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The Arrow #198
Hello everyone.
Greetings from Dallas.
Where, strangely enough, it has turned kind of cold-ish. It was hot Tuesday, then yesterday the skies were clear blue, but it was kind of chilly. It’s been that way since. I love crisp, fall days, but in this case, it turned on a dime.
Attended and participated in the big wedding over the weekend, more about which later.
We were snake bit on the flights both coming and going. I’ve already described the snafu getting there, which wasted most of a day. Getting back did not go without a hitch. We were delayed for hours at that as well.
As I’ve always said, the only thing fast about flying is the flying. The rest of the process is a huge time suck. Which is why I have an enormous hatred of terrorists. It used to be you could just go to the airport, go to the gate, and get on the plane. About the worst that could happen to you—aside from the plane going down, which was pretty rare—would be to get hijacked to Cuba.
Then they put in the metal detectors. Which were the first bit of technology that gobbled up time.
After 9/11, flying has become a nightmare. The security lines are long, the TSA agents surly (not all; but a lot), and the random searches time consuming. And, because of the chance of the lines being extra long on a given day along with the possibility of getting selected for a random search (or even if they see something they don’t know what is in your bag and decide to paw through it), means you have to get to the airport way early.
As I looked around at the thousands of people at the Denver airport, I could only imagine the amount of productive time lost per person multiplied by each one. And then multiply that by all the people at all the airports who have to get there early and wait and wait and wait. A HUGE productivity suck. All because of terrorists. Which is one reason why I have little to no sympathy for any of the terrorists organizations out there.
Our trip home was all too typical. Got there early. Our flight was delayed. Not a lot, but a little. And then again, just a little more. And then again. And with each delay came a gate change.
Finally, we get on the plane an hour after its scheduled departure, and after we’re all settled in the pilot comes on and tells us we’ll be delayed just a little bit more. During the walk around inspection the co-pilot found an issue. So we had to wait for maintenance to come fix whatever it was. As it turned out, maintenance couldn’t fix it. The plane could not fly.
So off we all get and wait. In due course—a couple of hours—they wrangle another plane, and we finally take off. Instead of arriving in Dallas circa 9 PM as originally scheduled, we arrived around 1 AM.
The whole airport, airport security, plane maintenance, delay issues are just a part of the shittification of everything. About which I’ll write at some point, because it’s a major annoyance of mine.
Despite being bookended by bad flight experiences, the wedding and the days preceding the wedding and after it were terrific. Got to catch up with some old friends and experience pretty glorious weather for that time of the year in Boulder.
The wedding was held in an apple orchard. I had never been to a wedding held in an orchard, but it turned out to be the perfect setting. Here are the bride and groom during the ceremony:
Pretty spectacular backdrop, but it got even better. Here was the view from our table a bit later at the wedding dinner.
A close up of the gorgeous sunset. Nothing quite like watching the sun go down behind the front range of the Rockies.
And, finally, here are MD and me along with the parents of the bride (standing behind us) and our friends from Belfast—(from L to R)Tara, John, and Lorcan Heenan—seated beside us.
I didn’t have the chance last week to deal with any comments, emails, etc. And there weren’t a lot of questions this week. Mainly people wrote to say how much they enjoyed the opera piece in the video of the week. Makes me proud to have such enlightened readers.
There were a few questions and comments from the previous week, so let me go over them.
Ravenous Appetite and Weight Loss
As you may recall, week before last I posted an email from a lady who could not lose weight because her ravenous appetite for delicious food overcame her ability to deny herself. I basically wrote that she needed to make the decision about what she wanted the most: to eat everything in sight or to be thin.
