The Arrow #139

Hello friends.

Greetings from Dallas.

MD and I flew back a couple of days ago. It isn’t as hot as it has been, but it’s plenty hot. I decided to go to the practice range the day after we got back. Given the heat, I figured no one would be there. But I was wrong. The range wasn’t packed, but there were plenty of other fools there swinging away along with me.

I can absolutely tell you that no one would be at the range in Montecito at 97F. It would be empty. But this is Texas, so if you want to go to the range, you go when it’s hot. Or you wait a few months.

On another note, MD and I leave for Scotland and Ireland in a few days. We had been planning a trip to Italy with another couple for about three years now. We haven’t been there in at least four years, so I was fired up about going. MD then introduced both the husband and wife of the other couple to frigging Outlander. They both got hooked as bad as she did, so all of a sudden there was talk of going to Scotland instead of Italy. Then there was a vote. It was 3-1 Scotland. I was pissed. I mean who wants to go to Scotland when Italy is available? [Well 75% of us apparently, the bride adds.]

In an effort to placate me, they (I had no role in planning the trip) set aside a day for golf at St. Andrews. Then they decided to add Ireland to the list, because we could get better rates flying through Dublin. So the last few days of the trip will be in Ireland. I’ll be playing Royal Port Rush, where I have played before. It’s a splendid course. And County Louth Golf Club, which I haven’t played, but is supposedly pretty good. Looks great in the photos.

So, I am placated. But in Italy all I would do is lay around and enjoy the place. With a lot of time to write. I’m not in charge of the scheduling on the Scotland/Ireland trip, and I know there is a lot planned. So, next week’s Arrow might be a bit travelogue-y.

For whatever reason, I read a lot more this last week than usual, so I’ll pass along some of what I found enlightening.

I read one of the best essays I’ve ever read on what is going on right now in terms of censorship and cancellation. Before I get to it, I want to briefly get into a book I’ve mentioned before. One that I, and a whole lot of other people, consider brilliant.

The Establishment Strikes Back

In around 2013 former CIA analyst Martin Gurri privately printed a book on what he believed was going to happen globally with the spread of the internet and social media. Word spread as to the substance of his work, and he ultimately got it published in 2014.

His book, Revolt of the Public and the Crisis of Authority in the New Millenium posited that with the growth of first the internet followed by the explosion of social media there would be a massive change in how the average person viewed the world.

Those of us with some years on us who lived in the pre-internet, cell phone, social media era remember how it was. The only information we got was from our local newspaper, the evening news, and maybe a national newspaper—The Wall Street Journal or The New York Times—if we subscribed. We might hear breaking news over the radio, if we happened to be listening. But that was about it. The news we got was carefully curated.

I have a friend who is a former Wall Street Journal investigative journalist who was up for a Pulitzer years ago. He used to give seminars on dealing with the media. He would always start out by asking the attendees this question: What is news?

He asked everyone to write down their answers anonymously. Once the answers were passed to him, he read them aloud. All of them were pretty much along the same line: News is when something important or out of the ordinary happens that people want to know about.

After reading all these answers, he would say, You are all wrong. News is what the news providers decide to report. In the pre-internet, social media days, if they didn’t report it, you didn’t know about it.

Who controlled all the major newspapers, television stations, radio stations, and virtually all of the media? The establishment. Most leaned a bit left of center (even the NY Times), but a few were centrist or a tad right of center. Most of them presented basically the same news.

The various media outlets didn’t report what they didn’t want you to know. That’s why JFK’s wild sexual escapades were never known publicly until fairly recently. The establishment didn’t think the average American should know.

The premise of Gurri’s book is that when internet use became widespread followed by the onslaught of social media, the establishment began to lose control of the information. Now the average Joe had the ability to search for his own information instead of waiting for it to be fed to him. If indeed it ever would be.

Gurri starts with the Arab Spring in 2011 and shows how social media was the driving force for that movement. He continues to explain how the access to information has completely changed society and has wrested control of the flow of information from the establishment.

