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This is an old revision of this page, as edited by Beall4 (talk | contribs) at 17:31, 26 November 2018 (→Specific Carbohydrate Diet). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

New sources to be evaluated (existing article is overly negative and outdated)

I really like skeptics. You normally do us a service, but I believe that it has gone well past NPOV with this article. I made an attempt to reign it in on the first paragraph, but it was reverted twice, and the revert was finally explained as missing two words ("health risk") in regards to nutritional quality. The referenced statement about nutritional quality and health risk is scientifically unproven and is speculation. Frankly, there is a "health risk" in any diet.

There are a number of new sources which invalidate much of the existing article. Looking at the edit history of the article, I am not confident that any attempt to introduce them will be successful (or that they'll be introduced in a way that minimizes their significance). So I'll document them here. Include them at your own risk, eh?

Clinical and Fecal Microbial Changes With Diet Therapy in Active Inflammatory Bowel Disease: "SCD therapy in IBD is associated with clinical and laboratory improvements as well as concomitant changes in the fecal microbiome." That speaks boldly to effectiveness. The article incorrectly claims, "scientific evidence is lacking." The article also referenced an older source which says the diet confers no proven health benefit". "Support for the diet's effectiveness comes only from users' testimonials" can also be reworded as "Support for the diet's effectiveness has been documented in both users' testimonials as well as laboratory testing". Source: [1]

Patients Perceive Clinical Benefit with the Specific Carbohydrate Diet for Inflammatory Bowel Disease: "The SCD is utilized by many patients as a primary and adjunct therapy for IBD. Most patients perceive clinical benefit to use of the SCD." Describing even that as just "testimonal evidence" is insufficient. Source: [2]

Diet as a Trigger or Therapy for Inflammatory Bowel Diseases: "There is compelling evidence from animal models that emulsifiers in processed foods increase risk for IBD." The article quotes an older source which says "there is no evidence to suggest that any particular food or diet causes, prevents or cures inflammatory bowel disease". Source: [3]

Nutrition in Pediatric Inflammatory Bowel Disease: From Etiology to Treatment. A Systematic Review: "there are pediatric data, mainly from case-control studies, which suggest that some dietary habits (for example consumption of animal protein, fatty foods, high sugar intake) may predispose patients to IBD onset." It further supports the previous source. Source: [4]

Deregulation of intestinal anti-microbial defense by the dietary additive, maltodextrin: "Dietary and environmental factors are implicated in the initiation and perpetuation of IBD; however, a singular causative agent has not been identified." Again, supporting. Source: [5]

Response to strict and liberalized specific carbohydrate diet in pediatric Crohn's disease: "Disease control may be attainable with the SCD in pediatric (Crohn's Disease)." A little bit weaker, but still supporting. Source: [6]

Resolution of Severe Ulcerative Colitis with the Specific Carbohydrate Diet: "Successful use of the SCD in children with UC has been documented. We describe previously unreported, highly beneficial results with both symptomatic and clinical improvement and complete remission of UC in an adult female with the SCD." Again, supporting research, and effectiveness. Source: [7]

IN SUMMARY: The entire article's POV which paints the Specific Carbohydrate Diet as unsupported by scientific evidence and ineffective is completely inaccurate in light of new sources.

Thank you for your attention. Please revise the article based on new sources and also return to NPOV.

