The Black Liszt

Category: Heart Health

  • Summary: The Medical-Industrial Complex

    Modern medicine can do wonderful things. I benefited from remission of an extremely rare form of cancer that was made possible by advances in the last couple of decades. At the same time, a great deal of what is done in medicine is controlled by the Medical-Industrial Complex, which causes untold waste and harm. These posts document the tip of that iceberg as my health journey has led me.

    I’ve long had a concern that what doctors do often doesn’t follow the clear evidence. For example, here’s a case of blatantly ignoring standard practice with something simple.

    https://blackliszt.com/2016/12/what-can-cats-teach-us-about-healthcare.html

    No big deal. But then I encountered something far more serious. I tell the start of my story here, about heart symptoms caused by blood pressure pills.

    https://blackliszt.com/2022/07/the-destructive-treatment-of-hypertension.html

    The next part of my story is when I discovered there’s a large study demonstrating that taking blood pressure pills doubles your chances of getting AMD, which makes you blind.

    6a0120a5e89f23970c02a2eecdf5e7200d

    https://blackliszt.com/2022/07/blood-pressure-pills-can-make-you-blind.html

    It’s a study that none of the relevant doctors ever tells you about.

    I backed up and studied hypertension. Expert opinion on the subject is united.

    https://blackliszt.com/2022/05/the-experts-are-clear-control-your-blood-pressure.html

    When you dig past the pronouncements of authorities, you discover that hypertension isn’t even a disease.

    https://blackliszt.com/2022/06/the-facts-are-clear-hypertension-is-not-a-disease.html

    So what happens when you stop taking the pills? At least in one anecdotal case, things change in good ways, and in any case, no harm.

    https://blackliszt.com/2022/11/how-to-cure-amd-macular-degeneration.html

    More digging led me to the bogus, incredibly destructive diet-heart hypothesis, proven false by the evidence but promoted on food packages and everywhere else.

    https://blackliszt.com/2021/12/trusting-science-the-whole-milk-disaster.html

    The idea is that eating red meat and full-fat dairy leads to heart disease.

    https://blackliszt.com/2022/02/the-experts-are-clear-dont-eat-much-saturated-fat.html

    When you dig past the propaganda, you learn that saturated fat is an essential and healthy part of your diet.

    https://blackliszt.com/2022/03/the-facts-are-clear-eat-lots-of-saturated-fat.html

    Eating saturated fat is supposed to increase your blood cholesterol, which leads to heart trouble, they say.

    https://blackliszt.com/2022/02/the-experts-are-clear-keep-your-cholesterol-low.html

    The widely-prescribed drugs that lower cholesterol don’t help with heart disease and cause problems of their own.

    https://blackliszt.com/2022/04/the-facts-are-clear-dont-take-cholesterol-drugs.html

    There is strong evidence that bad diet recommendations based on the bogus diet-heart hypothesis is a leading cause of the obesity epidemic that continues to worsen.

    https://blackliszt.com/2022/04/the-forbidden-question-what-caused-the-obesity-epidemic.html

    The current recommendations for diet and medical treatment of obesity continue the madness.

    https://blackliszt.com/2022/09/the-medical-treatment-of-obesity.html

    Exactly what ingredients are in the food you eat is crucial. Places that advertise that they’re healthy can be tricky and require careful study of ingredients:

    https://blackliszt.com/2021/06/ingredients-whole-foods-sneaks-in-sugar.html

    The ingredients of things that aren’t food should be read carefully:

    https://blackliszt.com/2021/04/ingredients-and-truth.html

    Many people receive reminders to get things like blood pressure and cholesterol checked so that drugs can be prescribed “if necessary.”

    https://blackliszt.com/2023/02/be-healthy-and-dont-schedule-your-heart-health-visit.html

    Disease Prevention and Testing

    Disease prevention sounds like a great idea. So does early detection of bad things. When you dig into the evidence and the numbers, a different picture emerges.

    Screening for colon cancer is a multi-billion dollar industry. The only large-scale study that’s ever been done shows that it doesn’t result in longer life.

    https://blackliszt.com/2023/01/value-of-colon-cancer-screening.html

    Everyone is supposed to get an annual flu shot. The CDC’s own numbers and massive studies show that you’re better off without it.

    https://blackliszt.com/2022/12/flu-shots-propaganda-reality.html

    Vaccine efficacy is often mentioned. Its technical meaning can be found, but the authorities rarely mention it. A large efficacy can still mean that you only have 1 chance in a hundred of being helped by the drug.

    https://blackliszt.com/2022/09/does-vaccine-efficacy-of-95-mean-i-wont-get-sick.html

    Your chances of being helped (NNT, Number Needed to Treat) must be considered along with the chances of being harmed, a thing that is too-often ignored.

    https://blackliszt.com/2022/09/nnt-for-benefits-and-for-harms.html

    The studies that are supposed to show treatment effectiveness are too often biased, and (shockingly) backed by data that is kept secret by law. If the treatment is wonderful, why keep the data secret?

    https://blackliszt.com/2022/11/revolutionize-health-by-making-medical-data-and-studies-open-source.html

    There is a proven path to make drug discovery and testing a quantum leap better. All the authorities and experts ignore it.

    https://blackliszt.com/2017/01/using-software-methods-to-speed-drug-discovery.html

    Given the results, the common-sense idea of wellness visits stops making sense in most cases.

    https://blackliszt.com/2023/02/be-healthy-and-schedule-your-annual-wellness-visit.html

    Of course there is a great deal more to be said on this subject. There are true experts, far more qualified than I am, some of whom are referenced in the above posts. My intention is these posts was to detail the journey that a normal patient took from trusting and naive to the opposite. Again, there are wonderful benefits for patients from doctors and hospitals; but not everything that is recommended is wise to take/do.

  • Blood Pressure Pills can make you Blind

    As a direct result of ridiculous, anti-scientific standards, pills to lower blood pressure are the mostly widely prescribed pills in the US, with over 100 million people supposedly cursed by the “disease” of hypertension. Did you know that there’s a never-refuted medical study published by the American Academy of Ophthalmology and sponsored by the National Eye Institute (part of NIH) showing that taking those pills greatly increases the risk of going blind? I didn’t think so.

    AMD: Age-related Macular Degeneration

    More than 11 million people in the US have this disease. It mostly affects people 60 and older. The most common variety of it – dry AMD – is progressive and has no cure. Eventually it leads to complete loss of vision. Here is the NEI description of the disease, its causes, prevention and non-cures. You will notice that there is NO mention of blood pressure medication.

    I have described the largely suppressed side effects of blood pressure medication, and my path to freedom, with the result that I'm not taking the pills and I'm healthier. Two years ago I was diagnosed with early stage AMD. After resolving the issue with harmful blood pressure pills, I decided to see if the pills also impacted AMD. While it wasn't too hard to find out about the side effects of blood pressure medications, including the ones related to heart health I experienced, I hadn't seen anything about vision in general, much less AMD. I decided to look harder.

    I mostly found things like this from the Cedars-Sinai website:

    111

    In other words, they don't really know. And they clearly state that "uncontrolled high blood pressure" — in other words, failure to take blood pressure medicine when you "should" — is a cause.

    OK, let's go to the professionals. the American Academy of Ophthalmology. What do they say about blood pressure drugs and AMD?

    11

    This blows me away. The very first risk factor they list is the garbage about saturated fat. Totally wrong. This is the cornerstone of the explosion of obesity that harms so many and has nothing to do with AMD. I'm suspicious. Scanning down the list, I see one of the causes they list is "have hypertension (high blood pressure)." Not "treating" it or "taking blood pressure medications," but simply "have" it. In the linked article about high blood pressure, they simply declare that it can lead to big trouble, and "can cause permanent vision loss." OMG! I'd better start taking pills to get my blood pressure under control!

    I guess it's clear. Whatever the cause of my AMD, it can't be the blood pressure pills I took for eight years.

    The Beaver Dam Eye Study

    Stubborn guy that I am, I kept looking. I found a little eye group in the DC area that promotes its services. I found them because my search engine surfaced two closely related blog entries on the site, one of them titled "The Link between Blood Pressure Drugs and AMD," a close match to my search string. Score! The second sentence of the post is: "If you take medication to lower your blood pressure, it’s important to know that you could be increasing your risk of developing AMD, or age-related macular degeneration." The bold was in the original!

    Both blog posts give a reference to the 2014 study and extract some details, all of which I have verified. Here is the attention-grabbing sentence from the blog post: "For residents who were not taking blood pressure drugs, only 8.2 percent of them developed early AMD. For residents who took medication for high blood pressure, nearly 20 percent of them developed AMD."

    The chances of getting AMD were more than doubled by taking the drugs.

    Here are the highlights of the study.

    Screenshot 2022-07-20 173158 T

    In short, thousands of people in a Wisconsin town were followed over 20 years, tracking their use of blood pressure medication and the incidence of AMD. Here is the conclusion at the top of the paper:

    Conclusions: Use of vasodilators is associated with a 72% increase in the hazard of incidence of early AMD, and use of oral b-blockers is associated with a 71% increase in the hazard of incident exudative AMD. If these findings are replicated, it may have implications for care of older adults because vasodilators and oral b-blockers are drugs that are used commonly by older persons. Ophthalmology 2014;121:1604-1611 ª 2014 by the American Academy of Ophthalmology.

