The Black Liszt

Category: Nutrition

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 more than doubles your chances of getting AMD, which makes you blind.

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.

August 31, 2023
The Medical Treatment of Obesity

In a prior post I asked why there is no search for the origins of the widely-acknowledged obesity epidemic that harms so many people. I suggested that the data shows that there is an obvious cause: the government nutrition recommendations that pervade our society and prominently stated on packaged food. The overweight/obesity numbers started their steady growth shortly after these were promulgated and people followed the recommendations.

Ignoring overwhelming evidence, the authorities continue the health-destroying drumbeat of bad eating advice. Now, the medical people who are charged with dishing out this destructive nonsense are being criticized for making the people who follow their advice feel bad. When will it end??

Smoking

When I was growing up, I saw advertisements and commercials for smoking.

The Marlboro Man was particularly memorable. The ad campaign generated billions of dollars of sales.

The tobacco industry was always concerned about their image; throat irritation from smoking was a well-known side effect, not to mention the growing number of deaths by lung cancer. So ads were created and widely shown claiming the support of the medical profession for smoking, for example:

We know today that smoking causes lung cancer. It wasn't until 1964 that the Surgeon General declared it the cause, and many years passed before other measures were taken. For example, United Airlines was the first to create a non-smoking section of the plane, in 1971. It took until 1990 for smoking to be banned on domestic flights in the US, and later for international flights.

Obesity

So where do we stand with obesity compared to smoking? I would estimate we're at about 1960. The government is hard at work revising the nutritional guidelines most recently updated in 2017, and the drafts that have come out strongly resemble the equivalent for nutrition of what for smoking would be: "smoking unfiltered cigarettes is just fine, but don't smoke too many a day, and make sure you practice breathing exercises regularly to keep your throat and lungs healthy."

As a reminder, the science is solidly behind consuming whole-fat dairy, eggs and meat, while minimizing sugar and carbs. Here is an example of the current version of nutritional insanity:

Sugar-loaded Frosted Mini Wheats and Lucky Charms are better than a whole egg, and ice cream with nuts is better than ground beef. Sure! I wonder what the role of the processed food industry has been in all this…?

Doctors and obesity

Doctors are required to dish out their profession's broken nutritional recommendations to one and all. They are particularly supposed to give good advice to the obese people those recommendations continue to harm. But now there's a new twist — doctors are being blamed for the on-going troubles of their obese patients!

Obese people are often “weight-shamed” by doctors and nurses — worsening their problem and causing them to wrongfully blame themselves for the condition, according to a new study.

Fat-shaming by medical professionals leads patients to feel humiliated and anxious about appointments — making them more likely to overeat, according to research from the University of London.

Researchers examined 25 previous studies centered on 3,554 health professionals and found evidence of “strong weight bias” — including that doctors and nurses tend to assume overweight people are lazy, according to the report, published in the journal of Obesity Reviews.

“[They] believe their patients are lazy, lack self-control, overindulge, are hostile, dishonest, have poor hygiene and do not follow guidance,” Dr. Anastasia Kalea, who authored the study, told the UK Guardian.

So what should physicians do?

The study concludes that medical professionals should be trained in “non-stigmatizing weight-related communication.”

Tam Fry, the chairman of the National Obesity Forum, said doctors and nurses should take responsibility for the role they play in the UK’s obesity epidemic.

“It is shameful that the condition continues to be regarded by health professionals as being solely a personal problem, little to do with them and it’s disgraceful that they stigmatize patients for being overweight,” said Fry, who was not involved in the study.

“This is the last thing a patient wants to hear from professionals who they trust will help them.”

It's clear that physicians are stuck between a rock and a hard place. If they dish out their profession's nutritional advice, the obese person will stay over-weight. If they dish out the limit-calories-exercise-more stuff, most people just can't keep it up — as we know from the obesity numbers. And if they bend over backwards to make sure to avoid giving obese people the slightest impression that their own actions might, just maybe, have something to do with their condition, then they've really blown it! Can't talk and what they're told to talk doesn't work.

Conclusion

Remember what happened with smoking — the decades it took for the cancer-causing truth about it came out, got proven, and the more decades it took for it to be acted on. We're still in the early innings here with nutrition in general, and saturated fat in particular. We can only hope that sanity and science can move more quickly this time.

