After writing my last post, I got to thinking a bit more about the UCLA study that set me off – the one in which the authors noted that 72.1% of people hospitalized for a heart attack had LDL levels below 130 mg/dl (the recommended level) and yet, instead of concluding that high LDL doesn’t cause heart disease, speculated that LDL targets should be set even lower.

Specifically, I wondered what percent of the population is below that level. After all, if 95% of all adults have LDL below 130 but only account for 72.1% of the heart attacks, then you could reasonably say LDL may have something to do with heart attacks. Or looking at it from the other direction, if 5% of all adults have LDL over 130 but account for 27.9% of all heart attacks, then yes, high LDL may be a problem.

It took some digging, but I eventually founds the statistics I wanted on the American Heart Association’s web site, both in web pages and PDFs. Here’s the magic number:

Percent of American adults (over age 20) with LDL Cholesterol at or above 130 mg/dl: 32.6%.

Just roll that one over in your brain for a moment. Now combine it with the UCLA study data, and here’s what you get:  people with “high” LDL make up 32.6% of the population, but account for just 27.9% of the heart attacks.

Boy, doesn’t that just make you want to toss back a Crestor cocktail? And keep in mind, that group would include people whose LDL levels are 130, 150, 175, etc.  We’ve been told for decades that the higher your LDL, the more likely you are to clutch your chest in the middle of the night. But if the “high” LDL group experiences slightly less than their share of heart attacks, how can that possibly be true?!

The lead investigator for the UCLA study suggested that the “optimal” LDL level hasn’t been set low enough; perhaps it should be 40-60 mg/dl.  Excuse me? Are we now supposed to believe that LDL is dangerous, but all levels above 60 are equally dangerous? Given the statistics I just cited, that’s the only possible explanation, except for this one:  LDL doesn’t freakin’ matter. It’s a meaningless number.

The AHA site also offered a slew of statistics broken down by race. Don’t bother trying to lock these in your brain because I’ll revisit them in a moment:

Among non-Hispanic whites age 20 and older, the age-adjusted prevalence of total blood cholesterol levels over 200 mg/dL is 45.0 percent of men and 48.7 percent of women; 15.3 percent of men and 18.1 percent of women have blood cholesterol levels of 240 mg/dL or higher.

Among non-Hispanic blacks age 20 and older, the age-adjusted prevalence of total blood cholesterol levels over 200 mg/dL is 40.2 percent of men and 41.8 percent of women; 10.9 percent of men and 13.1 percent of women have blood cholesterol levels of 240 mg/dL or higher.

Among Mexican Americans age 20 and older, the age-adjusted prevalence of total blood cholesterol levels over 200 mg/dL is 51.1 percent of men and 49.0 percent of women; 16.8 percent of men and 14.3 percent of women have blood cholesterol levels of 240 mg/dL or higher.

The age-adjusted prevalence of U.S. adults age 20 and older with LDL cholesterol levels of 130 mg/dL or higher, which is associated with a higher risk of coronary heart disease, is…

For non-Hispanic whites, 31.5 percent of men and 33.8 percent of women.
For non-Hispanic blacks, 34.4 percent of men and 28.6 percent of women.
For Mexican Americans, 42.7 percent of men and 30.4 percent of women.

“Age-adjusted” means they’ve balanced the data to compare people of similar ages.  If the average Mexican-American is 27 and the average white American is 39, it’s a bit pointless to compare the two groups directly.  With that mind, let’s organize these numbers so they make sense.  (I can’t stand clunky terms like “Non-Hispanic Whites,” so at the risk of offending the tender-hearted, I’m just going to refer to all three groups of over-20 Americans as White, Black, or Mexican.) 

Wow, looks those Mexican-American men are in deep trouble.  More than half have total cholesterol over 200, and nearly half have LDL levels above 130.  Fewer blacks than whites have high total cholesterol, but more blacks are in that “high LDL” category, so let’s see … going by the prevailing theories, I’m going to say Mexican-Americans have the highest of heart disease, then blacks, then whites.  So let’s check that analysis against the actual rates of coronary heart disease, also available on the American Heart Association site, and add that as our final table row:

Whoops! Just exactly the opposite of what the lipophobes have been telling us all these years. Mexican-American men, the “worst” in every cholesterol category, have the lowest rate of heart disease. Well, perhaps the experts were talking about women all along. Let’s check the data:

Looks like the black women caught a break here. They’ve got the best cholesterol levels in every category and therefore surely have the lowest rate of heart disease. Let’s add the actual rates of coronary heart disease in our final row:

Uh, gee, that’s kind of embarrassing, isn’t it? Mexican-American men, the group with the worst LDL figures, have the lowest rate of heart disease. Black women, the group with the best LDL figures, have the second-highest rate of heart disease. I thought perhaps the higher rate of heart disease among black women could be explained by a higher rate of smoking, but it turns out the AHA had those figures as well: 20.6% of white women smoke, but only 17.8% of black women.

Still think LDL levels have anything to do with heart disease? Please, print this out and hand it to your doctor if he ever tries to put you on a statin because your LDL is “too high.”

And here’s what really fries my bacon about these numbers: I found them in documents published by the American Heart Association — one of the many organizations still trying to scare us about high LDL. Their own statistics say they’re wrong.

In comparing the cholesterol statistics with the heart-attack data, I did notice a figure that seems to actually matter, either as a cause or a marker: low HDL. Here’s a quote from the press release about the UCLA study:

The study also showed that HDL cholesterol, or “good cholesterol,” levels have dropped in patients hospitalized for heart attack over the past few years, possibly due to increasing rates of obesity, insulin resistance and diabetes. Researchers found that 54.6 percent of patients had HDL levels below 40 mg/dL.

