The Resveratrol Bust, the ARB Scare, and Other Short Takes

Another missive from our favorite medical maven, Doc Gumshoe

By Michael Jorrin, "Doc Gumshoe", August 13, 2013

The Resveratrol Bust

Disappointing, but unsurprising, I say. At this point I’m willing to stake my bet that the wonderful promise of resveratrol isn’t going to pan out. What’s resveratrol? Let’s take a little journey back in our time machine

About Resveratrol

It goes back at least 70 years, to the discovery by Japanese investigators of the active ingredient in a plant used in some traditional healing practices, the white hellebore. It was then learned that grape vines, when attacked by a particular fungus, also secreted this substance, which was named resveratrol. It was speculated that resveratrol might be a natural defense agent for the grape vines, and protect them from rot and blight. And, who knows, it might be good for humans as well.

The French Paradox

Now, also going back quite a few years, we Americans began to look enviously across the pond at the French and the Italians. We were worried about cholesterol, and the Word was that we needed to cut way back on butter and eggs and bacon and well-marbled steaks. But those lucky French didn’t seem to fret too much about all those cholesterol-laden foods, and it didn’t seem to hurt them a whole lot. You would have thought they would be turning up daisies, but no, they enjoyed their filet mignon with sauce Bearnaise (butter, egg yolks, a splash of tarragon vinegar). Might it be because they washed it down with copious goblets of Chateau Margaux? In any case, the French had much lower heart disease rates than we did, and there had to be some reason for it.

In fact, there were beginning to be pretty rigorous studies that seemed to point to a clear benefit from consuming alcoholic beverages, especially in terms of heart disease and cardiovascular mortality. Not that those studies should have been all that surprising either!

Let me digress for a moment. Lots and lots of doctors knew that moderate alcohol consumption was, on the whole, beneficial. (Note, whenever I mention alcohol consumption, in this blog or anywhere else, please assume that there’s an autocorrect feature that inserts the word “moderate” in front of that phrase.) There was an English physician in the 18th century by the name of Anstey who observed that among his patients the drinkers outlived the teetotalers by a comfortable margin, and he proposed a rule – a drink before dinner and a couple of glasses of wine with dinner – as a formula for a long life.

The studies I’m talking about began hitting the peer-reviewed medical journals in the 1970s, and in 1996 there was a big review in the British Medical Journal that more or less clinched the case for moderate alcohol consumption. Overall, the studies this review cited concluded that drinking alcoholic beverages, mostly wine, lowered heart disease risk by about 30%.

However, the mainstream medical establishment was not about to recommend alcoholic beverages to ward off heart disease. Alcohol – excessive alcohol – was known to cause all manner of health problems, not even counting all the other problems associated with alcohol. So it had to be something else!

The Resveratrol Promise

Might it be resveratrol? If it protected grape vines from rot and blight, might it not have beneficial effects in humans? From my perspective, as an initial assumption, that was quite reasonable. After all, as I said in a previous offering, many, many natural substances are the source of our most valuable drugs – and by drugs, I mean substances that we take that have curative powers. Also, resveratrol is present in red wine, and red wine is what the French and Italians mostly drink.

So they did tests in laboratory animals, mostly mice. They gave mice the mouse equivalent of filet mignon with Sauce Bearnaise, and, predictably, the mice became obese. Then they gave the mice resveratrol, and the obese mice that got resveratrol survived longer than the ones that didn’t get resveratrol.

At this point the researchers began to get very, very cheerful. Down the road, perhaps, here was a drug that would not only counteract the adverse effects of the American cholesterol-laden diet, but also, possibly, increase longevity. If this drug got approved, not only would it be hugely beneficial for lots of people, but the developers would reap unimaginable gains.

A little problem with these tests in mice, however, was that the smallest amount of resveratrol that had any beneficial effect in mice was many, many times larger than the amount of resveratrol in the amount of wine that any human being could possibly drink in a day. To get the amount of resveratrol equivalent to the lowest effective daily dose of resveratrol in the mouse studies, a person would have to drink 60 liters of wine per day, and in some mouse studies, the daily resveratrol dose was equivalent to 900 liters of wine. Impractical, to say the least!

That should have made it pretty clear that it wasn’t the resveratrol in the wine that was counteracting the evil effects of the French diet. But that didn’t stop the research from continuing. The pot of gold at the end of the rainbow beckoned.

The Resveratrol Promise Fades

Unfortunately, when they got to studies of resveratrol in humans, the golden promise all but vanished. Here’s a really quick summary of three clinical trials:

  • One – in non-obese, post-menopausal women, 75 mg of resveratrol per day delivered no metabolic benefits whatever: no increase in metabolic rate, no beneficial effects on cholesterol or triglycerides, no change in markers of inflammation.
  • Two – in 24 obese men, resveratrol produced no beneficial effects on blood pressure, fat content, inflammatory or metabolic markers.
  • Three – in 27 normal weight men over the age of 65 all of whom were enrolled in an exercise program, 250 mg of resveratrol blunted the beneficial effects of exercise. Exercise increased oxygen uptake by 45% in the men who were not taking resveratrol, but resveratrol erased that benefit. Exercise also lowered blood pressure and lowered cholesterol and triglycerides, but resveratrol erased that benefit as well.