September 6, 2022
The forbidden question: What caused the obesity epidemic?

There is an obesity problem. Everyone knows it. Public health authorities proclaim it. Over half the population in the US is now obese. The consequences of being obese in terms of health are serious. Solutions are proposed, but they don’t seem to work. The question that’s almost never asked, the answer to which would help us understand AND FIX the problem, is pure common sense: what started the epidemic? What changed to cause the steady rise of overweight and obese people?

The reason no one wants to ask the question is because the most probable answer is something our major institutions, Experts and Authorities don’t want us to know: Their nutrition recommendations, widely promoted and visible on most food labels that you buy, are based on bad, corrupted science.

We now know how and why the science was wrong. After much study and careful trials, we know what's right. But because of the refusal of the authorities to admit and correct their error, millions of people continue to suffer and die of diseases they would not have if our Medical Health Elites would suck it up, admit error, and fix it.

There is an epidemic of obesity

The epidemic. Well known, accepted. Here's the FDA:

Here's the CDC:

Obesity is a serious chronic disease, and the prevalence of obesity continues to increase in the United States. Obesity is common, serious, and costly. This epidemic is putting a strain on American families, affecting overall health, health care costs, productivity, and military readiness.

Is it under control? The CDC again:

From 1999 –2000 through 2017 –2018, US obesity prevalence increased from 30.5% to 42.4%. During the same time, the prevalence of severe obesity increased from 4.7% to 9.2%.

What's bad about being obese?

According to the CDC, here are some of the consequences of being obese:

What are the medical costs resulting from obesity?

A highly detailed study was published in 2021 going into depth to determine the direct medical costs of obesity.

RESULTS: Adults with obesity in the United States compared with those with normal weight experienced higher annual medical care costs by $2,505 or 100%, with costs increasing significantly with class of obesity, from 68.4% for class 1 to 233.6% for class 3. The effects of obesity raised costs in every category of care: inpatient, outpatient, and prescription drugs. … In 2016, the aggregate medical cost due to obesity among adults in the United States was $260.6 billion.

In other words, obese people have more than double the medical care costs compared to those who are not obese. More important, the obese people themselves suffer the poor health resulting from their condition!

How are we told to prevent and/or fix it?

From the CDC:

Obesity is a complex health issue resulting from a combination of causes and individual factors such as behavior and genetics.

Healthy behaviors include regular physical activity and healthy eating. Balancing the number of calories consumed from foods and beverages with the number of calories the body uses for activity plays a role in preventing excess weight gain.

A healthy diet pattern follows the Dietary Guidelines for Americans which emphasizes eating whole grains, fruits, vegetables, lean protein, low-fat and fat-free dairy products, and drinking water.

In other words, exercise more, eat less, and follow the official diet guidelines which emphasize avoiding fat in meat and dairy.

The origins of the obesity epidemic

Did the obesity epidemic appear out of nowhere, for no reason? Nope. The key to understanding and responding to any epidemic is to trace its origins to the time and place of its start. Only then can you understand the problem and often get good ideas about how to mitigate the epidemic and prevent similar ones from getting started.

Look at this chart from the CDC:

A sharp upwards turn in Obesity and Severe Obesity took place in 1976-1980 and has continued rising. From the tables in the document from which this chart was taken, Obesity was about 14% and has risen to 43%, while Severe Obesity was about 1% and has risen to over 9%. That's about 3X and 9X increases. Total Obesity is now over 50% of the population! During this period the Overweight share has remained about the same (about 32%), which means that a large number of people "graduated" to higher levels of weight, probably many normals becoming Overweight while as many Overweights became Obese.

What happened when the "hockey stick" upwards trend in obesity started? It turns out something big happened, with lots of public attention. According to the government website on the history of nutritional guidelines:

A turning point for nutrition guidance in the U.S. began in the 1970s with the Senate Select Committee on Nutrition and Human Needs….