    Whatever the chances of you getting leads-to-blindness AMD are, you increase them by about three quarters by taking widely-prescribed blood pressure pills. Still think lowering your blood pressure is worth it, particularly considering the proven facts I describe here?

    So where are the headlines? Where are the cautions about the vision-killing side effects of blood pressure drugs? Where are the follow-up studies? Where are they on the websites of major public and private healthcare organizations? Nowhere, that's where they are. Nowhere!!

    It's clear that this isn't just ignorance. It's suppression. Just above I showed how there's no hint of a problem with blood pressure pills on the official AAO website. When I did a full search on Google for "AMD blood pressure," instead it showed me results for "And blood pressure." I corrected it and mostly found propaganda, but did find a reference to the Beaver Dam study. When I used my favorite non-Google search engine, which I like because they don't have thousands of engineers hard at work adding bias to the results, the very first result was a direct link into … the AAO website! … to a news item about the Beaver Dam study! The Expert-fueled AAO organization put a brief post on their site about the study, but failed to mention it anywhere else! Not only that, when you use their embedded (Google) search facility on the site, their own post fails to appear in the results!

    Why do you suppose that is? Pharma money? What about the ethics of the healing profession, not to mention their self-respect? Given the near-total suppression of the information, I suppose simple ignorance could explain the actions of most providers, along with "standards of care" that demand regular taking of blood pressure and prescribing medications according to standards. Which are wrong, not to mention destructive.

    I paid to get a copy of the full study. It had important information not included in the brief summaries. Look at this extract from Table 4 near the end of the paper:

    111

    The first line is the one often quoted. Let me show the math. Of the 2714 people in the study, 295 of them (more than 10%) got AMD because they were taking the BP pills.

    I took two pills for eight years. One was Amlodipine, a calcium channel blocker, which in the study nearly doubled the chance of getting AMD. I also took Losartan, an ARB, which had zero percent AMD — not because it was innocent, but because as shown in an earlier table, almost none of the participants took it. It could be awful, but the study was too small to know.

    An earlier table also showed the incredible extent of BP medication use. About a third of the participants in the youngest age group (under 64 years) took medications, while over two thirds of those over 85 were taking them. Most of whom shouldn't have been taking them at all! I  wonder, just wonder, if this could have something to do with the increasing incidence of AMD with age — you think that's a possibility that should be studied?

    Conclusion

    I used to think that the pharma and the industrial food industries make mistakes, like any industry, and you have to take the good with the bad. There is certainly some good. But the more I learn, the more I discover the all-too-widespread shameless self-dealing of the industries, strongly supported by government agencies and professional authorities. They force through regulation putting misinformation on our food and our diets in hospitals, and are making billions of dollars selling pills that are standard procedure for preventative care that, instead of keeping us healthy, actively make us sick — even to the point of making us blind — along with numerous other problems I have briefly touched on in prior posts.

     

  • The Destructive Treatment of Hypertension

    I’ve talked about how all the medical authorities are united in the importance of fighting the “silent killer” of blood pressure that’s too high, i.e., hypertension. I’ve described in detail that what doctors call ‘essential hypertension” is NOT a disease. Fighting the non-disease of hypertension is an ongoing bonanza for doctors and the drug companies while leading to serious problems for patients.

    In this post I’ll describe my personal experiences that led me to these observations. What happened to me was not unusual, and others have had it worse than I have.

    Getting Cancer and Hypertension

    Eight years ago I developed a rare form of cancer, desmoid tumor, of which there are about a thousand cases a year. I was treated with drug infusions. The drugs sometimes have bad effects on the heart, so I received tests and a consultation with a NYC cardiologist. She told me I had high blood pressure that must be treated immediately. I was surprised since my reading had always been low, but complied, ending up taking daily doses of Amlodipine and Losartan.

    This was unusual for me, because I normally dive in and check for myself everything that’s important to me. I didn’t in this case. I was consumed with my study of my rare cancer and the ineffective early advice I got. I found the one doctor in the country who knew how to treat it. The blood pressure seemed like a bump in the road at the time. My bad.

    I kept up with the daily drugs after that, with new prescriptions issued by my primary care doctor with minor adjustments. Not once did any doctor mention anything about side effects. I felt OK and did no research.

    About a year ago I started monitoring my blood pressure myself because I began experiencing symptoms it was hard to put a finger on. I knew the drugs I was taking were generics and had discovered the widespread corruption of generic drug makers and the ineffectiveness of the quality monitoring conducted by the FDA. I asked my primary care doctor for prescriptions for the branded versions of the drugs, which I hoped were more carefully monitored. I discussed in detail with my local CVS pharmacist, who ultimately was unable to get the drugs.

    Symptoms of Heart Trouble

    The symptoms increased. In March 2022 I had a tough time driving with symptoms that included being light-headed and a heart pulse rate that was high for me, as though I were exercising. I went to my primary doctor who gave me some tests including an EKG. With inconclusive results, she referred me to a cardiologist. The cardio guy gave me lots of tests, including an electro-cardiogram, a nuclear stress test, a week-long Holter monitor. This all took a few weeks.

    Meanwhile, I did what I should have done eight years ago – dove in and studied heart function and blood pressure. It didn’t take long for me to discover – surprise! – that the symptoms I experienced were the same as side effects of the drugs I was taking, and were widely reported by patients online. I tried to get FDA data on them and discovered the great lengths the FDA goes into order to keep drug adverse reactions as secret as possible – kind of like the way medical offices say you have full access to your medical records, except that they prevent it, as I have described in detail.

    I brought up the subject on my next visit with the cardiologist. He immediately dismissed the possibility. He refused to discuss it or take seriously the possibility that my symptoms were due to the drugs that he and all the other members of his profession profusely prescribe.

    After that I took matters into my own hands. I stopped taking the drugs after the last test was conducted, in order to avoid confusing the results. I continued daily blood pressure readings, sometimes more often.

    I finally got the results of all the tests. Nothing was wrong with me – except of course when you monitor for seven days straight, sometimes your heart beats fast. It’s scary! It’s called supraventricular tachycardia (SVT). Once or twice a day, for a dozen beats at a time and on the low end of the "fast" scale. Call 911! My valves are fine, no blockages, no Afib, etc. etc. His recommendation? Consult one of his friends to get either a pacemaker or a six hour operation to zap random bits of my heart in hopes that the scary SVT would go from 0.001% to zero. Maybe. NFW, thanks anyway, esteemed board-certified cardiologist.

    My first step after stopping the drugs was to start taking a well-reviewed natural heart-health additive based on L-Arginine. After 3 weeks I was better, but not satisfied. So I just stopped messing with my body and its extremely complex mechanisms. After my body cleared out, I was much better.

    The blood pressure numbers are interesting:

    Average        Systolic         Diastolic

    with drugs     137              64

    L-Arg only     157              74

    nothing          144              65

    Taking no blood pressure or other drugs resulted in Diastolic numbers that were unchanged and Systolic numbers that were 7 points higher, well within a healthy range, though not according to current cardiologist drug-pushing fashion.

    Side effects of blood pressure control drugs

    There are lots of non-government places to learn about the side effects of the awful blood pressure drugs — thanks, internet! No thanks at all, cardiologists! — and even published studies that show 10% of participants in studies dropping out due to the intolerable side effects.

    Here are a few samples of problems with Amlodipine from a data-rich site.

    fast, irregular, pounding, or racing heartbeat or pulse

    Common (1% to 10%): Palpitations, ankle edema

    Amlodipine has an average rating of 3.7 out of 10 from a total of 571 ratings for the treatment of High Blood Pressure. 20% of reviewers reported a positive experience, while 61% reported a negative experience.

    41% gave it 1 star out of 10

    Common in reviews below: “feeling lightheaded, heart palpitations and arrhythmia”

    After 35 years of taking it, “I took myself off of 2 years ago, but could not get through the withdrawals. It caused my heart to feel like it was beating out of my chest”

    After starting “suddenly I felt dizziness I went to ER they admitted me to the heart hospital. I was told I needed a pacemaker. I declined.”

    After strong heart beat “I attended a pre-operative assessment where I was given a routine ECG and this confirmed that I had become tachycardic while taking amlodipine. My pulse was racing at over 100 BPM”

    After stopping “Five weeks later I still have the tinnitus”

    After 6 years, “worse side effects have been; heart pounding/palpitations, fatigue, and increased anxiety…. I stopped taking the Amlodipine Besylate 10 mg. over 3 weeks ago and and have noticed that my energy level has increased, anxiety lessened and heart pounding decreased.”

    After 18 months “… anxious. Couldn't sleep, couldn't concentrate. I noticed muscle tics all the time, heart palpitations, more joint pains, memory loss and more. …I had myself convinced I had contracted some fatal condition (ALS, MS, etc…). After every specialist I could find, we decided it was anxiety. Then one day I read someone's account of anxiety and amlodipine. …try a switch. Today I am back to my old self.”

