The Arrow #195

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Hello everyone.

Greetings from Dallas.

Where the weather is its normal schizophrenic self this time of year. Huge thunderstorm a couple of mornings ago. Total black sky and rain, then beautiful in the afternoon. Now nice and balmy. Then another toad strangler of a thunderstorm night before last, but beautiful today, but might sleet tomorrow. Who knows?

My week got off to an inauspicious start. I was mindlessly scrolling through X/Twitter and came upon this tweet. Click on the Show more link to see how bad it supposedly is.

I had never heard of anything like this at all, so I clicked on the heart rate app on my watch to see where I fell on the chart.

Nice, eh? I guess this proves I’m a psychopath.

With that in mind, let’s head right into all the questions, comments, and poll responses from last week’s Arrow.

Poll Responses, Comments, and Emails

Food Deserts

I’ll start off with two readers who excoriated me for my take on food stamps and junk food. The first comes from a poll response.

Please indulge me while I blow a gasket about your answer about SNAP/Food stamps, which is in my estimation about as wrong as you've ever gotten anything (and I don't think you get much wrong). The undisputed fact is that the poor, especially urban poor people do indeed live in "food deserts" where much of what they can buy (and can afford to buy) are UPFs. What your description doesn't begin to take into account is then how food fits in to a much, much more complex social situation fueled by all kinds of addiction and real disadvantage and inability to cope with the non-stop stresses of being poor. One can pretend that this doesn't exist or doesn't matter or doesn't have real effects all one cares to, but it doesn't change the reality, which I know about because I have lived it. I've lived in poverty and with addiction, and when I've had to deal with both, that's a tunnel with not much light at the end, and takes a great deal of strength to even cope with, much less change how to cope with. So if we concede that food addiction is real, it's no less real for a poor person than it is for a comfortable-means person. People with limited access to the kinds of resources (personal, social, and financial) that are even very challenging for those who can afford them to obtain and use well, expecting such people to muscle up each and every day to straighten up and eat right, much less forcing them to do so, is as wrong-hearted as it is wrong-headed. It's absolutely too simplistic to say, "Well, they have the support to buy and eat good food" when the communities they live in are nearly nothing like the ones that government and medical entities are directing health information and recommendations at--including, possibly even most of all, communities like this one comprised of people who are motivated to go against guidelines insisted on by medicine and government (the whole, swapping diet sodas for other things should immediately remind you of prison barter systems, which should give you an entirely other window of perspective about what many of these peoples' lives are like). And then there is the double-standard in what you are saying, or perhaps it's even a triple standard. People who can afford to eat as much UPFs as they want drive up our insurance premiums and the cost of health care generally (for one thing, they USE the health care system a lot more than do the poor), and are allowed to do so without being forced to make food choices imposed on them by hardship or government intervention. How does that fit into the scenario of "we winding up paying for the way the poor spend our tax money"? We are now paying for everybody! Or at least the upwards of 60% of the nation who are overweight/obese, and not just with our tax money. What is the solution to how their costs are driving up insurance premiums? (And, sorry, the "accident" insurance analogy is far too simplistic to even past muster.) You've simply got the wrong end of the stick here. Reducing and restricting benefits didn't work when Reagan and then Clinton slashed them (for a vast complexity of reasons) and it won't work now--either on a practical (money) or social (life improvement) level. Of topics not in your lane--sorry, this is one. I don't think I've ever been actually angry at something you've written, but this blows a gasket. I've tried to keep my comments civil, and hope I have done so. [My bold]

The next one came in via email.

Sorry Dr. Eades but I have to take issue with one of your comments. You were replying to a comment from one of the polls. The person started by saying "those on food stamps are equal to everyone else." Your reply was that it isn't ok to "swill a soda followed by chips", or words to that effect. I'm not sure how you could be unaware of this, well travelled as you are, but there are whole swaths of this country where people can find little else TO eat, even if they want to. Also, good quality fresh veggies and high quality meats are very unavailable in many places and in any case, wouldn't be affordable on food stamps anyway. I don't see how being poor, should relegate the unfortunates to such a diet, and to castigate them for eating poorly while being unable to get anything better is the height of elitism. [My bold]

I think this might be the first time I’ve ever been accused of being an elitist. Obviously this whole situation is a sore point to a lot of people. Whenever I get several heated comments on a subject, I figure those are the tip of the iceberg of people who feel the same way, but just don’t bother to write. Consequently, I take them seriously.

