Talk:Low-fat diet

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Edits

The prior versions relied on secondary and not primary sources for studies about low-fat diets (i.e., newspapers versus journal articles). As this is frowned upon, I revised the article accordingly. (This was not signed, so I signed it myself) Jotakami (talk) 04:07, 22 May 2008 (UTC)

Why does it not surprise me that citation is needed on this page? Oh, yeah, that's right, because most Americans wholeheartedly believe a nutritional dogma that science has never supported. Scientific studies don't support the hypothesis that fats are bad in the diet because they aren't. Jotakami (talk) 04:07, 22 May 2008 (UTC)

The link to the Cochrane-review is no longer valid, it says "This review has been withdrawn." Arvixx (talk) 15:54, 7 November 2009 (UTC)

The only external link on the page(Low-Fat VS Low-Carb Diets For Weight Loss: Results are in. Low-Fat Diets lose! - By Dr. Kathlen Zenman, MPH, RD, LD)is to a web page that is itself a link to an advertisment and as such has been removed by myself.Pupplesan (talk) 20:43, 18 May 2010 (UTC)

Someone has added the subheading "Plant Based Diets" that includes anecdote by several vegan physicians, as well as claims about animal fat, animal protein and vegan diets, which are not supported by the references. I have seen the same claims on several other pages, using the same references (which include a bunch of books, including a book by a layperson and a bunch of cherry picked papers that are way too weak to support the claims) This is not scientific, not objective and certainly doesn't belong here. Looks like someone put this here to promote the vegan message (See discussion here: http://authoritynutrition.com/wikipedia-tainted-with-vegan-propaganda/ ). I'm removing it Krassssi (talk) 10:20, 28 October 2013 (UTC)

There plenty of PubMed and Nature and Plos articles that show the value of low fat diets on weight and epigenetics. I have started adding in those studies on the page.  Lowfatvegan (talk) 00:35, 9 November 2017 (UTC)

Too short

I am astonished at how short this page is compared to Low-carbohydrate diet. Solo Owl 13:23, 27 July 2013 (UTC) — Preceding unsigned comment added by Eall Ân Ûle (talk • contribs)

I agree. There is a lot that could be said about the history of the low-fat dietary recommendations. For example, the Ancel Keyes studies and the McGovern Commission, which first recommended the low-fat diet to the American public. I'll see if I can add something about it soon, pretty busy right now. Krassssi (talk) 10:24, 28 October 2013 (UTC)

Although it is an unpopular idea, some studies do suggest that a high carb, low fat diet is effective for weight loss. Therefore, I propose to add a heading that specifically discusses the HC-LF diet as a healthy diet that uses some of the research.--Kam4441 (talk) 02:40, 10 May 2018 (UTC)

Added External Links

I've added some links to reputable health promotion websites on the topic. This kind of information for the 'man on the street' seems to be missing on the rather technical and scientific wikipedia pages regarding Cholesterol. Lord Gorthol (talk) 13:43, 15 February 2015 (UTC)

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influence of carbohydrates section :

This study https://jamanetwork.com/journals/jama/fullarticle/2673150 seems to contradict the last statement on the page here. I am not an ace referencer or fat-diet researcher but if someone who is either of those things would like to look into this, that's the link and here http://www.latimes.com/science/sciencenow/la-sci-sn-diet-dna-20180220-story.html is a quicky summmary 116.231.75.71 (talk) 11:19, 21 February 2018 (UTC)

A summary quote from the Stanfard study, 600 fatso individuals :

Conclusions and Relevance: In this 12-month weight loss diet study, there was no significant difference in weight change between a healthy low-fat diet vs a healthy low-carbohydrate diet, and neither genotype pattern nor baseline insulin secretion was associated with the dietary effects on weight loss. — Preceding unsigned comment added by 116.231.75.71 (talk) 11:22, 21 February 2018 (UTC)

Edits on effects of low fat diets on men's testosterone

In regards to Whittaker's 2021 paper (https://www.sciencedirect.com/science/article/abs/pii/S0960076021000716).

The standardized mean differences show very consistent effect sizes across markers of androgen status (-0.38; -0.37; -0.38; -0.30), and all are statistically significant, the majority highly so. This would typically be phrased as there is strong evidence of an effect (please see the Cochrane Handbook for interpretation - https://training.cochrane.org/handbook/current/chapter-15. Moreover, these effects of notable size (0.2 = small effect; 0.5 = medium effect; 0.8 = large effect).