70.177.88.88 (talk) 20:36, 22 February 2017 (UTC)[reply]

References

  1. ^ https://www.ncbi.nlm.nih.gov/pubmed/28030510
  2. ^ https://www.ncbi.nlm.nih.gov/pubmed/27638834
  3. ^ https://www.ncbi.nlm.nih.gov/pubmed/27793606
  4. ^ https://www.ncbi.nlm.nih.gov/pubmed/27258308
  5. ^ https://www.ncbi.nlm.nih.gov/pubmed/25738413
  6. ^ https://www.ncbi.nlm.nih.gov/pubmed/26877615
  7. ^ https://www.ncbi.nlm.nih.gov/pubmed/26351419
Biomedical claims must be sourced to WP:MEDRS. We'd need some of those.Alexbrn (talk) 20:40, 22 February 2017 (UTC)[reply]

Point taken. I'm satisfied just to present accurate and truthful information from trusted sources. I realize that none of these may be primary considerations, so I'll let others Wikilawyer each other on how to include or exclude it. Best wishes, all. 70.177.88.88 (talk) 20:51, 22 February 2017 (UTC)[reply]

WP:MEDRS effectively means trusted sources; we don't use primary research in junky journals. Alexbrn (talk) 21:04, 22 February 2017 (UTC)[reply]

I understand enough of the Wikipedia game to know that I don't want to play it:

1. There is no evidence to support this diet.
2. Here is the evidence! [Provides seven published articles.]
3. Your evidence is inadmissible because it is published in reputable medical journals!
4. " ... "
5. There is no evidence to support this diet. :)

Hey, I'm happy to let someone else wikilawyer from here. Again, just wanted to introduce accurate and truthful information from trusted sources. As mentioned, I realize that none of these may be primary considerations to Wikipedia. Best wishes. Or, in the words of another amateur editor in the conversations above, "I give up." 70.177.88.88 (talk) 21:40, 22 February 2017 (UTC)[reply]

WP:MEDRS and recentism

Alexbrn has reverted the summary of the Brown reference, which is a review article in secondary source, in a reputable medical journal, saying about the 2011 article that "It's too old. Also irrelevant."[1]. However, this is the most up-to-date review article available about the SCD diet, and has an entire section about SCD, so I don't see how it can be irrelevant even if it's old. It's not ideal, sure, but per WP:MEDRS, it doesn't mean that the results can't be mentioned so long as the appropriate disclaimers are included. It's a far cry from an in-vitro study or a mouse study.

Seems to me like SCD (which was first used in 1923) has its time in the spotlight, and now the research spotlight has moved on to more nuanced and individualized diets:

  • the SCD diet is a low FODMAP diet ("The SCD is low in carbohydrates, specifically disaccharides (lactose, sucrose, maltose and isomaltose) and digestible poly-saccharides (starches). Monosaccharides (glucose, fructose and galactose) are permitted."), which now has strong evidence in support of efficacy.
  • the SCD diet is a wheat-free diet. Wheat was only tied to celiac disease in 1952, decades after SCD was first described. But it goes further than that, and is also a gluten-free diet as pointed out by this 2014 review article which says "There is a growing body of evidence of non-celiac gluten intolerance, which may also be addressed with these dietary restrictions.".
  • the SCD diet is also a low-dairy diet, which would help those with lactose intolerance or milk protein allergies.

The four medium-sized studies in Brown's 2011 review article are from 1979, 1981, 1986, and 1991. There have been a number of small studies since then, it seems unlikely that there will ever be large scale study as it would be considered a waste of money to combine these three very different dietary restrictions into a single study, and with a few extra restrictions thrown in for good measure (confounders galore!). Science has moved on, and I think we should include the data that was generated while SCD was being actively investigated with large (>100 person) studies in the 1970s and 1980s under the "history" section. But I have a feeling it would be quickly reverted like all other edits made to the page unless consensus is found first.