Most people wrote in support of the point I made. Many described their similar battles, and how carnivore or some other version of the low-carb diet had rescued them. But one reader didn’t see it that way. In her response to the poll, she wrote
I didn’t like your attitude to the lady who can’t lose weight! She’s done a lot of controlling by the sound of things with measuring glucoses and ketones, sticking to diets in the past ( if things don’t work it’s not really an incentive to stick to them) and doing CrossFit ( which I just couldn’t handle) so I think you came across as patronising. What I was expecting to read was you explaining all the minor nuances that could be at play - things like leptin resistance ( or lack of leptin) and all the other things that I don’t know about. As a menopausal woman on HRT I can tell that ‘you’ve never been pregnant’! What I mean by that, is that the hunger driven by presumably progesterone is very, very real! I am eating the same low carb, paleo with dairy, diet I have done for 8 yrs ( same meals over and over) and intermittent fasting 18/6 but I am hungrier at meals and can binge on roast shoulder of lamb or endless cheese. Everyone always says don’t do something that relies on willpower, because you’ll run out of it - well that’s true! I am hungry and I suspect this lady is too and what worked in the past isn’t working anymore. Please can you explain the finer nuances of weight management as we’re already doing everything that everybody tells us will work. I’ve added in weekly fasts, varying between 3 x 24hr up to 1 x 48 or 72hrs and by golly missing that 24hr meal is hard mentally and I don’t think I can spend the rest of my life being this uncomfortable weekly, I’m already dreading it each week. When I then do eat, like I said I cannot stop eating the roast shoulder of lamb ( straight out the oven, no veggies!). I’ve asked this several times before but why is my fasting glucose 6mmol/L and goes up to 7 after an hour of pottering or dog walking. It only gets down to 5 just before supper ( whether I ate lunch or not). It hits 7/7.3 about 2hrs after supper, then back to 6. The only time I get readings between 4-5 is from about 36hr fasting onwards. Ketones are 0.5 on ‘normal’ days and up to 1 after 24hrs, nearer 2 at 48hrs and 3-4 when I did 72hrs. My fasting insulin was 2 about 5 yrs ago and I’m trying to get it repeated but you have no idea how difficult that is in the U.K. if this is physiological insulin resistance then having an HbA1c of 5.7% surely can’t be ok? Surely I will be glycating left, right & centre and causing untold damage to my endothelia, my brain ( I follow Dale Bredesen for Alzheimer’s prevention) and increasing my risks for cancer. I only eat grass fed, organic, meat, fish, eggs and some cruciferous veggies, watercress/rocket salad, avocado and full fat milk ( one cappuccino daily) and Dr Willian Davis’ SuperGut yoghurts that I make with the equivalent of what you call ‘half and half’ and various cheeses. I also eat approx 2 squares of 90% dark chocolate
I can’t imagine the kind of comments I might have gotten had that part of the newsletter gone out without MD’s reading it first. She told me it was somewhat patronizing. Then she gave me suggestions as to how to mellow it out a bit. Which I did. She still thought it was a bit patronizing, but I ran with it as changed.
Another lady wrote me and reminded me of something I’ve always said: “Hunger always wins.”
As I was contemplating all this, I came across an article in the Wall Street Journal that I thought was relevant. It was sort of an excerpt from a new book I ordered, but haven’t had time to read. The author writes basically that people don’t have to do anything they don’t want to do…as long as they realize there are consequences and are willing to accept them.
But not hunger, you may say. You can’t defeat hunger. And I agree, but you’ve got to characterize just what kind of hunger you’re trying to overcome. If you just ate two hours before, you can’t be in the grip of the kind of gnawing hunger that can’t be overcome.
That’s the kind of hunger I was talking about when I discussed Dr. William Glasser’s ideas about giving up control over things you can control.
In my defense, I’ve seen way too many patients in my practice who came to me twice. The first time they came because of some reason other than their own desire to lose weight and improve their health. Outside forces were instrumental in their showing up in my office. They lost a bit, then never showed back up.
When they came the second time, they admitted that they had only half-assed the program, primarily because they weren’t motivated from within. Once they decided for themselves they wanted to lose weight and get better, then they did. The second time around.
This may sound patronizing—and I don’t mean it to be—but I’ll bet that if I could offer a million dollars to any of these folks if they would lose down to their ideal body weight, hunger wouldn’t be an issue. They would plow right through whatever hunger they might have had and lost the weight.
I will freely admit that peri- and post-menopausal women have a tough time of it. There is no doubt that weight comes on more easily than before. And it’s tougher to get rid of. Even with a good low-carb, ketogenic diet. But it’s almost impossible to get rid of the weight otherwise.
I’ve had a number of people ask me about HRT and how best to do it. I’ve never really answered because it’s not even remotely a one size fits all. I have a friend who is a doctor to the stars in Beverly Hills. He has a huge practice of celebs and the ultra-wealthy that he deals with. He told me that he gives them just enough estrogen to keep them from having whatever menopausal symptoms they’re suffering and as much progesterone as they can tolerate without becoming symptomatic of too much of it. All bio-identical, of course.
This system obviously works for him as he has a huge practice, and if it didn’t work, he wouldn’t have all the clients. He wrote a book about it years ago, and I just checked and discovered he has a new book out on his methods. I just ordered it myself to see if any of his recommendations have changed. So don’t slack on your estrogen or push your progesterone until you (and I) have read the book.
What I have learned from my own practice is that the whole HRT deal is not a one size fits all. It takes some fiddling with to get it right for every individual woman. It takes patience and time. And trial and error.
