[ed note: We feature the musings of our favorite health and medicine writer, Michael Jorrin, a couple times a month, and we’ve taken the liberty of calling him “Doc Gumshoe” (he’s not a doctor). You’ll find no stock picks in his pieces, but hopefully will get plenty of insight into the medical matters he explains so well. Michael’s words and opinions are his own, and they always spur plenty of discussion. Enjoy!]
We’ll start off with some stocking stuffers and work up to a couple of major items. But don’t be surprised if there are a few lumps of coal along the way!
A few of these are not quite new, but I think they bear repeating:
Dark Chocolate May Lower Blood Pressure
You have probably already heard that dark chocolate is “good for you,” but here are some data to back it up. This comes from a small but well-conducted study, in Italy, naturally. Subjects, 20 in all, had untreated hypertension at least greater than 140/90 mm Hg. They had either 3.5 ounces of dark or while chocolate per day, every day for a week. Then they were off chocolate altogether for another week, and finally they switched to the other kind of chocolate for a third week – the people who had been taking dark chocolate switched to white, and vice-versa. The dark chocolate lowered systolic blood pressure by 12 mm Hg and diastolic blood pressure by 8.5 mm Hg. And dark chocolate also improved insulin sensitivity and lowered LDL cholesterol. White chocolate didn’t do a thing. The difference was attributed to the high level of flavonoids in dark chocolate; these are absent in white chocolate and nearly absent in milk chocolate.
Coffee May Protect Against Diabetes
Lots of studies have confirmed this, including a huge meta-analysis from the Harvard School of Public Health. The most persuasive was a trial in 910 adults with impaired glucose tolerance, which is a stage leading to definite type 2 diabetes. The study reported that both past and present drinkers of coffee with caffeine had about a 60% reduction in diabetes risk, compared with coffee teetotalers. There weren’t enough decaf drinkers in the study to come to any conclusions, but caffeine by itself doesn’t seem to be the answer. Is there something else in the coffee? Or are the coffee teetotalers doing something else to increase their risk of diabetes, such as knocking back a sugary soft drink? As we go through this “mostly glad tidings” piece, the question of what people do instead comes up again and again, as you’ll see. In fact, here’s one …
Diet Soda Is Associated with Higher Risk of Stroke?
There was a presentation at a meeting of the American Stroke Association with a highly counter-intuitive finding: that consumption of diet soda was associated with a markedly higher risk of stroke. Diet soda increases stroke risk? What next?
This was based on the ongoing Northern Manhattan Study (Columbia University, Division of Stroke and Critical Care), in which 2,564 subjects were categorized into seven cohorts based on soda consumption, ranging from no soda at all (meaning less than one soda per month), regular soda, cohorts consuming various combinations of regular and diet soda, and the cohort of daily diet soda drinkers. Subjects were followed for 9.3 years, during which 559 cerebrovascular events – i.e., either strokes or transient ischemic events (TIAs) – were recorded. After compensating for age, sex, race, and “lifestyle,” diet soda drinkers had a 61% higher risk of stroke than those who drank no diet soda. Adjusting for previous heart disease, peripheral vascular disease, and metabolic syndrome lowered this difference, but it was still 48% higher in subjects who drank diet soda than in those who drank no diet soda.
The study authors did not suggest that they had any basis for believing that the artificial sweeteners themselves contributed to stroke risk. The senior author, Ralph Sacco (president of the American Heart Association), theorized that some people might wash down a high-fat meal with a diet drink, or that they ease their guilt about eating a sweet dessert by drinking diet soda. Others have commented that, while diet soda may taste sweet, it does not provide a sense of satiety, leading users to seek other means of satisfying their cravings.
Another puzzling finding from the ASA meetings was that the incidence of stroke is rising alarmingly in a most unlikely population: young males, aged 15 to 34, in whom stroke incidence increased by 51% from 1994 to 2005. Stroke incidence also increased in young women, but only by about 17%. During the same period, stroke incidence actually decreased in older people – in whites over age 65, and in blacks over age 85.
I wonder if those two findings – that both diet soda drinkers and young males are at a higher risk of stroke – could be linked. Both could point to dietary choices that are the real culprits. Is diet soda a marker for an overall preference for junk food? No doubt explanatory theories will soon emerge.
Breast Cancer Survival Improves!
This is an unquestionably glad tiding. The Journal of Clinical Oncology published a study reporting that breast cancer survival in women aged from 20 – 49 has improved dramatically, at the rate of 2.4% per year. The smallest improvement was in women aged 75 and older – 1.1% per year. This was attributed in large part to a big difference in the rate of screening mammograms – 80% to 90% in women under 65, compared to only 50% in women over 75. This despite the recommendation by the US Preventive Services Task Force that women below the age of 50 do not need mammograms. To the USPSTF I say, here’s mud in your eye!
Saturated Fat May Not Be Quite as Evil as It’s Made Out to Be!
How much harm does saturated fat in our diet actually do? A huge meta-analysis of prospective epidemiological studies concluded that evidence for increased cardiovascular risk due to dietary saturated fat is exceedingly weak. The study analyzed 21 studies with 347,747 subjects, who were followed for 5 to 23 years. The risk for total coronary heart disease, fatal CHD events, or stroke was assessed for subjects consuming the highest versus the lowest amounts of dietary saturated fat. And the results were that for all CHD, subjects that consumed the most saturated fat had a 7% higher risk than those who consumed the least saturated fat. The hazard ratio was 1.07, but the 95% confidence interval was 0.96 to 1.19, meaning that there was a statistical chance that the risk could be anywhere between 4% lower to 19% higher. For stroke, the hazard ratio was 0.81 – or about 19% lower for subjects consuming the highest versus lowest amounts of saturated fat. The overall hazard ratio for all heart disease and stroke combined was 1.00 on the nose, suggesting that saturated fat consumption – in these studies, at any rate – made no difference at all.