So: I propose to include a more nuanced and verbose description in the text about possible reasons that the SCD could have been effective for adherents back in the 19th century. We should be avoiding recentism on this historical angle, even if there are still some people that are trying it in the modern era. Pro crast in a tor (talk) 13:10, 28 April 2017 (UTC)[reply]

Your edit asserted this as current knowledge: "Some people with Crohn's disease show improvement by observing an elimination diet very similar to SCD". That's a pretty extraordinary claim. An old review which is critical about the research quality is not sufficient. And is the review even about the Haas/Gottschall diet (the subject of this article) anyway? Alexbrn (talk) 13:38, 28 April 2017 (UTC)[reply]
A direct quote from the Brown review article under the heading "SCD clinical trials": "Four clinical trials with relatively weak methodology and a conference proceeding support using the SCD to reduce GI symptoms in CD patients". To only say that the review article is "critical about research quality" is cherry picking just the first half of this summary sentence. I even added this quote to the reference, an edit which you also reverted.
And if you're asking me, _after_ reverting my edit and calling the review "irrelevant", "is the review even about the Haas/Gottschall diet", then you clearly didn't read the source. It includes under the "SPECIFIC CARBOHYDRATE DIET" section a brief history of Haas/Gottschall. And Brown was and still is the primary reference used in the article. I'm having a hard time assuming good faith with your apparent kneejerk reverts.
Perhaps I paraphrased poorly by changing "reduce GI symptoms" as "show improvement", but the review is clear that clinical trials support using SCD-like diets for CD patients. Brown et al also go through each of the clinical trials and document the methodology, each slightly different, and none of them a strict SCD, which I summarized as "elimination diets like SCD". All four were included under the "SCD clinical trials" heading, just below a so yes, according to a review article, they are SCD diets. This could be stated more clearly, too.
No opinion on including SCD's relationship to other diets that have attracted medical interest and shown efficacy? Pro crast in a tor (talk) 21:06, 28 April 2017 (UTC)[reply]
What the quoted sentence is saying, if you actually care about evidence, is "this shitty evidence says it works". If I went to you and said "Hey here is a napkin with scribbles on it that say I own this house. Want to buy it for $50K? Half the cost of the neighbor's house!" Will you give me $50K? I hope not. If I said - "Here is an umbrella that is probably full of holes, take it, it might rain!" wouldn't you look at me like i was an idiot? The review is not clear about SCD-like diets being useful for CD. Jytdog (talk) 21:20, 28 April 2017 (UTC)[reply]
I feel like the goalposts keep moving on your evidentiary standards. First you say the review article is irrelevant. Then you say it's an old study. Then you say it's not clear. Instead of trying to interpret the words to your POV, how about we just include exactly what it says, that weak evidence shows that SCD can reduce GI symptoms for CD? I've added this to the lede. Also, there is half a century of strong evidence that eliminating gluten from the diet helps celiac patients, and the SCD eliminated gluten (as well as a number of other things) from the diet in 1924, decades before the etiology of celiac disease was discovered in the mid-1950s. This also seems worth mentioning.
Also, you recently added a statement purported supported by Hou, "such claims are not supported by medical evidence", but Hou in fact says the exact opposite: "There is scientific evidence that dietary factors may influence both the risk of developing IBD and intestinal mucosal inflammation." Another direct quote from Hou is "There is a growing body of evidence of nonceliac gluten intolerance, which may also be addressed with these dietary restrictions. Avoidance of these foods is likely of little danger and could potentially improve gastrointestinal symptoms." Finally, you also added a reference to Hou to support the statement that "Support for the diet's effectiveness comes only from users' testimonials", but that's only him talking about internet websites, and not at all what Hou is saying if you read the whole review article such as the Clinical Trials section, which directly contradicts your statement. I've removed the unsupported Hou references, and added almost direct quotes from Hou instead, which is the most recent (2014) review article to talk about SCD specifically. I've also made a number of other changes, such as a number of improved ref links and ref date updates/fixes. Please work with me rather than reverting wholesale yet again. Pro crast in a tor (talk) 23:58, 28 April 2017 (UTC)[reply]
Nobody is moving goal posts. I just joined the discussion.
Both quotes you offer from Hou are about conditions, not treatments. Jytdog (talk) 00:54, 29 April 2017 (UTC)[reply]
Your 'irrelevant' and 'old' comments were in your revert messages yesterday. Hou's quotes are not just about conditions. Saying that a condition can be "addressed with these dietary restrictions" is a treatment IMO, and he's referring to all three dietary treatments (SCD, paleo, and gluten-free) in this context, which appears in the "Putting It All Together: What to Tell Patients?" summary section. Pro crast in a tor (talk) 03:45, 29 April 2017 (UTC)[reply]
So not hitting yourself on the head with hammer is a treatment for a headache? that is crazy. you can prevent a headache if you don't do that, and you can prevent the problems of celiac if you avoid gluten. another way to say it is "manage" celiac. not "treat" it. Jytdog (talk) 07:59, 29 April 2017 (UTC)[reply]

