Greetings everyone.

Hello from a bright and sunny Montecito after almost a week’s worth of rain.

Happy Thanksgiving to those of you in the States who celebrate it. MD has had the turkey cooking sous vide, which is the only way to cook turkey. If you try to cook it the traditional way in the oven, you end up with either properly cooked dark meat and white meat that is way overdone, or white meat that is perfect and dark meat that is undercooked. Both are perfectly cooked using the sous vide technique.

Before sous vide we always roasted our Thanksgiving turkey in the oven at a temperature that cooked the dark meat to perfection, but left the white meat overdone. Everyone fought for the dark meat and didn’t particularly like the overcooked white meat. The first time we did our Thanksgiving turkey sous vide, our youngest son declared that he always hated the white meat, but cooked sous vide, he liked it way more than the dark. It’s really transformative what sous vide cooking does for turkey. And many other dishes.

We’re having Thanksgiving at our son and DIL’s house, but MD is the main chef this year. She’s doing most of the cooking because they were out of town until late Tuesday night. There are a ton of people coming of all political persuasions. Even one who is a far lefty from the UK. And all (except for us and our kids and grandkids) have been vaccinated to some degree or another. Since MD is even baking the pumpkin pie, I begged her to make this one.

Being the non-confrontationalist she is, she refused. But she did go as far as making the one pictured below. It was the best I could get her to do, and I was surprised she even did it.

I didn’t eat a bite of it, because I hate pumpkin pie. Everyone else did, though, and no one said a word.

Speaking of Thanksgiving…

One of the many things I’m thankful for is your readership. I’ve been at this for almost four years now, and I can’t tell you how much I appreciate all of those who have stuck with me. And I’m exceptionally thankful for you premium subscribers. In fact, words can’t express how thankful I am. Your ongoing contribution really helps.

I’m thankful for the sharp eyed readers who inform me of typos that I can fix in the web version. I’m truly appreciative for those of you who have corrected me or called me out when I have misstated something or made an error. I love all the feedback I’ve been given, which has mostly been good. But I appreciate the bad, too. I’m just a pilgrim along the road of life like everyone else, and I certainly don’t know everything. So thanks for setting me straight.

I apologize for all the emails that have gone unanswered. When I have the time, I try to answer as many as I can. But when I get inundated with them, as I have been lately, it’s tough to keep up.

So thanks to all from the bottom of my heart. I really enjoy the back and forth and having you as readers.

A couple of things before we move on.

First, a minor rant on the ongoing shitification of everything.

I got a notice from one of my credit cards that there was a charge for The Financial Times (FT). I’ve subscribed to the FT for years using this same credit card and never had a problem. But this month, for some reason, something got tripped. In the notice they asked me whether or not this was a valid charge. I was to enter Y if it was and N if it wasn’t. I entered Y.

In due course, I get an email from the FT telling me my credit card was declined for the monthly subscription fee. So I have to call the credit card company, go through the long list of where I’ll be connected to when I push whatever button, none of which gets me to a human. I finally fiddle with it all until I get a human on the phone. A human from a call center in India. He’s reading a script. I tell him what the deal is, and he goes into his spiel. I get pissed and ask him why I’m going through all this for a charge I’ve made and paid for every month for five or six years. And when I have a ton of room on my card for more charges. He tries to find the correct script; I get even more pissed. Then I feel bad for him, tell him it’s not his fault, and I’m not mad at him. I'm angry at the system. He tells me he has put the charge through and apologizes for all the grief. I ask him why, after years of seeing this same monthly charge, would some nimrod decide it might be fraudulent? And why when I answered Y did they still deny the charge? He, of course, didn’t know.

That was part one. Then I had to go to the FT website and tell them the bill was paid. Of course, there was no way to do that. They wanted new credit card info since the other one had been denied. There was no choice for just try the card again. So I ended up on a chat line trying to get my subscription restarted. All the going back and forth by text chewed up another fifteen minutes or so. By the end of it all, I had spent over 40 minutes screwing with the thing just to get my subscription back in action.