    Conclusion

    I have re-learned one of life’s most important lessons: if you want to be healthy, take charge of your own health. It’s your health, no one else’s. You own it, you have to live with it. There are experts and authorities all over the place who are lined up to tell you what to do. They want you to pay them, take drugs and undergo invasive procedures. Most of these people are highly trained and well-meaning. They sometimes know things that are worth knowing. They can be of great help. It’s worth listening. But it is not worth mindlessly following their orders, because their profession’s best, standard advice is all too often wrong. WRONG. And not just wrong – actively harmful.

    Once I took my health into my own hands eight years ago, I found a truly expert doctor who brought my nasty rare cancer into remission, a place where I hope it’s happy. On the path, I stupidly and without examination followed doctor’s orders about blood pressure, following advice given to nearly half the population of the US. How could it possibly be bad? Easy. The same way the nutrition advice given to ALL the US population was and remains highly destructive, leading to the ongoing obesity epidemic and widespread avoidable suffering. The same way bad science about blood cholesterol has led to the most profitable drug in pharma history, treatment which shortens lives and makes patients less healthy.

    The good news is that you’re not alone. There are dedicated people devoted to discovering and putting out the facts so that diligent, self-reliant people can find out what’s best for their health, most importantly for those cases where the medical profession stubbornly clings to destructive error, as it has so often in the past. It’s your health. Own it!

  • The Facts are Clear: Hypertension is not a Disease

    The medical community, organizations and government agencies couldn't be clearer: hypertension (high blood pressure) is a silent killer. You may not feel anything wrong, but if you've got it, your risk of strokes and heart failure goes way up. Therefore it's essential to monitor and treat this deadly condition.

    They're all wrong. Hypertension is not a disease that needs to be cured. It may be a symptom of a problem, but not a problem itself, just like fever is a symptom, not the underlying problem. By treating it as a disease and giving drugs to lower blood pressure, the medical establishment makes patients less healthy and raises costs substantially. With a few exceptions, we would all be better off ignoring blood pressure and most of the associated advice.

    Drugs for "Curing" Hypertension

    The single most prescribed drug in the US is for lowering cholesterol. But most prescriptions for a disease are to reduce blood pressure.

    Screenshot 2022-04-23 152522

    Here's the story with blood pressure pills.

    In fact, a majority of the most prescribed drugs in the U.S. are used to treat high blood pressure or symptoms of it. That’s because 108 million or nearly half of adults in the U.S. have hypertension or high blood pressure.

    Is Hypertension a Disease?

    There is no doubt that blood pressure can be measured and that it varies greatly. What is hypertension? As I describe here, currently it's a systolic pressure reading above 120 (until 2017 it was above 140). There are lots of things you can measure about people. What makes this measurement bad?

    There's a clue buried deep in Doctor-language, a clue that is nearly always missed — but it's one that doctors with a basic education should know. The official name for high blood pressure is essential hypertension. What's that? Let's ask Dr. Malcolm Kendrick, a long-experienced cardiologist:

    At medical school we were always taught – and this has not changed as far as I know – that an underlying cause for high blood pressure will not be found in ninety per cent of patients.

    Ninety per cent… In truth, I think it is more than this. I have come across a patient with an absolute, clearly defined cause for their high blood pressure about five times, in total, and I must have seen ten thousand people with high blood pressure. I must admit I am guessing at both figures and may be exaggerating for dramatic effect.

    Whatever the exact figures, it is very rare to find a clear, specific cause. The medical profession solved this problem by calling high blood pressure, with no identified cause, “essential hypertension”. The exact definition of essential hypertension is ‘raised blood pressure of no known cause.’ I must admit that essential hypertension certainly sounds more professional than announcing, ‘oh my God, your blood pressure is high, and we do not have the faintest idea why.’ But it means the same thing.

    Hypertension = your blood pressure number is high. Kind of like having a high temperature, which we call a "fever," right? Wrong. When you get a fever, doctors first make an effort to determine the cause of the fever! What an idea! The fever is a clue that something is wrong, not the problem itself! Here's the real, bottom-line clue: When you treat fever you treat the underlying cause e.g. bacterial infection, NOT the fever itself! If we treated fever the way we treat hypertension, we would give drugs whose sole purpose was to lower the body temperature, ignoring the underlying bacterial infection that caused the fever. Wouldn't do any good! Maybe we'd sweat less, but the bacteria would rage away inside our bodies. But high blood pressure? Doctors ignore the cause and "treat" the symptom, which can often do more harm than good — except of course for the drug makers, who make out just fine.

    Makes me sick.

    Causes of hypertension

    From Kendrick:

    So, why does the blood pressure rise in some people, and not in others. It is an interesting question. You would think that, by now, someone would have an answer, but they don’t. Or at least no answer that explains anything much.

    Just as fever is caused by an infection (or something else), could it be possible that hypertension results from some underlying problem? Kendrick again:

    Looking at this from the other direction, could it be that cardiovascular disease causes high blood pressure. Well, this would still explain why the two things are clearly associated, although the causal pathway may not be a → b. It could well be b → a.

    I must admit that I like this idea better, because it makes some sense. If we think of cardiovascular disease as the development of atherosclerotic plaques, leading to thickening and narrowing of the arteries then we can see CVD is going to reduce blood flow to vital organs, such as the brain, the kidneys, the liver, the heart itself.

    These organs would then protest, leading to the heart pumping harder to increase the blood flow and keep the oxygen supply up. The only way to increase blood flow through a narrower pipe, is to increase the pressure. Which is what then happens.

    Over time, as the heart is forced to pump harder, and harder, the muscle in the left ventricle will get bigger and bigger, causing hypertrophy. Hypertrophy means ‘enlargement.’ So, in people with long term, raised blood pressure, we would expect to see left ventricular hypertrophy (LVH). Which is exactly what we do see.

    He goes on to give lots of detail about how this takes place, if you're interested.

    Correlation and Causation

    There's a little problem that everyone who knows about science and statistics is supposed to know. It's the difference between correlation and causation. Two things seem to happen at the same time. They are correlated. No problem. But does one of the cause the other? That's a whole other thing, and it's super-important. At McDonald's, burgers and fries are often seen together. They're correlated. Did the burger cause the fries? Fries cause the burgers? Nope. They're just listed together on the menu and lots of people like them together.

    How about knife cuts and bleeding? Definitely correlated. Causation? By looking at repeated cases of knives making cuts, you can determine that putting a knife into someone's skin nearly always causes bleeding.

    This is the problem at the heart of hypertension — except perhaps in extreme cases, hypertension can be correlated with heart attacks and strokes — but it can't be shown to cause them in the vast majority of cases.

    The range of blood pressure

    The authorities don't like to talk about this, but blood pressure varies HUGELY not just from person to person, but also by age and for a single person during the day!

    Here's something to give you the idea from a scientific paper:

    Screenshot 2022-05-26 154740

    The range of pressure for a single person can be rather larger. I just took my pressure this morning. The systolic was 126. In the previous days the readings were 159 and 139.I have taken my pressure with different devices over a year, and that variation is not unusual. It can vary that much in a couple hours, depending on my activity level.

    It is well-known in the medical community that blood pressure varies naturally with age, generally rising as you get older. Has anyone documented this statistically? If they have, I can't find it. Generally, what is normal is roughly 100 plus your age, so a 50 year old man would have 150, roughly 10 less for women. Here is an interesting description of the age factor from a former NASA astronaut and doctor.

    The assumed causation fails to hold

    A surprising amount of modern medical misinformation goes back to the diet-heart hypothesis put forward by Ancel Keys and supported by the seven countries study. It's what led to the obesity-causing fat-is-bad diet recommendations and the ongoing harm of reducing blood cholesterol using statins. Out of the same witch's brew came the notion that high blood pressure causes heart disease.This notion was supposedly locked down by the famous Framingham study, which continues to this day.

    In the year 2000, the edifice crashed when a careful review was published in the journal of the European Society of Cardiology, "There is a non-linear relationship between mortality and blood pressure." It includes references to the original Keys study and many following journal articles.

    The article is prefaced by a quote that is so appropriate, I can't help but share it with you:

    "For every complicated problem there is a solution that is simple, direct, understandable, and wrong." H. L. Mencken

    The authors start by explaining the current paradigm:

    "the relation of SBP (systolic blood pressure) to risk of death is continuous, graded and strong…" The formulation of this "lower is better" principle … forms the foundation for the current guidelines for hypertension.

    They point out that Ancel Keys himself concluded that "the relationship of overall and coronary heart disease death to blood pressure was unjustified."

    They went on to examine the detailed Framingham study data.

    Shockingly, we have found that the Framingham data in no way supported the current paradigm to which they gave birth.

    …

    Systolic blood pressure increases at a constant rate with age. In sharp contrast to the current paradigm, we find that this increase does not incur additional risk. More specifically, all persons in the lower 70% of pressures for their age and sex have equivalent risk.

    Cardiologist Kendrick in his recent book Doctoring Data points out

    Has this paper ever been refuted? No, it has not. Sadly, it was given the worst possible treatment that can be dished out by the medical establishment. It was completely ignored.

    …

    The benefits of blood-pressure lowering, whatever the level, became so widely accepted years ago that it has not been possible, ethically,[viii] to do a placebo-controlled study for a long time. I am not aware of any placebo-controlled trials that have been done in the last twenty years, or so.

