard N Sarrafzadegan N Sajjadi F Maghroun M Khosravi A Alikhasi H Rafieian M Azadbakht L Potato consumption and cardiovascular disease risk factors among Iranian population. Int J Food Sci Nutr 2012 63 913 920 22639829

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Poor quality carbohydrates are associated with long-term weight gain, diabetes, and CVD.

    “Consistent with this constellation of adverse effects, poor quality carbohydrates are associated with long-term weight gain, diabetes, and CVD.29, 89, 158, 167”
    Quote in the paperSubstantial claim0 of 10 sources checked
    • cites [29] Smith JD Hou T Ludwig DS Rimm EB Willett WC Hu FB Mozaffarian D Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts Am J Clin Nutr 2015 101 1216 1224 25854882 PMC4441808 source

      Not checked in the free run.

    • cites [89] Mirrahimi A de Souza RJ Chiavaroli L Sievenpiper JL Beyene J Hanley AJ Augustin LS Kendall CW Jenkins DJ Associations of glycemic index and load with coronary heart disease events: a systematic review and meta-analysis of prospective cohorts. J Am Heart Assoc 2012 1 e000752 23316283 PMC3541617 source

      Not checked in the free run.

    • cites [158] Bhupathiraju SN Tobias DK Malik VS Pan A Hruby A Manson JE Willett WC Hu FB Glycemic index, glycemic load, and risk of type 2 diabetes: results from 3 large US cohorts and an updated meta-analysis. Am J Clin Nutr 2014 100 218 232 24787496 PMC4144100 source

      Not checked in the free run.

    • cites [159] Wu Y Qian Y Pan Y Li P Yang J Ye X Xu G Association between dietary fiber intake and risk of coronary heart disease: A meta-analysis. Clinical nutrition 2015 34 603 611 24929874 source

      Not checked in the free run.

    • cites [160] Yao B Fang H Xu W Yan Y Xu H Liu Y Mo M Zhang H Zhao Y Dietary fiber intake and risk of type 2 diabetes: a dose-response analysis of prospective studies. European journal of epidemiology 2014 29 79 88 24389767 source

      Not checked in the free run.

    • cites [161] Atkinson FS Foster-Powell K Brand-Miller JC International tables of glycemic index and glycemic load values: 2008. Diabetes Care 2008 31 2281 2283 18835944 PMC2584181 source

      Not checked in the free run.

    • cites [162] Le KA Bortolotti M Role of dietary carbohydrates and macronutrients in the pathogenesis of nonalcoholic fatty liver disease. Curr Opin Clin Nutr Metab Care 2008 11 477 482 18542010 source

      Not checked in the free run.

    • cites [163] Gower BA Goss AM A lower-carbohydrate, higher-fat diet reduces abdominal and intermuscular fat and increases insulin sensitivity in adults at risk of type 2 diabetes. The Journal of nutrition 2015 145 177S 183S 25527677 PMC4264021 source

      Not checked in the free run.

    • cites [164] Basaranoglu M Basaranoglu G Sabuncu T Senturk H Fructose as a key player in the development of fatty liver disease. World J Gastroenterol 2013 19 1166 1172 23482247 PMC3587472 source

      Not checked in the free run.

    • cites [165] Stanhope KL Sugar consumption, metabolic disease and obesity: The state of the controversy. Crit Rev Clin Lab Sci 2015 1 16 PMC4822166 26376619 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Both red and processed meats, regardless of fat content, are linked to higher incidence of diabetes, although with approximately double the risk, gram-for-gram, for processed meats than for unprocessed red meats.

    “Interestingly, both red and processed meats, regardless of fat content, are linked to higher incidence of diabetes, although with approximately double the risk, gram-for-gram, for processed meats than for unprocessed red meats.172, 178”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [172] Pan A Sun Q Bernstein AM Schulze MB Manson JE Willett WC Hu FB Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. Am J Clin Nutr 2011 94 1088 1096 21831992 PMC3173026 source

      Not checked in the free run.

    • cites [178] Bendinelli B Palli D Masala G Sharp SJ Schulz MB Guevara M van der AD Sera F Amiano P Balkau B Barricarte A Boeing H Crowe FL Dahm CC Dalmeijer G de Lauzon-Guillain B Egeberg R Fagherazzi G Franks PW Krogh V Huerta JM Jakszyn P Khaw KT Li K Mattiello A Nilsson PM Overvad K Ricceri F Rolandsson O Sanchez MJ Slimani N Sluijs I Spijkerman AM Teucher B Tjonneland A Tumino R van den Berg SW Forouhi NG Langeberg C Feskens EJ Riboli E Wareham NJ Association between dietary meat consumption and incident type 2 diabetes: the EPIC-InterAct study. Diabetologia 2013 56 47 59 22983636 source

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  • May combine two claims.

    Premisecitation

    Frequent egg consumers (7+ eggs/week) have higher new-onset of diabetes; among patients with prevalent diabetes, frequent consumers experience more clinical CVD events.

    “Frequent consumers (7+ eggs/week) have higher new-onset of diabetes; and among patients with prevalent diabetes, frequent consumers experience more clinical CVD events.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [197] Shin JY Xun P Nakamura Y He K Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review and meta-analysis. Am J Clin Nutr 2013 98 146 159 23676423 PMC3683816 source

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  • May combine two claims.

    Premisecitation

    In several large studies, poultry is not significantly associated with CVD events; in other cohorts, poultry is associated with modestly lower risk of CVD, with smaller observed benefits than seen for fish, nuts, or legumes.

    “In several large studies, poultry is not significantly associated with CVD events;174, 186-189 and in other cohorts, with modestly lower risk of CVD, with smaller observed benefits than seen for fish, nuts, or legumes.52, 53”
    Quote in the paperSubstantial claim0 of 7 sources checked
    • cites [174] Abete I Romaguera D Vieira AR Lopez de Munain A Norat T Association between total, processed, red and white meat consumption and all-cause, CVD and IHD mortality: a meta-analysis of cohort studies. Br J Nutr 2014 112 762 775 24932617 source

      Not checked in the free run.

    • cites [186] Nagao M Iso H Yamagishi K Date C Tamakoshi A Meat consumption in relation to mortality from cardiovascular disease among Japanese men and women. Eur J Clin Nutr 2012 66 687 693 22333876 source

      Not checked in the free run.

    • cites [187] Takata Y Shu XO Gao YT Li H Zhang X Gao J Cai H Yang G Xiang YB Zheng W Red meat and poultry intakes and risk of total and cause-specific mortality: results from cohort studies of Chinese adults in Shanghai. PLoS One 2013 8 e56963 23451121 PMC3579947 source

      Not checked in the free run.

    • cites [188] Lee JE McLerran DF Rolland B Chen Y Grant EJ Vedanthan R Inoue M Tsugane S Gao YT Tsuji I Kakizaki M Ahsan H Ahn YO Pan WH Ozasa K Yoo KY Sasazuki S Yang G Watanabe T Sugawara Y Parvez F Kim DH Chuang SY Ohishi W Park SK Feng Z Thornquist M Boffetta P Zheng W Kang D Potter J Sinha R Meat intake and cause-specific mortality: a pooled analysis of Asian prospective cohort studies. Am J Clin Nutr 2013 98 1032 1041 23902788 PMC3778858 source

      Not checked in the free run.

    • cites [189] Haring B Gronroos N Nettleton JA von Ballmoos MC Selvin E Alonso A Dietary protein intake and coronary heart disease in a large community based cohort: results from the Atherosclerosis Risk in Communities (ARIC) Study. PLoS One 2014 9 e109552 25303709 PMC4193805 source

      Not checked in the free run.

    • cites [52] Poutahidis T Kleinewietfeld M Smillie C Levkovich T Perrotta A Bhela S Varian BJ Ibrahim YM Lakritz JR Kearney SM Chatzigiagkos A Hafler DA Alm EJ Erdman SE Microbial reprogramming inhibits Western diet-associated obesity. PLoS One 2013 8 e68596 23874682 PMC3707834 source

      Not checked in the free run.

    • cites [53] Park DY Ahn YT Park SH Huh CS Yoo SR Yu R Sung MK McGregor RA Choi MS Supplementation of Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032 in diet-induced obese mice is associated with gut microbial changes and reduction in obesity. PLoS One 2013 8 e59470 23555678 PMC3605452 source

      Not checked in the free run.

  • May combine two claims.

    Premisenone given

    Modern evidence supports relatively neutral cardiovascular effects of saturated fat and dietary cholesterol and more relevant effects of other compounds, such as heme iron, sodium, and other preservatives.

    “However, modern evidence supports relatively neutral cardiovascular effects of saturated fat and dietary cholesterol and more relevant effects of other compounds, such as heme iron, sodium, and other preservatives”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Methylmercury consumed from fish has no detectable influence on incident cardiovascular events, hypertension, or diabetes.

    “Methylmercury consumed from fish has no detectable influence on incident cardiovascular events, hypertension, or diabetes.216-218”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [216] Wolff E Dansinger ML Soft drinks and weight gain: how strong is the link? Medscape J Med 2008 10 189 18924641 PMC2562148

      Not checked in the free run.

    • cites [217] Mozaffarian D Shi P Morris JS Grandjean P Siscovick DS Spiegelman D Willett WC Rimm EB Curhan GC Forman JP Mercury exposure and risk of hypertension in US men and women in two prospective cohorts. Hypertension 2012 60 645 652 22868395 PMC3466587 source

      Not checked in the free run.

    • cites [218] Mozaffarian D Shi P Morris JS Grandjean P Siscovick DS Spiegelman D Hu FB Methylmercury exposure and incident diabetes in U.S. men and women in two prospective cohorts. Diabetes Care 2013 36 3578 3584 24026556 PMC3816920 source

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  • May combine two claims.

    Interpretationreasoning

    Overall evidence suggests small cardiometabolic effects of occasional egg consumption (e.g., up to 2-3 eggs per week) and possible harm with frequent consumption, especially among diabetics.

    “Overall evidence suggests small cardiometabolic effects of occasional consumption (e.g., up to 2-3 eggs per week); and possible harm with frequent consumption, especially among diabetics.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Fish and omega-3 intake have little association with diabetes risk, although protective associations are seen in Asian populations and fish oil supplementation modestly raises adiponectin.

    “Fish and omega-3 intake also have little association with diabetes risk, although protective associations are seen in Asian populations209-211 and fish oil supplementation modestly raises adiponectin.212”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [209] Zheng JS Huang T Yang J Fu YQ Li D Marine N-3 polyunsaturated fatty acids are inversely associated with risk of type 2 diabetes in Asians: a systematic review and meta-analysis. PLoS One 2012 7 e44525 22984522 PMC3439396 source

      Not checked in the free run.

    • cites [210] Zhou Y Tian C Jia C Association of fish and n-3 fatty acid intake with the risk of type 2 diabetes: a meta-analysis of prospective studies. Br J Nutr 2012 108 408 417 22857650 source

      Not checked in the free run.

    • cites [211] Wu JH Micha R Imamura F Pan A Biggs ML Ajaz O Djousse L Hu FB Mozaffarian D Omega-3 fatty acids and incident type 2 diabetes: a systematic review and meta-analysis. Br J Nutr 2012 107 Suppl 2 S214 227 22591895 PMC3744862 source

      Not checked in the free run.

    • cites [212] Wu JH Cahill LE Mozaffarian D Effect of fish oil on circulating adiponectin: a systematic review and meta-analysis of randomized controlled trials. J Clin Endocrinol Metab 2013 98 2451 2459 23703724 PMC3667269 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Omega-3's reduce inflammatory biomarkers, reduce myocardial oxygen utilization, and enhance cardiac function.

    “Omega-3's also reduce inflammatory biomarkers, reduce myocardial oxygen utilization, and enhance cardiac function.201, 205”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [201] Mozaffarian D Wu JH Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events. J Am Coll Cardiol 2011 58 2047 2067 22051327 source

      Not checked in the free run.

    • cites [205] Wu JH Mozaffarian D Omega-3 fatty acids, atherosclerosis progression and cardiovascular outcomes in recent trials: new pieces in a complex puzzle. Heart 2014 100 530 533 24459289 PMC6269084 source

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    Premisecitation

    Meta-analyses of randomized fish oil trials demonstrate risk reductions for cardiac death, but not total CVD, CHD, or stroke.

    “This finding is also consistent with meta-analyses of randomized fish oil trials which demonstrate risk reductions for cardiac death, but not total CVD, CHD, or stroke.109”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [109] Rizos EC Ntzani EE Bika E Kostapanos MS Elisaf MS Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis. JAMA 2012 308 1024 1033 22968891 source

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    Premisecitation

    While a minority of individual studies suggest similar cardiovascular risk for unprocessed red meat vs. processed meats, many other individual studies and meta-analyses support much stronger effects of processed meats, including low-fat deli meats, on CVD.