That third study really put the kibosh on resveratrol. The studies that showed no benefit they could swallow, and keep looking, hoping that more studies would detect some benefit eventually. But a study in which resveratrol nullified the very real benefits of exercise is hard to get around.

So, if it’s not resveratrol, might it, after all, be the alcohol in the wine that’s producing those benefits?

The Bona Fide Benefits of Alcohol

Just you won’t think that I’m pushing my own agenda, here are some excerpts from a publication of the Harvard School of Public Health:

Possible Health Benefits of Alcohol<

What are some of the possible health benefits associated with moderate alcohol consumption?

Cardiovascular Disease

More than 100 prospective studies show an inverse association between moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes. The effect is fairly consistent, corresponding to a 25 percent to 40 percent reduction in risk.

Beyond the Heart…

The idea that moderate drinking protects against cardiovascular disease makes sense biologically and scientifically. Moderate amounts of alcohol raise levels of high-density lipoprotein (HDL, or “good” cholesterol), and higher HDL levels are associated with greater protection against heart disease. Moderate alcohol consumption has also been linked with beneficial changes ranging from better sensitivity to insulin to improvements in factors that influence blood clotting, such as tissue type plasminogen activator, fibrinogen, clotting factor VII, and von Willebrand factor. Such changes would tend to prevent the formation of small blood clots that can block arteries in the heart, neck, and brain, the ultimate cause of many heart attacks and the most common kind of stroke.

So it’s not the red stuff in the wine, it’s the ethanol that confers those benefits. I need to add here, so that I don’t induce a dash to your local Rosie O’Grady’s, that “moderate alcohol consumption” is defined as two drinks per day for men and one drink per day for women; unfair some of you will say, but it’s based mostly on body weight, men being bigger and bulkier than women and thus have more body fluids for the alcohol to be distributed through. One drink is calculated as five ounces of wine or 12 ounces of beer or a jigger (an ounce and a half) of distilled spirits.

The J-Curve

That two drinks per day is actually the bottom of a J-curve. If we plot cardiovascular events (heart attacks, strokes, other serious cardiac events needing hospitalization) starting at its incidence in teetotalers, and then go on to measure its incidence in moderate drinkers, we find that this incidence is quite a bit lower in those moderate drinkers. But as consumption rises beyond the optimal two drinks per day point, the curve starts going up again, and by the time we get to about four drinks per day, it’s right back up to the rate for teetotalers, and it goes up from there. So the people who warn about the dangers of excessive alcohol consumption are right, of course, but it doesn’t become really excessive – i.e., more dangerous than being a teetotaler – until we get past that four drinks a day mark.

All that being said, we shouldn’t totally write off resveratrol. There’s at least a possibility that it may confer some benefit in other health-related areas, such as preventing osteoporosis and mimicking some of the benefits of a really strict diet. So far, not proven, but we’ll see.

And now, about something completely different …

The ARB Scare

This surfaced about two months ago, and the reverberations have been bouncing around in the medical community as well as among concerned patients. The scary possibility is that angiotensin receptor blockers, known as ARBs, might possibly “cause” an increase in cancers.

ARBs are antihypertensive, or blood-pressure lowering drugs. The appeared on the market about 15 years ago, and they have become a very widely-used and successful drug class. Drugs in this category are:

Atacand (candesartan), from AstraZeneca (AZN)

Avapro (irbesartan), from Sanofi (SNY)

Benicar (olmesartan), from Daiichi Sankyo (4568 Tokyo)

Cozaar (losartan), from Merck (MRK)

Diovan (valsartan), from Novartis (NVS)

Micardis (telmisartan), from Boehringer Ingelheim (BING.GR)

ARBs lower blood pressure by inhibiting the renin-angiotensin system (RAS), which affects both heart rate and peripheral arterial resistance – the squeezing pressure of arteries on the blood. The specific messenger that triggers this blood pressure increase is angiotensin 2, and ARBs block the receptors for this messenger by occupying the receptor sites so that the angiotensin 2 can’t link up with the receptor.

A previous category of drugs that did more or less the same thing were the ACE (angiotensin-converting enzyme) inhibitors, which interfered with the action of the enzyme that converted the inactive form of angiotensin into the active angiotensin 2. ACE inhibitors work quite well, but they shouldn’t be used in people with any kind of respiratory problems such as asthma, while ARBs do not have that issue. Most high blood pressure drugs have issues of one kind or another, and ARBs seem, so far, to have fewer. That explains why, at a recent meeting of the American College of Cardiology, when members were asked what antihypertensive drugs they would prescribe for themselves or a family member, the winning category was ARBs.