    A bit of sanity

    The same year (2017) the AHA and cardiologists were lowering the target blood pressure for everyone from 140 to 120, a group representing family physicians published an official guideline for treating hypertension in adults age 60 and over. Their method was rigorous, taking into account all available studies. Here is their core recommendation:

    ACP and AAFP recommend that clinicians initiate treatment in adults aged 60 years or older with systolic blood pressure persistently at or above 150 mm Hg to achieve a target systolic blood pressure of less than 150 mm Hg to reduce the risk for mortality, stroke, and cardiac events. (Grade: strong recommendation, high-quality evidence).

    What a breath of fresh air! And completely in line with this data-driven review that showed that a large number of people taking anti-hypertensive drugs just 1 in 125 were helped (prevented death), while 1 in 10 were harmed by side effects. Also in line with this careful study of people with elevated blood pressure in the range of 140-160; the study showed that none were helped by drugs, while 1 in 12 were harmed.

    BTW, if you're not familiar with the concept of NNT, you should learn about it. It's crucial.

    Hypertension Drugs can hurt you

    Doctors dish out hypertension drugs like candy. It's often the case that two different kinds of drugs will be required to get your blood pressure to "safe" levels. For reasons that don't seem to be studied, it's rare indeed for doctors to mention side effects; yet in repeated studies, the generally data-suppressing researchers can help but mention that the side effects are so bad that roughly 10% of study participants drop out of the study! (See above for references.)

    There are good lists of side effects at Drugs.com. Here's some information about Amlodipine:

    Side effects requiring immediate medical attention

    Along with its needed effects, amlodipine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur while taking amlodipine:

    More common

    • Swelling of the ankles or feet

    Less common

    • Chest tightness
    • difficult or labored breathing
    • dizziness
    • fast, irregular, pounding, or racing heartbeat or pulse
    • feeling of warmth
    • redness of the face, neck, arms, and occasionally, upper chest

    Rare

    • Black, tarry stools
    • bleeding gums
    • blistering, peeling, or loosening of the skin
    • blood in the urine or stools
    • blurred vision
    • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
    • chest pain or discomfort
    • chills
    • cold and clammy skin
    • cold sweats
    • confusion
    • cough
    • dark yellow urine
    • diarrhea
    • dilated neck veins
    • dizziness or lightheadedness when getting up from a lying or sitting position
    • extra heartbeats
    • fainting
    • fever
    • itching of the skin
    • joint or muscle pain
    • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
    • numbness and tingling of the face, fingers, or toes
    • pain in the arms, legs, or lower back, especially pain in the calves or heels upon exertion
    • painful or difficult urination
    • pale, bluish-colored, or cold hands or feet
    • pinpoint red or purple spots on the skin
    • red, irritated eyes
    • redness of the face, neck, arms, and occasionally, upper chest
    • redness, soreness or itching skin
    • shakiness in the legs, arms, hands, or feet
    • slow or irregular heartbeat
    • sore throat
    • sores, ulcers, or white spots on the lips or in the mouth
    • sores, welting, or blisters
    • sudden sweating
    • sweating
    • swelling of the face, fingers, feet, or lower legs
    • swollen glands
    • trembling or shaking of the hands or feet
    • unsteadiness or awkwardness
    • unusual bleeding or bruising
    • unusual tiredness or weakness
    • weak or absent pulses in the legs
    • weakness in the arms, hands, legs, or feet
    • weight gain
    • yellow eyes or skin
    Then there are the ones judged to be less severe:

    Side effects not requiring immediate medical attention

    Some side effects of amlodipine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

    Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Less common

    • Acid or sour stomach
    • belching
    • feeling of warmth
    • heartburn
    • indigestion
    • lack or loss of strength
    • muscle cramps
    • redness of the face, neck, arms, and occasionally, upper chest
    • sleepiness or unusual drowsiness
    • stomach discomfort, upset, or pain

    Those are the issues with just one of the many hypertension drugs, one of the most widely prescribed!

    Conclusion

    Blood pressure varies greatly, reflecting the human body's amazing self-regulation systems. In the vast majority of cases, blood pressure goes up with age. Lowering it by drugs does more harm than good. Except perhaps in extreme cases, high blood pressure does not cause disease. When pressure is extremely high, a search for the cause should be made. The ongoing focus on hypertension as a disease reflects nothing but the stubborn refusal of the medical establishment to admit that they were wrong, and of the pharma companies to give up a lucrative market.

  • The Experts are Clear: Control your Blood Pressure

    Most of us have heard about high blood pressure. It's one of those conditions that afflict a large number of people. Nearly half of American adults are said by the AHA to have it! You may be able to control it by maintaining a healthy lifestyle, things like avoid eating saturated fats, salt and alcohol, keeping your weight down and getting exercise. Fortunately, there are drugs that can help keep it under control.

    Why should anyone care? Strokes! Heart attacks! Premature death!

    Is this one of those things that floats in the air but isn't real? Let's take a look at what people who know what they're doing say about it.

    The American Heart Association (AHA)

    Blood pressure is all about the heart, right? So let's start with the medical association that's all about keeping our hearts healthy. They make it very clear why we should care:

    Health threats diagram

    Those folks at the AHA may be doctors who can't write legible prescriptions, but they were sure able to rope someone into producing a scary diagram! OK, you've got my attention. Here's the facts with blood pressure:

    HBP

    What can I do?? What if I maintain a good weight, eat a heart-healthy diet, cut back on salt and the rest and my BP is still scary? There are medications.

    How long will you have to take your medication? Perhaps for the rest of your life.

    OK, then. If that's what has to be done to avoid the things in the scary diagram above, then so be it.

    More American Heart Association (AHA)

    I decided to dig a bit deeper. When did they come to this conclusion?

    Here is a chart from the AHA as it was in May 2010:

    Screenshot 2022-04-15 150201

    Compare this to the same chart on the same site in April 2022, shown earlier.

    It appears some things have changed! Basically they've decided to crank up the alarm level on most of the numbers. You can observe the differences yourself; Stage 2 hypertension is a good example. In 2010 you had it if your numbers were more than 160/100, while now it's 140/90. In 2010, if your pressure was below 140, you didn't "have" hypertension — just "prehypertension." Now, stage 1 hypertension starts at 130.

    I did some research. The change happened in 2017. Here is the AHA's news release on the subject:

    High blood pressure should be treated earlier with lifestyle changes and in some patients with medication – at 130/80 mm Hg rather than 140/90 – according to the first comprehensive new high blood pressure guidelines in more than a decade. The guidelines are being published by the American Heart Association (AHA) and the American College of Cardiology (ACC) for detection, prevention, management and treatment of high blood pressure.

    The guidelines were presented today at the Association’s 2017 Scientific Sessions conference in Anaheim, the premier global cardiovascular science meeting for the exchange of the latest advances in cardiovascular science for researchers and clinicians.

    Rather than 1 in 3 U.S. adults having high blood pressure (32 percent) with the previous definition, the new guidelines will result in nearly half of the U.S. adult population (46 percent) having high blood pressure, or hypertension.

    A whole lot more people have high blood pressure! I sure hope they did their homework on this. Reading on we find:

    The new guidelines were developed by the American Heart Association, American College of Cardiology and nine other health professional organizations. They were written by a panel of 21 scientists and health experts who reviewed more than 900 published studies. The guidelines underwent a careful systematic review and approval process.

    OK, it looks like a whole team of experts was in on this one. 

    Harvard Medical School

    Better check with the people who train the best doctors. Let's make sure this is really up to date.

    Harvard

    Here's what they have to say:

    Arteries that are tensed, constricted, or rigid offer more resistance. This shows up as higher blood pressure, and it makes the heart work harder. This extra work can weaken the heart muscle over time. It can damage other organs, like the kidneys and the eyes. And the relentless pounding of blood against the walls of arteries causes them to become hard and narrow, potentially setting the stage for a heart attack or stroke.

    Most people with high blood pressure (known medically as hypertension) don't know they have it. Hypertension has no symptoms or warning signs. Yet it can be so dangerous to your health and well-being that it has earned the nickname "the silent killer." When high blood pressure is accompanied by high cholesterol and blood sugar levels, the damage to the arteries, kidneys, and heart accelerates exponentially.

    Sounds scary. Can I do anything about it?

    High blood pressure is preventable. Daily exercise, following a healthy diet, limiting your intake of alcohol and salt, reducing stress, and not smoking are keys to keeping blood pressure under control. When it creeps into the unhealthy range, lifestyle changes and medications can bring it down.

    They agree. There are pills I can take.

    Department of Health and Human Services (HHS)

    Let's make sure the government is on board. After some looking it was very clear that HHS is in favor of keeping blood pressure under control. Finding out exactly what they think and what they're doing proved to be a bit of a challenge. Here's some of the things I learned our government is doing to help us:

    • They have published standards and require reports requiring health providers to specify the frequency of visits and other things they are performing with their patient population to control blood pressure.
    • They sponsored the Million Hearts Risk Check Challenge, asking developers to create a new consumer app that informs consumers of their general heart risk, motivates them to obtain a more accurate risk assessment by entering their blood pressure and cholesterol values, and directs them to nearby community pharmacies (and other locations) offering affordable and convenient blood pressure and cholesterol screenings.
    • The Surgeon General issued a Call for Action to Control Hypertension. It's a major document issued in 2020. Sadly, the link to the document was broken, so I wasn't able to read this important initiative. But here's a helpful diagram about it:

    Hhs

    The fact that the document was issued is impressive. The section introducing it has a stirring ending: "We must act to preserve the nation’s cardiovascular health now and into the future. Together, we’ve got this!"