The lady who wrote the poll response above has a problem I’ve encountered a number of times. She can apparently overeat on low-carb foods. Usually meat is extremely satiating. People don’t normally binge on steaks—they binge on carby foods. Carbs override the off switch, which is why they are served as desserts. You can be stuffed, then when the dessert tray comes around, you suddenly think, hmmm, that carrot cake looks good; I’ll have a piece.
When Protein Power came out, MD and I used to get letters from readers telling us about how they ate tons of meat and cheese and other low-carb foods, yet weren’t losing weight. Some times they provided enough specific information that we could run their diets through out nutritional calculator and determine the carbs, calories, etc.
In come cases, these people were throwing down 5,000 to 6,000 calories per day and weren’t losing despite being below their carb limits. MD and I were always stunned that they weren’t gaining weight. But they weren’t—they were simply complaining that they weren’t losing.
Well, here’s how it all works.
If you cut carbs, you reduce insulin. If you reduce insulin, you can release fat from the fat cells to use as energy.
Most people find a low-carb diet satiating, and even though it seems like they’re eating a lot because they’re eating steak, eggs, butter, i.e., formerly forbidden foods, they don’t realize that their calorie count is pretty low. The reason is that the fat released from their fat cells on account of their lowered insulin is fueling much of their energy needs. Consequently, the blood flowing through their hypothalami (hypothalamuses?) sends the signal that they are not in a fuel deficit, so their hunger is cranked down. And they end up not eating all that many calories. And being satisfied.
Some people, however, must not get the hypothalamic signal, because they can eat a lot of meat, eggs, cheese, etc. What happens is that insulin falls, and the fat cells open, but there is no need to unpack their stored fat as the dietary fat and carbs are meeting—and exceeding—their energy needs. So the stored fat stays stored. It could get out, but there is no need for it.
The amazing thing is that they don’t gain. It’s pretty well known to all but the CICOers of the deepest dye that there is increased energy expenditure in those who follow low-carb diets. They simply burn more calories. When it has been studied, it turns out that they burn about 300 kcal more than those on low-fat, high-carb diets of similar calorie content. But based on the letters we’ve received, some appear to burn vastly more than that. Or they would be writing complaining about all the weight they had gained on our program rather than to complain that they just weren’t losing.
To the lady who wrote the long poll response above, I would say, if you know you’re going to eat the entire roast shoulder of lamb when it comes out of the oven, don’t put an entire shoulder of lamb in the oven. Just put in an amount that you think is the proper size given your size and protein needs. I suspect she would answer that it’s just too much trouble to cut it up before, then have to cook another part of it another time. But if you want to get a desired benefit, you’ve got to know yourself. And if you can’t resist eating it when it comes out of the oven, don’t put it all in to begin with. (In relation to the previous post that’s the doing component that you can choose in advance not to do.)
She also wrote asking me about her glucose, HbA1c, and all the nuances of fiddling with weight loss. That is something I can’t do unless I had access to her as a patient. I don’t know her labs. I don’t know what her thyroid status is. There are countless things I don’t know about her and her overall health, so I would be crazy to try to advise knowing what little I know based on her response. Sometimes it takes a lot of trying this and trying that to get the required result.
As I’m pretty sure I wrote before, having a voracious appetite might well be an indication for one of the GLP-1 receptor agonist drugs. What they primarily do is rein in the appetite. Both the first lady who wrote in and the one above say they’re consuming plenty of meat and other protein sources. If they can continue to eat that way, only less, after their appetite is inhibited by a GLP-1 agonist, they might do well. These would be just about the only cases in which I could ever imagine myself prescribing these drugs. And then it would be only after a long list of caveats.
Burning Fat or Burning Carbs?
I received an email from a long-time correspondent who had purchased a Lumen, which is a device that measures expired carbon dioxide. The amount of CO2 you breathe out basically tells you whether or not you are primarily burning fat or burning carbs or burning both. She wrote
I ate 15g of carbs for breakfast 5 hours ago (& 38g fat, 57g protein) and my Lumen reports that I am burning 95% carbs!
According to my calculations, that's 60 calories' worth of carbs, that I STILL haven't burned off? True, I've mostly been sitting, but still. I must have one helluva efficient body!
This is kind of a classic case of why it takes time to become low-carb adapted. If you are not low-carb adapted and you have an insulin issue, it can take a while. And during that period, you will burn carbs. Most people have about a day’s worth of glycogen (the storage form of glucose) stored in their tissues, mostly in the muscles and liver. The muscles contain about 400-500 grams of glycogen (1600-2000 kcal) and the liver holds about 100 grams (400 kcal).