The possibility that ARBs might be associated with increases in cancer risk was raised by a study published in Lancet Oncology back in 2010. This was a meta-analysis by Dr Ilke Sipahi of clinical trials with ARBs. The conclusions of this meta-analysis were that the risk of new cancers in the 61,590 patients in the five trials they analyzed increased from 6.0% in patients who did not take ARBs to 7.2% in patients who did take ARBs. The only specific cancer that was significantly higher in patients taking ARBs was lung cancer, with an incidence of 0.9% compared to 0.7% in patients not taking ARBs. No significant differences in cancer deaths were found in this study.

The brouhaha got started when a regulator at the FDA, Dr Thomas A. Marciniak, went against the directions of his bosses, arguing that warnings about the safety of ARBs should be make known to the public. Marciniak, on his own initiative, combed through the immense amount of data submitted to the FDA by the pharmaceutical companies, and concluded that ARBs increased lung cancer risks by about 24%. Officially, the FDA doesn’t agree, and neither do European regulatory agencies.

What could account for these huge differences?

At this time, nobody knows how Marciniak did his analysis. Dr Ellis Unger, the FDA chief of the drug evaluation division, suggests that the data used by Marciniak includes a large number of patient-reported events, collected as part of post-marketing data, many of which could be interpreted as new cancers, but which have not been independently investigated. ARBs have been in wide use for 15 years, have been studied in at least 25 clinical trials, and only in this instance is there a suggestion of cancer risk.

An interesting comment on this issue comes from Dr Henry Black, past President of the American Society of Hypertension. He notes, first, that there’s no mechanism of action whereby blocking the angiotensin 2 receptor could stimulate cancer cell growth. He points out that in the immense quantity of pre-clinical studies in animals, no increase in tumor growth was detected – otherwise, drug development would have stopped cold.

But more to the point, he questions the validity of the Sipahi meta-analysis. None of the studies in the meta-analysis by themselves attained statistical significance for the increase in cancers, and almost all of the increase came from two of the studies, both of which used telmisartan (Micardis). Overall, 85.7% of the patients in the meta-analysis were on telmisartan, raising serious questions about the legitimacy of generalizing the conclusions of this meta-analysis to the entire class of drugs.

Dr Black also raises a serious point about the potential for harm. Patients pick up these scary findings (as reported in the media, frequently with an alarmist slant), and decide to stop taking their medications, with possibly serious consequences. His conclusion was that the study was “very irresponsible and junk science.”

None of this decides the issue one way or another. The possibility cannot be ruled out that there is a cancer risk associated with ARBs, albeit a small one – the difference in incidence of new cancers reported in the Sipahi study was 1.2 percentage points, and of lung cancers, 0.2 percentage points. Not nothing, but not a whole lot. If I had hypertension, would I take an ARB? Probably yes, but I might pick one of the other ones rather than telmisartan.

This reminds me of the farrago in relation to the Women’s Health Initiative a few years ago, when a tiny – really tiny! – increase in the incidence of heart attacks occurring in women taking hormone replacement therapy (HRT) was trumpeted as a colossal increase in heart attack risk. The real difference was that in women on HRT, there were 37 heart attacks per 10,000 patient-years, while in women not on HRT, there were 30 heart attacks per 10,000 patient-years. The difference in absolute risk was less than 0.1%, but this was released to the press as a difference in relative risk of 23%.

A Bit More About Salt

Several readers have asked questions or commented about the issue of salt in our diets. One reader said, wasn’t it really the sodium that should be measured and monitored, and not the salt. Yes, sodium ions play a vital role in a great number of physiologic processes, including muscle contractions. However, sodium enters and exits our bodies in salt (sodium chloride) and that’s how we can keep track of it.

Someone else asked whether anti-caking agents in salt (many different ones are used) might not be responsible for its effects on blood pressure. The answer is, it’s the salt! We regulate the sodium concentration in our bloodstream with exquisite precision. When it’s too concentrated, we’re thirsty, we add fluids to dilute the concentration, the excess fluid raises our blood pressure temporarily, but we eliminate the excess fluid over time. After a day or so, we’ve made enough visits to the loo to get rid of the excess volume, and our BP returns to normal. But if we keep bingeing on salty snacks, some of us reset out internal blood pressure detectors to a “new normal,” and develop high blood pressure. There’s a lot of individual variation. Some people seem to be programmed to retain salt, and they are more susceptible to that variety of hypertension.

The Ministry of Truth Redefines Cancer!

A working group under the aegis of the National Cancer Institute (NCI) has issued recommendations that the words “cancer” and “carcinoma” be eliminated from some lesions that they consider unlikely to progress to cancer, and therefore probably do not require treatment. The motivation for making these changes is to reduce overdiagnosis and overtreatment, which they say is in many cases not only unnecessary, but harmful. These recommendations were published in the Journal of the American Medical Association (JAMA) on 29 July, and immediately widely reported.