In 1977, after years of discussion, scientific review, and debate, the U.S. Senate Select Committee on Nutrition and Human Needs, led by Senator George McGovern, released Dietary Goals for the United States. …

The recommendations included:

Increase the consumption of complex carbohydrates and “naturally occurring” sugars…

Reduce overall fat consumption…

Reduce saturated fat consumption to account for about 10 percent of total energy intake…

The widely publicized recommendations were followed up by the first in the series of official expert-approved documents:

In February 1980, USDA and HHS collaboratively issued Nutrition and Your Health: Dietary Guidelines for Americans,

It's important to note that the focus was NOT on obesity. It was on diet-related health, with a particular focus on heart disease. The consensus of Expert opinion at the time was that eating saturated fat causes heart disease. In an effort to reduce heart disease, the authorities started the drum-beat of "Stay healthy! Eat less saturated Fat!"

Obesity took off when we obeyed the Experts

The new dietary advice was shouted from the hill tops. It was pushed by government agencies. It was endorsed by every major health institution, and pushed by nutritionists and doctors everywhere. It was emblazoned on food packaging by law, each package stating how much of the evil, heart-killing saturated fat was in each serving, and how much of your "daily allowance" it used up.

The food that was offered in grocery stores and restaurants changed to reflect the "scientific" consensus. Bacon was bad. If you had to eat meat (even though you shouldn't), you should eat lean (no fat) meat. All these things are still what we see!

Here is a study based on the US National Health and Nutrition Examination Survey (NHANES) that demonstrates the strong linkage between the diet recommendations and the growth of obesity.

From a valuable study on obesity (behind a paywall):

When we put together the following…

1) Obesity is not a simplistic imbalance of energy in and energy out, but a far more complex matter of how, biochemically, the body can store or utilize fat. Carbohydrate is the best macronutrient to facilitate fat storage and prevent fat utilization.

2) Fat/protein calories have jobs to do within the body – they can be used for basal metabolic repair and maintenance. Carbohydrate is for energy alone; it needs to be burned as fuel or it will be stored as fat.

… carbohydrates can be seen as uniquely suited to weight gain and uniquely unsuited to weight loss. The macronutrient that we have been advising people to eat more of is the very macronutrient that enables fat to be stored and disables fat from being utilized.

Increasingly people ate what they were told to eat. Young people grew up eating in the new style, with vastly more packaged foods, sugar and carbohydrates than earlier generations. No surprise, they got fat early in life, and stayed fat.

Marty Makary MD, surgeon and Professor at Johns Hopkins,
treats this from a different angle in his recent book.

Dr. Dariush Mozaffarian, dean of Tufts University’s Friedman School of Nutrition—the nation’s leading nutrition school … recently wrote in the Journal of the American Medical Association, “We really need to sing it from the rooftops that the low-fat diet concept is dead, there are no health benefits to it.” As a gastrointestinal surgeon and advocate for healthful foods, I’m well aware how this low-fat teaching is based on the medical establishment’s embarrassing, outdated theory that saturated fat causes heart disease. A landmark 2016 article in the Journal of the American Medical Association found that the true science was actually being suppressed by the food industry. Highly respected medical experts like my former Johns Hopkins colleague Dr. Peter Attia are now correcting the medical establishment’s sloppy teachings. He and many other lipidologists know that the low-fat bandwagon has damaged public health. It was driven by an unscientific agenda advanced by the American Heart Association and the food industry, which sponsored the misleading food pyramid. These establishment forces spent decades promoting addictive, high-carbohydrate processed foods because the low-fat foods they endorsed require more carbohydrates to retain flavor. That 40-year trend perfectly parallels our obesity epidemic. Medical leaders like Dr. Attia have been trying to turn this aircraft carrier around, but it’s been a challenge. Despite the science, the dogma remains pervasive. In hospitals today, the first thing we do to patients when they come out of surgery, exhausted and bleary-eyed, is to hand them a can of high-sugar soda. Menus given to hospitalized patients promote low-fat options with a heart next to those menu items. And when physicians order food for patients in electronic health records, there’s a checkbox for us to order the “cardiac diet,” which hospitals define as a low-fat diet. Despite science showing that natural fats pose no increased risk of heart disease and that excess sugar is the real dietary threat to health, my hospital still hands every patient a pamphlet recommending the “low-fat diet” when they’re discharged from the cardiac surgery unit, just as we have been doing for nearly a half century. But nowhere is that now debunked low-fat recommendation propagated as much as in wellness programs.