The question not asked by that study is, what do people eat instead of saturated fat? And does that make any difference? A group of Danish scientists tried to answer that question. They found that substituting polyunsaturated fat (as in olive oil) for saturated fat does (slightly) reduce cardiovascular risk, but substituting mono-unsaturated fat has no benefit, and substituting transfats, as in margarine, is definitely worse. The big surprise is that substituting carbohydrates for the saturated fats in our diets is not beneficial, and may actually be harmful, particularly if the carbs are refined or have a high glycemic index (think high-fructose corn syrup). Possible consequences are thought to be mixed dyslipidemia (i.e., higher triglycerides and lower HDL-cholesterol), obesity, insulin resistance, and diabetes.
Do NSAIDs Increase Cardiovascular Risk or Not?
Considering that most of us take an NSAID from time to time, it would be nice to know whether they do or do not increase cardiovascular risk. We know that aspirin (a selective cox-1 inhibitor), tends to reduce the risk of stroke, and also probably the risk of heart attacks, because of its activity in reducing the tendency of blood to form clots. And we remember the bad news about increased CV risk with Vioxx (rofecoxib), a selective cox-2 inhibitor. But there has also been news trickling out over the past several years that the non-selective cox inhibitors, i.e., all the other NSAIDs, might also increase CV risk. So where are we?
Now, along comes a really huge study, conducted in Denmark, and based on the entire Danish population greater than 10 years of age – about 4.6 million. They found that more than half of these, about 2.7 million, had had at least one NSAID prescription in the past 8 years, and they weeded this population down to a little over a million, excluding individuals with established cardiovascular disease and other confounding comorbidities . What they found was that the ones who had taken either diclofenac (Voltaren) or rofecoxib (Vioxx) had a higher risk of cardiovascular death – nearly double for Voltaren and about 1.6 times higher for Vioxx – than individuals who had never taken an NSAID. These adverse events, by the way, were highly dose-related. On the other hand, the risk of CV events with ibuprofen (i.e., Advil, Motrin, etc.) was just a bit higher, and with naproxen (Naprosyn) it was actually lower.
How useful is this information, really? My guess is, not much. For one thing, Voltaren and Vioxx (for sure, Vioxx!) are not the drugs we take when our knees are aching. However, the crucial factor is; why were these individuals taking high doses of those drugs? Answer: because they were in pretty severe pain. You’re thinking, “well, that’s obvious.” But one of the adverse health consequences of musculoskeletal conditions like osteoarthritis is that it tends to limit patients’ capacity for exercise or even normal activity, which contributes significantly to cardiovascular risk. So maybe those Danes were more affected by their lack of exercise than by NSAIDs.
Will we ever know for sure? For now anyway, when I have aches and pains, I’ll reach for an NSAID.
Being A Bit Overweight Is Not So Terrible
Unless you want to be a fashion model, it might be that being overweight (i.e., BMI > 25 to 30) is not always and without exception a Bad Thing. The old familiar Goldilocks principle applies there as well. In a study in more than 9,000 patients aged 70 to 75, the lowest death rates for cardiovascular disease, cancer, and COPD, were in individuals with a BMI of about 27.5, which precisely in the middle of the “overweight” classification. Overall, the death rates in “overweight” subjects were about 13% lower than in those with “normal” BMIs. The highest risks were in underweight subjects of both sexes, and normal weight persons had approximately the same all-cause mortality hazard ratios as those who were over the “obese” marker – BMI greater than 30.0.
This certainly doesn’t mean that we should stuff ourselves with gigantic quantities of roast goose and flaming puddings over the holidays. And we should take note that the population in which that study was conducted was somewhat elderly, and sometimes underweight oldsters are a bit frail and don’t have much resistance when they get sick. But it does tell us that we should look at those vaunted BMI numbers with a skeptical eye.
Staying Alive
In baseball, “staying alive” means prolonging your time at bat by fouling off pitch after pitch, in the hope that you’ll eventually get a pitch you can wallop.
In treating a disease, it can mean something else. I know of no better example than the recently reported case of a man with refractory advanced chronic lymphocytic leukemia (CLL). He was not a candidate for a bone marrow transplant and was totally out of options. He was one of three patients who enrolled in a highly experimental clinical trial using genetically-modified T-cells to attack the malignant B-cells that cause CLL.
This was not a “last chance” trial; remission was not even an endpoint. The objective was to establish a safe dose; assessment of benefit was a secondary endpoint. However, two of the three patients in this trial have experienced complete remission; no evidence of leukemic cells was found in their blood, bone marrow, or lymph nodes one year after treatment. The third patient had a dramatic but partial response; his disease is now considered stable.
One of the patients who is now in total remission was so sick prior to treatment that on many days he was considered to be so close to death that his family was called to his bedside for final goodbyes. This man is now fully healthy; he gardens, plays golf, and has gained 40 pounds since his treatment.
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The treatment process, however, was exceedingly complex. First, about a billion T-cells were harvested from his blood. These were modified by exposure to an inactivated HIV-1 virus. DNA from humans, mice, cows, and viruses were used to modify the HIV-1 virus, which was used as a vector to engineer the T-cells to attack the leukemic B-cells. The modified T-cells were re-infused, and they then multiplied by a 1000-fold, expanding to a population of one trillion. These T-cells attacked and eradicated the patient’s entire B-cell population, eliminating all traces of leukemia. Because B-cells are active in combating infection, these patients may be susceptible to some infections and require periodic infusions of IVIg.
The study authors note that this therapy may also be useful for non-Hodgkin’s lymphoma and other leukemias, and that T-cells may be able to be modified with other vector types to treat other malignancies: in other words, a highly important breakthrough with the potential to change cancer care.