Yup, and we've got trouble this[2] edit-war attempt trying to imply effectiveness way beyond what the sources support. Alexbrn (talk) 08:26, 29 April 2017 (UTC)[reply]

Jytdog, isn't the whole point of a restrictive diet like gluten-free diet for CD to remove the hammer(s) from one's diet that are causing problems? 'Treat' or 'manage' both seem fine -- from a patient's point of view, they are synonomous. Brown uses "addresses", which perhaps is intentionally vague, so I think we should just use her exact wording if this is contentious. The gluten-free diet article uses the word "treatment".
Alexbrn, a single revert is not an edit war. I was trying out different wording previously, cf [3].
The summary sentence from the Brown review is "Four clinical trials with relatively weak methodology and a conference proceeding support using the SCD to reduce GI symptoms in CD patients". The lede currently reads "The diet can prevent exacerbating gut damage in people with celiac disease by eliminating cereals containing gluten, but it does not cure any diseases." Why is it unacceptable to add that SCD can reduce GI symptoms in CD patients? It's clearly supported by the Brown review.
Also, from the Hou review, both of you seem fine with the paraphrasing "there is no proven health benefit while risking imposition of an undue financial burden and potentially causing malnutrition" in the article, which comes from the summary section of Hou, and reads "At a practical level, adherence to defined diets may result in an unnecessary financial burden or reduction in overall caloric intake in patients who are already at risk for protein-calorie malnutrition.". But literally three sentences later, the direct quote "There is a growing body of evidence of non-celiac gluten intolerance, which may also be addressed with these dietary restrictions.", was reverted by jytdog, with the commit message, "this is not what hou says; it is not valid to read a treatment onto a description of a disease". Alexbrn also reverted a similiar (but not identical) edit with commit message "undue and kind of untrue". However, Hou is, in fact, referring to all three related restriction diets (SCD, paleo, and gluten-free) in _both_ of these quotes. Why allow one quote, and disallow another quote from the next paragraph? It sure looks like POV cherry picking to me.
My paraphrasing "There is also a growing body of evidence of nonceliac gluten intolerance, and symptoms may be reduced with dietary restrictions such as SCD" may not be ideal, but something like it should appear in the text. SCD is a gluten-free diet, after all, and the lede of gluten-free diet contains the well supported, "Gluten causes health problems for those with gluten-related disorders, including celiac disease (CD), non-celiac gluten sensitivity (NCGS), gluten ataxia, dermatitis herpetiformis (DH) and wheat allergy.[7] In these patients, the gluten-free diet is demonstrated as an effective treatment,[8][9][10]". Note the word "treatment" is used. For more, see review article doi:10.1053/j.gastro.2014.12.049. "Although there is clearly a fad component to the popularity of the GFD, there is also undisputable and increasing evidence for NCGS." Again, I believe the historical significant of SCD is being downplayed as the first gluten-free diet. We now know SCD to be overly-restrictive to gain the advantages of GFD, but it was the best option available from 1924 until the mid-1940s, and still works today if one can adhere to it. Pro crast in a tor (talk) 22:07, 30 April 2017 (UTC)[reply]
Thanks for pointing out that the GF diet article is screwed up. I will fix that.
What does "The diet can prevent exacerbating gut damage in people with celiac disease" mean to you? Jytdog (talk) 23:25, 30 April 2017 (UTC)[reply]
It's a very specific statement about celiac patients, and doesn't refer at all to IBD, IBS, Crohn's, or NCGS patients, which is a problem. Brown says the exact same thing on page 193 about Crohn's disease: "Removing certain foods that aggravate symptoms may prevent further GI damage and allow healing." I've updated the sentence accordingly. Pro crast in a tor (talk) 00:11, 1 May 2017 (UTC)[reply]