And here’s the magic number from the American Heart Association: American adults with HDL levels below 40 mg/dl: 16.2%.

Now we’re looking at a small fraction of the population that accounts for more than half of the heart attacks.  It should be clear to anyone with a functioning brain that raising HDL is a heck of a lot more important than lowering LDL.

If you’ve seen Fat Head or read any of the books or blogs I recommend, you already know what raises your HDL: eating more natural fat … exactly what the American Heart Association tells us to avoid.

I guess they’re too busy putting their seal of approval on boxes of Cocoa Puffs to actually check the relevant data — including their own.

p.s. — I’m leaving tomorrow for the low-carb cruise.  I’ll check comments when I can, but won’t be writing another post until I get back.

Awhile back, I bookmarked an online press release about a study of LDL levels among heart-attack victims.  Here’s the headline and opening paragraphs:

Most heart attack patients’ cholesterol levels did not indicate cardiac risk

A new national study has shown that nearly 75 percent of patients hospitalized for a heart attack had cholesterol levels that would indicate they were not at high risk for a cardiovascular event, based on current national cholesterol guidelines.

Specifically, these patients had low-density lipoprotein (LDL) cholesterol levels that met current guidelines, and close to half had LDL levels classified in guidelines as optimal (less than 100 mg/dL).

Holy jumpin’ jiminees! I said to myself.  We’re finally going to dump the stupid “high cholesterol causes heart disease” theory!  If nearly 75 percent of the people who suffer heart attacks have “normal” LDL levels and nearly half have “optimal” LDL levels, then it’s obvious to anyone with a functioning brain that high LDL isn’t the problem.

Then I read the next paragraph:

“Almost 75 percent of heart attack patients fell within recommended targets for LDL cholesterol, demonstrating that the current guidelines may not be low enough to cut heart attack risk in most who could benefit,” said Dr. Gregg C. Fonarow, Eliot Corday Professor of Cardiovascular Medicine and Science at the David Geffen School of Medicine at UCLA and the study’s principal investigator.

I read that paragraph a few times and concluded that UCLA was probably conducting a nationwide experiment with a title something like Behavioral Effects of a Press Release Specifically Designed to Inspire Intelligent People to Bang Their Heads Against The Nearest Immovable Object.

After I stopped banging my head on my desk, I kept reading:

While the risk of cardiovascular events increases substantially with LDL levels above 40-60 mg/dL, current national cholesterol guidelines consider LDL levels less than 100-130 mg/dL acceptable for many individuals. The guidelines are thus not effectively identifying the majority of individuals who will develop fatal and non-fatal cardiovascular events, according to the study’s authors.

Fabulous … so now the truly “safe” level of LDL is being pegged at 40-60.  Once we adopt those guidelines, the vast majority of the population will immediately require statins to meet them — which is probably the point.  An article about the study in USA Today certainly reached that conclusion … Boy, we may have to give statins to millions more people than we originally thought!  Although to be fair, the USA Today article included this quote as well:

But UCLA’s Fonarow, whose study was published in the American Heart Journal, says there’s another possibility. “There are two potential implications,” he says. “Either the threshold of what was set as an ideal LDL was set outrageously high, thus allowing the vast majority of patients to be missed, or LDL isn’t much of a risk factor.  It’s got to be one of the two.”

Unfortunately, the doctor seemed to leaning toward the lower-threshold theory.  I was beyond annoyed, but as the aspirin took effect, the swelling went down, and the mental fog cleared, it occurred to me that I’m missing a golden opportunity here:  Instead of complaining about bad science, I should learn to use it to my advantage.  All I’d have to do is identify the bad-science protocol and use it to build a theory that suits me.  So I thought about the “cholesterol kills!” theory and how it came to dominate medical thinking, then sketched out the basic steps:

• Identify an association
• Mistake the association for cause-and-effect and propose a theory
• Find a bit more weak evidence to support the theory
• Allow those with a financial interest in the theory to get on board and steer the research
• Explain away all evidence that the theory is wrong

With this protocol in mind, I am hereby announcing a bold new theory to the scientific world:

THE PRIMARY CAUSE OF HEART DISEASE IS HIGH TAX RATES

Here’s the association we need to get started:  In his book The Cholesterol Myths, Uffe Ranvskov included a chart that plotted municipal tax rates against heart-disease deaths for several cities in Sweden.  I’ve reproduced it below.

My goodness!  The evidence is clear … the higher the tax rate, the higher the rate of heart disease.  Boost the tax rate to 30%, you may as well just grab an Uzi and start spraying bullets into the streets.  Going in the other direction, Ravnskov calculated that if tax rates were lowered to 9.55%, heart disease would be conquered.  Well, I say Dr. Ravnskov was correct, even if he thought he was being funny in a Swedish sort of way. 

I’m only speculating at this point (we’re early in the process, after all), but my guess is that high taxes create stress, the stress produces an overabundance of cortisol, and the cortisol leads to inflammation that damages arteries. But I still need a bit more evidence, so I copied some charts from the American Heart Association site.  Here’s the first one.

Aha!  The evidence is clearly mounting.  The United States had no permanent national income tax until 1913, and as you can see, heart disease was quite rare before then.  But as tax rates climbed for the next several decades, so did heart disease. 