For more study

The experts are clear on this subject. You already know this, but here are highlights of their views on fat and on cholesterol. Here is background on how saturated and cholesterol became menaces. Here is why you should eat lots of saturated fat and why should not take drugs to lower your cholesterol.

With the billion-dollar-revenue American Heart Association continuing to villanize saturated fat, this insanity is unlikely to stop soon.

Before all this nonsense began…

We had a sensible approach to obesity:

Conclusion

The cause of the obesity epidemic is clear. No one talks about it because the people in charge refuse to admit their role in causing it. As the evidence from RCT's continues to pile up, careful reading shows that the emphatic language about saturated fat has lightened up a bit, but we're not even close to the equivalent of acknowledging, for example, that smoking cigarettes is bad for you. We should be shouting "eat lots of natural saturated fat, the kind in meat, milk, cheese and eggs." We're not there yet. Educated people can nonetheless make their own decisions and do just that — and improve their health as a result.

April 25, 2022
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:

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

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:

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!
April 8, 2022
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.

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."

March 15, 2022
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.

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.

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.

February 21, 2022
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:

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

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:

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:

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:

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:

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,

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.

February 1, 2022
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:

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.

December 6, 2021
Ingredients: Whole Foods Sneaks in Sugar

You really do have to read and understand the ingredients list of any food you buy. Even places like Whole Foods need to be carefully checked. Yes, the same Whole Foods that charges "whole paycheck" prices to supposedly only sell food that's good for you.

The Whole Foods brand Olives

Whole Foods is a grocery store with a huge selection of products produced by others. Whole Foods also has its own brand of products, some with standard packaging and some that are custom-packed. Someone I know went shopping there the other day and bought some Whole Foods olives, intrigued by what olives with "tangerine and chilis" would taste like.

After getting them home, my friend opened up the package and tried a couple of the olives. Yuck, what's this? These taste outrageously sweet! These are supposed to be flavored hot and with citrus! What's going on? At that point she took a closer look at the label:

Surprise! The third ingredient after olives and water is "cane sugar." More sugar than oil, more than vinegar, more than tangerines, more than red pepper and more than salt.

This being Whole Foods, the ingredient of salt isn't just any old salt, it's supposedly "sea salt," which sounds like it's better for you somehow. And the sugar isn't any old sugar, it's "cane sugar" — oh, right from sugar cane, it's "natural," right?

Sugar is a Big Problem

Most people like sugar, which is part of why deserts can taste so good. The trouble is that people who make food only care that you like it and want to buy more of it; they mostly don't care whether the food is healthy for you to eat. Regardless of what they say. Therefore, sugar of one kind or another is added to an astounding range and variety of foods, including ones that are "supposed" to be sweet.

Even the CDC, the well-funded government organization whose whole purpose is to keep us healthy, agrees that sugar is a problem.

Weight gain and obesity, type 2 diabetes and heart disease. Is that all? In the section on obesity, the CDC admits that obesity itself is a serious problem:

This being the CDC, all they do is admit that obesity is "associated with" those fatal things and nowhere do they spell out the curse of sugar added to foods and the need to read the ingredients. The picture above shows obviously sweet cupcakes, while much of the problem is with foods that aren't obviously sweet.

Getting information about sugar

You may have noticed my use of phrases expressing cynicism about the CDC. Although the statements I've excerpted above are true, they have appeared on the CDC after decades of being studiously ignored by this corrupt agency. This is because the CDC has long practice in putting its authority and the patina of "science" behind what various powerful pressure groups want to advance their own interests.

Sadly, like with so many other things, it's up to each person to look out for him/her self. In this case, it's pretty simple: moderate your ingestion of sugar in any form; avoid buying and eating packaged food that has any form of sugar added to it; for this purpose, trust only the small-print list of ingredients.

Conclusion

You can't depend on the idea that a "health oriented" store will only sell you healthy food. You can't depend on how a food product is labelled. You have to take control of your own health, which means taking control of what you eat, which means taking care about the ingredients of the food you buy. It's not too hard, it doesn't take much extra effort, and the payback in terms of length and quality of life are more than worth it.

