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.

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.

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.

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.

• 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?

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.

Mrs. Obama to Lead the Charge Against Obesity

According to a Reuters story a couple of weeks back, the First Lady will be heading up a new campaign against obesity.  Yes, of course, because all those other government-led campaigns against obesity did such a great job.  Here’s my favorite line:

Obama, who created a White House garden with local school children, said the solution to the obesity epidemic cannot come from government alone.

The solution can’t come from government alone?! Why would anybody believe the solution to obesity will come from government at all?  Based on what, their outstanding track record?  We didn’t have an obesity epidemic (such as it is) until they started telling us how to eat.

Here’s another choice quote:

Health and Human Services Secretary Kathleen Sebelius said at the launch that the Obama administration was investing $650 million in economic stimulus money in wellness and prevention programs aimed at obesity and stopping smoking.

Ummm … the media is careful with their camera work because they adore the guy, but in case you weren’t aware, President Obama is a smoker.  He tried to quit and couldn’t — despite being a Harvard-educated lawyer who knows smoking is bad for his health.  I’m trying to imagine the thinking here … “Sure, I can’t give up cigarettes, but if we spend $650 million to tell other people what’s good for them, they’ll change their behavior.”

Here’s a better solution:  get rid of corn subsidies.  That would actually save money instead of piling up more debt.

Jillian Michaels Sued

Jillian Michaels, a star on NBC’s popular reality show, “The Biggest Loser,” is being sued by Christie Christensen, who claims she didn’t lose weight with the supplements endorsed by the celebrity trainer, according to the Associated Press

I have mixed feelings about this one.  Jillian Michaels annoys me because she’s one of those “eat less, exercise more” gurus.  She horsewhips people who are already starving themselves into exercising for hours a day on the show … so of course they lose weight temporarily, but they can’t keep it off because they haven’t adjusted the amount of fat their bodies need to maintain their energy balance.  According to Gary Taubes, who’s tracked down the “The Biggest Loser” contestants, most have regained nearly all the weight.

On other hand, I can’t stand trial lawyers who run around suing everyone, and I really and truly can’t stand people who believe buying a weight-loss product that didn’t work warrants $5 million in damages.  For what, pain and suffering?  Mental anguish?  If we’re going to go down that road, Weight Watchers and Jenny Craig better start preparing their legal defenses right away.  The proper response is to ask for a refund, period.

Normal Weight, but “Obese”

From the DUH! files … an article on the ABC site notes that people can be “normal” weight, but still fat.  No kidding?  Pretty soon they may even realize people can be “overweight” without being fat or unhealthy.

Monika Sumpter did what many women dream of — she set a goal to lose weight and dropped 50 pounds. Despite losing all of that weight, her ratio of fat to muscle was around 25 percent, 5 percent from where she started and dangerously close to what some researchers say is an unhealthy situation.

So she lost 50 pounds and barely changed her fat-to-muscle ratio.  That means Ms. Sumpter lost quite a bit of muscle.  I’ll bet you dollars to donuts (and you can keep the donuts) she was on a high-carb, low-fat diet that didn’t provide enough protein — the kind Weight Watchers pushes.

If you read the article, you’ll see that she eventually took up resistance training and is now 20 pounds heavier than she was after the diet, but down to 14 percent body fat.  That means she has a higher BMI, but is quite a bit leaner.  So of course, embedded in the article is this link:

Are you a healthy weight? Click here to measure your body mass index.

As Mike Eades likes to say, Jesus wept.

Dumb Statistic About High School Football Linemen

Football linemen are more likely to die by age 50 than baseball players.  This article suggests it’s because of their size … they have larger waist-to-hip ratios than baseball players and are, of course, much bigger in general.

The article says the football players are more likely to have metabolic issues, but doesn’t say why.  Diet?  Maybe, maybe not.  Perhaps the combination of hormones and genetics that produce a 320-pound, six-foot, six-inch body also produce metabolic issues.  Insulin is, after all, a growth hormone.