John F. Kennedy cut income tax rates to boost the economy, and according to our chart, heart disease rates dipped soon thereafter … then rose again in the high-tax 1970s … then dipped again soon after Ronald Reagan’s tax cuts … then rose again after George “Read my lips!  No new taxes!” Bush raised taxes … then dipped a bit during Clinton’s term (we may have a paradox here) … then fell sharply around the time George “I’ll cut taxes but spend like crazy anyway” Bush enacted his economic policies.

Now let’s look at the second Heart Association chart, which shows hospital discharges for cardiovascular diseases — including people discharged alive, dead, or status unknown.  (I’m guessing the facilities that couldn’t determine if their patients were alive or dead were V.A. hospitals.)

I think our paradox just went away.  There’s a dip soon after Reagan’s tax cuts, a steady rise during Bush and Clinton — both of whom increased taxes — then a smaller dip that roughly parallels the term of Bush The Younger.  (Hey, his tax cuts weren’t as dramatic as Reagan’s, so that just proves my point.) 

I’m declaring my theory scientifically sound and well supported by the available evidence.

Getting people financially invested in my theory will be a piece of cake.  Roughly half the population votes against higher taxes anyway, and most of the other half only votes for higher rates when they’re told they won’t be the ones paying.  I’m pretty sure that within months after my theory gains some momentum, we’ll see a slew of well-funded studies concluding that we could save hundreds of thousands of lives each year by lowering the top tax rate to 20 percent. 

Eventually the gullible media will be on board as well.  Every April, there will be articles mentioning that there’s a spike in heart attacks during the last week before taxes are due.  The term “artery-clogging alternative minimum tax” will become common. Doctors will aggressively prescribe lower tax rates for patients with known risk factors … such as owning a successful business, living in California, or having at least one close relative named Wesley Snipes.

The trouble will come when the contrary evidence starts rolling in.  Large clinical trials will fail to show that reducing taxes actually reduces heart disease. Dr. Malcolm Kendrick will write a book pointing out that the French pay more in taxes than Americans do, but have lower rates of heart disease, and if you look around the world, there’s no correlation between tax rates and heart disease whatsoever.  A national study will conclude that 72 percent of all heart attack victims are already paying less than 20 percent in taxes.

But I know how to handle those little annoyances:

• Bury the clinical studies, or label them as “inconclusive.”
• Pretend the French don’t exist, and refer to them as a “paradox” if anyone brings them up.
• Conclude that our “optimal” tax rate of 20 percent is still too high and needs to be even lower.

Meanwhile, there will no doubt be a fair number of contrarians who don’t buy my theory and will insist on paying high tax rates despite my warnings.  I’ll tell them the same thing doctors tell me when I refuse to go on a low-fat diet:  Fine, you can ignore me if you choose … but don’t come crying to me when you have a heart attack.

I keep thinking the tide is turning.  I read several blogs written by MDs or biochemists who explain why it’s refined carbohydrates that are killing us, not saturated fat or cholesterol.  I listen to top-notch doctors and researchers cover the same topics in Jimmy Moore’s podcasts.  I watch the number of visitors to this blog tick up steadily every month (and bless you all for that).  We’re winning, I say to myself.  The word is finally getting around.

And then I do something stupid like check out the health articles on MSN.  (That hissing sound you hear is my optimism deflating.)  I don’t know what MSN’s audience size is, but I’m pretty sure if you added up the combined audiences for every blog in my blogroll plus every blog in their blogrolls, we’d be barely be the Hong Kong to MSN’s China.  No wonder when I tell people saturated fat doesn’t cause heart disease, they look at me like I just said, “I actually have three heads, but two of them are only visible when the moon is full.”

This evening after dinner (meatloaf from farm-raised goat and beef, plus cauliflower whipped with butter, feta cheese, sour cream and garlic) I read an MSN health article, followed a link, followed another link, followed another link, then decided I should quit while my blood pressure was still at its usual below-average level.  The MSN article, provided by Health.com, was on how to alter your diet to reduce your cholesterol.  Here are some quotes with my comments:

Want to cut cholesterol without cutting taste? Most people are afraid that “good for my cholesterol” means meals that are joyless (and tasteless).

That’s because most people have functional tastebuds.  The rest are survivors of chemical warfare or vegetarians.

Here are some simple substitutions that you can make to the food you already eat to help fight cholesterol painlessly.

Sprinkle walnuts, skip croutons

Carbohydrates can cause high levels of a type of low-density lipoprotein (LDL), also known as bad cholesterol. For a healthier salad, replace your carbo-laden croutons with walnuts, which are high in polyunsaturated fat-a good fat that can lower LDL while boosting HDL (aka good cholesterol).

Uh, wait a second … you’re admitting that carbohydrates raise a “type” of LDL?  I’m stunned.  The type that carbohydrates raise, by the way, is type B … otherwise known as the small, dense LDL that can actually perforate the walls of your arteries.  Hey, maybe I was pessimistic for no reason!  This health writer might actually get it right.

Sip red wine, not cocktails

Research suggests that moderate alcohol intake can produce a slight rise in HDL cholesterol (a so-called good cholesterol). But that won’t do you much good if you’re tossing back margaritas or mixed drinks with fruit juice, which contain carbohydrates. Switch to red wine; it has about a 10th of the carbohydrates of a margarita, and you’ll also get antioxidants such as flavonoids that are believed to lower LDL and boost HDL.

I’ll be dipped; she is going after the carbohydrates!  Man, I feel like such a dolt … as soon as I saw the Health.com logo, I was preparing myself to yell AAAAAARGGHHH a lot.  I can relax now.

Yes to edamame and nuts, no to cheese and crackers

For a pre-dinner snack, skip the crackers and cheese, which are sky-high in saturated fat - one of the prime culprits behind high cholesterol.

