GET https://rct.dev.bbntimes.com/science/the-mediterranean-diet-where-are-we-now

Response
200 OK
IP
3.21.106.9
Profiled on
Token
c2346c

ArticleController :: show

Request

GET Parameters

None

POST Parameters

None

Uploaded Files

None

Request Attributes

Key Value
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"App\Controller\ArticleController::show"
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"security.firewall.map.context.main"
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Symfony\Component\WebLink\GenericLinkProvider {#3637
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    3745 => Symfony\Component\WebLink\Link {#3745
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_security_firewall_run 
"_security_main"
_stopwatch_token 
"996583"
category 
"science"
slug 
"the-mediterranean-diet-where-are-we-now"

Request Headers

Header Value
accept 
"*/*"
accept-encoding 
"gzip, br, zstd, deflate"
connection 
"close"
cookie 
"PHPSESSID=r499l00d0l3l54e13n26b6l7iq"
host 
"rct.dev.bbntimes.com"
user-agent 
"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)"
x-php-ob-level 
"1"

Request Content

Request content not available (it was retrieved as a resource).

Response

Response Headers

Header Value
cache-control 
"no-cache, private"
content-type 
"text/html; charset=UTF-8"
date 
"Sat, 22 Feb 2025 08:46:02 GMT"
link 
"</build/runtime.js>; rel="preload"; as="script",</build/644.js>; rel="preload"; as="script",</build/502.js>; rel="preload"; as="script",</build/app.js>; rel="preload"; as="script",</build/view-more.js>; rel="preload"; as="script",</build/term-condition.js>; rel="preload"; as="script",</build/contact.js>; rel="preload"; as="script",</build/scroll-infinite-article.js>; rel="preload"; as="script",</build/app.css>; rel="preload"; as="style",</build/cookie-style.css>; rel="preload"; as="style",</build/term-condition-css.css>; rel="preload"; as="style",</build/contact-css.css>; rel="preload"; as="style",</build/comment-css.css>; rel="preload"; as="style""
x-debug-token 
"c2346c"

Cookies

Request Cookies

Key Value
PHPSESSID 
"r499l00d0l3l54e13n26b6l7iq"

Response Cookies

No response cookies

Session 6

Session Metadata

Key Value
Created 
"Sat, 22 Feb 25 08:45:40 +0000"
Last used 
"Sat, 22 Feb 25 08:46:01 +0000"
Lifetime 
0

Session Attributes

Attribute Value
_csrf/https-comment 
"W8yi9GBd2-5JrbkdOLV3QS_ApoODvendE8WD_HhxyqY"
_csrf/https-cookie_accept 
"00VYM3v4EwD6-SIfEZzSqVy1OIrCcznE0RozZw7G28U"

