This is a fun paper, clearly the authors have pre-determined that carnivore is non-evidence-based misinformation. I generally support their conclusion - All professional statements should be evidence based. The schism is what we consider sufficient evidence to provide advice. I'm personally not compelled by observational epidemiology with tiny hazard ratios and meaningless absolute risk.

Fernández et al. assessed misinformation on nutrition-specific topics in social media as a growing problem and identified audio-visual networks, such as Instagram, YouTube, and TikTok, as particularly associated with the spread of nutrition-related misinformation

The authors start off setting up carnivore as misinformation. Yet they don't support this.

Advocates of this approach promise far-reaching health benefits, which they attribute to the elimination of supposedly harmful plant-based foods.

Their framing language reinforces the author's personal bias.

these advantages contrast with prevailing recommendations that favour a balanced, plant-based diet for healthy individuals

Wait, I thought they wanted evidence based, yet they are using opinions as their counter factuals?

The CD lacks numerous plant compounds which are considered beneficial to health, such as bioactive substances and fibre [16,17,18,19,20]. Moreover, an elevated meat consumption is associated with the development of various diseases and reduced longevity [21].

Considered means opinion, associated is not causation. The metabolic context is a important consideration when saying something is beneficial.

Despite the growing popularity of CD`s on social media, knowledge in this young field of research is still limited.

A valid statement, which also means they can't classify things as misinformation because the research is limited (by their own admission).

Currently, there are hardly any significant clinical studies providing information on the short- and long-term effects of a CD.

Valid! The evidence base is small, including pro, and cons. Including classification of misinformation... in fact saying it's lacking something is a concern is also misinformation not informed by evidence by their own standards.

The following hashtags were used to focus the research account’s algorithm on carnivore topics: #plantfreemd, #carnivore,

Oh hey, they are looking at Anthony Chaffee.

detailed categories: Body, Movement, and Exercise (a1–a4), Food (b1–b4), Nutrition (c1–c4), Politics and society (d1–d5), Lifestyle (e1–e3), and Advertising (f1–f4). For example, the main category “Lifestyle” included the subcategories “mental and psychological strength”, “sports and physical activity”, and “health-related recommendations”.

The fact they are going through gymnastics to paint this as a political thing is funny. Yes Carnivore Doctors talk about health policies, but that isn't the same as typical political content, even though that is how they try to frame everything.

Microsoft Excel 365 was used for data maintenance and evaluation, employing descriptive statistics such as mean, median, standard deviation, and percentages

Ohh, didn't pass their python elective? Excel it is.

Ok, this is wild, their selection criteria was heavily curated, but then they try to draw demographic conclusions based on the people they selected with bias? what is this? Why are they even doing it? The limited themselves to 17 people.... not a random sample of their hashtags...

Food (45.7%); Politics and Society (31.6%); Advertising (25.1%); Lifestyle (22.8%); Nutrition (17.1%); Other (14.8%); Body, Movement, and Exercise (12.5%; Table 2).

Politics and society includes what exactly? If your trying to make health into a red vs blue political issue you should at least define what political content means.

Environmental issues (6.6%) and economic issues (4.1%) were found to be less relevant.

Ohh, politics includes being concerned for the environment. So even if every one of their tiny selection was a farmer... who only cares about soil health they would be painted as a political stooge in the abstract, fun.

climate change downplaying (30.2%), animal ethics (16.3%), and, in one case, raising awareness of food waste (4.7%).

A single post was 4.7% of their dataset! what the fuck is this. How do they define downplaying? Saying cows are good for the earth?