    Conclusion

    Governments and the big authorities in the field are united in the effort to keep us all more healthy by encouraging us all to address the "silent killer" of hypertension. They want us to address it first of all by lifestyle changes, but if that fails, medication is available to keep things under control. Even if we have to take a couple pills a day for the rest of our lives, that's a small price to pay for having a longer, healthier life.

     
    This is an issue that similar in many ways to the goal of maintaining a heart-healthy diet that minimizes saturated fat in meat and dairy products, and to combating LDL, the "bad" cholesterol in our blood; they all contribute in their own ways to keeping us healthy.
     
    We should all have our blood pressure checked and do what we have to do to keep it under control. If, that is, we want to live a long, heart-healthy life. Naturally there are contrasting views on this seemingly settled topic, for example here.
     

  • The Facts are Clear: Don’t Take Cholesterol-lowering Drugs

    I have described the background and evidence of the diet-heart fiasco — the hypothesis-turned-fake-fact that you shouldn't eat saturated fat because it raises your "bad" LDL cholesterol, which causes heart disease. Not only is it wrong — eating saturated fat is positively good for you!

    This deadly farce has generated a medical effort to lower the cholesterol of patients in order to keep them healthy. There have been over a trillion dollars in sales for cholesterol-lowering statin drugs so far.The entire medical establishment has supported this as a way to prevent heart disease.There's just one little problem, now proved by extensive, objective real-world evidence and biochemical understanding: Cholesterol, including the "bad" LDL, is NOT a cause of heart disease. Even indirectly. Lowering LDL via diet change or statins does NOT prevent heart disease. So don't avoid saturated fats or take statins!

    Here's the kicker: higher cholesterol is associated pretty strongly with living longer, particularly in women! And the side effects of the drugs are widespread and serious!

    Basic facts

    Let's start with a few facts:

    • Eating fat will NOT make you fat. Eating sugar will make you fat.
    • The human brain is 70% fat.
    • 25% of all cholesterol in the body is found in the brain.
    • All cells in your body are made of fat and cholesterol.
    • LDL is not cholesterol! HDL isn't either! They are proteins that carry cholesterol and fat-soluble vitamins. Lowering it lowers your vitamins.

    To get the big picture about the diet-heart hypothesis (the reason why you're supposed to take statins in order to lower your cholesterol in order to prevent heart disease), see this post on the Whole Milk Disaster. For more detail, see the post on why you should eat lots of saturated fat.

    To get lots of detail, read this extensive review of Cholesterol Con and this extensive review of The Clot Thickens — and by all means dive into the books. Here is an excellent summary written by an MD explaining the situation and the alternative thrombogenic hypothesis. Here is a recent paper in a peer-reviewed journal reviewing to what extent blood cholesterol causes heart disease.

    The Bogus Hyposthesis

    How did thing get started? Stupidity mixed with remarkably bad science. Here is a brief summary of a PhD thesis examination of the build-up to the Cholesterol-is-bad theory:

    The cholesterol hypothesis originated in the early years of the twentieth century. While performing autopsies, Russian pathologists noticed build-up in the arteries of deceased people. The build-up contained cholesterol. They hypothesised that the cholesterol had caused the build-up and blocked the artery leading to a sudden death (the term “heart attacks” was not much used before the end of World War II).

    An alternative hypothesis would be that cholesterol is a substance made by the body for the repair and health of every cell and thus something else had damaged the artery wall and cholesterol had gone to repair that damage. This is the hypothesis that has the memorable analogy – fire fighters are always found at the scene of a fire. They didn’t cause the fire – they went there to fix it. Ditto with cholesterol. The alternative hypothesis did not occur to the pathologists by all accounts.

    The pathologists undertook experiments in rabbits to feed them cholesterol to see if they ‘clogged up’ and sure enough they did. However, rabbits are herbivores and cholesterol is only found in animal foods and thus it’s not surprising that feeding animal foods to natural vegetarians clogged them up. When rabbits were fed purified cholesterol in their normal (plant-based) food, they didn’t clog up. That should have been a red flag to the hypothesis, but it wasn’t.

    Then Ancel Keys got involved, and the bad idea became gospel.

    Population studies

    Before taking drugs like statins to reduce cholesterol, doesn't it make sense to see if people with lower cholesterol lead longer lives? The question has been examined. Short answer: people with higher cholesterol live longer. 

    Here is data from a giant WHO database of cholesterol from over 190 countries:

    Men

    More cholesterol = longer life for men, a strong correlation. Even more so for women, who on average have HIGHER cholesterol than men:

    Women

    When you dive into specific countries and history, the effect is even more striking. Check out the Japanese paradox

    To illustrate the Japanese paradox, he reported that, over the past 50 years, the average cholesterol level has risen in Japan from 3.9 mmol/l to 5.2 mmol/l. Deaths from heart disease have fallen by 60% and rates of stroke have fallen seven-fold in parallel. A 25% rise in cholesterol levels has thus accompanied a six-fold drop in death from CVD (Ref 6).

    And the strange things going on in Europe led by those cheese-loving French:

    The French paradox is well known – the French have the lowest cardiovascular Disease (CVD) rate in Europe and higher than average cholesterol levels (and the highest saturated fat consumption in Europe, by the way). Russia has over 10 times the French death rate from heart disease, despite having substantially lower cholesterol levels than France. Switzerland has one of the lowest death rates from heart disease in Europe with one of the highest cholesterol levels.

    Hard-core RCT's (Randomized Controlled Trials)

    RCT's are the gold standard of medical science and much else. You divide a population into a control group for which nothing changes and a test group, which is subjected to the treatment you want to test. It's hard to do this with anything like diet! But it has been done in controlled settings a few times at good scale. The results of the RCT's that have been done did NOT support the fat-cholesterol-heart-disease theory and so were kept hidden. But in a couple cases they've been recovered, studied and published.

    A group of highly qualified investigators has uncovered two such studies and published the results in the British Medical Journal in 2016: "Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)." They summarize the results of their earlier study:

    Our recovery and 2013 publication of previously unpublished data from the Sydney Diet Heart Study (SDHS, 1966-73) belatedly showed that replacement of saturated fat with vegetable oil rich in linoleic acid significantly increased the risks of death from coronary heart disease and all causes, despite lowering serum cholesterol.14

    Lower cholesterol meant greater risk of death. Clear.

    The Minnesota study was pretty unique:

    The Minnesota Coronary Experiment (MCE), a randomized controlled trial conducted in 1968-73, was the largest (n=9570) and perhaps the most rigorously executed dietary trial of cholesterol lowering by replacement of saturated fat with vegetable oil rich in linoleic acid. The MCE is the only such randomized controlled trial to complete postmortem assessment of coronary, aortic, and cerebrovascular atherosclerosis grade and infarct status and the only one to test the clinical effects of increasing linoleic acid in large prespecified subgroups of women and older adults.

    Moreover, it was sponsored by the most famous proponent of the diet-heart hypothesis: Ancel Keys. So what happened? Here's a brief summary from an article in the Chicago Tribune after the 2016 BMJ study was published:

    Second, and perhaps more important, these iconoclastic findings went unpublished until 1989 and then saw the light of day only in an obscure medical journal with few readers. One of the principal investigators told a science journalist that he sat on the results for 16 years and didn't publish because "we were just so disappointed in the way they turned out."

    From the BMJ 2016 paper:

    The traditional diet heart hypothesis predicts that participants with greater reduction in serum cholesterol would have a lower risk of death (fig 1⇑, line B). MCE participants with greater reduction in serum cholesterol, however, had a higher rather than a lower risk of death.

    …

    The number, proportion, and probability of death increased as serum cholesterol decreased

    Wowza. The "better" (lower) your blood cholesterol levels, the more likely you were to die. In fact, "For each 1% fall in cholesterol there was a 1% increase in the risk of death."

    Problems with Statins

    Not only do statins not work to lengthen lives, taking them is a bad idea because of their side effects. This is a starting place. For example, check the side effects of a leading statin:

    11

    Good effects vs. side effects

    We know for a fact that lowering your blood cholesterol is a bad idea. We know the drugs that do it have side effects. It's natural to think that the drugs normally do their thing and in rare cases there are side effects. Often, this is far from the truth. Here are excerpts from an article that explains the basic medical math concept of NNT

    Most people have never heard the term NNT, which stands for Number Needed to Treat, or to put it another way, the number of people who need to take a drug for one person to see a noticeable benefit. It's a bit of a counterintuitive concept for people outside medicine, since most people probably assume the NNT for all drugs is 1, right? If I'm getting this drug, it must be because it is going to help me. Well, wrong.

    What about the side effects of statins?