But the violence of football may also be a factor in the shorter average lifespan.  I can’t recall where I read about it, but someone measured the impact of two pro linemen hitting each other.  To reproduce the same impact, the average man would have to stand 30 feet from a garage door, then run into it as fast as he can.  These guys take those hits dozens of times per game … not to mention practice sessions.

But what annoyed me about the article was this:

Recent studies suggest that this phenomenon may impact the next generation of players as well. A recent report in the Journal of the American Medical Association  that examined the incidence of overweight players and obesity among 3,683 high school football linemen found that 45 percent were classified as overweight and 9 percent would be classified with severe obesity.

“As younger athletes in high school and college are encouraged to get larger for competitive reasons, these conditions may manifest themselves in younger and younger populations,” explains Dr. John Helzberg, FACG, Co-director of the Division of Gastroenterology, Saint Luke’s Hospital of Kansas City, Clinical Professor of Medicine, University of Missouri- Kansas City School of Medicine, who co-authored the study.

Coaches aren’t encouraging high-school football players to get fatter.  They’re encouraging them to get heavier — by working out and putting on muscle.  That doesn’t harm your health; it improves you health.  (Even ABC figured that out.)  What would be truly unhealthy would be facing off against a defensive tackle who outweighs you by 40 pounds. 

That’s why the claim that 45 percent of high-school linemen are “overweight” is just stupid.  Remember, we’re talking Body Mass Index measurements here.  If you’re a six-foot male, you go into the “overweight” category as soon as you top 185 pounds.  A football lineman who doesn’t weigh at least that much goes into a different category:  it’s called guy about to get his @$$ kicked.

Okay, back to my software project …

First, for you hard-core Paleo types out there, I realize dairy products aren’t Paleo.  It’s unlikely that Paleolithic humans tried to chase down wild, horned animals and milk them … and those who did probably made a dramatic exit from the gene pool. But unless someone can prove to me that butter and cheese are harmful, I’m going to keep eating them because they taste awesome. 

These days I buy Kerry Gold butter, which comes from grass-fed cows in Ireland.  Unlike Costco butter, which is nearly white, Kerry Gold is a deep yellow.  The first time I tasted it, I was transported back in time to my grandmother’s kitchen.  (Stupidly, I forgot to buy Microsoft stock in 1982 on the return trip.)  This is how butter tasted when Grandma served it.  It’s how butter is supposed to taste.

I also buy raw-milk cheese from a vendor at our local Farmers’ Market.  Some months ago, I went to see a naturopathic doctor in California because my digestion was sluggish.  His first piece of advice was to give up diet sodas completely.  So I did, after some backsliding.  Now I don’t even like the stuff.  The last time I bought a Diet Coke, I took a few sips and tossed the rest.  Yee-uck.

The doctor’s second piece of advice was to stop eating cheese — unless I could find locally-produced raw-milk cheese.  As he explained, raw milk cheese contains live enzymes that make it digestible.  But if you pasteurize the cheese to death to transport it across the country, it’s more like plastic — his words, not mine.

In Tennessee, raw milk seems to be semi-legal.  Some farmers sell it openly at the Farmers’ Market, but the farmer we prefer can’t …  because his farm is 40 miles away.  But if we request it ahead of time by sending an email, he can legally sell it to us.

When I heard that explanation, I tried several times to make sense of it, then stopped when I thought my head was about to explode.  Apparently, if the farmer drives a cooler full of raw-milk cheese 40 miles and then sells it to just anybody who wanders buy, the cheese will feel slutty and throw a temper-tantrum that results in an explosion of salmonella bacteria.  However, if I request the cheese ahead of time, the cheese views it as an arranged marriage and is happy.

A growing number of people who understand the benefits of eating real food want to buy raw milk, but can’t — at least not legally in many states.  Some manage to find it anyway.  To get an idea of the effort this requires check out this blog post: 

Just as promised, I found the milk in the fridge. “Nelson” was printed neatly on the glass with indelible ink on an otherwise unlabeled jar. No one was around except for a dog, who surveyed my intentions and went back to guarding the cows. I left the money on the counter and departed with my contraband.