If you’re on a standard or high-carb diet, you basically convert extra glucose to glycogen (muscle starch, they call it) and store it away in the muscle and liver. Then when you need energy, you extract it from glycogen, convert it to glucose, and burn it.
When you go on a low-carb diet for a period of time (the time varies with the individual), you end up burning fat most of the time instead of glucose. Your glycogen stores remain full in case you need them.
But why would you need them if you’re burning fat?
Well, if you do heavy exercise and end up going anaerobic, you can burn only glucose.
If you are doing aerobic exercise, then you can burn fat or glucose. If you’re low-carb adapted, you’ll burn mainly fat. It requires oxygen to burn both fat or glucose under normal circumstances. They both end up going into the electron-transport chain in the mitochondria and burn efficiently, providing a lot of energy.
But if you exercise hard enough—like I do when I do my band workout—you’ll end up puffing and panting, which means you have gone anaerobic. In other words, you’re burning only glucose, which you can do, but it’s not nearly as efficient. So when you go anaerobic, you pant and puff and it takes you a while to get your breath back.
As you get more and more in shape, it takes more and more work to go anaerobic. When I first started with the bands, I did a certain number of reps on the weenie band, which had me panting like a lizard before I knew it. Now if I go back and do the same number of reps with the weenie band, I don’t even break a sweat. So I’m not anaerobic, as I was when I started. I still puff and pant, but have to use the larger bands and more reps to get there.
Knowing all this, you should see your use of fat vs carbs go up as you become more low-carb adapted. But even if you are low-carb adapted, if you check right after a brutal workout, your Lumen is going to show you are burning glucose. You couldn’t do that workout otherwise.
I got my own Lumen a few days ago, and I’ve been playing around with it. I’ve discovered that you need to use it pretty much at the same time every day, and not shortly after a meal. Just for grins, I tried mine last night 30 minutes after dinner. Dinner was a steak, a couple of tablespoons of green peas cooked in butter, and a half cup of heirloom cherry tomatoes cut in half. My reading came out half carbs, half fat. Other times, it comes out mainly fat. I would like to see it continuously lower in carb and higher in fat burning, but I stay pretty much at my ideal body weight, so I eat a few more carbs than I would if I were trying to lose weight. How many carbs? Maybe 60-70 g/d.
I don’t know how the Lumen evaluates alcohol, which I sometimes drink in the evening. My bet is that it would read it as fat. But just in case. I never check it at night.
Which confirms what I’ve believed for a long time. That glucose, like oxygen, is toxic. Your body needs it for what it needs it for and gets rid of the rest. I think the body burns glucose preferentially just to get rid of it first, not because it’s such a fabulous source of energy.
After trying the Lumen out, I arranged an affiliate agreement with them. So if you want one and purchase it through this link, I’ll get a small commission that does’t affect your price at all. In fact, you’ll get the best price available.
If you do get one, let me give you some advice that I wish someone would have given me. (MD did give me the advice, but only after I had blown my brains out trying the damn thing. She had never used one, but she figured out what I was doing wrong.)
It gives you explicit instructions on how to use it, but I overdid it. It tells you to blow into the thing for four seconds. Easy enough, thinks I. So I begin to blow into it, and it tells me I haven’t gone for four seconds when I clearly have. I try again. Same thing. I’m hyperventilating trying to get enough breath to blow into the frigging thing, and it keeps kicking me off, saying I haven’t blown into it for four seconds. There is a little circle on the screen and a ball that goes into the circle and turns green when you blow into it. You don’t have to blow your brains out to get the ball in the circle. Just a nice slow breath will do.
The object is to get the ball in the circle and keep it there for the four seconds. I was blowing for all I was worth and blew the thing way out of the circle. Once I was corrected like a dog with a shock collar, I was able to do it easily over and over. If you get one, don’t be like Mike. Just keep the ball in the circle, and you’ll be golden.
I’m going to cut my carbs to see how long it takes me to get to the burning almost all fat category. I love fooling with gadgets like this.
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Vaccines Again
I haven’t written about vaccines in a while, but I watched a video a few weeks ago that reinvigorated my interest. I would have put it up earlier, but it’s behind a paywall. I kept hoping that with time the paywall would come down, but it hasn’t so far.
The video was of a discussion Dr. Peter McCullough had with Roman Bystranyk, the co-author of one of my two favorite books on vaccines, Dissolving Illusions. (In case you’re wondering, the other is Turtles All the Way Down.) This video is so good that, at least in my view, it would be worth the five bucks to sign up for a month of Dr. McCullough’s Substack just to watch it.