    Many people who take the drug develop chronic aches and pains. The drug also causes noticeable cognitive impairment in a proportion of those taking it, and some even end up being diagnosed with dementia – how big the risk is unfortunately isn't known, because proper studies haven't been carried out that could answer that question. Additionally, the drug causes blood sugar levels to rise, resulting in type 2 diabetes in around 2% of those taking the drug – it is in fact one of the most common causes of type 2 diabetes.

    NNT applied to statins:

    Well, if you've already had a heart attack, i.e. you've already been established to be at high risk for heart attacks, then the NNT over five years of treatment is 40. In other words, 39 of 40 people taking a high dose statin for five years after a heart attack won't experience any noticeable benefit. But even if they're not the lucky one in 40 who gets to avoid a heart attack, they'll still have to contend with the side effects.

    How many patients are told about NNT? If you haven't had a heart attack, the NNT is vastly greater than 40, and yet statins are prescribed when cholesterol is "too high" no matter what. Many of the side effects happen in 10% of the cases, which is four times greater than the number of people who are "helped." Doctors who do this are indeed members of the "helping profession;" the question is, who exactly are they helping?

    Here, here and here are more details about NNT for statin use.

    Conclusion

    If you value science, you should not worry about lowering your cholesterol. If you value your life and health, you should be happy to have high cholesterol. Likewise, you should avoid taking cholesterol-lowering drugs because in the end they hurt you more than they help you. If you're worried about pharma companies losing profits, it's a much better idea to just send them a monthly check — forget about their drugs!

     

  • The Facts are Clear: Eat Lots of Saturated Fat

    The experts and authoritative institutions are clear: you should eat a low-fat diet and take drugs to reduce your blood LDL cholesterol to safe levels in order to make your heart healthy.  Here is their advice about saturated fat and about blood cholesterol. The capital-E Experts are wrong. They were wrong from the beginning. There was never any valid evidence in favor their views, in spite of what you might read. The quantitative and biochemical evidence is now overwhelming.  Here is my summary of the situation. In this post I’ll cover more of the evidence.

    Origins and growth of the saturated fat – cholesterol – heart hypothesis

    How did such a bogus theory get started? An experiment with intriguing results was one start. Here's a summary:

    The hypothesis harks back to the early part of the twentieth century, when a Russian researcher named Nikolai Anitschkow fed a cholesterol [animal fat] rich diet to rabbits and found that they developed atherosclerosis (hardening of the arteries, the process which in the long run leads to cardiovascular disease). … Rabbits, being herbivores, normally have very little cholesterol in their diets, while humans, being omnivores, generally consume quite a bit of cholesterol. Regardless, the data was suggestive, and led to the hypothesis being formulated.

    A paper titled “How the Ideology of Low Fat Conquered America” was published in the Journal of the History of Medicine and Allied Sciences in 2008. Here is the abstract:

    This article examines how faith in science led physicians and patients to embrace the low-fat diet for heart disease prevention and weight loss. Scientific studies dating from the late 1940s showed a correlation between high-fat diets and high-cholesterol levels, suggesting that a low-fat diet might prevent heart disease in high-risk patients. By the 1960s, the low-fat diet began to be touted not just for high-risk heart patients, but as good for the whole nation. After 1980, the low-fat approach became an overarching ideology, promoted by physicians, the federal government, the food industry, and the popular health media. Many Americans subscribed to the ideology of low fat, even though there was no clear evidence that it prevented heart disease or promoted weight loss. Ironically, in the same decades that the low-fat approach assumed ideological status, Americans in the aggregate were getting fatter, leading to what many called an obesity epidemic. Nevertheless, the low-fat ideology had such a hold on Americans that skeptics were dismissed. Only recently has evidence of a paradigm shift begun to surface, first with the challenge of the low-carbohydrate diet and then, with a more moderate approach, reflecting recent scientific knowledge about fats.

    The early chapters of The Big Fat Surprise book provide a good summary with details of the rise to dominance of the low-fat & cholesterol-is-bad theory.

    Strong Data Showing that Saturated Fat is Good

    There were problems with the diet-heart hypothesis from the beginning.

    The first chapters of The Big Fat Surprise have summaries of studies that were made on peoples around the world who subsisted almost exclusively by eating animals and/or dairy, all of them strongly preferring fatty organs over lean muscle.

    A Harvard-trained anthropologist lived with the Inuit in the Canadian Arctic in 1906, living exactly like his hosts, eating almost exclusively meat and fish. “In 1928, he and a colleague, under the supervision of a highly qualified team of scientists, checked into Bellevue Hospital  … to eat nothing but meat and water for an entire year.” “Half a dozen papers published by the scientific oversight committee that scientists could find nothing wrong with them.”

    George Mann, a doctor and professor of biochemistry, took a mobile lab to Kenya with a team from Vanderbilt University in the 1960’s to study the Masai. They ate nothing but animal parts and milk. Their blood pressure and body weight were 50% lower than Americans. Electrocardiograms of 400 men showed no evidence of heart disease, and autopsies of 50 showed only one case of heart disease.

    Similar studies and results came from people in northern India living mostly on dairy products, and native Americans in the southwest. There were many such studies, all of them showing that the native peoples, eating mostly saturated fat, were not only heart-healthy, but free of most other modern afflictions such as cancer, diabetes, obesity and the rest.

    Of course the question was raised of other factors that might lead to these results. The questions have been answered by intensive studies. For example, some formerly meat-eating Masai moved to the city and lost their health. For example, Inuit who changed their diet to include lots of carbohydrates supplied by government were studied by doctors who determined they lost their health.

    From the book:

    In 1964, F. W. Lowenstein, a medical officer for the World Health Organization in Geneva, collected every study he could find on men who were virtually free of heart disease, and concluded that their fat consumption varied wildly, from about 7 percent of total calories among Benedictine monks and the Japanese to 65 percent among Somalis. And there was every number in between: Mayans checked in with 26 percent, Filipinos with 14 percent, the Gabonese with 18 percent, and black slaves on the island of St. Kitts with 17 percent. The type of fat also varied dramatically, from cottonseed and sesame oil (vegetable fats) eaten by Buddhist monks to the gallons of milk (all animal fat) drunk by the Masai. Most other groups ate some kind of mixture of vegetable and animal fats. One could only conclude from these findings that any link between dietary fat and heart disease was, at best, weak and unreliable.

    One of the foundational studies in the field is the Framingham Heart Study, started in 1948 and still going on.

    In 1961, after six years of study, the Framingham investigators announced their first big discovery: that high total cholesterol was a reliable predictor for heart disease.

    This cemented things. Anything that raised cholesterol would lead to heart disease. The trouble came thirty years later, after many of the participants in the study had died, which made it possible to see the real relationship between cholesterol and mortality due to heart disease. Cholesterol did NOT predict heart disease!

    The Framingham data also failed to show that lowering one's cholesterol over time was even remotely helpful. In the thirty-year follow-up report, the authors state, "For each 1% mg/dL drop of cholesterol there was an 11% increase in coronary and total mortality."

    Only in 1992 did William P. Castelli, a Framingham study leader, announce, in an editorial in the Archives of Internal Medicine:

    In Framingham, Mass, the more saturated fat one ate … the lower the person's serum cholesterol … and [they] weighed the least.

    Game over! No wonder they've kept it quiet. And not just about heart health — about weight loss too!

    Here is an excellent article with references to and quotes from many journals. Here is the introduction:

    Many large, government-funded RCTs (randomized, controlled clinical trials, which are considered the ‘gold-standard’ of science) were conducted all over the world in the 1960s and 70s in order to test the diet-heart hypothesis. Some 75,000 people were tested, in trials that on the whole followed subjects long enough to obtain “hard endpoints,” which are considered more definitive than LDL-C, HDL-C, etc. However, the results of these trials did not support the hypothesis, and consequently, they were largely ignored or dismissed for decades—until scientists began rediscovering them in the late 2000s. The first comprehensive review of these trials was published in 2010 and since then, there have been nearly 20 such review papers, by separate teams of scientists all over the world.

    Far from believing that saturated fat causes heart disease, we can be quite certain that it's positively healthy on multiple dimensions to eat it — it's people who don't eat enough saturated fat who end up overweight and sickly!

    Sadly, there are still Pompous Authorities who assure us with fancy-sounding studies that we really should avoid eating fat. This study from 2021 dives into just such a fake study — a RCT (random controlled trial) study — that purported to show that eating fat remains a bad idea. Wrong. Here's the summary:

    Hiding unhealthy heart outcomes in a low-fat diet trial: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial finds that postmenopausal women with established coronary heart disease were at increased risk of an adverse outcome if they consumed a low-fat ‘heart-healthy’ diet.

    These books by Dr. Malcolm Kendrick dive in more deeply and are moreover a pleasure to read. Among other things, The Clot Thickens explains the underlying mechanisms of arteriosclerosis (blood clots, heart disease) and what actually causes them.

    Here are several articles with evidence from many scientists on the subject of saturated fat.

    Latest Results

    The evidence continues to pour out — not that the vast majority of "professionals" change their tune about what constitutes a healthy diet. Here is a new paper published by Oxford written by cardiologists.

