The alleged person Jimmy Moore

I’ve never actually met Jimmy Moore, so I can’t say for sure he’s real.  Sure, I read his Livin’ La Vida Low-Carb blog every day, we exchange emails regularly, we’ve spoken on the phone, and he’s threatened to drop by for a visit in October, when he’ll be in Nashville for a wedding.  Still, he may be a pod person, created by the meat and dairy industries to fool us into thinking their products won’t kill us. (His shows, after all, are called “podcasts” … coincidence?)

I’m suspicious because Jimmy’s total cholesterol is well over 300, which puts him in the category I sang about in the closing song for Fat Head:  “I’m shopping for my coffin, but don’t shed me any tears … ‘cuz according to the experts, I’ve been dead for several years.”

Score that high on a cholesterol test, and your doctor will break into an impression of the scarecrow from the Wizard of Oz, arms flying in opposite directions as he lurches for a bottle of Lipitor and a defibrillator at the same time.

To make matters worse, Jimmy has a family history of heart disease.  His father had a quintuple bypass a year ago.  His brother Kevin died of heart failure at age 41.  And Jimmy was morbidly obese for much of his life.

Worst of all, Jimmy lives on a diet that’s around 70% fat (much of it saturated), and he has committed the cardinal sin of refusing to accept the sacrament of statin drugs, despite many warnings from his doctor.  In other words, according to the Holy Church of Accepted Advice For Living a Long and Healthy Life, Jimmy is a condemned man, a heart attack waiting to happen.

And yet when he had a heart scan recently, the amount of plaque build-up in his arteries was measured at …(drum roll, please) … Zero.  None.  Nada.  No plaque.  Despite being a walking bundle of supposed risk factors, he has no signs of heart disease whatsoever.

This goes against everything we’ve been told about heart disease for the past 40-plus years. (Or, as his doctor put it when reading the test results, “That’s not possible.”)  If Jimmy does visit in October, I may have to serve him a drink in a cracked glass so I can send a blood sample to a lab.  There’s a good chance it will come back labeled “Not human, unable to identify.”

But let’s assume Jimmy is human, and is also alive and well.  Perhaps he’s just an outlier.  Surely, if we compare cholesterol levels and heart disease across large populations, we’ll see a pattern, right?

Hardly.

Check out this video by Dr. Malcolm Kendrick, author of the very enlightening and very funny book The Great Cholesterol Con, speaking about the world-wide MONICA study:

Dr. Kendrick arranged his data to demonstrate a crazy up-and-down pattern in the heart-disease death rate as you go up the cholesterol scale.  I was curious what the data would look like on a scatter chart.  (Yes, I’m that big of a dweeb.) 

So I went prospecting for MONICA data on the internet and ended up finding two useful nuggets:  1) average cholesterol levels for men in various countries, and 2) heart-disease death rates for men aged 35 to 75 in those same countries – in other words, men who died prematurely due to heart disease.  (If I die of a heart attack at age 95, I’ll consider it a victory.)

I plotted the results for 40 of the most populous countries.  But before we get to those, take a look at these charts, courtesy of Tony at Emotions for Engineers, demonstrating what different degrees of correlation look like:

A perfect correlation equals 1.0, which produces a trendline starting in the lower left and rising to the upper right.  If x (horizontal axis) causes y (vertical axis), the data from studies comparing them should be strongly correlated.  Researchers rarely get excited about a correlation of less than 0.8, unless their grants are running out.

With that in mind, take a look at the average cholesterol levels for men in 40 countries plotted against the annual heart-attack death rates per 100,000 men in those same countries:

Do you see a meaningful pattern there?  If so, you probably also see secret messages from the CIA in crossword puzzles and college baseball scores – published solely for your benefit, of course. 

Or perhaps you just work for one of the organizations that’s been promoting the Lipid Hypothesis for the past 50 years.  I found and downloaded the MONICA data from the official website of the British Heart Foundation, the U.K. equivalent of the American Heart Association.  The same site includes (of course) recommendations for reducing your risk of a heart attack:

It is now universally recognised that a diet which is high in fat, particularly saturated fat, sodium and sugar and which is low in complex carbohydrates, fruit and vegetables increases the risk of chronic diseases – particularly cardiovascular disease (CVD) and cancer … The dietary changes which would help to reduce rates of coronary heart disease (CHD) in the UK population were detailed in the 1994 report of the Government’s Committee on the Medical Aspects of Food and Nutrition Policy (COMA). This recommended a reduction in fat intake, particularly saturated fat intake, a reduction in sodium intake and an increase in fruit and vegetable and complex carbohydrate intake.

I ran the CORREL function on the data in Excel, and the result was -0.25 … a negative correlation.  In other words, there is no meaningful correlation at all, but the tiny correlation that does exist would point towards heart disease rates going down as cholesterol levels go up. 

I can only imagine the conversations that go on in organizations like this when they look at the results of large studies like MONICA:

“Did you finish analyzing the cholesterol data?”

“Yes, Doctor Higginbotham, all done.”

“And?”

