‘Twas the night before statins, and all through the land
Our lipids were lethal, as we’d soon understand.
Our eggs were all stacked in the fridge with great care
In hopes they’d be scrambled, or fried if we dare.

The children were calm and well-fed in their beds,
While visions of sausages danced in their heads.
The dads, mostly lean, and wives often thinner
Had just settled down for a porterhouse dinner.

When out in the world there arose such a clatter,
They sprang from their plates to see what was the matter,
And what on the cover of TIME should appear,
But an arrogant scientist, peddling fear.

Cheers and belief from an ignorant press
Gave a luster of truth to the new, biased mess.
So away to the doctor we flew in a pack,
In hopes of a plan to end heart attacks.

He was dressed in all white from his neck to his butt
(which conveniently hid the size of his gut).
He sat us all down for a well-meaning chat:
“More carbohydrates — avoid all that fat!”

So sugars and starches we passed through our lips,
Only to wear them on bellies and hips.
Our hearts with their plaques continued to swell,
We grew diabetic and weren’t feeling well.

The doctor announced it was likely our fault –
We were, after all, still eating salt.
“But there’s no other option,” he said with shrug,
And pulled out his pad to prescribe some new drugs.

“Now Crestor!  Now Zocor!  Then Lipitor next!
Now Lipex!  Now Lescol, and best take Plavix!
To the depths of the liver!  To the artery wall!
Force it down, force it down, foul cholesterol!”

Our appetites crazed, we soon looked like blimps.
Our children lost focus, our manhood went limp.
The doctor examined joints now wracked with pain
And concluded the patients were old or insane.

He chose Celebrix for muscles that ache,
And added Cialis to the drugs we should take.
“Now stick to your diet, and be of good cheer,
If this doesn’t work, I’ll do lap-band next year!”

We’ve got family coming in to celebrate our first Christmas in Tennessee.  I’ll be taking the rest of the week off, except to check comments.  Happy holidays to all of you.

Sometimes when I read health and medical articles in the newspaper, I don’t know whether to laugh, cry, scream, or just bang my head against the wall.  If memory serves, a recent article about the wonders of gastric-bypass surgery prompted a full round of each, followed by a string of expletives that made me grateful my daughters were in school.  (If my memory is fuzzy, it’s probably because of the head-banging.)

The article, which appeared in our local newspaper but originated with the Los Angeles Times, was headlined: Gastric bypass: Is it a diabetes fix?  Here is a link to the online version so you can read the full story in all its glorious stupidity.  In the meantime, I’ve pasted several snippets below, with my comments interspersed.

The discovery came about by accident more than a decade ago: Weight-loss surgery often led to dramatic improvements in the control of Type 2 diabetes, often before patients had even left the hospital.

Wow, that’s amazing!  I wonder what it is about having surgery that reduces a patient’s runaway blood sugar so quickly.  Perhaps by the time most of us reach adulthood, we have a big wad of undigested cotton candy sitting in our small intestines, left over from childhood trips to the state fair.  Remove the intestines, remove the cotton candy.  Makes sense.

Or perhaps it has something to do with the post-surgery diet, which consists of two to three ounces of sugar-free liquids or sugar-free gelatin.  Newsflash:  if you stop dumping sugar and starch into your digestive system, your blood sugar goes down.

Today, evidence of the connection is so solid that some doctors say surgery should be considered as a treatment for diabetes, regardless of a person’s weight or desire to lose weight.

Yes, more surgery is clearly the answer.  Granted, a couple of generations ago we had only a fraction of the Type 2 diabetes rate we see today, and that was long before surgeons were comfortable ripping people’s guts out.  But what the skeptics forget is that safety standards were lax in those days, and lots of people used to accidentally rip their own guts out in day-to-day activities like chopping wood, tossing lawn darts, and going fishing with really big hooks.  It’s much safer and far less painful to let a surgeon remove your intestines.

“We thought diabetes was an incurable, progressive disease,” says Dr. Walter J. Pories, a professor of surgery at East Carolina University and a leading researcher on weight-loss surgery.

Well, of course you did, Doctor Doofenshmirtz.  That’s because people in your profession have been trying to cure diabetes with low-fat diets, then scratching their heads in amazement when the diets don’t work.  By the way, if you’re ever quizzed on the topic of alcoholism, the answer is: No, you can’t cure it by switching from bourbon to scotch.  I thought you should know.