The whole thing was not that big of a deal. But it’s little unexpected annoyances like this that consume a lot of time these days, and it fries me that I have to deal with them. I know I’m not alone. Everyone has to deal with this kind of crap. But when I think of all the people wasting all their time doing this, it really torques me. It’s just more of the shitification of everything these days.

On another annoyance…

I had to terminate The Arrow prematurely last week because of a power outage. This happened once before as a consequence of a glitch in the installation of the Tesla roof. The folks from Tesla came out and made it right. Fortunately, I saved all the numbers to get to the inner sanctum of Tesla customer service. This time the Tesla rep put my son and me through all the steps to check things out. When nothing worked, she declared it was a problem with the power company.

You might wonder what the power company had to do with it since it is a Tesla roof that converts solar power into electrical power. The problem with solar power and wind power is the storage of the electricity generated. The sun shines only a certain number of hours per day and the wind only blows when it blows. You must be able to store the power generated when the sun is shining (or the wind is blowing) to be used at other times.

Unless you want to invest in a huge bank of batteries, you must be able to access another power source when your use of electricity exceeds the storage capacity of your batteries. Thus the connection to the power company. The Tesla roof produces more electricity than the house uses, but it can’t all be stored in the batteries we have. So the overflow goes back to the power company and we get credit for it.

At times when the use of electricity, mainly at night, exceeds what is stored in the batteries, then the power grid takes over. But every month the power bill is a negative, reflecting the fact that more electricity flowed from the roof to the power company than the other way.

In the case last Thursday, the batteries were depleted, but we were getting no electricity from the power company. As it ended up, the Tesla rep was correct. We called the power company. The folks there checked it remotely and said there was a problem with the transformer. I figured we were going to be out of electricity for the night and until they could maybe get someone out the next day. Instead, she said someone would be out that same night.

The guy arrived in about 30 minutes, spent about two hours up on the power pole behind the house, fixed the transformer, and we had power. But it was about midnight when he finished, and The Arrow had already been sent.

I’m reporting this not as a rant, but because I figure others might want to understand how home solar works. I certainly didn’t until this power outage and the one before educated me. Before that, I figured you had the roof installed, the electricity went to your batteries, and Bob’s your uncle. But it doesn’t work exactly that way.

Moving on…

A couple of Arrows ago, I wrote about a missed landing coming into the Santa Barbara airport. The pilot came in too hot I think and ended up bailing on the landing and going around again. As I mentioned, I’ve flown a zillion miles and this has only happened one other time. But this time, as we were all disembarking, the pilots, who are usually out there saying adieu, were nowhere to be seen. The cockpit door was closed.

My best friend in Dallas is a senior pilot for American Airlines. I texted him about it, and here is what he texted back.

I’m just passing this along in case any readers out there end up in the same situation. Pretty standard stuff; no biggie.

Speaking of flying… Our youngest son just completed his third cross-country solo flight, so he has his private pilot license in sight. Then it’s on to instrument rating, multi-engine, CFI and building hours toward working for the airlines.

Comments, Poll Responses, and Emails

Glucose and the heart

Just a couple today. This from a poll respondent:

It’s not a double standard at all. The heart prefers ketones and fat, but it uses glucose first if it’s available just like the other muscles. When it is said that the heart prefers ketones and fat, it means that it performs better on those fuels than on glucose. Not that it uses them first.

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Gums and Various Other Gunk

I received this question via the comments week before last and intended to deal with it last week, but didn’t:

Here is what I wrote in response:

Let me elaborate a bit more.

Until I became sensitized to the whole ultra-processed foods idea, I’ve got to admit that I simply looked at the carb content on food labels. I simply read what was in whatever food I was considering in terms of actual food content and completely ignored all the chemicals, gums, preservatives, etc at the bottom of the list of ingredients.

