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Comment by Gatsky | Hacker News Reader

There are randomised controlled trials of diets (without caloric restriction). They show that some diets are better than others for real clinical endpoints, eg mediterranean vs low fat diet for secondary prevention of cardiac events [1]. The effect size in that example is not small, it is large, despite most participants already being on a statin. This data shows that diets are biologically active and significantly impact health. Therefore, the philosophy you espouse cannot be correct, or at least needs to be heavily modified.

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

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You haven't controlled for body weight changes though. Nobody doubts that diets (if adhered to) can reduce weight. So if biomarkers improve relative to an alternative diet, the question is it because A) the Med diet is more effective at weight loss, or B) the Med diet has benefits outside weight loss. The research you linked is interesting, but confounded by weight loss. Research that has directly tried to control for this has generally found that the health benefits of the Med diet are mostly or wholly attributable to the mediating impact of weight/fat loss.[1]

This is a critical question, because GLP-1 agonists like semaglutide are far more effective at weight loss (with much lower dropout rates) than any diet known to mankind. So if the benefit of the Med diet is mediated by weight loss, who cares in the age of GLP-1 agonists? It's like arguing about the fastest hot air balloon after the invention of the jet engine.

[1]https://www.semanticscholar.org/paper/Obesity-Mediates-the-A...

You just forget that there might be side-effects showing up in the long-run that we simply don't know yet (and possibly), why the mediterrean diet has been tested for a few hundred years already (where "diet" means what we have access to and eat, and not a small subset of foods forced on us that relies on a lot of mental effort to follow)

GLP-1 agonists were discovered in the 1980s, and there are already statistically significant population samples who have been using them to treat T2D for decades. Any serious common side effect would have been already discovered from the large-scale clinical trials that have been repeatedly conducted.

The real problem is that we spend hundreds of billions advertising food.

If we spent 10% of what we spent on food advertising on large, well funded cohort studies, we'd be far better off as a species.

Humanity's greatest crime is how little science we fund.

Incorrect. They controlled for changes in weight, it is not confounded by weight loss. RCT >> cross sectional analyses.

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