Session Usage

6 Usages
Stateless check enabled
Usage
Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:76
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Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:79
Show trace 
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Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:52
Show trace 
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Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:56
Show trace 
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    "type" => "->"
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    "line" => 76
    "function" => "handleRaw"
    "class" => "Symfony\Component\HttpKernel\HttpKernel"
    "type" => "->"
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  [
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    "line" => 197
    "function" => "handle"
    "class" => "Symfony\Component\HttpKernel\HttpKernel"
    "type" => "->"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/runtime/Runner/Symfony/HttpKernelRunner.php"
    "line" => 35
    "function" => "handle"
    "class" => "Symfony\Component\HttpKernel\Kernel"
    "type" => "->"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/autoload_runtime.php"
    "line" => 29
    "function" => "run"
    "class" => "Symfony\Component\Runtime\Runner\Symfony\HttpKernelRunner"
    "type" => "->"
  ]
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    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/public/index.php"
    "line" => 5
    "args" => [
      "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/autoload_runtime.php"
    ]
    "function" => "require_once"
  ]
]
Symfony\Component\Security\Core\Authentication\Token\Storage\UsageTrackingTokenStorage:41
Show trace 
[
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/security-core/Authentication/Token/Storage/UsageTrackingTokenStorage.php"
    "line" => 41
    "function" => "getMetadataBag"
    "class" => "Symfony\Component\HttpFoundation\Session\Session"
    "type" => "->"
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    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/twig-bridge/AppVariable.php"
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    "function" => "twig_get_attribute"
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    "class" => "Symfony\Bundle\FrameworkBundle\Controller\AbstractController"
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  [
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    "function" => "handle"
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    "class" => "Twig\Template"
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  ]
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    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/twig/twig/src/Template.php"
    "line" => 379
    "function" => "display"
    "class" => "Twig\Template"
    "type" => "->"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/twig/twig/src/TemplateWrapper.php"
    "line" => 38
    "function" => "render"
    "class" => "Twig\Template"
    "type" => "->"
  ]
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/twig/twig/src/Environment.php"
    "line" => 280
    "function" => "render"
    "class" => "Twig\TemplateWrapper"
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  [
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    "function" => "render"
    "class" => "Twig\Environment"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/framework-bundle/Controller/AbstractController.php"
    "line" => 453
    "function" => "doRenderView"
    "class" => "Symfony\Bundle\FrameworkBundle\Controller\AbstractController"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/framework-bundle/Controller/AbstractController.php"
    "line" => 253
    "function" => "doRender"
    "class" => "Symfony\Bundle\FrameworkBundle\Controller\AbstractController"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/src/Controller/ArticleController.php"
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    "function" => "render"
    "class" => "Symfony\Bundle\FrameworkBundle\Controller\AbstractController"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/http-kernel/HttpKernel.php"
    "line" => 181
    "function" => "show"
    "class" => "App\Controller\ArticleController"
    "type" => "->"
  ]
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/http-kernel/HttpKernel.php"
    "line" => 76
    "function" => "handleRaw"
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    "type" => "->"
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  [
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    "line" => 197
    "function" => "handle"
    "class" => "Symfony\Component\HttpKernel\HttpKernel"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/runtime/Runner/Symfony/HttpKernelRunner.php"
    "line" => 35
    "function" => "handle"
    "class" => "Symfony\Component\HttpKernel\Kernel"
    "type" => "->"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/autoload_runtime.php"
    "line" => 29
    "function" => "run"
    "class" => "Symfony\Component\Runtime\Runner\Symfony\HttpKernelRunner"
    "type" => "->"
  ]
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/public/index.php"
    "line" => 5
    "args" => [
      "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/autoload_runtime.php"
    ]
    "function" => "require_once"
  ]
]
Symfony\Component\Security\Http\Firewall\ContextListener:171
Show trace 
[
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/security-http/Firewall/ContextListener.php"
    "line" => 171
    "function" => "remove"
    "class" => "Symfony\Component\HttpFoundation\Session\Session"
    "type" => "->"
  ]
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/event-dispatcher/Debug/WrappedListener.php"
    "line" => 116
    "function" => "onKernelResponse"
    "class" => "Symfony\Component\Security\Http\Firewall\ContextListener"
    "type" => "->"
  ]
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/event-dispatcher/EventDispatcher.php"
    "line" => 220
    "function" => "__invoke"
    "class" => "Symfony\Component\EventDispatcher\Debug\WrappedListener"
    "type" => "->"
  ]
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/event-dispatcher/EventDispatcher.php"
    "line" => 56
    "function" => "callListeners"
    "class" => "Symfony\Component\EventDispatcher\EventDispatcher"
    "type" => "->"
  ]
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/event-dispatcher/Debug/TraceableEventDispatcher.php"
    "line" => 139
    "function" => "dispatch"
    "class" => "Symfony\Component\EventDispatcher\EventDispatcher"
    "type" => "->"
  ]
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/http-kernel/HttpKernel.php"
    "line" => 214
    "function" => "dispatch"
    "class" => "Symfony\Component\EventDispatcher\Debug\TraceableEventDispatcher"
    "type" => "->"
  ]
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/http-kernel/HttpKernel.php"
    "line" => 202
    "function" => "filterResponse"
    "class" => "Symfony\Component\HttpKernel\HttpKernel"
    "type" => "->"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/http-kernel/HttpKernel.php"
    "line" => 76
    "function" => "handleRaw"
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    "type" => "->"
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  [
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    "function" => "handle"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/autoload_runtime.php"
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    "function" => "run"
    "class" => "Symfony\Component\Runtime\Runner\Symfony\HttpKernelRunner"
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  [
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      "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/autoload_runtime.php"
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    "function" => "require_once"
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]

Flashes

Flashes

No flash messages were created.