Whether this form of treatment can be more widely used in CLL and other cancer patients who have reached the end of the road will depend on whether the process of modifying the T-cells can be carried out more efficiently and economically. This will require the participation of the pharmaceutical industry, which is good at getting things done efficiently and economically. Personally, I can’t think of anything more important than pursuing life-saving medical treatment strategies; our experience shows that as treatment options are developed and employed, costs do eventually come down.
A Possible Cure for Hepatitis C
The rate of new hepatitis C infections in the US has plummeted in the past 30 years, from about 200,000 new cases per year in the 1980s to a bit more than 15,000 cases per year in 2010. But the death rate from hep C is at least 15,000 per year, and it’s not expected to diminish any time soon, because of the huge backlog of people who have been living with the disease for the past decades. Transmission of hep C is primarily through shared needles, and presumably the drug-addicted have gotten wise to the danger, to some degree at least. Another route of transmission was tattoo parlors, and maybe those have also cleaned up their acts. And it can also be transmitted during sex.
In patients who develop symptoms from hep C infections, it is typically treated with interferon, with or without ribaravin, by injection, for as long as a year, and this treatment produces dire side effects, which affect most patients – fatigue, nausea, headache, depression.
However, new drugs appear to be coming along that will change treatment radically. The front-runner is sofosbuvir, from Gilead (GILD), which just won FDA approval on December 7th. Gilead also has another hep C agent, ledipasvir, which they plan to market in combination with sofosbubir so as to provide an oral treatment for the hep C subtype known as genotype 1, which accounts for about 70% of hep C infections. Other pharma outfits – AbbVie (ABBV), Merck (MRK), Bristol-Myers Squibb (BMY), and Johnson & Johnson (JNJ) – are also in the race to bring hep C drugs to market.
The Glad Tidings about these drugs is that – so far at least! – the cure rates are much higher, near 100%, than for interferon-based treatments, and the side effects profiles are much, much more benign.
The Lump of Coal in connection with these tidings is that the drugs will cost lots and lots of money – perhaps as much as $100,000 for a course of treatment. And since the hep C demographic is probably neither prosperous nor equipped with Cadillac insurance plans, this will likely be a problem – for all of us, except for those pharma outfits which stand to profit, and their stockholders (full disclosure, Doc Gumshoe is a Gilead stockholder!)
And another Lump of Coal …
A Hoped-For Cure for HIV Fails
The hope was that a bone-marrow transplant would be an effective cure for HIV infections – that is, a definitive cure, not just a treatment that would keep the virus in check. We don’t want to go into it in detail, but the current accepted standard of treatment for HIV is what’s termed HAART – highly active antiretroviral therapy – which consists of a combination of agents that attack the virus on several fronts. At its best, HAART works quite well, reducing the viral load in HIV patients to levels so low that they cannot be detected by usual laboratory tests. But that doesn’t mean that the virus has been totally eliminated. Nor does it mean that the virus cannot be transmitted from one person to another – it greatly reduces the risk, but it does not totally eliminate it. Therefore, many persons with HIV continue taking drugs after viral loads have dropped to undetectable levels, enduring the many adverse effects that this entails.
For that reason, the hope was that giving HIV patients a bone-marrow transplant would result in a total cure. The rationale is that the process replaces all of a patient’s bone marrow with donor bone-marrow, and that the new blood cells generated by the new bone-marrow would entirely replace all of the old blood cells which were infected with HIV. The patients in this experimental treatment were two men who had been on antiretroviral therapy for years, and whose viral load was undetectable. They continued on HAART while preparing for the bone-marrow transplant. The preparation for the transplant includes a regimen that weakens the existing bone-marrow, so that the new marrow can more easily replace it.
The precedent for this attempt was that a man with HIV who received a bone-marrow transplant 5 years ago has been virus free since then. However, in that case the donor had a rare mutation that made his blood cells highly resistant to HIV. The donors in this present attempt did not have this mutation; the experiment (if we can call it that) was to see whether new bone-marrow, and therefore new blood cells, could wipe out the HIV-infected blood cells and thus cure the disease.
For a few months after the transplant, the treatment seemed to be working. No virus was detectable, and the men stopped taking the antiretroviral drugs. But, unfortunately, the virus came back in both men. So they have gone back on drug therapy, and presumably will stay on it indefinitely.
It had not been proposed that bone-marrow transplantation would be the answer for the many millions of HIV-infected people in the world. But if the experiment had worked, it might have led to treatment modalities that could be more widely adopted. This failure is at least a major stumbling block in that quest.
Some People May Think These Are Goodies, To Others …
More sleep appears to lower coronary artery calcification. This may be good news or bad news, depending on how much sleep you ordinarily get. A study in about 500 adults aged 35 to 47, followed for five years, found that for every extra hour of sleep they got beyond the mean of 6.1 hours, the odds of coronary artery calcification were lowered by 34%, which is equivalent to a 16.5 mm Hg drop in systolic blood pressure.
And, finally, eating too much tofu may lead to cognitive deficits. This comes from a really long-term study in 3700 Japanese in Hawaii which found that those who ate tofu twice a week doubled their risk of developing cognitive deficits in old age. The theory is that some chemicals in soy may interfere with the brain’s ability to maintain nerve connections. That’s only a theory, of course. Doc Gumshoe’s theory is that dedicated tofu-gobblers are avoiding some activity, as yet unidentified, that is good for brain health. Or maybe it’s a special characteristic found only in Japanese who have taken residence in Hawaii. I’m happy to have an excuse to avoid tofu, but as for my loyal readers, I would bet that tofu once a year, as a special penance, is entirely harmless.