Also, the included studies show very low heterogeneity, besides 1 outlining sample in the total testosterone meta-analysis, likely due to the ethnicity of that sample.

Tha authors state in their first highlight that 'Low-fat diets decrease testosterone levels in men', which intended to be the complete summary of the research. They do state that further randomized controlled trials are needed, but likely in an effort to direct future research, as their results are very strong.

The words 'limited evidence' do not accurately reflect the content of this review. I suggest omitting the word 'limited', to rephrase the sentence to 'There is evidence that low-fat diets compared to high-fat diets...'

In response to Alexbrn, a direct quote from the article:

'To summarise, our findings indicate that endogenous T production decreased on LF diets, leading to lower FT and TT.' — Preceding unsigned comment added by Nutritionandhealtheditor (talk • contribs) 17:25, 29 March 2021 (UTC)

Great, so you can cherry pick. This POV-pushing is just so tiresome. Alexbrn (talk) 17:53, 29 March 2021 (UTC)

David Ludwig, professor of nutrition at Harvard T.H. Chan School of Public Health

• Have low-fat diets made us fatter? 2015. Harvard Chan School news. Discussing David Ludwig, professor of nutrition at Harvard T.H. Chan School of Public Health.
• Will The 'Always Hungry' Diet Revolutionize Weight Loss? A Q&A With The Author, Dr. David Ludwig. Jan 2016. Forbes.

Further burying the insane myth of the low-fat diet that overall has greatly increased weight gain in the US. As a personal aside (don't blow a gasket over an anecdote) most anyone who has water-fasted remembers their amazement at the near complete lack of hunger after the first day. Point being that a diet that makes you constantly hungry can not succeed for most people. A regular amount of unrefined healthy balanced fats and oils causes satiety, and the likelihood of more success in maintaining a healthy weight with more ease. The professor goes into much more detail, studies, etc.. --Timeshifter (talk) 17:04, 26 March 2023 (UTC)

Doctor: Low-fat diets stuffed with misconceptions. By David Ludwig. October 17, 2016. CNN. I know he is just one author but the article has lots of links. And the history is enlightening as to why the low-fat craze still survives. And why Wikipedia needs to stop propagandizing for it with opinions unsupported by systematic reviews.

Excerpts

Despite concerns for the lack of high-quality scientific evidence, the government and all the major professional nutrition associations had by the 1990s recommended that everyone beyond infancy eat a high-carbohydrate/low-fat diet. ... To facilitate this change, the government’s Healthy People 2000 goals officially called upon the food industry to increase “to at least 5000 brand items the availability of processed food products that are reduced in fat.” The food industry followed suit, replacing fat in food products with starch and sugar. With government acquiescence and professional society participation, all sorts of sugary products were promoted as “low-fat” or “fat-free” – such as Froot Loops and Frosted Flakes. ... with the low-fat diet remaining deeply embedded in public consciousness and food policy. In fact, according to a recent Gallup survey, a majority of Americans still actively avoid eating fat.

--Timeshifter (talk) 04:58, 25 July 2023 (UTC)

We are no longer in the 1990s. Low-fat diets have not been recommended by health and medical authorities for over 20 years. The website you cite makes that clear. "For the last half of the 20th century, most major health organizations, including the American Heart Association, recommended a low-fat diet. Yes, they did, but the message has changed dramatically. Now, the American Heart Association, the federal dietary guidelines, and other nutrition authorities have shifted away from advising people to limit the total amount of fat in their diets" [1]. Science progresses. The consensus view is no longer low-fat. A good idea would be to add a history section to the article making it clear that health organizations no longer recommend low-fat diets. Psychologist Guy (talk) 18:02, 25 July 2023 (UTC)

I agree. A history section is needed. Here is why. David Ludwig writes:

Responding to new evidence, the 2015 USDA Dietary Guidelines lifted the limit on dietary fat, unofficially ending the low-fat diet era. But you’d never know it, because a full accounting of this failed experiment has not been made. In the absence of this corrective process, public health harms persist, with the low-fat diet remaining deeply embedded in public consciousness and food policy. In fact, according to a recent Gallup survey, a majority of Americans still actively avoid eating fat.