When I read the book, I assumed Dr. Humphries, the physician, did all the research and Mr. Bystrianyk was simply the writer. The truth is that he did all the heavy lifting and reached out to her and her credentials to give the book more prestige. Granted, he didn’t reach out to her just because she was a doc, she had her own worries about vaccines. But all the parts I found so compelling were the data Bystrianyk collected and analyzed.
In the video he mentions that they’ve got a new edition of the book that has just come out (which is what I linked to above). The foreword was written by Dr. Mercola, with whom I agree about the vaccines, just not about diet. The new book is pricier than the older one, which you can also find at the link above. I bought both the paperback and the Kindle version of the older one, so I could more easily access the citations. (I hate dealing with citations on a Kindle.)
For some reason, I didn’t notice the older version of the book was published in 2013. It was so relevant to what I was reading about the Covid vaccines that I assumed it had just been published, when the reality was it was almost ten years old.
In his interview, Mr. Bystrianyk talks about all the time and effort he put in digging up old articles in papers and medical journals all over the world. I’ve dug out a lot of medical articles in my time—thousands of them, in fact—but nothing like he did for their book.
It is absolutely stunning what he unearthed. You can find a lot of it on the book’s website, including all the graphics. Which I did not realize. When I posted graphics from the book in previous editions of this newsletter, I had to screen capture them on my iPad, then airdrop them to my laptop. I had no idea they were available online. The chart below is one of my favorites for many reasons.
It shows data from the UK on the various diseases and their death rates over time. (The UK had vastly better data than the US for the years pre-1900.) It shows deaths from all these diseases dropping off dramatically long before vaccines came into being. Which is the natural course of infectious diseases—they attenuate over time.
The most interesting part of the chart is the line for scarlet fever. As you can see, it was the biggest killer of all, yet it dropped to nothing. And there has never been a vaccine for scarlet fever.
When MD was a little kid she got sick with a high fever, rash, and a sore throat; her grandmother, who was born in the late 1800s, took her to the doctor. When he diagnosed MD with scarlet fever, her grandmother almost fainted, because in her time, it was a death sentence. Now it’s almost never seen, and if it is, you just prescribe penicillin and it kills it fast. Which is what they did for MD—shots in the butt, much to her displeasure, she tells me. But, as you can see from the chart, deaths were already way, way down even before penicillin was discovered.
Thanks to Dissolving Illusions and Turtles All the Way Down (along with a lot of other study), my views on vaccines have done a 180 reversal. As I’ve written before, based on what I was taught in medical school, I had always assumed vaccines were the great medical triumph, one of the best things medicine had ever derived. Now I’m encouraging everyone, including my own grandchildren, to completely avoid them. All of them.
The main reason is that unbelievable as it seems there have never been any placebo-controlled trials looking at vaccines. All vaccines have been tested not against placebo, but against previous versions of the vaccines. Big Pharma has used the excuse that since vaccines are so wonderful it would be unethical to give a placebo to the control group. As a consequence, the only studies we have show that the vaccines prevent the disease they were designed to prevent, but it is unknown if they cause more harm than good over the long run. In many cases—measles, mumps, and rubella, for example—don’t really kill anyone. Neither does chicken pox. But no one knows the long term risks of vaccines for these diseases because none of the vaccines have ever been tested against placebo.
Despite reading these books (and many other books and scientific articles) I had my doubts, but they were laid to rest when I watched Aaron Siri’s deposition of Dr. Stanley Plotkin, the so-called Godfather of vaccines. Dr. Plotkin is your typically insufferable, arrogant, know-it-all, prick of an academic physician, and you could see his illusions dissolve as Siri continued to provide him with data showing the vaccines had never been tested against placebo. It was wonderful to watch and see such an arrogant prick humbled.
To give him credit, though, after his ordeal, Dr. Plotkin co-authored a paper in the New England Journal of Medicine about the lack of safety standards in the vaccine development process and how to fund such studies after the fact.
There have been a number of studies done looking at kids who haven’t been vaccinated compared to those who have in terms of illnesses later on. In all of them that I’ve seen, the kids who were not vaccinated had fewer medical problems and fewer visits to doctors or the emergency room than did their fully-vaccinated cohorts. But those aren’t randomized controlled studies.
There may be differences in parents who choose not to vaccinate their kids, which could confound the data. We really need RCTs of these things before we foist them off on children everywhere. In many places they are mandated in schools, which I believe is insane since we have no idea if they are truly helpful or harmful. If the vaccines work, and you want your kid to be vaccinated, and the vaccine is efficacious at preventing whatever the disease is, he/she should be safe. If they don’t work, then what difference does it make.