“A careful analysis of the data from 40 of the largest countries shows no relationship between cholesterol levels and heart disease whatsoever.”

“Hmm … that’s it, then.  We’d better keep telling people to cut back on saturated fat.”

“Why, Doctor?”

“Because it raises cholesterol.”

“But … uh … I’m afraid I don’t understand.”

“Well, it’s complicated, so let me explain it this way:  Shut up.”

Fortunately, a lot of doctors like Malcolm Kendrick and Uffe Ravnskov and Mike Eades refuse to shut up.  Same goes for a lot of bloggers like Jimmy Moore.

Yes, Jimmy has high cholesterol – very high, by most standards.  But he also has very low triglycerides and high HDL, and only 2 percent of his “too high” LDL is the small, dense type that can penetrate the walls of an artery and lead to heart disease.  He achieved those numbers by ignoring the experts and cutting the sugars and starches from his diet, not the fats.  He’s not an outlier, any more than the hundreds of thousands of people who die from heart disease every year despite having low cholesterol. 

As for whether or not Jimmy Moore really exists …I’ll let you know in October.

Jason Sandeman, a chef and writer who produces the Well Done Chef blog, offered to write an occasional guest column, including step-by-step recipes for preparing real food.  Below is Jason’s latest guest post.  (You can read his previous guest column here.) 

Fall is around the corner, and your tomato vine is bursting with ruby red colored tomatoes. In fact, if you are like me, you have so many that you cannot possibly use them all. Your friends and family shy away from you around this time of year, afraid if they shake your hand, they’ll arrive home and find tomatoes in their pockets. You have a real problem on your hands, and you need to act before the fruit flies take up residence.

Below is a simple recipe that you can follow to take those tomatoes to the next level. You can also store them for a long while, up to 6 months in the freezer. See after the recipe for some tips on using this creation.

Oven Roasted Tomatoes

Preparation time: 5 minutes
Cooking time: up to 2 hours
Difficulty: easy

Makes 60 half tomatoes, about 1 plastic container full

Ingredients:

• 30 Roma tomatoes (I prefer these, but you can substitute whatever you are growing on your vine.)
• Extra-Virgin olive oil to coat
• 10 cloves garlic, peeled
• 1 bunch of thyme
• to taste salt
• to taste pepper

1 cookie pan with sides at least 1/2 inch deep

Preparation:

Pre-heat the oven to 200°C (400°F).

Cut tomatoes in half lengthwise, keeping the core intact.

Toss in a large bowl with the extra-virgin olive oil, garlic cloves, salt and pepper.

Line the tomatoes cut-side down on the cookie sheet; nestle the garlic cloves and thyme sprigs in between rows of tomatoes. Drizzle remaining olive oil over the tomatoes.

Roast in the oven for 15 minutes, until the skins blister.

Remove from the oven, peel off skins. (I save them for veal stock, but you can throw them away if you like.) Pour off the juice into a container; reserve.*

Lower the temperature of the oven to 135°C (275°F).

Place the tomatoes back into the oven and roast for 20 minutes.

Remove tray from the oven; pour off juices into container, place the tomatoes back into the oven.

Repeat as necessary, until the tomatoes are not giving off any juices, and are almost dry.

Remove from oven; cool. Pick out the garlic cloves and thyme. Reserve the roasted garlic for another use.

Pack tomatoes into a container with a little extra-virgin olive oil and refrigerate. The tomatoes will keep up to 2 weeks refrigerated, or up to 6 months frozen.

*Note: The juices you save would make a great base for a tomato vinaigrette. Perhaps that is another post?

Now, for the bonus part. Take an onion, fry until soft, add 10 or so oven roasted tomatoes. Add 500 mL (2 cups) of the chicken stock in my previous guest post. Chop some fresh oregano or basil,and toss it in the pot. Blend the mixture until smooth with a hand blender. Voila! Near-instant soup. Let’s see franken foods create that!

If you’ve read or heard some of my press interviews, you know that Fat Head didn’t actually begin as a response to Super Size Me. My intention was a shoot a demo for a TV show I wanted to produce: funny but thoughtful guy examines issues of the day.  The topic I planned to explore for the pilot episode was the ridiculous prejudice we have against fat people in modern society.  I watched Super Size Me as part of my initial research, became very annoyed, and decided to produce Fat Head instead.

Last week, Newsweek’s online edition ran a two-part article that’s related to my original idea. The Fat Wars: America’s Weight Rage is a good read, with one exception:  the author believes too much fatty food has made us fat.  The second part is titled Fat and Healthy: Why It’s Possible – another theme I touched on in Fat Head.  Here are some quotes, with my comments.

Cintra Wilson, style columnist for The New York Times, recently wrote a column so disdainful of JCPenney’s plus-size mannequins that the Times’ ombsbudman later wrote that he could read “a virtual sneer” coming through her prose.

I haven’t seen the plus-size mannequins, but I’m glad to know JCPenny’s has them. When I walk through a mall and see stick-figure mannequins in every store window, it annoys me. Most women will never look like that, even if they’re not fat, for the simple reason that most women don’t have bones the size of toothpicks. Sending the message to teenage girls and young women that they should all be this skinny is a prescription for bulimia.