AAAAAARGGHHH!!!  Do these goofy reporters ever check the latest research?  When Christopher Gardner of Stanford conducted a controlled study of three different diets, he reported (reluctantly, by his own admission) that people on the Atkins diet showed the greatest improvement in lipid profiles.  Pretty impressive, considering that another diet in the study was the Ornish low-fat plan. 

Of course, I wasn’t surprised by Gardner’s results because while I was researching Fat Head, Dr. Mike Eades challenged me to eat all the natural saturated fat I could stand for a month while cutting out sugar and starch.  If you’ve seen the film, you know what happened — my total cholesterol and LDL plummeted, while my HDL shot up.

Edamame is low in saturated fat and one cup contains about 25 grams of soy protein, which is thought to actively lower LDL (although the evidence is conflicting). Buy them frozen, dump them into boiling water, and drain after 5 minutes-that’s all there is to it.

The dust-bunnies under my bed are also low in saturated fat, but I wouldn’t eat them, boiled or otherwise.  If you think soy is good for you, do yourself a favor and read Lierre Keith’s amazing, beautifully-written book, The Vegetarian Myth.  If that’s too much of an undertaking, check out this page or this page from the Weston A. Price website.

Vinegar and lemon juice beats salad dressing

As everyone knows by now, drenching a salad in high-fat salad dressing is like smoking cigarettes while jogging: It totally defeats the purpose. A low-fat alternative is a step in the right direction, but the best option for lower cholesterol is drizzling your salad with balsamic vinegar or lemon juice.

I can hear my favorite journalism professor from college yelling across 30 years of time:  “Never, ever, use phrases like ‘everyone knows’ to make a point, because there’s nothing that ‘everyone’ knows!”

If you’d prefer to avoid absorbing most of the nutrients when eating a salad or vegetables, then yes, using a high-fat salad dressing will totally defeat that.  Most important nutrients are fat-soluble, so without fat in a meal, they’ll just pass through your body and eventually fortify the health of whatever critters live in your local sewage system.

If the purpose of eating a salad is to amuse your friends with your wacky pucker-face, definitely go for the lemon juice and vinegar. 

Ditch the butter for margarine spread

One tablespoon of butter contains more than 7 grams of saturated fat-that’s more than a third of the recommended daily value. It also contains 10 percent of your daily value for dietary cholesterol, which, though it isn’t as harmful as was once thought, is one of the main sources of high cholesterol (and atherosclerosis).

Hmmm, that would explain the sky-high rate of heart disease in 1900, when Americans consumed four times much butter per capita as we do today.  The French still consume four times as much butter as we do, but have a far lower rate of heart disease — even though they have a higher rate of smoking.  If only we could import that paradox thing …

Switch the butter with a vegetable-oil-based spread such as Smart Balance or Olivio (which also contains olive oil); you’ll be replacing a bad fat with a good fat.

Yes, because Mother Nature has no idea how to produce good nutrition for humans; all the best health-enhancing foods were created in a lab.  Here’s a little gem from the Smart Balance web site:

Smart Balance uses natural saturates (palm fruit oil) and balances it with polyunsaturates from soy and canola oils. This comprises the patented, heart-healthy Smart Balance blend that we believe to be superior to other methods of avoiding trans fatty acids.

That little balancing-and-blending act would involve extracting the oils with hexane, mixing them with sodium hydroxide and passing them through a centrifuge, mixing them again with hydrated aluminum silicate to bind to and remove the unwanted speckles, passing them through a steam distillation chamber to deodorize them, then adding artificial color and flavor.  My advice:  never eat food that has a patent number attached to it.

And instead of using butter to grease the pan while cooking, try olive oil or white wine vinegar.

“Honey, I can’t get the low-fat cookies unstuck from the pan!”
“Who cares?  They taste like vinegar anyway.”

Use ground turkey, not ground beef

Red meat is a source of both saturated fat and dietary cholesterol-two of the main sources of blood cholesterol. Ground turkey contains half the saturated fat of 85 percent lean ground beef, and it can be substituted easily for beef in most recipes.

Ground beef:  40% of the fat is monosaturated (like olive oil), and most of what’s left raises HDL.  It also raises LDL, but only the harmless, fluffy kind — i.e., not the same type raised by carbohydrates.  And even “Dr. Lipid Hypothesis” Ancel Keys eventually concluded that dietary cholesterol has no effect on the amount of cholesterol in your blood, as have several clinical studies.  Yes, I can certainly see why we’d want to avoid ground beef.

Skip the fatty sour cream, choose fat-free Greek yogurt

Whether it’s used as a garnish or in a sauce, sour cream adds a shot of saturated fat to otherwise heart-healthy meals. To cut out that excess fat without sacrificing taste or texture, swap the sour cream with no-fat Greek yogurt-one of the world’s healthiest foods.

Since you’re a professional health writer and all, did you happen to notice either of the studies published this year that concluded there’s no association whatsoever between saturated fat intake and heart disease?  Have you seen the many other studies published over the years that reached exactly the same conclusion … like this one, from the European Heart Journal:

The commonly-held belief that the best diet for the prevention of coronary heart disease is a low saturated fat, low cholesterol diet is not supported by the available evidence from clinical trials.

And if you believe swapping sour cream for fat-free yogurt doesn’t sacrifice taste … well, then I’m sorry about the chemical-warfare attack and I sincerely hope my government wasn’t involved in any way. 

Now I’d better go listen to one of Jimmy Moore’s podcasts to preserve my sanity.