    “Consistent with this, while a minority of individual studies suggest similar cardiovascular risk for unprocessed red meat vs. processed meats,170, 171 many other individual studies and meta-analyses support much stronger effects of processed meats, including low-fat deli meats, on CVD (Figure 6).172-174”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [170] Sinha R Cross AJ Graubard BI Leitzmann MF Schatzkin A Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med 2009 169 562 571 19307518 PMC2803089 source

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    • cites [171] Bernstein AM Sun Q Hu FB Stampfer MJ Manson JE Willett WC Major dietary protein sources and risk of coronary heart disease in women. Circulation 2010 122 876 883 20713902 PMC2946797 source

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    • cites [172] Pan A Sun Q Bernstein AM Schulze MB Manson JE Willett WC Hu FB Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. Am J Clin Nutr 2011 94 1088 1096 21831992 PMC3173026 source

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    • cites [173] Chen GC Lv DB Pang Z Liu QF Red and processed meat consumption and risk of stroke: a meta-analysis of prospective cohort studies. Eur J Clin Nutr 2013 67 91 95 23169473 source

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    • cites [174] Abete I Romaguera D Vieira AR Lopez de Munain A Norat T Association between total, processed, red and white meat consumption and all-cause, CVD and IHD mortality: a meta-analysis of cohort studies. Br J Nutr 2014 112 762 775 24932617 source

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    Interpretationcitation

    Observed harms of processed meats are consistent with high levels of sodium (~400% higher in processed meat) and predicted effects of this sodium on BP, which explain most of the observed cardiovascular risk.

    “In contrast, observed harms of processed meats are consistent with high levels of sodium (~400% higher in processed meat) and predicted effects of this sodium on BP, which explain most of the observed cardiovascular risk.176”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [176] Al-Solaiman Y Jesri A Mountford WK Lackland DT Zhao Y Egan BM DASH lowers blood pressure in obese hypertensives beyond potassium, magnesium and fibre. Journal of human hypertension 2009 24 237 246 19626043 PMC2841705 source

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    Premisecitation

    Higher egg consumption associates with lower risk of hemorrhagic stroke, potentially related to protective effects of dietary cholesterol on vascular fragility.

    “On the other hand, higher egg consumption associates with lower risk of hemorrhagic stroke,196 potentially related to protective effects of dietary cholesterol on vascular fragility.198, 199”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [196] Rong Y Chen L Zhu T Song Y Yu M Shan Z Sands A Hu FB Liu L Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. BMJ (Clinical research ed) 2013 346 e8539 PMC3538567 23295181 source

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    • cites [198] Ding EL Mozaffarian D Optimal dietary habits for the prevention of stroke. Semin Neurol 2006 26 11 23 16479440 source

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    • cites [199] Iso H Lifestyle and cardiovascular disease in Japan. J Atheroscler Thromb 2011 18 83 88 21307610 source

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    Premisecitation

    In short-term randomized trials, adding milk or dairy to energy-restricted diets increases lean mass and reduces body fat, while no significant body compositional effects are seen when adding dairy to ad libitum diets.

    “In short-term randomized trials, adding milk or dairy to energy-restricted diets increases lean mass and reduces body fat, while no significant body compositional effects are seen when adding dairy to ad libitum diets.232, 233”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [232] Chen M Pan A Malik VS Hu FB Effects of dairy intake on body weight and fat: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2012 96 735 747 22932282 PMC3441106 source

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    • cites [233] Abargouei AS Janghorbani M Salehi-Marzijarani M Esmaillzadeh A Effect of dairy consumption on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Int J Obes (Lond) 2012 36 1485 1493 22249225 source

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    Premisecitation

    In cohorts utilizing objective blood biomarkers, greater dairy fat consumption is associated with lower incidence of diabetes and CHD, with mixed findings for stroke.

    “In cohorts utilizing objective blood biomarkers, greater dairy fat consumption is associated with lower incidence of diabetes59-61, 242, 243 and CHD,39, 244, 245 with mixed findings for stroke.246”
    Quote in the paperSubstantial claim0 of 8 sources checked
    • cites [59] Mozaffarian D Cao H King IB Lemaitre RN Song X Siscovick DS Hotamisligil GS Trans palmitoleic Acid, metabolic risk factors, and new-onset diabetes in U.S. adults: a cohort study. Ann Intern Med 2010 153 790 799 21173413 PMC3056495 source

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    • cites [60] Mozaffarian D de Oliveira Otto MC Lemaitre RN Fretts AM Hotamisligil G Tsai MY Siscovick DS Nettleton JA trans-Palmitoleic acid, other dairy fat biomarkers, and incident diabetes: the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr 2013 97 854 861 23407305 PMC3607658 source

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    • cites [61] Forouhi NG Koulman A Sharp SJ Imamura F Kroger J Schulze MB Crowe FL Huerta JM Guevara M Beulens JW van Woudenbergh GJ Wang L Summerhill K Griffin JL Feskens EJ Amiano P Boeing H Clavel-Chapelon F Dartois L Fagherazzi G Franks PW Gonzalez C Jakobsen MU Kaaks R Key TJ Khaw KT Kuhn T Mattiello A Nilsson PM Overvad K Pala V Palli D Quiros JR Rolandsson O Roswall N Sacerdote C Sanchez MJ Slimani N Spijkerman AM Tjonneland A Tormo MJ Tumino R van der AD van der Schouw YT Langenberg C Riboli E Wareham NJ Differences in the prospective association between individual plasma phospholipid saturated fatt source

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    • cites [242] Kratz M Baars T Guyenet S The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. Eur J Nutr 2013 52 1 24 22810464 source

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    • cites [243] Kratz M Marcovina S Nelson JE Yeh MM Kowdley KV Callahan HS Song X Di C Utzschneider KM Dairy fat intake is associated with glucose tolerance, hepatic and systemic insulin sensitivity, and liver fat but not beta-cell function in humans. Am J Clin Nutr 2014 99 1385 1396 24740208 PMC4021783 source

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    • cites [244] Khaw KT Friesen MD Riboli E Luben R Wareham N Plasma phospholipid fatty acid concentration and incident coronary heart disease in men and women: the EPIC-Norfolk prospective study. PLoS Med 2012 9 e1001255 22802735 PMC3389034 source

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    • cites [245] de Oliveira Otto MC Nettleton JA Lemaitre RN Steffen LM Kromhout D Rich SS Tsai MY Jacobs DR Mozaffarian D Biomarkers of dairy fatty acids and risk of cardiovascular disease in the Multi-ethnic Study of Atherosclerosis. J Am Heart Assoc 2013 2 e000092 23868191 PMC3828802 source

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    • cites [246] Yakoob MY Shi P Hu FB Campos H Rexrode KM Orav EJ Willett WC Mozaffarian D Circulating biomarkers of dairy fat and risk of incident stroke in U.S. men and women in 2 large prospective cohorts. Am J Clin Nutr 2014 100 1437 1447 25411278 PMC4232012 source

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    Premisecitation

    Total milk intake is generally unassociated with diabetes, while fermented milk is linked to lower risk.

    “While total milk intake is generally unassociated with diabetes, fermented milk is linked to lower risk;57, 227, 229”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [57] Sluijs I Forouhi NG Beulens JW van der Schouw YT Agnoli C Arriola L Balkau B Barricarte A Boeing H Bueno-de-Mesquita HB Clavel-Chapelon F Crowe FL de Lauzon-Guillain B Drogan D Franks PW Gavrila D Gonzalez C Halkjaer J Kaaks R Moskal A Nilsson P Overvad K Palli D Panico S Quiros JR Ricceri F Rinaldi S Rolandsson O Sacerdote C Sanchez MJ Slimani N Spijkerman AM Teucher B Tjonneland A Tormo MJ Tumino R van der AD Sharp SJ Langenberg C Feskens EJ Riboli E Wareham NJ InterAct C The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study. Am J Clin source

      Not checked in the free run.

    • cites [227] Ericson U Hellstrand S Brunkwall L Schulz CA Sonestedt E Wallstrom P Gullberg B Wirfalt E Orho-Melander M Food sources of fat may clarify the inconsistent role of dietary fat intake for incidence of type 2 diabetes. Am J Clin Nutr 2015 101 1065 1080 25832335 source

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    • cites [228] Diaz-Lopez A Bullo M Martinez-Gonzalez MA Corella D Estruch R Fito M Gomez-Gracia E Fiol M Garcia de la Corte FJ Ros E Babio N Serra-Majem L Pinto X Munoz MA Frances F Buil-Cosiales P Salas-Salvado J Dairy product consumption and risk of type 2 diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. Eur J Nutr 2015 Epub Feb 7 25663611 source

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    • cites [229] Nestel PJ Mellett N Pally S Wong G Barlow CK Croft K Mori TA Meikle PJ Effects of low fat or full-fat fermented and non-fermented dairy foods on selected cardiovascular biomarkers in overweight adults. Br J Nutr 2013 110 2242 2249 23756569 source

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    Premisecitation

    Bacterial cultures used for fermentation synthesize vitamin K2 (menaquinones), which may improve insulin sensitivity.

    “Bacterial cultures used for fermentation synthesize vitamin K2 (menaquinones), which may improve insulin sensitivity.230, 231”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [230] Walther B Karl JP Booth SL Boyaval P Menaquinones, bacteria, and the food supply: the relevance of dairy and fermented food products to vitamin K requirements. Adv Nutr 2013 4 463 473 23858094 PMC3941825 source

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    • cites [231] Choi HJ Yu J Choi H An JH Kim SW Park KS Jang HC Kim SY Shin CS Vitamin K2 supplementation improves insulin sensitivity via osteocalcin metabolism: a placebo-controlled trial. Diabetes Care 2011 34 e147 21868771 PMC3161300 source

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    Premisecitation

    The impact of cheese consumption on long-term weight may vary depending on how it is consumed: more weight gain is seen when cheese is accompanied by refined carbohydrates, and less weight gain or even relative weight loss when cheese replaces refined carbohydrates.

    “The impact of cheese consumption on long-term weight may vary depending on how it is consumed: more weight gain is seen when cheese is accompanied by refined carbohydrates, and less weight gain or even relative weight loss when cheese replaces refined carbohydrates.29”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] Smith JD Hou T Ludwig DS Rimm EB Willett WC Hu FB Mozaffarian D Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts Am J Clin Nutr 2015 101 1216 1224 25854882 PMC4441808 source

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    Premisecitation

    Yogurt appears protective against long-term weight gain, although when sugar-sweetened, approximately half the benefit appears lost.

    “Yogurt appears protective against long-term weight gain,28, 29, 51 although when sugar-sweetened, approximately half the benefit appears lost.29”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [28] Mozaffarian D Hao T Rimm EB Willett WC Hu FB Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011 364 2392 2404 21696306 PMC3151731 source

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    • cites [29] Smith JD Hou T Ludwig DS Rimm EB Willett WC Hu FB Mozaffarian D Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts Am J Clin Nutr 2015 101 1216 1224 25854882 PMC4441808 source

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    • cites [51] Wang H Troy LM Rogers GT Fox CS McKeown NM Meigs JB Jacques PF Longitudinal association between dairy consumption and changes of body weight and waist circumference: the Framingham Heart Study. Int J Obes (Lond) 2014 38 299 305 23736371 PMC3809320 source

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  • May combine two claims.

    Interpretationcitation

    Farmed salmon have similar or higher levels of omega-3 fatty acids and likely similar net health benefits compared with wild salmon.

    “Because farmed salmon are fed, while wild salmon hunt for their food, farmed salmon have similar or higher levels of omega-3 fatty acids201 and likely similar net health benefits.200”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [200] Mozaffarian D Rimm EB Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA 2006 296 1885 1899 17047219 source

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    • cites [201] Mozaffarian D Wu JH Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events. J Am Coll Cardiol 2011 58 2047 2067 22051327 source

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    Premisecitation

    Intake of yogurt, but not milk, is consistently associated with lower incidence of diabetes; cheese intake also associates with lower diabetes risk in several although not all studies.