Now that I’ve become more enlightened, I look at everything in the list of ingredients. And I’m always surprised to find all kinds of crap in what should be just plain food. As the lady above reported, her heavy whipping cream contains gellan gum. I checked at the grocery store a couple of days ago and found that a number of brands add gums or one sort or another to their heavy whipping cream. Some contain all kinds of stuff. The Lucerne brand has, in addition to the cream, plain old milk, carrageenan, mono and diglycerides, and polysorbate 80. Just in case you think I’m kidding you, here is the label.

Looking up the calorie count of heavy cream in our favorite pure cream, I discovered it was 60 kcal per tbsp. Below are the Nutritional Facts and the ingredients from Alexandre Family Farms heavy whipping cream.

I did the same with whole milk (which I assume is the milk used) and found it to be 6 kcal per tablespoon. The calorie count listed on the carton of Lucerne heavy whipping cream was 50 kcal per tbsp. Which is less than the 60 kcal per tbsp found in Alexandre Farms pure heavy cream. I ran the calculations, and it turns out that ~17.5 percent of the volume of the Lucerne brand is milk and the rest heavy cream.

Since milk is considerably less expensive than heavy cream, it looks like Lucerne is doing a little cost savings by mixing the milk in with the cream.

But then they add all the other stuff to make it more “creamy.”

If you look at the individual ingredients in this witch’s brew of what is labeled as heavy cream, you’ll find that you might not want to purchase this brand.

Carrageenan is derived from red seaweed that acts as a thickening agent, emulsifier, and stabilizer in various food products. It is an odorless yellowish to colorless powder commonly found in products such as dairy alternatives, yogurt, cottage cheese, and other processed foods.

Carrageenan has been linked to several potential health concerns, particularly regarding digestive health. Studies have shown that carrageenan can trigger inflammation and may contribute to conditions such as bloating, irritable bowel syndrome, and inflammatory bowel disease (IBD). While the FDA continues to approve carrageenan as a food additive, the National Organic Standards Board voted to remove it from their approved list in 2016, meaning foods containing carrageenan can no longer be labeled "USDA organic." Some researchers advocate for reconsidering its widespread use in the Western diet due to potential carcinogenic properties observed in animal models.

Mono and diglycerides are emulsifiers widely used in the food industry, consisting of glycerol molecules with one or two fatty acids attached. They serve as additives that help oil and water blend together while improving texture, stability, and shelf life in a multitude of processed food products.

In researching the issues with mono and diglycerides, I came across a slew of troubling facts. First, these products contain trans fats. The FDA has put a ban on trans fats as part of the fat in foods, but don’t ban them in mono and diglycerides, because these are considered emulsifiers and not food. Jesus wept.

Second, although the FDA classifies them as "generally recognized as safe" (GRAS), mono and diglycerides can contain trace amounts of contaminants including lead, nickel, cadmium, mercury, and arsenic. Lovely.

Finally, the health risks associated with their use are inflammation, cardiovascular problems, insulin resistance, obesity, and stroke.

Approximately 70% of emulsifiers used in U.S. food products are mono and diglycerides.

Polysorbate 80 is a synthetic compound used as an emulsifier and surfactant in foods, pharmaceuticals, and cosmetics. It is a viscous, water-soluble yellow liquid that helps prevent fats from separating in the various products in which is used.

The product can compromise gastrointestinal function by increasing intestinal membrane permeability. It disrupts gut microbiota composition, decreasing beneficial bacteria while increasing inflammation-associated bacteria. And it may alter nutrient absorption, particularly of minerals like potassium and calcium.

Polysorbate 80 can worsen radiation-induced gastrointestinal toxicity in cancer patients receiving radiotherapy. It alters gut microbiota composition, potentially leading to severe radiation-induced GI tract injury. It can cause severe non-immunologic anaphylactoid reactions in some individuals. The growing consumption of polysorbate 80 over recent decades has been associated with an increase in various chronic inflammatory and metabolic conditions.