June 8, 2021
Ingredients and Truth

What's inside the food I'm eating or the substance I'm putting in my body? As I hope we all know, two of the most important factors in health and sickness are WHAT and HOW MUCH we ingest. You would think that paying attention to what we ingest and its varying impacts, good and bad, would be front and center in research and education. Yes, we're told to have a "healthy" diet. We're told some things about what that means. Sadly, a great deal of what we're told is wrong, and even worse, few people pay attention to the actual SUBSTANCE, i.e. the ingredients, of what we eat.

Even though lists of ingredients are printed on food packages in tiny print, how many people read them and make informed decisions based on what they read? Based on the incredible and growing fraction of people in our society who are overweight, I think it's fair to guess that the number of people who make such judgements for themselves is minuscule and, unlike their bodies, shrinking.

A Lesson about Reading the Ingredients by the Dentist

I went to the dentist last week for a periodic cleaning and exam. At the end the hygienist prepared the little plastic bag she gives patients containing a toothbrush, paste, and floss. They are freebies by the manufacturers hoping to win new customers. The hygienist added an extra box of a different toothpaste, saying that my gums bled quite a bit and I should try this toothpaste that reduces gum bleeding.

OK, I thought. I had a couple minutes waiting for the X-ray and for the dentist to come examine me, so I examined the box.

See the red streak on the bottom, drawing your attention to "Helps prevent bleeding gums?" My next thought was "I wonder how it pulls that off?" Yes, I know, I'm a nerd, but that really was my next thought. So I turned to the ingredients. Here they are:

My curiosity was immediately piqued. Just one active ingredient! And it's fluoride, the thing common to all toothpastes. 0.454%. Pretty exact amount. It's purpose is stated to be "Anticavity, Antigingivitus." Nothing about bleeding!

Let's look at the other box, the one with the "regular" toothpaste. Let's see what's different about the ingredients. Maybe there's a different amount of fluoride?

Wow. Exactly the same active ingredient, the same in every detail. But the purposes! The same animosity towards cavities and gum rot, but somehow in this toothpaste the fluoride has a new, added purpose: fighting hypersensitivity! I wonder if that's accomplished by putting the fluoride through extra training or something to give it a new purpose in life? What's that about?

Let's look at the front of the box:

Things are getting clear. The normal toothpaste is called Sensodyne, supposedly to attack sensitivity. With fluoride. Same active ingredient.

It's clear, number one, that our wonderful regulators don't care how products are described or sold, so long as the universally-ignored ingredients list in tiny print is accurate.

Oh, wait! Maybe I'm being too hasty! I'd better check the so-called "inactive" ingredients. Maybe one of them is the key thing that makes the difference.

Here we are for Sensodyne:

And the corresponding information for the terrific product that helps prevent bleeding:

A careful check shows that the two products have the same, the identical blankety-blank ingredients!

I'm a complete, total pain in the neck, I know, so I mentioned this politely as a question to my dentist and hygienist. They had no explanation. Oh, the hygienist said, it's what the salesperson said.

I've had many different dentists over the years as I've lived in different places. I've always gotten the little bag of freebies at the end. Has there been an uprising in the dental professional community about this decades-long lying and misrepresentation? If you've heard of it, please let me know.

Conclusion

The big companies making toothpaste and other things you put in your mouth depend on their ability to lie about the virtues of what they're selling and get away with it. They know through experience that no one pays attention to ingredients and that the relevant professionals ignore the issue if they're even aware of it.

The example I've given is trivial. It's just toothpaste and whatever you pick is unlikely to hurt you. But things that you put in your mouth and then swallow or breathe in are a whole different matter. The trouble is that exactly the same blatant lying goes on with food products as I've illustrated here with toothpaste. It would stop if the government made it stop. But it won't. It's the government, after all, the same government that continues to dish out misinformation about nutrition.

It will only stop when consumers rise up and act: start paying attention to ingredients and stop buying products with ingredients that are bad for them. Do schools teach this? I would say that schools spend 10X more time on sex education and political indoctrination than they do on teaching kids what ingredients mean and how to select and control what they eat — except that implies that the amount time spent on that is greater than zero, which it probably isn't in most cases.

I will return to this health-essential issue in future posts.

April 20, 2021