    1

    The authors asked exactly the right question:

    Cardiovascular disease (CVD) is the leading global cause of death. For decades, the conventional wisdom has been that the consumption of saturated fat (SFA) undermines cardiovascular health, clogs the arteries, increases risk of CVD and leads to heart attacks. It is timely to investigate whether this claim holds up to scientific scrutiny.

    They found and went through more than ten years of recent published studies, p through 2021. Here is their conclusion:

    Findings from the studies reviewed in this paper indicate that the consumption of SFA is not significantly associated with CVD risk, events or mortality. Based on the scientific evidence, there is no scientific ground to demonize SFA as a cause of CVD. SFA naturally occurring in nutrient-dense foods can be safely included in the diet.

    Here is a summary in a journal of the history and latest research on the subject, focused on the national nutrition guidelines, which maddeningly fail to reflect the facts about this subject.

    What more needs to be said?

     Conclusion

    This is an incredibly important issue regarding the health of people. It's also an in-progress example of the difficulty of shifting a paradigm, even when the evidence against the dominant paradigm (avoid eating saturated fat, use drugs to keep your cholesterol low) is overwhelming. Could it be possible that billions of dollars a year of statins and related cholesterol-lowering drug sales has something to do with it? Then again, when was the last time you heard a prestigious Expert or institution say "Sorry, we were wrong, we'll try hard not to blow it again; we won't blame you if you never trust us again."

  • The Experts are Clear: Keep your Cholesterol Low

    Everyone knows it’s important to maintain a healthy diet, things like avoiding fatty meat and fish and whole-fat dairy products. All the experts tell us it’s so, and the nutrition guides on food products help us choose food wisely. Everyone knows what “fat” is. Most of us have also heard of “cholesterol,” but it’s not so clear just what that is. It gets clear when you visit a doctor, have your blood tested, and hear the doctor tell you that your cholesterol levels dangerously high. The doctor says you’ve got to get your cholesterol under control, or else your odds of getting heart disease and dying early go way up.

    The doctor will probably tell you that you can help yourself by eating less saturated fat, which causes cholesterol to rise. Depending on how high your numbers are, the doctor may also put you on statin drugs, which lower your cholesterol levels the same way other drugs help lower dangerously high blood pressure. It’s just something you have to do in order to lead a long and healthy life. Are you ready for an incapacitating heart attack, or are you going take a couple pills every day? Is that so bad?

    The CDC

    Let’s make sure this is really true. Let's go to the federal CDC, the Center for Disease Control and Prevention.

    CDC

    Hey, they've got a whole section on cholesterol! Fortunately the CDC makes clear that it’s a myth that all cholesterol is bad for you. There’s HDL, which is good for you. And then there’s…

    LDL (low-density lipoprotein), sometimes called “bad” cholesterol, makes up most of your body’s cholesterol. High levels of LDL cholesterol raise your risk for heart disease and stroke.

    They go on to explain exactly why LDL is bad for you:

    When your body has too much LDL cholesterol, it can build up in the walls of your blood vessels. This buildup is called plaque. As your blood vessels build up plaque over time, the insides of the vessels narrow. This narrowing can restrict and eventually block blood flow to and from your heart and other organs. When blood flow to the heart is blocked, it can cause angina (chest pain) or a heart attack.

    There is something you can do with your diet to help things:

    Saturated fats can make your cholesterol numbers higher, so it’s best to choose foods that are lower in saturated fats. Foods made from animals, including red meat, butter, and cheese, have a lot of saturated fats.

    But then, in the end, the important thing is to avoid getting a heart attack or stroke. The good news is that that there are drugs to help:

    Although many people can achieve good cholesterol levels by making healthy food choices and getting enough physical activity, some people may also need medicines called statins to lower their cholesterol levels.

    Department of Health and Human Services (HHS)

    Is the government united in the effort to reduce bad cholesterol. Let’s make another check, to the appropriately named Department of Health (HHS).

    Apparently the whole world, according to WHO, is sure that heart disease is a huge killer:

    Cardiovascular diseases—all diseases that affect the heart or blood vessels—are the number one cause of death globally, according to the World Health Organization (WHO).

    They’re also sure that, in addition to diet, cholesterol has a firm place on the list of heart-harming things:

    Your health care provider can assess your risk for cardiovascular disease through preventative screenings, including weight, cholesterol, triglycerides, blood pressure, and blood sugar.

    The American Heart Association (AHA)

    How about the professional organization of heart doctors – what’s their position on cholesterol? It’s pretty clear:

    LDL cholesterol is considered the “bad” cholesterol, because it contributes to fatty buildups in arteries (atherosclerosis). This narrows the arteries and increases the risk for heart attack, stroke and peripheral artery disease (PAD).

    Harvard Medical School

    Better check with the people who train the best doctors. Let's make sure this is really up to date.

    Harvard

    Here's what they have to say:

    Too much LDL in the bloodstream helps create the harmful cholesterol-filled plaques that grow inside arteries. Such plaques are responsible for angina (chest pain with exertion or stress), heart attacks, and most types of stroke.

    What causes a person's LDL level to be high? Most of the time diet is the key culprit. Eating foods rich in saturated fats, trans fats, and easily digested carbohydrates boost LDL

    OK, but what if for various reasons diet doesn't get things under control?

    Several types of medication, notably the family of drugs known as statins, can powerfully lower LDL. Depending on your cardiovascular health, your doctor may recommend taking a statin.

    Conclusion

    The science has spoken. The leading authorities in the field of heart health speak it clearly, without reservation and without qualification. Heart attacks are a leading cause of death everywhere.  Blood plaques cause heart attacks. Blood plaques are caused by having too much LDL, the bad cholesterol, in the blood. Your LDL is raised by eating too much saturated fat. You can reduce your chances of getting a heart attack by strictly limiting the amount of saturated fat you eat and by taking drugs, primarily statins, that reduce the amount of LDL.

    Why wouldn’t any sane person at minimum switch to low-fat dairy and lean meats, if not go altogether vegan? And then, to be sure, get their blood checked to make sure their LDL level is under control.  The only one who can keep you healthy is YOU, blankity-blank-it! And if you by chance run into some crank telling you otherwise, you shouldn’t waste your time.

  • The Experts are clear: Don’t Eat Much Saturated Fat

    Any reasonably aware person knows that it’s important to maintain a healthy diet. High on the list of what “healthy eating” means is limiting the amount of saturated fat in your diet. This impacts all the meat and dairy products you consume. You should only drink reduced-fat milk for example. If you must eat meat, make sure it’s lean, and never eat something obviously fatty like bacon. This isn’t just something experts say at their conferences. It’s the official recommendation of all government bodies, and brought to the attention of ordinary people by nutrition labels on food products. Warning: there are contrarian views on this subject.

    Cheese

    Here’s a nice goat cheese I bought:

    Goat cheese front

    When you turn it over, here’s most of the nutrition label:

    Goat cheese back

    Wow, calories must be important – they’re first and in big type. Right after calories comes Fat.  It must be really important, because I’m told not just how much fat there is, but how much of the fat I’m allowed to eat a day is in each serving.

    This is interesting. There’s 6 grams of Total Fat, which is only 8% of my daily allowance, but 4 grams of the Fat is Saturated Fat, 2/3 of the total, and that’s 20% of my daily allowance. Couldn’t be clearer: I can eat a fair amount of fat, but I’d better make sure that only a tiny part of it is Saturated. Doing the arithmetic, they only want me to eat 20 grams of Saturated fat, while I’m allowed 76 grams of Total Fat.

    I wonder if I’m getting this right, because some of those labels seem like things you should get lots of, like vitamins and potassium. I’d better check.

    FDA

    Oh, good, the FDA’s food label page  links right to a whole initiative they sponsor, the Healthy People initiative! How great is that, they’re concentrating on the big picture, keeping us all healthy. What a great government we have!

    Here’s what they have to say about diet at a high level:

    Healthy diet

    Pretty clear, huh? Just like I said above: eat only lean meat, and low fat dairy. Saturated fats are bad for you. Everyone knows it. The importance is so great, it’s on the label of nearly every food product.

    American Heart Association (AHA)

    Let’s admit it, though, sometimes the government lags behind the latest science. Let’s make sure that’s not the case here.

    What about the major medical organization that concentrates on heart, the American Heart Association? Their position seems very clear:

    Heart

    They sound pretty sure about themselves. Why are they so certain? Here's what they say as of November 2021: "Decades of sound science has proven it can raise your 'bad' cholesterol and put you at higher risk of heart disease."

    OK, there are decades of science backing them up. Still, it's pretty broad, talking about not eating "too much" saturated fat. Do they have something more specific to say? Here it is:

    AHA

    Hmm, how does that relate to the FDA's food label? On the cheese label above, the Saturated Fat was 4g, which is 20% of the recommended total. Arithmetic: if 4g is 20%, then 20g is the limit imposed by the FDA, which is almost 50% more than the professional organization of medical cardiologists recommends! I thought our government was looking out for our health — the FDA should get with it!

    Harvard

    Hold on here, let's not jump to conclusions. Let's check in with that incredibly prestigious medical school, Harvard Medical School?