Finally, it is limited to 1.0% concentration in products due to potential toxicity concerns.

All this risk of potential health issues to save a few cents by replacing ~17.5 percent of the heavy cream with milk. All the above ingredients combine to make the cream-milk combo taste and have the mouth feel of real heavy cream.

You would never know from looking at the front of the container.

This is why you (and I) should carefully read the labels and select products that don’t have all this crap added to them.

I want to go over one other product and an n=1 experiment.

Our middle son has been on a pretty strict carnivore diet for about nine months now. He eats meat and dairy and that’s about it. He’ll occasionally have a drink of whiskey, but not very often. In addition to his real food carnivore diet, he has been adding a couple of Fairlife Core Power protein drinks per day. He’s been lifting weights, so wants to add protein to help with muscle protein synthesis. These drinks come with various protein content. He uses the one containing 42 grams of “complete protein.”

Here are the ingredients in Fairlife Core Power, which, by the way, is owned by Coca Cola, as shown on their website:

As you can see, the drink contains a montage of different sweeteners: acesulfame potassium, monk fruit, stevia leaf extract, and sucralose. Of these sweeteners, the monk fruit and stevia are pretty harmless. The other two have a long list of problems associated with them. I’m not sure if the juice concentrate is used as a sweetener or a flavor enhancer.

You can see the carrageenan, cellulose gel, and cellulose gum, which are thickeners, and emulsifiers.

Here is a photo of the Nutrition Facts from the container:

I clipped it off in the photo, but the bottle contains 14 ounces of the stuff. In considering this, I came across something weird.

According to its label, the product contains primarily “lowfat grade A milk.” When I looked up the calorie count and protein amount in lowfat milk, I came up with these Nutritional Facts from my food content calculator for 14 ounces:

Hmmm, thinks I. This doesn’t quite compute. Let’s go through it together and compare.

Low-fat milk contains 19.1 g of carbohydrate in 14 ounces. The same 14 ounces of Core Power contains only 8 g of carbohydrate. What happened to the other 11.1 g? Remember, according to the Core Power label shown above, everything other than the list of additives, is 99 percent low-fat milk. How did they suck the 11.1 g of carb out.

You may think the lactase enzyme added may have gotten rid of the carb. But the carb in milk is lactose, which is a combination of glucose and galactose. The lactase simply breaks the bond between the two, but doesn’t decrease the amount of sugar overall.

Even more mystifying is the protein. 14 ounces of low-fat milk contain 13.1 g of protein. 14 ounces of Core Power, which allegedly is 99+ percent low-fat milk, contains 42 g of protein. Where did the other 28.9 g come from? There is no listing on the label for added protein. No whey protein isolate or any other type of protein whatsoever.

Something doesn’t compute.

Our kid loves these Core Power drinks (and I kind of liked them myself until I read the ingredients), but when I showed him all the crap they were full of, he was bummed. He didn’t know what to replace them with. I told him to get some whole milk and some whey protein and throw them in a blender to make a shake. He instead threw them in a little blender bottle shaker he has and mixed them that way.

After he drank the first one, he told me he felt a lot better than he did when he drank the Core Power. He said the latter made him have a bit of indigestion, which he attributed to the milk. He has had no symptoms whatsoever with the whole milk-whey protein combo.

MD is always looking for ways to increase her protein intake. She tried the Core Power a few months ago, and they caused her to have issues. After just a few of them, she abandoned them altogether. Her go-to had always been a couple of scoops of protein in a half cup of full fat yogurt. She has not tried the milk-whey protein combo yet.

As I wrote above, it’s only an n=1 experiment, but given the ingredients included in the Core Power drinks, I would bet others would find the same thing.

