Cartoons for the holidays I

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Dementia rates are dropping

According to a new study by the National Institute on Aging, the dementia rate in Americans 65 and older fell by 24 percent over 12 years. In 2000, people received a diagnosis of dementia at an average age of 80.7; in 2012 the average age was 82.4. Nobody knows why.

The study was nationally representative. That is, it included all races, education, and income levels. The study included 21,000 Americans 65 and older who participate in the Health and Retirement Study which regularly surveys people and follows them as they age. To assess dementia, participants are asked, among other things, to recall 10 nouns immediately and after a delay, to serially subtract seven from 100, and to count backward from 20.

Researchers were surprised about these results, especially given the increase in diabetes, which supposedly increases the risk of dementia. The study also reaffirmed another finding: that those with more education were less likely to develop dementia than those with less. But here’s what I love: compared with people of normal weight, overweight and obese people had a 30 percent lower risk of dementia.

Four to five million Americans develop dementia each year. It is the most expensive disease in America, costing up to $215 billion a year, surpassing heart disease at $102 billion and cancer at $77 billion.

I would hate to take the test for dementia. I’m not sure I could easily subtract seven from 100, and on down, or even remember 10 nouns. However, I’m quite certain I can count backward from 20. I’m thinking I might start practicing with the words and subtraction so I can ace the test.

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More bad pharma behavior at home and abroad

An executive at Valeant, a major pharmaceutical company, and the head of a mail order pharmacy called Philidor RxServices have been secretly enriching each other: the Valeant guy steered his company’s products through Philidor and Philidor altered prescriptions such that Valeant’s brand name drugs were dispensed instead of a cheaper generic drug. What’s more, at least 90 percent of the drugs Philidor dispensed were those sold by Valeant. The Valeant guy got about $30 million from this maneuver. He gave $10 million to the Philidor guy. Of course, it was more complex than this, but this outline is true.

Meanwhile, in China, GlaxoSmithKline, another big pharma company, was nailed for fraud and bribery. The company has been charged with giving kickbacks to doctors and hospital workers who prescribed its medicines. It was also pitching drugs for unapproved uses and bribing regulators with money and gifts. In one scheme, Glaxo funneled cash through a network of 700 travel agencies and consulting firms to bribe doctors and workers at government-owned hospitals. By the way, both Eli Lily and Pfizer have also been bribing doctors in China. In the past China had been looking the other way. Now it’s no more Mr. Nice Guy.

I regularly scan the business pages of The New York Times just to see what’s going on. The above two stories are recent. But stories like these involving big pharma appear on a regular basis. So I ask myself, are drug companies worse than others from an ethical/moral standpoint? It seems that they are. I don’t know the reason for this unless it’s that the culture of drug companies is one of greed and deceit.

I hope you don’t depend on life-saving drugs. It’s nice to just say no.

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LDL and HDL: Neither good nor bad; just doing their jobs

I’ve just finished watching a French-made, feature-length documentary called, in English, “Cholesterol Capers: The Damaging Lunacy of theDiet-Heart Hypothesis.”   (It has English sub-titles, in case you’re wondering.)  It’s mostly about debunking the notion that saturated fat and cholesterol cause heart disease.

Anyhow, I liked the way one of the French scientists discussed HDL and LDL—the supposed “good” and “bad” cholesterol, respectively. In the first place, HDL and LDL are not types of cholesterol, which, by the way, is a sort of alcohol. They are lipoproteins: packages that carry fats, cholesterol, and proteins to and from the liver to various organs. The term density refers to the proportion of protein in the packages. The less protein, the more fats and cholesterol (low density lipoprotein or LDL); the more protein, the less fats and cholesterol (high density lipoprotein or HDL). The scientist in the film described the lipoproteins as “little submarines”. 

The liver produces both LDL and HDL. LDL is the little submarine containing cholesterol, fats and protein that carries its cargo to the organs (cells) that need it. Sometimes a cell will have too much cholesterol. To handle this problem, the little HDL submarine shows up and picks up the unwanted cholesterol as well any other excessive materials and takes it to the liver. This is why LDL (the cholesterol delivery submarine) is considered “bad” and the HDL (the cholesterol collection submarine) is considered “good.”

But, as the scientist says in the film, “To show how this story of good and bad cholesterol is absurd,” picture the liver a hospital and an organ as the scene of an accident. The ambulance going to the accident would be considered bad, while the ambulance going to the hospital would be considered good. Both, of course, are necessary. What's more, new research has shown that people over 60 with the highest levels of LDL lived the longest.

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Consider your cholesterol normal, no matter what

As I’ve said in an earlier post, I refuse to have my cholesterol checked. As far as I’m concerned, all this worry about cholesterol is nonsense. Our livers manufacture cholesterol for a reason: cholesterol is essential to life. It constitutes half the dry weight of your cerebral cortex; it’s essential for producing many important hormones, including testosterone and estrogen; it is used as the raw material in tissue repair; it is an important component of cell membranes; it’s used for the production of vitamin d; it facilitates mineral metabolism, serotonin uptake in the brain, and regulation of blood sugar levels…and on and on.

Like much else in the natural world, the range of cholesterol values follow a normal distribution curve—a bell curve. This is a fundamental and widely used concept of statistical analysis. For example, if you measured the height of the population within a country you would find that a small number of people are very short; most people are average; a small number are very tall. The short, tall, and average-sized people are all normal. The same is true for cholesterol. Some of us naturally have low cholesterol and some naturally have high cholesterol and most of us are somewhere in between. All are normal, but most fall in the 200-250 milligrams per deciliter of blood (mine, if I recall, was 240 thirteen years ago, the last time it was checked).

People who have heart disease and people who do not have heart disease fall within this same range. That is, their cholesterol has no bearing on whether or not they have heart disease, as proven by the Framingham Study, one of the largest studies ever done on cholesterol. Other studies have confirmed this fact.

Nevertheless, the threshold for what is considered high cholesterol has been progressively lowered, each time without scientific evidence to support the lowering of the threshold. Of course, each time the threshold is lowered, millions more people become eligible for cholesterol-lowering medications—massively increasing the market size for the drugs and increasing the profits for pharmaceutical companies. 

I say, leave your cholesterol alone. Don’t mess with Mother Nature!

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The Hunger Winter with an obesity twist

In 1944, the Nazi army occupied Holland and restricted the food supply to the western part of that country, cutting the daily diet of its inhabitants to 750 calories a day or less. A typical day’s worth of food might consist of a couple of slices of bread, a turnip, and one or two small potatoes. About 20,000 people died before the Allied troops liberated the region in May 1945. (Audrey Hepburn was a survivor of that event. She was 16.)

Because of the clear beginning and ending dates as well as the excellent record-keeping in the Netherlands, epidemiologists have been able to follow the long-term effects of the famine (called the Hongerwinter.) Among other things, they looked at how starvation affects the outcome of pregnancy.