But the establishment hasn’t taken it lying down. The totally unexpected election of Donald Trump in 2016 caught them completely by surprise even though Gurri had predicted it. He hadn’t predicted Trump specifically back in 2013, but he did predict an outsider populist president would be elected as a consequence of the internet and social media.

After being caught off guard by the Trump election, the complacent establishment roused and sprang into action. They realized that if one of their own could be beaten by the likes of Donald Trump, they were in danger of totally losing control. They realized they controlled all the major media, the leadership of the US intelligence apparatus, and all the social media outlets, so they hatched a plan to deem everything they didn’t want to get into public circulation disinformation or misinformation.

If they could all gang together and prevent information they didn’t want to have freely circulating in the public sphere, then they would regain some measure of control over the narrative. Which is exactly what they did.

Gurri predicted the coming revolt of the public against the establishment, and a brilliant essay by former intelligence agent Jacob Siegel describes in detail how the establishment fought against this revolt.

The essay is long. Which I fear may put a lot of people off of reading it. But it is well worth your time. [The bride read it and agrees with me.] It explains in great detail what has been going on over the past several years. I learned many, many things I did not know till I read it.

For instance, I always wondered about all these Covid-driven changes in the election rules. Article 1, Section 4 of the Constitution states that the “Times, Places, and Manner of holding elections…shall be prescribed in each State by the Legislature thereof…” Which means the various state legislatures set the rules for elections in their states. For example, the California State Legislature has allowed for ballot harvesting, which many other states consider unlawful. But, under the terms of the Constitution, California can do it however the legislature wants.

I couldn’t figure out why, during the 2020 elections, so many state legislatures rolled over due to Covid and allowed practices they had theretofore shunned. Then I read this in the Siegel essay:

SOURCE

The above is the only part of this essay I’m going to quote, because the whole thing is so good, if I started quoting more, I would end up quoting it in its entirety. I encourage you to read it in full.

Whether you agree with everything the establishment has done or not or whether you hate Donald Trump or love him, I suggest you still read it. Because at some point, the worm will turn, and your team will be on the losing side. Then all the force will be on the opposing side, and history will allow them to use it. For instance, your candidates for higher office may well be arrested and charged with crimes. Now there is plenty of precedent.

You may think I’m a raging Trump fan, but nothing could be further from the fact. If I had my way, Donald Trump would evaporate. But that isn’t going to happen. And now that he is good and pissed, there’s no telling what he will do if he happens to get elected. An outcome that is looking more and more likely.

Alex Berenson, who is a total Trump loather, wrote a couple of interesting articles on the situation. One titled Why the elites are so hated and Donald Trump is stronger than ever after three indictments, and another headlined On the coming radicalism of Donald J. Trump. Both make for interesting reading, especially given Berenson’s distaste for Trump.

Another article worth reading is Mutually Assured Destruction is the Only Solution to Political Lawfare. The author’s contention is that the party on the outs needs to begin charging and arresting members of the other party when they become the minority. That’s the only thing that will prevent them from charging and arresting again once they’re back in power.

It’s a distasteful proposition for any country that’s not a tin pot dictatorship.

We’ve already seen how this works with the federal judiciary.

There is no single individual in the United States with as much power as a single federal judge. Not even the president. A federal judge can strike down a law with the stroke of a pen. Then the lawsuits start. But until the lawsuits are resolved—which can take years—the fiat law imposed by a single judge will be in effect. Same thing can happen with a presidential executive order. Someone who doesn’t like it sues in federal court, and a single judge can issue a ruling shutting down the executive order until it is litigated.

All of this power invested in one individual means the people who are potential federal judges need to be vetted carefully. And should be as non-partisan as possible. Presidents get to pick federal judges, but then they have to pass muster in the Senate. In the old days (before Harry Reid), that would require 60 senators to approve. Unless there is at least a 60 seat party majority in the Senate, which is unlikely in these partisan days, the pending judicial nominees have to be approved by members of both sides (it used to be a two thirds majority, which, in my view, was even better). This means the judges up for the job have to have evidenced fairness and non-partisanship in their previous judicial roles.