An example of the lesions they are proposing to rename is ductal carcinoma in situ (DCIS). They propose to remove the scary word “carcinoma” from the name and relabel it as an “indolent lesion of epithelial origin,” using the accronym IDLE. Other conditions currently labelled as cancers that they are proposing to rename include prostate cancer and Barrett’s esophagus. They acknowledge that in some cases, these lesions will progress to cancers, but not necessarily so in every case, and in the meantime it’s best to avoid frightening patients into demanding treatment, which might be unnecessary.

However, a paper currently in press in Molecular Oncology by Catherine Cowell and seven other investigators at Memorial Sloan Kettering puts the risk that DCIS will become metastatic breast cancer at about 40% if left untreated. The authors acknowledge that there is no current way of assessing which DCIS lesions will progress to metastatic breast cancer. The same thing is true for a number of the other so-called “IDLE” lesions that these NCI folks don’t want to scare patients about. Clearly, research is needed to identify the markers that predict which cancers will progress and which will not. But lulling patients into complacency so that they will not seek treatment strikes me as irresponsible and demeaning to patients. To the NCI and the collaborators in this exercise in semantic management of disease, I cry “Shame!”

* * * * * * *

Doc Gumshoe is having a good time writing these. He likes to exercise his little grey cells and he enjoys swimming against the tide, when the occasion seems to warrant it. He pays attention to readers’ questions and, when he doesn’t have an immediate response, he tries to heed the advice of Miss Truesdell, his 11th grade math teacher, whose usual response to “I don’t get it” was “Apply yourself!” He’ll keep applying himself! Best to all, Michael Jorrin (aka Doc Gumshoe)


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54 Comments on " The Resveratrol Bust, the ARB Scare, and Other Short Takes"

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David J. Rose DDS
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David J. Rose DDS
August 13, 2013 11:54 am

Thank you. Excellent analysis.

michael achey, md
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michael achey, md
August 13, 2013 12:01 pm

Actually, it isn’t all about the salt. In many folks it is about insulin and its effect on the kidneys. About half of us half a syndrome known as insulin resistance. We require higher than normal levels of insulin to control blood sugars at any level. This extra insulin causes salt to be retained in the body. A low carbohydrate diet rapidly reduces insulin levels and all this extra salt comes pouring out. Often, these patients need to use extra salt during the first two weeks of the new diet just to maintain normal sodium levels and blood pressure.

bluesharpbob
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August 13, 2013 12:05 pm

Just a note to say I really enjoy reading your articles. Mankind has been looking for “magic bullets” everywhere since the first Snake Oil Salesmen eons ago, the real one’s are extremely few & far between. I think the bottom line is you can’t compensate for unhealthy habits & life styles with pills & supplements, though many companies make tons of money trying to convince folks they can.

john weissman
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john weissman
August 13, 2013 12:15 pm

Excellent writing, excellent info, thanks much. Got an unopened bottle of resveratrol in the reefer and not sure what to do with it now. The issue of sodium is complex. We need it, and the adrenal gloands can suffer if deprived of sodium. Food is the first and last domain of health, not drugs, not alcohol. Drinking any amount of alcohol with a bad food diet is bad for you. Blood thinning, and reduction of stokes, heart attacks can be achieved, BTW by drinking water thruout the nite, even at risk of peeing alot.

botcher
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botcher
August 13, 2013 12:32 pm
This is an excellent article. I have found that many of the things becoming the new “fad” for healthy eating ends up being nothing more than marketing hype. Many of these types of fads and the rigid doctrine of the health industry gets into the mindset of the public and we get fatter and less healthier the more we listen to the latest infomercial, Dr. Oz show or internet health information website masquerading its real purpose as a storefront. There are too many health professionals holding onto the dogmas handed down from so-called experts who relied on flawed studies to… Read more »
John Ellis, MD
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John Ellis, MD
August 13, 2013 12:39 pm
Your article on resveratrol was most interesting and goes to show how early reports of something get blown out of hand and often with profit motives. I was reading a local magazine today and encountered yet another alarmist article about GM foods, connecting them with every possible malady, which is certainly not correct. Then there was a recent and yet another most inconclusive story online about a neurosurgeon basically saying that cell phones cause cancer when it fact, the evidence does not. The so-called evidence is the most sketchy imaginable and one has to recall that associations are not causation.… Read more »
ddugger
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ddugger
August 14, 2013 4:50 pm
Just a caution to dismissing early or even established – especially in nutrition where the science seems to take a left turn from previous studies very frequently. You might have noted that like the conflicting resveratrol study sited in the article above – there was also a recent similar study questioning the benefits of omega-3 supplements. It even suggested omega-3 supplements might increase risks to aggressive forms of prostate cancer. It too, was to based on extremely small populations and a questionable experimental design. In recent years there have been many such “shocking” studies on Vit. E, D, C and… Read more »
Elliott
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Elliott
August 14, 2013 6:58 pm

While not an expert in nutrition, I have no bias against supplements other than the only large scale trials on specific vitamins that I am aware of have demonstrated either no value or harm. Please advise if I am incorrect.

