Hello everyone.

Well, major snafu last week that I heard about from polls, comments and emails. I somehow started off writing about Nicole Shanahan, who is the billionaire woman who was Bobby Kennedy’s vice presidential running mate during his short term run at the presidency. I think I identified her correctly as Nicole Shanahan a couple of times, then for whatever impulse started calling her Kate Shanahan. I know a female doctor named Cate Shanahan, but not Kate. Where the Kate came from, I can’t begin to figure out.

So, sorry if you had to try to figure out if it were two different people I was talking about with similar names. My apologies.

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Chronic Disease in the USA

I read the Wall Street Journal fairly religiously, and over the past couple of months or so since RFK’s taking the lead of the HHS, I’ve noted an argumentative tone toward everything he wants to do. Obviously, the WSJ is the paper of Wall Street and not Main Street, and since Big Pharma, Big Food, and Big Medicine are headquartered on Wall Street and not Main Street, I figured the paper was just writing for its audience. Imagine my surprise when I opened this weekend’s edition only to find a comprehensive article on Americans and chronic disease.

The article titled “How Chronic Disease Became the Biggest Scourge in American Health” didn’t really pull any punches. It laid the situation out pretty much as it is. And it isn’t good.

When I was a kid, my grandfather bought our family a set of the 1958 World Book Encyclopedia. Since all my siblings were significantly younger than I, it pretty much became my domain. I suspect I read the entire thing cover to cover. Not at one go, of course, but by looking up everything I looked up over the three or four years I read in it intensively, I probably hit just about everything.

Until I got used to seeing it over and over, I was always amazed at how the US fared against the rest of the world in almost any topic I looked up. It didn’t matter what it was; the US was always the best. At least according to the World Book.

As I continued to grow up and looked at other sources, I found pretty much the same. Whatever the topic, the US seemed to always come out on top. I think every kid in America during those years learned the same thing. The US had the greatest productivity, the biggest army, the most airplanes, the largest agricultural output—whatever the product, we lead the field.

Now, somehow, 50 years later, we find ourselves at the very bottom of the statistics on health. I’ve posted in earlier versions of The Arrow the graphic from the NY Times showing the US as having the least longevity while at the same time having the highest medical expenditures in the industrialized world. I knew the obesity statistics were bad, but I was stunned to learn that longevity was so low despite our huge expenditure on medical care.

Now comes the WSJ with an updated graph showing it’s even getting worse.

Unlike the NY Times graphic, this one shows only life expectancy at birth. But it is well known that the US has the largest per capita medical expenses in the world.

You can see from the big dip starting in 2021 that we fared more poorly from Covid than the rest of the countries charted. As we all learned during those years, people with multiple co-morbidities fared the worst. And the US had more people with co-morbidities than just about anywhere else, which the WSJ notes.

The article continues:

Most of this devolution in American health began circa 1990.

As we’ve discussed many times in these pages, the changes took place in the American diet around the late 1970s, early 1980s. The first nutritional guidelines had just come out, and they recommended upping the carbs and cutting the fat, especially saturated fat. The saturated fat was replaced by various seed oils, which now represent a huge percentage of the average America diet. In the mid 1970s flour enrichment was jacked up from where it had been in the 1940s, giving us all a bigger load of niacin. The shift from table sugar to high-fructose corn syrup, which started to be added to everything occurred then as well. Along with an increase in snack foods.

One of my pet theories is that cutting saturated fat has been problematic. We’ve eaten saturated fat since we evolved from Australopithecines, so it would make sense that since we’ve co-evolved with saturated fat, it would be a more vital nutrient than people give it credit for. I have no proof of this, it’s just a theory of mine that makes sense to me.

At the same time, another change was made that I just learned about relatively recently, but haven’t had the chance to do a deep dive on it and write about it here. The baby formula companies changed formulas and changed the guidelines on average weights of babies at given ages. Since breast fed babies weighed less than these new guidelines pushed by the formula makers, many mothers switched to formula or added it to the diet of breast milk to help their babies gain more weight. Just to show you how awful formula is, here are the ingredients for the most popular baby formula today:

Which according to my trusty Perplexity is Similac Pro-Sensitive Milk-Based Powder Infant Formula. I suspect many, if not most, others have a similar list of ingredients.

Since these changes all happened around the same time, it’s difficult to pinpoint which is the major culprit, if it is indeed one. I suspect it’s all of them to one extent or another. A perfect (but very deleterious) storm.

Given all the changes circa 1980, for some reason, the recent focus of the press has been on ultra-processed foods. They have become the bête noire of the American diet. And have done so without any real studies being done on them. There have been exactly two RCTs on UPFs: one of two weeks and one of one week.

