Greetings everyone.

Many of you will be overjoyed that I won’t be whining about airline trips gone awry this week. It’s primarily because I didn’t make any flights since the one I wrote about last week. But that doesn’t mean all is right with the world. There is still the shittification of everything else.

When we went to our meeting last week, I met a lady who had a watchoid-looking thing called a Whoop, an item I had never heard of. She showed me how it collected all kinds of health parameters in real time that could be read back whenever or even transmitted to, say, a doctor. It can do an EKG, which I did on myself just grasping hers with my thumb and forefinger without her even taking the thing off. It measures all kinds of sleep parameters, which is what really attracted my attention. I don’t sleep very much at night, and almost never during the day. I always go to bed late (usually past midnight) and wake up spontaneously early in the morning. I’ve always wondered how much REM sleep and deep sleep I’m really getting.

I’ve been wanting to get an Oura ring to find out, but I hate wearing rings, so I’ve avoided purchasing one. (My wedding ring has got to be the thinnest gold band ever made, which is why I can tolerate it.) When I learned from the lady I met that she used to use an Oura ring, but the Whoop (dumb name, in my view) provided vastly more data, I decided I would buy one.

At the airport during our long delay, I fired up my laptop and found a Whoop on Amazon. I also found out you don’t really buy one; you pay for a year of monitoring, and they throw in the device for free. It costs about $250 for the year. Amazon said that if I ordered within the next two hours or so, that it would be delivered to me the next day (Wednesday of last week.)

It did not come on Wednesday. In fact, here it is Thursday of this week, and it still hasn’t shown up. I’ve gotten a notice each day that they were having issues, but that my Whoop would be arriving tomorrow. As the bard wrote, “Tomorrow, and tomorrow, and tomorrow, Creeps in this petty pace from day to day,…” And each tomorrow promised another tomorrow. Finally, today, instead of promising it tomorrow, Amazon said it would be delivered this coming Sunday. Time will tell.

The entire delivery process—at least in terms of timing—got blown up during Covid. Prior to that, things ordered pretty much arrived when they were promised. Once all these companies realized that people would accept late deliveries due to Covid, they adopted that as their full-time practice now it seems.

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Hyperactivity at the HHS

Teaching Nutrition in Medical School

One of the items on RFK’s wishlist is that nutrition be taught in medical schools and even earlier in the pre-med curriculum. And not only that, he wants it to be a significant course and intends to get it included in the MCAT (the test everyone has to take to apply to medical school).

This all sounds fine and dandy, but the problem I see is that there is no consensus on what the proper diet is. Who gets to choose? RFK supposedly is on a mainly carnivore diet with some fermented vegetables and the like. Is that going to be the diet taught in medical school. Somehow I don’t really think so. Just as with the nutritional guidelines, industry is going to jump in to try to influence the make up of any nutritional classes taught in medical school in an effort to get their particular product included. I have a hard time seeing this work out to be anything but a chaotic mess.

When I was in medical school, we had two hours of nutritional ‘training’ taught by hospital dietitians. The entire course was about how to write dietary orders on the charts of hospitalized patients so the dietitians could provide them with the appropriate diet. There were low-sodium diets, a low-fat diet, a low-cholesterol diet, a liquid diet, a soft diet, the list goes on.

There was absolutely nothing about the biochemical actions inspired by the food or different macronutrients we were learning how to write orders for. In other words, there was no nutrition as we think of nutrition involved.

If RFK can pull this off, which diet is going to be the diet of choice? There is a new one out almost every day.

Are medical students going to be taught to feed their patients whole grains and minimal red meat, which is kind of where the zeitgeist is heading these days? Or are the students going to be taught the virtues of a low-carb diet? Or somewhere in between?

What department is going to administer the nutrition course? There are no nutrition departments in most medical schools. Will nutrition be foisted off onto the dietitians? Most medical schools have dietitian schools associated with them. Since no other department save maybe biochemistry would be willing to take on the task, I just can’t see how it would work. Don’t get me wrong; I would love it if they were all taught good low-carb, whole food, good fat, plenty of quality protein, no junk, and NBS nutritional principles.

Many deans of medical schools tell all their freshman medical students the following on their orientation: “You’re going to learn a lot of material over the next four years, but half of it will be wrong or out of date in five years. Problem is, right now we don’t know which half that is.”