By the way, David Ludwig is a professor of nutrition at the Harvard T.H. Chan School of Public Health. Wikipedia: "currently ranked as the best school for public health in the world by both the Academic Ranking of World Universities and EduRank. It is also ranked as the second (tie) best public health school in the nation by U.S. News & World Report." --Timeshifter (talk) 23:16, 25 July 2023 (UTC)

This is a meaningless discussion, because the advice to eat low-fat did not come with the advice to "eat truck loads of sugar instead". So if anything there could be a history section describing how Americans swapped fat for sugar and never really followed a low-fat diet. CarlFromVienna (talk) 08:00, 26 July 2023 (UTC)

Systematic review shows low-fat diets are worse

Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. In: The Lancet Diabetes & Endocrinology. 2015 Dec;3(12):968-79. doi: 10.1016/S2213-8587(15)00367-8. Epub 2015 Oct 30. Deirdre K Tobias, Mu Chen, JoAnn E Manson, David S Ludwig, Walter Willett, Frank B Hu.

Findings and Interpretation. Bolding added.

Findings: 3517 citations were identified by the search and 53 studies met our inclusion criteria, including 68 128 participants (69 comparisons). In weight loss trials, low-carbohydrate interventions led to significantly greater weight loss than did low-fat interventions (18 comparisons; WMD 1·15 kg [95% CI 0·52 to 1·79]; I(2)=10%). Low-fat interventions did not lead to differences in weight change compared with other higher-fat weight loss interventions (19 comparisons; WMD 0·36 kg [-0·66 to 1·37; I(2)=82%), and led to a greater weight decrease only when compared with a usual diet (eight comparisons; -5·41 kg [-7·29 to -3·54]; I(2)=68%). Similarly, results of non-weight-loss trials and weight maintenance trials, for which no low-carbohydrate comparisons were made, showed that low-fat versus higher-fat interventions have a similar effect on weight loss, and that low-fat interventions led to greater weight loss only when compared with usual diet. In weight loss trials, higher-fat weight loss interventions led to significantly greater weight loss than low-fat interventions when groups differed by more than 5% of calories obtained from fat at follow-up (18 comparisons; WMD 1·04 kg [95% CI 0·06 to 2·03]; I(2)=78%), and when the difference in serum triglycerides between the two interventions at follow-up was at least 0·06 mmol/L (17 comparisons; 1·38 kg [0·50 to 2·25]; I(2)=62%). Interpretation: These findings suggest that the long-term effect of low-fat diet intervention on bodyweight depends on the intensity of the intervention in the comparison group. When compared with dietary interventions of similar intensity, evidence from RCTs [randomised controlled trials] does not support low-fat diets over other dietary interventions for long-term weight loss.

--Timeshifter (talk) 16:31, 21 July 2023 (UTC)

The article already stated that low-fat diets are not better or worse than other diets. But I have included this review as a footnote. CarlFromVienna (talk) 11:17, 24 July 2023 (UTC)

The systematic review says: "low-carbohydrate interventions led to significantly greater weight loss than did low-fat interventions". And this is from The Lancet. It is important that people know this significant fact according to WP:NPOV.

People shouldn't only hear the same junk science propaganda about low-fat diets being what people should do. I knew this decades ago. The studies were flawed from the beginning. If you do a study of any diet that maintains lower daily calories people will lose and maintain that lower weight during the study.

But that is not what counts. What counts is what people do after the study. And low-fat diets have long been known as boomerang diets due to the frequent hunger cravings maintained by the blood sugar oscillations of high carbohydrate diets. Especially when not based on whole grains. Food without enough oil tastes worse. To make it taste better people buy foods with more sugar of all types. Even more blood sugar oscillations, diabetes, prediabetes. So people actually get fatter once they stop maintaining the calorie restrictions, and only maintain the low fat. All of this is well known for decades but completely ignored by many nutritionists propagandized by the decades-old received wisdom of low-fat diets.