“This operation takes about an hour, and two days in the hospital, and these people go off their diabetes medication. It’s unbelievable.”

No, I believe it.  They’re able to go off their medication because the surgery also forces them to go off sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream.  In fact, about all they can eat are tiny portions of meat and vegetables.

But experts still aren’t sure why obesity surgery helps resolve Type 2 diabetes or how long the effect might last.

It’ll last as long as the newly-mangled patients avoid sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream

This much is clear: Patients who have weight-loss surgery begin to lose weight rapidly, which by itself improves Type 2 diabetes, allowing diabetics to more easily control their blood glucose levels. But something else appears to be occurring as well.

The “something else” is what’s not occurring:  consuming sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream

There is strong evidence that surgery — especially gastric bypass surgery, which makes the stomach smaller and allows food to bypass part of the small intestine — causes chemical changes in the intestine, says Dr. Jonathan Q. Purnell, director of the Bionutrition Unit at Oregon Health & Science University.

Yes, all kinds of wonderful changes occur in the digestive system when you rip out several feet of it.  Here are just a few:

• Reduced ability to absorb fat-soluble vitamins, leading to chronic deficiencies in vitamins A, B12, D, E and K - even if you take a lot of supplements.
• Dumping of poorly-digested food into the large intestine, causing dizziness, bloating, diarrhea and fatigue.
• Ulcers.
• Nausea and vomiting

But researchers now suspect it has other functions related to metabolism.

Of course it does, you @#$%ing idiots!  When you’re limited to a few ounces of protein and vegetables per day and have to give up sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream, your metabolism changes.

Surgery somehow alters the secretion of hormones in the gut that play a role in appetite and help process sugar normally.

No, making a drastic change in your diet alters the secretion of hormones.  When you give up sugar and starch, you don’t need nearly as much insulin anymore.  Ask Dr. Jay Wortman.  He gave up sugar and starch after becoming a Type 2 diabetic, and he doesn’t need medication either.  (But of course, the Canadian government is convinced his new diet causes heart disease.)

But diabetes also tends to resolve or improve in 50% to 80% of people who have lap-band surgery, in which a band is placed around the top of the stomach to make it smaller, he says. And there is some evidence that the effect occurs in a newer type of weight-loss surgery called gastric sleeve, in which a portion of the stomach is removed so that it takes the shape of a tube or sleeve.

Uh, what a minute … I thought you were just telling us that removing several feet of the intestines creates magical hormonal changes.  The lap band and the lap sleeve just force you to eat less — which for most people means focusing on protein foods and giving up sugar and starch.  Do you see the contradiction here?

Evidence suggests the effect on diabetes can last for an extended period or even indefinitely, particularly if people don’t regain a lot of weight.

It’s not regaining the weight that causes diabetes to return.  The weight gain and the diabetes are both caused by people deciding they can fill their itty-bitty stomachs with itty-bitty servings of sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream.  Then they get insulin spikes that make them ravenously hungry, so they eat more than they’re supposed to.  Some even manage to stretch their itty-bitty stomachs back to a nearly-normal size.

“There is durability, but we also know that some people do get the disease back again,” Purnell says… It’s not clear yet why people have different responses.

Well, let me take a shot at explaining this mystery, Dr. Frankenstein:  some people stick to the recommended post-surgery diet of meat and vegetables.  Some people go back to eating the sugar and starch that made them fat and diabetic in the first place.

Studies from several other countries show that surgery also results in remission of diabetes for people who are not morbidly obese.

So let me get this straight:  obesity causes diabetes, yet we can cure people who aren’t obese but still have diabetes by ripping their guts out and forcing them to stop filling up on sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream.  Call me crazy, but it’s starting to sound like diet might have something to do with developing Type 2 diabetes.  (No, wait … it’s a progressive, incurable disease that nobody can really explain …)

There is even discussion, particularly in other countries, of performing weight-loss surgery for people with Type 2 diabetes who are not overweight.

Of course there is.  Other countries don’t have our obesity rate.  How the heck are the bariatric surgeons in France and Spain supposed to make a living if they’re only allowed to operate on fat people?

