Food fight: controversy over red meat guidelines rumbles onBMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m397 (Published 06 February 2020) Cite this as: BMJ 2020;368:m397
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Diets, Inflammation and Heart Disease - From 20/20 to 2020. Re: Food fight: controversy over red meat guidelines rumbles on
Comparisons of recent publications by Zhong , Rubin , and Johnston  would suggest that our current understanding - surrounding the impact of diets and heart disease – has left us with little more than a food fight .
It is well established that cholesterol plays an important role in the development of the inflammatory tissue process known as coronary artery disease [5,6]. It is incorrect to say that coronary artery disease is an inflammatory process and that cholesterol is unimportant – as cholesterol is defined as one of the contributing factors to the inflammatory process described in the “Inflammation and Heart Disease” theory itself [5,6].
Measurement of changes in inter alia weight, cholesterol, CRP, fibrinogen, and homocysteine, alone without measurement of the actual tissue impact – viz. coronary artery disease – provides limited information about the effect of either diet or drug treatments.
While some initial investigations into the measurable impact various diets have on coronary artery disease exist, the results to date have been semi-quantitative and need further absolute quantification  to provide accurate, consistent and reproducible results.
More than 20-years after the introduction of the “Inflammation and Heart Disease” Theory, we have yet to conduct the research needed to understand the changes occurring in tissue of the coronary arteries following specific dietary practices.
1. Zhong VW, Van Horn L, Greenland P, et al. Associations of Processed Meat, Unprocessed Red Meat, Poultry, or Fish Intake With Incident Cardiovascular Disease and All-Cause Mortality. JAMA Intern Med. Published online February 03, 2020. doi:10.1001/jamainternmed.2019.6969
2. Rubin R. Backlash Over Meat Dietary Recommendations Raises Questions About Corporate Ties to Nutrition Scientists. JAMA. Published online January 15, 2020. doi:10.1001/jama.2019.21441.
3. Johnston BC, Zeraatkar D, Han MA, et al. Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium. Ann Intern Med 2019. DOI: 10.7326/M19-1621.
4. Dyer O. Food fight: controversy over red meat guidelines rumbles on. BMJ 2020;368, doi.org/10.1136/bmj.m397
5. Fleming RM. Chapter 64. The Pathogenesis of Vascular Disease. Textbook of Angiology. John C. Chang Editor, Springer-Verlag New York, NY. 1999, pp. 787-798.
6. 20/20 special on Inflammation and Heart Disease. https://www.youtube.com/watch?v=Hvb_Ced7KyA&t=22s
7. The Fleming Method for Tissue and Vascular Differentiation and Metabolism (FMTVDM) using same state single or sequential quantification comparisons. Patent Number 9566037. Issued 02/14/2017.
Competing interests: No competing interests