How many studies have there been on excess carbohydrates? Many, many, many. And a lot of them long term. Yet the press seldom fingers excess carbohydrates as one of the causes of the epidemic of bad health, while at the same time they never fail to mention the rinky dink studies done on UPFs and how they are “proof” they are bad.

Don’t get me wrong. I do think UPF are problematic for a number of reasons. But it would be nice to see some long-term studies to prove it. One of the reasons I believe a low-carb diet works so well is that it cuts out most of the UPFs, because most of them are fairly carb-laden.

In terms of where we in the US stand as a country in consumption of UPFs, it’s where you would imagine. In first place.

Notice that Italy is at the bottom of the list in terms of UPF. I just watched a video over the weekend that contained an anecdotal report on what happened when a couple of overweight people moved to Italy.

This is an interview Richard Nikoley had with Sean Ring, who is a financial writer. Most of the interview is Sean discussing what he sees happening to the US economy after the election of Donald Trump. At 41:19 in the interview, Richard asks Sean about the MAHA movement. His answer is pretty interesting. Sean lives in Italy and has for a while, I presume. He recently moved his overweight parents there, and his discussion of what happened to them is certainly interesting. I’ve cued the video to the 41.19 mark, but this platform has been pretty erratic in terms of whether it abides by my cueing or not. You may have to find it.

Also, to keep me from getting a hundred emails on the subject, Sean himself seems a bit overweight. He doesn’t mention his history in moving to Italy, so I have no idea what his story is in terms of weight loss. He may have lost a ton from where he started. I don’t know. I’ve heard many similar reports from people moving abroad and experiencing the same thing Sean’s parents did.

Can Obesity Be Permanently Reversed?

I was reminded by one of Richard’s comments in the video above about the idea common to a lot of people that it is impossible to permanently reverse obesity. I can tell you from a lot of experience that it is possible—it just takes work. Continued work.

Many people have “reversed” their type 2 diabetes (T2DM) with diet. But this doesn’t mean they’re cured; it simply means they’re in remission. Which means it could come back. And what would most likely cause it to come back? Obviously, going back on their former diet that got them into T2DM in the first place.

When obese patients came into our practice to get help losing their excess weight, MD and I asked them to provide a dietary history. It was amazing to read these. A significant number of patients would have histories very much like the following: 15 yrs ago, did Weight Watchers, lost 30 pounds. Ten years ago did Jenny Craig, lost 40 pounds. Five years ago did Optifast, lost almost 50 pounds.

I always wondered when I read these histories what the thought processes of these patients were. If I developed some sort of serious legal problem and I found a lawyer who got me out of it (whatever it was), then five years later, I got into the same problem, I would go back to the same lawyer.

Obviously, overweight individuals don’t think that way. When I would ask about the Weight Watchers, or Jenny Craig, or Optifast, I almost always got the same response: “That one didn’t work for me.” I would point out to the patient that he/she lost 40 pounds, so how did it not work. The answer would always be, “Because the weight came back.”

I would then ask, What if you had extremely high blood pressure and I put you on a medicine that brought it down to normal, what do you think would happen if you just quit taking the medicine? They would always admit that their blood pressure would probably go back up.

I would then tell them that the other programs they were on and the one I was going to design for them would help them lose their excess weight as quickly and safely as possible, but when the weight was gone, if they went back to their old way of eating, their obesity would come back.

I explained to them that if they had a metabolic condition, obesity (but in many cases other issues as well) that responded to treatment—just like in the blood pressure example—and they abandoned the treatment as soon as they lost the weight they wanted to lose, it would all come back.

Many of these patients lost their excess weight and were able to keep it off. But not all. Not by a long shot. It was those patients who took seriously my admonition about making permanent dietary changes who were able to be long-term successes. Those who adopted the attitude of Woo Hoo, the diet is over, then went back to their old way of eating failed.

It’s not easy to change your diet permanently, but that’s what it takes. If you’re not willing to do that, then don’t waste your time and money on a weight loss program.

What I’m trying to say here is that permanent weight loss is indeed possible if you put out the effort. The continued effort.

But there seems to be a movement afoot spreading the notion that permanent weight loss is an impossibility. I’ve encountered it more and more lately. In fact, I got an email a day or two ago that tee’d this whole subject up for me.

I subscribe to all kinds of websites, so I get a ton of emails. I got one from someone named Scott Young, who is supposedly an expert on rapid learning. I think he went through the whole MIT Computer Science curriculum in a couple of years. I usually give his stuff a glance, but the recent email subject line was book reviews, which are like catnip to me. So I opened the email. I had read most of the books on the list, but one I hadn’t jumped out at me.

