Before I stop with the diet stuff, I want to touch on Dr. Ancel Keyes one last time. The reason for that is I saw a title to a video on how Keyes was the guy who is responsible for the Statin drugs becoming a very big thing.
I don't know if he personally had much to do with it, but once his view on cholesterol and heart disease was adopted by the public, the medical establishment, and the drug manufacturers got busy.
In 2005 the market in the US for Statin drugs was estimated at about $19 billion dollars. Not chump change, we could say. What does that work out per person? Lipitor is the most successful drug ever developed by 2003, with a sales of about $12 billion in 2008.
All of this is based on Keyes' lipid heart disease hypothesis.
Besides the cost, there are some fun side effects with these drugs. Muscle issues, more diabetes, and liver damage. One might ask if they do any good. I would answer that they do lower cholesterol. And then I might ask back, why would you want to lower your cholesterol. You could point to Keyes and say, there you go.
LDL cholesterol is supposed to be the bad actor. However if you want to look at what Dr. Ali says on YouTube, you will hear that LDL is a real important item and you don't want to suppress it. Also the older you are, the more protective all cholesterol levels are. The higher the better. There is no study that links high LDL with heart disease. Dr. Ali is a cardiologist with a fair amount of experience. Worth listening to, he is an interesting speaker.
(High triglycerides are associated with heart problems however. I don't know if the Statins will lower those, but a low carb diet with deal with them quite effectively.)
Dr. Ali feels that his eyes were opened. He used to toe the default line and probably did not care much about Keyes or the position of the standard of care for cardiac patients. He has decided that he and the standard of care and his fellow cardiologists were wrong. In fact with the traditional treatment, he feels that doctors were actively killing patients.
The current research supports his new view.
One more factoid and I'll leave the low carb band wagon behind. Back in the 30s before there was commercial insulin, the standard of care for diabetics was a low carb high fat diet. When insulin became available the care changed over from diet to drugs. There are a number of doctors who have gone back to a diet based care. Diabetes in patients has either moved into remission or is in control, frequently with no drugs or a much lower dose.
I think that blood sugar is the motivation I had to stop eating carbs. When I was at my last place of work they would do blood work every year for free. Over the 10 years my fasting glucose went from about 102 to about 125, it steadily bumped up a few points every year. There is some higher blood sugar in the family. My grandfather took oral insulin and I think my dad had some indications of creeping issues. I figured I was going to have to face this eventually. Sadly I can't report the current numbers. I'll follow up with a wellness check with the doctors once they get back to work. However I have to think that I'm doing myself some good. I've lost about 10% body weight and last measure my blood pressure was falling - which was another item on the rise.
If anyone is interested, YouTube is a great source to look into some of these items. Dr. Ali is there and Dr. Anwin, as well as many others. Search for low carb high fat or keto and lots of stuff will come up. I watched a bunch of talks from the low carb conferences, which have been held over the last 5 or 6 years. It's fascinating to hear the history of all this.
Monday, May 25, 2020
Sunday, May 17, 2020
It's Sad, that SAD
I've promised a tale. It will not be a happy one. It has not ended well for a lot of people and it's a tale of government and power and long term terror. SAD is shortcut for Standard American Diet.
We have to go back to the early 1950s and we have a guy named Ancel Keyes. Ancel was not an MD, but held a PhD in fish physiology. Ancel went to Italy and saw how thin the people were and what they ate and decided to look into it. From that data and others he collected he put forth the fat intake - heart health theory.
He has a famous Seven Country Study, where he shows that the less fat a nation eats, the less heart attacks they have. At the bottom was Italy and Japan and at the top, id est, the ones with the most heart attacks, was the US.
Interesting points about this famous graph. There were originally 24 countries in the data, but some of them didn't fit the curve, so they were excluded. Poor science there, you should not exclude data unless you have a very good reason and if you do exclude them, and you'd better explain why.
One of the countries that didn't make the list was France. The French have a diet very high is saturated fat and very little heart disease. The joke is that if Ancel had vacationed in France we never would have heard of him. So France is a problem for this theory and to explain it, they just call it a "conundrum" or "paradox." Again with the science, if you have a confounding fact, you have to explain it or change your theory. In this case they labeled it and ignored it.