As you can imagine, a diet that provides only 450 to 750 calories per day is very hard on a developing fetus. All the infants were affected, but the effects differed, depending on when they were conceived relative to the starvation period. The point I’m making today supports my ongoing defense of fat people: Those children whose mothers had been malnourished early in pregnancy had higher obesity rates than normal. 

Something had happened to their development in the womb that affected them decades later. That effect, it is now understood, has to do with epigenetics: chemical modifications to our genetic material that change the way genes are switched on or off but don’t alter the genes themselves. In this case, to radically oversimplify, the “hold on to that fat” gene was switched on and stayed on. Not only that, the effect was passed on: the grandchildren of the malnourished women also have problems with obesity.

None of my children are obese or even overweight. Maybe it’s because I routinely gained 40 pounds with each one. I was the fat one.

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Bottled water foolishness

Those of you who read my blogs or know me are aware that I am strongly opposed to buying drinking water. I think you should drink tap water. (Note to my relatives in Flint: if your pipes have not been fixed, you may be excused.) I have written one post about this, called “Hydration foolishness”—which I encourage you to read—but am now adding more ammunition:

• On average, it takes 2,000 times as much energy to bottle water, transport it, and refrigerate it than getting it from your tap. What’s more, global plastic consumption rose from 5.5 million tons in 1950 (when everyone got their water from a tap) to around 100 million tons in 2009. 
• About half the people in US drink water from a bottle—either occasionally or as their main source. Nearly 50 billion plastic bottles of water were sold in the US last year!
• Drinking bottled water is a waste of your money. If you bought a single-serving bottle every day (about $1 apiece in New York), you'd spend about $365. But if you were to refill a single-serving plastic bottle of water (16.9 ounces) in New York City every day for a year, it would cost you only 63 cents.
• Just under a third of those billions of bottles sold in the US is recycled.
• About eight million metric tons end up in the ocean every year. That’s on top of the 110 million metric tons of plastic already there. (About half of this comes from China, Indonesia, the Philippines, and Vietnam.)

So get your water from the tap! The bottled water you are drinking may be coming from a tap anyway, since 25% of the water sold in the US comes from a municipal source (and half the leading bottled water brands get their water from my drought-stricken state of California).

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The latest on prostate cancer

If you’re a guy and a biopsy shows you have early prostate cancer, it’s tough to know what to do. That’s because the cancer could be either the kind that grows so slowly it never amounts to anything and you’ll die with it; or the cancer could progress and you could die of it. Early on, there’s no way to distinguish between the two types. If you opt for surgery—which perhaps was unnecessary—it is likely to leave you impotent and incontinent. With radiation, you’ll have bowel problems and also impotence (usually not permanent).

A new study tried to help with that decision. Researchers divided 1,643 men with a diagnosis of early prostate cancer into three groups: a third had surgery, a third had radiation, and a third had active monitoring. Active monitoring involves regular exams of the prostate, periodic biopsies, and PSA tests that may indicate the disease is worsening.

Of the monitored group, 33 of them had the cancer spread to distant parts of their bodies. But it also spread in 13 who had surgery and 16 who had radiation. As time went on, more and more of the monitored patients wound up having treatment, but not all those actually needed it. In fact, 80 percent of them had shown no signs of progression. Apparently they (or their doctors) lost their nerve.

Overall, researchers found no difference in death rates between men who had surgery or radiation and those who were actively monitored and who were treated only if the cancer progressed. Also, death rates were low: only about one percent of patients died ten years after the diagnosis.

As far as I’m concerned, the takeaway from this study is that you’re better off with the active monitoring. If it looks like the disease is progressing, you can have surgery or radiation. On the other hand, you could be among the group with the slow growing cancer who will never need treatment—and thus not have to deal with the side effects.

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Are you smart enough to perform a home pregnancy test?

In the old days (my youth) a pregnancy test consisted of providing a urine sample to the doctor who would send it to a lab for analysis. The lab would send the results to the doctor who would then inform the patient. In 1967, Margaret Crane, a 26-year-old product designer who worked for one of the labs (a pharmaceutical company), noticed the urine analysis kits and wondered, “why not just cut out the doctor entirely?”

That night she designed a user-friendly home-testing version of the analysis kit and brought it into the company, begging her managers to consider the idea. They all said no. For one thing, they imagined a scenario in which “a senator’s daughter, unmarried, found she was pregnant and jumped off a bridge.” Such an outcome would be the end of their company, they reasoned.

It wasn’t only suicides they feared. The opposition to home testing was multifaceted. To begin with, there’s resistance to giving patients control over their bodies, not to mention giving them the right to obtain private information about their bodies. What’s more, those in charge feared antagonizing doctors and aligning themselves with “fast women” who desired a fast test. They were also worried that frightened 13-year olds would be the main users of the test and questioned whether their patients could handle bad news. They also questioned whether patients were smart enough to perform a home test, saying, for example, they “have a hard time following even relatively simple instructions.”

It took ten years to break these barriers. Even though 1967 was the dawn of the sexual revolution, abortions were generally illegal and 26 states barred single women from obtaining birth control. The home test kit was not available in the United States until 1977—four years after Roe v. Wade and ten years after Ms. Crane proposed it. Too late for me.

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Cheap and effective diabetes treatment

Within minutes of eating food containing sugars or starch—which convert to glucose—your pancreas secretes insulin. If all is working properly, insulin prompts tissues to take up the glucose from the blood and either use it for energy or, if not needed immediately, to store it in your liver or muscles.  A steady diet of highly refined carbohydrates may lead to insulin resistance, a condition in which cells get tired of the whole business and fail to respond to insulin. If the cells fail to respond to insulin, they fail to take up the glucose. If the cells don’t take up glucose, it remains in the blood, a condition that leads to diabetes.

Two physicians who specialize in obesity and diabetes recently wrote an article in The New York Times touting a low carb diet for treating diabetes (it’s the old fashioned way). The idea here is to reduce the glucose in the blood by eating less of it. Seems like a no brainer, but most doctors, and even the diabetes association don’t recommend low carb diets. They’re afraid that patients will see their blood sugar fall too low. Instead, to lower glucose levels doctors either prescribe insulin injections or medications that increases their patients’ own production of insulin. “A patient with diabetes can be on four or five different medications to control blood glucose, with an annual price tag of thousands of dollars” the authors say.

These two doctors have succeeded in getting hundreds of patients off their medications as the result of low carb diets. For example, one man had been told by his doctor that he’d need to be on insulin for the rest of his life, but the drugs cost him hundreds of dollars a month—even with insurance. They put him on a low carb diet. “Within five months, his blood-sugar levels had normalized…and he no longer needs to take insulin.”  They also refer to dozens clinical trials showing the effectiveness of low carb diets in treating diabetes.