In Obama’s last term, he tried to appoint many far left judges to the federal judiciary (a lifetime appointment). The GOP and Mitch McConnell would not give team Obama the 60 votes needed for approval. Had these been middle of the road judges, it wouldn’t have been a problem—as it hadn’t been for decades—but these weren’t middle of the road picks. Harry Reid, then the Senate Majority leader, threatened to use the nuclear option, which meant switching the process from a 60 vote majority for approval to a simple majority. At the time, there were 52 Dems in the Senate, which gave them a majority. Mitch McConnell warned Reid that if he used the nuclear option, it would come back and bite him in the rear once the GOP was in charge, as it would be at some point in time.

Reid blew the threat off, deployed the nuclear option, and got a bunch of judges appointed to the federal bench via a simple majority.

Then the GOP took over in 2016. And the worm turned. When the Dems wouldn’t approve Trump’s nominees to the Supreme Court, McConnell deployed the nuclear option and ramrodded them through with a simple majority.

So, now instead of having fairly non-partisan federal judges at all levels, we have Obama judges and Trump judges. Prior to all this, whenever you would read about a federal judge issuing a controversial ruling, the judge was always named in the article. Now, when such articles appear, they usually name the judge followed by “appointed by Obama” or “appointed by Trump.”

Politics should not be the way judges are appointed, but, thanks to Harry Reid, that’s the reality now.

Okay, on to other things. I’m depressing myself just writing about all this.

Let’s look at something less depressing. Maybe heart disease and Lp(a) instead.

New Drug for Lp(a)

A few days ago I was cruising through the torrent of medical sites I usually read and came upon a report about a new drug seeking approval. According to early studies, this one decreases the levels of lipoprotein a, usually written as Lp(a) and pronounced lipoprotein little a.

What is Lp(a), and what does it do?

Lp(a) is a lipoprotein just like LDL. The difference is it has an Apo(a) attached to it, which, in a general sense, helps it to prevent cracks and fissures in blood vessels. And also makes it more difficult to break up clots.

Malcolm Kendrick, in his (highly recommended) book The Clot Thickens, has a pretty good summary of what we know about Lp(a):

Lp(a) is probably the only one of the lipoproteins that actually has a detrimental effect on the heart. Lp(a) gets itself enmeshed in forming clots and keeps them from dissolving. Lp(a) is often found in high concentrations in coronary plaque, which is not a good sign.

Who knows how many little clots form on our arterial walls then dissolve under the actions of the body’s anti-clotting mechanisms. Having Lp(a) as a part of the clot makes the internal clot busting more difficult. Which is why Lp(a) is so strongly associated with heart attack.

Now, there is a drug under investigation that reduces the levels of Lp(a). According to the report

Wow, a drug that treats a risk factor for heart disease may finally be coming to market. As you can see from the article about this drug, one of the things that most excites the authors is that there is nothing yet found that decreases Lp(a).

But is that true?

Nope.

I’ve known for years what treats it. And have treated elevated Lp(a) in my own patients.

Take a look at the title and abstract of this paper from 26 years ago.

You can see from my red underlining above what treats Lp(a). Saturated fat.

At the time this study was done, interest in the negative health benefits of trans fats were looming. I suspect this study intended to show that trans fats had a negative effect on Lp(a). The literature cited was all over the place, with most of it showing an increase in Lp(a) with increased trans fatty acid intake.

Since the intention of the study was probably to show trans fats raise Lp(a) as much as, if not more than, saturated fats, I’m sure they were surprised to find that saturated fats significantly lowered Lp(a) levels.

In case you’re wondering if any more modern studies duplicated the results of this one from 1997, the answer is yes. There are a number of them.

Here are the results of a Harvard study published in 2022.

As you can see from the red line, the Low-Carb diet, which was 20 percent carbohydrate (which ain’t all that low) and 21 percent saturated fat reduced Lp(a) by 14.7 percent.

When MD and I were doing countless interviews after the publication of Protein Power in 1996, the question we were asked over and over again was some variant of the following: If your program works as well as you claim it does, why aren’t there any studies showing that?