Since I’ve spent the last two posts bagging on MeMe Roth and the other food cops, I may as well continue, but along a different line.  This time, I want to explain why they’re not just annoying, but profoundly mistaken.  Their prescriptions for “helping” people lose weight don’t work, have never worked, and will never work.  Here’s why:

They still believe gaining or losing weight works like a simple savings account.  Take in too many calorie deposits and your account — your fat tissue — grows.  So to shrink your account — why, heck, it’s easy! — just make smaller deposits by eating less, or make bigger withdrawals by exercising.

This theory is a classic of example of the famous H.L. Mencken quote:  “For every complex problem there is an answer that is clear, simple, and wrong.”  It’s so wrong, even Kelly Brownell — the morbidly obese expert on obesity who thinks the rest of us are suffering from a lack of calorie-count laws –  can’t keep his weight down in spite of all his supposed knowledge.

To understand why the bank-account analogy wrong, we need to revisit what is perhaps the single most enlightening concept Gary Taubes put forth in Good Calories, Bad Calories:  homeostasis.  In biology, homeostasis refers to a condition of balance, one that your body insists on maintaining.  Blood sugar is a good example.  Eat a candy bar, your blood sugar rises, so your pancreas produces insulin to bring it down.  Skip the carbs entirely, your blood sugar falls, so your body produces glucose from protein to raise it again.  The body insists on keeping blood sugar within a very narrow range.

When we’re talking about body fat, homeostasis is the amount of fat we need to provide our bodies with a reliable source of energy.  If you haven’t already seen it, watch this YouTube clip from Fat Head, which explains how body fat feeds our cells:

Now, here are some quotes from Good Calories, Bad Calories to expand the idea a bit further:

Clinicians who treat obese patients invariably assume that the energy or caloric requirements of these individuals is the amount of calories they can consume without gaining weight.  They then treat this number as though it were fixed by some innate facet of the patient’s metabolism.  Pennington explained that this wasn’t the case.  As long as obese individuals have this metabolic defect and their cells are not receiving the full benefit of the calories they consume, their tissues will always be conserving energy and so expending less than they otherwise might.  The cells will be semi-starved even if the person does not appear to be.  Indeed, if these individuals are restraining their desire to curb, if possible, still further weight gain, the inhibition of energy expenditure will be exacerbated.

Pennington suggested that as the adipose tissue accumulates fat, its expansion will increase the rate at which fat calories are released back into the bloodstream … and this could eventually compensate for the defect itself.  We will continue to accumulate fat - and so continue to be in positive energy balance - until we reach a new equilibrium and the flow of fat calories out of the adipose tissue once again matches the flow of calories in.

In other words, people whose hormones have put them in fat-accumulation mode aren’t in a state of energy balance unless they’re eating more and getting fatter.  And once they’re fat, they can’t remain in a state of energy balance — homeostasis — unless they remain fat.   With that in mind, let’s take the bank-account analogy promoted by the MeMe Roths of the world and make some adjustments so it actually resembles biological reality.  (I’m using simple numbers here for clarity.)

In our system, the fat tissue is still a savings account of sorts, but we can only pay our energy bills by making automatic debits from a checking account — the calories that flow through our bloodstream or are easily accessible in the form of glycogen.  To get through the day, we need to make hourly payments of 100 calories or so, depending on our metabolisms.  Meanwhile, the bank wants us to keep the checking-account balance as close as possible to, say, 500 calories.  When the checking account runs low, our system is designed to automatically transfer calories from savings into checking.

Still with me?  Good.  Now here’s the catch:   The bank will only let us transfer a small percentage of our savings into checking each hour.  The exact percentage allowed is determined by a mix of hormones, with insulin acting as the primary account manager. With that in mind, let’s check on the account status for two women:  Skinny Minnie and Fatty Patty. 

Skinny Minnie (who has long, straight, blonde hair and wears glasses) has a pretty good deal going.  At 120 pounds, she only keeps about 52,500 calories (15 pounds) in savings, and her bank allows her to transfer 0.30% of the balance into checking every hour — about 157 calories, which is more than enough to pay her hourly energy bill when she hasn’t eaten in awhile.

As a result, Minnie’s body is perfectly happy with the small savings account.  When she eats, calories go into both checking and savings, but then begin flowing from savings back into checking pretty quickly.  So she feels satisfied on small meals, and if she does overeat a bit, her body senses the high balance and starts spending energy like crazy … it turns up the heat, and she feels compelled to go run for four miles.  Soon her checking account is back down to 500 calories, and the savings account remains right around 52,500.  Minnie can even decide she wants to lose five pounds before her high-school reunion and accomplish that goal by eating less for awhile — at 115 pounds, she can still transfer 105 calories per hour into savings.  She doesn’t even feel hungry.

Patty’s deal isn’t quite as good.  At 140 pounds, she keeps 105,000 calories (30 pounds) in savings.  She doesn’t want the large account, but she needs it … the bank only allows her to transfer 0.10% of the balance to checking each hour — 105 calories, just enough to pay the bills.  While she considers herself overweight, she’s just barely in a state of energy balance as far as the bank is concerned.

A few years later, Patty’s situation gets a little worse.  Thanks to genetics, menopause, frankenfats, stress, too many refined carbohydrates, or a combination of factors, her hormonal mix changes.  She becomes insulin-resistant, and the bank is compelled to change the rules.  A higher proportion of what she eats must go into savings …and worse, she can only transfer 0.075% of those savings to checking each hour — 79 calories. 