This was actually the least secretive element in my quest to find raw milk. Getting here had required everything short of a secret handshake.

After delicately putting the word out that I was looking, I was interviewed by a local gatekeeper who gave me the name of someone else who would send me in the right direction. In order to get that far, I had to prove my bona fides. The gatekeeper wanted to know my experience with raw milk, an attempt to ascertain whether I was a state health official operating a sting.

You’d almost think some of these state regulators have confused raw milk with heroin.  In fact, it’s probably easier to score heroin. 

Curious about which states have outlawed raw milk, I checked the state-by-state listings on a Weston A. Price site, The Campaign For Real Milk.  Tennessee is still listed as a state that outlaws raw milk, so that’s old information.  At least I hope it is … a vendor at the Farmers’ Market here sells it.  Perusing the state laws confirmed one of my most deeply-held and cherished beliefs:  governments are inherently stupid.  Here are few examples:

Idaho
Even though state law permits the sale of raw milk if the farmer obtains a retail raw milk license,in practice the Idaho Dept. of Agriculture refuses to license anyone to sell raw milk. There has not been a retail raw milk licensee in the state for the past 15 years.

That’s an interesting way of handling it.  Maybe California could use that technique to reduce traffic congestion.
 “Sure, it’s legal to drive here, but you need a license.”
“Okay, where do I get a license?”
“Sorry, we don’t actually issue any.”
“But … I need to drive!”
“Then you’d better get a license.”

Illinois
Raw milk sales are legal on the farm if the farmer complies with the following conditions:

1. No advertising the sale of raw milk.
2. Customers must bring their own individual containers.
3. The customer MUST put the milk from your container into their container.

Okay, I see … the farmer has raw milk in a container.  If I take it home in that container, the milk will be contaminated.  But if the milk is poured from his container into a plastic milk jug that’s been sitting in my “to be recycled” bin for the past three weeks, the contamination goes away and the milk is now safe … but only if I do the pouring, and only if I didn’t find the farmer in the yellow pages. 

Kentucky
Raw milk sales are illegal with one exception: An individual with a written recommendation from a physician may purchase raw goat milk.

“So why do I feel so terrible, doctor?”
“According to your labs, you have a rare intestinal disorder.  It’s called Capralactinecessitis.”
“Oh my gosh!  Can it be treated?”
“Yes, but only if you drink milk that would kill a healthy person.  I’ll write a prescription.”

Maine
Raw milk sales are legal on the farm and in retail stores. Raw milk and raw milk products must have a label on the product containing the words “not pasteurized.” Farmers do not have to obtain permit to sell raw milk if their sales are only on the farm and they do not advertise.

No, that’s not particularly stupid.  I listed Maine because — Stephen King-style horrors! — raw milk is sold there, both on farms and in stores.  If the stuff is as dangerous as the detractors say it is (assuming you don’t neutralize the contaminants by pouring the milk into your own container), wouldn’t the population of Maine be dwindling by now?  Wouldn’t we have heard about it on the news?

Michigan
Raw milk sales are illegal. Michigan was the first state to pass mandatory pasteurization laws-the year was 1948-and has some of the strictest milk laws on the books. Farmers may not even sell raw milk from the farm. In 2002, at hearings on the revision of the Michigan State Dairy Code, the industry attempted to amend the code to make it illegal for dairy farmers, their family members, their farm workers, and even their farm animals to drink the farm’s raw milk.

“Open the door!  Police!  I said OPEN THE DOOR!  Okay, guys, kick it in.”
BOOM!  CRASH!
“Drop the bottle, lady!  I said drop it!  Starsky, grab the kid; he’s got a milk moustache!”
…
“So, what’re you in for, kid?”
“Well, I was milking Daisy and I took a sip.”