Also, the word "treatment" is used extensively in the literature, so I don't think it means just what you think it means. This 2017 review "Celiac disease and non-celiac gluten sensitivity" in BMJ says "The only known treatment is adherence to a lifelong strict gluten-free diet.", and that's literally the first sentence under the heading "Treatment". Another article says "a strict gluten-free diet is the only treatment for celiac disease to date". This is just two of top 5 hits -- there are 1500+ hits for "gluten-free diet" and "treatment". Pro crast in a tor (talk) 00:25, 1 May 2017 (UTC)[reply]
You went and added a paper that doesn't even discuss SCD. oy. Jytdog (talk) 01:48, 1 May 2017 (UTC)[reply]
  • i have gone ahead and added the quote from Hou: "However, we lack large prospective controlled trials to provide the dietary recommendations patients’ desire. Taken together, studies of exclusive enteral nutrition, exclusion diets, and semi-vegetarian diets suggest that minimizing exposure of the intestinal lumen to selected food items may prolong the remission state of patients with IBD. Even less evidence exists for the efficacy of the SCD, FODMAP, or Paleo diet. " So, they say "suggests" with regard three things (which means the evidence is not strong enough to say more than "suggests" and then is quite explict in saying "there is even less evidence" about SCD - so we cannot even say "suggests" there, right? Jytdog (talk) 04:56, 1 May 2017 (UTC)[reply]
What I believe Hou is saying is that there's no data to recommend SCD over any other diet, not that SCD has been shown to have no efficacy. Each of the three examined diets have been known, via extensive case reports and several small scale studies, to provide symptomatic relief, often for resistant patients that have tried all the other alternatives. Put simply, it's impossible to know in advance which diet is "best", ie, which one is most likely to bring symptomatic relief (which, after you tell people there is no cure, is really all people want). In another quote, Hou says, "essentially all food groups- fruits, vegetables, meats, and grains- have been noted by patient self-report to exacerbate symptoms and do not provide generalizable information for other patients with IBD. Rather, patients may be instructed to be aware of their diet through food diaries and their symptoms and make modifications specific to the individual patient."
My take is that medical diet interventions have problems with specificity, same as most drug discovery. SCD, GFD, and paleo will all give the same symptomatic relief for people with celiac disease or NCGS, making them equivalent by one measure. But since people have a hard time adhering to the more restrictive SCD, and GFD is all that's necessary, GFD is probably preferred over SCD and paleo, as malnutrition is possible if a patient doesn't enjoy any of their available food options.
Food intolerances are quite common for celiac patients, as Brown points out. If someone has both celiac and lactose intolerance, only SCD will help them fully. If someone has celiac and a milk protein intolerance, only the paleo diet might bring symptomatic relief (assuming the milk protein is abundant in SCD-compliant hard cheeses, and it's a version of paleo that doesn't allow dairy). The medical diet first recommended should be the one that's most likely to bring symptomatic relief, and existing studies just don't have the resolving power to distinguish between the observed efficacy rates of the diets. There are also case reports of every single permutation of "person tries X, then Y, and only Z works" for the three diets. So, a "lack of evidence for the efficacy" is more about resolving power than about saying that the diet is pseudoscience with only a placebo effect.
Also, I've been meaning to add a note about Haas' hard-headedness on starch after the gluten-celiac disease link was discovered. Thanks for adding it. Pro crast in a tor (talk) 06:43, 1 May 2017 (UTC)[reply]
You are reading against the surface meaning of Hou. Based on the evidence, one can only "suggest" X about the three diets; there is even less evidence about SCD and the others... what is elided is "so we really can't tell patients much of anything about them". When a reviewer writes "suggests" it is a very intentional thing. It means "we cannot say anything more definitive but the evidence is kinda sorta pointing this way." Jytdog (talk) 16:28, 1 May 2017 (UTC)[reply]