    Here’s what they have to say in an article from November 2021:

    Aa

    Isn't it wonderful that they make it clear that it isn't just bacon and fatty cheese we need to be careful about? Reading a bit further,

    Capture

    Higher than the AHA, but lower than the FDA. I guess they don't all read the same scientific studies, or something. But at least they all agree that Saturated Fat is bad for you. Reading a bit farther in the article, they say plainly that eating too much Saturated Fat "can raise the amount of harmful LDL cholesterol in your blood. That, in turn, promotes the buildup of fatty plaque inside arteries — the process that underlies most heart disease."

    Couldn’t be clearer.

    Mayo Clinic

    Just to be absolutely, double-plus positive, maybe it's worth checking one of the best hospital medical systems in the world, the Mayo Clinic. They're doctors, after all, not researchers or institutional employees. Let's see what they say. OMG! Look at what I found in the section on nutrition myths!

    Eating fat will make you fat. The fat-free and low-fat diet trend is a thing of the past (80s and 90s, to be exact). Yet, some individuals are still scared of fat.

    Isn't that what all this focus on fat avoidance is all about? Let's read on:

    Be aware that fats aren’t created equal. Choose heart-healthy unsaturated fats, such as olive and canola oil, nuts, nut butters and avocados over those that are high in saturated and trans fats, including fatty meats and high-fat dairy products.

    Now I get it. The FDA nutrition food label had a high limit for fats in general (which are OK), but a low limit for saturated fats, the bad kind. So the Mayo Clinic is on board too. All the experts agree!

    Conclusion

    There are crazy people out there who ignore the clear message of the government, the Experts and leading authorities in the field of health and nutrition. Some of these crazy people even write books, the obvious intent of which is to make more of the population lead crappier lives and die sooner. Here's a brief summary. Why the FDA, the agency supposedly charged with keeping us healthy, permits these health-destroying, misinformation-filled books to be published, I have no idea.

    Regardless of the distractions: government and the big authorities in the field are united in the effort to keep us all more healthy by encouraging us all to strictly limit the amount of Saturated Fat we eat.

  • Trusting Science: the Whole Milk Disaster

    I trust science. The gradual emergence of science has led to a revolution in human existence that has happened so quickly and with such impact that it is hard to gain perspective on it.

    Trusting science is not the same as trusting the pronouncements of people who are designated scientific experts. Establishing the truth of a scientific theory is an entirely different process than the social dynamics of rising to a position of leadership in a group of any kind. Official experts, whether government, corporate or academic, nearly always defend the current version of received truth against challenge of all kinds; most of those challenges are stupidity and ignorance. My go-to expert on this subject, as so many others, is Dilbert:

    Dilbert expert

    Sadly, those same establishment experts tend to be the strongest opponents of genuine innovation and scientific advances of all kinds. As I explain here, with examples from Feynman and the history of flight, one of the core elements of successful innovation is ignoring the official experts.

    My skepticism is well proven in the case of so-called Computer Science, which doesn't even rise to the level of "useful computer practices" much less science. As I have shown extensively, Computer Science and Engineering is largely a collection of elaborate faith-based assertions without empirical foundation. And computers are all numbers and math! If it's so pathetic in such an objective field, imagine how bad it can get when complex biological systems are involved.

    This brings us to the subject of saturated fat (solid fat of the kind that's in meat), whole milk and human nutrition. This ongoing scandal — for which no one has been imprisoned, sued or even demoted — in spite of its leading to widespread obesity and other health-damaging conditions — is still rolling along. The hard science concerning the supposed connection between saturated fat, cholesterol and heart disease is in. The results are clear. It is positively healthy for people to eat saturated fat. Period. The scandal is that the "expert" people and organizations that have declared saturated fat and cholesterol to be dangerously unhealthy for many decades refuse to admit their errors and continue to waffle on the subject.

    This is relevant to computer science because of the stark differences between the two fields. Software is esoteric and invisible to nearly everyone, while the results of eating are tangible to everyone, and the statistics about the effects are visible and measurable. The common factor is … people. In both cases there is a wide consensus of expert opinion about the right way to build and main software, and the right way to eat and live in order to be healthy. Experts! From blood-letting to flying machines, they lead the way!

    Usually the Science-challengers are wrong

    It has taken me a great deal of time to dig in to this scandal, in part because there are so many cases of "the experts are all wrong — me and my fringe group have the truth." I wanted to make absolutely sure "it's good to eat saturated fat" wasn't another of these. After all, the simple notion that eating fat makes you fat makes common sense!

    The Scandal

    Surely the diet recommendations of the major medical and government institutions in favor of limiting fat must be valid! Sadly, this is not the case. Rather, it's a wonderful example of how hard paradigm shifts are to accomplish, particularly when the prestige of major institutions are involved. And, sadly, how prestige and baseless assertions have substituted for science, shockingly similar to bloodletting and other universally-accepted-on-no-objective-basis practices.

    A basic, understandable summary of the subject may be found in The Big Fat Surprise, which is loaded with appropriate detail. Here is a summary:

    "the past sixty years of low-fat nutrition advice has amounted to a vast uncontrolled experiment on the entire population, with disastrous consequences for our health.

    For decades, we have been told that the best possible diet involves cutting back on fat, especially saturated fat, and that if we are not getting healthier or thinner it must be because we are not trying hard enough. But what if the low-fat diet is itself the problem? What if those exact foods we’ve been denying ourselves — the creamy cheeses, the sizzling steaks — are themselves the key to reversing the epidemics of obesity, diabetes, and heart disease?"

    Yes, this sounds like what an anti-science crank would say. All I can say is, dig in. You'll find the shoddy beginnings of the fat-cholesterol-heart hypothesis; the biased studies that seemed to support it; the massive, multi-decade Framingham study which was trumpeted as supporting the anti-fat theory, but whose thoroughly confirmed and vetted results were actively suppressed for many years; the uncontested studies that disprove the anti-fat recommendations; and the improved understanding of the biological systems that thoroughly debunks the widely promoted campaign against saturated fat and LDL, the "bad" cholesterol.

    More detail

    If you want a start on more detail, I recommend Dr. Sebastian Rushworth at a high level and the recent book by long-term cardiac doctor Malcolm Kendrick that gives the details of the studies and biology that explain what really happens.

    Here are a couple explanations from Dr. Rushworth:

    "the LDL hypothesis basically says that heart disease happens because LDL somewhow ends up in the arterial wall, after which it is oxidized, which starts an inflammatory reaction that gradually leads to the hardening of arteries and eventually to bad things like heart attacks and strokes."

    "… the LDL hypothesis is bunk. There is by now a wealth of evidence showing that LDL has little to do with heart disease, such as this systematic review from BMJ Evidence Based Medicine, which showed that there is no correlation whatsoever between the amount of LDL lowering induced by statins and other LDL lowering drugs, and the benefit seen on cardiovascular disease risk (if indeed any benefit is seen – it often isn’t)."

    Rushmore's summary of the Kendrick book is:

    "The ultra-short elevator pitch version of what he argues in the book is that heart disease is what happens when damage to the arterial wall occurs at a faster rate than repair can happen. That’s why everything from sickle cell disease to diabetes to high blood pressure to smoking to rheumatoid arthritis to cortisone treatment to the cancer drug Avastin increases the risk of cardiovascular disease – they all either increase the speed at which the arterial wall gets damaged or slow down its repair. It’s why heart disease (more correctly called “cardiovascular disease”) only affects arteries (which are high pressure systems) and not veins (which are low pressure systems), and why atherosclerosis (the hardening of the arteries that characterizes heart disease) primarily happens at locations where blood flow is extra turbulent, such as at bifurcations.

    This alternative to the LDL hypothesis is known as the “thrombogenic hypothesis” of heart disease. It’s actually been around for a long time, first having been proposed by German pathologist Carl von Rokitansky in the 19th century. Von Rokitansky noted that atherosclerotic plaques bear a remarkable similarity to blood clots when analyzed in a microscope, and proposed that they were in fact blood clots in various stages of repair.

    Unfortunately, at the time, von Rokitansky wasn’t able to explain how blood clots ended up inside the artery wall, and so the hypothesis floundered for a century and a half (which is a little bit ironic when you consider that no-one knows how LDL ends up inside the artery wall either, yet that hasn’t hindered the LDL hypothesis from becoming the dominant explanation for how heart disease happens). We now know the mechanism by which this happens: cells formed in the bone marrow, known as “endothelial progenitor cells”, circulate in the blood stream and form a new layer of endothelium on top of any clots that form on the artery wall after damage – thus the clot is incorporated in to the arterial wall.

    In spite of the fact that probably at least 99% of cardiologists still believe in the LDL hypothesis, the thrombogenic hypothesis is actually supported far better by all the available evidence. While the LDL hypothesis cannot explain why any of the risk factors listed above increases the risk of heart disease, the thrombogenic hypothesis easily explains all of them.

    Conclusion

    Many major institutions have dialed down their fervent condemnation of the low-fat and LDL-is-bad myths, but haven't done what they should do, which reverse their positions and mea culpa. They should at minimum take at least part responsibility for the explosion of obesity, useless pharma mega-dollars wasted, and the attendant health disasters for countless humans. The fact that they're not helps us understand the resistance to correction of the similarly powerful mainstream myths about software. It's not about the LDL or the software; it's about people, pride, institutions, bureaucracy and entrenched practices and beliefs that fight change.

     

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