The entire Covid fiasco turned vaccines into a political football with the Democrats for and the GOP ambivalent. Now all the blue states have vaccine mandates for schools. Probably some red ones as well.
Plus, there are other aspects of getting childhood vaccines that impact the population at large.
For instance, the prevalence of shingles has quadrupled over the last 40-50 years, especially in younger adults. Shingles is caused by the varicella virus (the virus that causes chicken pox) hiding dormant in the nerve roots around the spinal column. During a time of reduced immunity, this virus can migrate up from the nerve root and cause a painful, blistery outbreak on the skin, which is called shingles.
Back in the old days before the vaccinations for chicken pox, kids routinely got chicken pox, which is a highly contagious, but benign disorder. Every kid who had chicken pox had parents and grandparents who had also had chicken pox. The parents and grandparents had natural immunity from having had chicken pox themselves, but every time they were around the kids or grandkids with chicken pox, they got the airborne equivalent to a booster shot. Thus their own immune systems were bolstered against the virus.
Now that kids aren’t getting chicken pox, the older generations are breaking out in shingles. Who knows what these vaccinated kids will get later in life.
I really like 1440 Media. I read their newsletter every day. And I get a lot of my odds and ends links from them. They truly are a non-partisan, non-biased daily news newsletter. Great links and easy to read. You can get all of the previous day’s news in about three minutes. Highly recommended. And it’s free. Give them a look.
If you're frustrated by one-sided reporting, our 5-minute newsletter is the missing piece. We sift through 100+ sources to bring you comprehensive, unbiased news—free from political agendas. Stay informed with factual coverage on the topics that matter.
Wokeness in Medicine
Just when you think things can’t get stupider, they get stupider than you could even have imagined.
I didn’t think anything could get stupider than the study I wrote about a couple of months ago. It’s a well-known medical fact that black people and white people have different risks for disease. Black people are much more prone to develop heart disease. high blood pressure, and stroke than are white people. White people in general come down with certain types of cancer more often than do black people.
In my view, it isn’t racist to say this. It’s a fact. Hispanic people develop type 2 diabetes at greater rates than do white people. It’s not racist to say that; it’s factual. There are many other racial differences in disease susceptibility.
A few months ago I wrote about the PREVENT study, which, as I recall, averaged the cholesterol levels of blacks with those of whites on a population basis and determined that the indications for statins could be reduced. Which is fine with me, because I believe in the majority of cases they’re useless, anyway. But if you really believe statins prevent heart disease, you’re giving black folks a disadvantage in the statins sweepstakes by averaging them in to prevent racism.
But we’re talking statins, which in my view are worthless, so it’s no big loss. Just an example of how we’ve gone over the edge in an effort to be woke and deny there is any difference in the races, other than one has been exploited by the other.
But there is an even more moronic idea embedded in this study that I was unaware of. When I first saw this, I thought it was satire. But sadly it wasn’t.
Believe it or not, it was an article in Stat, which is a serious medical news source. It’s doubtless heavily funded by Big Pharma, because there is seldom anything in there about the downside of drugs.
This article advocates treating patients by ZIP code rather than race. ZIP codes don’t have the stigma that race does, apparently. So if you happen to be a black guy living in a predominately white ZIP code, your specific risk factors will be minimized. Conversely, if you’re a white guy living in a predominately black ZIP code, you will be considered as having the same risk factors that black people do.
I mean how screwed up can you get?
The article starts out describing how a black physician named Joseph Wright who is the chief health equity officer (which tells you all you need to know) for the American Academy of Pediatrics got a notice from his physician.
A calculator embedded in Wright’s health record had automatically pulled in his data, including the blood test he had done that morning. The calculator’s result indicated his arteries could be narrowing dangerously: He should start taking a statin right away, his doctor said.
Wright knew well that Black patients are at higher risk for heart disease and stroke, and about 30% more likely to die from heart disease than white patients. That’s why the calculator had included his race — along with his age, cholesterol, and blood pressure among other traits — to predict his risk. But he also knew — better than most — that there was nothing inherent to his physiology as a Black man that easily explained that higher risk. Dispelling the myth of biological differences between races is part of his work. [My bold]
“Dispelling the myth of biological differences between races is part of his work.” Just think about that for a minute. Could there be a more stupid statement?
Dr. Wright has black skin, so in that way he is different than a white person. And it’s not just a matter of different coloration. Black people tend to develop scars called keloids when their skin is injured; white people usually don’t. That’s a biological difference in skin. He has different hair. He has different facial features. He probably has a different physique with a different muscle pattern. That is all different biology. These are all obvious differences to anyone who isn’t woke and has good sense. What are the odds that there would be other differences as well? Pretty damn high, I would say.