    “For example, intake of yogurt, but not milk, is consistently associated with lower incidence of diabetes; while intake of cheese, which has high calorie, fat, and saturated fat content, also associates with lower diabetes risk in several although not all studies.57, 179-184, 224, 226-228”
    Quote in the paperSubstantial claim0 of 10 sources checked
    • cites [57] Sluijs I Forouhi NG Beulens JW van der Schouw YT Agnoli C Arriola L Balkau B Barricarte A Boeing H Bueno-de-Mesquita HB Clavel-Chapelon F Crowe FL de Lauzon-Guillain B Drogan D Franks PW Gavrila D Gonzalez C Halkjaer J Kaaks R Moskal A Nilsson P Overvad K Palli D Panico S Quiros JR Ricceri F Rinaldi S Rolandsson O Sacerdote C Sanchez MJ Slimani N Spijkerman AM Teucher B Tjonneland A Tormo MJ Tumino R van der AD Sharp SJ Langenberg C Feskens EJ Riboli E Wareham NJ InterAct C The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study. Am J Clin source

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    • cites [179] Swaminathan S Fonseca VA Alam MG Shah SV The role of iron in diabetes and its complications. Diabetes Care 2007 30 1926 1933 17429063 source

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    • cites [180] Zhao Z Li S Liu G Yan F Ma X Huang Z Tian H Body iron stores and heme-iron intake in relation to risk of type 2 diabetes: a systematic review and meta-analysis. PLoS One 2012 7 e41641 22848554 PMC3406072 source

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    • cites [181] Wittenbecher C Muhlenbruch K Kroger J Jacobs S Kuxhaus O Floegel A Fritsche A Pischon T Prehn C Adamski J Joost HG Boeing H Schulze MB Amino acids, lipid metabolites, and ferritin as potential mediators linking red meat consumption to type 2 diabetes. Am J Clin Nutr 2015 101 1241 1250 25948672 source

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    • cites [182] Kim Y Keogh J Clifton P A review of potential metabolic etiologies of the observed association between red meat consumption and development of type 2 diabetes mellitus. Metabolism 2015 64 768 779 25838035 source

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    • cites [183] Micha R Michas G Lajous M Mozaffarian D Processing of meats and cardiovascular risk: time to focus on preservatives. BMC Med 2013 11 136 23701737 PMC3680013 source

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    • cites [184] Daley CA Abbott A Doyle PS Nader GA Larson S A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef. Nutr J 2010 9 10 20219103 PMC2846864 source

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    • cites [224] Gao D Ning N Wang C Wang Y Li Q Meng Z Liu Y Dairy products consumption and risk of type 2 diabetes: systematic review and dose-response meta-analysis. PLoS One 2013 8 e73965 24086304 PMC3785489 source

      Not checked in the free run.

    • cites [225] Aune D Norat T Romundstad P Vatten LJ Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. Am J Clin Nutr 2013 98 1066 1083 23945722 source

      Not checked in the free run.

    • cites [226] Chen M Sun Q Giovannucci E Mozaffarian D Manson JE Willett WC Hu FB Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. BMC Med 2014 12 215 25420418 PMC4243376 source

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    Premisecitation

    Children who drink more low-fat milk gain more weight, while those who drink more whole-fat milk gain less weight, over time.

    “For instance, children who drink more low-fat milk gain more weight, while those who drink more whole-fat milk gain less weight, over time.62-66”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [62] Scharf RJ Demmer RT DeBoer MD Longitudinal evaluation of milk type consumed and weight status in preschoolers. Arch Dis Child 2013 98 335 340 23508869 PMC4439101 source

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    • cites [63] Noel SE Ness AR Northstone K Emmett P Newby PK Associations between flavored milk consumption and changes in weight and body composition over time: differences among normal and overweight children. Eur J Clin Nutr 2013 67 295 300 23031848 source

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    • cites [64] Huh SY Rifas-Shiman SL Rich-Edwards JW Taveras EM Gillman MW Prospective association between milk intake and adiposity in preschool-aged children. J Am Diet Assoc 2010 110 563 570 20338282 PMC3229928 source

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    • cites [65] Berkey CS Rockett HR Willett WC Colditz GA Milk, dairy fat, dietary calcium, and weight gain: a longitudinal study of adolescents. Arch Pediatr Adolesc Med 2005 159 543 550 15939853 source

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    • cites [66] Noel SE Ness AR Northstone K Emmett P Newby PK Milk intakes are not associated with percent body fat in children from ages 10 to 13 years. The Journal of nutrition 2011 141 2035 2041 21940511 PMC3192461 source

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    Premisecitation

    Butter consumption is not significantly associated with incident CHD, stroke, or total mortality.

    “Butter consumption is also not significantly associated with incident CHD,223 stroke,222 or total mortality58 (Figure 6).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [223] Qin LQ Xu JY Han SF Zhang ZL Zhao YY Szeto IM Dairy consumption and risk of cardiovascular disease: an updated meta-analysis of prospective cohort studies. Asia Pac J Clin Nutr 2015 24 90 100 25740747 source

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    • cites [222] Hu D Huang J Wang Y Zhang D Qu Y Dairy foods and risk of stroke: a meta-analysis of prospective cohort studies. Nutr Metab Cardiovasc Dis 2014 24 460 469 24472634 source

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    • cites [58] O'Sullivan TA Hafekost K Mitrou F Lawrence D Food sources of saturated fat and the association with mortality: a meta-analysis. American journal of public health 2013 103 e31 42 23865702 PMC3966685 source

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    Premisecitation

    In longitudinal studies evaluating habitual intakes of dairy foods, relationships with CVD and diabetes do not consistently differ by fat content but appear more specific to food type.

    “In longitudinal studies evaluating habitual intakes of dairy foods, relationships with CVD and diabetes do not consistently differ by fat content but appear more specific to food type: e.g., cheese, yogurt, milk, butter (Figure 6).57, 221-226”
    Quote in the paperSubstantial claim0 of 7 sources checked
    • cites [57] Sluijs I Forouhi NG Beulens JW van der Schouw YT Agnoli C Arriola L Balkau B Barricarte A Boeing H Bueno-de-Mesquita HB Clavel-Chapelon F Crowe FL de Lauzon-Guillain B Drogan D Franks PW Gavrila D Gonzalez C Halkjaer J Kaaks R Moskal A Nilsson P Overvad K Palli D Panico S Quiros JR Ricceri F Rinaldi S Rolandsson O Sacerdote C Sanchez MJ Slimani N Spijkerman AM Teucher B Tjonneland A Tormo MJ Tumino R van der AD Sharp SJ Langenberg C Feskens EJ Riboli E Wareham NJ InterAct C The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study. Am J Clin source

      Not checked in the free run.

    • cites [221] Soedamah-Muthu SS Verberne LD Ding EL Engberink MF Geleijnse JM Dairy consumption and incidence of hypertension: a dose-response meta-analysis of prospective cohort studies. Hypertension 2012 60 1131 1137 22987924 source

      Not checked in the free run.

    • cites [222] Hu D Huang J Wang Y Zhang D Qu Y Dairy foods and risk of stroke: a meta-analysis of prospective cohort studies. Nutr Metab Cardiovasc Dis 2014 24 460 469 24472634 source

      Not checked in the free run.

    • cites [223] Qin LQ Xu JY Han SF Zhang ZL Zhao YY Szeto IM Dairy consumption and risk of cardiovascular disease: an updated meta-analysis of prospective cohort studies. Asia Pac J Clin Nutr 2015 24 90 100 25740747 source

      Not checked in the free run.

    • cites [224] Gao D Ning N Wang C Wang Y Li Q Meng Z Liu Y Dairy products consumption and risk of type 2 diabetes: systematic review and dose-response meta-analysis. PLoS One 2013 8 e73965 24086304 PMC3785489 source

      Not checked in the free run.

    • cites [225] Aune D Norat T Romundstad P Vatten LJ Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. Am J Clin Nutr 2013 98 1066 1083 23945722 source

      Not checked in the free run.

    • cites [226] Chen M Sun Q Giovannucci E Mozaffarian D Manson JE Willett WC Hu FB Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. BMC Med 2014 12 215 25420418 PMC4243376 source

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    Premisecitation

    Some observational studies evaluating total or selected dietary flavonoids observe lower risk of cardiometabolic events; no long-term clinical trials have been performed.

    “Some observational studies evaluating total or selected dietary flavonoids observe lower risk of cardiometabolic events;299, 300 no long-term clinical trials have been performed.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [299] Perez-Vizcaino F Duarte J Flavonols and cardiovascular disease. Mol Aspects Med 2010 31 478 494 20837053 source

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    • cites [300] Buitrago-Lopez A Sanderson J Johnson L Warnakula S Wood A Di Angelantonio E Franco OH Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ (Clinical research ed) 2011 343 d4488 PMC3163382 21875885 source

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    Premisecitation

    Compared to nondrinkers, regular moderate consumption - up to ~2 drinks per day for men, ~1-1.5 drink per day for women - associates with lower incidence of CHD and diabetes, although not stroke.

    “Conversely, compared to nondrinkers, regular moderate consumption – up to ~2 drinks per day for men, ~1-1.5 drink per day for women – associates with lower incidence of CHD and diabetes, although not stroke.288, 289”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [288] Baliunas DO Taylor BJ Irving H Roerecke M Patra J Mohapatra S Rehm J Alcohol as a risk factor for type 2 diabetes: A systematic review and meta-analysis. Diabetes Care 2009 32 2123 2132 19875607 PMC2768203 source

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    • cites [289] Ronksley PE Brien SE Turner BJ Mukamal KJ Ghali WA Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ (Clinical research ed) 2011 342 d671 PMC3043109 21343207 source

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    Premisecitation

    In meta-analyses of trials, green tea, black tea, and herbal roselle tea each modestly lower BP; green and black tea, but not herbal roselle tea, also lower LDL-cholesterol.

    “However, in meta-analyses of trials, green tea, black tea, and herbal roselle tea each modestly lower BP;279-281 while green and black tea, but not herbal roselle tea, also lower LDL-cholesterol.282-284”
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    • cites [279] Liu G Mi XN Zheng XX Xu YL Lu J Huang XH Effects of tea intake on blood pressure: a meta-analysis of randomised controlled trials. Br J Nutr 2014 112 1043 1054 25137341 source

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    • cites [280] Yarmolinsky J Gon G Edwards P Effect of tea on blood pressure for secondary prevention of cardiovascular disease: a systematic review and meta-analysis of randomized controlled trials. Nutrition Reviews 2015 73 236 246 26024546 source

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    • cites [281] Serban C Sahebkar A Ursoniu S Andrica F Banach M Effect of sour tea (Hibiscus sabdariffa L.) on arterial hypertension: a systematic review and meta-analysis of randomized controlled trials. Journal of hypertension 2015 33 1119 1127 25875025 source

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    • cites [282] Aziz Z Wong SY Chong NJ Effects of Hibiscus sabdariffa L. on serum lipids: a systematic review and meta-analysis. J Ethnopharmacol 2013 150 442 450 24120746 source

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    • cites [283] Onakpoya I Spencer E Heneghan C Thompson M The effect of green tea on blood pressure and lipid profile: a systematic review and meta-analysis of randomized clinical trials. Nutr Metab Cardiovasc Dis 2014 24 823 836 24675010 source

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    • cites [284] Wang D Chen C Wang Y Liu J Lin R Effect of black tea consumption on blood cholesterol: a meta-analysis of 15 randomized controlled trials. PLoS One 2014 9 e107711 25237889 PMC4169558 source

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    Premisecitation

    In short-term trials, fruit juice has no appreciable effects on blood pressure, cholesterol levels, or glucose-insulin homeostasis.

    “In short-term trials, fruit juice has no appreciable effects on blood pressure, cholesterol levels, or glucose-insulin homeostasis.267, 268”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [267] Liu K Xing A Chen K Wang B Zhou R Chen S Xu H Mi M Effect of fruit juice on cholesterol and blood pressure in adults: a meta-analysis of 19 randomized controlled trials. PLoS One 2013 8 e61420 23637831 PMC3634794 source

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    • cites [268] Wang B Liu K Mi M Wang J Effect of fruit juice on glucose control and insulin sensitivity in adults: a meta-analysis of 12 randomized controlled trials. PLoS One 2014 9 e95323 24743260 PMC3990696 source

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    Premisecitation

    The pattern of drinking is important: benefits are seen with moderate use across multiple days per week, not with high levels on a few days.

    “In addition, the pattern of drinking is important: benefits are seen with moderate use across multiple days per week, not with high levels on a few days.293”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [293] Bagnardi V Zatonski W Scotti L La Vecchia C Corrao G Does drinking pattern modify the effect of alcohol on the risk of coronary heart disease? Evidence from a meta-analysis. Journal of epidemiology and community health 2008 62 615 619 18559444 source

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    Premisecitation

    SSBs are associated with incidence of diabetes and CHD.

    “SSBs are also associated with incidence of diabetes and CHD (Figure 6).257, 258”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [257] Imamura F O'Connor L Ye Z Mursu J Hayashino Y Bhupathiraju SN Forouhi NG Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ (Clinical research ed) 2015 351 h3576 PMC4510779 26199070 source

      Not checked in the free run.

    • cites [258] Xi B Huang Y Reilly KH Li S Zheng R Barrio-Lopez MT Martinez-Gonzalez MA Zhou D Sugar-sweetened beverages and risk of hypertension and CVD: a dose-response meta-analysis. Br J Nutr 2015 113 709 717 25735740 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Worldwide, 184,000 cardiometabolic deaths per year are estimated to be attributable to SSB consumption.

    “Worldwide, 184,000 cardiometabolic deaths per year are estimated to be attributable to SSB consumption.260”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [260] Singh GM Micha R Khatibzadeh S Lim S Ezzati M Mozaffarian D on behalf of the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group Estimated global, regional, and national disease burdens related to sugar-sweetened beverage consumption in 2010. Circulation 2015 in press PMC4550496 26124185 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Coffee intake associates with lower risk of CHD and stroke in a nonlinear fashion: compared with no intake, lowest risk is seen at 3-4 cups/day, with increasing risk at higher intakes.