“Doctors say, ‘If I can lower glucose by medications, why send patients to surgery?’” Purnell says. “Surgery, however, allows people to have meaningful and sustained weight loss and their diabetes is better. There are risks involved with surgery, obviously, but it makes sense, to me, to do surgery.”

Spot-on, Dr. Frankenstein.  As you know from your advanced medical training, there are only two types of treatments that can make sick people well: drugs and surgery. 

Now if you’ll excuse me, I need to go bang my head against the wall.

Over the weekend, I came across this video, courtesy of the British government. Take a look:

Well, that’s it, then. Despite the fact that I love saturated fat, after viewing this disturbing video, I’ve come to a painful and reluctant conclusion: I must stop injecting saturated fat directly into my arteries.

I briefly considered continuing the practice, reasoning that I could minimize the accumulation of grease with proper medical treatment … in this case, a twice-weekly injection of Liquid Drano. But during a brief scan of the medical literature, I discovered that while Drano is effective against grease, it also dissolves hair. I’m bald enough as it is. I don’t want to go through life resembling my baby pictures.

(Rumor has it that when my father stood staring at me through the maternity-ward window, the obstetrician patted him on the shoulder and said, “Don’t worry, Mr. Naughton. You’ll learn to love him.”)

My wife, who loathes wasting food, is bound to be annoyed with my new restrictions. Just this morning, she concluded the after-breakfast cleanup by funneling leftover bacon grease into two dozen syringes - my own personal party tray for Monday Night Football. I usually wait until halftime to begin pumping lard into my arteries, although if I crank up my appetite with a first-quarter beer or two, all bets are off. I’ve been known to empty every syringe before the second-half kickoff, then call Dominos and order a pint of pepperoni grease. Never again.

Desperate to know exactly which foods won’t clog my arteries, I decided to subject a number of them to the experiment featured in the video, employing the same rigorously scientific methods. My wife was out running errands, so my daughters assisted - partly out of intellectual curiosity, and partly because they were concerned I’d introduce a plunger as an uncontrolled variable and skew the results.

We began simply enough, taking turns stuffing slices of bread down the drain. Since the British government’s experiment specified a month’s worth of saturated fat, we didn’t stop until the drainpipe held a total of 120 slices of bread - half of them toasted.

After the plumber packed up his wrenches and left, we incorporated his expert opinion into our conclusion: bread definitely clogs your arteries, especially when consumed with milk. Or, to use the expert’s jargon, “What the @#$%?! You guys clogged the $#@& out of this pipe!”

With bread eliminated from the heart-healthy list, we moved on to other dietary staples. It turns out that rice and beans don’t totally clog your arteries, but can dramatically impede the flow. So do most vegetables, although the effects are somewhat mitigated by thorough boiling. (This may, in fact, explain the extremely low rate of heart disease in Scotland.) Clearly the theories espoused by the raw-foods advocates don’t hold up to actual scientific research.

On his return, the plumber agreed, noting, “If you’re gonna stick a coupla pounds of brussel sprouts down the drain, you gotta cook the @#$%ing things first!” I promised to include his opinion in the discussion section of our academic paper. Then, so my daughters would stop attempting to steer our research down a blind alley, I answered the question they’d been posing since the plumber’s initial visit: Yes, some men have hair on their buttocks. However, the association with heart disease is statistically insignificant.

As the experiment progressed, we were stunned to realize that a month’s worth of nearly all foods will clog your arteries: hamburgers, chicken wings, pork chops, lettuce, hard-boiled eggs, potatoes, cheese, cashews, pickles, bananas and apples, to name just a few.  Chunky-style peanut butter appears to be the most artery-clogging of all.

When I called the plumber again, a pre-recorded voice that sounded very much like the plumber’s informed me that the number was no longer in service. I asked for the new number, but the pre-recorded voice replied that it was unlisted. Business must be good when you can rely exclusively on referrals.

When my wife returned home, we began to appreciate the true cost of high-quality scientific research. She spelled out, loudly and specifically, the size of the grant that would be required to re-stock the laboratory. Until we receive such a grant, I’m afraid we won’t be able to determine if the results are repeatable.