I scrolled down to the footnote to see what it said.

My sense is that someone is spreading the notion that diets don’t work. And that the only thing that can bring about permanent weight loss is the new line of GLP-1 drugs. Which is insane, since none of these drugs have been around long enough to show permanent weight loss. They have been around long enough to show a multitude of health problems in those who use them.

Based on my experience with myself and a lot of patients, permanent weight loss is achievable without using GLP-1 agonists. It just takes a good mind set, some effort, and, most importantly, a willingness to change.

Big Ag Skullduggery

I just got wind of a bill that just got passed in Georgia. A similar bill was passed not long ago in North Dakota. With these successes, I’m sure every state will be targeted now. And, unless some real activists join the fray, every state will pass it, except maybe California.

It is one of those bills that on the surface seems pretty benign. But given the real circumstances, the bill is far, far from benign.

The bill (SB 144 in Georgia) says that manufacturers of various pesticides and other crop chemicals can’t be sued for damages caused by their products if said products have passed muster with the EPA.

Which seems reasonable on the surface. The EPA investigates and clears it, the manufacturer sells it to farmers, farmers spread it on their crops, and we eat the crops. If we get sick, we’re out of luck in terms of lawsuits against the manufacturer because the EPA has cleared the product as safe.

But it’s not reasonable. It is a sleazy, slimy, low-life, dishonest way of getting around one of the true facts of life today. The entire regulatory system of the US Government, including the EPA, has been overtaken by regulatory capture. The regulators are not independent—they are former and future employees of the businesses being regulated.

So, now, the average schmuck doesn’t stand a chance. Big Ag gets a regulator into the EPA, or makes big promises to someone already in there to approve a crop chemical. Once approved, it can be used without fear of an avalanche of lawsuits even if it does harm a ton of people. All that might happen is that the EPA or other regulatory agency says, Whoops, we screwed up on that one. Now let’s get rid of its approval. Meanwhile, how many people have died or been injured and are entitled to no compensation.

If you don’t think regulatory capture is an issue, go back a month or so ago and look at where all the folks in the HHS went when RFK came in. They all went back to Pfizer and other drug companies, which is where they came from in the first place.

For the most part, I dislike lawyers. But the good ones play an important role. They are the predators keeping the big companies in check. With these lawyers always circling, big companies are not willing to put products out that impact millions of people without considerable testing. They know if they do, and if there is a problem, they will get sued for tens of millions of dollars.

With this new law in Georgia, all Big Ag has to do is get one or two of their people inside. These folks see that the product gets EPA approval, then the company is off scot-free irrespective of how many people they kill.

If there were more integrity in the regulatory agencies, such a bill would be fine. But as long as we have regulatory capture of these agencies, these laws can lead to nothing but disaster.

You should fight them tooth and toenail should they come to your state.

The MAHA Report

The MAHA Report: Making Our Children Healthy Again just came out today. You can read it in its entirety here (pdf). It is a comprehensive 68-page report on what the MAHA movement intends to do to make our children (and adults) healthy again.

The plans range from the attack on chronic diseases to the vaccine schedule and vaccine safety.

I read the entire thing when it came out—I actually skimmed it, because this is Arrow day—and found only one little glitch that was probably left over from one of the older documents they used. It was on page 15.

I’m sure they meant seed oils there and not saturated fat. At least I’m hoping so.

There is much in the document—which, btw, has citations for everything—on UPF, which has got to be one of Bobby Kennedy’s major issues. As I mentioned in one of the sections above, UPFs have been studied via RCTs in only two very short term (one for two weeks; the other for one week) kind of Mickey Mouse trials. I’m hoping that the HHS will fund and conduct some long term RCTs to confirm that UPFs are as worrisome as everyone seems to think they are.

I’m hoping they will do the same thing with seed oils, since no long-term RCTs have been done on them.

Everything else in this report makes me happy as a clam. I just fervently hope they can carry it all out within the next four years.

McDonald’s French Fries the Old Way

I came across this video Malcolm Gladwell made a few years ago about his experience with McDonald’s French fries cooked in beef tallow. I was going to use my new transcription tool to give you the full text, but then as I listened to the whole thing, I found it extremely entertaining.

The gist of it is that McDonald’s used to fry their French fries in beef tallow, and everyone thought they were the best fries on the market.

In the late 1980s, this jerk named Phil Sokolof came along and ruined it for everyone.