My bet is that most of us would feel a whole lot better and have a lot fewer symptoms if we just avoided ultra-processed foods. I suspect many of us go around feeling crummy because of all the additives in today’s diet. We don’t know we feel crummy until we cut all the additives out of our diet, then realize how much better we feel, sleep, perform, etc. Feeling crummy is just our default. Until we begin to feel as is our birthright, we don’t know how lousy we felt before.

I’ve thought a lot about Big Food and what makes it tick.

If you run a food company there are only so many ways you can compete. You can claim a stake in the market then grow as the population grows. Which is fairly slow growth. You can come up with some new product that takes the market by storm. You can take a chunk out of some other food company’s market by making a tastier, more addictive version of a particular food. Or you can make addictive products to make people eat more, so you capitalize on both the growth of the population and the growth of the girth of the population.

In other words, you could sell heavy cream without additives at a higher price, or sell adulterated “heavy” cream with almost 20 percent milk and a handful of additives mixed in to make it even more “creamy” than actual heavy cream. Then you have a product with a greater shelf life that is cheaper and has better mouth feel than the real stuff.

For my money—and it is more money—I would rather have the real stuff.

Ozempic Shrinks Hearts

It’s a pretty well-known fact (and worry) that the GLP-1ra drugs reduce hunger and, consequently, food intake. And it’s also well known that if protein intake is inadequate, especially in older people, muscle tissue begins to breakdown. We’ve been over all this in various issues of The Arrow a thousand times.

But what has never occurred to me (though it should have, I’m embarrassed to admit) is that since the heart is a muscle, too, if you lose other muscle due to lack of protein intake, it makes sense that you might lose heart muscle as well.

Which is what a handful of researchers decided to explore in a short study titled Semaglutide Reduces Cardiomyocyte Size and Cardiac Mass in Lean and Obese Mice.

They used mice instead of humans to see what happens to heart muscle when mousy subjects get injected with GLP-1ra meds.

Here’s what they did.

They fed male mice a crappy kind of rodent chow, which is composed of 45 percent fat (lard and soybean oil), 20 percent protein, and 35 percent carb (sugar and corn starch). It’s a diet that would make anyone fat. They fed the mice on this slop for ten weeks, during which time they gained a fair amount of weight.

Then, for reasons unknown to me, they switched the mice to standard chow until they lost almost a third of the weight they had gained. In the paper, the authors wrote that they did this to “simulate the reduced caloric intake employed in the STEP1 (STEP 1: The Semaglutide Treatment Effect in People with Obesity) clinical trial.” I am familiar with this study, and I didn’t recall any front end weight-loss phase before starting the injections. I went back and couldn’t find anything in the paper about it. Then I even went to the protocols for the study and skimmed them (they are 271 pages long) and found nothing about a Step 1 phase. So I’m not really sure what the authors are talking about.

After the mice lost about a third of their gained weight, they randomized them into two groups, one of which got the GLP-1 while the other got sham injections of placebo. After three weeks researchers evaluated both groups of mice for muscle mass loss, heart size, and heart strength.

Here’s what they found.

If you look at ii. above, you can see that the mice on the GLP-1ra drugs (Sema) lost more body weight than those on placebo (Veh for vehicle). You can also see there is some overlap, so some of those on Sema lost less than those on Veh, though overall the Sema group lost more.

Looking at iii., it is apparent that those on Sema lost vastly more fat than those on Veh. There was a little overlap, but not much.

Iv. is interesting. It shows that there is no significant difference in the two groups statistically using hypothesis testing. But eyeballing it tells a different story. The ejection fraction of the mice on Sema is higher than that of those mice on Veh.

The ejection fraction is the fractional amount of blood pushed out of the heart per beat. If you’ve got an ejection fraction of 70 percent, that means you’re pumping out 70 percent of the blood volume relative to the heart chamber’s volume. Normal is between 50 and 70 percent. The higher the ejection fraction, the more powerful the heart beat and the healthier the heart.