I’ve had a paper up on one of my tabs for a couple of months now that I’ve been wanting to post about. This gives me the perfect opportunity.

The paper titled “Food Deserts and the Causes of Nutritional Inequality” published in The Quarterly Journal of Economics analyzes the very issue the above commenters allude to: food deserts. (Copy of the article in full from my Dropbox.)

There exists this idea that poor people live in what are called food deserts. Food deserts are areas in which there is no fresh, wholesome food, only crap food, i.e., fast food outlets and convenience stores. Since these folks live in these areas, the only options they have for food are these crap outlets. Were they to live in areas where plenty of fresh, wholesome food was available, they would improve their diets. Or so the thinking goes.

The authors of the above paper did a deep dive into this situation and found that it doesn’t hold. When people in these so-called food deserts were given the opportunity to purchase decent food, only 10 percent of them took advantage of it. The other 90 percent continued to eat crap.

The basic conclusion of the paper is that food deserts exist not because purveyors of crap rush into these neighborhoods to exploit those who live there, but instead because those neighborhoods are where the demand for crap food is the highest. The crap food purveyors simply move in to meet the demand.

Managerial types spend an inordinate amount of time trying to figure out how to incentivize their employees to perform at their best. Since I’m not a managerial type, I have no clue as to how to incentivize people living in these neighborhoods to eat better food. I think pretty much any way you cut it, it would be a tough sell.

If you look at smoking statistics, you discover that the majority of people who still smoke fall into the same class as those who live in ‘food deserts.’ And these are the folks who can least afford to spend the money required to feed a smoking habit. There can be no one on earth who doesn’t know that smoking is just about the worst thing you can do for your health, yet many spend a chunk of their budget on cigarettes.

The various governmental agencies have tried to incentivize people to quit smoking by adding huge amounts of tax to tobacco products, yet many on lower incomes continue the habit and continue to choose to use their dollars to support it. Unless they quit, they will end up ultimately being a burden on the healthcare system.

What if instead of trying to de-incentivize smoking the government provided free cigarettes? Would that be a good thing? If so, we, the taxpayers, would be paying for both the cigarettes AND the damage the cigarettes most assuredly cause. Would that be fair?

It’s the same issue with crap food, with the only difference being people have to eat to live, but they don’t have to smoke to do so. In fact, quite the reverse on that one. But it is well known that consuming crap food will lead to all kinds of later health issues. So why subsidize it? Especially since we as a society are going to have to pay for the consequences later when these folks all come down with obesity, diabetes, high blood pressure, heart disease, and all the rest.

I see where the readers are coming from; there have been periods in my life that I barely scraped by. So I do understand being broke and just trying to keep it all together. But I remain unrepentant for what I wrote. People need to take personal responsibility for their actions. As with just about everyone, I’ve had bad things happen to me in my life. And in almost every case, it was something I brought on myself because of my own decisions.

Feel free to disagree.

Carnivore Diet

I got a host of responses from folks who have done well on a carnivore diet. Here is my favorite testimonial.

I moved to carnivore a little over eighteen months ago and it saved my life. Some of the positives are, no more IBS, no more kidney disease or diabetes or carpal tunnel. I have no more psoriasis, my serious heart function issues are mostly gone. All of my joint pain is gone as are one hundred and thirty lbs, not done with the weight loss yet. Even my eye floaters are gone along with my age spots on my hands. I am seventy four years old and no longer feel like I am dying.

Converting to an ancestral diet often brings about seemingly miraculous changes. I’ve heard many similar stories from folks who have gone carnivore. I wrote about it a bit a couple of years ago, but evolutionary biologist Michael Rose has data showing that switching to an ancestral diet in the later years of life slows the aging process to a crawl.

His research demonstrates that consuming an agricultural diet in the early years of life may actually bring about a few health benefits. But switching to an ancestral diet later on, pays large dividends. I need to write more about this as it is fascinating. Especially the experimental process he spent years of his career on to discover this.