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Doc Gumshoe wishes all his readers – and indeed, all that vast population of non-readers – the best of the season and any other ensuing seasons. Do please keep the comments coming – I’ll do my best to respond before too much water flows under the bridge. A future topic I have in mind is how best to avoid migraines and how to manage them when they occur. And I’ve been reading a bit about the possible merits of deliberately employing placebos for some clinical treatments. I wiIl carefully consult with the spirit of Miss Charlotte Truesdell before launching on that one. Best to all, Michael Jorrin (aka Doc Gumshoe)
OK, here’s what I wanted to call this piece: “Drink More Coffee, Eat More Chocolate, Don’t worry if you Gain a few more pounds for the Holidays, and Sleep More. ” Obviously an exaggeration, but studies that point us in this direction always make me very, very happy. Thanks Doc!
OK, but let’s not forget that chocolate is only one ingredient in a chocolate bar. They also contain lots of sugar and butterfat and can also contain corn syrup, soy products, colouring, flavouring etc. etc.
It would seem that, to get the benefits of chocolate, one should limit intake to pure, unadulterated chocolate itself (which can be rather bitter and unpleasant) but at least is free of junk carbs and chemicals.
Seasons greetings to all from Canada.
Are you trying to depress me, Rusty? I’m trying to read between the lines and only see the good news for flabby gluttons like myself — it’s the holidays, after all!
Lest we forget that even “all natural” foods are full of chemicals. Enjoy the coffee, the chocolate bar, and embrace the “junk food” . How soon we forget how many people have died from starvation. — Happy Christmas to all who wish to be wished Happy Christmas!
Starvation! Really? When so many of here in North America are committing slow suicide with a knife and fork.
Ah well, let’s not dwell on such matters here at the height of the Festive Season. Eat, drink and make merry and leave the compensatory deprivations for next year.
It’s fascinating re;starvation. Annals of Internal Medicine last week ran three original studies (one a metanalysis of other studies) on the issue of whether multivitamin supplements help people. Clearly they do not, and studies showed this. An accompanying editorial said quite emphatically that it was time for the vitamin silliness to stop. The natural and alternative iatrophobic crowd has gone mightily berserk, calling it fraud and the evil doctor-pharma axis subversively at work.
Funny. We are among the very most overfed people on earth (not the most…..that distinction belongs to Nauru, which got hopelessly wealthy from its phosphate deposits. 95 per cent of Naurans are obese). Do we really think that MORE nutrition is going to be of benefit?
If it was not obvious before that medical doctors are untrained in nutrition and have a strong and unhealthy bias, these ridiculous comments should make it abundantly clear. Really, vitamins are silly? What is that, a defence of natural foods being stripped of the bulk of their vitamins through processing? Be brave, tell me that white bread is superior to whole grain because a few synthetic chemically synthesized vitamins have been added back to substitute for the naturally occurring ones stripped out, (about 80%) in the milling process, the major one being Vit. E that occurs in the germ. Oh I forgot, Vit. E. is unimportant and has no protective properties in respect to heart disease, totally contradictory to what was found in extensive studies by the Schutt Bros. way back when.
This has to be the height of ignorance in terms of health: “Do we really think that MORE nutrition is going to be of benefit?” Me thinks you are confusing CALORIES with nutrition.
OBESITY is actually a sign of MALNUTRITION, too many empty calories lacking essential vitamins and minerals, enzymes, phytonutrients, anti-oxidants, fibre and all things in natural unadulterated foods that build healthy cells and tissues, rather than being stored as fat. More, or should I say BETTER nutrition will not lead to obesity, I would like to know who paid for the “STUDY” in the annuals of Internal Medicine, debunking vitamins, some junk food manufacturer or a drug company? Lets get real, drugs may alleviate symptoms, even on occasion save lives in emergencies, but BUILD REAL GENUINE HEALTH, never in a million years, they are ultimately destructive and habit forming.
Doc Gumshoe:
Gilead is definitely not a buy here; in fact, I would probably be selling it. Every conceivable bit of good news (including today’s announcement of very high SVR rates for HCV genotypes 1-3 regardless of prior treatment status, presence of cirrhosis or use of ribavirin) have all been baked into the stock price. From here, it can only disappoint. The FDA will appove ledispasvir in Q!, and sofosubuvir/ledipasvir once daily for either 8 or 12 weeks will quickly become HCV standard of care. I have mixed feelings about Gilead. For them,it has never been enough to succeed; it is very important to them that others fail. They walked away from an agreement with BMS to co-market sofosubuvir with daclatasvir, BMS’s brilliant NS5a inhibitor. Part of their strategy has been to advance sofosbuvir/ledipasvir so as to prove there is no need for HCV proteinase inhibitor; this immediately lays waste to the billions spent on proteinase inhibitor development by Merck, Vertex, BMS, Janssen, and others. They want to succeed, but they aim to do so in a way that assures that others falter and lose money.
Thanks much for the article. I really appreciate that you avoid the “bad science” assumption of single-variable hypotheses (I call these “magic bullets”), and question whether or not other undefined significant variables may have an effect on findings.
Also, although you are not offering investment advice, could you please identify the entity that is conducting the chronic lymphocytic leukemia clinical trials?
yum yum. I’m off to gorge on dark chocolate and take a nap. then I will have a cup of very strong black coffee before returning to my desk. It’s what the Doc ordered.
Thanks, Doc! Looking forward to your piece on migraines. Hurry up, willya?
Dark chocolate helps migraines! (anecdotally anyway)
If you read the ingredients in the chocolate you buy,you can eliminate the bad kind..Stay away from Choc. that is processed with Alkali and buy 60% or better dark chocolateand go easy on it..:-))
Hi John,
I read a book recently that recommended dark chocolate as having a beneficial effect on blood pressure. So I bought some Ghirardelli Intense Dark chocolate. It has 3 different types of pieces, a 60% cacao, a 72% cacao and a salted, more sweetened, almond chip piece. The serving size is 4 pieces (43g) yielding 14g of sugar and 15mg of sodium. It does not appear to be processed with Alkali.