In the graphic above, you can see the ejection fraction is greater in those mice that got the Sema and lost all the weight. It doesn’t fit with the expected outcome given the loss of heart tissue mass, which you can see in vi. and vii. below. Both the LV (left ventricular—the part of the heart doing the pumping) and total heart weight are less in the Sema treated mice.

So why would the ejection fraction be improved if the heart were smaller?

I suspect it was a surprise to the researchers as well. And I’ll bet they fiddled a bit with the statistics to make it come in as no significant difference. But just eyeballing it, you can see there is a difference. If the heart had less mass, it would seem impossible that it could be pumping harder.

My take on it is that the mice on placebo are still overweight and over fat (see ii. and iii. above), and the increase in resistance this causes may affect the ejection fraction. The heart is pumping against a pressure gradient (the blood pressure already in the arteries), and if that is increased due to the increase in fat mass in the Veh mice, then it would stand to reason that their ejection fraction might be compromised a bit. Whereas the mice on Sema, despite having lost some cardiac mass, may still have an easier time pumping the blood.

At least that’s my analysis. Which makes a great deal of sense. To me, at least.

There is another aspect of this study that is interesting. The paper is a short report, so the explanations of everything are condensed or provided only in the graphics. Along with the mice that were overfed with the high-sugar, high-fat chow, there was another group that was fed normal chow for the same period of time. These mice did not gain excess weight or body fat.

These normal sized mice were also injected with the GLP-1ra drug (Sema) to see what happened to their heart size and function. The graphic below shows what happened.

The normal sized mice did not lose body weight nor experience a decrease in cardiac function (ejection fraction). They did, however, undergo a decrease in heart size and myocyte (heart muscle cell) size.

I don’t know how that jibes with my theory on why the ejection fraction did not decrease despite a decrease in heart size. I suppose we’ll have to wait for other studies to see what they show.

I’ve discussed what this all means from a physiological perspective. At least as I understand it. My friend Matt Briggs made a video on this same paper describing how a statistician looks at it. You may find it interesting if you are of a statistical bent.

Obesity and the Grim Reaper

A recent paper in The Lancet titled “National-level and state-level prevalence of overweight and obesity among children, adolescents, and adults in the USA, 1990–2021, and forecasts up to 2050” shows graphically why obesity really cuts life short.

Before we get to the graphic, let me define a couple of terms that far too many people use interchangeably: prevalence and incidence. Though used in a wide variety of circumstances, I’m going to describe them as applied to disease.

Prevalence, as in the title of the above paper, means the percentage of people who have a disease or disorder at any given time. If you want to know how many people have, say, diabetes on November 28 in the United States, you want to know the prevalence.

Incidence tells you how many people will develop a disease or disorder in a defined period of time. If you were to say, X out of 100,000 people developed diabetes in 2024, you would be talking about incidence.

The graphic in the above linked paper that caught my attention is presented below:

This graph shows the prevalence of people with obesity with age in the United States. What it tells us is how many people are obese in the US at any given age. Starting from the left, you can see that at young ages, somewhere around 15 percent of kids are obese. When I was a kid, it was under 2 percent.

You can see that as people age, more and more become obese until the obesity levels out at about 50 percent. In this graphic, obesity is defined as a BMI of 30 or greater. I know all the arguments as to why BMI is not a great way to determine obesity for the individual, but on a population basis it isn’t all that bad.

From the graphic above, you can see that obesity tops out at ~50 percent around age 35 and levels off there for about another 30-35 years. Starting in the late 60s, it starts to drop off. Since we’re talking prevalence here (not incidence), this means one of two things. Either more people are losing weight starting in their late 60s, or more people with obesity are dying. I suspect the latter.

If you look at the vertical red line I added, you’ll notice it’s at around the inflection point. People gain weight as they get older, maintain that weight, then start to die off.