And that is material there is consensus on. Right now there is no consensus on diet. You’ve probably got way, way more docs putting people on low-fat diets, low-cholesterol diets, and/or 1,500 calorie diets than docs putting people on sound, low-carb diets. And this includes physicians who work in academia.

There are many, many studies out there on the various diets, and even many that compare one diet to another. As I’ve written about a number of times in these pages, the Public Health Collaboration (PHC) in the UK is the only organization I know of that keeps a running comparison of low-carb diets vs low-fat and low-calorie diets.

Many of the comparisons are between ad libitum low-carb diets and calorically-restricted low-fat and low-cal diets, and the low-carb diets still come out on top. Here is a graphic showing the difference in success on the low-carb vs other diets.

As I have told many of my physician friends who were contemplating putting their patients on low-carb diets, you will be totally surprised at the outcome. It’s not just a diet; it is a therapeutic modality that is quite powerful. More powerful than anything you have ever used. You have to use it with care in your patients with diabetes and/or hypertension, who often lower their sugar levels or their water retention levels quickly. I tell them that they should take their type 2 diabetic patients and any patients on diuretic meds for HBP off their meds when they start the diet, otherwise they may quickly drop their blood sugar levels (or degree of fluid retention) too low and get woozy (or even pass out).

A good low-carb diet is a treatment diet, a therapeutic modality, not just a weight loss diet, but even in terms of weight loss, the PHC data shows it to outperform both the low-fat and low-cal diets.

As I said above, I believe RFK will have a tough time with this one, but it will pay huge dividends if he can pull it off. I have all my digits crossed that he can.

Just as I was finishing this section, MD sent me a Harvard study on nutrition showing all the foods they claim you should eat to stay healthy into your 70s. It is, of course, an observational study, but the vast majority of people don’t even understand what that means. (Not the readers of Holy, of course. They do.)

And because it has big numbers, most people think it is more accurate, which is not true.

Holy cow! 100,000 people! 30 years! Sounds prestigious until you dig into the actual study. Here is what the researchers did.

The researchers basically trawled through a couple of large databases generated by nutritional questionnaires, i.e., the kind where they ask the subjects how many times did you eat cheese over the last year. Multiple other studies have shown these types of nutritional questionnaire studies to be totally unreliable. And it doesn’t matter whether you’re looking at a 100 subjects or 100,000, as in this case, they are still unreliable.

The authors of the study then tried to correlate dietary patterns based on the subjects guessing how much cheese or arugula or corn they ate over the previous years. Then they tried to correlate that to health at 70 years old. Jesus wept!

Here’s what they determined were the top six foods folks people should eat for healthy aging. This list comes from a press article about the study:

• 5 Daily Servings of Green Leafy Vegetables

• 4 Daily Servings of Whole Fruit

• 5 to 6 Servings of Whole Grains

• Safe, Fatty Fish

• Healthy Fats

The authors explain what theses mean in more detail in the article. But you can pretty much guess what they are. Healthy fats are olive oil and avocado oil (which I don’t have much a a problem with). But where is the protein. Other than in the fatty fish? And one serving of ‘plant-based protein’?

Interestingly, there is a recipe linked in the article under the title “Try This Easy Whole Grain Recipe.” It’s made with farro and a bunch of plants. Made me wonder how many of the 100,000 people in the database regularly consumed farro.

Another interesting bit about this recipe is that after describing how full of goodness it is, it says, “It makes a nourishing meal on its own or a great sidekick to grilled proteins.”

Grilled proteins?!?! Nowhere in the article does it mention proteins. It’s almost as if they didn’t exist. Other than the safe, fatty fish, of course. And of all the nutrients, it’s the only one that is categorically essential. The rest are window dressing.

The journal this study was published in was Nature Medicine, an extremely prestigious journal. Yet the study itself is a next-to-worthless observational study. With these kinds of studies getting published right and left in big time journals, how are RFK et al going to promote the low-carb diet as the diet to be studied in medical schools?

See the problem?

RFK and Big Food

I wrote a week or two ago that I thought RFK was going to have an easier time with Big Food than with Big Pharma. Now I’m not so sure.

I didn’t realize that the HHS had already hickeyed a major cereal company with a $75M loss over added dyes in their products. I didn’t realize Kellogg was in financial trouble, nor did I know that Italian food giant Ferrero was looking to buy it.

According to the Wall Street Journal

You can see how the stock prices of a few major breakfast cereal companies have drifted downward this year despite the overall market being up. Kellogg is up because it is being courted. But for $75M less than it was before.