Minnesota
The Department of Agriculture prohibits the sale of raw dairy with the exception of “milk, cream, skim milk, goat milk, or sheep milk occasionally secured or purchased for personal use by any consumer at the place or farm where the milk is produced.” The farmer cannot advertise and customers must bring their own containers. The state interprets “occasionally secured or purchased for personal use” to mean that farmers cannot sell raw milk to regular customers on a routine basis.

So you can buy raw milk from a farm as long you don’t decide you like it and go back on a regular basis.  Great, we’ll have people showing up at farms wearing Groucho Marx glasses to avoid detection.  See, here’s the thing:  if the raw milk makes you sick, you won’t be going back.  That’s why I only tried vegetarian chili once.

Nevada
Raw milk sales are legal but, in practice, there are no raw milk sales in the state. In order for a farmer to obtain a permit from the state dairy commission to produce and distribute raw milk, the county milk commission must first certify the farm for the production of raw milk or a raw milk product. There has never been a county milk commission in existence at any time, so to this point, there has been a de facto prohibition of raw milk sales.

Most of us who saw “Brazil” took it as a warning.  Apparently some government folks took it as an inspiration.

New Jersey
Raw milk sales are illegal. To obtain other unpasteurized dairy products, residents travel to Pennsylvania and New York, which both allow raw milk.

“Waddaya want me to do with this jamook, boss?”
“Bury him in Pennsylvania, but transfer him to your own duffel bag so he don’t rot.  And pick up a gallon of raw milk while you’re out there.”

Pennsylvania
Raw milk sales are legal on the farm and in retail stores. Raw milk for retail producers must have a permit and can only sell to stores if they have their own packaging operation with labeling and bottling machines.

For Pete’s sake, didn’t the Pennsylvania regulators learn anything from the Great Raw Milk Massacre in Illinios?!  You can’t let the farmers bottle this stuff themselves!  You’ve got to make the consumers pour the milk into their own jugs, or all hell will break loose.

Rhode Island
Raw milk sales are illegal with one exception: An individual may purchase raw goat milk from a producer if that person has a written, signed prescription from a physician.

So that lady from Kentucky with Capralactinecessitis can live in at least one other state and still receive treatment.  Lucky break.

Now if you’ll excuse me, it’s late and a wedge of Baby Swiss beckons.  I expect to wake up tomorrow without experiencing any ill effects.

Quick Facts about Being a Registered Dietitian

If your profession has something to do with food and nutrition, it is a
must for you to learn as much as you can about the field that you are in.
This is where your understanding about the basic facts of your specific
field proves to be useful.

For example, if you want to become an RD or a Registered Dietitian, your
primary role would be to promote good health through proper eating.  If
your service as a dietitian is required by a senior citizen, for example,
you will be responsible for preparing food and developing a modified diet
to suit the health requirements of the individual.

Dietitians are also involved in research, while those in the medical
community help patients get the nutrition that they need from artificial
sources if they are unable to consume food normally.

Frequently Asked Questions about Registered Dietitians

Now that you already have an idea about the basic role of an RD, take a
look at the following list of frequently asked questions regarding their
profession:

1. What are the requirements for being a Registered Dietitian?

If you want to become a Registered Dietitian, you need to complete an
internship of at least 900 hours.  However, a nutritionist who wants to
acquire state certification may or may not be required to complete the
same number of hours of internship.

Those who would like to become certified nutritionists with a licence to
practice in their respective states would be required to complete an
internship. This usually requires anywhere from six to twelve months of
internship. If you cannot commit yourself to doing a full-time internship,
there are part-time internship programs which would take about two years
to be completed.

2. Are there state-specific requirements when it comes to the credentials
that you need to have in order to become an RD?

The agency which provides the list of the 46 states which have regulating
laws for dietitians and nutritionists is the Commission on Dietetic
Registration.  This is the credentialing agency for the American Dietetic
Association or ADA – and they are the institution which sets up
requirements such as the 900 hours needed for an RD internship.