But as good scientists like to say, the drain doesn’t lie. We are confident in our preliminary conclusion: nearly all foods clog your arteries. The only exception seems to be ice cream, which apparently can be cleared from your arteries with a steady stream of warm water. If you want to avoid heart disease, we’d suggest injecting ice cream (and nothing but ice cream) into your arteries, followed by periodic injections of warm water.

Or you could try chewing and swallowing your food, thus allowing your digestive system to process it. The effects on your arteries could, at least in theory, be somewhat different.

(I’ll be posting this on both of my blogs, since it’s partly about health, partly about politics and current events. Pretty convenient for me, since I’m in play rehearsals and don’t have as much time to write.)

There are a lot of proposals to “fix” health care floating around, all with various cost predictions - most of which are probably about as accurate as the predictions provided by a magic 8 ball. Whatever price tags you’re seeing now, just triple them in your mind. That way, the actual cost will only be double what you expected.

I have my own proposals to address the rising costs of health care. And unlike the proposals coming out of Congress, I don’t need thousands of pages to explain them. Better yet, my proposals aren’t based on the theory that the best way to bring down health-care costs is to spend another trillion dollars or so. In fact, my proposals would actually save the taxpayers money.

Seriously, they would. And I’m not talking about the kind of pie-in-the-sky “We’ll spend billions on this program now, but it will save money in the long run” nonsense that usually comes out of Washington. (If just half of the “save money in the long run” predictions I’ve heard in my lifetime had come true, we’d be running huge surpluses right now.) Nope, I’m talking about real, spend-less-money savings.

Here’s how the federal government can realize those savings:

• Stop telling us what to eat, and admit that the earlier attempts to tell us what to eat were a mistake.
• Stop subsidizing corn and other grains.

These proposals would produce both short-term and, more importantly, long-term savings. The short-term savings are based on a principle of economics that’s so stupidly simple, even the average congressman can grasp it: if you stop spending money, you end up spending less.

For decades, the federal government has been employing people whose job is to tell us what they think we should eat. In addition to their salaries, taxpayers also pay for the dubious research they conduct and the mountains of literature they produce and distribute. I say “dubious” because the primary purpose of the current research seems to be to prove that their previous advice wasn’t actually wrong … which it was. We don’t need these people. And for reasons I’ll explain shortly, we would’ve been better off without them.

The taxpayers also foot the bill for billions of dollars in annual farm subsidies. These subsidies were enacted in the 1930s as a “temporary” solution to the price shocks and instability of the Great Depression - which apparently never actually ended. In our continuing efforts to lift ourselves out of the Great Depression, we now provide wealthy corporations like Archer Daniels Midland with subsidy payments. Same goes for “farmers” like Scottie Pippin, the former star forward for the Chicago Bulls, who without government checks would no doubt have to strap his trophies to the top of a rusty old truck and seek work in California.

But even as the country struggles to escape the effects of the stock market crash of 1929, it’s probably time to end those subsidies. And we’d be healthier if we did, again for reasons I’ll explain shortly. In the meantime, we’d save billions - instantly. Once again, for the benefit of any federal policy-makers out there: if you stop spending money, you end up spending less.

The long-term savings are based on another economic principle that’s not stupidly simple, but merely logical, so at this point we’ll probably lose any government policy-makers who happen to stumble across the blog. But here it is anyway: When lots and lots of people get sick, health-care costs go up.

I know, I know … you probably thought we’re just as healthy as ever, but the insurance companies keep jacking up their rates simply because nobody’s had the political will to stop them. The fact is, the profit margin in the health-insurance industry is pretty much what it’s always been: around 3%. (Actually, a report I saw recently said it’s dropped to about 2.2% in recent years.) Insurers aren’t creating the spiraling cost of health care; they’re just passing it along to us in the form of spiraling premiums.

We can sit in town hall meetings and shout all we want about pre-existing conditions, levels of reimbursement, co-payments, deductibles, portability, public versus private competition, and the true number of the uninsured. None of that changes the simple fact that when people get sick enough to require medical care, someone is going to pay for it.

Shifting the cost of being sick from one group of people to another doesn’t reduce the cost; it just sticks someone else with the bill. The only way to reduce to the real cost of medical care (aside from refusing to treat sick people, which isn’t a good idea) is to require a lot less of it.