After taking it almost daily for a few weeks, I noticed I was getting headaches so I discontinued it.
Dr. Gumshoe,
I really appreciate your articles and the comments they inspire (or provoke). Regarding your upcoming article on migraines, I would note that early retirement put a sudden and permanent end to my migraines. I always told my boss that work gave me a headache, and that turned out to be the case. I simply never had another mgraine in the eleven years since retirement, which removed virtually all stress from my life.
Yep, Last thing you want to be is laying in some hospital bed dying of nothing…..
Bottom Line , Eat , Drink and be Merry ! Why worry ? Nobody is leaving this world alive anyway!
I make , eat & sell my own pure organic chocolate with little bit of organic powdered sugar, organic cocoa powder & organic coca butter and NOTHING also, and I temper my chocolate on real marble.
It is healthy and it taste great.
comming from a family with a history of diabetes I will now drink more coffee. I plan on drinking more of the flavored coffees at starbucks. I hope they benefit as well as black coffee.
Coffee is the Worlds favourite drug. So what would you expect from me, you guessed it, I haven’t had a coffee in at least 50 years. Reasons: 1) After doing a comprehensive and encyclopedic study on caffeine and its negative effects that mirror nicotine and refined sugar, I decided it was something best avoided. 2) A healthy body does not need stimulants, in fact addiction to stimulants indicates an under nourished body crying out for some real nutritious food and I found plenty of evidence that support that thesis. Coffee, cigarettes and high sugar foods artificially boost the blood sugar level, which requires the body to secrete insulin to control the blood sugar level so it establishes a yo-yo effect, up-down until the adrenals are exhausted, so it is self defeating, leading eventually to diabetes. Unless people with addictions make radical changes in their diet to achieve what I call “super nutrition” they will have cravings that can only be met by one of the three, for example, attend AA meetings or observe ex smokers and where do they hang out, you guessed it, around the coffee pot. While various organizations do great work in helping people to break addictions to nicotine or alcohol, in realty, unless they approach it from a nutritional basis, all they really do is transfer the addiction to another substance that meets the cravings poor nutrition has caused. In other words if an alcoholic with the help of AA gets clean, if he is still a chain smoker, or a heavy coffee drinker, his/her addiction problem has not actually been resolved, it has just been transferred and still lurks in the background.
I love the smell of coffee brewing, but I hate the taste, much too bitter for me and that of course gets solved for most people by adding cream and or sugar, or even worse, artificial sweeteners. Truckers are famous for their coffee consumption, (for that matter junk food as well) and how many grossly overweight ones do you see? Lack of exercise is of course part of the problem because they spend so much time behind the wheel. I know because I spent 20 years as an expedite courier frequently putting in a full day of local work then having a night run for an urgent delivery once or twice a week putting in 16-17 hours of driving out of 24 and I found eating nutritious snacks like sunflower seeds and other nuts kept my blood sugar level steady, and I drank only water or pure fruit juices. Incidentally as Doc mentions, DIET Soda’s are no panacea, they are in fact WORSE than regular soft drinks which are bad enough, that I have never bought anything more than the occasional ginger ale to spice up a fruit punch. Coke or Pepsi would go broke if they had to depend on me.
Some good information in this column, for example, I whole heartedly agree with Doc’s observation, “Both could point to dietary choices that are the real culprits. Is diet soda a marker for an overall preference for junk food/” My rejoinder, absolutely.
Now I will confess that I was for many years 100% opposed to chocolate as well, but that was based more on the extremely high refined sugar content, and I still don’t think the average “chocolate coated candy bar is healthy” but the flavanoid content of genuine dark chocolate is winning me over and I enjoy it occasionally. Actually I enjoy dark chocolate flavoured almond milk quite regularly, as a substitute for pasteurized milk. Since I believe that every plant, (including many regarded as weeds) has a positive purpose and use, I am considering other possible ways of utilizing the equally flavinoid rich coffee berries, maybe roasting them and drinking the resulting brew is not the best application to get their positive qualities, so you see I am open minded and willing to take a second look at issues that are controversial.
If HIV viras was eliminated by bone marrow transplant from a donar with HIV resistand bone marrow, would that lead not be worth following up. Maybe it could be helped if every successfully treated candidate had to provide bone marrow for at least two other patients
Albert, that happens when the stem cell donor is CCR5-negative. CCR5 is a protein on the surface of T-lymphocytes that HIV uses as a portal of entry. CCR5-negative people are out there, but rare. There are in fact, other HIV-infected stem cell recipients who have been closely watched to see if the stem cell transplant phenomenon, with its graft versus host effects, might eradicate HIV. In those patients, the HIV does seem to be absent, undetectible for a few months, but always comes back.
A very cool company called CalImmune is using the CCR5 effect as a new therapy for HIV. They are treating HIV patients using silencing/inhibitory RNA (technology licensed from Benitec in Australia) to block CCR5 expression. Their early results are promising, and more will follow in the spring. Many are optimistic that this approach could provide a functional HIV cure.
People without CCR5 who get HIV are so-called elite controllers. After infection, they have virus present in blood for a few months, and then it goes away. They subsequently never have virus by PCR, and never get AIDS-defining illnesses. They never require ART. Interestingly, CCR5 negative people seem to be descended from people who survived bubonic plague in the middle ages. That defect somehow makes you impervious to plague.
RE Eating and still suffering, check your B 12 level…. and if you do take B 12, make sure it is not a combinant with Cyanide, which is very commonly used to combine with B 12. The Cyanide is POISON to the brain. Get the Methylo combinant. To your good health.