It is true that the US had the most heart attacks. We were in the best shape economically of all the countries post WWII and ate more fat. Here is another cute fact: while it is true that we had more heart attacks, we also had better markers for all the other diseases! So if you were willing to accept a heart attack, you could avoid or delay the onset of everything else.
Where did the heart attacks come from? In those days there were a lot of smokers in US. Smoking doesn't help your heart health.
Back to Dr. Keyes. He, to his credit, took his theory, got some backers and ran all the way to the goal line with. He made the cover of Time! He affected the first wave of federal dietary guidelines. I'm not sure, but he might never have looked at another fish.
Senator McGovern empaneled a committee and looked into diet and health. There is a famous video clip of McGovern telling a scientist who said that we don't know the answer to diet and health. The clip is McGovern saying that he didn't have to luxury of being able to wait for the true story.
The American Heart Association was new and they embraced Dr. Keyes and help push the narrative. They wanted funding and backing Keyes turned into a gravy train that is running to this day.
Keyes determined the "correct" diet for Americans. There was no basis for any of his numbers, he just made them up. There was no experimental data for this position. Interestingly there was a lot of evidence that refuted this theory. There were published studies that went to the 1890s and onward that found no problems with saturated fat or any fat consumption and health. A group of scientists did speak up, and they were fighting the good fight with all the data and the truth, but lost in the court of public opinion. McGovern's committee came up with dietary guidelines, these were passed to other federal stakeholders and were modified. McGovern thought that 5 servings of grains a day would be fine, but it was 7 to 11 when it came back.
And the first food pyramid was dully published and sent out to schools and became the authority to which all dietary advice must be bent. The guidelines are reviewed every five years and while they are started to change, they are fairly intact to this day.
I can remember going to the library in 1980 or so and looking at a bunch of diet books. I was looking for a better way to eat. Probably wanted to lose a few pounds, etc. I went through about seven books and they all said the same thing: low fat, high carbs, grains and breads are fine.
Some of you will remember when all of the food industry started to push their low fat foods. As much of the fat as possible was removed. A big problem showed up immediately. If something is low fat, it frequently doesn't taste very good. No one wants to eat it and if you are in the business this is a problem. But good old American know how found the answer and that was sugar. So we swapped out fat for sugar and carbs. Americans swapped the fat intake/calories for carbs. The amount of protean is about the same. We were good little citizens and towed the line.
One of things about fat is that when it is metabolized, it produces chemicals that make you feel full. Think of it as being self-limiting. This is not true for carbs. You can eat too much and only want more. Fruit has this feature as a survival mechanism. Animals will eat as much as they can get and then eventually spread seeds. It is in fruit's interest to have developed this mechanism.
So the feds ran with this food pyramid. How has the general heath of Americans been this last forty years? Well, one might suggest that it could be better. We are very fat and 9% diabetic and I'm not sure that heart disease has gotten better either.
I think it costs about $400,000 per diabetic patient. Note that about 30% of us are prediabetic... Other countries are in this same boat. Australia is right there with us. This cannot end well if things stay the same.
So government made a very bad decision and to this day have not admitted to it, nor fixed their advice. The American Heart Association is still pushing Keyes' stuff.
Try this quote from Wikipeadia about Keyes:
"In particular, he hypothesized that dietary saturated fat causes cardiovascular heart disease and should be avoided. Modern dietary recommendations by health organizations, systematic reviews, and national health agencies corroborate this."
Note the wonderful circular logic of this: "modern recommendations ... corroborate this." Of course Keyes helped write these recommendations. Sheesh. Of course there are very powerful institutions blocking any changes to this. To wit, the sugar industry, the soft/sport drink guys, etc.
There has been modern research that proves that fat is not the problem, but carbs are. I saw a talk yesterday and the researcher was pretty sure that his data showed that fructose is an especially bad actor and there is a chemical radical released when metabolized from it that really helps cancers get on with their business. So don't think that fruit is going to save you.
Kids are showing up with fatty liver issues. Normally this is a disease of drinkers, but not nine year olds. Kill the sugar, usually ingested via soft and sport drinks, and you can fix this is a matter of weeks.