We require much more medical treatment than we should largely because the federal government told us what we should eat, and by gosh, we listened. As you already know if you’ve seen Fat Head or read Good Calories, Bad Calories, the only macronutrient we consume more of now than in previous generations is carbohydrates. (We’ve actually cut back on fat, especially men.)

This didn’t happen by accident. It was the result of a senate committee on nutrition, headed by George McGovern, who believed everyone should switch to a low-fat, high-carbohydrate diet to prevent heart disease. Plenty of researchers and scientists, including the head of the National Academy of Sciences, tried to tell the committee they were wrong - but McGovern knew he was right because his own doctor said so. (With that kind of authority backing you, it’s just a waste of time to wait for actual scientific proof.)

And so, with a big push from the McGovern committee, the FDA and the USDA, the low-fat, high-carb diet became the rage. We became a nation of fat-phobic grain and sugar eaters.

Meanwhile, the federal government made it cheaper for us to eat sugar and starch through massive grain subsidies. As the old farmer told the stars of King Corn, “You couldn’t make any money growing corn if not for the government payments.” Those government payments are the reason we feed cattle corn instead of letting them eat grass as nature intended. Subsidies are the reason high-fructose corn syrup is in half the products you’ll find in the grocery store, including bread. Dirt-cheap subsidized corn is the reason for Big Gulps and endless refills at the soda dispenser.

And here’s the happy result of all that government involvement in food and nutrition: Nearly one-fourth of all senior citizens have type II diabetes.  Just think of the impact on Medicare expenditures. Diabetes isn’t just a disease; it’s a driver of many other ailments, including kidney failure, blindness, heart disease, cancer and Alzheimer’s. Diabetes puts senior citizens in wheelchairs. It puts them in assisted-care facilities. And as a harbinger of health-care disasters yet to come, type II diabetes is even showing up in adolescents now. That never used to happen.

You are paying the toll for the diabetes epidemic even if you’re in fine health and have private insurance. Your taxes, of course, pay for all those diabetes-related Medicare costs - but so do your health-insurance premiums, whether you realize it or not.

You’ve probably seen media stories about hospitals charging $10 for an aspirin. Perhaps you were even outraged at the very idea. But there’s a reason hospitals put $10 aspirins on your bill: Medicare, expensive as it is, doesn’t actually cover the full cost of many treatments hospitals are required to provide. So they make up for the Medicare deficits with $10 aspirins and other exorbitant charges - all billed to your insurance.

Much, if not the majority, of our ever-increasing health-care costs are driven by chronically high blood sugar and diabetes. But diabetes isn’t like the swine flu. We aren’t catching it from each other. We don’t need to spend billions of dollars to develop a type II diabetes vaccine.

What we need is for officials in Washington to stop beating up on the health-care industry, and instead call a giant press conference to make an announcement like this:

Ladies and gentlemen, the nutrition advice we’ve been handing out since the 1970s was clearly wrong. You could even say it was dead wrong. Saturated fats are not and never have been the cause of heart disease and cancer. And let’s face it, fat is delicious. We scared you away from a taste your body loves, and we feel really stupid about that. We especially feel stupid about recommending corn-oil margarine. It tastes awful and it promotes inflammation. It’s not a natural food, despite the picture of the hot-looking Native American lady on the box.

It turns out we should have been warning you about sugars and starches all along. Those are the real problem. So please, embrace your fatty foods. Enjoy your meats, your eggs, your cheeses, and be sure to drizzle lots of butter on your vegetables. We were at least right about the vegetables. But we were totally wrong about grains. They’re not a natural food for humans, and you should try to cut back on them as much as possible.

And to encourage you to do so, we’re going to cease all farm subsidies so the price of grain-based foods will reflect the actual cost of production. We suspect a lot of corn farmers will choose to retire or grow other crops, and we wish them well.

Again, we’re very sorry, and we have all turned in our resignations. Thank you, and enjoy your dinners.

No, this wouldn’t solve the problem overnight. Millions of people are already sick. Somebody is going to pay to treat them. But we could at least prevent future generations from developing the same diseases. That alone would stop the spiral.

Then, with the cost of health care held in check by actual health, we could resume debating about who’s going to pay for the costs of treating injuries and illnesses that aren’t caused by metabolic syndrome and diabetes.

I have a feeling it would be a much more civil discussion. Lower bills tend to have that effect on people.