Esophageal Cancer and Low-Carb

Here is a comment from a reader who went through the ordeal and survived.

I had Stage II œsophageal cancer 10 years ago, and now take no medication, and eat normal food. I had already been on a low-carb diet for 5 years, so had no comorbidities. Probably provoked by an anti-inflammatory for flare-up of a long-term back problem, which gave me GERD. I had chemotherapy with FolFox, and 20 radiotherapy treatments. I stuck to a strict ketogenic diet, when I could swallow! Blockages persisted for up to 36 hours.

Despite the GI surgeon, I refused the brutal surgery, as it had been planned too soon after the final scan. This upset the system; it “lost” me for a couple of months. After another PET was performed, no cancer could be seen.

My only residual effect is a 13-mm length of stenosis, which means I have to take my time and chew my food very thoroughly, as otherwise there are occasional logjams still.

Verner Wheelock published my story on his excellent blog:

http://vernerwheelock.com/212-recovering-from-cancer-case-history-of-archie-robertson/

I would encourage everyone to read the linked blog above. It’s really an amazing story. Especially given the typical survival rates of any one diagnosed with esophageal cancer.

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Big Med, Big Pharma, and Big Tech. In Collusion?

In catching up on my Medscape reading, I just discovered that the American Board of Internal Medicine (ABIM) has revoked the Board Certifications of Pierre Kory, M.D. and Paul Marik, M.D. for recommending and prescribing ivermectin for Covid. Both physicians were vocal about what they viewed as wrong-headed science promoted by the government and the various medical societies.

A loss of board certification isn’t the end of the world. As a doctor, it isn’t required to practice, so the loss won’t hurt their ability to earn a living. But it is a loss of prestige.

Since all these various boards get funding from the pharmaceutical industry (or at least I think they do—everyone else in medicine does), I suspect Big Pharma had a hand in it.

From Medscape:

The American Board of Internal Medicine (ABIM) has revoked certification for two physicians known for leading an organization that promotes ivermectin as a treatment for COVID-19.

Pierre Kory, MD, is no longer certified in critical care medicine, pulmonary disease, and internal medicine, according to the ABIM website. Paul Ellis Marik, MD, is no longer certified in critical care medicine or internal medicine.

Marik is the chief scientific officer and Kory is president emeritus of the Front Line COVID-19 Critical Care Alliance, a group they founded in March 2020. The FLCCC gained notoriety during the height of the pandemic for advocating ivermectin as a treatment for COVID. It now espouses regimens of supplements to treat "vaccine injury" and also offers treatments for Lyme disease.

Also this in the article from Arthur Caplan:

"This isn't a free speech question," said Arthur Caplan, PhD, the Drs. William F. and Virginia Connolly Mitty Professor of Bioethics at NYU Grossman School of Medicine's Department of Population Health, New York City. "You do have the right to free speech, but you don't have the right to practice outside of the standard of care boundaries," he told Medscape Medical News.

The ABIM action "is the field standing up and saying, 'These are the limits of what you can do,'" said Caplan. It means the profession is rejecting those "who are involved in things that harm patients or delay them getting accepted treatments," he said. Caplan noted that a disciplinary action had been a long time in coming — 3 years since the first battles over ivermectin.

At the bottom of the piece there is this disclosure:

Caplan served as a director, officer, partner, employee, advisor, consultant, or trustee for Johnson & Johnson's Panel for Compassionate Drug Use (unpaid position) and is a contributing author and advisor for Medscape. [Italics in the original][My bold]

One wonders how he could be employed and not have a salary? My guess is that he’s into Big Pharma up to his ears. I have other issues with Dr. Caplan that I wrote about here. Among other things, he, too is taken with the notion of food deserts. But in his case, he decries them on one hand, while promoting them on the other. And, from appearances anyway, he’s been victimized by them. Couldn’t possibly be by his own appetite. (This is an old blog post, so some of the links might not still work, but you can easily see what my issues are.)

The story gets even worse.

Before I get into it, you’ve got to understand that both of these physicians were highly regarded before Covid. Dr. Marik is probably the most published author on critical care issues ever. These guys were as mainstream as mainstream could be until the scales fell from their eyes re the Covid fiasco.