The doctors who wrote the article attended the annual diabetes association convention this summer and found not “a single prominent reference to low-carb treatment among the hundreds of lectures and posters publicizing cutting-edge research… Instead, we saw scores of presentations on expensive medications for blood sugar problems.” They also reported that recently 45 international medical and scientific societies, including the American Diabetes Association, called for bariatric surgery as a standard diabetes treatment. Bariatric surgery involves stapling, binding, or removing part of the stomach to help people shed weight. Seems a bit extreme to me.

Because my husband’s father had diabetes, we have been on a low carb regimen for about 25 years. So far, so good!

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Bribe of scientists by sugar industry uncovered!

Recently, a postdoc researcher was going through the archives at Harvard and other universities and discovered internal documents of the Sugar Research Foundation (now known as the Sugar Association) showing that they bribed three Harvard scientists to play down a link between sugar and heart disease and instead point the finger at fat. The scientists, who are now dead, were paid an equivalent of $50,000 in today’s dollars (the bribery occurred in the 60’s). At the time, research had begun pointing the finger at sugar. To counteract this direction, John Hickson, a top sugar industry executive, discussed a plan to shift public opinion “through our research and information and legislative programs.”

The scientists published, in the New England Journal of Medicine, a review of research--hand picked by the sugar people--that was skewed to make sugar look innocent and saturated fat look guilty. As Dr. Stanton Glantz, a professor of medicine at UCSF says, “It was a very smart thing the sugar industry did, because review papers, especially if you get them published in a very prominent journal, tend to shape the overall scientific discussion.” (The New England Journal of Medicine did not require financial disclosures until 1984.)

Thus, for fifty years, the role of nutrition in heart disease has been largely shaped by the sugar industry. Incidentally, one of those three scientists went on to become the head of nutrition at the United States Department of Agriculture where he helped shape the dietary guidelines. The guidelines put carbohydrates at the base of the pyramid, telling us that we should be eating 6 to 11 servings of bread, cereal, rice and pasta a day. No fat, but a heck of a lot of carbs, which, by the way, convert quickly to sugar.

The sugar industry’s influence (and that of other scientists, such as Ancel Keys, who also doctored his data) led Americans to choose low-fat, high sugar foods that some experts now blame for fueling the “obesity crisis.” For example, people didn’t eat much yogurt until the low-fat, sugared varieties came on the market. Now they are hugely popular. A six-ounce container of strawberry-flavored Yoplait, advertised as 99 percent fat free, has more sugar than a Twinkie.

I’m no purist where sugar is concerned, but I refuse to buy anything advertised as low fat. Which reminds me: one of the things that annoys me about this anti-fat business is that canned tuna—which used to be packed in oil—is now packed in water. I hate that!

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Your body image: it's more complicated than you think

When he was 19, Ian Waterman suffered a severe bout of viral gastroenteritis that left him with a terrible disability: he lost his sense of proprioception—the ability to sense where his limbs were at any given moment. The sensations from his muscles and joints that would normally alert him to changes in posture and movement simply stopped. Even though his motor functions were still intact, the disease rendered him nearly helpless. 

Ian is now in his sixties and has learned to function pretty well. Still, the only way he knows where his limbs are or what they are doing is to look at them. To control his movements, must consciously command his muscles to contract or relax. If he sneezes, he collapses into a heap. Likewise, if the lights go out when he is standing, he collapses into a heap. For him, without thought, there is no movement. He can never relax.

Can you imagine?! Be glad your proprioception is intact! If all is working well, sensors in your muscles and tendons are constantly supplying information to your brain, which does an amazing job of making sense of it all. For example, your brain compares signals from muscles that are flexing with those that are relaxing. It also constantly monitors the movements of your arms relative to one another, making it possible to align them for tasks. You don’t have to think about all of this like Ian does.

Proprioception enables us to form a kind of central map of our bodies—it’s both a sense of self and body image. Sometimes our brains' processing of sensory input gets out of whack and our body images become disturbed, as is the case with anorexia nervosa, in which people see themselves as overweight; or somatoparaphrenia a condition in which people deny that a part of their body, such as an arm or leg, actually belong to them (they insist on amputation); or phantom limb, where an amputated limb is perceived to continue to exist.

Now I'm going to put my feet up and relax. No problem!

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Are you a former cheerleader? You can be a drug rep!

If you’re looking to be a pharmaceutical sales rep, it’s better to have been a cheerleader than to have a degree in science.  I am not making this up. The cheering adviser at the University of Kentucky, where the cheerleading squad are national champions, says he regularly gets calls from recruiters looking for talent. The cheerleaders, he says, have "Exaggerated motions, exaggerated smiles, exaggerated enthusiasm - they learn those things, and they can get people to do what they want." The recruiters don’t ask about majors. Science? Who cares?

There’s such a demand for former cheerleaders that an employment firm, called Spirited Sales Leaders, specializes in cheerleaders and has a database of thousands of potential candidates. You can find it on the internet. The company’s web site features a picture of a cheerleader.

Cheerleaders are generally attractive. On weekends, some of the cheerleader/drug reps work the professional football games. If you’ve seen these cheerleaders, you can imagine that there’s undeniable sex appeal. If the doctor is a male, the cheerleader sales rep has an advantage. A former male drug rep remembers a sales call with the “all-time most attractive, coolest woman in the history of drug repdom.” At first, he said, the doctor “gave ten reasons not to use one of our drugs.” The cheerleader “gave a little hair toss and a tug on his sleeve and said, ‘come on, doctor, I need the scrips.’” To which the doctor replied, “OK. How do I dose that thing?”

If you must know, I used to be a cheerleader, but I am a terrible salesperson. At least I majored in science.

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The EpiPen ripoff

The EpiPen is an injection device that comes pre-loaded with epinephrine (adrenaline). It’s used as an emergency treatment for severe allergies. People with severe allergies keep them on hand—as do schools and camps. They need to be replaced every year.

Here’s why the EpiPen is a ripoff: 

• In 2004, an EpiPen cost $50 (pack of two).
• The pharmaceutical company Mylan acquired the EpiPen in 2007 and began raising prices.
• Now Mylan is charging $600 (pack of two).
• The drug itself, costs just $1.00.
• Mylan holds the patent for the auto-injector.
• Mylan has a monopoly on the market; two competitors have dropped out.
• Mylan has moved their headquarters to the Netherlands to reduce taxes.
• The chief executive “earned” $19 million in 2015.

$600 for this?

 In response to the outcry, Mylan says it will offer a “generic” version for $300. What? A generic injector? They’re old injector model? The medicine itself will not change. Makes no sense to me.