In Burbank, I lived in a two-story townhouse and shared walls with neighbors on either side, so I was always self-conscious about making noise.  Not anymore.  I’m in a stand-alone house now, with plenty of yard space separating me from my neighbors.

So after getting my Mac set up in my new home office earlier this week, I waited until my wife and kids were gone, then fired up iTunes and cranked the Kplisch speakers all the way to seven.  Man, I was rockin’ out.

Strange thing, though … after an hour or so, I couldn’t hear the music quite as well.  So I cranked the speakers to eight.  That helped – for awhile.  Then, once again, the sound mysteriously began to fade.  So I cranked the speakers to nine.  Two hours later, the sound faded yet again. 

Dangit!  I’ve never had problems with my Mac before, but something was obviously wrong.  I could still feel the bass from the woofer thumping in my chest – my glass of fizzy water was also rattling across my desk – but the volume just wasn’t there.

So I cranked the system to all the way to ten.  That helped, but only for awhile.  Frustrated, I called the local Mac repair guy.  However, something was also clearly screwed up with my new Comcast phone system, because I could barely hear anything on the other end.  I ended up shouting into the phone, “IF YOU CAN HEAR ME ON YOUR END, I’M GOING TO GIVE YOU MY ADDRESS!  CAN YOU PLEASE GET OVER HERE NOW?!”

Well, apparently the phone could at least transmit sound, because the repair guy showed up an hour later, by which time I was really having trouble getting full volume from my Mac.  I told the guy what was wrong:

“I’M HAVING A HARD TIME HEARING MY MUSIC!”

“Geez, Pal, stop yelling at me!”

“WHAT?!”

“STOP YELLING AT ME!!”

“OH, OKAY!  I mean … oh, okay.”

Turns out the guy is what Seinfeld would call a low-talker.  His lips moved, but hardly any sound came out.  (I’m pretty sure I didn’t agree to wear a puffy shirt during my next standup show.)  I managed to explain that my sound was fading and I wanted it nice and loud again.  He listened to the system and mumbled something.

“WHAT?!”

“Your sound system is fine.”

“WHAT?!!”

“I SAID YOUR SOUND SYSTEM IS  FINE!  I THINK MAYBE YOU’RE GOING DEAF!”

“HOLY CRAP!  WHAT THE HECK COULD CAUSE THAT?!”

“MAYBE YOUR MUSIC WAS TOO LOUD!”

“WELL, IT DOESN’T SOUND VERY LOUD TO ME!  CAN YOU FIX THE SYSTEM SO IT WILL GO TO ELEVEN?!  NO, WAIT … I WANT IT TO GO ALL THE WAY TO FIFTEEN!”

“IF I DO THAT, YOU’LL BE CALLING ME NEXT WEEK TO MAKE IT GO TO TWENTY!”

“OH, I SEE … WELL, HOW MUCH DOES THAT COST?!”

“STOP YELLING AT ME!”

Okay, none of that actually happened.  I am a tad hard of hearing thanks to some nasty childhood earaches that caused my eardrums to tear, but the Kplisch system can still knock me across the room if I turn it up to five.  But I thought about the ever-increasing volume scenario when I saw an ad online for Januvia, a Merck medication designed to control blood sugar for Type II diabetics.

Most of you probably know this already, but diabetes comes in two forms.  Type I diabetes produce little or no insulin, often from an early age.  They usually need insulin injections to keep their blood sugar normal, and to keep from wasting away – without insulin, they can’t store fat.

Type II diabetes do produce insulin.  In fact, they tend to produce lots of insulin – but it’s not enough to keep their blood sugar under control.  Why not?  Simple:  they’ve become resistant to the stuff.  When the body’s insulin receptors are constantly flooded with insulin, they become damaged and stop working … just like the cilia in your ears can become damaged by too much noise.  Worse, the beta cells in the pancreas can become overworked from constantly cranking out the insulin and burn out.