Travis, re Louis Basenese, teaser on Graphene ….what is his teaser ,,re the Graphene being mined and processed here in the US> ?
post a url for Louis Basenese and Graphene, I thought that was an old Oxford Club. Louis has been pushing CLIR since 12/10 which is an old portfolio holding from 2012
Myron: re: your 5:09 on 22 December: LOUDER, ducky, louder! I do love your posts! Do stop, won’t you? You are making me laugh so hard I just spewed toxic, chemical-laden Diet Coke out my nostrils. When you blog, I get the feeling that your whole world turns pink from the warm glow thinking in your arguments about “natural” benefits. Let’s see Myron…..rabies is natural, and so is ricin, brown recluse venom, radiation and anthrax, and so are snakes in the grass. There have always been people like you lurking. In Nietzsche’s day, there were naturists, and Nietzsche called them fools because nature is whimsical, unaccountable, brutal, amoral, and violent. “To live,” wrote Nietzsche, “is that not wanting to be anything other than natural?”
If you would read (or have someone read to you) the study in what you calls “annuals”(sic) of Internal Medicine, you would know those studies were federally funded. They are certainly not the first to show that vitamin supplements do nothing more than give you expensive urine. The vitamin/supplement crowd flourishes in the new anti-intellectual Dark Age now upon America, and as a result of that, people now spend dollar for dollar just as much on vitamins as they do on pharmaceuticals. This means those vitaminmonger companies that so warm you heart could amply and richly fund all the studies they want. Will we ever see that happen? Do not hold you breath Myron.
There are actually good studies that show that heavy vitamin takers die younger Myron, and there is a reason for it. Your body is not meant to be chock full of antioxidants because oxidation is a critically important activity in vivo for many reactions, including mitochondrial ATP production and especially including immune-mediated actions against pathogens and tumors. The vitamin takers die younger, Myron, and they are more likely to die of cancers because all those inane antioxidants hobble the immune system.
Where were you Myron when the SELECT trial was done? Vitamin E and selenium do NOT confer benefits. Vtamin E alone makes prostate cancer more likely, and selenium makes diabetes more likely. Obesity as vitamin deficiency? Myron you have been sleeping too long with “The Maker’s Diet” under your pillow. Herbalife shareholder are you? Shaklee salesman as a sideline?
And on the other hand, I sometimes think it’s great that so many Americans have become kooky about vitamins and supplements. It just keeps hepatologists like me in business:
http://www.nytimes.com/2013/12/22/us/spike-in-harm-to-liver-is-tied-to-dietary-aids.html?_r=0
So you are saying that if “kooky people” turned rational and turned to pharmaceuticals instead of vitamins and supplements to protect their health, it would be “BAD KARMA” for you, a delicious irony. Be careful what you wish for.
Merry Christmas, Myron. My hope is that in 2014, you will stick to commenting on things you may know something about, such as mines and mining companies and precious metals. I have MD and PhD degrees from one of the 10 best medical schools in the world. Author Steven Pinker has written that it takes 10,000 hours of devoted study to master a field. By that criterion, I have 10,000-hour “degrees” in chemistry, in medicine, in biochemistry, in molecular biology, in internal medicine, and in my subspecialty. I may be going out on a limb here, but I predict you have no such formal training in any area related to medicine or science. I doubt you have published peer-reviewed papers or conducted any randomized controlled clinical trials. I’m just saying…..
I think we can safely conclude that “following the money” is a safe course to determine who is being objective and who is supporting propaganda. The SWAMI (who is apparently afraid to disclose his real name)” says; “people now spend dollar for dollar just as much on vitamins as they do on pharmaceuticals” which must be galling to those in the highly profitable pharmaceutical business, look at the profits they are missing!
Anybody who thinks the FDA protects our health, I have a bridge I would like to sell you.
Having tried and failed to get control of regulation of the dietary supplement business I guess “ridicule” is now the strongest arrow in their quiver. Based on dollar expenditure it would seem that the “SWAMI” is suggesting half the population is deceived, the problem being he picked the wrong half. The fact is the organic movement in foods and supplements is now growing faster than conventional groceries. I guess the people are “voting with their dollars” so all the cut burn and poison gang are left with is sensational headlines to distort the facts. I read your “harm-to-the-liver-tied-to-dietary-aids posting which is inflammatory and highly misleading. First of all, anybody who is oriented to health through nutrition would not be using every concentrated panacea offered to lose weight, and certainly not steroids they would adopt a natural foods diet that would gradually and safely adjust their weight. 2) The article itself if read carefully shows that a greater problem than concentrated green tea is DRUGS: “Most of the liver injuries tracked by a network of medical officials are caused by prescription drugs used to treat things like cancer, diabetes and heart disease, he said.” but how many people reading the inflammatory headline will pick up on that and conclude this is a typical case of the “pot calling the kettle black” and seeking to deceive the ill-informed. SWAMI has the audacity to label informed people choosing nature over mad scientists concoctions in a lab as “Iatrophobic”, so what are you suggesting SWAMI, that the harm doctors can do should just be ignored, or swept under the rug, in a “out of sight out of mind” posture? I venture to state there are THOUSANDS of cases of harmful drug and vaccination effects swept under the rug for every ONE case of somebody being harmed by green tea, so much for being objective.
While not intending to make this personal, I don’t need a medical degree to determine that the mother shown in the wheel chair is NOT on a healthy diet, and therefore most likely the rest of the family. She would not be as obese as she obviously is, the point being that unfortunate people like that are being preyed on by the medical profession because instead of recognizing an unhealthy lifestyle and counselling them, the easiest and most profitable response is simply to write a prescription giving them a false sense of hope that some “magic pill” will right the wrong they are doing to their bodies by bad food choices that lack the nutrient density to build healthy cells and tissues.