A few days ago, I read a Substack post by John Leake, who writes for Peter McCullough’s Courageous Discourse Substack. He wrote that Dr. Marik had been canceled by Amazon over a book he wrote on cancer therapy. The book, titled Cancer Care: The Role of Repurposed Drugs and Metabolic Interventions in Treating Cancer, is about the metabolic basis of cancer. And how to treat it from a metabolic perspective. Which is hos Tom Seyfried, who is quoted throughout the book, treats cancer.

According to the McCullough post, here is the notice Dr. Marik received from Amazon about his book and about his account:

Hello,

We are terminating your account effective immediately because we found that you have published titles with misleading content that have the potential to mislead or defraud our customers.

You can see the violations reflected in the following title(s):

58840430 / Cancer Care: The Role of Repurposed Drugs and Metabolic Interventions in Treating Cancer, PRI-4BJKMH3ENCP / Cancer Care: The Role of Repurposed Drugs and Metabolic Interventions in Treating Cancer

As part of the termination process:

• We will close your account

• You're no longer eligible to receive any outstanding royalties

• You'll no longer have access to your accounts. This includes, editing your titles, viewing your reports and accessing any other information within your account

• All of your published titles will be removed from sale on Amazon

That’s Amazon for you. I had the same thing happen to be, but on a smaller scale. Over the almost 20 years I’ve been blogging, I wrote book reviews and recommended many, many books. I was an Amazon affiliate, which meant that any time a reader clicked on one of my book links, it went to Amazon. If the reader purchased the book through Amazon, I got a small commission. (It used to be that the commissions on these books were a buck or two; now it’s just pennies.)

Out of the blue, I got a notice from Amazon much like the one above. It didn’t remove my own books, i.e., the ones MD and I wrote, but it did cancel my account as far as receiving any commissions from the hundreds of book links scattered throughout my blog. I had violated some arcane rule I didn’t even know existed. The Amazon fine print describing their rules is totally opaque, so they’re basically no help. When I appealed, I was turned down. I had to learn from others that at some point Amazon had decided affiliates had to set up their system to go through an extra click before getting to Amazon. Which is why if you click on one of my book recommendations now, you’re taken to a different page and given the opportunity to click through to Amazon there or not.

I’ve changed some of the links in my blog, but far from all of them. If anyone clicks on one of the links that hasn’t been changed, Amazon doesn’t pay me even the few cents I should get for having recommended the book or whatever.

I’m sure I could recover if I sued, but it’s not worth it. Nor is it worth it to the many other people this has happened to.

So, like me, they are going to deny Dr. Marik whatever royalties he’s due from books having nothing to do with the one they banned. And why they banned it, I’ll (and he’ll) never know.

You can get the book free by going to the FLCCC Alliance page for the book.

It can get pretty technical, but nowhere near as technical as Dr. Seyfried’s book, which, by the way, is still for sale on Amazon. And will doubtless remain so as Dr. Seyfried didn’t stir the waters about Covid and/or the vaccines.

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Three Egg Stories

Nick Norwitz and the 720 Eggs

Sounds like a title from Dr. Seuss, but it’s not. It’s Nick Norwitz describing how he ate a dozen eggs per day for an entire month.

What do you think happened to his cholesterol levels after this egg-consumption Bacchanalia? Did his levels go up? Or go down?

As it turned out, his LDL-cholesterol levels fell a tiny bit over the first two weeks, then quite a bit more during the second two weeks when he added more carb to his diet. You can watch the video to see why. Or at least why Nick thinks his LDL fell.

It’s been known for years that it’s difficult to reduce cholesterol levels by eating less cholesterol. Every cell in the body makes cholesterol (which should tell you how important cholesterol is), so if you don’t eat it, your body will simply make it. And if you eat a lot of it, your body won’t make it. Which is why it’s difficult to control cholesterol levels simply by decreasing your intake of it.

Even Ancel Keys knew this. At first, he thought dietary cholesterol was a contributing factor to serum cholesterol, but he was ultimately disabused of that opinion. He then turned to fat, especially saturated fat, as his villain.