So Patty eats a little more.  But when she’s not eating — and especially during the 12 hours or so between dinner and breakfast — her checking account is being debited faster than it’s being replenished.  The bank sends a not-so-polite message to Patty’s body:  YOU MUST INCREASE YOUR SAVINGS ACCOUNT TO 140,000 CALORIES TO MEET YOUR HOURLY ENERGY WITHDRAWALS.

Patty’s body heeds the warning.  It ramps up her appetite.  It lowers the thermostat a bit and orders her to sit still more often by making her feel tired.  Thanks to these measures Patty soon finds herself at 150 pounds.  Minnie looks on in disgust, thinking to herself (or saying aloud on Fox News), “Come on, Lady, eat a little less and take up jogging, would you?”

Unfortunately, Patty’s well-meaning doctor is also concerned and orders her to cut back on fat and eat more fruits and grains.  She does, and as a result her body is even more conditioned to burn glucose instead of fat.  She craves carbohydrates.  Her hormonal balance goes off again, she becomes more insulin-resistant, and soon she can only transfer 0.06% from savings into checking each hour.  Her body receives another warning from the bank:  YOU MUST INCREASE YOUR SAVINGS ACCOUNT TO 175,000 CALORIES TO MEET YOUR HOURLY ENERGY WITHDRAWALS.  A few months later, Patty weighs 160 pounds.  She’s now at 31% body fat and clinically obese.

Patty becomes disgusted with her larger figure and goes on Weight Watchers.  She feels okay on the low-calorie meals for a few days, but as soon as she loses four pounds, her savings account is once again unable to replenish her checking account at the necessary hourly rate.  The bank sends another message:  WHAT THE HECK DID I JUST TELL YOU?!  GET YOUR SAVINGS ACCOUNT BACK UP TO 175,000 CALORIES IMMEDIATELY OR WE’LL BE FORCED TO REPOSSESS THE FREE TOASTER.

Patty doesn’t care about the toaster and refuses to listen.  But her body is afraid of the bank manager and undermines her efforts to shrink the savings account any further.  It turns down the thermostat again.  It feeds Patty some depressants so she’ll sit around even more.  It begins siphoning off an even higher proportion of what she eats into savings.  Soon she’s back in state of energy balance, but just barely. 

Patty’s weight loss stalls at seven pounds, and she gives up.  Sitting on the sofa for hours each day, she eventually watches Oprah and learns from Dr. Oz that she can’t lose weight because she’s depressed and needs to learn to love herself so she’ll stop punishing herself with food.

Like I said, this is a simplified and somewhat silly analogy, but it’s a lot closer to biological reality than the simple bank-account theory that has inspired all those brilliant solutions promoted by Meme Roth, Kelly Brownell, CSPI and the other food cops.  Let’s see how their ideas would work out in our banking system:

Force restaurants to list the calorie counts of every food item on the menu.

The calorie counts are already easy to find, and anyone who wants to know them will find them.  (At McDonald’s, all you have to do is look at the back of the paper placemat.)  These laws aren’t about providing information; they’re about confronting people:  look how many calories you’re about to consume, Fatty Patty!  Don’t do it!

Great … so Patty orders a smaller meal at McDonald’s when she stops for lunch.  But in order to stay in a state of energy balance and avoid starving at the cellular level, she needs all the calories she’s been consuming, because she needs to stay at 160 pounds.  So after that smaller lunch, she eats a bigger dinner — or a normal dinner plus a dish of ice cream while watching the Tonight Show.  The point is, her body is going to order her to eat enough to keep the savings account as high as it needs to be.

Ban fast-food restaurants in poor neighborhoods.

Riiiiiiight.  So instead of getting their nice, cheap carbohydrates from McDonald’s, poor people will get them from snacks at the convenience store or junk food from the grocery store.  As long as the account manager has set a small transfer rate, people have to keep the savings account high — so they do.  Where exactly they obtain the deposits doesn’t matter.

Force communities to build more bike paths and walking trails.

This is one of Kelly Brownell’s big fat ideas.  (If people would just exercise more, they wouldn’t look like me, you see …)

Fine, so Patty takes up walking.  Nothing wrong with that — exercise is good for your health — but as far Patty’s weight it concerned, the extra walking just means she’s depleting the checking account a little faster.  As long as that transfer rate remains small, she’ll just have to eat more to keep the savings-account balance where it needs to be.  If she doesn’t, her body will ramp up her appetite until she can’t ignore it any longer.  That’s why, as Gary Taubes pointed out, overweight people have trained for and run marathons without losing a pound.

Declare all obesity-related diseases “elective” and make fat people pay for them out of pocket so they don’t burden the rest of us.

That’s one of MeMe’s hair-brained (long, straight, blonde hair-brained and glasses that make me look smart) ideas.

Yes, that would certainly work, you see, because Patty is simply choosing to eat too much and be fat.  If she just ate less and moved more, she would magically alter her hormonal balance so she’s in a state of homeostasis at 120 pounds, just like Skinny Minnie … I mean, Skinny MeMe.  Stupid, stupid, stupid.  That would be about as easy for Patty to do as it would be for Skinny MeMe to voluntarily starve herself down to 85 pounds.

The only way to make your body happy with a smaller savings account is to change the hormonal mix and increase the transfer rate.  Some people who decide to go on low-calorie diets stumble onto it by accident … they give up desserts, sodas, potato chips and other junk and bring their insulin levels down in the process.  Kind of like the pope who managed to avoid the plague because his doctor told him to sit in a huge ring of fire to ward off the bad humors.  It worked … but bad humors had nothing to do with it.  The fire warded off the fleas and the rats.