Server Parameters

Server Parameters

Defined in .env

Key Value
APP_ENV 
"dev"
APP_SECRET 
"0a988e63f011514eaabfc650b599af4d"
CORS_ALLOW_ORIGIN 
"*"
DATABASE_URL 
"mysql://bbndb_rctuser:33F5W25z40or0f7@localhost:3306/rct_bbntimes"
GOOGLE_RECAPTCHA_SECRET_KEY 
"6LdV5fgpAAAAANxzTG8ZMfIjil1wu-1vrQvnUt-x"
GOOGLE_RECAPTCHA_SITE_KEY 
"6LdV5fgpAAAAAENKcn73MJAhQrbtQeqgyC4wDLMP"
MAILER_DSN 
"smtp://no-reply%40rct.dev.bbntimes.com:Bl6%26gLD48%26Of919@rct.dev.bbntimes.com:465"
MARIADB_PASSWORD 
"i!87pK&!85ezc8"

Defined as regular env variables

Key Value
APP_DEBUG 
"1"
BASE 
"/public"
CONTEXT_DOCUMENT_ROOT 
"/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com"
CONTEXT_PREFIX 
""
DOCUMENT_ROOT 
"/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com"
FCGI_ROLE 
"RESPONDER"
GATEWAY_INTERFACE 
"CGI/1.1"
HTTPS 
"on"
HTTP_ACCEPT 
"*/*"
HTTP_ACCEPT_ENCODING 
"gzip, br, zstd, deflate"
HTTP_CONNECTION 
"close"
HTTP_COOKIE 
"PHPSESSID=r499l00d0l3l54e13n26b6l7iq"
HTTP_HOST 
"rct.dev.bbntimes.com"
HTTP_USER_AGENT 
"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)"
PASSENGER_COMPILE_NATIVE_SUPPORT_BINARY 
"0"
PASSENGER_DOWNLOAD_NATIVE_SUPPORT_BINARY 
"0"
PATH 
"/usr/local/sbin:/usr/local/bin:/usr/sbin:/usr/bin:/sbin:/bin:/snap/bin"
PHP_SELF 
"/public/index.php"
PP_CUSTOM_PHP_CGI_INDEX 
"plesk-php81-fastcgi"
PP_CUSTOM_PHP_INI 
"/var/www/vhosts/system/rct.dev.bbntimes.com/etc/php.ini"
QUERY_STRING 
""
REDIRECT_BASE 
"/public"
REDIRECT_HTTPS 
"on"
REDIRECT_PASSENGER_COMPILE_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_PASSENGER_DOWNLOAD_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_REDIRECT_HTTPS 
"on"
REDIRECT_REDIRECT_PASSENGER_COMPILE_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_REDIRECT_PASSENGER_DOWNLOAD_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_REDIRECT_SCRIPT_URI 
"https://rct.dev.bbntimes.com/science/the-mediterranean-diet-where-are-we-now"
REDIRECT_REDIRECT_SCRIPT_URL 
"/science/the-mediterranean-diet-where-are-we-now"
REDIRECT_REDIRECT_SSL_TLS_SNI 
"rct.dev.bbntimes.com"
REDIRECT_REDIRECT_STATUS 
"200"
REDIRECT_REDIRECT_UNIQUE_ID 
"Z7mOyZDyWLT8YV1VjBo96QAAAI4"
REDIRECT_SCRIPT_URI 
"https://rct.dev.bbntimes.com/science/the-mediterranean-diet-where-are-we-now"
REDIRECT_SCRIPT_URL 
"/science/the-mediterranean-diet-where-are-we-now"
REDIRECT_SSL_TLS_SNI 
"rct.dev.bbntimes.com"
REDIRECT_STATUS 
"200"
REDIRECT_UNIQUE_ID 
"Z7mOyZDyWLT8YV1VjBo96QAAAI4"
REDIRECT_URL 
"/public/science/the-mediterranean-diet-where-are-we-now"
REMOTE_ADDR 
"3.21.106.9"
REMOTE_PORT 
"54296"
REQUEST_METHOD 
"GET"
REQUEST_SCHEME 
"https"
REQUEST_TIME 
1740213961
REQUEST_TIME_FLOAT 
1740213961.9614
REQUEST_URI 
"/science/the-mediterranean-diet-where-are-we-now"
SCRIPT_FILENAME 
"/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/public/index.php"
SCRIPT_NAME 
"/public/index.php"
SCRIPT_URI 
"https://rct.dev.bbntimes.com/science/the-mediterranean-diet-where-are-we-now"
SCRIPT_URL 
"/science/the-mediterranean-diet-where-are-we-now"
SERVER_ADDR 
"5.196.1.209"
SERVER_ADMIN 
"[no address given]"
SERVER_NAME 
"rct.dev.bbntimes.com"
SERVER_PORT 
"443"
SERVER_PROTOCOL 
"HTTP/1.1"
SERVER_SIGNATURE 
"<address>Apache Server at rct.dev.bbntimes.com Port 443</address>\n"
SERVER_SOFTWARE 
"Apache"
SSL_TLS_SNI 
"rct.dev.bbntimes.com"
SYMFONY_DOTENV_VARS 
"APP_ENV,APP_SECRET,DATABASE_URL,MARIADB_PASSWORD,CORS_ALLOW_ORIGIN,MAILER_DSN,GOOGLE_RECAPTCHA_SECRET_KEY,GOOGLE_RECAPTCHA_SITE_KEY"
UNIQUE_ID 
"Z7mOyZDyWLT8YV1VjBo96QAAAI4"