Low-fat diets overall actually make people fatter on average over time. It's counterintuitive which is a big reason why people keep falling for it. Eating more fat than a low-fat diet actually makes you less fat. A reasonable amount of fats and oils. Not a high-fat diet. Good fats, of course, so one doesn't get heart disease, clogged arteries, etc.. --Timeshifter (talk) 16:25, 24 July 2023 (UTC)

I appreciate your interpretation but the study comes with its own interpretation and I think we must stick with it. To my knowledge any caloric restriction will not only lead to short-term weight loss but also to ling-term weight maintenance. You mention long-term compliance, which may differ between diets, but the review above was not a study comparing compliance. CarlFromVienna (talk) 16:48, 24 July 2023 (UTC)

I was quoting from the findings. That is important. This is from the interpretation section: "evidence from RCTs [randomised controlled trials] does not support low-fat diets over other dietary interventions for long-term weight loss." Please include it in the article.

You wrote: "To my knowledge any caloric restriction will not only lead to short-term weight loss but also to ling-term weight maintenance." That is original research, or received wisdom, on your part. And untrue unless you can back that up with systematic reviews. See: WP:Original research. And: WP:Verifiability. --Timeshifter (talk) 17:35, 24 July 2023 (UTC)

Unfortunately, the words "long-term" are often abused in modern nutritional research in regard to randomised controlled trials because such trials are actually short-term. Long-term really should mean over 10 years (20 or 30 years is long-term), but in this context for RCTS when they use "long-term" they mean trials that are no longer than 1 year. 1 year is not long-term. I just clicked on the above systematic review and they are indeed citing 1 year trials. Think about a human lifespan. The user above is claiming "Low-fat diets overall actually make people fatter on average over time", then let's see the 30, 40, or 50 year data? Citing trials that are only 1 year is not good evidence for anything long-term. It should also be noted that the drop out rate for these diets is very high. Psychologist Guy (talk) 22:32, 24 July 2023 (UTC)

Also conflict of interest with that systematic review, one of the co-authors is low-carb author David S. Ludwig as is another. Psychologist Guy (talk) 22:41, 24 July 2023 (UTC)

Well then, put that in the article. Systematic review shows that "evidence from RCTs [randomised controlled trials] does not support low-fat diets over other dietary interventions for long-term [one year trials] weight loss."

Currently the article has a one paragraph section on body weight, and some incorrect info in the lede. The section has 2 references. One is the systematic review I linked to. One is basically an opinion piece.

A Lancet peer-reviewed systematic review obviously trumps an opinion piece: "low-carbohydrate interventions led to significantly greater weight loss than did low-fat interventions" That contradicts the current lede. --Timeshifter (talk) 23:19, 24 July 2023 (UTC)

I agree that the piece by Endocrine Society should be removed. I am not saying the source is unreliable but if you read the paper, it contains only 1 line about low-carb and low-fat diets, and all it does is cite the 2015 Ludwig, Willett systematic review. This is probably undue and is bad cherry-picking. I do not think we should cite an entire review for 1 line of text that is basically just citing the 2015 systematic review. We do not need this source at all. A better option here would be to remove both these sources. I had a look online and couldn't find any other modern systematic reviews. In conclusion there is lack of evidence on this topic, we do not have the data. I would support removing the body weight section. Psychologist Guy (talk) 23:37, 24 July 2023 (UTC)

The Lancet systematic review is from 2015. As far as systematic reviews go that is not old.

The findings states: "53 studies met our inclusion criteria, including 68,128 participants (69 comparisons)."

That is a serious systematic review.

The authors are: Deirdre K Tobias, Mu Chen, JoAnn E Manson, David S Ludwig, Walter Willett, Frank B Hu.

Just because you don't like one of them doesn't disqualify the systematic review. --Timeshifter (talk) 00:30, 25 July 2023 (UTC)

Yes it is a reliable source but it is a single review that has not been updated, confirmed or the results replicated by different researchers in 8 years. If you look around on Wikipedia on other diet and nutrition related articles you will see that we normally update articles with recent systematic reviews that are not less than 5 years and we do not normally cite just one review. How can we update this section when no other reviews have been published? Maybe you can help but I suspect there are not any other reviews on this. The review you are citing is 8 years old and there has been no follow up with no other systematic reviews published. The way evidence-based medicine works is looking at the totality of the evidence and not just one review. Consistent results are important. Anyone can find a single review that supports their point of view. There will always be an outlier. If you had 3, 4 or 5 reviews with the same results from different researchers you may have a valid case. The truth is, not enough reviews have been published on this topic because there is a lack of long-term data. We wouldn't just cite one review on the topic and conclude the case is closed. Psychologist Guy (talk) 02:49, 25 July 2023 (UTC)