    “Coffee intake also associates with lower risk of CHD and stroke but in a nonlinear fashion: compared with no intake, lowest risk is seen at 3-4 cups/day, with increasing risk at higher intakes.270”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [270] Ding M Bhupathiraju SN Satija A van Dam RM Hu FB Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies. Circulation 2014 129 643 659 24201300 PMC3945962 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Based on animal experiments and limited human data, artificial and non-nutritive sweeteners may not be benign, with potential impact on cognitive processes, oral-gastrointestinal taste receptors, glucose-insulin and energy homeostasis, metabolic hormones, and the gut microbiome.

    “However, based on animal experiments and limited human data, these artificial and non-nutritive sweeteners may not be benign, with potential impact on cognitive processes (e.g., reward, taste perception), oral-gastrointestinal taste receptors and glucose-insulin and energy homeostasis, metabolic hormones, and the gut microbiome.262-265”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [262] Swithers SE Martin AA Davidson TL High-intensity sweeteners and energy balance. Physiol Behav 2010 100 55 62 20060008 PMC2855968 source

      Not checked in the free run.

    • cites [263] Shankar P Ahuja S Sriram K Non-nutritive sweeteners: review and update. Nutrition 2013 29 1293 1299 23845273 source

      Not checked in the free run.

    • cites [264] Burke MV Small DM Physiological mechanisms by which non-nutritive sweeteners may impact body weight and metabolism. Physiol Behav 2015 PMC4661139 26048305 source

      Not checked in the free run.

    • cites [265] Pepino MY Metabolic effects of non-nutritive sweeteners. Physiol Behav 2015 PMC4661066 26095119 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Although 100% fruit juice and SSBs have similar sugar content, 100% fruit juice is linked to relatively less long-term weight gain.

    “Although 100% fruit juice and SSBs have similar sugar content, the former is linked to relatively less long-term weight gain.28”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [28] Mozaffarian D Hao T Rimm EB Willett WC Hu FB Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011 364 2392 2404 21696306 PMC3151731 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Habitual alcohol and acute binges associate with higher risk of atrial fibrillation.

    “Habitual alcohol and acute binges associate with higher risk of atrial fibrillation.286”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [286] Larsson SC Drca N Wolk A Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis. J Am Coll Cardiol 2014 64 281 289 25034065 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    BP-lowering occurs with as little as 6.3 g/day (30 kcal/day) of dark chocolate and correlates with increased endothelial nitric oxide production.

    “BP-lowering occurs with as little as 6.3 g/day (30 kcal/day) of dark chocolate and correlates with increased endothelial nitric oxide production.298”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [298] Taubert D Roesen R Lehmann C Jung N Schomig E Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial. JAMA 2007 298 49 60 17609490 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Based on a target consumption level of 2000 mg/d, 1.65 million annual global cardiovascular deaths are estimated to be attributable to excess sodium intake.

    “Based on a target consumption level of 2000 mg/d, 1.65 million annual global cardiovascular deaths are estimated to be attributable to excess sodium intake.304”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [304] Mozaffarian D Fahimi S Singh GM Micha R Khatibzadeh S Engell RE Lim S Danaei G Ezzati M Powles J Global sodium consumption and death from cardiovascular causes. N Engl J Med 2014 371 624 634 25119608 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Sodium raises BP in a dose-dependent fashion, with stronger effects among older individuals, hypertensives, and Blacks.

    “Sodium raises BP in a dose-dependent fashion, with stronger effects among older individuals, hypertensives, and Blacks.304”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [304] Mozaffarian D Fahimi S Singh GM Micha R Khatibzadeh S Engell RE Lim S Danaei G Ezzati M Powles J Global sodium consumption and death from cardiovascular causes. N Engl J Med 2014 371 624 634 25119608 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In North America and Europe, most sodium (~75%) comes from packaged foods and restaurants, and little from home cooking or table salt; while in Asian countries, most sodium comes from soy sauce and salt added during cooking or at the table.

    “In North America and Europe, most sodium (~75%) comes from packaged foods and restaurants, and little from home cooking or table salt; while in Asian countries, most sodium comes from soy sauce and salt added during cooking or at the table.302”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [302] Brown IJ Tzoulaki I Candeias V Elliott P Salt intakes around the world: implications for public health. Int J Epidemiol 2009 38 791 813 19351697 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The remarkable heterogeneity of different flavonoids and their dietary sources limits inference for class effects, and clinical benefits and dose-responses are not well-established.

    “The remarkable heterogeneity of different flavonoids and their dietary sources limits inference for class effects, and clinical benefits and dose-responses are not well-established.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In a large sodium study which excluded sick individuals at baseline and collected multiple 24-hour urine per subject, participants with lowest intakes (<2300 mg/d) experienced 32% lower CVD risk than those consuming high intakes, with evidence for linearly decreasing risk.

    “In comparison, during extended surveillance in a large sodium study which excluded sick individuals at baseline and collected multiple 24-hour urine per subject, minimizing the potential influence of these biases, participants with lowest intakes (<2300 mg/d) experienced 32% lower CVD risk than those consuming high intakes, with evidence for linearly decreasing risk.317”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [317] Cook NR Appel LJ Whelton PK Lower levels of sodium intake and reduced cardiovascular risk. Circulation 2014 129 981 989 24415713 PMC4181831 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In randomized trials, potassium lowers BP, with stronger effects among hypertensives and when dietary sodium intake is high.

    “In randomized trials, potassium lowers BP, with stronger effects among hypertensives and when dietary sodium intake is high.325”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [325] Binia A Jaeger J Hu Y Singh A Zimmermann D Daily potassium intake and sodium-to-potassium ratio in the reduction of blood pressure: a meta-analysis of randomized controlled trials. Journal of hypertension 2015 26039623

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A Mediterranean or DASH-type diet reduces, while a typical Western diet increases, the BP-raising effects of sodium.

    “For instance, a Mediterranean or DASH-type diet (e.g., richer in fruits, vegetables, nuts) reduces, while a typical Western diet increases, the BP-raising effects of sodium.326, 327”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [326] D'Elia L Barba G Cappuccio FP Strazzullo P Potassium intake, stroke, and cardiovascular disease a meta-analysis of prospective studies. J Am Coll Cardiol 2011 57 1210 1219 21371638

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [327] Sacks FM Svetkey LP Vollmer WM Appel LJ Bray GA Harsha D Obarzanek E Conlin PR Miller ER 3rd Simons-Morton DG Karanja N Lin PH Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 2001 344 3 10 11136953 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    The sum of evidence suggests that optimal levels of sodium intake are ~2000 mg/d and could be lower.

    “Overall, while adverse effects of rapid sodium reduction cannot be excluded, and true optimal lower limits remain uncertain, the sum of evidence suggests that optimal levels of sodium intake are ~2000 mg/d193, 200-204 and could be lower.304”
    Quote in the paperSubstantial claim0 of 7 sources checked
    • cites [193] Mannisto S Kontto J Kataja-Tuomola M Albanes D Virtamo J High processed meat consumption is a risk factor of type 2 diabetes in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention study. Br J Nutr 2010 103 1817 1822 20187985 PMC3496924 source

      Not checked in the free run.

    • cites [200] Mozaffarian D Rimm EB Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA 2006 296 1885 1899 17047219 source

      Not checked in the free run.

    • cites [201] Mozaffarian D Wu JH Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events. J Am Coll Cardiol 2011 58 2047 2067 22051327 source

      Not checked in the free run.

    • cites [202] Zheng J Huang T Yu Y Hu X Yang B Li D Fish consumption and CHD mortality: an updated meta-analysis of seventeen cohort studies. Public Health Nutr 2012 15 725 737 21914258 source

      Not checked in the free run.

    • cites [203] Larsson SC Orsini N Wolk A Long-chain omega-3 polyunsaturated fatty acids and risk of stroke: a meta-analysis. European journal of epidemiology 2012 27 895 901 23179632 source

      Not checked in the free run.

    • cites [204] Leung Yinko SS Stark KD Thanassoulis G Pilote L Fish consumption and acute coronary syndrome: a meta-analysis. The American journal of medicine 2014 127 848 857 e842 24802020 source

      Not checked in the free run.

    • cites [304] Mozaffarian D Fahimi S Singh GM Micha R Khatibzadeh S Engell RE Lim S Danaei G Ezzati M Powles J Global sodium consumption and death from cardiovascular causes. N Engl J Med 2014 371 624 634 25119608 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Compared with carbohydrate, 16:0 raises blood LDL-cholesterol, yet simultaneously raises HDL-cholesterol, reduces triglyceride-rich lipoproteins and remnants, and has no appreciable effect on ApoB.

    “For instance, compared with carbohydrate, 16:0 raises blood LDL-cholesterol, yet simultaneously raises HDL-cholesterol, reduces triglyceride-rich lipoproteins and remnants, and has no appreciable effect on ApoB,341 the most salient LDL-related characteristic.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [341] Mensink RP Zock PL Kester AD Katan MB Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr 2003 77 1146 1155 12716665 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Several vitamins and nutrients associate with lower CVD risk in observational studies, but trials of supplements, including folate, B-vitamins, beta-carotene, vitamin C, vitamin E, and selenium, have shown no significant effects on atherosclerosis progression or CVD events.

    “Several vitamins and nutrients associate with lower CVD risk in observational studies, but trials of supplements, including folate, B-vitamins, beta-carotene, vitamin C, vitamin E, and selenium, have shown no significant effects on atherosclerosis progression or CVD events.19, 331, 332”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [19] Mozaffarian D Appel LJ Van Horn L Components of a cardioprotective diet: new insights. Circulation 2011 123 2870 2891 21690503 PMC6261290 source

      Not checked in the free run.

    • cites [331] Mente A de Koning L Shannon HS Anand SS A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med 2009 169 659 669 19364995 source

      Not checked in the free run.

    • cites [332] Ye Y Li J Yuan Z Effect of antioxidant vitamin supplementation on cardiovascular outcomes: a meta-analysis of randomized controlled trials. PLoS One 2013 8 e56803 23437244 PMC3577664 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    High doses of rapidly digested glucose induce postprandial hyperglycemia, hyperinsulinemia, and related metabolic disturbances.

    “High doses of rapidly digested glucose induce postprandial hyperglycemia, hyperinsulinemia, and related metabolic disturbances.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [164] Basaranoglu M Basaranoglu G Sabuncu T Senturk H Fructose as a key player in the development of fatty liver disease. World J Gastroenterol 2013 19 1166 1172 23482247 PMC3587472 source

      Not checked in the free run.

    • cites [165] Stanhope KL Sugar consumption, metabolic disease and obesity: The state of the controversy. Crit Rev Clin Lab Sci 2015 1 16 PMC4822166 26376619 source

      Not checked in the free run.

    • cites [166] Malik VS Hu FB Fructose and Cardiometabolic Health: What the Evidence From Sugar-Sweetened Beverages Tells Us. J Am Coll Cardiol 2015 66 1615 1624 26429086 PMC4592517 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Discrepancies in findings could partly relate to different time periods of biologic sensitivity - e.g., some vitamins and nutrients could be important only early in the disease course.

    “Thus, discrepancies in findings could partly relate to different time periods of biologic sensitivity — e.g., some vitamins and nutrients could be important only early in the disease course.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Palmitic acid (16:0) exhibits in vitro adverse effects; whereas medium-chain (6:0-12:0), odd-chain (15:0, 17:0), and very long-chain (20:0-24:0) saturated fats may have metabolic benefits.

    “For instance, palmitic acid (16:0) exhibits in vitro adverse effects; whereas medium-chain (6:0-12:0), odd-chain (15:0, 17:0), and very long-chain (20:0-24:0) saturated fats may have metabolic benefits.61, 338, 339”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [61] Forouhi NG Koulman A Sharp SJ Imamura F Kroger J Schulze MB Crowe FL Huerta JM Guevara M Beulens JW van Woudenbergh GJ Wang L Summerhill K Griffin JL Feskens EJ Amiano P Boeing H Clavel-Chapelon F Dartois L Fagherazzi G Franks PW Gonzalez C Jakobsen MU Kaaks R Key TJ Khaw KT Kuhn T Mattiello A Nilsson PM Overvad K Pala V Palli D Quiros JR Rolandsson O Roswall N Sacerdote C Sanchez MJ Slimani N Spijkerman AM Tjonneland A Tormo MJ Tumino R van der AD van der Schouw YT Langenberg C Riboli E Wareham NJ Differences in the prospective association between individual plasma phospholipid saturated fatt source

      Not checked in the free run.

    • cites [338] Malik VS Chiuve SE Campos H Rimm EB Mozaffarian D Hu FB Sun Q Circulating Very-Long Chain Saturated Fatty Acids and Incident Coronary Heart Disease in U.S. Men and Women. Circulation 2015 PMC4519378 26048094 source

      Not checked in the free run.