It was a difficult question to answer because there really weren’t any recent studies showing low-carb diets to be superior to low-fat or low-calorie diets in terms of weight loss or any other parameters. It was just taken as a given that the low-fat diet was heart healthy and the best way to lose weight. When we would debunk this, the follow up question was always, Well, why don’t you do a study?

People don’t understand the study business. We weren’t academics getting grants. We were clinicians taking care of patients. It’s difficult for clinicians in practice to do studies. We approached each patient a bit differently depending upon that particular patient’s likes and dislikes, how much he/she needed to lose, and whatever other medical issues were involved. You can’t do that in a study. You have to treat everyone the same. Which is just not feasible when you’re being paid to render the best individual care possible to a given patient.

In the early 2000s a couple of studies were published in the New England Journal of Medicine. Both compared low-carb to low-fat diets in terms of weight loss and blood sugar control. Both were conducted by non-believers in the efficacy of the low-carb diet. I don’t know this for a fact, but I would bet the rationale for the studies was to show once and for all that low-carb diets were simply fad diets that didn’t live up to their hype.

In both studies, the low-carb diet emerged as the clear winner on all counts. I’m proud to say that the study with the best results of the two used the diet outlined in our book Protein Power as the low-carb diet for that group. [We were not involved in any way; they just chose our diet as the study diet.] Here is the link for the other.

After these two studies, the floodgates finally opened and studies started accumulating. Virtually all of them, one after another, showed the superiority of the low-carb diet as a weight loss agent.

Then the hue and cry went up along the lines of, Okay, well, maybe you’ll lose weight faster on a low-carb, high-fat diet, but you’ll clog your arteries in the process. You’ll at least be thin when you die of your heart attack.

Then people started studying low-carb diets in terms of what they do to cardiac risk factors. Which is what the Harvard study quoted above was looking at.

After a low-calorie run-in dietary program during which the subjects lost 10-15 percent of their body weight, they were divided into three groups, each of which was put on a different maintenance diet. Protein was kept the same 20 percent in each of the three diets while carbohydrate and fat varied.

The Low-Carb group got 20 percent of their calories from carbohydrate and 60 percent from fat. Those in the Moderate-Carb group got 40 percent of both carbs and fat, while the High-Carb group got 60 percent of their calories from carbs and 20 percent from fat. The study lasted for 20 weeks.

The main outcome was to see what the lipoprotein insulin resistance score (LP-IR) was for each group. Here is a general explanation of what the score entails.

At the end of the 20 week study, the results were as follows.

Which means on average those in the Low-Carb group dropped their LPIR score by 5.3 points whereas those on the Moderate-Carb arm dropped a tiny 0.02 points. Those on the High-Carb are saw their scores increase by 3.6 points.

The study was set up to evaluate just the LPIR, but the researchers checked the Lp(a) as well. Which, as mentioned above, fell by 14.7 percent on the low carb arm.

So low-carb diets not only allow you to lose weight more quickly, they reduce insulin resistance and drop Lp(a).

So there is an “effective tool” and an “available treatment” to deal with Lp(a), it’s just not one that will set the patient back a thousand dollars a month like the one under investigation likely will.

Just think about how many ribeye steaks could be purchased for $1,000.

Cochrane In A Tailspin

For years the Cochrane Collaboration has been the place for scientists and doctors to go to get the real scoop on various drugs and medical treatments. The researchers who are part of the collaboration are scrupulous in their vetting of studies in an effort to bring the most up-to-date and unbiased findings to the fore.

A few months ago, the Cochrane Collaboration issued a report saying that after analyzing all the studies in print, there was little to no evidence masks work to prevent the transmission of viruses. Since it was Cochrane issuing the report, it got plenty of attention. Including from the New York Times, which had been all in on the masking from the get go. An opinion writer, who, as it later turned out, was one of the authors of a sloppy paper the Cochrane folks refuted, wrote a piece savaging the Cochrane report.