SCD is a gluten-free diet

Jytdog, why did you remove that the SCD is a gluten-free diet from the lede? It's now known that this fact was the main reason for SCD's success in the 1920s to 1940s, before gluten was discovered. Do you really think this is a controversial point? Haas debated this in the late 1940s, believing that the starch component was still important, but we know better now.

If source A says SCD is a gluten-free diet, and source B says gluten-free diets reduce GI symptoms for NCGS patients, do you really need a source that directly says that SCD addressed NCGS? Gluten let alone NCGS wasn't even known back in the 1920s. I consider SCD a historic diet, not a modern one, so of course Fasano doesn't mention SCD directly. But any diet that is gluten-free is, well, a gluten-free diet, and so Fasano et al's review applies. They're clearly related.

I've now re-added an updated CCFA ref date twice, and you've reverted it yet again with this edit. Also,

  • You reverted my "prevent" with your "exacerbate". "Exacerbate damage" doesn't appear in Brown, but "prevent damage" does. There's no reason to use the weaker word.
  • "allow healing" is also in review as a direct quote, and which you removed
  • The statement that SCD "does not cure any diseases" is a straw man because no one (credible) claims that it does. In fact, Brown starts off her review with, "Crohn’s disease (CD) is a chronic inflammatory condition of unknown origin or cure." Why highlight it, while also removing anything about the fact that SCD does "address GI symptoms"?
  • You also reverted the addition of Crohn's disease from the list of diseases addressed by SCD, which is a direct quote from a review article that was put onto the talk page, which you ignored.
  • there is not one single Specific Carbohydate Diet, as Brown acknowledges. The first was banana, the second was Haas 1951, the third was Gottschall 1987. You removed my specification of Gottschall under details. Why?

I am having a hard time assuming good faith on your part. I see that you've been previously banned from editing anything related to GMOs for similar behavior. Please stop. Pro crast in a tor (talk) 02:23, 1 May 2017 (UTC)[reply]

Specific Carbohydrate Diet

Please see discussion at User_talk:Jytdog#Specific_Carbohydrate_Diet, which had been inappropiately pasted here in this diff, and which I removed and replaced with this note, in this same diff being signed now. Jytdog (talk) 18:14, 21 November 2018 (UTC)[reply]

3O Response: The 3O request asks about the reversions (two total), which I see were made by two different editors (only one of whom posted to this discussion). That is a perfectly normal practice on Wikipedia, called Bold-Revert-Discuss (BRD). Editors are encouraged to be bold in editing; if someone opposes the edit, they are free to revert it to the earlier version. The two editors can then discuss the edit, along with any other editors who are watching the article, and try to find a consensus (agreement) on what is the best way to present the article. Reinstating the edit (reverting the revert) or BRR without consensus is generally frowned upon and may be considered disruptive editing.
Discussion requires good faith efforts from all parties, hearing each other out and considering the merits of different approaches. Editors often cite various Wikipedia policies and guidelines, which represent the collective wisdom of the community. One should make an effort to understand these when they are brought up in a discussion; becoming aware of the issues helps move the discussion forward.
Wikipedia's policies for sources are a bit more restrictive when concerning biographies of living persons (BLP) and medicine, which can be difficult subjects for a new editor. Wikipedia:Identifying reliable sources (medicine) and Wikipedia:Manual of Style/Medicine-related articles identify some of the issues. Based on those guidelines, I generally support the reversion (I have not examined every detail.
@Beall4: I notice that you only have 9 edits on your account; a major rewrite to a medical article may present a very steep learning curve for you. I would advise that you instead propose smaller edits, or try editing less-difficult topics to learn the process. Alternatively, you can experiment with editing in your sandbox. You can ask for further assistance at The Teahouse, a user group which specializes in helping new users. There's a lot to learn about how Wikipedia works, and I hope this does not discourage you from editing. – Reidgreg (talk) 17:52, 21 November 2018 (UTC)[reply]