Especially since it is well known that black people have higher rates of heart disease, stroke, and especially high blood pressure.
Think about dogs. They all descended from wolves. They all can interbreed, just like humans. But they all look totally different by breed. And each breed has its own set of health issues. If you brought a cocker spaniel into a vet, the vet probably wouldn’t check him for hip dysplasia. If you brought in a mastiff, that would probably be the first thing the vet thought about.
People are the same. We all evolved from a common ancestor, but along the way we diverged enough that we look somewhat different and have developed different disease patterns. We, like dogs, are all the same species. We can interbreed. Be we have subtle biological differences that makes us prone to different diseases. It is, in my view, at least, insane to brush all that under the rug in an effort to pretend we all have the same risk pattern for a variety of diseases.
But the woke powers that be want to disregard biological differences and instead blame them on socio-economic status. Which, admittedly, has some relevance to health. No one could deny that. But is that a better way to evaluate someone than by considering the long history of the various races having different predilection for disease?
Here is what is now recommended by this idiotic study.
PREVENT includes these social factors in a bid to refine its predictions.
It does so by giving clinicians the option of factoring in a patient’s ZIP code to get more personalized risk estimates. Those five digits are used to call up a community’s social deprivation index, a combination of seven measures that reflect an area’s socioeconomic footing, including rates of poverty and unemployment.
“It’s not just a question of removing race,” said Mitchell Elkind, the AHA’s chief clinical science officer. “It’s actually a more active proposal to include social determinants of health.”
The article goes on
But even when medical records give a fuller picture of patients’ lives, it’s not a foregone conclusion that the new data will improve risk scores.
When researchers tested PREVENT, adding the optional ZIP-code-based deprivation index to its baseline risk factors only minimally improved the calculator’s ability to discriminate between patients with and without cardiovascular disease. And in a recent study, Ghosh found that replacing race in the ASCVD calculator with several social determinants didn’t improve its predictive abilities.
So, basically, it doesn’t work, but that does’t matter. It’s woke, so let’s go with it.
The other thing I despise about this article, which has nothing to do with wokeness, is the way it makes statins sound like life-saving drugs and the imperiousness of doctors who prescribe them.
The guy in question who got the bad health report didn’t want to go on statins. So his doctor negotiated with him to take a calcium scan. Which turned out negative.
The last line of the article tells the tale.
“His doctor wrote him a note: They’d hold off on the daily statin.”
They’d hold off the statin!?!? They (his doctor(s) don’t have the decision making capacity. They can only recommend. I hate this whole notion of doctors demanding that patients go on specific meds, especially statins. The patients are well within their rights to tell the doctor to jump up a fat dog’s ass. The patient is in control of his/her life, not the doctor.
I’ll be so glad when this woke BS is behind us. If I should live so long.
On another note, if you want another primer on LDL-cholesterol and statins, take a look at this recent talk of Dr. David Diamond’s.
Okay, one last important thing before we get to the Odds and Ends and the video of the week.
Zoe and Malcolm’s Mighty Triumph
I don’t know how many of you know about this or not, but my friends Zoë Harcombe and Malcolm Kendrick have been in a battle to the death with a major UK tabloid, the Daily Mail.
A writer for the tabloid accused both Zoë and Malcolm of knowingly making false statements about the efficacy of statins. The article disparaged both of them in the nastiest of ways, so they sued for libel. Which is a lot easier in the UK than in the US, but still is not a walk in the park. It is expensive and massively time consuming. Not to mention gut wrenching, when one considers the downside, which is paying the legal fees of the other side should you lose.
But they didn’t lose. In fact, they kick the crap out of the Daily Mail and the beta male writer who wrote the piece.
Said the Daily Mail in which was part of the settlement,
On 3 March 2019, The Mail on Sunday published articles (one headlined "The deadly propaganda of the statin deniers") in which we featured Dr Zoë Harcombe PhD, a researcher, writer and public speaker on diet, health and nutritional science, and Dr Malcolm Kendrick, a GP, writer, and lecturer, with an interest in cardiovascular disease. Dr Harcombe and Dr Kendrick brought proceedings for libel.
At trial, the Court held that our articles had accused Dr Harcombe and Dr Kendrick of knowingly making false statements about statins, and that a very large number of people ceased to take statin medication and were exposed to serious risk of heart attack or stroke on a scale worse than the MMR vaccine scandal as a result of those false statements. The articles also alleged that there were strong grounds to suspect Dr Harcombe and Dr Kendrick of making these statements motivated by the hope that they would benefit materially, and included quotes from the then Health Secretary, Matt Hancock, which suggested that their statements were ‘pernicious lies’.