So as soon as government makes a decision, then industry adopts to it and soon have a vested interest in keeping it going. Look at wind farms and solar panels, they are not cleaner, only work when the weather is proper, never at night if you are a solar panel -- don't ask about clouds and dust and solar eclipses and grid problems - this good green stuff! And it is, but that is federal and state money being sent to some developers. The food industry is tightly connected to high sugar, low fat. Changes may come, but it will be slow and there will be impediments to any changes.
So what is the answer to this type of things? I might suggest that the federal government not get involved in making these decisions. You eat what you want. Set up your own schools. Let private companies develop energy sources - if they are profitable, great, if not then we will not take a long, long, expensive bath.
One could write books about this and some have! There are interesting stories worth looking into. The Atkin's diet and others are banging on the door a bit and some doctors have embraced the low carb diets for themselves and their patients. I find it convincing and they have data to prove their points. The dietary guidelines are being modified, but very slowly. There is a lot of damage to repair, but wonderfully a lot of folks respond and get better is a very short time with a dietary change. Maybe we will see the day when products are advertised as "Low Carb, High Fat!" Until then we'll always have bacon.
---
There are a lot of interesting talks by researchers on this subject. I've watched a bunch on YouTube. Search for HFLC or "low carbs down under" and you'll find a bunch. See the talks by Phinney and Dr. Ali, Dr. Unwin.
We have to go back to the early 1950s and we have a guy named Ancel Keyes. Ancel was not an MD, but held a PhD in fish physiology. Ancel went to Italy and saw how thin the people were and what they ate and decided to look into it. From that data and others he collected he put forth the fat intake - heart health theory.
He has a famous Seven Country Study, where he shows that the less fat a nation eats, the less heart attacks they have. At the bottom was Italy and Japan and at the top, id est, the ones with the most heart attacks, was the US.
Interesting points about this famous graph. There were originally 24 countries in the data, but some of them didn't fit the curve, so they were excluded. Poor science there, you should not exclude data unless you have a very good reason and if you do exclude them, and you'd better explain why.
One of the countries that didn't make the list was France. The French have a diet very high is saturated fat and very little heart disease. The joke is that if Ancel had vacationed in France we never would have heard of him. So France is a problem for this theory and to explain it, they just call it a "conundrum" or "paradox." Again with the science, if you have a confounding fact, you have to explain it or change your theory. In this case they labeled it and ignored it.
It is true that the US had the most heart attacks. We were in the best shape economically of all the countries post WWII and ate more fat. Here is another cute fact: while it is true that we had more heart attacks, we also had better markers for all the other diseases! So if you were willing to accept a heart attack, you could avoid or delay the onset of everything else.
Where did the heart attacks come from? In those days there were a lot of smokers in US. Smoking doesn't help your heart health.
Back to Dr. Keyes. He, to his credit, took his theory, got some backers and ran all the way to the goal line with. He made the cover of Time! He affected the first wave of federal dietary guidelines. I'm not sure, but he might never have looked at another fish.
Senator McGovern empaneled a committee and looked into diet and health. There is a famous video clip of McGovern telling a scientist who said that we don't know the answer to diet and health. The clip is McGovern saying that he didn't have to luxury of being able to wait for the true story.
The American Heart Association was new and they embraced Dr. Keyes and help push the narrative. They wanted funding and backing Keyes turned into a gravy train that is running to this day.
Keyes determined the "correct" diet for Americans. There was no basis for any of his numbers, he just made them up. There was no experimental data for this position. Interestingly there was a lot of evidence that refuted this theory. There were published studies that went to the 1890s and onward that found no problems with saturated fat or any fat consumption and health. A group of scientists did speak up, and they were fighting the good fight with all the data and the truth, but lost in the court of public opinion. McGovern's committee came up with dietary guidelines, these were passed to other federal stakeholders and were modified. McGovern thought that 5 servings of grains a day would be fine, but it was 7 to 11 when it came back.
And the first food pyramid was dully published and sent out to schools and became the authority to which all dietary advice must be bent. The guidelines are reviewed every five years and while they are started to change, they are fairly intact to this day.
