You're setting up impossible criteria for what studies you will accept as evidence against your position by saying you will only accept RCT's with all-cause mortality as the end point as evidence. Like I said, nobody does this for studying diet...
You seem to have a double standard for what qualifies as sufficient evidence against your view vs. for your view, as evidenced by the fact you think that the context of a keto or carnivore diet would completely reverse clearly evident trends despite a complete lack of evidence. Where are your RCT's with all-cause mortality as an end point studying the keto diet? Where are your RCT's showing that increasing LDL-C and apo-B does not increase CVD risk over lifespan-scale experiments?
You conveniently chose to ignore the Mendelian randomization studies on LDL-C and apo-B.
Your view on ldl-c and apo-b goes against expert consensus (https://www.lipidjournal.com/article/S1933-2874(24)00240-X/fulltext, https://www.jacc.org/doi/10.1016/j.jacc.2022.07.006, https://pubmed.ncbi.nlm.nih.gov/28444290/), there is very compelling evidence that both, especially apo-b, have a causal role in long-term CVD progression.
While the conversation has been interesting, I feel that continued exchange will not be particularly productive.
I did read your links, I think it is very interesting but doesn't really move the needle much when we have so much evidence to the contrary
Some Commentary on the linked RCT: https://nutritionsource.hsph.harvard.edu/2016/04/13/diet-heart-ramsden-mce-bmj-comments/. https://ebm.bmj.com/content/21/5/185.full
The study design, in mental health patients, of creating so many artificial foods with corn oil/ omega 6 and no omega 3 as well as the limited monitoring of cholesterol levels and limited length of the study also limits the interpretation of the results. The potential correlation of sudden cholesterol drop with mortality can also be confounded by sudden weight loss, which correlates with diseases like cancer.
Meta analysis of 60 RCT’s linking LDL-C lowering therapies with reduced CVD events:
https://www.atherosclerosis-journal.com/article/S0021-9150(24)01108-0/fulltext
How do you explain how statins reduce risk of CVD events or why those with familial hypercholesterolemia have such high rates of CVD?
It also still does nothing to address apo-b…