Unfortunately, MeMe Roth and the goofs she works with at CSPI have no clue about homeostasis or the connection between hormones and weight gain.  They tell people to avoid sugar — that’s good — but they also promote low-fat diets with lots of fruits, potatoes and grains.  That might work just fine for Skinny MeMe, but it’s a disaster for people with insulin problems.

So she’s not just annoying, she’s not just a busybody, and she’s not just wrong.  She’s part of the problem.  The sooner she shuts up, the better off we’ll be.

My video post about the Food Cops sparked an online debate with someone who says he doesn’t want MeMe Roth policing our food, but still believes she made some valid points.  Specifically, he agrees that:

• Obesity should not become socially acceptable because that does indeed make it socially contagious, and 60% of Americans are already overweight.
• If you ruin your own health, it’s not just your business because everyone else pays the cost.

There’s so much wrong with those two little opinions, I hardly know where to begin.  But I must, so I will.

(NOTE:  We’re discussing public policy here, so this post is at least as much about politics and economics as it is about diet and health.  Those of you who don’t care for my libertarian politics … you’ve been warned.)

Let’s start with the easy one:  60% of Americans are overweight!  That figure is, of course, based on the Body Mass Index, which classifies pretty much everyone with thick bones or decent muscles as overweight, regardless of how fat they are.  To be considered “normal,” you must actually be thin, as opposed to merely not fat.

The usual comeback is something like “I don’t see a lot of people walking around who look like bodybuilders.”  Neither do I.  But I see plenty of men built like, say, George Clooney, who is on the lean side and not particularly muscular.  He’s also overweight according to the BMI standard. 

Despite the artificially low threshold, as I noted in an earlier post, only 38% of American adults are more than 10 pounds above “normal.”  I don’t know what percentage of Americans are actually fat, but it’s not even close to 60%.

But waaaaaaaait … aren’t more people really and truly fat now than a generation ago?  Yes, obviously.  Which brings us to the second point:  social acceptability and social “contagion” have nothing to do with it.

MeMe Roth likes to point out that obesity tends to cluster around marriages and social groups.  Gee whiz, it must be socially contagious — they’re catching the “it’s okay to be fat” attitude from each other!  See, it’s not just a personal choice (as MeMe often says) … we have to shame you into losing weight to protect your innocent friends and family.

That’s utter hogwash.  Guess what?  Alcoholism clusters around families and social groups.  Nerdiness clusters around families and social groups.  Obama-worship clusters around families and social groups.  See, here’s the wacky alternate theory:  people tend to marry and hang around with people who share their values and like them for who they are.  I hung out with the nerds in high school.  Why?  Because I was one of them.  I fit in.  I didn’t catch nerdiness from one of them by borrowing a contaminated slide-rule.

Whether it’s becoming acceptable or not — and I don’t believe it is – most obese people hate being fat.  They’ve tried over and over to lose weight, but failed because of all the bad advice they’ve been given; they’ve failed because their hormones are screwed up, so they’re not in a state of energy balance unless they’re fat.  They’re not going to magically succeed at losing weight because naturally-skinny “I’ve never even been on a diet” MeMe Roth finally shames them into it.  They’ll just be fat and ashamed.  (You think being 20 pounds overweight is unhealthy?  Try developing an eating disorder … then tell me how healthy you feel.)

By the same token, they’re not going to become fatter just because we accept them for who they are — which is what anyone with an ounce of compassion would do in the first place.  And yet, here’s what my debate opponent believes:

Are big is beautiful magazines, clothes etc not a way of spreading acceptance for obesity? Obesity IS socially accepted in America. I mean for God sakes, the US is the 3rd fattest country in the world with more than 60% of its citizens being overweight, how can it be socially unacceptable when the majority is fat?

Oh, horrors!  We’ve got magazines and clothing manufacturers telling people who can’t become thin that they’re actually beautiful.  We mustn’t have that … they should go through life feeling ugly and unacceptable because they don’t meet MeMe Roth’s standards.  Good lord, that attitude is so callous and stupid, it’s beyond comprehension.  And by the way, a lot of big people are beautiful.  I thought Jordin Sparks, one of MeMe’s “bad role models,” was lovely.

Now, the truth is, there are people who could probably lose weight but don’t care to.  So what?  The United States is a melting pot, and some cultures have different attitudes about body size.  (As Eric Oliver pointed out in our interview, the “thin is beautiful” and “thin is virtuous” attitudes are somewhat of a holdover from our Puritan heritage.) 

Some people also operate under a different value system.  I’d rather be healthy than eat french fries and ice cream and pizza, even though they’re delicious.  But other people would rather live large, suck up all the pleasure they can, and to hell with the consequences.  And guess what?  That’s okay, too.  How they live their lives is their business … not mine, or yours, or MeMe’s.

I’m guessing at this point at least a few of you are mentally protesting:  But then we all have to pay for it!  Or as my debate opponent put it:

It’s her business when she has to pay for the cost of obesity. So when Mr LardAss decides to buy another burger its his choice, but when he gets sick because of it, its no longer his choice IF his choice now affects other peoples economy. Or do you want to pay for treatment of lung cancer patients who smoked for 40 years despite the warnings?

(Burgers make you sick?  I’ll have to just let that one go.  This is already going to be a long post.)

So, do we really want to venture into “but we all pay the cost!” territory?  Fine, let’s go.  You bring the flashlight, I’ll bring the snacks.