So far, all I’ve read about is removing or changing the dyes in these cereals. One wouldn’t think that would be a major process. Just substitute one for the other. But I’m obviously not an industrial engineer.

The spokeswoman went on to say that Kellogg promised a decade ago to ditch all artificial flavors and colors from its branded cereals by the end of 2018. “But naturally dyed Froot Loops didn’t test well with consumers.”

So, obviously, they bagged that plan. Now they’re under the gun. They should have never put the artificial junk in the American food to begin with. They didn’t use it in Canada or Europe.

RFK and CDC Treachery

You’ve probably heard by now that there have been mass firings and resignations at the CDC. I don’t know if RFK fired CDC Director Susan Monarez, but she refused to go unless fired by Trump. So Trump (or the Whitehouse as the reports say) fired her, but now, as I understand it, her lawyer is telling her to hang in there. Her firing (pseudo firing?) inspired four other top level CDC staff to tender their resignations. I just don’t know at this point whether four or five are gone.

From what I’ve been able to gather, the CDC folks were not honest with the HHS staff on the death statistics involving children and Covid. The CDC provided data showing Covid was much worse than it is both in terms of infection and deaths in an effort to keep the shots for children approved.

If you want to read the real story on it, take a look at Maryanne Demasi’s Substack. She’s the best investigative reporter out there on this stuff. Most of her posts are behind paywalls, but if you’re really interested in what’s going on, she is the source. It’s well worth the few bucks per month.

If you do take the plunge, and I highly recommend that you do, make sure to go back a week or so ago and read her interview with Retsef Levi, who I think is the most astute member of the ACIP.

Based on the inaccurate information provided to him by the folks who are now fired, RFK revoked the Emergency Use Authorization (EUA)for the COVID vaccine.

What does this mean?

It means that the rapid, broad approval previously granted during the pandemic has been replaced with much stricter guidelines. Vaccines are now officially recommended only for high-risk groups, primarily those 65+ or with specified health conditions, and emergency access for healthy adults and children has ended. Jesus did not weep!

With RFK’s decision to revoke the EUA, vaccines for COVID-19 must now meet the usual FDA approval standards, and only those at higher risk for severe disease (seniors, people with chronic health issues) are officially eligible.

You can probably still get a Covid shot if you want it, but you will have to go through your doctor to do so. We’ll just have to see how it sorts itself out over time.

One thing we know for sure is that there will be a lot fewer Covid vaccines given and a lot of income the pharmaceutical industry won’t be getting from here on.

Okay, there is a ton of other Bobby Kennedy stuff we could go over, but I don’t want to overdo it. Let’s move on to something else.

Menopausal Metabolic Mayhem

If the comments and poll responses and emails I have gotten over the years are any gauge, there is tremendous interest among my readers in WTF happens at menopause (especially, but not exclusively to women) that completely derails metabolic balance, resulting in the acquisition of ten, twenty, sometimes forty stubborn pounds of body weight/fat or more.

We’ve promised we would tackle that issue in Protein Power 2.0 (and we will if we can ever get loose from other obligations to finish it) but, in the meantime, if what you’re seeking is a science-based explanation and a science-grounded approach, it’s already out there now in our friend Amy Alkon’s newly released book, appropriately titled Going Menopostal. The title gives you a glimpse into Amy’s style: humorous, satirical, witty, irreverent, but always grounded in good hard science and common sense.

Amy is a veteran science writer, who spent eight years researching this topic, as she was going through it herself and learning firsthand how woefully misguided and ignorant current medical dogma is on menopause and peri-menopause, regarding both how to evaluated it and how best to remedy it. MD and I helped vet some of the sections.

Going Menopostal empowers women to ask the right questions, demand the appropriate tests to get the real answers, and thus institute effective therapies. MD and I can’t recommend it highly enough. If you or someone you love is headed into peri-menopause or menopause (or already there) run, don’t walk to get this book! Better yet, just click here.

Statins, HbA1c, Diabetes and You

I had a couple of folks email me about a presentation Nick Norwitz made a few days ago on a statin paper he had not seen. Well, I hadn’t seen it either. What’s weird is that we should have both seen it, but had both somehow overlooked it.

The reason both of us should have seen it was because it was in the journal Cell Metabolism, which is a prestigious, high impact journal on biochemistry and metabolism, the subject we both enjoy the most. I read every issue cover to cover.