Sub Requests 6

CookieController :: renderAnalysis (token = 257157)

Key Value
_controller 
"App\Controller\CookieController::renderAnalysis"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"076dce"

AppController :: renderHeader (token = 36b1aa)

Key Value
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App\Entity\Article {#1094
  -id: 2054
  -title: "The Mediterranean Diet: Where Are We Now?"
  -slug: "the-mediterranean-diet-where-are-we-now"
  -introtext: "<p>The lead up to the&nbsp;<a href="http://mdrproject.com/" target="_blank" rel="nofollow noopener">Mediterranean Diet Roundtable</a>&nbsp;conference at Yale University, where I will be privileged to serve as speaker and MC has been, in a word, turbulent.&nbsp;Over just the past couple of weeks, there has been a bounty of news regarding the meeting’s eponymous topic, involving both trials, and tribulations.</p>\r\n"
  -content: """
    \r\n
    <p>As for&nbsp;<a href="http://mdrproject.com/program-2018/" target="_blank" rel="nofollow noopener">the conference</a>, it will draw experts and attendees from around the world, and celebrate the science, culinary delights, and commercial opportunities of one of the world’s iconic diets.&nbsp;Just this year, the Mediterranean diet was voted “best overall” in the annual rankings by&nbsp;<a href="https://www.usnews.com/info/blogs/press-room/articles/2018-01-03/us-news-reveals-best-diets-rankings-for-2018" target="_blank" rel="nofollow noopener">U.S. News &amp; World Report</a>.&nbsp;(Disclosure: I was one of the judges; my vote made only its small contribution to the communal verdict.)&nbsp;This year, as in recent years, a steady stream of peer-reviewed publications has highlighted the health benefits of this dietary pattern.&nbsp;This year, as for many years, decades, and generations, the Mediterranean diet is making its crucial contribution to the abundance of years in life, and to the vital, disease-free life in those years, enjoyed by two of the world’s&nbsp;<a href="https://www.bluezones.com/" target="_blank" rel="nofollow noopener">Blue Zone populations</a>, in Ikaria, Greece, and in Sardinia, Italy.&nbsp;</p>\r\n
    <p>This was also the year that&nbsp;<a href="http://cuisinicity.com/" target="_blank" rel="nofollow noopener">my wife</a>&nbsp;and I co-hosted one of&nbsp;<a href="https://oldwayspt.org/" target="_blank" rel="nofollow noopener">Oldways’</a>&nbsp;magnificent culinaria.&nbsp;Our eating, drinking, walking, learning, communing&nbsp;<a href="https://oldwayspt.org/events/sicily-culinaria-2018" target="_blank" rel="nofollow noopener">tour of Sicily</a>&nbsp;was its own particular feast of delights, and a vivid reminder of why eating in that part of the world so well expresses the opportunity to love food that loves us back.</p>\r\n
    <p>Thus went the narrative in its complimentary consistency, until the last few weeks.&nbsp;Then, in rapid succession, we heard that a major study of the Mediterranean diet was flawed and retracted; that the Mediterranean diet could, and perhaps should involve routine meat consumption; and that the Mediterranean diet was, in fact, disappearing from the Mediterranean.&nbsp;Trials and tribulations, indeed!&nbsp;Let’s consider them in turn.</p>\r\n
    <p>The study involving the methodologic flaw, and the retraction of a publication in the&nbsp;<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1200303" target="_blank" rel="nofollow noopener">New England Journal of Medicine</a>&nbsp;was the now famous&nbsp;<a href="http://www.predimed.es/introduction.html" target="_blank" rel="nofollow noopener">PREDIMED</a>&nbsp;study.&nbsp;Given the media penchant for&nbsp;<a href="https://www.kevinmd.com/blog/2014/04/deadly-consequences-media-distortion-health-medicine.html" target="_blank" rel="nofollow noopener">comforting the afflicted and afflicting the comfortable</a>, this was clearly an irresistible opportunity for the latter- so the attendant headlines were&nbsp;<a href="https://www.vox.com/science-and-health/2018/6/20/17464906/mediterranean-diet-science-health-predimed" target="_blank" rel="nofollow noopener">predictably extreme</a>.</p>\r\n