Thank you for taking the time to give a third party opinion. I am confused about the process, as I understand wikipedia is designed to have discussion on the content to achieve the most accurate representation of the data. We have not had any discussion on the content to resolve the matter, and it is described above that the revision is not reviewed in detail. The reason to support the reversion it seems is based on the experience of editing rather than the content. Yet, in my initial discussion with jytdog as posted above, I am told that experience or credentials do not matter in this space. Although I am not "experienced" with wikipedia, I have a great deal of experience with the subject matter of this article, as a speaker on the topic. I would like to have a discussion about the content please. The revision is a more in depth and accurate representation of the science. If there are specific references that would be advised to change if the ones listed are felt to be too primary, I can provide alternate secondary sources. In order for wikipedia to be the described venue for constant improvement, the discussion of the science is most pertinenet. I agree discussion is paramount to resolving an issue, so it is disappointing that the revision was reverted back so quickly that it would not have been possible to even have read it, and furthermore discussion upon the detail was not welcome nor continued.01:42, 26 November 2018 (UTC) — Preceding unsigned comment added by Beall4 (talk • contribs)
What Reidgreg is talking about, is understanding the policies and guidelines here in Wikipedia. That does matter. You are completely ignoring WP:MEDRS. If you do have "alternate secondary sources" as you say, please post the citations here so we can discuss them. Ideally you will have read MEDRS before posting, and only post ones that you believe satisfy the criteria there (which are not at all hard to understand for someone in the field of medicine). Thanks. Jytdog (talk) 02:10, 26 November 2018 (UTC)[reply]
@Beall4: Please don't copy and paste conversations from other pages here, as it makes a mess and doesn't properly provide context for the discussion. Instead, propose specific changes to the article, with reliable sources, and gain consensus here. You are unlikely to ever get consensus for replacing the entire content wholesale, but proposals for incremental changes are welcome. Bradv 17:10, 26 November 2018 (UTC)[reply]

If needed I can summarize the conversation below but it seems more clear to include the last point of discussion to continue the conversation. Please review the revised article and compare it to the existing one. As per the talk page on this article, it is in great need of updating as the references are as old as 2012. I have provided 23 references, most of them from 2017 and in order to bring the article in date, it requires complete revision. I have stated my reasons for revising it, following the guidelines, and the criticism was in the references. Please continue the conversation below regarding the content of the article.Beall4 (talk) 17:31, 26 November 2018 (UTC)beall4 26 November 2018[reply]

The first three references you cited were from 1951, 1955 and 1963. The 4th ref is to a book by a nonspecialist first printed in 2004, and the fifth was a spam link to the website of the author of that book. These citations have nothing to do with the criteria described in MEDRS. If you write here again without reading MEDRS and engaging with the edit you actually made, i will close this discussion and will ask you not to post here again. This is not a matter of "feeling" - MEDRS offers objective criteria and you need to actually engage with it. Jytdog (talk) 23:21, 18 November 2018 (UTC)

The first reference is actually the same that is currently used on the existing page, and the second two are from medical journals written by the founder of the diet. The fourth is the same reference currently used on the existing page and the fifth links to the author. Are these the only references that you have concern with as to not meeting the criteria of MEDRS? — Preceding unsigned comment added by Beall4 (talk • contribs) 02:07, 19 November 2018 (UTC) — Preceding unsigned comment added byBeall4 (talk • contribs)

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