If you look at age 75-79, you can see that the obesity prevalence has fallen from circa 50 percent down to about 38 percent. Remember, this means the number of living people with obesity. So if there has been a decline, that means one of the two things I mentioned earlier. Either people start losing weight between late 60s and late 70s, or more obese people die than do non-obese people.

As the population gets older, more and more people rapidly die. By age 80, only 30 percent of the living population is obese. Which means of the people who die, the majority are obese.

It looks to me like the human body can tolerate obesity and keep going until the mid-to-late 60s. Then the condition starts to take its toll in terms of longevity. More people begin to die at that point than do non-obese people.

In my view, obesity can be viewed as the whole panoply of disorders caused by insulin resistance and hyperinsulinemia: obesity, high blood pressure, lipid disorders, diabetes, and all the rest.

I’m mentioning all this not to terrify those who are obese, but to sound a warning. It’s never too late to ditch a bunch of excess weight. Now—or the day after Thanksgiving—is the best time to start.

A New Cause of Heart Disease

I say new, because it is new to me. I just read about it in a journal, not a medical journal, but the Wall Street Journal. I’m not proud. I’m happy to learn from any credible source.

I was just catching up on my WSJ reading yesterday, when I came across an article from this past weekend headlined I Was in Great Health. So Why Were My Arteries Clogged?

The piece was about a man in his late 60s who decided to go to the doctor for a checkup. He was adopted, so he knew no family history. He had always been athletic and in good health, but decided at his age, maybe he ought to get a once over by a doc.

The doctor he selected told him he couldn’t find anything wrong, but just for grins, maybe he should get a calcium scan just to make sure his heart was in good order. He goes to get the calcium scan and it reads out as 2,424, which he (and probably his physician) interpret as being absolutely positively widespread heart disease.

(I would have loved to have seen his plaque volume and slice thickness, so I could have evaluated it via the method discussed in the Criqui paper I’ve written about so often.)

As they almost always do, his physician sent him immediately to a cardiologist.

Then…

The guy gets scheduled for a coronary angiogram. When he gets the results, he discovers that no artery has more than 40 percent blockage (which sounds bad, but really isn’t. You can pump plenty of blood with a 40 percent blockage) and all his plaque is stable. (In my view, with the calcium score he had, if it weren’t stable plaque, he would have long before had problems.)

The angiogram also shows that you can’t use the calcium score to tell how much blockage there is. It’s not designed for that. I tells only the amount of calcium in the arteries, which reflects the degree of plaque, not how much it is occluding anything.

What’s really interesting about all this is that the guy’s calcium score got worse after following all the dietary recommendations provided by the nutritionist.

He wonders why, after all the steps he took with the dietary changes and the statins (note there were signs of liver damage from his statins), his calcium score got worse. He goes back to the lipidologist, who has an idea and decides to run one more test.

His lipidologist…

The author of the article takes this newfound diagnosis to his cardiologist.

Like most physicians, I, too, had never heard of sitosterolemia, so I was extremely grateful to have read this guy’s history.

I immediately went to PubMed, only to discover there are not a lot of papers on sitosterolemia. I did discover that it is a rare autosomal regressive disease, requiring the genes from both parents to manifest.

But I wonder if just having one of the genes causes a minor taste of the disorder. For example, I have one of the genes for hemochromatosis. My cousin, who was my closest relative when we were young, ended up with both genes, and he died of hemochromatosis. In my case, my ferritin (an iron-storage protein), if left alone, is sky high. I give blood frequently to keep it down.

If that is the case with Sitosterolemia, then there may be milder cases than the full-blown syndrome. And many, many more people involved.

There is no doubt that consuming a lot of plant-based food will generally send LDL-levels down, but how many of those are increasing plant-sterol levels, which aren’t tested for?

I’ve just begun looking into all this, so I don’t have any answers yet.

But it is a fascinating genetic disease. I wanted to include it along with the WSJ article linked above to give everyone a heads up on it. I’ll continue to burrow in and find out everything I can and provide updates.