    • cites [339] Lemaitre RN Fretts AM Sitlani CM Biggs ML Mukamal K King IB Song X Djousse L Siscovick DS McKnight B Sotoodehnia N Kizer JR Mozaffarian D Plasma phospholipid very-long-chain saturated fatty acids and incident diabetes in older adults: the Cardiovascular Health Study. Am J Clin Nutr 2015 101 1047 1054 25787996 PMC4409688 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The large WHI randomized trial substantially lowered total dietary fat among nearly 50,000 US women followed for nearly a decade, and did not show benefits for any major endpoint including heart disease, stroke, cancers, diabetes, or insulin resistance.

    “The large WHI randomized trial substantially lowered total dietary fat among nearly 50,000 US women followed for nearly a decade, and did not show benefits for any major endpoint including heart disease (Figure 2, top panel), stroke, cancers, diabetes, or insulin resistance.36-39”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [36] Howard BV Van Horn L Hsia J Manson JE Stefanick ML Wassertheil-Smoller S Kuller LH LaCroix AZ Langer RD Lasser NL Lewis CE Limacher MC Margolis KL Mysiw WJ Ockene JK Parker LM Perri MG Phillips L Prentice RL Robbins J Rossouw JE Sarto GE Schatz IJ Snetselaar LG Stevens VJ Tinker LF Trevisan M Vitolins MZ Anderson GL Assaf AR Bassford T Beresford SA Black HR Brunner RL Brzyski RG Caan B Chlebowski RT Gass M Granek I Greenland P Hays J Heber D Heiss G Hendrix SL Hubbell FA Johnson KC Kotchen JM Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized C source

      Not checked in the free run.

    • cites [37] Tinker LF Bonds DE Margolis KL Manson JE Howard BV Larson J Perri MG Beresford SA Robinson JG Rodriguez B Safford MM Wenger NK Stevens VJ Parker LM Low-fat dietary pattern and risk of treated diabetes mellitus in postmenopausal women: the Women's Health Initiative randomized controlled dietary modification trial. Arch Intern Med 2008 168 1500 1511 18663162 source

      Not checked in the free run.

    • cites [38] Micha R Mozaffarian D Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence. Lipids 2010 45 893 905 20354806 PMC2950931 source

      Not checked in the free run.

    • cites [39] Chowdhury R Warnakula S Kunutsor S Crowe F Ward HA Johnson L Franco OH Butterworth AS Forouhi NG Thompson SG Khaw KT Mozaffarian D Danesh J Di Angelantonio E Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med 2014 160 398 406 24723079 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Discrepancies between observational studies and supplement trials may also relate to residual bias in observational studies from other lifestyle behaviors or due to other nutritional factors in vitamin-rich foods.

    “Discrepancies between observational studies and supplement trials may also relate to residual bias in observational studies from other lifestyle behaviors (i.e., observed benefits are not due to diet) or due to other nutritional factors in vitamin-rich foods (i.e., observed benefits are due to diet but not to the specific identified vitamins or nutrients).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Certain carbohydrate-containing foods (e.g., fruits, legumes, vegetables, minimally processed whole grains) are protective, while foods rich in refined grains, starches, and added sugars are harmful.

    “Certain carbohydrate-containing foods (e.g., fruits, legumes, vegetables, minimally processed whole grains) are protective, while foods rich in refined grains (e.g., white bread, white rice, crackers, cereals, bakery desserts), starches (e.g., russet or white potatoes), and added sugars (e.g., SSBs, candy) are harmful.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    High doses of rapidly digested glucose and fructose are each harmful, via both distinct and partly overlapping pathways.

    “Thus, high doses of rapidly digested glucose and fructose are each harmful, via both distinct and partly overlapping pathways.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    The current restriction on total fat shapes numerous government feeding programs and policies; drives industry marketing of fat-reduced desserts, snacks, salad dressings, processed meats, and other products of poor nutritional value; and leads most Americans to actively avoid dietary fat while eating far too much refined carbohydrates.

    “The current restriction on total fat shapes numerous government feeding programs and policies;336 drives industry marketing of fat-reduced desserts, snacks, salad dressings, processed meats, and other products of poor nutritional value; and leads most Americans to actively avoid dietary fat337 while eating far too much refined carbohydrates.21”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [336] Mozaffarian D Ludwig DS The 2015 US Dietary Guidelines: Lifting the ban on total dietary fat. JAMA 2015 313 2421 2422 26103023 PMC6129189 source

      Not checked in the free run.

    • cites [337] Gallup. Americans Still Avoid Fat More Than Carbs 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [21] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015 Available at: http://www.health.gov/dietaryguidelines/2015-scientific-report/. March 25, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    Total carbohydrate has little influence on cardiometabolic health, while the types and quality of carbohydrate have major impact.

    “Since that time, it has become clear that while total carbohydrate has little influence on cardiometabolic health, the types and quality of carbohydrate have major impact (Figures 6-7; see Carbohydrate-rich foods, above).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Randomized trials confirm observational cohort findings that diets higher in healthful fats, exceeding the current 35% limit, reduce risk of cardiovascular disease and diabetes.

    “In contrast, randomized trials confirm observational cohort findings that diets higher in healthful fats, exceeding the current 35% limit, reduce risk of cardiovascular disease (Figure 2, bottom panel) and diabetes.24, 25, 34, 35”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [24] Appel LJ Sacks FM Carey VJ Obarzanek E Swain JF Miller ER 3rd Conlin PR Erlinger TP Rosner BA Laranjo NM Charleston J McCarron P Bishop LM Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. JAMA 2005 294 2455 2464 16287956 source

      Not checked in the free run.

    • cites [25] Gadgil MD Appel LJ Yeung E Anderson CA Sacks FM Miller ER 3rd The effects of carbohydrate, unsaturated fat, and protein intake on measures of insulin sensitivity: results from the OmniHeart Trial. Diabetes Care 2012 PMC3631872 23223345 source

      Not checked in the free run.

    • cites [34] Estruch R Ros E Salas-Salvado J Covas MI Pharm D Corella D Aros F Gomez-Gracia E Ruiz-Gutierrez V Fiol M Lapetra J Lamuela-Raventos RM Serra-Majem L Pinto X Basora J Munoz MA Sorli JV Martinez JA Martinez-Gonzalez MA Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013 29897867 source

      Not checked in the free run.

    • cites [35] Salas-Salvado J Bullo M Estruch R Ros E Covas MI Ibarrola-Jurado N Corella D Aros F Gomez-Gracia E Ruiz-Gutierrez V Romaguera D Lapetra J Lamuela-Raventos RM Serra-Majem L Pinto X Basora J Munoz MA Sorli JV Martinez-Gonzalez MA Prevention of diabetes with Mediterranean diets: a subgroup analysis of a randomized trial. Ann Intern Med 2014 160 1 10 24573661 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Saturated fat represents a highly heterogeneous category, with fatty acid chain lengths ranging from 6 to 24 carbons, deriving from diverse foods, and possessing dissimilar biology.

    “Saturated fat represents a highly heterogeneous category, with fatty acid chain lengths ranging from 6 to 24 carbons, deriving from diverse foods, and possessing dissimilar biology.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [61] Forouhi NG Koulman A Sharp SJ Imamura F Kroger J Schulze MB Crowe FL Huerta JM Guevara M Beulens JW van Woudenbergh GJ Wang L Summerhill K Griffin JL Feskens EJ Amiano P Boeing H Clavel-Chapelon F Dartois L Fagherazzi G Franks PW Gonzalez C Jakobsen MU Kaaks R Key TJ Khaw KT Kuhn T Mattiello A Nilsson PM Overvad K Pala V Palli D Quiros JR Rolandsson O Roswall N Sacerdote C Sanchez MJ Slimani N Spijkerman AM Tjonneland A Tormo MJ Tumino R van der AD van der Schouw YT Langenberg C Riboli E Wareham NJ Differences in the prospective association between individual plasma phospholipid saturated fatt source

      Not checked in the free run.

    • cites [338] Malik VS Chiuve SE Campos H Rimm EB Mozaffarian D Hu FB Sun Q Circulating Very-Long Chain Saturated Fatty Acids and Incident Coronary Heart Disease in U.S. Men and Women. Circulation 2015 PMC4519378 26048094 source

      Not checked in the free run.

    • cites [339] Lemaitre RN Fretts AM Sitlani CM Biggs ML Mukamal K King IB Song X Djousse L Siscovick DS McKnight B Sotoodehnia N Kizer JR Mozaffarian D Plasma phospholipid very-long-chain saturated fatty acids and incident diabetes in older adults: the Cardiovascular Health Study. Am J Clin Nutr 2015 101 1047 1054 25787996 PMC4409688 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Observational studies demonstrate links between higher plasma vitamin D, which is largely driven by sun exposure, and CVD risk; however, large trials of vitamin D supplements have shown no benefits.

    “Observational studies demonstrate links between higher plasma vitamin D, which is largely driven by sun exposure, and CVD risk; however, large trials of vitamin D supplements have shown no benefits.104”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [104] Ford JA MacLennan GS Avenell A Bolland M Grey A Witham M Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis. Am J Clin Nutr 2014 100 746 755 25057156 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    High doses of rapidly digested fructose have little influence on blood glucose or insulin levels, but more directly stimulate hepatic de novo lipogenesis, hepatic and visceral adiposity, and uric acid production.

    “In comparison, high doses of rapidly digested fructose have little influence on blood glucose or insulin levels, but more directly stimulate hepatic de novo lipogenesis, hepatic and visceral adiposity, and uric acid production.164-166”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [164] Basaranoglu M Basaranoglu G Sabuncu T Senturk H Fructose as a key player in the development of fatty liver disease. World J Gastroenterol 2013 19 1166 1172 23482247 PMC3587472 source

      Not checked in the free run.

    • cites [165] Stanhope KL Sugar consumption, metabolic disease and obesity: The state of the controversy. Crit Rev Clin Lab Sci 2015 1 16 PMC4822166 26376619 source

      Not checked in the free run.

    • cites [166] Malik VS Hu FB Fructose and Cardiometabolic Health: What the Evidence From Sugar-Sweetened Beverages Tells Us. J Am Coll Cardiol 2015 66 1615 1624 26429086 PMC4592517 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Total saturated fat, carbohydrate, and protein each appear relatively neutral for CHD; while effects of total monounsaturated fat remain uncertain.

    “For instance, total saturated fat, carbohydrate, and protein each appear relatively neutral for CHD; while effects of total monounsaturated fat remain uncertain (see below).21, 349”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [21] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015 Available at: http://www.health.gov/dietaryguidelines/2015-scientific-report/. March 25, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [349] Mozaffarian D Micha R Wallace S Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med 2010 7 e1000252 20351774 PMC2843598 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In certain Western nations, statin use may account for a large proportion of declining blood cholesterol after 2000; however, due to relatively low use for primary prevention prior to this period, statins cannot explain the observed similar declines in blood cholesterol over the preceding 20-30 years.

    “In certain Western nations, statin use may account for a large proportion of declining blood cholesterol after 2000;347, 348 however, due to relatively low use for primary prevention prior to this period, statins cannot explain the observed similar declines in blood cholesterol over the preceding 20-30 years.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [347] Bandosz P O'Flaherty M Rutkowski M Kypridemos C Guzman-Castillo M Gillespie DO Solnica B Pencina MJ Wyrzykowski B Capewell S Zdrojewski T A victory for statins or a defeat for diet policies? Cholesterol falls in Poland in the past decade: A modeling study. Int J Cardiol 2015 185 313 319 25828672 source

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    • cites [348] Kypridemos C Bandosz P Hickey GL Guzman-Castillo M Allen K Buchan I Capewell S O'Flaherty M Quantifying the contribution of statins to the decline in population mean cholesterol by socioeconomic group in England 1991 - 2012: a modelling study. PLoS One 2015 10 e0123112 25856394 PMC4391910 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Although falling blood cholesterol concentrations in some Western nations correlate with decreases in saturated fat, changes in dietary fats cannot explain much of the blood cholesterol changes across or within most nations.

    “For example, although falling blood cholesterol concentrations in some Western nations correlate with decreases in saturated fat, changes in dietary fats cannot explain much of the blood cholesterol changes across or within most nations.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [346] Micha R Khatibzadeh S Shi P Fahimi S Lim S Andrews KG Engell RE Powles J Ezzati M Mozaffarian D on behalf of the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE) Global, regional, and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys. BMJ (Clinical research ed) 2014 348 g2272 PMC3987052 24736206

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Total monounsaturated fat intake is not associated with lower incidence of diabetes; associates with trends toward greater CVD in some cohort studies; and increases atherosclerosis in primate experiments.