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Homeostasis: How your body keeps in balance--or not

Our bodies continually seek to keep everything in balance—a condition called homeostasis. For example, we maintain an internal temperature of around 98.6 degrees no matter the outside temperature. Our bodies can also maintain an acid/alkali balance as well as levels of fluid, glucose, and calcium. In general, these balancing activities are the result of hormonal triggers.

All very nice. But stress can throw a monkey wrench into our nicely balanced systems. When stressed, our bodies release hormones such as cortisol and adrenalin to facilitate our “fight or flight” responses. While these reactions might come in handy for fighting off a predator, they result in wear and tear on our bodies. Specifically, high blood pressure (hypertension) is a normal response to chronic stress. Over time, adrenaline and cortisol tighten blood vessels and cause salt retention, conditions that can lead to long-term changes such as arterial wall thickening. Thickened arterial walls increase the blood pressure set point. Our bodies adapt to the higher set point and work to maintain it.

 Populations dealing with racism, poverty, fractured families, and joblessness are extremely stress-prone. In fact, high blood pressure disproportionately affects blacks, especially in poor communities. (American blacks have hypertension at a much higher rates than West Africans). Anyone with an increased and continuous need for vigilance—ready to flee or fight—is especially vulnerable to hypertension. But other stressors can have the same effect. In the U.K. studies of postal workers showed that people at the lowest level of the Civil Service occupational hierarchy—people with little job control and more financial instability—had nearly twice the death rate than that of administrators.

A new term, allostasis, has been coined as an alternative to the word homeostasis. While homeostasis is about preserving constancy, allostasis is about adapting to external circumstances, allowing for fluctuations in response to changing demands, including social circumstances. In the words of cardiologist Sandeep Jauhar, my source for this information, “Allostasis is a politically sophisticated theory of human physiology.” It also explains many modern chronic diseases.

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More useless surgeries

Last week I discussed surgery for meniscus tears, which many studies have proven to be useless. Here are more useless surgeries:

• Spinal fusion ("welding" together adjacent vertebrae)
• Vertebroplasty/Kyphoplasty (injecting a sort of cement into the spine to shore it up)
• Appendectomy (removing the appendix; apparently most can be avoided by antibiotic treatment)
• Coronary stenting (placing a tube inside an artery to open it up)
• Shoulder surgery for impingement (removing a bit of bone from the outer end of the shoulder blade where arm bone “impinges”)
• Ruptured Achilles’ tendon surgery (wearing a boot works just as well)
• Many fracture surgeries (if the bones are roughly aligned, they will heal themselves)

There are actually many more useless surgeries. My principle source for this information is Ian Harris, MD, PhD—an Australian orthopedic surgeon and professor of orthopedic surgery who directs a research unit that focuses on surgical outcomes. He admits to performing surgery that doesn’t work. Sometimes, he says, “If a patient complains enough, one of the easiest ways of satisfying them is to operate.” The title of his book, by the way, is Surgery, the Ultimate Placebo. If we expect a treatment to work, it is more likely to be perceived as working.

Dr. David Kallmes of the Mayo Clinic, believes that doctors continue to do some of these operations because insurers pay and because doctors remember their own patients who seemed better afterward. “I think there is a placebo effect not only on patients but on doctors.”

Not everything can be fixed.

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Your torn meniscus and mine

I have a “shredded” meniscus. (The meniscus is the cartilage in your knee that serves as a shock absorber in your kneed.) I’d been having pain when I bent my knee certain ways. My chiropractor said my tibia and fibula were misaligned. He would re-align the bones, but it made no difference. I finally had an MRI, which showed the meniscus tears. In my case, the pain was caused by the fluid that accumulates as a result of the irritation and inflammation.

My treatment, so far, has been cortisone shots to the knee—two of them, three months apart. They have helped quite a bit. The orthopedic surgeon who treated me believes surgery is a better solution. I question that. 

At least five different high-quality randomized controlled trials show that meniscus surgery is next to useless. Nevertheless, about 400,000 middle-aged and older Americans a year have it. The thing is, there is no clear relationship between knee pain and meniscus tears. In fact, most people over forty have a meniscus tear and most do not have pain. I’m pretty sure my left knee, which doesn’t hurt, is probably just as bad. When people undergo the surgery and report feeling better, the result is due to the placebo effect.

When I suggested to my doc that he drain the fluid, he said it would just come back. I think he's right about that. But I could do it myself! I have discovered, on YouTube, people who do such things--stick themselves with needles to drain the fluid! One man, who has had his knee drained twice by a doctor, starts with three shots of tequila. See for yourself: https://www.youtube.com/watch?v=aPhBE1bscpE  I recommend skipping the tequila-drinking portion. Actually, you might want to skip the whole thing. EEEW!

My knee pain isn’t all that bad and it doesn’t hurt to walk. For me, it helps to know what was causing the problem.

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Flossing: You can quit!

I’ve never been a regular flosser. Just another tedious thing to do. Plus it spatters the bathroom mirror. Now it turns out that it’s been overrated. Yea!

Apparently, until recently, no one had bothered to study whether flossing had any value. Now, however, the American Academy of Periodontology acknowledged that flossing has not been shown to prevent cavities or severe periodontal disease. In reviewing 12 randomized controlled trials published in The Cochrane Database of Systematic Reviews, researchers could not find any studies that proved the effectiveness of flossing.

It may be that if you flossed the way your dental hygienists do, it might be effective, as was the case when professionals flossed the teeth of children on school days for nearly two years. (Can you imagine?!) They saw a 40 percent reduction in the “risk” of cavities, whatever that means. At any rate, it looks like we can stop feeling guilty about not flossing.

So now, you’ve got all this floss sitting around. Here are just a few of the many ways to use it (where provided, click on the links for YouTube demonstrations):

• Sew up gunshot wounds. This has been done!
• Cut up food (https://www.youtube.com/watch?v=J0btXb4O21I)
• Escape prison by combining a ton of it to make a rope or mix it with toothpaste to saw through wire. This has been done!
• Remove a ring (https://www.youtube.com/watch?v=CSq_7e6DJMg). This one made me laugh out loud.

I'll still floss when I've got food stuck in my teeth. Otherwise, I'm done.

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The health benefits of dirt

Hundreds of thousands of people around the world eat dirt. Here, in southeastern states such as Georgia, a white clay called kaolin is the dirt of choice (not just any dirt will do). Apparently, it’s mostly women who crave dirt, especially pregnant women. "Every time I get pregnant, I get a craving -- I have to eat it," says one woman who has given birth to four healthy babies. Some medical professionals believe that minerals in certain clays are especially beneficial for pregnant women. As one said, "Mineral demand goes up substantially during pregnancy. Soil is nature’s multi-mineral supply."  Other researchers believe that eating dirt while pregnant strengthens both the mother’s and child's immune systems. It can also have a calming effect on the mother’s gastrointestinal system, since the clay (also found in Maalox and Rolaids) contains antacid compounds. Because clay absorbs toxins, people in traditional cultures cook food such as potatoes and acorns in clay as a way of protecting against the toxic alkaloids and tannic acids that would otherwise make these food inedible.