In states such as Washington, New Mexico, North Dakota and Maryland,
dietitian is actually different from a nutritionist – while other states
do not clearly define the difference between the two professions.

3. Which agency can you consult if you have further questions regarding
the RD profession?

Check with your state’s Board of Dietetics if you have any questions
regarding the internship requirements for your state.

All in all, whether you’re a nutritionist or an RD, what’s important is to
learn about the state-specific requirements of your profession beforehand
so that there is no confusion between the terms nutritionist and dietitian
as defined by your state’s laws.

About the Author

Amanda Clary writes a non commercial blog focused on her experience on
helping her family and friends to eat healthy. She is a “Nutritionist for
Hobby” and writes on the online nutrition certification blog to help people learn how to get certified and learn all the aspects related to this job (Skills, requisites, everyday problems, upgrading, etc.).

Just Say No to In-Breeding

by Matt Stone of 180DegreeHealth.com

In-breeding is just wrong. I mean, if two things are related to one another, they just shouldn’t be comingling. Things get nasty. People talk. Banjos run wild.

But it’s totally okay for insulin resistance and glucose to hook up. They can shag all night. Get married. Have kids with the normal 10 fingers and 10 toes. All kinds of good stuff. Nothing the least bit immoral or chromosomally risky about. Why? ‘Cuz glucose and insulin resistance are unrelated.

Recently, I was asked to do a guest blog post by Fat Head Master and Commander Tom Naughton, a man who I hold in the utmost regard for translating the work of Gary Taubes into something smart, clever, understandable, and friggin’ hilarious. It’s a tough task indeed — making Taubes palatable to a broad audience is like making a low-fat product taste good. You need lots of high-fructose corn syrup. Crap, bad example, Gary Taubes is a mad HFCS hater! And Naughton too! Don’t worry, I am too. I can usually count the grams of fructose I eat per week on one hand.

Round of applause for Tom. Tom contacted me to do this guest post PRECISELY because he knows that some of my research, theories, and therefore beliefs are not congruent with his and the rest of the low-carb crowd. That is the mark of a real researcher. It still amazes me how much the disease called “like-minded camaraderie” stifles the great health debate. Some low-carb gurus are more stubborn and set in their beliefs than frickin’ vegans. I won’t name any names.

So let’s take another look into insulin resistance, because one thing I can promise you is that it is more complicated than Glucose = Insulin = Obesity, Type 2 diabetes, heart disease, and Cancer. If you get absolutely nothing out of this article, if I lose you along the way, don’t forget that. Everyone who demonizes ANY macronutrient group, especially one that can be found in the milk of every mammal on earth, is a hopeless intellectual cripple.

To begin with, let’s look at just how fragile the Carbs = Disease hypothesis is. You thought the Fat = Disease hypothesis was comical in its simplicity and oversimplification, wait ’til you get a load of this! (Note: I’m not a fan of a low-fat diet, don’t think saturated fat is harmful, and am not a vegetarian, a food-combiner, calorie-counter, or any other kind of diet-dogma nutcase. I’m a researcher with an open mind who’s tried it all).

One of my favorite examples is that continent that eats a primarily low-fat, starch-based diet, but has health that is irrefutably better than the status quo in the United States and many European countries. It’s called Asia. In reference to the British article about Big Fat Lies in which starch was demonized, I created a fun game. It’s called “Count all the obese people on a low-fat, starch-based diet.” Feel free to participate.

Another fine example that shows the greater complexity of the issue of insulin resistance and the disease that stems from it — and its relationship to dietary carbohydrate — is that of the Pima Indians.

Now, wait a second. Didn’t Gary Taubes show that the Pima Indians of Arizona are now the most obese, diabetic, insulin-resistant people on earth? Yes, he did! That I won’t deny. What I’m talking about is the Mountain Pima of Northern Mexico. They don’t live on the American reservation and they continue to follow their traditional farming practices. Their diet does not consist of mostly meat, white flour fried in vegetable oil (fry bread), Pepsi products, alcohol, and packaged “food” products — like the diet of the American Pima. They are the genetic twins of the American Pima, but they, as Andrew Weil describes, “remain lean, active, and free of the diseases of Western civilization, while their relatives from the same gene pool have ballooned into the fat, hypertensive, diabetic Indians who are now so numerous in southern Arizona and northern Mexico.”