    “Yet, total monounsaturated fat intake is not associated with lower incidence of diabetes;355 associates with trends toward greater CVD in some cohort studies;155 and increases atherosclerosis in primate experiments, potentially due to enrichment of LDL cholesteryl oleate and increased LDL proteoglycan binding.356”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [355] Micha R Mozaffarian D Saturated fat consumption and effects on cardiometabolic risk factors and coronary heart disease, stroke, and diabetes mellitus: A fresh look at the evidence. Lipids 2010 45 893 905 20354806 PMC2950931 source

      Not checked in the free run.

    • cites [155] Jakobsen MU O'Reilly EJ Heitmann BL Pereira MA Balter K Fraser GE Goldbourt U Hallmans G Knekt P Liu S Pietinen P Spiegelman D Stevens J Virtamo J Willett WC Ascherio A Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr 2009 89 1425 1432 19211817 PMC2676998 source

      Not checked in the free run.

    • cites [356] Degirolamo C Shelness GS Rudel LL LDL cholesteryl oleate as a predictor for atherosclerosis: evidence from human and animal studies on dietary fat. J Lipid Res 2009 50 Suppl S434 439 19029117 PMC2674687 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    LA consumption lowers LDL-cholesterol and triglyceride-rich lipoproteins and raises HDL-cholesterol.

    “LA consumption lowers LDL-cholesterol and triglyceride-rich lipoproteins and raises HDL-cholesterol.349”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [349] Mozaffarian D Micha R Wallace S Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med 2010 7 e1000252 20351774 PMC2843598 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Monounsaturated fat improves BP and cholesterol and, when consumed in place of saturated fat, lowers glucose among those predisposed to insulin resistance.

    “Monounsaturated fat improves BP and cholesterol353 and, when consumed in place of saturated fat, lowers glucose among those predisposed to insulin resistance.354”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [353] Schwingshackl L Strasser B Hoffmann G Effects of monounsaturated fatty acids on cardiovascular risk factors: a systematic review and meta-analysis. Annals of Nutrition and Metabolism 2011 59 176 186 22142965 source

      Not checked in the free run.

    • cites [354] Schwingshackl L Strasser B Hoffmann G Effects of monounsaturated fatty acids on glycaemic control in patients with abnormal glucose metabolism: a systematic review and meta-analysis. Annals of Nutrition and Metabolism 2011 58 290 296 21912106 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Cheese, a leading source of saturated fat, is linked to neutral or even beneficial effects on CHD and diabetes.

    “Cheese, a leading source of saturated fat, is also linked to neutral or even beneficial effects on CHD and diabetes (see Milk, Cheese, Yogurt, above).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    While certain saturated fat-containing foods such as dairy, nuts, and vegetable oils promote health, these findings do not support benefits of other saturated fat-rich foods.

    “Yet, while certain saturated fat-containing foods such as dairy, nuts, and vegetable oils promote health,20 these findings do not support benefits of other saturated fat-rich foods.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] Mozaffarian D Mann DL Zipes DP Libby P Bonow RO Nutrition and Cardiovascular Disease and Metabolic Diseases. Braunwald's Heart Disease; A Textbook of Cardiovascular Medicine 2014 Elsevier/Saunders Philadelphia 10th Edition. Chapter 46

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Judging long-term health impact of foods or diets based on isolated macronutrient composition is unsound, often creating paradoxical food choices and product formulations.

    “Judging long-term health impact of foods or diets based on isolated macronutrient composition is unsound, often creating paradoxical food choices and product formulations.336, 340”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [336] Mozaffarian D Ludwig DS The 2015 US Dietary Guidelines: Lifting the ban on total dietary fat. JAMA 2015 313 2421 2422 26103023 PMC6129189 source

      Not checked in the free run.

    • cites [340] Mozaffarian D Diverging global trends in heart disease and type 2 diabetes: the role of carbohydrates and saturated fats. Lancet Diabetes Endocrinol 2015 26134688 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Continued prioritization of saturated fat reduction relies on selected evidence: effects on LDL-cholesterol alone; historical ecologic trends in certain countries but not in others; and expedient comparisons with polyunsaturated fat.

    “Continued prioritization of saturated fat reduction relies on selected evidence: effects on LDL-cholesterol alone (discounting the other, complex lipid and lipoprotein effects); historical ecologic trends in certain countries (e.g. Finland) but not in others; and expedient comparisons with polyunsaturated fat, the most healthful macronutrient.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    These lines of evidence support guidelines to increase healthful vegetable oils rich in polyunsaturated fats and phenolics, optimally in place of refined grains, starches, and added sugars.

    “These lines of evidence support guidelines to increase healthful vegetable oils rich in polyunsaturated fats and phenolics, optimally in place of refined grains, starches, and added sugars.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Humans synthesize relatively little EPA and DHA, for which diet remains the major source.

    “Humans also synthesize relatively little EPA and DHA,344 for which diet remains the major source.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [344] Siri-Tarino PW Sun Q Hu FB Krauss RM Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr 2010 91 502 509 20071648 PMC2824152 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Cohort studies suggest that consumption of olive oil, but not mixed animal and plant sources of monounsaturated fat, is linked to lower risk; while vegetable oil sources of monounsaturated fat increase LDL cholesteryl oleate but reduce LDL proteoglycan binding.

    “For instance, cohort studies suggest that consumption of olive oil, but not mixed animal and plant sources of monounsaturated fat, is linked to lower risk;352 while vegetable oil sources of monounsaturated fat increase LDL cholesteryl oleate but reduce LDL proteoglycan binding.357”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [352] Schwingshackl L Hoffmann G Monounsaturated fatty acids, olive oil and health status: a systematic review and meta-analysis of cohort studies. Lipids Health Dis 2014 13 154 25274026 PMC4198773 source

      Not checked in the free run.

    • cites [357] Jones PJ MacKay DS Senanayake VK Pu S Jenkins DJ Connelly PW Lamarche B Couture P Kris-Etherton PM West SG Liu X Fleming JA Hantgan RR Rudel LL High-oleic canola oil consumption enriches LDL particle cholesteryl oleate content and reduces LDL proteoglycan binding in humans. Atherosclerosis 2015 238 231 238 25528432 PMC4346138 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Total blood cholesterol fell similarly in the US and France between 1980 and 2000, but national changes in dietary fats may explain only about 20% of the decline in the US, and virtually none of the decline in France.

    “For instance, total blood cholesterol fell similarly in the US and France between 1980 and 2000, but national changes in dietary fats may explain only about 20% of the decline in the US, and virtually none of the decline in France.346”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [346] Micha R Khatibzadeh S Shi P Fahimi S Lim S Andrews KG Engell RE Powles J Ezzati M Mozaffarian D on behalf of the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE) Global, regional, and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys. BMJ (Clinical research ed) 2014 348 g2272 PMC3987052 24736206

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Tissue levels of even-chain saturated fatty acids (e.g., 14:0, 16:0), that appear most harmful, commonly result from endogenous hepatic synthesis in response to dietary carbohydrate; 14:0 and 16:0 blood levels correlate more with dietary starches and added sugars than meats or dairy.

    “Furthermore, tissue levels of even-chain saturated fatty acids (e.g., 14:0, 16:0), that appear most harmful, commonly result from endogenous hepatic synthesis in response to dietary carbohydrate;46 14:0 and 16:0 blood levels correlate more with dietary starches and added sugars than meats or dairy.61”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [46] Volk BM Kunces LJ Freidenreich DJ Kupchak BR Saenz C Artistizabal JC Fernandez ML Bruno RS Maresh CM Kraemer WJ Phinney SD Volek JS Effects of step-wise increases in dietary carbohydrate on circulating saturated Fatty acids and palmitoleic Acid in adults with metabolic syndrome. PLoS One 2014 9 e113605 25415333 PMC4240601 source

      Not checked in the free run.

    • cites [61] Forouhi NG Koulman A Sharp SJ Imamura F Kroger J Schulze MB Crowe FL Huerta JM Guevara M Beulens JW van Woudenbergh GJ Wang L Summerhill K Griffin JL Feskens EJ Amiano P Boeing H Clavel-Chapelon F Dartois L Fagherazzi G Franks PW Gonzalez C Jakobsen MU Kaaks R Key TJ Khaw KT Kuhn T Mattiello A Nilsson PM Overvad K Pala V Palli D Quiros JR Rolandsson O Roswall N Sacerdote C Sanchez MJ Slimani N Spijkerman AM Tjonneland A Tormo MJ Tumino R van der AD van der Schouw YT Langenberg C Riboli E Wareham NJ Differences in the prospective association between individual plasma phospholipid saturated fatt source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    While unprocessed red meats and butter may be relatively neutral for CHD, no studies demonstrate appreciable benefits, all meats appear to increase diabetes, and processed meats are strongly linked to CHD.

    “While unprocessed red meats and butter may be relatively neutral for CHD, no studies demonstrate appreciable benefits, all meats appear to increase diabetes, and processed meats are strongly linked to CHD (see Meats, above).20, 29, 173, 178”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [20] Mozaffarian D Mann DL Zipes DP Libby P Bonow RO Nutrition and Cardiovascular Disease and Metabolic Diseases. Braunwald's Heart Disease; A Textbook of Cardiovascular Medicine 2014 Elsevier/Saunders Philadelphia 10th Edition. Chapter 46

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [29] Smith JD Hou T Ludwig DS Rimm EB Willett WC Hu FB Mozaffarian D Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts Am J Clin Nutr 2015 101 1216 1224 25854882 PMC4441808 source

      Not checked in the free run.

    • cites [173] Chen GC Lv DB Pang Z Liu QF Red and processed meat consumption and risk of stroke: a meta-analysis of prospective cohort studies. Eur J Clin Nutr 2013 67 91 95 23169473 source

      Not checked in the free run.

    • cites [178] Bendinelli B Palli D Masala G Sharp SJ Schulz MB Guevara M van der AD Sera F Amiano P Balkau B Barricarte A Boeing H Crowe FL Dahm CC Dalmeijer G de Lauzon-Guillain B Egeberg R Fagherazzi G Franks PW Krogh V Huerta JM Jakszyn P Khaw KT Li K Mattiello A Nilsson PM Overvad K Ricceri F Rolandsson O Sanchez MJ Slimani N Sluijs I Spijkerman AM Teucher B Tjonneland A Tumino R van den Berg SW Forouhi NG Langeberg C Feskens EJ Riboli E Wareham NJ Association between dietary meat consumption and incident type 2 diabetes: the EPIC-InterAct study. Diabetologia 2013 56 47 59 22983636 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Pro-inflammatory effects of LA have been theorized and popularized, but such inference is based largely on rodent experiments, with little supportive evidence in humans.

    “While pro-inflammatory effects of LA have been theorized358 and popularized, such inference is based largely on rodent experiments; with little supportive evidence in humans.359-362”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [358] Lands WE Dietary fat and health: the evidence and the politics of prevention: careful use of dietary fats can improve life and prevent disease. Ann N Y Acad Sci 2005 1055 179 192 16387724 source

      Not checked in the free run.

    • cites [359] Pischon T Hankinson SE Hotamisligil GS Rifai N Willett WC Rimm EB Habitual dietary intake of n-3 and n-6 fatty acids in relation to inflammatory markers among US men and women. Circulation 2003 108 155 160 12821543 source

      Not checked in the free run.

    • cites [360] Poudel-Tandukar K Nanri A Matsushita Y Sasaki S Ohta M Sato M Mizoue T Dietary intakes of alpha-linolenic and linoleic acids are inversely associated with serum C-reactive protein levels among Japanese men. Nutr Res 2009 29 363 370 19628101 source

      Not checked in the free run.

    • cites [361] Kalogeropoulos N Panagiotakos DB Pitsavos C Chrysohoou C Rousinou G Toutouza M Stefanadis C Unsaturated fatty acids are inversely associated and n-6/n-3 ratios are positively related to inflammation and coagulation markers in plasma of apparently healthy adults. Clin Chim Acta 2010 411 584 591 20097190 source

      Not checked in the free run.

    • cites [362] Johnson GH Fritsche K Effect of dietary linoleic acid on markers of inflammation in healthy persons: a systematic review of randomized controlled trials. Journal of the Academy of Nutrition and Dietetics 2012 112 1029-1041, 1041 e1021-1015 22889633 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A few cohorts have seen protective associations of animal protein intake with risk of hemorrhagic stroke; causality and mechanisms remain unclear, but have been hypothesized to relate to potentially protective effects of animal protein or dietary cholesterol on vascular fragility.

    “A few cohorts have seen protective associations of animal protein intake with risk of hemorrhagic stroke; causality and mechanisms remain unclear, but have been hypothesized to relate to potentially protective effects of animal protein or dietary cholesterol on vascular fragility.198, 199”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [198] Ding EL Mozaffarian D Optimal dietary habits for the prevention of stroke. Semin Neurol 2006 26 11 23 16479440 source

      Not checked in the free run.

    • cites [199] Iso H Lifestyle and cardiovascular disease in Japan. J Atheroscler Thromb 2011 18 83 88 21307610 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    LA is associated with significantly lower risk of CHD, whether in comparison to carbohydrate or saturated fat; and in meta-analysis of controlled clinical trials, consumption of n-6 rich vegetable oils, in place of animal fats, reduces CHD events.