Doug
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Doug
August 14, 2013 7:55 pm
How large is “large scale”? Here’s a double-blinded placebo-controlled study that attributed a 50% reduction in mortality to Coenzyme Q10: http://www.escardio.org/about/press/press-releases/pr-13/Pages/first-drug-in-decade-improves-heart-failure-mortality.aspx Here’s a meta-analysis that attributes a 7% reduction in mortality to vitamin D supplementation: http://www.ncbi.nlm.nih.gov/pubmed/17846391 Of course as is now famous, coffee drinking is reputed to be even better for you than vitamin D: http://www.nih.gov/news/health/may2012/nci-16.htm In the 21st century scientific research is a commercial enterprise, and consumers of scientific information need a finely tuned skepticism, as is pointed out in this classic essay: http://www.mantleplumes.org/WebDocuments/Charlton2008.pdf What to believe? That’s not easy to decide! “I have been asked to talk about… Read more »
Sam D
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Sam D
August 13, 2013 12:42 pm

I wonder where medicine will be in 100 years? Wow.

ddugger
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ddugger
August 13, 2013 12:53 pm
Michael, I’m always amazed when very competent people in one field publish their limited views on technical fields far from their base profession and expertise. Your article is a great example. While you may have had fun writing the article, the complexities of the topics – especially resveratrol that you attempt to discuss intelligently, are far beyond this article. The recent study you site as stumbling block for resveratrol research is a scientific/statistical joke. When have you seen any peer reviewed clinical pharmaceutical studies based on these small numbers of individuals. Did you even note that the resveratrol used in… Read more »
dheath
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dheath
August 13, 2013 2:44 pm

From a brief glance at the PDR, it appears that most drugs are approved with only about 800 to 1200 patients studied, hardly a good predictor of outcomes except in the most gross way (patients did not die, seemed better).

GALT
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GALT
August 13, 2013 3:45 pm
Your opening and closing comments are rather ironic which invites Heinlein’s observation that; “Specialization is for Insects.” and that you might want to exercise a little more due diligence before making and Ass of you and “umption”, because you seem to have confused your “gumshoes”, Stock being Travis, and Doc being Michael, whose qualifications are sufficient to give his comments consideration for the subject of this article. Your points are interesting and your questions valid and I am certain that Michael, the Doc Gumshoe will be prompted to respond to them in the appropriate manner and we will all benefit… Read more »
MEH
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MEH
August 13, 2013 3:48 pm

Excellent post ddugger! I appreciate the intelligent review of the information, lets hear from you often! meh

Patrick Allen
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Patrick Allen
August 13, 2013 8:39 pm

An interesting response; since you have written to us from such a clearly well-informed position, perhaps you could kindly refer us to the studies, or a suitable sample thereof, on resveratrol that substantiate your point, and let us further evaluate its merits.

ddugger
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ddugger
August 14, 2013 3:58 pm
I usually try Wikipedia first as a source of basic info./refs. and as it turns out they have a pretty good technical review of resveratrol mechanisms (http://en.wikipedia.org/wiki/Resveratrol#Mechanisms_of_action) and nearly 200 refs. on the subject. One of the few resveratrol supplement companies that have actually done any studies on the performance of their product and comparing it to other resveratrol supplements is Longevinex (not a recommendation – just how they differ) and they post their reports and studies on their website (http://www.longevinex.com/articles/). Clearly they have their own “for profit” agenda – just like all the pharmaceuticals you see advertised on your… Read more »
kraftidiot
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kraftidiot
August 13, 2013 1:02 pm

Issues dear to my heart.

hommie
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hommie
August 13, 2013 1:06 pm

Great article. I’ll drink to that,

Sharon Logue
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Sharon Logue
August 13, 2013 1:58 pm

I just downloaded Sagan’s Demon Haunted World, thanks for the reference. It’s been bothering me ever since Mayor Bloomberg (wannabe biochemist) said 16 oz Slurpees make us fat; no one knows where the missing honey bees are, and limpets carry magic molecules. I’m trying to connect the dots, and I’m missing something elemental here.