    <p>In fact, this story, so ostensibly linked to the Mediterranean Diet, was really about something else altogether: the scrutiny of peer review, and the policing of science.&nbsp;There is a very good analogy for this process in the approval of drugs or vaccines by the FDA.&nbsp;Studies are conducted and carefully reviewed, and a decision is made.&nbsp;But those studies almost never involve more than thousands, and often only hundreds of participants.&nbsp;Once a drug is approved, its use may involve hundreds of thousands, or even millions.&nbsp;That provides a wealth of new information in the form of “post approval surveillance.”&nbsp;That new scrutiny is always valuable, and can even at times reverse a decision about a drug, as it did- rightly or wrongly- for&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1779871/" target="_blank" rel="nofollow noopener">Vioxx</a>.</p>\r\n
    <p>Much the same happened here.&nbsp;The original paper was, of course, peer reviewed.&nbsp;But one among the thousands of subsequent readers noticed a data discrepancy others had missed.&nbsp;This is just the kind of policing scientists expect of one another; it is science working as it should.&nbsp;&nbsp;The flaw involved the distribution of participants to different arms of the study through randomization.&nbsp;There was a lot of dialogue between the journal and the investigators; careful reassessments on both sides; and then, recently, a conclusion.&nbsp;The original paper was, indeed, retracted- and replaced with a corrected version.</p>\r\n
    <p>The mistake was made by a research associate, and did not involve any of the lead investigators.&nbsp;Their only involvement was failing to discern the error, meaning they are human.&nbsp;There was no cheating, no scandal, no conspiracy, whatever headlines may have implied.&nbsp;An honest mistake was made, and went overlooked until now.</p>\r\n
    <p>The mistake was that spouses of some of the randomized participants were invited to participate, too.&nbsp;But since they were given the same dietary assignment as their significant other, they were not randomized.&nbsp;This violates the requirements for a randomized trial, and can compromise the data in ways&nbsp;<a href="http://sk.sagepub.com/books/clinical-epidemiology-and-evidence-based-medicine" target="_blank" rel="nofollow noopener">beyond the scope of this discussion</a>.</p>\r\n
    <p>The replacement paper involves the obvious remedy: the non-randomized participants were excluded, and the remaining data re-analyzed.&nbsp;If anything, because this reduced the sample size of the original trial, it should have threatened the finding that the Mediterranean diet conferred a distinct health benefit.&nbsp;But that did not happen.&nbsp;The reanalysis, based only on properly randomized participants, reaffirmed the original findings.&nbsp;Yes, folks, after the data correction-&nbsp;<a href="https://www.everydayhealth.com/mediterranean-diet/diet/study-retracted-plan-still-good-heart-health/" target="_blank" rel="nofollow noopener">the Mediterranean diet is still good for us</a>.&nbsp;</p>\r\n
    <p>To be clear, we don’t know that just because the PREDIMED findings stood up to this dissection.&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/9989963" target="_blank" rel="nofollow noopener">Randomized trials</a>&nbsp;that long predate PREDIMED told us the same.&nbsp;The experience of two of the world’s five&nbsp;Blue Zone&nbsp;populations tells us the same.&nbsp;Conclusions in science are almost never the result of one study, no matter how large or robust, and the Mediterranean diet is certainly no exception.&nbsp;What we know most reliably,&nbsp;<a href="https://www.linkedin.com/pulse/diet-delusions-evidence-david-l-katz-md-mph-facpm-facp-faclm/" target="_blank" rel="noopener">we know from many studies, many kinds of studies</a>, and the clear correlation of research findings with real-world experience in large populations over extended periods of time.&nbsp;Our confidence in the advantages of the Mediterranean diet is born of all of these- so you, too, may be confident of them.</p>\r\n
    <p>Moving on, we also heard recently, again with a retinue of&nbsp;<a href="http://www.newsweek.com/red-meat-fine-moderation-study-says-981574" target="_blank" rel="nofollow noopener">effusive headlines</a>, that a study indicated the benefits of including red meat in a Mediterranean diet.&nbsp;This time, though, the flaw was much more fundamental than a statistical error.&nbsp;This study was designed not to search for truth, but to generate a specific answer.&nbsp;No matter the design of a study,&nbsp;<a href="https://www.huffingtonpost.com/david-katz-md/post_8304_b_5752160.html" target="_blank" rel="nofollow noopener">the answer is rarely any better than the question</a>.</p>\r\n