    “LA is also associated with significantly lower risk of CHD (Figure 7), whether in comparison to carbohydrate or saturated fat;350 and in meta-analysis of controlled clinical trials, consumption of n-6 rich vegetable oils, in place of animal fats, reduces CHD events (Figure 7).349”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [350] Farvid MS Ding M Pan A Sun Q Chiuve SE Steffen LM Willett WC Hu FB Dietary linoleic acid and risk of coronary heart disease: a systematic review and meta-analysis of prospective cohort studies. Circulation 2014 130 1568 1578 25161045 PMC4334131 source

      Not checked in the free run.

    • cites [349] Mozaffarian D Micha R Wallace S Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med 2010 7 e1000252 20351774 PMC2843598 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Few longitudinal studies have reported on total protein intake and CHD events, with generally null results.

    “Few longitudinal studies have reported on total protein intake and CHD events, with generally null results.189, 386”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [189] Haring B Gronroos N Nettleton JA von Ballmoos MC Selvin E Alonso A Dietary protein intake and coronary heart disease in a large community based cohort: results from the Atherosclerosis Risk in Communities (ARIC) Study. PLoS One 2014 9 e109552 25303709 PMC4193805 source

      Not checked in the free run.

    • cites [386] Nilsson LM Winkvist A Eliasson M Jansson JH Hallmans G Johansson I Lindahl B Lenner P Van Guelpen B Low-carbohydrate, high-protein score and mortality in a northern Swedish population-based cohort. Eur J Clin Nutr 2012 66 694 700 22333874 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In these trials, the average intake of n-6 polyunsaturated fat was ~15% energy, higher than current guidelines that recommend up to 10-11% energy from polyunsaturated fat.

    “Notably, in these trials, the average intake of n-6 polyunsaturated fat was ~15% energy,349 higher than current guidelines that recommend up to 10-11% energy from polyunsaturated fat.370”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [349] Mozaffarian D Micha R Wallace S Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med 2010 7 e1000252 20351774 PMC2843598 source

      Not checked in the free run.

    • cites [370] Joint FAO/WHO Expert Consultation on the Risks and Benefits of Fish Consumption - Executive Summary 2010 Available at: ftp://ftp.fao.org/FI/DOCUMENT/risk_consumption/executive_summary.pdf. May 21, 2010

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    In trials, TFA have unique adverse effects on blood lipid and lipoproteins, including raising LDL-cholesterol, ApoB, triglycerides, and lipoprotein(a); and lowering HDL-cholesterol and ApoA1; these effects are generally consistent whether TFA replaces saturated, monounsaturated, or polyunsaturated fat.

    “In trials, TFA have unique adverse effects on blood lipid and lipoproteins, including raising LDL-cholesterol, ApoB, triglycerides, and lipoprotein(a); and lowering HDL-cholesterol and ApoA1; these effects are generally consistent whether TFA replaces saturated, monounsaturated, or polyunsaturated fat.377”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [377] Howard BV Manson JE Stefanick ML Beresford SA Frank G Jones B Rodabough RJ Snetselaar L Thomson C Tinker L Vitolins M Prentice R Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial. JAMA 2006 295 39 49 16391215 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Emerging evidence suggests that 18:2 TFA isomers may be most adverse; these can be formed through not only partial hydrogenation but also other industrial processes such as oil deodorization and high temperature cooking.

    “Emerging evidence suggests that 18:2 TFA isomers may be most adverse; these can be formed through not only partial hydrogenation but also other industrial processes such as oil deodorization and high temperature cooking.380, 381”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [380] Lambelet P Grandgirard A Gregoire S Juaneda P Sebedio JL Bertoli C Formation of modified fatty acids and oxyphytosterols during refining of low erucic acid rapeseed oil. J Agric Food Chem 2003 51 4284 4290 12848499 source

      Not checked in the free run.

    • cites [381] Velasco J Marmesat S Bordeaux O Marquez-Ruiz G Dobarganes C Formation and evolution of monoepoxy fatty acids in thermoxidized olive and sunflower oils and quantitation in used frying oils from restaurants and fried-food outlets. J Agric Food Chem 2004 52 4438 4443 15237949 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Sociocultural determinants include cultural norms, social pressures, social class, social networks, and race/ethnicity.

    “Sociocultural determinants include cultural norms, social pressures, social class, social networks, and race/ethnicity.390”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [390] Brug J Kremers SP Lenthe F Ball K Crawford D Environmental determinants of healthy eating: in need of theory and evidence. The Proceedings of the Nutrition Society 2008 67 307 316 18700052 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    LA appears to have anti-inflammatory and insulin-sensitizing effects.

    “Indeed, LA appears to have anti-inflammatory and insulin-sensitizing effects.363-365”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [363] Keys A Menotti A Karvonen MJ Aravanis C Blackburn H Buzina R Djordjevic BS Dontas AS Fidanza F Keys MH Kromhout D Nedeljkovic S Punsar S Seccareccia F Toshima H The diet and 15-year death rate in the seven countries study. Am J Epidemiol 1986 124 903 915 3776973 source

      Not checked in the free run.

    • cites [364] Harris WS Mozaffarian D Rimm E Kris-Etherton P Rudel LL Appel LJ Engler MM Engler MB Sacks F Omega-6 fatty acids and risk for cardiovascular disease: a science advisory from the American Heart Association Nutrition Subcommittee of the Council on Nutrition, Physical Activity, and Metabolism; Council on Cardiovascular Nursing; and Council on Epidemiology and Prevention. Circulation 2009 119 902 907 19171857 source

      Not checked in the free run.

    • cites [365] Jebb SA Lovegrove JA Griffin BA Frost GS Moore CS Chatfield MD Bluck LJ Williams CM Sanders TA Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial. Am J Clin Nutr 2010 92 748 758 20739418 PMC3594881 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    TFA also appear to have many non-lipid adverse effects, promoting inflammation, endothelial vasodilator dysfunction, insulin resistance, visceral adiposity, and arrhythmia, although strength of evidence for these non-lipid effects varies.

    “TFA also appear to have many non-lipid adverse effects, promoting inflammation, endothelial vasodilator dysfunction, insulin resistance, visceral adiposity, and arrhythmia, although strength of evidence for these non-lipid effects varies.378, 379”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [378] Micha R Mozaffarian D Trans fatty acids: effects on metabolic syndrome, heart disease and diabetes. Nat Rev Endocrinol 2009 5 335 344 19399016 source

      Not checked in the free run.

    • cites [379] Wallace SK Mozaffarian D Trans-fatty acids and nonlipid risk factors. Curr Atheroscler Rep 2009 11 423 433 19852883 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Small amounts of "natural" TFA are found in meats and milk of ruminants, contribute minimally to diet (<0.5%E), and do not associate with CVD risk; trans-16:1n-7, a trace TFA biomarker of dairy fat, is linked to lower risk of diabetes and sudden death.

    “While small amounts of “natural” TFA are found in meats and milk of ruminants (e.g., cow, sheep, goat; formed by gut microorganisms), these contribute minimally to diet (<0.5%E) and do not associate with CVD risk;375 indeed, trans-16:1n-7, a trace TFA biomarker of dairy fat, is linked to lower risk of diabetes and sudden death.247”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [375] Mozaffarian D Aro A Willett WC Health effects of trans-fatty acids: experimental and observational evidence. Eur J Clin Nutr 2009 63 Suppl 2 S5 21 19424218 source

      Not checked in the free run.

    • cites [247] Mozaffarian D Natural trans fat, dairy fat, partially hydrogenated oils, and cardiometabolic health – the Ludwigshafen Risk and Cardiovascular Health Study Eur Heart J 2015 in press PMC4816962 26582177 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Arachidonic acid, the prototypical metabolite of LA, is commonly considered pro-inflammatory, but is also the natural precursor to specialized proresolving mediators (SPMs) of inflammation.

    “Arachidonic acid, the prototypical metabolite of LA, is also commonly considered pro-inflammatory, but is also the natural precursor to specialized proresolving mediators (SPMs) of inflammation.368, 369”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [368] Serhan CN Chiang N Van Dyke TE Resolving inflammation: dual anti-inflammatory and pro-resolution lipid mediators. Nat Rev Immunol 2008 8 349 361 18437155 PMC2744593 source

      Not checked in the free run.

    • cites [369] Spite M Claria J Serhan CN Resolvins, specialized proresolving lipid mediators, and their potential roles in metabolic diseases. Cell Metab 2014 19 21 36 24239568 PMC3947989 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Both n-3 and n-6 polyunsaturated fats are beneficial, little interaction between them is evident, and their ratio is not a practical metric to evaluate health effects.

    “Because both n-3 and n-6 polyunsaturated fats are beneficial, little interaction between them is evident, and their ratio is not a practical metric to evaluate health effects.364, 374”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [364] Harris WS Mozaffarian D Rimm E Kris-Etherton P Rudel LL Appel LJ Engler MM Engler MB Sacks F Omega-6 fatty acids and risk for cardiovascular disease: a science advisory from the American Heart Association Nutrition Subcommittee of the Council on Nutrition, Physical Activity, and Metabolism; Council on Cardiovascular Nursing; and Council on Epidemiology and Prevention. Circulation 2009 119 902 907 19171857 source

      Not checked in the free run.

    • cites [374] Griffin BA How relevant is the ratio of dietary n-6 to n-3 polyunsaturated fatty acids to cardiovascular disease risk? Evidence from the OPTILIP study. Curr Opin Lipidol 2008 19 57 62 18196988 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In controlled trials, compared with saturated fat, LA reduces hepatic steatosis and systemic inflammation and increases lean muscle mass.

    “In controlled trials, compared with saturated fat, LA reduces hepatic steatosis and systemic inflammation and increases lean muscle mass.366, 367”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [366] Bjermo H Iggman D Kullberg J Dahlman I Johansson L Persson L Berglund J Pulkki K Basu S Uusitupa M Rudling M Arner P Cederholm T Ahlstrom H Riserus U Effects of n-6 PUFAs compared with SFAs on liver fat, lipoproteins, and inflammation in abdominal obesity: a randomized controlled trial. Am J Clin Nutr 2012 95 1003 1012 22492369 source

      Not checked in the free run.

    • cites [367] Rosqvist F Iggman D Kullberg J Cedernaes J Johansson HE Larsson A Johansson L Ahlstrom H Arner P Dahlman I Riserus U Overfeeding polyunsaturated and saturated fat causes distinct effects on liver and visceral fat accumulation in humans. Diabetes 2014 63 2356 2368 24550191 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    There is growing evidence and consensus that food-based dietary patterns are the best means to reduce cardiovascular disease, obesity and weight gain, and diabetes, replacing outdated emphases on total fat, other isolated nutrients, or calorie counting.

    “There is growing evidence and consensus for such food-based dietary patterns as the best means to reduce CVD, obesity and weight gain, and diabetes,21 replacing outdated emphases on total fat, other isolated nutrients, or calorie counting.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015 Available at: http://www.health.gov/dietaryguidelines/2015-scientific-report/. March 25, 2015

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Such barriers might include limited patient visit time, insufficient financial or other provider incentives, suboptimal knowledge or experience, and inadequate tools for assessing and monitoring behaviors over time.

    “Such barriers might include, for example, limited patient visit time to focus on behavior change, insufficient financial or other provider incentives for health promotion, suboptimal knowledge or experience on the most effective behavior change strategies and relevant behavioral targets, and inadequate tools for assessing and monitoring behaviors over time.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    Many electronic medical records systems have fields for tobacco use and body weight, although their accuracy and consistency of use remains variable.

    “Many electronic medical records systems have fields for tobacco use and body weight, although their accuracy and consistency of use remains variable.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Taste plays a role in consumer choice, but so do availability, price, packaging, marketing, convenience, and culturally-driven perceptions of norms, status, and prestige.

    “Undoubtedly, taste plays a role in consumer choice, but so do availability, price, packaging, marketing, convenience, and culturally-driven perceptions of norms, status, and prestige.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    These complex determinants each represent a potential barrier, but also a promising lever and opportunity, for encouraging healthful diets.

    “These complex determinants each represent a potential barrier, but also a promising lever and opportunity, for encouraging healthful diets.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Each of these levers are powerful and can be used to influence selection of healthier foods.

    “Each of these levers are powerful and can be used to influence selection of healthier foods.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Policy strategies can complement health systems efforts while also reducing social and racial disparities due to clustering of suboptimal diet habits, local environments, and disease risk factors.

    “Policy strategies can complement health systems efforts while also reducing social and racial disparities due to clustering of suboptimal diet habits, local environments, and disease risk factors.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Social and environmental factors play key roles in shaping dietary habits.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The US Centers for Disease Control and Prevention named reduced fatalities from motor vehicle accidents as one of the top 5 public health successes of the 20th century.