Merv Avants
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Merv Avants
August 13, 2013 2:32 pm

This is a worthwhile article. It is not necessary to be a Ph.D. or M.D. to review the scientific literature and draw (and share) conclusions, as you did. Good work.

patrul2
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patrul2
August 13, 2013 2:43 pm

As a dedicated wine drinker ( with meals only ) for almost 60 years, I can testify that I observe none of the rules suggested by the vegans and hysterical anti-cholesterol people and still enjoy rather good heart health, high HDL levels, etc. Now if someone suggests that wine drinking causes Waldenstrom’s macroglobulenimia, that will be a different story.

gillo
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gillo
August 13, 2013 2:45 pm

ddugger, thanks for bringing some rationality into this discussion–in particular regarding resveratrol. This is not the first instance in which Doc Gumshoe has misunderstood or misconstrued scientific information. I would have hoped for better from the Gumshoe empire.

maurice karnaugh
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maurice karnaugh
August 13, 2013 3:01 pm

As a scientist, I am always impressed when members of a non-scientific community write knowlegeably on arguably scientific topics (with appologies to any members of the investment community who may feel slighted). Now, I think I’ll have a drink. I’m slightly partial to fino on ice. Thanks, doc.

Robert Holland
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Robert Holland
August 13, 2013 3:11 pm
About GMO’s: This ain’t your fathers Monks changing genes! The problem with GMO’s is created by the MIX OF SPECIES. Instead of exchanging genes within the plant kingdom, gene expression in GMO’s is accomplished mixing Virus gene with Plant kingdom genes. A virus vector was used to change corn into disease resistant corn that will produce a chemical that wards off natural predators of corn. Trouble is: this gene got into the corn via a viral vector, and our guts have viruses also. The genetic information of the plant kingdom genes will not effect our viral gut genes, but the… Read more »
Dave Shortt
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Dave Shortt
August 13, 2013 4:04 pm
Hi Travis, I love these articles, and they demonstrate why your a great analyst, and in my opinion your research no matter the discipline, be it health or finance or general welfare is always of excellent value. You would put many health magazine journals to shame. Then again perhaps your audience here unlike the casual Mens Health reader is more intuitive, and stimulated by hard analysis. Which may be of less interest to the casual MH reader. I too have heavily researched the myriad scientific contradictions of resveratol. It is a very tricky subject, and i wonder if it is… Read more »
Robert Holland
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Robert Holland
August 13, 2013 4:15 pm
Upgate to GMO commentary: These Alternative Medicine MD’d have written that our gut genes can easily assimilate the viral gentic material that was delivered to the corn via a viral vector, and that our gut genes are in fact then producing the chemical that produces corn resistance to predators of corn. I’m not sure if this is proven. If this chemical is remaining on the corn, it could still simply ‘pass through’ to the gut, still potentially causing asthma and other allergic reactions. If on the other hand, our gut genes have assimilated this gene, our gut flora could be… Read more »
leo
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leo
August 13, 2013 4:42 pm

Thanks debugger and Holland for jerking their chain. Those are the kind of “experts” that hinder progress on all fronts. At least Travis’s fun is open ended and shows requisite humility to be taken as offered, not arrogant closed minded “expertise”.

Ventureshadow
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Ventureshadow
August 13, 2013 5:22 pm

While we learn about the false warning concerning Angiotension Receptor Blockers (ARBs), let’s note the newly discovered adverse reaction termed Benicar Bowels, named after one of the ARBs. Apparently the ARBs sometimes induce a bowel syndrome with the same signs and symptoms as celiac sprue. Moreover, the apparent incidence of celiac sprue seems to be rising enormously. BEWARE BENICAR and the other ARBs.

Bob Desrochers
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Bob Desrochers
August 13, 2013 5:51 pm

I’m just wondering what ddugger’s educational background is, which allows him to so eloquently debunk Doc Gumshoe’s resveritrol article. Is he by chance associated with Dr Sinatra?

Eric
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Eric
August 13, 2013 7:30 pm
Small amounts alchol seems to impart some benefits. the amount quoted as 2 drinks as maximum benefit from a cardiovascular standpoint only refers to males. For females it is one drink per day at most. the risk of Breast cancer is significantly higher in women and this starts clearly by two drinks per day and earlier if alcohol intake is dailyin. Liver cirrhosis afflicts american indians at highe rates even with as little as one drink per day. Far better for americans to reduce their obesity ,diabetes,hypertension and cardiovascular disease all by restricting their meat and dairy fat and oil… Read more »
ddugger
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ddugger
August 14, 2013 4:16 pm

You can find me on the web. Any eloquence was purely accidental. I’ve worked in biotechnology development and animal nutrition research for much of the past 40 years – and still do. I don’t know Dr. Sinatra. I don’t even have any of Frank’s recordings.

Doug
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Doug
August 13, 2013 9:32 pm
When I subscirbed I thought Stock Gumshoe was a superior financial blog. Little did I know I was signing up for Quackwatch Jr! Resveratrol prevents a fatal circulatory illness in rats: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730375/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2745434/ Does it also work in humans with the same dreadful affliction? The evidence isn’t in yet, but considering the lack of other effective treatments, I think it is worth trying. In general, it seems that there is a lot of good evidence that resveratrol may be a very beneficial substance, although there is still genuine doubt about whether human clinical studies will match the spectacular results in… Read more »
ddugger
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ddugger
August 14, 2013 4:52 pm

Doug, Very well said.