What I do know, is that it does indeed require specialized tests to determine the amount of plant sterols in the blood. The normal range is less than 1 mg/dl of sitosterol in the blood. Those with sitosterolemia often have 10-65 mg/dl levels. I’m wondering if those who have just one gene for the problem may have intermediate levels. I’ll let you know after I’ve delved into it.

I find this stuff absolutely fascinating, but I live an extremely boring life. You, however, may find it dull as dishwater and comment through the polls as one respondent did last week about The Arrow #203: “Interesting, but not riveting.”

I’m really interested in finding out if the one-gene-only variety can cause a touch of the disorder. I’ll keep you posted.

Odds and Ends

• Yet another prominent scientist comes out declaring SARS-CoV-2 was unleashed by a lab leak in Wuhan.

• Scientists have developed a new vaccination strategy for malaria—boosting immunity through bites from mosquitoes carrying a genetically engineered version of the parasite that causes malaria. What could possibly go wrong?

• Study describes why Aztec “death whistles” sound like human screams. Study.

• 2,500 years ago the Greek historian Herodotus wrote about a type of ship he traveled on in Egypt. Since nothing like it has ever been found, it was written off as fiction. Now one has been found at the bottom of the Nile. Herodotus was right.

• A parachute found in an outbuilding in North Carolina could be the new evidence that may crack the 53-year-old D.B Cooper case. I’ve been interested in this case since it all happened.

• Jaguar’s been testing the “no such thing as bad publicity” maxim. Bud Lite tested it, too. And it didn’t work out all that well for them. I suspect the same will happen to Jaguar.

• What’s it like to be massaged by a robot? Here is a report from someone who actually had it done.

• In Belize, archaeologists discover 4,000-year-old canals used to fish by predecessors of ancient Maya.

• The Spanish cop, 20 million euros and 13 tonnes of cocaine. It’s always the ones you least expect.

• The 25 most influential cookbooks from the last 100 years—at least according to the New York Times.

• Why does virtually every film in modern memory end with some variation of the same disclaimer: “This is a work of fiction. Any similarity to actual persons, living or dead, or actual events, is purely coincidental”?

• Could your workout routine be shaping your brain as much as your body? New research suggests that athletes demonstrate significantly superior working memory compared to their sedentary counterparts.

• Rand Paul claims feds refusing to hand over docs that unlock origins of COVID-19. A new administration may change that. I would be nice to know for sure. One way or another.

• Big Pharma still won’t come clean about the Covid shot’s deadly side effects. I suspect a lot of this will change when Jay Bhattacharya takes over the NIH. At least I hope so.

• Ancient inscription on statue carved by 'King Midas' tribe finally deciphered.

• Groundbreaking study on DEI cancelled by Bloomberg and New York Times. Maybe there has suddenly been a long-awaited outbreak of good sense. Let’s hope so.

• NSA warns—reboot your iPhone or Android weekly as zero-click attack defense. Is this valid advice, or not?

• A boy who found a shiny rock while playing at a beach has been told the item is a Neanderthal hand axe that could be 60,000 years old.

• “The mainstream media is dead! Long live the mainstream media!” Interesting article on where the author thinks the mainstream media is heading.

• Why President Coolidge never ate his Thanksgiving raccoon, despite the raccoon’s long history in American culinary tradition. There is still a huge ‘Coon Supper in Arkansas that any politician hoping to get elected must attend.

  Newsletter Recommendations

Video of the Week

Okay, it wouldn’t be Thanksgiving without a dose of Alice’s Restaurant. I just read this past week that Alice of Alice’s Restaurant fame died at age 83. RIP Alice. You’ll never know how much pleasure your namesake song has provided me for the last 50 years.

Without further ado.

Time for the poll, so you can grade my performance this week.

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

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This newsletter is for informational and educational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.

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