    “The US Centers for Disease Control and Prevention named reduced fatalities from motor vehicle accidents as one of the top 5 public health successes of the 20th century.406”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [406] Centers for Disease Control and Prevention (CDC) Motor-vehicle safety: a 20th century public health achievement. MMWR Morb Mortal Wkly Rep 1999 48 369 374 10369577

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The perspective that humans are biologically wired to prefer specific unhealthful foods is overly simplistic and inconsistent with several lines of empirical evidence.

    “This perspective is overly simplistic and inconsistent with several lines of empirical evidence.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationnone given

    Most dietary fats are healthful, making a food's fat content a poor marker of its intrinsic harm or benefit.

    “For instance, most dietary fats are healthful, making a food's fat content a poor marker of its intrinsic harm or benefit (see Total fat).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Diet-related obesity, diabetes, and cardiovascular disease present enormous health and economic burdens.

    “The global challenges of diet-related obesity, diabetes, and CVD present enormous health and economic burdens404”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [404] Institute of Medicine Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health 2010 The National Academies Press Washington, D.C. 20945571

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationnone given

    Food-based priorities for cardiometabolic health include more fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and whole grains, and fewer red meats, processed meats, and foods higher in refined carbohydrates and salt.

    “These include food-based priorities for more fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and whole grains; and fewer red meats, processed (sodium-preserved) meats, and foods higher in refined carbohydrates and salt (Figure 3).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Successful, sustainable improvements in population dietary behaviors require close collaboration among multiple stakeholders, including academics, clinicians, health systems, insurers, community organizations, schools, workplaces, advocacy groups, policy makers, farmers, retailers, restaurants, and food manufacturers.

    “Successful, sustainable improvements in population dietary behaviors will require close collaboration among multiple stakeholders, including academics, clinicians, health systems, insurers, community organizations, schools, workplaces, advocacy groups, policy makers, farmers, retailers, restaurants, and food manufacturers.10, 391, 404”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [10] Afshin A Micha R Khatibzadeh S Schmidt LA Mozaffarian D Brown GW Yamey G Wamala S Dietary Policies to Reduce Non-Communicable Diseases. The Handbook of Global Health Policy 2014 John Wiley & Sons, Ltd. West Sussex, UK First Edition. source

      Not checked in the free run.

    • cites [391] Nugent R Bringing Agriculture to the Table: How Agriculture and Food Can Play a Role in Preventing Chronic Disease 2011

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [404] Institute of Medicine Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health 2010 The National Academies Press Washington, D.C. 20945571

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    The great majority of these studies had durations between 6 weeks and 6 months, and very few extended beyond 1 year.

    “The great majority had durations between 6 weeks to 6 months; very few extended beyond 1 year.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [400] Afshin A Babalola D McLean M Yu Z Ma W Chen C-Y Mozaffarian D Evaluation of information and communication technology for prevention of noncommunicable diseases 2015 submitted

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

147 of 147

  • The paper relies on this without support.

    Short-term weight loss can be achieved by any type of calorie-reduced diet.

    “Whereas short-term weight loss can be achieved by any type of calorie-reduced diet, in the long-term, counting calories may not be biologically nor behaviorally relevant.”

  • The paper relies on this without support.

    Translation of nutrient-based targets to the public proved difficult: few people understand or can accurately estimate their daily consumption of calories, fats, cholesterol, fiber, salt, or single vitamins.

    “Translation of nutrient-based targets to the public also proved difficult: few people understand or can accurately estimate their daily consumption of calories, fats, cholesterol, fiber, salt, or single vitamins.”

  • The paper relies on this without support.

    Other vascular conditions such as peripheral arterial disease, chronic kidney disease, cognitive decline, heart failure, and atrial fibrillation are also influenced by diet-related risk factors.

    “Other vascular conditions such as peripheral arterial disease, chronic kidney disease, cognitive decline, heart failure, and atrial fibrillation are also influenced by diet-related risk factors.”

  • The paper relies on this without support.

    Nutrition science has been transformed in the past two decades by more rigorous evidence from well-designed metabolic studies, prospective cohorts, and randomized clinical trials.

    “Compared with historical dietary recommendations which were based largely on cross-national studies, short-term experiments, and animal models, nutrition science has been transformed in the past two decades by more rigorous evidence from well-designed metabolic studies, prospective cohorts, and randomized clinical trials.”

  • The paper relies on this without support.

    Obesity is challenging to treat after it has developed.

    “Because obesity is so challenging to treat after it has developed, the primary prevention of weight gain is a promising strategy for individual patients and populations.”

  • The paper relies on this without support.

    In the short-term, the best predictor of success is mindfulness with one's chosen diet.

    “In the short-term, the best predictor of success is mindfulness with one's chosen diet.”

  • The paper relies on this without support.

    Not every population in the world can consume a traditional Mediterranean diet.

    “Based on sociocultural and feasibility considerations, not every population in the world can consume a traditional Mediterranean diet.”

  • The paper relies on this without support.

    The health effects of foods are optimally inferred from well-designed prospective observational and interventional studies of clinical endpoints, together with supportive evidence from interventional studies of surrogate risk markers and animal/experimental models.

    “Inference on their health effects is optimally derived from well-designed prospective observational and interventional studies of clinical endpoints, together with supportive evidence from interventional studies of surrogate risk markers. Relevant mechanisms and pathways are further informed and elucidated by animal and experimental models.”

  • The paper relies on this without support.

    When considering the health effects of any food, the comparison or reference food is important.

    “when considering the health effects of any food, it is important to consider: compared to what?”

  • The paper relies on this without support.

    Cardiometabolic effects of different foods can be envisioned along a spectrum of benefit vs. harm.

    “Cardiometabolic effects of different foods can be envisioned along a spectrum of benefit vs. harm (Figure 3)”

  • The paper relies on this without support.

    BP-lowering from potassium is related to both increased urinary potassium excretion and a lower urine sodium-to-potassium ratio.

    “BP-lowering is related to both increased urinary potassium excretion and a lower urine sodium-to-potassium ratio.”

  • The paper relies on this without support.

    In short-term trials, calcium and magnesium supplements modestly lower BP, although with substantial heterogeneity among studies.

    “In short-term trials, calcium and magnesium supplements also modestly lower BP, although with substantial heterogeneity among studies.”

  • The paper relies on this without support.

    Most of the trials of antioxidant vitamins, for reasons of power, evaluated up to a few years of treatment in patients with established CVD or at high risk.

    “Most of these trial, for reasons of power, evaluated up to a few years of treatment in patients with established CVD or at high risk.”

  • The paper relies on this without support.

    Most observational studies of antioxidant vitamins evaluated long-term or habitual intake among generally healthy populations.

    “In contrast, most observational studies evaluated long-term or habitual intake among generally healthy populations.”

  • The paper relies on this without support.

    Diets higher in antioxidant vitamins tend to be rich in fruits, vegetables, nuts, and whole grains, foods that contain multiple other beneficial factors including other vitamins, minerals, phytochemicals, and fiber, as well as being foods that can provide benefit by replacing unhealthful foods.

    “For example, diets higher in antioxidant vitamins tend to be rich in fruits, vegetables, nuts, and whole grains, foods that contain multiple other beneficial factors including other vitamins, minerals, phytochemicals, and fiber, as well as being foods that can provide benefit by replacing unhealthful foods.”

  • The paper relies on this without support.

    Social and environmental factors play key roles in shaping dietary habits.

    “Given the key roles of social and environmental factors in shaping dietary habits, policy (population-based) approaches are crucial to achieve broad success.”

  • The paper relies on this without support.

    The food industry is far more heterogeneous than the tobacco industry, from types of products to commitments to healthfulness.

    “The food industry is far more heterogeneous, from types of products to commitments to healthfulness.”

  • The paper relies on this without support.

    The food industry has demonstrated responsiveness to dietary guidelines and public preferences over the last 40 years.

    “The food industry has also demonstrated responsiveness to dietary guidelines and public preferences over the last 40 years: e.g., low-fat products, margarine, noncaloric sweeteners, low-carb products, gluten-free, organic, and many others.”

  • The paper relies on this without support.

    Several factors have limited translation of knowledge to action, including evolving messages and confusion about specific dietary priorities, uncertainty regarding effective methods for behavior change, and inadequate tools to monitor diets efficiently.

    “Several factors have limited translation of this knowledge to action, including evolving messages and confusion about specific dietary priorities, uncertainty regarding effective methods for behavior change, and inadequate tools to monitor diets efficiently.”

  • The paper relies on this without support.

    Food systems have made tremendous progress in reducing food-borne illness, increasing volume and production, improving convenience and stability, and reducing cost.

    “Our food systems have also made tremendous progress in reducing food-borne illness, increasing volume and production, improving convenience and stability, and reducing cost – all important priorities of the last century.”

  • The paper relies on this without support.

    Healthfulness for chronic diseases, particularly cardiometabolic diseases, has been the great failure of the food system.

    “Healthfulness for chronic diseases, in particular cardiometabolic diseases, has been the great failure – one that must now be addressed with modern nutrition and policy science.”
21 of 21

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The replacement of fat with sugar in the manufacture of low-fat processed foods during the 1980s and 1990s when the low-fat dietary advice was dominant in the USA and other countries is a well-documented historical example of mal-substitution.

    “The second is the replacement of fat with sugar in the manufacture of low-fat processed foods during the 1980s and 1990s when the low-fat dietary advice was dominant in the USA and other countries (50,51) .”

    From Ultra-processed foods and the limits of product reformulation (2018) · cites this paper as [50]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Low sodium intake is stated in grams rather than milligrams

    Minor

    The stated example of low sodium intake, <3000 g/d, would include the 4000+ mg/d intake the paper calls very high. The surrounding sodium thresholds are expressed in mg/d, making the low-intake threshold inconsistent with them.

1 of 1

Cites

2 retracted

Flagged first, then by citations

5 of the 403 references couldn’t be matched to a known paper.

Research works printed but not linked: 11

  1. Davis C, Saltos E. Dietary recommendations and how they have changed over time. America’s Eating Habits: Changes and Consequences. Washington, DC: US Department of Agriculture, Economic Research Service; 1999. Agriculture Information Bulletin No. 750.
  2. Institute of Medicine. Safety of Genetically Modified Foods: Approaches to Assessing Unintended Health Effects. Washington DC: The National Academies Press; 2004.
  3. National Institute for Health and Clinical Excellence. Prevention of Cardiovascular Disease at Population Level (NICE Public Health Guidance 25). London: National Institute for Health and Clinical Excellence; 2010.
  4. World Health Organization. WHO Guideline: Sodium Intake For Adults and Children. Geneva, Switzerland: WHO; 2012.
  5. 10.1056/nejm200101043440101 · DOI · Paper page
  6. 10.1007/s11745-010-3393-4 · DOI · Paper page
  7. United Nations. Draft Outcome Document of the High-level Meeting on the Prevention and Control of Non-communicable Diseases. 2011.Accessed October 11, 2015. http://www.ncdalliance.org/sites/default/files/resource_files/UN%20High-Level%20Summit%20Zero%20Draft.pdf.
  8. US Food and Drug Administration. FDA Cuts Trans Fat in Processed Foods. 2015. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm372915.htm. Accessed July 16 2015.
  9. 10.1136/bmjopen-2013-003733 · DOI · Paper page
  10. 10.1371/journal.pone.0124845 · DOI · Paper page
  11. 10.1161/circ.131.suppl_1.p323 · DOI

Cited by

Sorted by citations

Related

Authors
Mozaffarian, D.
Affiliations
Tufts University (US)
Corresponding author
Mozaffarian, Dariush
ORCID
Mozaffarian, Dariush
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2016-01-12
Volume
133
Issue
2
Pages
187-225
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.115.018585
PMC
PMC4814348
OpenAlex
W2226817873
Cited by
2,216
References
403
Citations by year
2026: 195 · 2025: 232 · 2024: 258 · 2023: 230 · 2022: 284 · 2021: 220 · 2020: 226 · 2019: 198 · 2018: 170 · 2017: 144 · 2016: 54 · 2015: 3 · 2014: 1
FWCI
187.06
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Heart, Lung, and Blood Institute (R01HL085710, R01HL115189)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Nutrition, Health, and Society Studies
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
Keywords
cardiovascular disease, diabetes mellitus, obesity, nutrition policy, diet patterns, whole foods, red and processed meat, added sugars, trans fatty acids, refined grains, phenolic compounds, diet-microbiome interactions, personalized nutrition, lifestyle modification, food system policy, economic incentives, neighborhood environment, health systems reform
MeSH terms
Cardiovascular Diseases, Diabetes Mellitus, Diet, Diet Fads, Energy Metabolism, Feeding Behavior, Food, Food Preferences, Forecasting, Health Policy, Health Priorities, Health Promotion, Humans, Nutritive Value, Obesity, Risk Factors, United States, Weight Gain, Nutrition Policy, Dietary Supplements, Genetic Predisposition to Disease, Food, Genetically Modified, Nutritional Sciences, Precision Medicine, Recommended Dietary Allowances

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

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