We are now up to 3 systematic reviews showing that low-fat diets are worse than other diets concerning multiple health areas. I have never heard of a rule on Wikipedia concerning medical articles that we do not cite quality systematic reviews just because we only have one of them per health area. And we certainly don't exclude them just because they contradict the current article section based on questionable references. Systematic review trumps questionable references. --Timeshifter (talk) 04:22, 25 July 2023 (UTC)

Found another systematic review. It confirms the results of the previously discussed systematic review:

• Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. 04 December 2015. British Journal of Nutrition.

From the Abstract: "In all, eleven RCT with 1369 participants met all the set eligibility criteria. Compared with participants on LF [low fat] diets, participants on LC [low carbohydrate] diets experienced a greater reduction in body weight."

But see modified fat diet section farther down this talk page. Type of fat matters greatly concerning cardiovascular risk. --Timeshifter (talk) 04:46, 25 July 2023 (UTC) --Timeshifter (talk) 04:46, 25 July 2023 (UTC)

Timeshifter, when I say that keeping body weight long-term depends on burning the same amount of energy you consume, that is not original research, but basic nutritional knowledge that you can find in any text book. (Sareen S. Gropper, Jack L. Smith, Timothy P. Carr: Advanced Nutrition and Metabolism. Seventh Edition, 2018, p. 292) It has not been established that the amount of macro nutrients plays any role in this. That is why neither low fat nor low carb diets are superior in keeping body weight long-term. By the way, text book trumps reviews. I cannot engage further in this discussion as I'm currently on holiday :) CarlFromVienna (talk) 06:39, 25 July 2023 (UTC)

Textbooks with out-of-date info do not trump systematic reviews. --Timeshifter (talk) 11:17, 25 July 2023 (UTC)

We can all just cherry-pick a negative or positive health outcome from a review if it suits us, we must be careful to cite all the evidence not just one finding. We must also read the methodology of the review and what trials they used. The same review in the very abstract you cited says " Our findings suggest that the beneficial changes of LC diets must be weighed against the possible detrimental effects of increased LDL-cholesterol". The findings of the review you cited found that there was a significant LDL-c increase on the low-carb diet. These trials were 6 months to 1 year, this is not long-term health data. This is quite alarming. The authors of the review later authored a paper noting the increased risk of CVD from low-carb diets [2]. Above you seem to be using this review and another to show that "low-fat diets are worse than other diets concerning multiple health areas" but this doesn't appear to be the case with cardiovascular risk-factors. If you want cite the fact that low-carb diets bring about more weight loss within a year, I don't think anyone will dispute that because that is what the findings of the reviews support as you have quoted. If you want to add that to the article go ahead but don't leave out the cardiovascular risk-factors. Psychologist Guy (talk) 18:39, 25 July 2023 (UTC)

I agree with all of that. See my reply about editing farther down. Also see section:

#Cardiovascular risk. Modified fat diet works. Reduction of total fat does not. --Timeshifter (talk) 23:43, 25 July 2023 (UTC)

Recent reviews

I realise the article cites mostly older reviews. There doesn't seem to be much recent data. This was published [3] but it doesn't really tell us much. Psychologist Guy (talk) 23:55, 24 July 2023 (UTC)

That article is about mortality, not weight loss. And it certainly does not say a low-fat diet is better than a Mediterranean diet (which is definitely not a low-fat diet).

From results: "Mediterranean dietary programmes proved superior to minimal intervention for the prevention of all cause mortality ... 17 fewer per 1000 followed over five years". Compare to: "low fat programmes proved superior to minimal intervention for prevention of all cause mortality ... 7 fewer per 1000."