Travis Johnson, Stock Gumshoe
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4825
August 13, 2013 9:48 pm
I do think of this search for specificity as particularly American — it’s not just that we find a bit of wine to be good for you and too much to be bad and socially embarrassing, it’s that we must know exactly how much is good and what the specific line on the bottle should be at the end of the evening… and better yet, we’d rather know exactly which compound in the wine it is that’s healthful, and how much of it, and how can we get that exact amount most efficiently. Not that this search for knowledge is… Read more »
Jason A.
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0
Jason A.
August 14, 2013 12:10 pm

Trav, what are your feelings on another ballyhooed supplement…Astaxanthin ?

packrateric
Member
2
August 13, 2013 10:12 pm
One more comment on the J curve for benefit versus harm…that pont is at one drink not two in the summation of studies . As Per Uptodate: “A meta-analysis of the association between alcohol and nonfatal myocardial infarction found no additional benefit above 0.5 portion daily [17]. A meta-analysis of data from 29 cohort studies found that the lowest mortality was associated with consumption of 5 to 7 grams of alcohol per day (about one drink every other day) [18]. A more recent meta-analysis of 34 studies, using the same methodology as the analysis above [18] but including 10 subsequently… Read more »
Mike Bernier
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0
Mike Bernier
August 13, 2013 11:25 pm

Shoddy research, on your part and the rat analysis as well. You could not be more wrong. Good Luck.

Jack Croes
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Jack Croes
August 13, 2013 11:49 pm

How many angels can dance on the head of a pin? The doctors and your critics who have commented on your medical article seem to be dancing around the truth. Very small differences mean too much to them. I think your article was instructive and interesting. Here and there you might have been a teensy wrong but you were slso right on many. If you come across any other medical news you want to express, I will be right here to read it.

Jim Tutsock
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Jim Tutsock
August 14, 2013 12:47 am
I spend over 150 dollars a month on supplements including resveratrol and have taken them for a very long time. I am in better shape than my brother or sister who take very little or none. I cannot say with any conviction that I know any of the 10 to 15 separate items I take has actually demonstrated an actual effect except for Probiotics which are now all the craze. I started 17 years ago and I can tell you most of what you see on TV is low quality and their money is in the advertising and not the… Read more »
John Harris
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0
John Harris
August 14, 2013 11:40 am
Renaming prostate cancer is hardly something to cry shame over. From what I read most of the cases labeled as prostate cancer will grow so slowly that something else will kill that man long before the prostate cancer does. Indeed most men who die of other causes late in life, who for whatever reason get autopsies, are found to have prostate cancer that was never diagnosed and did not kill them. That is the slow variety that should indeed be renamed. It is benign but still gets called cancer and subsequent rush to treatment causes untold unnecessary treatments and suffering,… Read more »
Roger
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Roger
August 14, 2013 1:14 pm

I remember a discussion regarding prostate inspections, and the equally uncomfortable acts directed at women, cervical if I remember. The proposal was that these invasions mainly result in needless further medical procedures and charges, and have the unwanted consequence of driving many people away from medical exams of any kind, resulting in death from some other agent. As usual, Europe does things differently and the effect is beneficial.

Mike L
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Mike L
August 14, 2013 3:32 pm

I agree, Resveratrol is not necessarily the magic ingredient in wine.
Small amounts of ethanol may be. You probably don’t even have to drink the wine, just gargle with it. (Or brush your teeth once in a awhile. That’s even cheaper! )

Untreated gum disease has been known since the 1700’s to promote death from cardiovascular disease. Infections (the chronic inflammation) might be controlled with the ethanol you get with wine (the same antibacterial in Lysterine)

This may explain why even moderate (daily) wine drinking confers the benefit.

Frank
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Frank
August 14, 2013 7:46 pm
As a non-scientific person with limited medical education, I really do appreciate the comments after the Doc Gumshoe articles, both for and against, appea. And thanks to Robert Holland for his comments. What I don’t appreciate though, is the ad hominem content combined with personal attacks. They seem to come from readers, considering the vocabulary and facts and citations used, who are highly educated and knowledgeable, and have no need for it. Ad hominem comments always seem to come from those who are assuaging feelings of inner anger and personal deficiencies, and are usually aimed at covering up lack of… Read more »
GALT
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GALT
August 15, 2013 7:54 am
Well, Frank, you will find a few more fallacies than the ad hominem here, the most prominent one being the argument from authority by people who actually have “no idea” whom they are attempting to criticize……..confusing their “gumshoes”, with Doc being Michael, who is fairly new here, and unfortunately for this article did NOT include his credentials, which might have been useful, and given the critics pause, had they actually been paying attention. Hopefully, Doc will correct this in future offerings. Still, if you are really interested in determining the “cause” for the condition you cite, several recent works may… Read more »
packrateric
Member
2
August 14, 2013 8:00 pm

A 41 percent increase in the risk of breast cancer
Occurs in women who consume 2 to 5 drinks per day .