This exchange between Swami Karma Swim (really?) and Marvin is right on time, and refreshingly less obscured by statistical cant than the ravings I expected to hear after the CBC account of the arrogant interpretation of the 3 vitamins-are-a-scam-and-can-even-kill-you studies (reported in the Annals, therefore doubtless the voice of the medical establishment or one of its hydra heads). What is obvious to everybody but our overpaid medical professionals is that we medipeons live here and experience their remedies alongside the effects of our vitamin/supplement intake, and are – with respect -in a lot better position to assess the impact of each on our wellbeing. Which is OUR goal in pursuing either route. That the “alternative”route is taken at our non-tax-subsidized expense, in a country where increasingly major proportions of our obese tax dollar is secure in the death grip of the medical profession, pretty much tells you who will win this credibility fight. The public disenchantment with doctors results from a thousand daily studies undertaken by volunteers in every Canadian neighborhood, when their visit to the doctor results in 5 minutes of callous dismissal with a lab test requisition, then a prescription of (you guessed it) an overkill antiobiotic that is much surer to make us sicker than to alleviate the first condition. Next comes a furtive risky a word-of-mouth remedy from a health food store or (gasp) a home-prepared version that works. All these self-serving conclusions of science are broadcast against a background of pharmaceutical ads approved by the FDA or Health Canada listing the many common human conditions that must be absent to try them, and the longer list of toxic results, including death. We have no right to the results of those tests that the lab performs – they belong to the doctor, who does not pay for them, barely reads them, is pretty darn good at burying or losing them, and not much good at interpreting them. Any wonder that we now go in to see our GP with a clear goal, arrived at by Internet research, of what we might need to be tested for to diagnose our symptoms. Something that the doc can’t handle anymore because they can only deal with one symptom per appointment, never put it together, and don’t believe anything they read on the Internet – IF they in fact read the Internet. And the new campaign of government, at least in BC, is ‘EVERYONE needs to have a Family Doctor because that person can interpret and treat them in the context of their lives and previous conditions.’ Who the hell WRITES that stuff, and where do they live? Family physicians where I live do NOTHING that resembles medical treatment; when I had a suspected ITU, diagnosed by the Nurses’ Line, my clinic with 6 doctors IN just didn’t have time to get someone to write a lab requisition for a urine test, and proposed I go to ER. (after which visit they could safely prescribe treatment for pneumonia). My Health Store personnel, at under $20 per hour, knows a lot more about remedies that cure than my GP who drops in to the office now and then between maternity leaves. Get real, folks, medical diagnosis and treatment has become popularized, given the current alternative, and is not going back on the orders of those asleep at the switch on their “symptom,” not ‘patient’ centered healthcare.
I don’t think you are a ‘klutz” at all, you have a well reasoned and logical response to those who think you should bow to their supposedly superior wisdom when the motivation is really $$$. Amazing how a high income, way above average can so easily distort logic and common sense. Animals just by instinct are smarter than humans, what do they do when they don’t feel well? Ever heard of the term “off their feed” a common expression among any experienced farmer? Animals STOP EATING to give their body an opportunity to cleanse itself while humans think they need to keep stuffing their face to keep up their strength. IMPOSSIBLE, when the digestive system is overloaded no amount of food will maintain your strength. A person can go without food for around 30 days, but only about 3 days without water before running into trouble. A 3 day fast on pure water will do wonders for virtually any symptoms your body may be manifesting, it dosen’t take exhaustive tests to give your symptoms a “NAME” before it can be treated with some unnatural drug that suppresses the symptoms and interferes with normal bodily processes. For those who have no experience with fasting let me assure you that you will not become ravenously hungry, rather after the first 3 days you are likely to feel so much better you will want to keep on fasting. In fact you are not truly fasting until after the 3rd day, it simply takes the body that long to adjust to a fasting mode and decide it is time to “clean house” which it does very efficiently when given the opportunity. True hunger disappears after the 3rd day, but you may have an empty feeling not to be confused with true hunger which will not return until the body has rid itself of its toxic material.
I have no way of knowing how many people reading this have ever fasted personally or have studied into it, so I may be subjecting myself to a lot of ridicule, but let me assure you that just because someone has spent 10,000 hours in study of medical specialties like bio-chemistry, molecular biology, science, internal medicine and calling themselves a doctor does not make them an authority on health, or fasting if they have never experienced it personally. I will readily admit that “SWAMI” knows more about DISEASE than I do, and maybe thats the problem since they rarely if ever see any truly healthful people, all they deal with is dis-ease without ever acknowledging most of it is lifestyle induced.
In terms of HEALTH, given my library of books by doctors who have an open mind and ONLY use drugs as a last resort or in emergencies, many of them with medical degrees. my adult lifetime (60 years) of study into natural healing methods I have easily put in my “10,000 hours” I simply did not choose it as a profession. By his disdainful dismal of all “alternative medicine” he (or she) since no real name is disclosed, (just boasting about his Western medicine education) is unfairly dismissing Eastern medicine with thousands of years of history as invalid (Chinese herbal, Indian Aurvyedic, probably misspelled) to name only 2 out of dozens of disciplines worthy of consideration. This is like going to a Chevrolet dealer for an objective opinion on a Ford, or a Catholic Priest for an objective opinion on the Protestant or Jewish faith. So Swami, I am “commenting on things I know something about” based on practical experience and reading what experts in different disciplines have to say. I have posted 2 must see videos for the open minded to evaluate, maybe neither will convince some people, but at least the information is available.
I just recently saw some statistics that over 60 years and billions of dollars in research money, very little progress has been made by the medical profession in stemming the tide of cancer and heart disease deaths, yet the late Joanna Brandt’s book, “The Grape Cure” documents hundreds of cases of cancer patients being cured after failure of the “cut, burn and poison” approach, imagine the cure rate if caught early BEFORE the medical crew was let loose to destroy the bodies natural immune system with their nostrums. I personally knew the doctor that was instrumental in implementing the original chemotherapy treat-ments and he late in his life turned to nutritional approaches.