Based on quantitative data collection and qualitative content analysis, the following dietary recommendations were extracted from the sample in descending order of frequency:

• 1. High-fat red meat should form the basis of a CD.
• 2. Eggs and animal fats are important sources of nutrients after red meat.
• 3. White and processed meats can be consumed. When it comes to processed meat, choose less processed varieties.
• 4. Dairy products can be included in the diet. Dairy products with a high fat content and low carbohydrate content are preferred. Raw dairy products are recommended.
• 5. Fish, seafood, shellfish, and organ meats can also be added to the diet.
• 6. Do not consume highly processed foods.
• 7. Do not consume plant-based and carbohydrate-rich foods.
• 8. Do not consume seed oils.
• 9. When choosing foods, prefer the following: pasture-raised animal products, organically produced foods, wild-caught fish, and products from grass-fed animals.
• 10. Consume enough salt.
• 11. Dietary supplements are usually unnecessary.
• 12. A CD can be used as an elimination diet.

All of this seems fine, except maybe organ meats, and raw dairy

From a nutritional perspective, food choices in a CD tend to correspond to a high-risk dietary pattern due to the high consumption of animal-based foods and the avoidance of plant-based foods.

Evidence based! Where?

Consuming meat products is often linked with an elevated risk of diet-related illnesses and a higher number of disability-adjusted life years [28, 29].

Ohh, observational epidemiology with meaningless absolute risk... of course

Paradoxically, the main motivation for many carnivores is maintaining and achieving good health

A scientific person would ask if they are achieving the good health they desire rather then assuming they don't and calling it a paradox. EVIDENCE BASED, REMEMBER?

According to the collected data and the derived dietary recommendations, the CD is a high-fat, high-protein animal-based diet which excludes the consumption of plant-based and (highly) processed foods. The resulting pattern of macronutrients positions the CD as a low-carb-high-fat (LCHF) diet, which, depending on how it is practiced, can potentially induce ketosis.

If you are not in ketosis on a carnivore diet, it's not a carnivore diet.

There are no known recommendations regarding the proportion of energy that should be consumed from fat, protein or carbohydrates in a CD.

Have they done ANY research on LCHF before writing this paper? All their references are plant based observational epidemiology and opinions. There are many recommendations, the % of energy from protein doesn't change on carnivore, and they must know it... the rest is fat.. you replace the carbs with fat. Thats the key.

Due to the high protein intake, it can be assumed that the resulting increase in gluconeogenesis either counteracts ketogenesis or results in only low concentrations of ketone bodies in the blood.

Evidence based! Where is the evidence that carnivore is high protein? That is an assumption pulled out of their observational hole.

Therefore, a possible explanation for the reported positive effects of a CD, such as weight loss, improvement of autoimmune and diabetic diseases, and anti-inflammatory effects could be based on an LCHF or ketogenic approach

Could be, why are we speculating? This is a discussion of social media activity, yet here we are in the discussion going over all the authors straw men arguments based on ideas without evidence.

The CD’s high protein content could also be responsible for the weight loss, as people tend to eat less at subsequent meals after consuming a protein-rich meal, leading to lower energy intake

And fat, don't forget fat... since its a fat based diet. I mean really, they are calling out Anthony Chaffee in the paper, why didn't they talk to him to get some of their discussion questions worked out?

The carnivore lifestyle, which emphasises health-related topics such as sports, exercise, and mental health, coupled with limited food selection, could - additional to ketogenic-related metabolic mechanisms - contribute to a negative calorie balance, which is a key factor in weight loss.

Oh, mother fucker, this is rich.. Evidence based WHERE? They are ASSUMING THE CICO MODEL..... Which any of the 10% of the doctors they just studied could have told them isn't the right model, its about hormones.....

Thus, the health improvements could be partially due to the placebo effect.

Could be, why don't you do a study to get some evidence...

Taken together, these factors highlight the tension between perceived benefits and the potential health risks suggested by current evidence.

Bias again... the only evidence they have is observational, no case reports, no studies... they want evidence based recommendations but their own discussion can't limit to the established evidence. But lets say Observational is sufficient, then they HAVE A DUTY to mention the pro-meat observational studies (which are still trash), and they would have to change their conclusion to something like 'while evidence is divided, the perceived benefits of the diet should be confirmed by interventional trials'