Karla Soares-Weiser, the editor-in-chief of Cochrane ended up rushing “out a statement undermining Cochrane scientists’ assessment that masks provide little help in stopping community transmission of viruses” and since has been on the receiving end of a lot of blowback from the scientists involved.

Investigative journalist Paul Thacker wrote a thorough report on the imbroglio that I found quite interesting.

Usually his stuff is behind a paywall, but this piece is not, so I’m posting it for your enjoyment.

Are You An NPC?

According to one of my favorite writers, Gurwinder Bhogal, you probably are. For those of you who don’t know what an NPC is, here is how he describes one after talking about how so many people have developed knee-jerk, botlike behavior about certain issues.

He discusses the different routes to the “truth” that different people take. Most of them are following the path of least resistance, which is what we all do a lot of the time simply because our time is limited. So we want to make the most efficient use of it.

The five common NPC species are as follows.

1. The Conformist. That’s the person who follows the current thing.

2. The Contrarian. Just what you would expect. Always against the current thing.

3. The Disciple. They follow a person in whom they believe.

4. The Tribalist. Needs no explanation. Look at today’s politics.

5. The Averager. Someone who seeks a middle position in everything.

Gurwinder goes on at length describing these different NPC species. I find myself falling into different categories depending upon the subject. All except #1. I’ve never really been a conformist.

These are all shortcuts to the “truth” we may be seeking. But do we need to know the real truth about many things we seek the truth in? Does it matter?

This is a question I ask myself all the time. At least a half dozen times per day. Does this really matter to me? I’ve been blessed or plagued (depending upon how you look at it) with an almost insatiable curiosity. I’m even curious about what I’m curious about. And what I’m not curious about.

Some things set me off down a rabbit hole of discovery while other things don’t particularly ring my chimes. And I’m curious as to why they don’t ring my chimes. Then I spend time thinking about that, because some things I’m not curious about, I probably should be.

And even worse, one curiosity that sends me down one path gets trumped by a newer, shinier curiosity, and I’m off in another direction. For example, a few days ago I started reading Sean McMeekin’s excellent book on the Russian revolution, an epochal event ultimately changing the world and causing tens of millions of people to lose their lives. And I realized I knew little about it except its rough date. So, I’m off reading along, and while going through my emails, I come across a review of the book The Swerve, which is about Poggio Bracciolini’s discovery of Lucretius’s ancient poem On the Nature of Things and how it changed the world. I had started reading this book years ago, but found it kind of boring, so laid it aside. The review I read said the book started slowly, but got better page by page. So, I drag it off my bookshelf and dig in. Totally abandoning, for the moment, the Russian revolution.

Neither of these books will change my life, so why bother with them? There are so many other things I could be doing that might indeed change my life (for the better, one hopes), yet I don’t do them because I’m going down first one rabbit hole, then the next. (I’m sure the bride will comment here when she vets this issue. She’s lived with it for many decades.) [The bride avers this is a solid truth.]

Gurwinder discusses how we spend much of our time searching for the truth about issues that are secondary and tertiary to the issues really critical to our lives. Which takes time away from those primary issues that we should be spending more time on.

His entire piece is terrific, and I encourage you to read it. I’ll have to work to do it, but I’m going to try to devote more time to primary issues and less to the rest.

Here is his piece in its entirety.

Uncoupling For Weight Loss

Years ago MD and I along with a partner, who was a neurosurgeon, developed a weight-loss supplement that worked incredibly well. We had it evaluated by an independent research lab, which, after a study on 90 subjects discovered it generated almost twice the weight loss as placebo in those who were following a moderately-restricted low-carb diet and doing a modest amount of exercise.

I don’t want to get into the supplement or that whole episode right now. It’s a story for a different day. But I do want to get into how it worked.

It worked by increasing mitochondrial uncoupling. Which is a nice thing. But it’s not all that nice when someone who doesn’t even know what a mitochondrion is asks you how your supplement works.

I read a recent article Ben Bikman wrote for his company on how a low-carb diet stimulates uncoupling. When I looked up the study, it turned out that the subjects in the study were the same subjects in the study I wrote about above in the section about saturated fat and Lp(a), so I thought it would be good to discuss in the context of uncoupling.