Fatness has always been seen as a slight on the American character. Ours is a nation that values hard work and discipline, and it’s hard for us to accept that weight could be not just a struggle of will, even when the bulk of the research-and often our own personal experience-shows that the factors leading to weight gain are much more than just simple gluttony.

If being lean were simply a matter of being disciplined – usually defined as eating less – there would be very few obese people in America. People don’t eat because they’re gluttonous or compensating for a lousy childhood. They eat because their cells run out of fuel and they become hungry. Starving yourself may work temporarily, but it goes against your deepest, most primal instincts.  It can also depress your metabolism and make it more likely you’ll gain weight when you finally give in to the hunger and eat more.

The real problem, of course, is that we’ve been told to eat lots of high-carbohydrate foods that tell our bodies to store fuel as fat … which in turn makes us hungrier than we should be.

“There’s this general perception that weight can be controlled if you have enough willpower, that it’s just about calories in and calories out,” says Dr. Glen Gaesser, professor of exercise and wellness at Arizona State University and author of BigFat Lies: The Truth About Your Weight and Your Health, and that perception leads the nonfat to believe that the overweight are not just unhealthy, but weak and lazy.

The funny thing is, most of the lean people I know don’t count calories at all – because they don’t have to. At mealtimes, my naturally-thin wife does the same thing I do: she eats until she’s not hungry anymore. So does my son, who eats like a horse (that is, if horses liked potato chips and Coca-Cola) but literally can’t gain weight – he’s tried, both while playing high-school basketball and during boot camp.

“A lot of people struggle themselves with their weight, and the same people that tend to get very angry at themselves for not being able to manage their weight are more likely to be biased against the obese,” says Marlene Schwartz, director of the Rudd Center for Food Policy and Obesity at Yale University. “I think that some of this is that anger is confusion between the anger that we have at ourselves and projecting that out onto other people.”

Been there, done that. Before I understood that carbohydrates were making me fat, I’d try eating less, lose a few pounds, then stall, then give up. Then I’d look at myself in the mirror after my morning shower and think, “You fat @#$%!  Why don’t you just stick to a diet and get rid of this blubber?” This is what 40 years of bad dietary advice has done to millions of people.

What is it about fat people that makes us so mad? As it turns out, we kind of like it. “People actually enjoy feeling angry,” says Ryan Martin, associate professor of psychology at the University of Wisconsin, Green Bay, who cites studies done on people’s emotions. “It makes them feel powerful, it makes them feel greater control, and they appreciate it for that reason.”

I’ve said it more times than I count: some people aren’t happy unless they’re angry about something. You can usually spot those people by counting the number of bumper-stickers on their cars. If you count more than two, for Pete’s sake, don’t do anything the driver could construe as cutting him off in traffic – especially if you’re fat.

Think of health care: when president Obama made reforming health care a priority, it led to an increased focus on obesity as a contributor to health-care costs. A recent article in Health Affairs, a public-policy journal, reported that obesity costs $147 billion a year, mainly in insurance premiums and taxes … So the overweight, some people argue, are costing all of us money while refusing to alter the behavior that has put them in their predicament in the first place.

Here’s a crazy idea: maybe the people who make that argument are attacking the wrong end of the equation. If we didn’t make everyone pay for every else’s health care, it wouldn’t be an issue.  And of course, it’s not obesity that drives up health-care costs – it’s high blood sugar. Obesity is a symptom, not the cause. Both of the type II diabetics in my family are lean as rails. They use a lot more medical resources than I do, and I’m considered overweight.

A study published last month in the Annals of Surgery supported this “obesity paradox.” The report, which looked at more than 100,000 patients who had undergone nonbariatric general surgery, found that overweight and moderately obese patients had mortality rates 15 and 27 percent lower, respectively, than normal-weight patients.

That’s it, then … the next time I run into a skinny person on the street, I’m going to grab him by the arm and scream, “Stop wasting my health-care tax dollars, you scrawny @#$%! Go grab a donut and a soda, then sit your skinny @## down and gain some weight! Discipline, Man! Discipline!”

The point is that not all fat people are unhealthy or out of shape, and not all thin people are healthy and in good shape. But it’s amazing how many people make those assumptions.

Years ago, I had a good friend in Chicago who’s one those naturally-lean types. One day he got a guest pass for the health club where I was a member and joined me for a workout. As we huffed and puffed our way around the Nautilus circuit, I could tell by his expression that he was frustrated to realize he couldn’t lift nearly as much weight as I could. (He more or less admitted as much later.) Until that day, he’d assumed my belly and love handles were a sign that I was in lousy shape.

But I wasn’t in lousy shape. I worked out regularly and walked 15 to 20 miles per week. I was actually in pretty good shape. I was also fat.

To close, I put together a sequence of clips from my interview with Dr. Eric Oliver, author of “Fat Politics,” who spoke about some of the same issues brought up in the Newsweek article. If you bought the Fat Head DVD (and bless you if you did), you’ll recognize some of this footage from the bonus tracks.