First off, as Nick Gillespie pointed out on Stossel, the MeMe Roths of the world are attacking the wrong end of the problem.  If your bad habits impose costs on others because of socialized medicine, then the problem is with socialized medicine. Coercing us into all supporting each other is not actually a proper role for the federal government. But that’s where we’re at, so let’s take it from there: 

If anything you do (or don’t do) that imposes a cost on society is my business, then pretty much your whole life is my business.  It’s my business if you don’t attend college — you’re more likely to be unemployed later in life, and that will cost me, by gosh. It’s my business if you play football — you could get badly hurt and run up some big bills.  It’s my business if you don’t exercise — people who exercise are healthier on average than people who don’t, regardless of body size. 

It’s also my business if you drink, smoke, jet-ski, skateboard, surf, spelunk, hike in the wilderness, gamble in Vegas, piss off your boss and get fired, visit friends in dangerous neighborhoods, or have kids.  After all, if my neighbor has four kids and I have two, he’ll cost the public school system $216,000 more than I will, while also receiving two extra tax deductions.  Waaaaaaah!  He’s having a negative impact on my economy! It’s not just his business anymore; we’re all paying for those kids.

Uh … but no, we’re not all paying.  In the United States, the top 1% of income-earners pay 40% of the income taxes.  The top 10% of income-earners pay 70% of the income taxes.  But of course, incomes taxes aren’t the whole story — there are payroll taxes and Medicare taxes that are flatter, so let’s re-adjust:  for all federal taxes combined, the top 1% pay 28% of the taxes, the top 10% pay 55% of the taxes, and the top 20% pay 70% of the taxes.  (The bottom 50% pay close to nothing.)

In other words, if you’re not in the top 10% for income, it’s unlikely you’re subsidizing anyone’s life.  If you’re not in the top 20%, it’s far more likely that you’re being subsidized.

So, fat people cost “society” a lot of money?  If you’re not in the group Uncle Sam considers “rich,” then get over it.  You’re not the one paying.  (My best friend is paying, but he would never tell other people how to live.  That’s one of the many reasons we’re best friends … people with similar values hanging around together and all that.  Or it’s just socially contagious.)

But so far, we’re still assuming people with bad health habits are costing our beloved government extra money.  That’s not always the case, either.  Let’s take my debate opponent’s example of the guy who smoked for 40 years.  (I’m using today’s figures, but they would hold up over time … unless inflation-adjusted taxes and spending go down.  Yeah, right.)

So, Mr. Socially Irresponsible Stupid Smoker (a.k.a. Mr. Siss) puffs away on a pack and half per day for 40 years, then gets lung cancer, and we all pay for it through Medicare.  Let’s see how that works out:

The average cost to Medicare of treating a lung-cancer patient is just under $40,000.  (Wow, that is rather a lot.)  But in 40 years, Mr. Siss will pay $50,000 in cigarette taxes.  Then again, more than half of that is state tax, so he does cost the federal treasury a lot more than a non-smoker, right?

Wrong.  Because believe it not, everyone who doesn’t die in an accident will eventually get sick and die anyway.  Many of them rack up big Medicare bills on the way out.  My 95-year-old non-smoking, naturally thin grandmother has probably cost Medicare more than she and my grandfather ever paid in taxes in their entire lives.

So ultra-healthy MeMe Roth doesn’t smoke and therefore doesn’t get lung cancer at age 65.  Instead, she gets pancreatic cancer or colon cancer at age 85.  She’ll still receive Medicare treatment, at a cost of around $25,000.

Meanwhile, because Mr. Siss is a smoker, his lifespan will be (on average) 10 years shorter than a non-smoker’s.  That means he’ll collect about $140,000 less than average in Social Security payments.  If MeMe Roth lives 10 years longer than average because she’s so skinny and healthy and doesn’t eat at McDonald’s, she’ll collect $140,000 more than average in Social Security payments.  So here’s the final tally on the federal side of the ledger:

Mr. Socially Irresponsible Stupid Smoker:
Medicare:  (-$40,000)
Cigarette Taxes:  $22,000
Social Security vs. Average:  $140,000
Net:  $122,000

Mr. Socially Irresponsible Stupid Smoker saved the federal government $122,000 compared to someone who never smoked, had an average lifespan and never had a single Medicare procedure.

MeMe Roth:
Medicare:  (-$25,000)
Social Security vs. Average:  (-$140,000)
Net: (-$165,000)

MeMe Roth cost the federal government an extra $165,000 compared to someone who lived an average lifespan and never had a single Medicare procedure.  If MeMe doesn’t get cancer in her old age and never requires a Medicare procedure, she’ll cost the federal government an extra $140,000 … just by living ten years longer than average.

Since the cost to society makes it everyone’s problem, I think there’s only one possible conclusion we can reach here:  We must all demand that MeMe Roth take up smoking immediately.  I’m sick and tired of paying the bills for those selfish, skinny non-smokers.

See how stupid it gets when you decide other people’s lives are your business?

Fellow comedian and blogger Josh Goguen alerted me that a recent episode of Stossel dealt with obesity and the food police.  I recorded the episode, took a few clips, and added some comments in the form of subtitles and some Fat Head clips.

I actually find MeMe Roth more annoying than the sue-happy lawyer.   This is a woman who is obviously naturally thin.  She was born on the finish line and thinks she won a race.  So now she feels justified in telling other people how to eat, and in criticizing pretty much every overweight person in the public eye.  (You may recall when she proclaimed American Idol contestant Jordin Sparks a bad role model because of her size.)

My advice:  never take advice on losing weight from anyone who’s never had to work at it.  They have no flippin’ clue what they’re talking about.