What the medical doctors won’t tell you or more likely don’t even realize is that the majority of all their treatments have never been held up to the scrutiny of double blinded controlled trials – what they call the gold standard – that of course is missing for most vitamin and supplement therapies as well. For many drugs the trials were done with a specific age group but never done with older or younger groups yet that drug gets used with the other age groups anyway. Or they are done on groups that don’t represent everyone, like those with comorbid conditions. I don’t actually know but don’t believe Ritalin has ever been tested (double-blind randomized placebo controlled trials) with elementary age children but it sure gets used a lot on them. The term “off-label use” which is widespread actually means it has not been tested and approved for such use. And certainly most all surgery has never been double blind tested because it is just not ethical to do so – they rarely just cut you open, do nothing, and sew you back up. That is just rarely done.. The medical world works as much with what works historically and anecdotally as with what they know by gold standard testing. But they rarely admit all that and call the kettle black on any supplements that seem to work well but have no gold standard proof of efficacy. I know I take a prostate supplement daily (saw palmetto and other odds and ends) that literally keeps me going (if I stop the stream slows way down). I also find I can beat back most colds with 4 or 5 grams of vit. C and a few grams of D daily for a few days. And I have read the intravenous Vit C works wonders against bugs of all sorts, virus and bacteria. If I had a antibiotic resistant staff infection at the hospital I would not wait for double blinded trials, I would ask for intravenous Vit C therapy. But good luck finding an MD that will do it. I have recurring low grade cancer (lymphoma) that gets treated with chemo about every 4-5 years. I asked my oncologist to prescribe low dose naltrexone – an off label use of a drug that has some evidence of preventing recurrence of such low grade B-cell cancers. The low dose is virtually harmless but my oncologist refuses because there is no gold standard double blinded tests yet. Well he is blinded by the gold test and it is all to common with the medical doctors. Try to get hyperbaric oxygen after a stroke which could prevent just about all the damage strokes do, but doctors have not even heard of it let alone prescribe it. Fact is MD’s are trained to use FDA approved drugs, and surgeons are trained to use surgery. They use the tools they are trained in. Don’t expect them to know much about vitamins or alternative therapies. Don’t expect a surgeon to suggest chiropractic adjustments for your low back pain instead of surgery, but you would be nuts not to try the conservative measure first.
John: I am truly sorry to hear you have what sounds like an indolent B-cell lymphoma. I would strongly encourage you to be certain you have been tested for hepatitis C. Though you may lack obvious risk factors for it, believe me it is out there and is highly etiologic (it is more lymphotropic than hepatotropic) for B-cell lymphoproliferative disorders. In patients with such disorders, curing the HCV definitely augurs eradication of the cancer.
As regards pharmacotherapies, randomized controlled trials are, have always been, and will always be the method the FDA (and every other analogous organization) uses for approving drugs. It is the only methodology that makes any sense, as placebo effects are powerful, and RCT’s allow one to look for evidence of both non-placebo benefit and toxicity. I don’t believe one can indict surgery on the basis that RCT’s are done to evaluate it. Surgery is a brute force final option to be invoked when conservative strategies have failed. You do surgery when there really is nothing else reasonable left to do.
As regards naltrexone and B-cell disorders, that notion has been around for a long time. There is a difference between absence of evidence and evidence of absence. Here it seems to be the latter, evidence of absence of benefit. I feel it may have a pseudo-placebo benefit in that it may boost brain endogenous opioid elaboration and thus confer some mild euphoria. But there is a complete and utter lack of a sound basis for how naltrexone might be even remotely beneficial. Moreover, it bears the taint of the pseudoscience crowd, who aggressively advocate it as beneficial, curative for HIV, psoriasis, sarcoidosis, Sjogren syndrome, and a dizzying array of cancers. No rational mechanism can be articulated in any such instant, and evidence is only anecdotal, and there confounded by confirmation bias (anecdotes that are not confirmatory are ignored). The plural of anecdote just isn’t data. This whole issue of whether there is a plausible mechanism for benefit is critical. The drug doxycycline got irresponsibly pushed forward by certain shady people, alleging that it had unusual benefits, such as protecting the brain in head trauma, and preventing the enlargement of aortic aneurysms. There was no plausible mechanism, and millions of dollars were spent to study it for these indications. It has no benefit at all. Nor should it.
All of these vitamin and supplement questions could easily be studied by their advocates, as that industry had $28 billion in revenue last year. Why do they never fund a study? Because such a study would in no way boost sales, as they are already selling to a segment of the population that chooses to ignore data and is hostile to RCTs and other formal tests. If Shaklee or Herbalife supported a trial, they stand only to lose, and they know this, so they do not.
I find it unfortunate that vitamin C mythology continues to swirl. It got this way because, frankly, Dr. Pauling was a nut. A smart guy, he felt, after winning a Nobel Prize, that he could do no intellectual wrong, lost his moorings, and spent the rest of his career shilling for vitamin C. His work on that does not stand up to scrutiny, and RCT’s of vitamin C show no benefit for psychiatric illness, infectious disease, cancer or vascular disease. It has been studied exhaustively. And there is NO reason it should help those things. It does one thing in vivo: it is a cofactor for collagen synthase. No reason that this should help a cold. It gives you expensive urine.
I do like the idea that you take vitamin D. Deficiency, a serum level of less than 30 ng/mL, is pandemic. It is a huge horizon now with dozens of RCT’s being done. By about two dozen molecular mechanisms, it turns on the immune system against bacteria, viruses and cancer. People with levels about 30 ng/mL basically get sick about half as often. Especially given the lymphoma, I would say: why take it now and again? Stay on it. It cannot hurt and probably will help.