How could I flip through a journal and overlook an article with the words “statins aggravate insulin resistance…” and not stop and read it. I’m not a big statin fan, so this would have been catnip to me. How did I miss it?

Once I found out about it, I started reading and got really excited. But one issue hit me like a big speed bump saying, whoa there, partner, let’s think about this. Before I get to the speed bump, let’s review the paper.

It is a really straightforward study.

The researchers put 30 subjects on 20mg of atorvastatin (Lipitor) for 16 weeks while keeping 10 subjects on placebo.

At various points during the 16 weeks, subjects were tested for a number of parameters.

As you can see from the graphics below, the total cholesterol (TC) and LDL dropped nicely with the Lipitor.

That’s all as it should be. Statins do lower total cholesterol and LDL levels, so no surprise here. Whether that accomplishes anything health-wise is another question.

Here are a few more parameters you might find surprising.

As you can see, both HgA1c and insulin levels went up in the subject taking lipitor.

It is apparent from the graphic on the left that not only do insulin levels rise in those taking statins, but insulin resistance does as well.

On the right graphic, it’s obvious that GLP-1 drops off precipitously, which is what got Nick so worked up.

The big surprise here is the fall off in GLP-1. It’s already known that statins increase HbA1c and insulin. Which is why diabetes is a risk factor for those who take statins.

Everyone seemed to go radio silent on this paper. It wasn’t touted anywhere. Which, if you think about it, it makes perfect sense. As Nick says: statins are the most profitable drugs in the history of medicine. One out of every person over 40 is taking a statin. (God help them!) That’s a lot of drug being sold every single day.

I’ve written—as have a lot of other people—that Big Pharma spends an enormous amount of money on all sorts of media. One of the reasons they drop those mega bucks is to prevent negative press reports. Now you’re seeing that in action.

The exciting part of this paper, if it is legit, is the fact that the authors have come upon a mechanism that shows how statins increase insulin, blood sugar, and reduce GLP-1.

Apparently, statins have a profound effect on the microbiome. One of the things statins do is to reduce the amount of clostridium, which, in turn, reduced the amount of a bile acid called ursodeoxycholic acid (UDCA, for short). When this bile acid is present, it prevents the statins from increasing insulin resistance, increasing blood sugar, and decreasing GLP-1.

As it turns out, there is a cheap fix. One can purchase a product through Amazon (and I’m sure a bunch of other outlets) called TUDCA. It is basically UDCA conjugated to the amino acid taurine. In your GI tract, the taurine is broken off, and you’re left with UDCA.

The paper goes on to discuss how they tested all this in mice to look for causality and found that giving UDCA ended up preventing the statin from increasing insulin resistance, HbA1c, and the big drop off in GLP-1.

But despite all this, I have some problems with the paper.

First, the study included only 30 subjects. There is a rule in medicine that you don’t rely on just one study. You would like to have it confirmed by another group or two or three. If all get the same results, then you might be cooking.

The other thing that bothers me is that this paper is just too perfect. The reason that bothers me is that it was done in China.

There is a very good book available called Science Fictions about how fraud, bias, negligence, etc. make relying on studies incredibly difficult. For the most part, this book is excellent. But it does have one major flaw. The author has bought into the Andrew Wakefield-autism debate completely on the wrong side. So, I do have issues with the book on that count, but based on the literature searches I’ve done on other parts, I think they’re pretty much okay.

The author himself is a researcher, and he got tired of reading papers that had issues, so he delved into the problem and discovered how widespread it was. Especially when the Chinese are involved.

Here is a paper I found on my own a few years ago. It shows that around 54 percent of Chinese researchers have admitted to fraud.

So, when I see a perfect paper come out of China all of my spidey senses engage. I hope this paper is valid and can be repeated. But I wouldn’t use it to alter meds on my patients until I saw it corroborated, especially from somewhere other than China.

Odds and Ends

• New US study shows elephants, just like humans, call out to each other using their names.

• Tattoos have been around for a while. High-resolution near-infrared data reveal dazzlingly complex Pazyryk tattooing methods.

• It turns out people didn’t want to spend twice as much on fake meat to fix the weather.

• The daughter of a former Nazi official posted an ad to sell her property and the photos revealed a looted painting that had been missing for eight decades.

• Listen as U of Exeter choir revived previously unheard 500 year old monastic music buried in an Abbey wall. No very harmonious, but take a listen.