We accept the findings of the Court that the inclusion of the Hancock quote created a misleading impression of what he said. We also accept that these allegations are untrue and ought not to have been published.
We are happy to set the record straight, and apologise to Dr Harcombe and Dr Kendrick for the distress caused. We will not repeat the allegations and have agreed to pay substantial damages and costs.
Major congrats to both of them. When I responded to Zoë’s note notifying me of their victory, she wrote back telling me she would give me the full story next time we’re together. Can’t wait to hear the gory details.
The Wait is Over
Here ye, all fans of the bride’s Caddo Bend romance series: Rising Sun, Book 3 in the series is out and available on Amazon! Find out what’s next for Dr. Maggie, JD, and all the friendly folk in Caddo Bend, Arkansas. It’s just coming on Christmas in Caddo Bend; there will be carols and snow on the Square.
Odds and Ends
Twin boys born conjoined celebrate 1st birthday after separation surgery. An incredible medical teamwork effort to do this.
Nice graphic showing the different generations—Boomers, Gen Z, Millennial, and Gen alpha. Find your generation — and what it means — by year. I can never remember them all.
Feed raccoons for years, and they might swarm you in herds. A Washington woman found this out the hard way.
An 18-year old Nepalese teenager has broken the world record for the youngest mountaineer to summit Earth’s 14 highest peaks.
Amazing Coast Guard rescue of a man clinging to a cooler. He had spent the night floating in the open ocean after Hurricane Milton had destroyed his boat.
Top Oregon official put on leave for allegedly prioritizing ‘qualified’ job candidates over ‘gender identity.’ What a strange choice. Competence over diversity. Who could imagine?
Risky play exercises an ancestral need to push limits. Dartmouth anthropologists tout the benefits of monkey bars and other ‘dangerous’ playground equipment for successful child development.
Survey shows almost 40% of the public would agree to World War II-style RATIONING of meat and fuel to slash carbon emissions. I don’t believe it. 40% of people can’t be that stupid, can they?
With no running water, Asheville finds other ways to flush thousands of toilets.
Must be something in the water. Grizzly bears going nuts this year out west. Bowhunter rescued by helicopter after he was treed by a one in Montana.
Your tasty, wholesome steak is safe for now: the lab-grown meat revolution looks like it’s over. It will go down as one of the biggest failures in food history. Thank God.
Gallup poll says for 3rd consecutive year, more U.S. adults have no trust at all in the media (36%) than those who trust it a great deal or fair amount. Another 33% of Americans express “not very much” confidence. Which means 31% believe the media, which is troubling.
More UK climate insanity. Durham institution aimed to cut its environmental footprint by turning off heating for the day, but ended up cancelling initiative after parents complained. The school wanted to emphasize sustainability. Jesus wept.
Early English burials show what smoking does to bones and teeth. It was a nasty habit then and still is today.
Is the myth of plastic recycling finally being exposed? Great story about the barge Mobro 4000 and it’s load of garbage.
A giant pumpkin weighing 2,471 pounds wins California contest in town called the Pumpkin Capitol of the World.
How the medical insurance claim game works.
Hunormous new Grand Egyptian Museum cataloging 700,000 years of Egyptian history opens to the public. I would give my right [fill in an appropriate body part] to go to this museum.
Speaking of Egypt, paraglider spots a dog wandering around at the top of the massive Great Pyramid of Giza. Amazing video. Amazing dog.
Researchers discover how taste guides mosquitoes’ biting behavior, which deter biting and halt disease spread. If they come up with something that works, I would like to be dipped in it.
Video of the Week
Okay, it’s going to be difficult to match last week’s VOTW. It got more positive comments than any other video of the week ever. But this week’s is nice, too. Just not in that chirpy, funny, flirty was last week’s was.
Emma Kok is a 15-year old young woman from The Netherlands who has been afflicted with gastroparesis since she was a baby. She has been on a feeding tube since diagnosed and has not grown as much as she should have had she not been so afflicted. From what I could read about her, she was bullied in school because she was small and different. Fortunately, her disease hasn’t impacted her voice. Here she is in a massive triumph over illness and bullying singing Voilà with Andre Rieu and his orchestra. (English lyrics and song story here.) Enjoy!
Time for the poll, so you can grade my performance this week.
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That’s about it for this week. Keep in good cheer, and I’ll be back next Thursday.
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