Sokolof had made a fortune in business and had a heart attack at an early age. He had no medical or scientific training, yet he determined that saturated fat and cholesterol were the driving forces behind heart disease. He started using his millions of dollars to run ad campaigns in newspapers and road signs warning people off saturated fat.

He got a few fast food restaurants to succumb to his threats of exposure for using these ‘dangerous’ fats. But his Moby Dick was McDonald’s. He started a pressure campaign that McDonald’s laughed off, but he ultimately won out. As a consequence, McDonald’s switched from beef tallow to seed oils in their fryers in the early 1990s.

In my view, there is nothing worse than a no-nothing do-gooder with a huge pocketbook, and Sokolof qualified. No telling how many more people died because of the McDonald’s switch, which was first switch to a trans fat combo. Then how many more because of the seed oils that came after. HIs goal was to prevent people from dying of heart disease; his actions probably did the opposite.

Here is the video. It’s a fun and easy watch. Then ask yourself why McDonald’s hasn’t gone back to beef tallow. My bet is that they will before long. For the good of American health, I hope they do.

Odds and Ends

• One big question still looms large: “Was there yet another Soviet mole — a so-called “Fourth Man” — at the highest levels of American intelligence?”

• Beneath the slopes of a lush forest in Alberta, Canada, paleontologists are analyzing the thousands of buried dinosaurs, all killed in an instant on a day of utter devastation, trying to figure out exactly what happened.

• Here is something you probably won’t read about very often. Rattlesnakes provide plenty of benefits to farmers and others.

• What is driving the drop in overdose deaths?

• Could it be possible that horses triggered the deadly 1918 flu pandemic? New research says yes.

• Men are dying from 'Broken Heart Syndrome' at twice the rate of women. Who says women are the weaker sex?

• Nature Magazine SciComm writer Max Kozlov misleads about his NIH reporting, because why not? Who believes the mainstream reporters today, anyway?

• Can humans really smell insects? I can, so I assume other humans can as well. Why such a debate?

• It is said that the kingdom and the Tower of London will fall if the six resident ravens ever leave the fortress. Here is their story.

• Actions that Americans think are least acceptable to do in public. I agree with them all except for one. I take pictures of people all the time without their permission.

• 23andMe, the iconic DNA-testing company, agreed to be purchased out of bankruptcy on Monday for $256 million. Regeneron said it would “ensure compliance” with 23andMe’s privacy policy, which will be reviewed by a court-appointed ombudsman.

• Capuchin monkeys caught on camera ‘abducting’ baby howler monkeys in a strange tradition seen for the first time. A primate fad?

• Study shows a marked decline in semicolons in English books. The semicolon is one of my favorite punctuation marks; its use, according to Kurt Vonnegut, “shows [I’ve] been to college.”

• Scientists have uncovered the genetic explanation behind ginger cats—most of which are male—ending a decades-long feline mystery.

• A top Food and Drug Administration (FDA) official said on May 15 that she never took a COVID-19 vaccine due to concerns about biodistribution. I’ll bet she suggested others take it, though.

• When legendary investor Warren Buffet made a very bad deal that was going to cost him greatly, he ran to Uncle Sam to bail him out. I wish I could do that.

• Why cursive writing and penmanship is important even in this era of the text message.

• The U.S. just ran a solar storm emergency drill showing the real deal would be a catastrophe. We are clearly ill-prepared for unfavorable space weather.

• Another massive AI fail. A major newspaper publishes a summer reading list—but the books don't exist.

• Frog-in-bucket-of-milk folklore leads to potential new antibiotics. I wondered about this one, so looked it up on trusty Perplexity. Indeed people in Russia and Finland used frogs to keep their milk cold, not understanding that it didn’t really do so. But it did keep it fresher.

Newsletter Recommendations

Video of the Week

As a proud alumnus (well, along with MD, proud alumni) of the University of Arkansas system, I was pleased to hear that in a turn of events that took the global music and collegiate athletics world by storm, the Arkansas Razorbacks Marching Band has been ranked the #1 marching band in the world. The announcement, made by a joint panel from ESPN, Guinness World Records, and the International Marching Arts Committee, has catapulted the once-underdog band into international acclaim, surpassing even some of the most storied programs in history.

Their ascendence to this honor was fueled in large part by their outstanding performance at the 2024 NCAA National Championship halftime show, so I thought I’d share that with you. Alas, there was NO VIDEO available commemorating this epic performance at least none that I or my friend Mr. Perplexity could find. So I had to settle for another performance, but a good one. This one done at a home game, at halftime, at Fayetteville. and in honor of the Armed Services. I love a good college marching band, and I love a Salute to Service, and I hope you will, too! Go Hogs!

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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