I can remember going to the library in 1980 or so and looking at a bunch of diet books. I was looking for a better way to eat. Probably wanted to lose a few pounds, etc. I went through about seven books and they all said the same thing: low fat, high carbs, grains and breads are fine.
Some of you will remember when all of the food industry started to push their low fat foods. As much of the fat as possible was removed. A big problem showed up immediately. If something is low fat, it frequently doesn't taste very good. No one wants to eat it and if you are in the business this is a problem. But good old American know how found the answer and that was sugar. So we swapped out fat for sugar and carbs. Americans swapped the fat intake/calories for carbs. The amount of protean is about the same. We were good little citizens and towed the line.
One of things about fat is that when it is metabolized, it produces chemicals that make you feel full. Think of it as being self-limiting. This is not true for carbs. You can eat too much and only want more. Fruit has this feature as a survival mechanism. Animals will eat as much as they can get and then eventually spread seeds. It is in fruit's interest to have developed this mechanism.
So the feds ran with this food pyramid. How has the general heath of Americans been this last forty years? Well, one might suggest that it could be better. We are very fat and 9% diabetic and I'm not sure that heart disease has gotten better either.
I think it costs about $400,000 per diabetic patient. Note that about 30% of us are prediabetic... Other countries are in this same boat. Australia is right there with us. This cannot end well if things stay the same.
So government made a very bad decision and to this day have not admitted to it, nor fixed their advice. The American Heart Association is still pushing Keyes' stuff.
Try this quote from Wikipeadia about Keyes:
"In particular, he hypothesized that dietary saturated fat causes cardiovascular heart disease and should be avoided. Modern dietary recommendations by health organizations, systematic reviews, and national health agencies corroborate this."
Note the wonderful circular logic of this: "modern recommendations ... corroborate this." Of course Keyes helped write these recommendations. Sheesh. Of course there are very powerful institutions blocking any changes to this. To wit, the sugar industry, the soft/sport drink guys, etc.
There has been modern research that proves that fat is not the problem, but carbs are. I saw a talk yesterday and the researcher was pretty sure that his data showed that fructose is an especially bad actor and there is a chemical radical released when metabolized from it that really helps cancers get on with their business. So don't think that fruit is going to save you.
Kids are showing up with fatty liver issues. Normally this is a disease of drinkers, but not nine year olds. Kill the sugar, usually ingested via soft and sport drinks, and you can fix this is a matter of weeks.
So as soon as government makes a decision, then industry adopts to it and soon have a vested interest in keeping it going. Look at wind farms and solar panels, they are not cleaner, only work when the weather is proper, never at night if you are a solar panel -- don't ask about clouds and dust and solar eclipses and grid problems - this good green stuff! And it is, but that is federal and state money being sent to some developers. The food industry is tightly connected to high sugar, low fat. Changes may come, but it will be slow and there will be impediments to any changes.
So what is the answer to this type of things? I might suggest that the federal government not get involved in making these decisions. You eat what you want. Set up your own schools. Let private companies develop energy sources - if they are profitable, great, if not then we will not take a long, long, expensive bath.
One could write books about this and some have! There are interesting stories worth looking into. The Atkin's diet and others are banging on the door a bit and some doctors have embraced the low carb diets for themselves and their patients. I find it convincing and they have data to prove their points. The dietary guidelines are being modified, but very slowly. There is a lot of damage to repair, but wonderfully a lot of folks respond and get better is a very short time with a dietary change. Maybe we will see the day when products are advertised as "Low Carb, High Fat!" Until then we'll always have bacon.
---
There are a lot of interesting talks by researchers on this subject. I've watched a bunch on YouTube. Search for HFLC or "low carbs down under" and you'll find a bunch. See the talks by Phinney and Dr. Ali, Dr. Unwin.
Wednesday, May 6, 2020
Diet Details
I wanted to write about what interesting things I've run across in re the low carb - high fat diet.
Back a few months ago it was my view of how digestion works is that we have little miners in us and that they would chase down the molecules and nutrients that we need. For example we have to eat some iron, but we didn't need to eat liver. These little guys would store and use what was required and pass on the rest.
Some of that is correct, but I was wrong on several fronts. So let me lay out a simplified view of the actual symptom. It looks like researchers have nailed all the details down to inter-cellular levels and it seems to be quite reliable. I'm comfortable with accepting this view as being correct.