You may now be hankering for some dirt. You can get kaolin clay on the internet. Just look it up.

There’s a clay deposit in Canada that has been found to contain powerful antibiotics. In fact, solutions of the clay can kill 16 different strains of multi-drug-resistant bacteria—such as Staphylococcus aurea—that commonly infect hospital patients. As one scientist noted, the antimicrobial clay provides “new hope in a battle that the medical community is currently not winning.” Actually, the find is not new. Natives of the region, the Heiltsuk, have used the clay for medicinal purposes for generations.

You can get some dirt-inhabiting bacteria to spray on yourself. A company called AOBiome sells a tonic that contains billions of cultivated Nitrosomonas eutropha, an ammonia-oxidizing bacteria that is most commonly found in dirt. It once lived happily on us too before we started washing it away with soap and shampoo. The AOBiome spray re-introduces these critters as nature intended. They act as a built-in cleanser, deodorant, anti-inflammatory and immune booster. 

Recent studies have shown that farm children who are exposed to animal manures have significantly less asthma than farm children who do not.

Something for everyone in dirt!

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Sunscreen surprises

I’m not very good about using sunscreen, mostly because I figure it’s too late. The damage is done: I have lots of skin cancer and other unsightly sun-induced blemishes. I do use it on my face when I’m going to be outside for hours, hoping to keep my nose from getting any redder.

Scanning the shelves of sunscreen is all very bewildering. It’s hard to choose. I usually opt for a high SPF (Sun Protection Factor). It turns out there’s not much difference between high and low SPF. Sunscreen with SPF 15 blocks about 95 percent of all incoming UVB rays; those with SPF of 40 block 97 percent; etc. The higher SPF sunscreens do block more rays, but in actual use, it’s not clear if they’re that much more effective than the lower-rated ones.

It’s all very disheartening. According to my source, no sunscreen is effective for longer than two hours without reapplication. Plus you need a lot for it to be effective: two fingers-length of product applied to each of the “eleven areas of the body” for a day at the beach say Drs. Aaron E. Carroll and Rachel C. Vreeman, both pediatric doctors and professors. (They don’t specify those eleven areas.) In other words, to follow the recommended amount, you’d have to use up almost an entire bottle of sunscreen during your outing. Also, you should apply it thirty minutes before you go out in the sun to let the ingredients bind to the skin, then apply it again twenty minutes later. Apparently, these first two applications are the most effective.

What this says to me is, unless you follow these rigorous recommendations, the sunscreen isn’t helping all that much. And it’s all a terrific amount of bother. I maintain that there’s a big genetic component to skin cancer. How come my sister doesn’t have skin cancer? Or my husband? He has never used sunscreen and has no skin cancer, while his classmate from Fresno, where both grew up, has plenty of it. Like much else, it's the luck of the draw.

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Stop with the hand wipes!

It seems that those hand wipe dispensers, such as you see at supermarkets, have become increasingly prevalent. They’re for wiping down the handles of shopping carts before using them--I guess so you don't pick up other people's cooties. You also see more of those dispensers in other places. I’ve always thought they were silly: just one more thing to make people fear their environment.

It turns out, they do more harm than good. They (and many other products) are impregnated with a chemical called triclosan, which kills the native bacterial species on our hands--bacteria that act as a defensive layer against “invaders.” In other words, they disrupt the natural balance of bacteria on our hands. Triclosan kills weak bacteria but favors the tolerant, including those that eat triclosan[!]. What’s more, overuse of such products helps encourage antibiotic-resistant germs. In fact, resistance to triclosan is already evident. Triclosan also disrupts endocrine systems—at least in fish, who have been found to have lower sperm counts than those who are not exposed to triclosan. (Triclosan has entered our water systems.)

We don’t need to be at war with the microbial world. In fact, exposure to some bacteria encourages a stronger immune system. A newly published study of 1,037 children in New Zealand, which began in 1972 and continues to this day, showed that children who frequently sucked their thumbs or bit their nails (had their hands in their mouths) were significantly less likely to test positive for allergies than those who did not. (It did not, however, affect their likelihood of having asthma or hay fever.) Other studies have shown an increase in allergies and asthma in people living in overly sterile environments. What's more, most people who use antibiotic soap are no healthier than those who use normal soap; and chronically sick people who use antibiotic soap appear to get sicker!

All of this supports what is called the “hygiene hypothesis” which holds that our germaphobic ways may be making us sick by harming our microbiome—those bacteria, viruses, fungi, etc. that live in and on our bodies. We end up with an underutilized immune system unable to distinguish friend from foe. So stop with the hand wipes.

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Your marriage and your health

Back in the 80s, scientists at Cal Berkeley began a laboratory study of married couples (not like Kinsey, I might add). The couples, who had been married at least 15 years, were asked to talk for 15 minutes about their days, followed by another 15 minutes in which they were told to rehash areas of ongoing contention in their relationships—in other words, to argue. All sessions were recorded on video. The couples also completed detailed questionnaires about their health. Every five years, for at least 20 years, the couples returned to the lab and repeated the drill: discussion, argument, health report.

In studying the couples’ interactions, scientists examined facial expressions and voices, taking note of the emotions shown by the test subjects during arguments. For example, when angry, people’s eyebrows lower, their eyes widen, lips compress, and voice volume increases. The researchers then compared the subjects’ emotions with their health questionnaires. Here is what they learned:

Over the years, spouses, especially husbands, who seethed with anger while arguing were much more likely than calmer spouses to report symptoms of cardiac problems, such as chest pain or high blood pressure. Spouses who stonewalled (refused to respond) were more prone than others to develop muscular problems such as back pain. Interestingly, angry spouses rarely developed back pain and stonewallers rarely reported cardiac symptoms. People whose main response to conflict was sadness or fear did not report many cardiac or musculoskeletal problems at all.

I don’t know whether the fear/sadness people developed some characteristic health problems. I wasn’t willing to pay $11.95 to get the full journal article (Emotion, May, 2016) to find out. My guess is that their health issues were all over the map.

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Sweat as an emotions barometer--and more

Not long ago, I was taking care of my daughter who was recovering from complicated surgery on her hand. I was also helping with the dog walking. I noticed that my feet were often sweaty during my stint—slipping around in my flip-flops. Though the weather was hot, I knew that sweating on the soles of my feet happens under stress because this has happened to me before. Apparently I was more nervous about this care-taking activity than I was conscious of.