So what do drugs like Januvia do?  Here’s a quote from official website:

JANUVIA works differently from other medicines to lower blood sugar in 2 ways. It’s a once-daily prescription pill that, as part of your type 2 diabetes treatment plan, helps your body

• Increase the insulin made in your pancreas
• Decrease the sugar made in your liver

Okay, let’s see … you’ve become insulin-resistant from eating too many high-carb foods that jacked up your insulin.  So what’s the obvious solution?  Well, you must need a drug that horsewhips your body into producing even more insulin.  You need to crank those speakers up to eleven.  Then twelve.  Then fifteen.  Then of course you’ll suffer all the effects of elevated insulin, such as a higher cancer risk, thickening arteries, high blood pressure, excess damage to billions of cells in your body, etc. – but at least your blood sugar will be under control.

I’m not blaming Merck.  They’re a drug manufacturer, so they produced a drug.  It apparently does what it was designed to do.  But if the high priests of The Holy Church of Accepted Advice For Living A Long and Healthy Life hadn’t scared people into cutting back on fat and eating more carbohydrates, a drug like Januvia wouldn’t be necessary. 

Dr. Mike Eades once described to me how people end up on these toxic drugs:

1. Patient goes to Well-Meaning Doctor with a variety of health problems:  elevated triglycerides, weight gain, insulin resistance, etc.
2. Well-Meaning Doctor puts Patient on a lowfat diet, as he was trained to do in medical school.  This of course means the patient will be eating more carbohydrates to satisfy his appetite.
3. Patient returns for a follow-up.  The symptoms haven’t improved or have gotten even worse.
4. Well-Meaning Doctor scratches his head and says, “Well, the diet doesn’t seem to be working.  We’ll have to put you on (insert wonder drug here).” 

The Well-Meaning Doctor probably learned about the wonders of the drug at a seminar sponsored by the manufacturer, by the way.

I referred to these drugs as toxic with good reason.  Here are the possible side-effects of Januvia, once again from their own web site:

• Hives
• Rash
• Swelling of the face, lips, tongue and throat
• Upper respiratory tract infection
• Stuffy or runny nose
• Sore throat
• Headache

Awesome!  Scratch your rash, wipe your runny nose, wheeze to your wife that you’d like another serving of mashed potatoes, spoon them over your swollen lips, and enjoy the flavor on your swollen tongue.  Swallow carefully, though, because that sore throat is getting serious.  Maybe the aspirin you take for the headache will help your throat, too.

Here’s another possible side-effect not listed on the site:  in rat studies, sitagliptin (Januvia’s chemical name) led to an increase in pancreatic cancer.  Gee, you’d almost think a body doesn’t like having a drug do a beat-down on its pancreas. 

There is, of course, a natural alternative:  stop forcing your body to smack down your blood sugar several times per day.  Then you won’t need so much insulin.  Many Type II diabetics have been able to stop taking insulin and any other blood-sugar medications simply by eliminating sugar and starch.  That’s how it worked for Dr. Jay Wortman, the medical expert behind the wonderful documentary My Big Fat Diet.

And here is the list of unpleasant side-effects from giving up sugar and starch:

• You won’t be able to eat sugar or starch.

That sure sounds like the better treatment to me.

A note about my hearing, by the way:  Sometimes people speak to me and I don’t respond because (duh) I don’t know they’re speaking to me.  This generally leads to one of two reactions:  1) They try again, with extra volume, or 2) they decide I’m aloof and give up. 

I’m not aloof.  I like pretty much everyone I meet unless they give me a reason to change my opinion.  If you happen to see me onboard Jimmy Moore’s low-carb cruise and I don’t respond if you talk to me, try again.  But don’t crank it up to eleven … I’m a little hard of hearing, not deaf.

Last week I pointed out several flaws in how researchers gathered data for the NIH-AARP Diet and Health Study, which has generated a slew of scary headlines such as Animal Fat Linked to Pancreatic Cancer.  

I also mentioned that even without those flaws, observational studies can at best only produce statistical associations. They don’t prove cause and effect … although you wouldn’t always know that from the headlines.

When people mention that obesity is associated with Type II diabetes and therefore must cause diabetes, I’ll sometimes reply that gray hair is also associated with diabetes and suggest we start giving Grecian Formula to everyone to prevent it.  That usually generates a reply along the lines of, “Come on, that’s ridiculous.  A lot of people develop diabetes when they’re older and happen to have gray hair.”

That’s the good news:  people don’t confuse an association with a cause when it’s obviously ridiculous.  The bad news is that if an association isn’t ridiculous, researchers often do believe they’re seeing cause and effect – especially if the association confirms a pre-existing bias.