Food comes in a limited number of forms. We have the fats, the carbs, and protean. The body handles them separately. I'll add fiber to that too as a separate category.
So fats have their own tube and get passed down to the colon and there you get some bile being added. There are a lot of vitamins in fat and this is where the get absorbed. Bile is not released in the absence of fat intake and if you take vitamin D3 for example, you have to take it with some fat or it won't get absorbed. There are a lot of good vitamins in animal fat; a lot of them on the required list.
Proteins and fibers go through the stomach and get an acid bath and then into the small intestine. Stuff gets extracted from there and then fiber is passed on to the large intestine. The colon uses more of a fermentation process to deal with fiber. Interesting point that the researchers have made is that the human system is not optimized for fiber and vegetarian food. The gorilla is. Gorilla colons are ten times longer than a human's. Note their large bellies! Basically if you are vegan or something, you are not using your body as designed.
Now the most interesting item are the carbs. They get processed by the liver and readily get into the blood stream. The total amount of glucose in the entire blood stream is about a teaspoon's worth. When more carbs hits the blood stream than that, insulin is released. Insulin in quite a material and does a lot. It's main job is storage. If the glucose is not needed for immediately energy or for short term storage in the muscle, then is it converted to fat and stored in fat cells. Note that you don't get more fat cells, they just change in size as they fill or empty.
The problem is if you have too much glucose running around. The body will keep producing insulin. If this goes on for too long then the body become insulin resistant. And soon after that you get diabetes. One of the effects of this is that various cells and the brain get starved for glucose, which is the energy source. It is suggested that a fair amount of senior dementia is due to lack of glucose in brain cells, due to too much insulin. The insulin damages some of the cellular mechanisms which then block the movement of glucose into the cells. The cells are starved for energy.
The standard treatment for diabetes has been a low fat, high carb diet and more insulin. Because if there is too much blood sugar, then adding more sugar makes sense and the same for insulin!
There is a GP from the UK who was in practice for 25 years. He had two problems, well, three I guess. He was a product of traditional medical schools, he was a bit of a scientist, and he became diabetic. But he was lucky in that he had a patient who "cured" herself of diabetes. To his credit he didn't fall back on his training, which told him that there was nothing to be done about diabetes, it was a long downhill run and part of getting older. He looked into it being a scientist. He had never seen diabetic remission in his 25 years of practice.
So what was the cure? It was just eating very few carbs. After his research into this patient, he adopted the diet himself. His condition is under control unless he eats bananas. By the way, he is a very amusing and likeable speaker and can be found on YouTube, his name is Dr. David Unwin, worth the watch.
What happens when the body is "starved" for glucose? I did mention that glucose in cellular energy material and the brain needs a lot of it. Well, the body being an impressive multifunctioning device will take the fat out of its stores and convert the fat back to glucose as needed. So basically, no problem! The fat storage system is so efficient that we all have energy for a long time just in the fatty material. There has been some research in extreme athletes who are using a no carb diet. Some of them have less than three percent body fat, they still have lots of energy ready to go.
Finally if the brain needs more glucose, it will convert protean to glucose. If there is no protean intake, then you start to lose lean body mass - think of those in starvation.
As I have adopted this diet, I'm down a bunch of weight, my waist is getting smaller, I'm no longer hungry, and I really don't miss the carbs. Having the fat burning mechanism running, as energy is needed, it is pulled from the fat stores. So I'm not looking for the next meal. Also what I can eat is pretty good. Cheese, nuts, meat, cream, salads, basically anything but sweets. It is quite satisfying and then there is bacon! I do miss a few things. Barb made a peach cobbler the other day and I did have a couple of very small servings. She did a nice job and it tasted real good...
That's a bit of a simplified view of digestion, there are YouTube resources if you are interested. Look for Unwin and Phinney if you want to know more.
I want to talk about how the standard American diet came about. It's a sad big government moment that should scare us all. It's not the only one and there will be more down the road.
Back a few months ago it was my view of how digestion works is that we have little miners in us and that they would chase down the molecules and nutrients that we need. For example we have to eat some iron, but we didn't need to eat liver. These little guys would store and use what was required and pass on the rest.