The kind of sweat glands on your feet, as well as everywhere else on your body, are called eccrine sweat glands. (A second kind, called apocrine, are mostly limited to your armpits and anus area. I’m sticking with eccrine sweat glands in this post.) Sweat glands, which are controlled by your nervous system as well as hormones, are particularly numerous on your feet, palms, face, and armpits. (Our palms have around 370 sweat glands per square centimeter.) For our primitive ancestors, having lots of sweat glands on their hands and feet increased friction and enhanced grip—part of the fight or flight mechanisms. Sweat also cools our skins, reduces body temperature, allows us to get rid of excess water and electrolytes and helps to protect our skin from bacterial colonization.

Because it is derived from your blood plasma, sweat is 99 percent water, but also contains sodium, chloride, and other elements. When all of your sweat glands are working at maximum capacity, you can lose more than three liters per hour. But you normally sweat about a quart a day. You may be one of those who gets muscle cramps after sweat-inducing exercise. This is generally the result of losing electrolytes (sodium, etc.). I understand that drinking two-and-a half ounces of salty pickle juice almost instantly relieves the cramping. If you try this, let me know if it works.

Sweat is odorless. It’s the interaction with bacteria that causes the odor. Deodorants work by killing the bacteria on your skin. Antiperspirants, which are classified as drugs, block the top of your sweat glands and plug them up (doesn’t sound like a good idea to me). You may have noticed, as I have, that polyester clothes are stinkier than cotton. That’s partly because polyester is less absorbent than cotton, a characteristic that helps promote odor-causing bacteria. But it also promotes a different type of bacteria than cotton—the kind that degrades fatty acids and amino acids into “malodorous compounds,” as one researcher explains it. Malodorous I don't want to be. I'm sticking with cotton.

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Your ambulance service may be owned by private equity firm

Private companies now represent about 25 percent of all ambulance providers. Because of the 2008 financial crisis, many municipalities have struggled to pay for basics and have turned to private equity firms to provide ambulance and fire-fighting services. Thus, when you dial 911, you may be interacting with private equity

Private equity firms invest money from wealthy individuals and pension funds. Because these firms are primarily skilled in making money, not providing services, studies have shown that some have used cost cutting, price increases, and litigation to improve their bottom lines.

Private equity investors swept into the ambulance business with high hopes (“tremendous growth potential,” as one investor stated). But it didn’t always play out as they had hoped and several have gone bankrupt. To keep afloat, some firms fell back on a time-tested moneymaking strategy: cutting costs. In many cases this meant fewer ambulances and staff, slower response times, failed heart monitors, ambulances breaking down, shortages of supplies, and much more. At one company, emergency workers were forced to supply needed medications by swiping supplies from hospitals. In fact, they were pressured by their supervisors to raid hospital supply carts. As one worker who swiped supplies said, “There’s only a couple of things that terrify paramedics. Being without your critical medications is one of them. I make no apologies.”

I’ll bet you thought that your government supplied your local ambulances. I did, so I looked it up and discovered that in my county (Santa Cruz, California) the service is provided by a contractor called American Medical Response, which, I discovered, was acquired in 2011 by a private equity firm, Clayton, Dubilier & Rice. In the next county, Santa Clara, services are provided by Rural/Metro, a company that went bankrupt in 2013. (It was paying hundreds of thousands a month in fines for things such as failing to have three ambulances at the ready and for responding too slowly to emergencies.) In 2015 it was purchased by Envision Healthcare Holdings, the parent company of American Medical Response, which, as I mentioned, is owned by Clayton, Dubilier and Rice. It’s all horribly Byzantine.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Exercise as medicine

It’s long been known that working out is good for the brain, but, until recently, scientists didn’t know why. It turns out that when we work out our muscles produce a protein called cathepsin B, which promotes the production of new brain cells. In the studies that resulted in this finding, the people (and mice) were running on treadmills. I don’t know if a less rigorous workout would lead to this brain-enhancing effect. I hope so.

But there are plenty of health benefits that don’t require running. I recently came across an analysis of 305 randomized controlled trials (340,000 participants) showing how exercise can be almost a “miracle cure.” Here is a sampling of the conclusions:

• Osteoarthritis of the knee: improves both pain and function.
• Rheumatoid arthritis: increases aerobic capacity and muscle strength.
• Heart attacks: reduces all-cause mortality by 27 percent and cardiac mortality by 31 percent.
• Heart disease: as good as drugs in preventing mortality.
• Diabetes: helps control blood sugar.
• Depression: improves symptoms.

You can reap these benefits by exercising (moderate intensity) 30 minutes five times a week. Walking or bicycling can do the trick; even vacuuming and lawn mowing. The idea is to get your heart rate between 110 and 140 beats per minute. I have an Apple watch with a heart rate counter (which I generally ignore). But today at Jazzercise I paid attention, and found that I got a high reading of 129, though more often it was around 108.

Commenting on the “meta analysis” of the benefits of exercise, editors at the British Medical Journal noted that, while exercise isn’t really a miracle cure, it is nevertheless “the best buy for public health.” I wish that lying on the couch and reading (a favorite pastime) had similar health benefits.

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Hip replacement profiteering

A couple of years ago, I thought I might need a hip replacement. My left hip hurt a lot, especially walking upstairs. Turns out it was “only" bursitis, which is bad enough. I’m glad for that. Hip replacement devices are way overpriced and sometimes dangerous. Yet the market for them is enormous: In 2011, more than 645,000 hip replacements were performed in the US. Undoubtedly, they do improve the lives of many people. But their profit margins are unconscionable. 

An artificial hip costs about $350 to manufacture. But hospitals pay an average $4,500 to $8,000 for the device. In the case of one manufacturer, Medtronic, the overall cost of making its products is about 25 percent of what it sells them for, yielding a gross profit margin of about 75 percent.

After purchasing the device, the hospital then marks up the price for sale to the patient. The cost of implant procedures vary according to where you live. Overall, the cost averages $30,000. It’s cheapest in Birmingham, Alabama ($11,327) and highest in Boston ($73,987)—a 313 percent cost variation. In Boston, though, you could get a replacement for as low as $17,000. I guess you have to shop around. But if you live in the Fort Collins-Loveland area of Colorado, shopping around won’t do much good: in that area, the average cost is $55,686.

Plus, there are the kickback shenanigans. That is, device manufacturers pay doctors to use their products. In 2007 the five major device manufacturers paid over $200 million to about five hundred orthopedic surgeons.

Finally, safety can be an issue. In most devices, the ball (at the top of the femur) is metal and the metal socket is lined with plastic. One company developed a device that eliminated the plastic, making it metal on metal. It was purported to last longer than the older devices. But it was poisoning people. Small particles of cobalt and chromium were coming off the device and entering the bloodstream.

If you’re getting a hip replacement, there’s probably not much you can do about the cost. But in selecting a model, go for the tried and true.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Angiograms: often an unnecessary rip-off

An angiogram lets doctors look for blocked blood vessels. Beginning at the groin (sometimes the arm), doctors thread a catheter through the arterial system until it reaches a coronary (heart) artery. Then they squirt in some dye and take a look at an image of the arterial system that shows up on a screen.