    <p>You can imagine that if you wanted to know whether red meat was a “good” addition to a Mediterranean diet, you would compare such a diet with meat, to such a diet without meat.&nbsp;You might even examine the “dose response” to meat by having no-meat, low-meat, and high-meat study arms.&nbsp;You would have to wrestle with other details- such as how to match the diets for foods other than meat, but let’s ignore those subtleties.&nbsp;At a minimum, I bet we can agree that if you- unbiased soul that you are- wanted to study the health effects of meat in the context of Diet X, you would do something like the above.</p>\r\n
    <p>In this case, however,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/29901710" target="_blank" rel="nofollow noopener">the study</a>&nbsp;was funded, and presumably commissioned by The Beef Checkoff, and the Pork Checkoff.&nbsp;(I do not oppose industry funding per se; I just oppose&nbsp;<a href="https://www.huffingtonpost.com/david-katz-md/industry-funded-research_b_8016628.html" target="_blank" rel="nofollow noopener">true conflicts of interest</a>&nbsp;that replace a legitimate pursuit of insight with a foregone conclusion.)&nbsp;There was no “meat free” diet arm.&nbsp;Rather, Americans with a typically bad baseline diet were sequentially assigned to a much better, Mediterranean diet with a moderate amount of very lean, clean meat- and the same dietary pattern with much of that red meat replaced by poultry.&nbsp;Yes, seriously.</p>\r\n
    <p>So, despite the headlines assuring us that red meat is OK now, the study was designed from the start to guarantee that conclusion; that was never actually tested.&nbsp;This study asked and answered two questions: (1) is a Mediterranean diet better- with regard to various biomarkers- than a typical American diet? And (2) is there much difference between that diet with lean red meat versus similar amounts of poultry?&nbsp;The answer to the first was “yes,” and may I add: duh.&nbsp;The answer to the second was “no,” and again- no surprise.</p>\r\n
    <p>Which brings us to the one bit of news about the Mediterranean diet that is most genuinely newsworthy, and deeply disturbing.&nbsp;The Mediterranean diet is&nbsp;<a href="https://www.washingtonpost.com/news/wonk/wp/2018/05/30/mediterranean-children-stopped-eating-the-mediterranean-diet-and-they-now-have-the-highest-obesity-rates-in-europe/?utm_term=.74ea93a2325b" target="_blank" rel="nofollow noopener">waning in the lands of its origin</a>.&nbsp;This is despite its robust benefits to health and sustainability, and is at odds with the weight of scientific evidence.&nbsp;This is partly because of the kinds of media distortions noted above that serve to obscure&nbsp;<a href="http://www.truehealthinitiative.org/" target="_blank" rel="nofollow noopener">fundamental truths</a>&nbsp;about&nbsp;<a href="https://www.annualreviews.org/doi/abs/10.1146/annurev-publhealth-032013-182351" target="_blank" rel="nofollow noopener">diet and health</a>.&nbsp;Mostly, though, it is because of&nbsp;<a href="https://www.linkedin.com/pulse/companies-love-misery-david-l-katz-md-mph-facpm-facp-faclm/" target="_blank" rel="noopener">predatory profiteering</a>.&nbsp;<a href="https://www.nytimes.com/interactive/2017/09/16/health/brazil-obesity-nestle.html" target="_blank" rel="nofollow noopener">Large companies are willing to adulterate food supplies around the world</a>, as they have done&nbsp;<a href="https://www.nytimes.com/2013/02/24/magazine/the-extraordinary-science-of-junk-food.html" target="_blank" rel="nofollow noopener">here at home</a>, to market junk while maximizing profit, whatever the&nbsp;<a href="https://www.nytimes.com/2017/12/11/health/obesity-mexico-nafta.html" target="_blank" rel="nofollow noopener">consequences to public health</a>.</p>\r\n
    <p>We thus convene at Yale to celebrate a healthful, sustainable culinary tradition rooted in heritage, buoyed by science, sense, and global consensus, at a time when we are forced to wonder: can we save it?</p>
    """
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