Some of that is correct, but I was wrong on several fronts. So let me lay out a simplified view of the actual symptom. It looks like researchers have nailed all the details down to inter-cellular levels and it seems to be quite reliable. I'm comfortable with accepting this view as being correct.
Food comes in a limited number of forms. We have the fats, the carbs, and protean. The body handles them separately. I'll add fiber to that too as a separate category.
So fats have their own tube and get passed down to the colon and there you get some bile being added. There are a lot of vitamins in fat and this is where the get absorbed. Bile is not released in the absence of fat intake and if you take vitamin D3 for example, you have to take it with some fat or it won't get absorbed. There are a lot of good vitamins in animal fat; a lot of them on the required list.
Proteins and fibers go through the stomach and get an acid bath and then into the small intestine. Stuff gets extracted from there and then fiber is passed on to the large intestine. The colon uses more of a fermentation process to deal with fiber. Interesting point that the researchers have made is that the human system is not optimized for fiber and vegetarian food. The gorilla is. Gorilla colons are ten times longer than a human's. Note their large bellies! Basically if you are vegan or something, you are not using your body as designed.
Now the most interesting item are the carbs. They get processed by the liver and readily get into the blood stream. The total amount of glucose in the entire blood stream is about a teaspoon's worth. When more carbs hits the blood stream than that, insulin is released. Insulin in quite a material and does a lot. It's main job is storage. If the glucose is not needed for immediately energy or for short term storage in the muscle, then is it converted to fat and stored in fat cells. Note that you don't get more fat cells, they just change in size as they fill or empty.
The problem is if you have too much glucose running around. The body will keep producing insulin. If this goes on for too long then the body become insulin resistant. And soon after that you get diabetes. One of the effects of this is that various cells and the brain get starved for glucose, which is the energy source. It is suggested that a fair amount of senior dementia is due to lack of glucose in brain cells, due to too much insulin. The insulin damages some of the cellular mechanisms which then block the movement of glucose into the cells. The cells are starved for energy.
The standard treatment for diabetes has been a low fat, high carb diet and more insulin. Because if there is too much blood sugar, then adding more sugar makes sense and the same for insulin!
There is a GP from the UK who was in practice for 25 years. He had two problems, well, three I guess. He was a product of traditional medical schools, he was a bit of a scientist, and he became diabetic. But he was lucky in that he had a patient who "cured" herself of diabetes. To his credit he didn't fall back on his training, which told him that there was nothing to be done about diabetes, it was a long downhill run and part of getting older. He looked into it being a scientist. He had never seen diabetic remission in his 25 years of practice.
So what was the cure? It was just eating very few carbs. After his research into this patient, he adopted the diet himself. His condition is under control unless he eats bananas. By the way, he is a very amusing and likeable speaker and can be found on YouTube, his name is Dr. David Unwin, worth the watch.
What happens when the body is "starved" for glucose? I did mention that glucose in cellular energy material and the brain needs a lot of it. Well, the body being an impressive multifunctioning device will take the fat out of its stores and convert the fat back to glucose as needed. So basically, no problem! The fat storage system is so efficient that we all have energy for a long time just in the fatty material. There has been some research in extreme athletes who are using a no carb diet. Some of them have less than three percent body fat, they still have lots of energy ready to go.
Finally if the brain needs more glucose, it will convert protean to glucose. If there is no protean intake, then you start to lose lean body mass - think of those in starvation.
As I have adopted this diet, I'm down a bunch of weight, my waist is getting smaller, I'm no longer hungry, and I really don't miss the carbs. Having the fat burning mechanism running, as energy is needed, it is pulled from the fat stores. So I'm not looking for the next meal. Also what I can eat is pretty good. Cheese, nuts, meat, cream, salads, basically anything but sweets. It is quite satisfying and then there is bacon! I do miss a few things. Barb made a peach cobbler the other day and I did have a couple of very small servings. She did a nice job and it tasted real good...
That's a bit of a simplified view of digestion, there are YouTube resources if you are interested. Look for Unwin and Phinney if you want to know more.
I want to talk about how the standard American diet came about. It's a sad big government moment that should scare us all. It's not the only one and there will be more down the road.
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