If they see blockage they thread a thin wire through the catheter and across the blockage. Over this wire, they pass a second catheter that holds an expandable balloon on the end. They inflate the balloon, which pushes plaque to the side and stretches the artery open. This is called angioplasty. Often, they also insert a wire mesh tube (stent) into the blocked area to hold it open.

If you have a completely blocked artery, these procedures may be life-saving. But angiograms are frequently performed as elective procedures on people with no symptoms of heart problems. According to the American Medical Association, 35% of the procedures are “inappropriate” and another third are questionable. That’s a lot, especially considering that the procedure typically costs around $8000 and angioplasty costs about $30,000. (An efficient “cath lab” in a hospital can perform around twelve diagnostic angiograms in a day—a big money maker.) Moreover, while major complications are not common, the procedure can cause tears in blood vessel walls and major bleeding.

The thing is, there’s no predicting where a heart attack will originate. It could start anywhere where there is plaque, even if the plaque is not obstructing blood flow. (A heart attack occurs when a clot breaks off the plaque and blocks the artery). A study performed in 2011 found that only a third of heart attacks originated in plaques that were blocking at least half of an artery. The remainder began with the rupture of plaques that appeared to be causing no problems. In other words, the partly blocked area visible in an angiogram is no more likely to be the site of a heart attack than any other plaque.

You will be unhappy to learn that, according to Dr. Gregg W. Stone, a cardiologist at Columbia, “Half the people over 65 have blockages.” We just need to get comfortable with that fact. As Dr. Judith Hochman, a cardiologist a NYU Longone says, “People believe that if they have a blockage, they have to fix it mechanically. It seems logical, but in medicine, many things that seem logical are not true.”

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Take two aspirin...

Voltaire said “the art of medicine consists of amusing the patient while nature cures the disease.” Of course I love that idea. Case in point: during World War II, Archibald Cochrane was a prisoner of war in Germany and was in charge of overseeing the health of 20,000 fellow prisoners who suffered from diarrhea, typhoid, diphtheria, and other infections. With no medicine except for aspirin and antacids, he expected hundreds to die. But in his six months at the camp, only four prisoners died, three of whom had been shot by their captors. When he returned to Britain, he began to question many of the standard medical practices—such as bed rest after a heart attack—that were later shown to be ineffective. He was also instrumental in calling for more randomized trials to test the efficacy of medical treatments.

Twenty years ago an organization was named after him: The Cochrane Collaboration.  It's is a global network of scientists and others who study the best evidence from research to determine whether treatments actually work. They have 37,000 contributors from more than 130 countries who work together to produce credible health information free from commercial sponsorship.

You can go to their Web site and look up the results of their studies. For example, I randomly chose “Acupuncture for tension-type headache” and got the following report: “The available evidence suggests that a course of acupuncture consisting of at least six treatment sessions can be a valuable option for people with frequent tension-type headache.” To come to this conclusion, they explain, they “reviewed 12 trials with 2349 adults, published up to January 2016.” It's a good site for looking up medical treatments. 

Anyhow, back to letting nature cure the disease. I have what seems like millions of actinic keratosis on my skin—those scaly patches that are supposedly pre-cancerous. Occasionally, I have them “burned” off. Just recently they have started to disappear on their own. It’s called spontaneous regression. Go nature!

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Cortisone injections: a second look

Last October I wrote a post about cortisone injections. I wrote about it because unrelenting pain in my left hip prompted me to see an orthopedic surgeon. I thought I might need a hip replacement. But the pain was from bursitis, not arthritis. The doctor gave me a cortisone shot at the site of the bursitis. When I wrote the post, I was disappointed in the results. After a few weeks, the pain came back—probably because I’d overdone physical activity too soon after the injection. A few weeks after that the pain receded again and now, over two years later, my hip is pain free.

Last May, I had another injection—this time in my right knee. For the past seven or eight months, bending my knee had been painful—although walking didn’t hurt. So I lived with it, but then it kept getting worse. My range of motion kept getting smaller. Not knowing the cause was driving me crazy, so I had an MRI. (My chiropractor said that my lower leg bones were misaligned with my thigh bone, which may be true.) The MRI showed torn cartilage and lots of fluid in and around me knee. So I got another cortisone shot.

The shot was not to dull the pain, but to reduce the inflammation that was causing the fluid build-up, which was the source of the pain. Bending my knee forced the fluid up and down my leg. Cortisone is a powerful anti-inflammatory drug. Supposedly, reducing the inflammation would also cause the fluid to subside, which, apparently it has. My knee is much better.

Those of you who follow my posts know that I resist medical treatments (I don’t have annual checkups, for example). But I do seek medical help if I’ve got a problem. So now I’m all for cortisone shots if needed. But too many injections over a short period of time can cause damage to the tendons, ligaments, and cartilage at the injection site. Also, studies have shown that giving cortisone shots to people with tendinitis, such as tennis elbow, makes them worse off than doing nothing. The shots impede healing and can put you higher risk for continuing damage. It turns out that this type of tendinitis is not from inflammation but from tears in the tendon.

So be careful.

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More reasons not to diet

This post is a follow-up to an earlier one about dieting, which basically says that your body wants to be a certain weight, which is why you regain the weight you lost. Sandra Aamodt, a neuroscientist, tells us the same thing: “The root of the problem [inability to lose weight and keep it off] is not willpower but neuroscience.” When your weight drops below what is normal for your body, your body not only burns fewer calories but also produces more hunger-inducing hormones. When you lose weight, your brain declares a state of starvation emergency and institutes these corrective measures.  “The brain’s weight-regulation system considers your set point to be the correct weight for you, whether or not your doctor agrees.” 

Dieting just makes matters worse. After about five years, 41 percent of dieters gain back more weight than they lose. For example, in a study of 4,000 twins, researchers found that dieters were more likely to gain weight than their non-dieting identical twins. Even worse, studies show that dieters are more likely than non-dieters to become obese over the next one to 15 years. For example, a study of elite athletes who dieted to qualify for their weight classes (boxers and wrestlers) were three times more likely to be obese by age 60 than their peers who competed in other sports.

What’s more, we’ve been taught to believe that being fat can be deadly—that you’ll develop diabetes or heart problems and die an early death. In fact, there’s little evidence that dieting improves health. For example, in a 2013 six-year study of obese and overweight people with diabetes, researchers compared those who dieted with those who didn’t and found that the dieters had a similar number of heart attacks, strokes, and deaths from heart disease as those who didn’t diet. More recently researchers who studied a group of overweight diabetics for 19 years found that intentional weight loss had no effect on mortality. Yet another study showed no relationship between health improvements and amount of weight lost.