For those of you who have been around for months, you may recall that I’ve written a few times about how the mitochondria work. For the newbies, I’ll go over it quickly.

When we break down food to its component parts—fats, carbs, and protein—the bonds holding those macronutrients together are torn apart. The energy released is captured by specific molecules that transport it to the mitochondria. In the mitochondria this energy is used to create an electro-chemical gradient across the inner mitochondrial membrane. This gradient acts like a dam holding back a river. It’s a storehouse of power. When the water held back by a dam is released, it runs through a chute and turns a turbine that captures the energy of the rushing water as electricity, which is then used to light homes. And anything else that needs lighting.

In the mitochondria these positive charged particles rush through a similar kind of turbine, many of which are located in the membrane, and basically turn the turbine in a way that produces ATP, which is the energy currency of the body.

This system doesn’t just run helter skelter cranking out ATP like crazy. It is run on demand. As we need more ATP, the little mitochondrial turbines churn it out. And they churn out a lot of it. It’s estimated that we each produce about our body weight in ATP each day.

Now if we have food coming down the pike, and we need energy, that food is broken down and its constituents are sent to the mitochondria to fuel the ATP turbine. We need energy constantly just to live, so there is always fuel coming down the pipeline. If we are doing heavy work, then more fuel comes into the mitochondria to drive the turbines. If we are sitting on our rears, not as much.

When we don’t need a lot of fuel and still have plenty of fuel available, that extra fuel is sent to storage. The storage place for most of it is our fat. That is our main battery. Everything—carbs and protein—can be converted to fat if not needed. So if we don’t need a lot of energy to support our life, and we take a lot of energy in, the extra gets stored in fat. And we gain weight. If we generate more energy to live than we take in, we pull fat from our fat stores and lose weight.

Let’s say we’re cranking along living our normal life, which requires X amount of ATP to fuel it, so we’re in a steady state. We aren’t gaining or losing weight. We’re just holding steady.

Now let’s assume something causes our mitochondria to leak power across the membrane. In the example of the dam holding back the water, this would represent holes in the dam. Our mitochondria could still generate plenty of energy to keep us going. We would never notice there was a problem, in fact. But the pipeline feeding the mitochondria would have to carry more fuel than before to meet the energy need.

This is called uncoupling.

If there is no uncoupling, the energy supplied to the mitochondria by stored fat would be roughly X and the energy produced as ATP would be roughly X. But if uncoupling is present, then it may take 2X of energy supplied to the mitochondria to produce X energy as ATP.

You could see how this would increase weight loss. You would be burning two or three times as much fat to produce the same amount of ATP.

There are all kinds of things that are uncoupling agents.

Based on this Ben Bikman paper, the low-carb diet is one of them.

Back to the study.

There are several points along the path within the mitochondria leading to the production of ATP. By using various agents, the researchers were able to check where along the way the respiration was occurring. In the chart below, the dark bars, which represent the high-carb diet, have the lowest amount of change in respiration. As you can see, the low- and mod-carb diet increase the respiration the most with the last set of columns representing the most uncoupling, which was driven by the low-carb diet.

It’s much more complex than I’ve made it out to be, because we’re not just talking energy, we’re talking masses of nutrients as well. My recent talk in San Diego discussed all this and why scientists need to start looking at mass instead of just energy, which is almost always what they’ve looked at since the days of Atwater back in the late 1800s.

Okay, now you know why it’s difficult to explain uncoupling.

Video of the Week

Here is Linda Yaccarino, X’s (the social media site formerly known as Twitter) new CEO on their new policy of Freedom of Speech, not Reach. In other words, we’ll let you say it, but we won’t let it be spread.

She says she’s talking about speech that’s lawful, but awful. I don’t know what that means. Is saying the mRNA vaccines are not safe or efficacious awful. Who knows? Who decides? Troubling, to say the least. I guess you put up the post, and you’ll figure out if they deem it awful.

That’s about it for this week. Keep in good cheer, and I’ll be back next Thursday from Scotland.

Now for the poll:

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