Month: August 2010

New Heart Scan Results: Good News (lipid scores)

Seth Roberts6 Comments

My recent heart scan results were 50% lower (= better) than predicted. Apparently I am doing something right.
You might think that my lipid values would reflect that. Not quite. They were measured twice in the last two weeks, first with a Cholestech LDX machine (instant results); second, ordinary lab tests.
Here are the scores (first test, second test). Total Cholesterol: 210, 214, which is “borderline high” (borderline bad) according to the Cholestech LDX quick reference sheet. HDL = 17, 36, which is “low” (bad). TRG = 62, 75, which is “normal”. LDL = 180, 163, which is “high” (bad).

There is no hint in these numbers that I am doing the right thing! If anything, they imply the opposite, that I’m doing the wrong thing. This supports all those people, such as Uffe Ravnskov, who say the connection between cholesterol and heart disease is badly overstated.

In Tokyo — Wanna Meet?

Seth Roberts1 Comment

From Thursday Sept 2 through Sunday Sept 6 I will be in Tokyo. If you’d like to meet, let me know.

One Tokyo restaurant:

Please enjoy the dinner of the chef recommendation adhering to a “place of production”, “freshness”, a “season”, “health”, and “beauty” as a menu of a season.

Exactly. Words such as freshness, season, and so on in restaurant descriptions are indeed quotations but usually the quotation marks are missing.

New Heart Scan Results: Good News (raw data)

Seth Roberts3 Comments

Here are the details of my two heart scan scores, one recent, the other one and a half years ago.

February 2009:

August 2010:

To give some context, this group of patients given a whole bunch of treatments (“statin therapy, niacin, the American Heart Association Therapeutic Lifestyle Changes (TLC) diet, omega-3 fatty acids and vitamin D-3 supplementation”) meant to improve these scores managed, on average, about a 0% change in scores after 1-2 years of the treatments. Which is better than the usual 25%/year increase, but not as good as what happened to me.

New Heart Scan Results: Good News (explanation)

Seth Roberts3 Comments

My recent heart scan score was about 50% less than you’d expect from an earlier score. Why the improvement?

During the year between the two tests, I’d made one big change: eat much more animal fat. That’s the obvious explanation. Three things support it:

1. Mozaffarian et al., as I blogged, found a similar result.

2. The animal fat (pork fat and butter) had both produced large immediate improvements when I began to eat them. The pork fat had improved my sleep; the butter, my arithmetic scores. This sort of large immediate effect we associate with the supply of a missing necessary nutrient — giving Vitamin C to someone with scurvy, for example. My brain, at least, needed much more animal fat than I’d been eating. Different parts of the body need different nutrients, sure, but they all must work well with the same set of nutrients. If Nutrient X helps one part of the body, it is more likely to help another part.

3. My initial score put me at the 50th percentile for my age. I’d had an unusual diet for a long time. I stopped eating bread, potatoes, rice, pasta, and dessert 13 years ago. I’d started consuming lots of omega-3 and fermented foods a few years earlier. It was possible that those other changes produced improvement but if so it was a strange coincidence that, as my score got better and better over the years, I happened to measure it for the first time just when it crossed the 50th percentile.

This explanation makes a prediction: If you greatly increase your animal-fat intake, your heart scan score should improve. A commenter said what he’d read on paleo-diet forums supported this prediction: “If you hang out in the paleo/low carb forums, you see this kind of thing a lot.”

New Heart Scan Results: Good News (context)

Seth Roberts8 Comments

I posted yesterday that a recent heart scan found my arteries about 50% less calcified than a previous scan predicted. Apparently the improvement was due to eating much more animal fat (pork fat and butter).

In 2004, an American Journal of Clinical Nutrition article found something similar: heart disease progressed less in women who ate more saturated fat. “In postmenopausal women with relatively low total fat intake, a greater saturated fat intake is associated with less progression of coronary atherosclerosis,” the authors wrote. Here’s how they saw this finding:

The inverse association between saturated fat intake and atherosclerotic progression was unexpected. However, this finding should perhaps be less surprising. Ecologic and animal experimental studies showed positive relations between saturated fat intake and CHD risk (8). However, cohort studies and clinical trials in humans have been far less consistent (9 –12). Furthermore, most studies of dietary fat and CHD risk have been performed in men (15, 16). The relations in women—particularly postmenopausal women—are much less well-established, and evidence from dietary intervention trials suggests that diets low in saturated fat may have different effects on CHD risk factors in women (15, 17–22).

In their study, women with the highest intake of saturated fat did not get worse during the study period, whereas women with lower intakes did get worse.

An editorial about this study described some of the evidence that supports the “article of faith” that “saturated fat . . . accelerates coronary artery disease”:

One of the earliest and most convincing studies of the better efficacy of unsaturated than of saturated fat in reducing cholesterol and heart disease is the Finnish Mental Hospital Study conducted in the 12 y between 1959 and 1971. In this study, the usual high-saturated-fat institutional diet was compared with an equally high-fat diet in which the saturated fat in dairy products was replaced with soybean oil and soft margarine and polyunsaturated fats were used in cooking. Each diet was provided for 6 y and then the alternate diet was provided for the next 6 y. After a comparison of the effects of the 2 diets in both men and women, the incidence of coronary artery disease was lower by 50% and 65% after the consumption of polyunsaturated fat in the 2 hospitals.

My results make the results of that earlier study exceedingly puzzling. I found a large change in one direction; the Finnish study found a large effect in the opposite direction. Given the huge effect (50% or 65% reduction) observed in the Finnish study, it is hard to understand why “cohort studies and clinical trials in humans have been far less consistent”.