Thus based on all the evidence, according to Aamodt, “Dieting is rarely effective, doesn’t reliably improve health, and does more harm than good.” So stop it.

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Are you overweight? Good!

Overweight people live longer than supposedly “normal” weight people. This has been well documented and is irrefutable. For example, a study that followed 1.8 million people for ten years found that people with a body mass index (BMI) between 26 and 28 had the highest life expectancy. Not only that, they found that people with a BMI between 18 and 20 (supposedly optimal) had a lower life expectancy than those with a BMI between 34 and 36 (obese). The most recent study, published in the May, 2016 Journal of the American Medical Association, showed that people with a body mass index of 27 have the lowest risk of dying early from any cause. Another study involving 250,000 people with heart disease found that overweight patients had better survival rates and fewer heart problems than those with a “normal” index number.

The definitions of what is “overweight,” “normal,” and “obese” are defined by the World Health Organization, National Heart, Lung and Blood Institute, and other organizations. They are based on BMI figures. Don’t know your BMI? It’s easy to compute with an online calculator. Here’s a link to one: BMI calculator. You only need to know your height and weight.

As you’ll see on this site, here is what the National Heart, Lung, and Blood Institute says is normal, overweight, etc.:

Underweight = <18.5
Normal weight = 18.5–24.9 
Overweight = 25–29.9 
Obesity = BMI of 30 or greater

My BMI is 26, which makes me overweight, as well as 65 percent of my fellow Americans including Michael Jordan in his prime. Arnold Schwarzenegger, when he was Mr. Universe at age thirty-three, had a BMI of 33, which made him technically obese.

So what the heck? Where do the supposed experts come up with what is normal, etc.? I don’t know. Under the circumstances, it makes no sense to me.

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In defense of fat people--again

Hah! I have long maintained that fat people can’t help being fat—that their (our) bodies want to be a certain weight. I wrote an earlier post on that subject.  Now I have new ammunition to support my argument, as reported in the journal Obesity and The New York Times. 

For six years, researchers followed contestants on The Biggest Loser TV show to see how they fared following their weight loss.  Here is a nutshell summary. 

• Thirteen of the 14 contestant regained most if not all their lost weight; four are heavier now than before the competition; only one, with great effort, has managed to maintain her weight.
• Their metabolisms became dramatically lower—as much as 800 calories a day—and stayed that way. In other words, after losing weight, their bodies were not burning enough calories to maintain their thinner weight. They had to eat even less to maintain their weight.
• The hormones that regulate weight either rose or fell. For example, their levels of leptin, which controls hunger, went from normal at the start of the weight loss to nearly zero. The levels of the hormones that made them want to eat rose. The only way they could maintain their weight loss is to be hungry all the time.

What all this means, as one of the researchers said, “You can’t get away from a basic biological reality. The body puts multiple mechanisms in place to get you back to your weight.” As I’m sure you’ve noticed, there’s a weight you can maintain without any effort, and that is the weight that your body is going to fight to defend.

For a detailed account of the study, see this article from The New York Times.

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Forget fish oil supplements

I used to take them myself, although I tend to gag on large pills and hated doing it. I was happy to learn from a number of reliable sources that fish oil supplements have no value for preventing heart disease. For example, according to the National Institutes of Health: “Omega-3s in supplement form have not been shown to protect against heart disease.” Former president of the AMA, Robert Eckel has also stated that nearly all studies regarding fish oil supplements show no benefit at all.

My most reliable resource on this topic is Dr. John Ioannidis, a brilliant guy at Stanford University of Medicine, whose specialty is uncovering flaws in published research and who long ago showed the worthlessness of fish oil supplements. He says "These claims do not easily die away."  Indeed, every year people in the US spend $1.2 billion a year on fish oil and similar supplements. You are probably among them. I say this because the use of fish oil supplements have quadrupled over the last five years and because almost one in five older adults now take them. “There’s a major disconnect,” says researcher Dr. Andrew Grey. “The sales are going up despite the progressive accumulation of trials that show no effect.”

What’s more, fish oil supplements are largely unregulated. Tests performed on 30 top-selling fish oil supplements for levels of omega-3 fatty acids found that six of those products contained levels of omega-3s that were, on average, 30 percent less than stated on their labels. Tests that looked for two particular omega-3’s (DHA and EPA), found that, on average, these fats were 14 percent less than listed on their packaging.  

Although fish oil supplements have not been shown to be harmful, they can cause bleeding if you take blood thinners such as Coumadin, or even aspirin.

Might as well save your money and avoid choking down those giant pills.

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Hidden fat research uncovered!

From 1968 until 1973 Dr. Ivan Frantz Jr. of the University of Minnesota Medical School conducted a controlled clinical trial comparing diets containing saturated fats with those containing vegetable oils and no saturated fats. He hoped to prove that replacing saturated fat, such as butter and other animal fats, with corn oil would protect them against heart disease and lower their mortality. The research subjects lived in mental hospitals and a nursing home where diets can be strictly regulated. Half the subjects were fed meals rich in saturated fats from milk, cheese and beef; the others ate a diet where the fat consisted of corn oil. The result: the participants who ate the low saturated fat diet reduced their cholesterol by an average of 14 percent. Nevertheless, the low-saturated fat diet did not reduce mortality. In fact, the study showed the greater drop in cholesterol, the higher risk of death during the trial.

Even though this research was one of the largest controlled clinical trials ever conducted, the data were never fully analyzed or published. In fact, they’d been virtually hidden away and were only recently discovered in a dusty box by Dr. Frantz’s son (Frantz senior died in 2009). “My father definitely believed in reducing saturated fats,” he said, noting also that his father was probably startled by what seemed to be no benefit in replacing saturated fat with vegetable oil. In other words, the trial results were a disappointment.

While some nutritionists protest these findings, which have recently been published in the journal BMJ, plenty of other scientists find support for them. For example, one scientists analyzed four similar trials in which vegetable oils were substituted for animal fats. Those trials also failed to show any reduction in mortality from heart disease. In 2013, Dr. Christopher Ramsden, who is a medical investigator for the National Institutes of Health, discovered a similar trial that been carried out in Australia in the 1960s, but also had not been fully analyzed or published. Like the others, the results showed that those who replaced saturated fat with vegetable oils lowered their cholesterol, but were also more likely to die from a heart attack than the control group who ate more saturated fat.  “One would expect that the more you lowered cholesterol, the better the outcome. But in this case the opposite association was found. The greater degree of cholesterol-lowering was associated with a higher, rather than lower, risk of death.”

I love this. For a long time, I have believed that those who have instilled a fear of saturated fat and cholesterol have done us a terrible disservice. Because I get quite exercised about these topics, you can find more posts about them: one on why I refuse cholesterol checks and one on the misinformation about saturated fat.

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