Ancel Keys has been dead for almost 20 year, and he knew it long, long before he died, yet everyone still gasps at the thought of eating too much cholesterol. If you told someone you had eaten ten eggs in a day, the first response would be something about your cholesterol levels. It’s just that ingrained in most of us.

And is doubtless why Nick decided to do a video about eating two cartons of eggs per day, which calculates to 720 per month.

But Nick is a young guy, and youth is extremely protective against dietary screw ups. If you’re young, you can recover from almost any dietary extravagance. What about if you’re older, though? Would you still have the same result?

How about if you’re a lot older and ate 720 eggs in a month? Would your cholesterol levels do the same as Nick’s. What if you were, say, 88 years old.

And what if instead of eating 720 eggs in one month, you ate 720 eggs every month for 30 years, would that affect your cholesterol levels?

You may be asking yourself, Who in the world would do something that extreme?

Elderly Man Eats Two Dozen Eggs Per Day for 30 Years

An 88-year-old man consumed 25 eggs per day (two cartons plus one) for 30 years as documented by his physician. The man lived in a retirement community and had the eggs delivered to him daily. Nick was just a piker compared to this guy.

His total cholesterol levels was 200 mg/dl, his LDL-cholesterol was 142 mg/dl, and his HDL-cholesterol was 45 mg/dl.

I know about this because it was written up in case report in the New England Journal of Medicine (NEJM) in 1991 titled “Normal plasma cholesterol in 88-year-old man who eats 25 eggs per day.” MD and I wrote about in Protein Power.

When this article was published, the country was in the throes of total anti-cholesterol hysteria. It was picked up and reported on in just about every newspaper and news TV program as if it were some sort of freak of nature. When, instead, the old guy’s response was pretty normal.

When I read the NEJM paper, something jumped out at me. In the summary of the paper was this sentence:

…most of the physiologic processes involved in cholesterol balance and in maintaining a normal plasma cholesterol level were studied in an unusual patient, an 88-year-old man who for psychological reasons had eaten about 25 eggs per day, in addition to regular meals, for many years. [My bold]

Based on all my work with patients following low-carb diets, I could understand that someone throwing back a couple of cartons of eggs per day would have a normal cholesterol level. My own patients would generally correct their lipid levels fairly quickly despite eating a lot of saturated fat and cholesterol, as long as they kept their carbs controlled. What I had trouble figuring out though was how this elderly gent could eat this many eggs along with a standard retirement home diet (filled with carbs) and not have his lipids get out of whack.

If you look at the nutritional value of eggs, you’ll see that they just don’t contain cholesterol, they are loaded with saturated fat as well.

One egg has the following values:

  • Energy: 71.9 kcal

  • Protein: 6.24 g

  • Fat: 5.01 g (of which 1.61 g is saturated)

  • Carbs: minimal

If you analyze for 25 eggs, you find that this 88-year-old slender guy was consuming 1,798 kcal/day just in eggs. He was also getting 156 g of quality protein along with 125 g of fat, 40 g of which was saturated fat. He was consuming almost no carbs from the eggs, but according to the paper, he was getting these eggs along with his regular meals.

1,800 kcal per day is a lot for an elderly person to throw back every day, and this guy was eating this many calories in addition to regular fare. It didn’t make sense to me, so I reached out to the author of the paper and asked him. He checked with the nurses who took care of the elderly man, and, as it turned out, all the guy was eating were the eggs. He was offered the typical nursing home fare, but he never ate it. Which made sense.

He was on a very-low-carb diet. Here is how his energy intake broke down for the 1798 kcal he was getting from his 25 eggs:

  • Fat: 63%

  • Protein: 35%

  • Carb: 2%

I wish they had shown his triglyceride lab levels. Given this energy breakdown, I’m pretty confidant they would be below 50 mg/dl. It all just goes to show that as long as your not a lean-mass hyper responder, you’re going to normalize your lipid levels if you cut the carbs. Lipids are more responsive to carbs than they are to dietary fat.

Egg Whites, Egg Yolks, and the Asian Ketogenic Diet

I came across an interesting study from Thailand that is illustrative of why you should eat the yolks of eggs.

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