--Timeshifter (talk) 00:47, 25 July 2023 (UTC)

I never said the review was about weight loss, I was merely looking for reviews that mention low-fat diets and hardly any exist, so I doubt the article can be updated in regard to health effects which seems to be be focusing on clinical data. You will find that there is hardly any clinical data out there on low-fat diets. There are hardly any reviews for clinical trials covering any health effects, the data does not exist. Not many in the nutritional world take low-fat diets seriously anymore. In the 60s and 70s there was indeed a low-fat message being pushed by certain governmental and health organizations but that idea is now obsolete. Psychologist Guy (talk) 02:11, 25 July 2023 (UTC)

I don't know what planet you are living on, but the low-fat craze is far from over:

https://www.google.com/search?q=low-fat+foods

Stop making stuff up: "Not many in the nutritional world take low-fat diets seriously anymore." You just cited a 2023 systematic review article where 5 of the 7 dietary programs reviewed were low fat:

Comparison of seven popular structured dietary programmes and risk of mortality and major cardiovascular events in patients at increased cardiovascular risk: systematic review and network meta-analysis. Published 29 March 2023. The BMJ. https://doi.org/10.1136/bmj-2022-072003

"40 eligible trials were identified with 35 548 participants across seven named dietary programmes (low fat, 18 studies; Mediterranean, 12; very low fat, 6; modified fat, 4; combined low fat and low sodium, 3; Ornish, 3; Pritikin, 1)."

Only 2 of the 7 are not low fat diets: Mediterranean, and the modified fat diet.

--Timeshifter (talk) 03:50, 25 July 2023 (UTC)

Your evidence is a Google search? It doesn't matter if these diets are popular or not, that is irrelevant to what experts say. Governmental, dietetic and medical organizations no longer recommend low-fat diets to the general public, so you are promoting obsolete ideas, over 20 years out of date. A diet low in saturated fat that is recommended by current health authorities is not a "low-fat diet" because these health authorities encourage the consumption of polyunsaturated fats from nuts, seafood and vegetables oils.

What health authorities currently recommend is a balanced Mediterranean diet, Nordic diet or plant-based diet, none of these diets are "low-fat". Low-fat diets in general avoid or forbid nuts, seeds and vegetable oils, they also restrict polyunsaturated fat and this is not in line with mainstream dietary advice. Low-fat diets are not part of the consensus view. You will also find that mainstream nutritional textbooks no longer recommend low-fat diets, so yes low-fat diets are no longer endorsed by most in the nutritional world, they are very much on the fringe. What I typed was accurate. That's why there are less clinical trials on this topic. If you look at the latest review on popular diets from the American Heart Association they rate Nordic diet, Mediterranean diet and pescetarian diet the highest (90-100), whilst a low-fat diet is given a score of 78 [4]. If you check dietetic organizations they are not recommending low-fat diets so my point is valid. The diet that has the most clinical trials is the Mediterranean diet and this what many of the experts currently advocate.

Hopefully you realise that Nathan Pritikin was publishing his low-fat diet in the 1970s. This is very old stuff and the trials are over 20 years old. The review I cited notes "Modified fat, Ornish, and Pritikin diets showed low or very low certainty evidence". This is low-quality evidence. As I said in my original post the review doesn't tell us very much. Psychologist Guy (talk) 17:54, 25 July 2023 (UTC)

All of that should go in the article. My point was that the review you found was for 2023. That means doctors, nutritionists, etc. were putting people on the low fat diets studied by that review. I am curious as to the years of those studies. See my reply in the section higher up: #David Ludwig, professor of nutrition at Harvard T.H. Chan School of Public Health. We definitely need a history section as you suggested. People are still misinformed. --Timeshifter (talk) 23:26, 25 July 2023 (UTC)

Cardiovascular risk. Modified fat diet works. Reduction of total fat does not.

Reduced or modified dietary fat for preventing cardiovascular disease. 16 May 2012. Cochrane Database of Systematic Reviews (Cochrane Reviews) from the Cochrane Library. https://doi.org/10.1002/14651858.CD002137.pub3

From Main Results: "24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I2 50%). Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction ...."

From Authors' conclusions: "The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat, but not reduction of total fat, in longer trials." --Timeshifter (talk) 04:17, 25 July 2023 (UTC)

This is pretty much accepted knowledge that nobody would dispute. If you want to make improvements why not add this review to the article. Psychologist Guy (talk) 18:19, 25 July 2023 (UTC)

Thanks for asking, but I prefer doing research on references, and letting others do the article editing. I am not good at it, and I hate the edit wars on medical articles. I concentrate on tables and charts for a few medical articles. --Timeshifter (talk) 23:30, 25 July 2023 (UTC)