A JAMA Cardiology case report claimed a man ate 6-9 pounds of cheese, butter, and hamburger daily until cholesterol oozed from his skin. The presenter argues the report is implausibly written, omits crucial patient history, and lacks the rigor expected of a major journal, potentially fueling distrust in medicine.
Man on a carnivore diet starts oozing cholesterol from his skin. The media has been binging on this story over the last week like a hungry lion with a fresh kill. But sadly, this medical case report, the medical case report at the center of the story, it reads more like a Monty Python skit than a proper report. In my opinion, this report is an embarrassment, a big misstep, and actually ammunition for the carnivore diet movement that will only serve to widen the chasm of trust between the general public and conventional medicine. This is harmful, and let me make that case, starting by reviewing the medical case report published in JAMA Cardiology. Here it is. Here is the entire report. You're seeing it on screen. It describes the patient only as a man in his 40s. Providing no other pertinent medical genetic family or other history. But here's the kicker: it vaguely claims he was eating 6 to 9 pounds of cheese, butter, and hamburger daily and losing weight. So there are either two possibilities. One, either this report is inaccurate as written, or the subject in question is the fat man from Monty Python's Meaning of Life. And I don't think that's the case. Now, let me explain the real issue here. N=1 case reports, they're fine, they can have value, including as cautionary tales. And I also don't subscribe to the idea that there is one best human diet, and I do fully believe there are genetic susceptibilities that could be contraindications for a carnivore diet. However, this is supposed to be a top cardiovascular journal. JAMA Cardiology. But the report as it's written is sloppy, devoid of really important details, and pretty much implausible. Don't believe me? Go ahead, try for yourself to eat 96 ounces of meat, butter, and cheese over even one day. Go ahead, I bet you can't even come close. Then imagine this is the least amount of food you could eat every single day for 240 days. And some days you'd eat 50% more than that. Can you do it? I bet not. And the fact that this prestigious academic journal accepted this and published this strongly suggests to me they're willing to lower their standards to an absolute zero provided the content is effective propaganda to get them clicks and targeted against a stigmatized extreme dietary pattern that doesn't align with what the status quo deems as normal or healthy. This lowering of academic and intellectual standards to attack the other is what bothers me so deeply. It's why I'm doing this video, not to defend carnivore. It would bother me just as much if the report read, "Man in his 40s ate 12,000 calories of broccoli per day and grew tree bark as skin." Now, what is gonna happen? Correction, what is happening? Because I see it in real time. Those who conceive of a carnivore diet as a dangerous fad will wave this report like a cautionary flag without considering its merit or lack thereof. And those who are fans of the carnivore diet or just even carnivore curious will pick up on its clear and obvious deficits, which are clear to anyone who takes just 2 minutes and a handful of neurons to process the words on the page. And they'll inevitably conclude that conventional medicine and "the science" is corrupt, untrustworthy, and out to get them. Now, these extreme polarized points of view will widen the chasm of mistrust, pushing each party to a greater extreme. Nobody will be helped, and dinner tables will be divided. And as an aside, I did reach out and message JAMA Cardiology to see if they truly felt this was a report that they wanted to showcase under their brand. Thus far, no response. If they do respond, I'll let you know in the comments. And as a nuance note, I recognize the format of this cardiovascular images category under which the case report is filed has a tight 150-word limit. But that doesn't excuse the deficiencies in this report. If JAMA Cardiology is wise, they'll retract it. Or update it. But I'm not holding my breath. I'll also reinforce— while this case is an extreme example of low publication standards and bias, this is part of a pattern. I won't go into it too much in this video, but for more, start by seeing these two newsletters. And finally, to end this video on a lighter note and for some comic relief, here's some quotes from colleague physicians and medical students. I asked them to react to this report after they read it, and here's what they had to say. One doctor said, "If I wrote this report as a first-year medical student, my attending would have cut off my balls." Another doctor said, "This case report is so sloppy, they should put it between two burger buns and call it a sloppy joe." A medical student said, "Where's that nun from Game of Thrones with the shame bell?" And one surgeon said, "I'm no carnivore, but dang it if this isn't a feather in the carnivore community's cap." Is this really JAMA Cardiology? Now, as my final words, let me say I don't fancy myself as a shield of the carnivore diet. Far from it. I have my questions and concerns. But here I detect a deficiency of intellectual integrity. And publishing double standards that will eat at public trust in medicine and science like that lion eating its kill.