New Heart Scan Results: Good News

Seth Roberts18 Comments

One and a half years ago, in February 2009, I got a heart scan. It’s an X-ray measurement of how calcified your arteries are. Persons with high scores are much more likely to have a heart attack than persons with low scores. Scores in the hundreds are dangerous. Tim Russert, who died at age 58 of a heart attack, had a score of about 200 ten years before his death. Above age 40, the scores typically increase about 25% per year. That puts Russert’s score when he died at around 2000.

A few weeks ago I got another scan, at the same place with the same machine. Here are my scores. February 2009: 38 (about 50th percentile for my age). August 2010: 29 (between 25th & 50th percentile). In other words: 47% lower than expected. The earlier scan detected 3 “lesions”; the recent scan detected 2. The woman who runs the scanning center — HeartScan, in Walnut Creek, California — told me that decreases in this score are very rare. About 1 in 100, she said.

The only big lifestyle change I made between the two scans is to eat much more animal fat. After I found that pork fat improved my sleep, I started to eat a large serving of pork belly (with 80-100 g of fat) almost every day. Later I switched to 60 g of butter every day. The usual view, of course, is that to eat so much animal fat is v v bad and will “clog” my arteries. In fact, the reverse happened. Judging from this, the change was v v good.

Assorted Links

Seth Roberts2 Comments

Asthma and Probiotics

Seth Roberts15 Comments

In a long comment on an earlier post, JohnG tells how he failed and succeeded to get rid of disabling exercise-induced asthma. Lots of things didn’t work:

I tried Vitamin D; it didn’t work, but it did help my nasal allergies somewhat. I tried low carb dieting, and just like Dr. Lutz of “Life Without Bread†said, it made asthma worse while it practically cured my nasal allergies. I also tried the Dr. Sears approach of taking as much as 7.5g of EPA/DHA a day; no change at all in the exercise induced asthma.

The idea that asthma is due to lack of microbes made sense to him and he started trying fermented foods and probiotics. At first, nothing:

I re-reviewed the probiotic slant and found the Helminth story and all the trials that were going on in PubMed for them. With that logic in hand, I set about to find a probiotic that worked. I tried yogurt, kefir, fermented cabbage, and buttermilk to no avail. I then tried store bought probiotics one by one. I tried The Maker’s Diet probiotic and it didn’t help; but I do think it helped make a 20 year long wart go away. I also tried all forms of probiotics on the market; even LGG. Nothing.

Finally, success:

I bought this super high dose probiotic and took it along with a L. Sporogenes/bacillus coagulans. Voila, three days later I could really feel the difference during exercise. I continued that for 10 days. By the 10th day, I didn’t have to hit my inhaler at all during exercise. Wow!

First, I had to decide which probiotic did the trick. I didn’t want to spend a ton on that high dose probiotic, so I stuck with the Bacillus Coagulans and it continued working normally. So, I found my probiotic. Now, I needed to verify it wasn’t placebo. A close cousin to exercise induced asthma is the phenomenon of waking up sneezing and then promptly getting an asthma attack/or closure after that.

I went off my bacillus coagulans that I had been on for 14 days. By the second day, I noticed a little difference. By the third day, I had to hit my inhaler during the workout. By the 10th day (bacillus coagulans supposedly lives in your intestines 7 days), I was full-blown back to having to use 4 inhaler puffs and it wasn’t doing the trick. This was test phase one.

I then went back on the bacillus coagulans for 10 days. The same process repeated itself. The nightly asthma attacks abated after about 4 days and the same no-puff needed during exercise continued as well.

I then went back off the bacillus coagulans for 10 days. I got the asthma back at day 3.

I’ve now been back on 5 billion CFU’s of bacillus coagulans (duraflora) for 18 days. I don’t have to use my inhaler for exercise. I can feel the asthma come on very slightly and then go away.

Very impressive. Shows what can happen if (a) you think for yourself, (b) persist, and (c) have access to a lot of helpful information. I think he needed all three.

Web Alternative to Peer Review

Seth Roberts4 Comments

Mixing traditional and new methods, the journal [“the prestigious Shakespeare Quarterly”] posted online four essays not yet accepted for publication, and a core group of experts . . . were invited to post their signed comments on the Web site MediaCommons, a scholarly digital network. Others could add their thoughts as well, after registering with their own names. In the end 41 people made more than 350 comments, many of which elicited responses from the authors. The revised essays were then reviewed by the quarterly’s editors, who made the final decision to include them in the printed journal, due out Sept. 17.

The NY Times article never says how many of the four posted essays were published. If all of them made the cut, then perhaps the web stuff was just for show. And if any of them didn’t make the cut, the public embarrassment would be great. Perhaps too great. I suspect that all of them made the cut and the whole thing was closer to a publicity stunt than something that you could plausibly do again and again. If the probability of acceptance given that your essay is posted is 100%, what matters is getting posted. Peer review wasn’t replaced by web review; it was replaced by behind-closed-doors review.

Another instance of academics outwitting this particular journalist:

To Mr. Cohen, the most pressing intellectual issue in the next decade is this tension between the insular, specialized world of expert scholarship and the open and free-wheeling exchange of information on the Web. “And academia,†he said, “is caught in the middle.â€

Haha! Poor poor professors! Caught in the middle! I was under the impression that professors = expert scholarship. Anything to distract attention from the real change: The more education you can get from the Web, the less you need to get from professors. The more evaluation you can get from the Web (e.g., by reading someone’s blog), the less you need to get from professors. The less professors are needed, the fewer of them there will be.

Thanks to Dave Lull.