• The Eiffel Tower was once vermillion — and that’s not the only color. And four other global landmarks that used to look totally different.

• 29 minutes and 3 seconds is how long a Croatian freediver held his breath underwater, beating the last world record by nearly five minutes and about doubling the time managed by bottlenose dolphins. How is that even possible?

• Watch what it takes to build a wristwatch from scratch. 

• The top 40 counties with the most calories per person. And surprisingly #1 isn't the USA.

• Some US Landmarks are radioactive. One of them is the US Capitol, which might explain the bizarre behavior of some members of congress. Or maybe the eat a lot of Brazil nuts.

• Man attempts to 'break Amazon' by buying and returning anvils. A weighty subject to be sure, but I’m not sure I see the point.

• Pet rats create mini masterpieces that sell for thousands. Maybe I need to set a few live traps and put a few to work.

• Of the nine most famous bridges in the world, MD and I have so far visited six. Can you guess which ones are still on the to-do list?

• Why do we say eleven and not 'oneteen'? Another great answer alongside my go-to 'Why is there air' when asked 'Do you have any other questions?' 

• Beware the Ides of March, said the soothsayer in Shakespeare’s Julius Caesar. What are the 'ides' and why was it so-called? 

• My favorite fruit is the tomato, so the annual food fight in Bunol, Spain is nothing short of sacrilege to me!

• The 101 Best Movie Performances of the 21st Century. By someone’s measure at any rate. My mileage would vary; many on the list I have never heard of, let alone seen. But it may give you some fodder for passive visual entertainment on upcoming fall and winter evenings.

Newsletter Recommendations

Video of the Week

This week’s VotW is technically just an audio of the week: a portion of Gabriel Fauré’s Requiem, which is unlike any other requiem you care to mention. If you’ve never heard it, I encourage you to listen to the whole thing, even if you think you don’t like requiems. Here’s a bit about it from the concert program of one of the performances MD’s chorus did of the work in Santa Barbara.

Most requiems are commissioned in memory of someone or prompted by the death of someone near and dear to the composer. But when a journalist asked Fauré why he wrote his, he wrote back, “My Requiem was composed for nothing…for fun…!”

A mass for the dead written for “fun?” Indeed, Fauré’s Requiem, reflects a view of the end of mortal life that is very different from that presented by Mozart, Beethoven, Berlioz, or Verdi. While the press referred to his Requiem as a “lullaby of death”, Fauré referred to the requiems of Berlioz and Verdi, with their descriptions of wrath and hellfire, as “thunderous fanfares”. Conversely, he saw death as “a happy deliverance”, an aspiration towards happiness above rather than as a painful experience.

One would expect a Fauré requiem to be different. Further, having been a church organist and choirmaster for more than a decade at the time, Fauré wrote “I have instinctively sought to escape from what is thought right and proper, after all the years of accompanying burial services on the organ! … I wanted to write something different.” And clearly, he did so and at the age of 43. By the time of his death in 1924, he would be known as France’s leading composer and this Requiem would be one of his most memorable works.

In the summer of 2011, MD and her chorus (and I along with my sister, MD’s sister, and the other ‘roadies’ as we dubbed the non-singing spouses, family, and friends along for fun) toured Spain, performing the Fauré Requiem in first one glorious cathedral with fabulous acoustics then another. I’d had previously heard them perform it in a church in SB (also with great acoustics) but hearing it in those ancient, thick stone walls and high-buttressed ceilings was other wordly, especially the last movement.

One of my favorite parts of the Fauré Requiem is the In Paradisum. And it’s the Bride’s definite favorite, and not only because it features the sopranos, channeling their inner choir boys. MD even wrote it into one of her novels: two main characters listen to it in her second Caddo Bend novel, Eye of the Storm.

This portion of the work is where the dear departed is being led to heaven by a band of angels. And it offers the perfect sound track for that visual.

So perfect, in fact, that the late legendary American composer and choral conductor Paul Salamunovich (LA Master Chorale) requested that it be queued up to be played in his last few minutes at the end of his life so that he could hear it one last time. You can keep it queued up and listen to it whenever you like in this recording of it by the Atlanta Symphony and Chorus, conducted by Robert Shaw (with whom MD’s conductor, JoAnne Wasserman, sang and studied many years ago.)

Here is the lyric translation for non-Latin speakers (like me, though the Bride had four years of it, herself).

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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