Since observational studies produce so many alarmist headlines, I thought it would be a worthwhile exercise to recall just how spectacularly wrong a theory based on a statistical association can be.  This is a real-world example that generated a lot of headlines back in the day.

For decades, heart-disease researchers have known what while women certainly do develop heart disease, they typically develop it later in life than men … usually after menopause.  Naturally, this got the white-coat crowd wondering if female hormones – particularly estrogen – might protect against heart disease.  The theory seemed to make sense:  men don’t produce as much estrogen as women, and women don’t produce as much after menopause.

In the 1960s, men were given estrogen as part of a large clinical trial called the Coronary Drug Project – but that arm of the trial was stopped early because the men taking estrogen began dying from heart disease at a higher rate than men in the control group.  So the theory was adjusted:  estrogen appears to protect women from heart disease, but not men.

Then a major observational study gave the estrogen theory some real traction.  For 15 years, the Harvard Nurses Health Study had been tracking the diets, health habits and disease rates of more than 120,000 nurses.  When researchers pored over the mountains of data produced by that study, they found a startling statistic:  women who took estrogen had a 40% lower rate of heart disease than women who didn’t.  And women who continued taking estrogen were less likely to suffer a heart attack than women who took it for awhile and then stopped.

You can imagine the research papers and the headlines that resulted.  There calls among researchers and doctors alike to start prescribing estrogen to all post-menopausal women who had risk factors for heart disease.  More cautious researchers called for a controlled clinical trial before estrogen was given out like heart-healthy candy, and were criticized for it.  How could they, in good conscience, deny this obvious wonder drug to millions of women while waiting for long clinical trials to play out? 

A  pharmaceutical company, Wyeth-Ayerst, eventually funded the clinical trials – hoping, of course, that estrogen would be shown to prevent heart disease.  More than 16,000 women were randomized and enrolled in the study.  For five years, half received estrogen and half received a placebo.

The results were hardly what Wyeth-Ayerst had expected:  The women taking estrogen developed heart disease at a higher rate – 30% higher, in fact.  They were also more likely to suffer a stroke … another cardiovascular disease.  Later clinical trials confirmed the bad news.

The experts were flabbergasted.  The statistical correlation in the Harvard Nurses Study couldn’t have been more convincing:  women who took estrogen were far less likely to have a heart attack.  And it couldn’t have been fluke –  there were too many subjects involved.

So what happened?  Nobody can say for sure, but some researchers at the time offered an explanation that makes perfect sense:  the women in the Harvard study who took estrogen were more concerned about their health.  That’s why they took a hormone replacement in the first place. 

In other words, estrogen didn’t create healthy nurses, but health-conscious nurses did take estrogen.  Meanwhile, the health-conscious nurses were less likely to develop heart disease … for any number of reasons.

This really isn’t all that surprising. In clinical trials, people who religiously take their pills tend to have better health outcomes than people who don’t.  And guess what?  It doesn’t matter if the pill they’re taking is the actual drug or the placebo.  The difference is in the people, not necessarily in the pill. 

Some people care about their health.  Some people are lackadaisical about health.  Researchers call them “adherers” and “non-adherers.”  I have my own, more colorful labels.  The point is, we’re talking about different kinds of people, and that difference can produce statistical correlations in observational studies that have little if anything to do with the true cause and effect.

Think about the estrogen studies again for a moment: we now know that estrogen doesn’t prevent heart disease and in fact can make it worse.  And yet in a large, observational study, taking estrogen was associated with a steep reduction in heart disease – almost certainly because health-conscious women were more likely to take it.

Now think about some of the alarmist headlines and health-nanny propaganda you’ve read over the years, and ask yourself what’s really going on.  Here a few examples I came up with:

Does a diet high in saturated fat cause cancer and heart disease?   Nope.  But since saturated fat has been demonized for 30 years, health-conscious people probably eat less of it.

Does giving up meat make you healthier?  Nope.  But most people who become vegetarians are probably health conscious.

Do whole grains prevent diabetes and cancer?  Hell, no.  But they’re less likely to cause those diseases than white-flour products, and health-conscious people are more likely to choose them.

Does watching Fat Head at least three times give you a high IQ?  Uh … no.  But I’d like to think there’s a strong statistical correlation.