This is not a “very small difference ” nor” is it dancing around the truth”

It is fair warning that 2 drinks per day is not safe or healthy for half the population ( women). Reference is Uptodate.

At these levels of risk if alcohol were to be judged by the FDA drug standards it would not have a prayer.

John Harris
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0
John Harris
August 16, 2013 10:42 am

So give us that “up to date” reference, Moderate daily use is defined over and over in the literature as only 1-2 drinks for women (some say only 1, but I also see 1-2 in many of the studies still providing health benefits not harm). But if you go to 5 drinks a day that curve starts going back up into harm. Still 41% increase in breast cancer for 2 drinks a day??? – I would like to see the documentation for that wild claim.

Ethan
Guest
0
August 14, 2013 8:10 pm

Thanks Doc Gumshoe for exercising your grey blob.

The piece about over-diagnosing and over treatment was the most interesting to me.

Ethan

Abelhorn
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Abelhorn
August 15, 2013 9:51 am

I would suggest you do an updated study on Resveratrol, as there is much new information from many sources, in other words before you rant please know
what your talking about, (Wikipedia then to the companies) are you kidding me?

Nuttsman, PhD
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Nuttsman, PhD
August 15, 2013 11:22 pm
The real paradox in the French Paradox is that only red wine confers the benefit. So, although it is probably not resveratrol that confers the benefit it stands to reason that in fact the colored compounds found in red wine have a protective effect on the heart and arteries. Hence, your statement: “So it’s not the red stuff in the wine, it’s the ethanol that confers those benefits. ” is probably false. White wine has just as much alcohol as red wine, yet confers no specific protection. Studies point to the antioxidant potency of the anthocyanins and procyanins (both colored… Read more »
John Harris
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0
John Harris
August 16, 2013 10:37 am
With all due respect to Nuttsman (with their PhD), numerous studies have shown that it is principally the ethanol that confers cardio-protection as well as protection from a host of other diseases including some cancers, indeed all cause mortality. Just Google health benefits of alcohol and you will get dozens of references in peer reviewed literature supporting the health benefits of moderate daily use of alcohol. While it may be true that there are some minor additional health benefits found in red wine (and red grape juice) those benefits are minimal compared to the surprisingly dramatic and statistically very significant… Read more »
yobee
Irregular
0
yobee
August 16, 2013 2:50 pm
An alternative explanation of the French Paradox is that the French eat lots of Vitamin K2 rich foods that we have been told for half a century to avoid, such as egg yolks, cream, cheeses and lamb and other fatty meats. Vitamin K2 activates two proteins, one of which removes calcium from arteries and other soft tissues, and the other which deposits the calcium in bone, where it should be. See “Vitamin K2 and the Calcium Paradox” by Kate Rheaume-Bleue for an interesting review of this fairly new science. Personally, K2 supplements reversed my angina in about three weeks.
Gerald
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Gerald
August 17, 2013 5:57 pm
It’s “educational” to see that 95% approx of all comments are about booze…. My comment will likely be lost in the shuffle, but I couldn’t find a “reply” on top of the Gumshoe newsletter, which might have had a chance of being read. Simply the ridicule of the doctor who pointed out that there was about a 24% increased risk with using ARB was very unmerited. the figures in the study showed that the incidence increased from .7% to .9%. That is simply an increase of .2% on a figure of .7% which to me is a more than 25%… Read more »
Jennifer Estes
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Jennifer Estes
September 14, 2013 10:05 am
It seems you have hit a nerve but I applaud you effort to keep us thinking and reading. . Years ago I asked my doctor about resveratrol after seeing it on TV as the supplement to keep young. His comment was, it make not keep you young but there didn’t seem to be a down side, so I began taking it and I will continue. I would love to see what you would find in joint treatment with PRP or Prolotherapy, both which I have had for my back and knees. In both situations I avoided surgery and in the… Read more »
Doug
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0
Doug
September 14, 2013 6:45 pm

You are doubtless unaware of the latest research that for females of all ages the higher your cholesterol the lower your mortality risk.
http://www.naturalnews.com/033975_high_cholesterol_heart_attacks.html
http://www.ncbi.nlm.nih.gov/pubmed/21951982
So except in unusual cases there’s no point in trying to lower your cholesterol. If I remember the research correctly, a cholesterol above 271 means a 28% reduction in mortality risk.
Also, my own personal experience is that lowering cholesterol by a natural substance (polycosanol) generated the same side muscular weakness effects a from statin drugs.
Best of luck!

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