What their diet does consist of, in contrast to the American Pima, is EVEN MORE high-glycemic carbohydrates. Their staples are corn (gasp), potatoes (shriek), beans (Holy Lectins, Paleo Man!), and other grains and tubers, along with primarily game meats. Oh, and by the way, I’m not a big fan of Andrew Weil either. Dr. Santa has some kind of boner for soy products and eats enough fructose and polyunsaturated fat to, well, be fat.

What about fructose? Taubes talks about its unique metabolic property. He calls it “the most lipogenic carbohydrate.” Is this significant? I thought high-glycemic carbohydrates that raised our blood sugar and insulin levels the fastest caused insulin resistance and the constellation of metabolic syndrome. I wonder what Richard J. Johnson, author of The Sugar Fix (2008) has to say about that?

“…we have powerful direct evidence to show that consuming too much fructose-rich sugar and HFCS causes the toxic brew of conditions known as metabolic syndrome. Moreover, this same body of research suggests that starchy foods do not induce metabolic syndrome.”

“It’s worth noting here that the glucose in starchy foods may cause blood glucose levels to rise, which stimulates the pancreas to produce insulin. But this is normal and healthy. Dietary glucose does not cause insulin resistance; fructose does.”

“And so begins a vicious cycle caused by eating high-GI foods, which overstimulate the pancreas. It’s an interesting theory, but it is not well supported by the metabolic facts. Stimulating the pancreas to produce insulin is not the problem. Your body is supposed to produce insulin when blood glucose levels rise, so that’s normal and healthy. It is insulin resistance that is closely linked to metabolic syndrome and weight gain. Glucose does not cause insulin resistance. Fructose does. Glucose does not trick your body into persistent hunger. Fructose does.”

Jesus, Dick, settle down. Take it easy, bro. We get the point. Ever think to enroll yourself in fructose-anger management class?

Of course, fructose is a low-glycemic carbohydrate. It causes the lowest blood sugar spike of any carbohydrate. It makes Pepsi (caffeine also can intensify insulin resistance), look like a better choice than a baked potato, when the metabolic effects of the two are as different as Anthony Colpo and Ghandi (they are both bald, but that’s about it). Hence the name of one of the chapters in my most recent book , “The Glycemic Index Catastrophe.”  This is just the tip of the iceberg when it comes to analyzing the glucose vs. fructose issue.  And that is one hell of a big iceberg involving leptin, the hormone with the greatest influence over metabolic rate, appetite, and levels of lipolysis (fat burning) and lipogenesis (fat storage) of any other biochemical. 

In fact, if you had to narrow down insulin resistance to one primary biochemical reason, it would be the state of “leptin resistance,” also thought to be caused primarily by fructose — whereas other dietary carbohydrates have the opposite effect. That’s why starch-based cultures in Asia and elsewhere don’t overeat, have healthy metabolisms, and are generally better off than people in places that put “sugar on top.”

So let me throw this out at you. Even if your blood sugar and insulin surge after ingesting potatoes or rice due to having insulin resistance, let it be known that those potatoes and rice didn’t cause your insulin resistance. Low-glycemic fructose played the heaviest hand in creating that fabulous metabolic state you find yourself in. Cortisol-triggering inflammation from omega 6 overload is a prime suspect as well. If you don’t believe that cortisol can trigger metabolic syndrome, then shoot yourself up with cortisone every day for a year and tell me how it goes for ya. Fructose, cortisol, and other factors, such as lack of key nutrients lost in the carbohydrate-refining process, all play a role.

Which brings up another key point. Refined and unrefined carbohydrates cannot be equated. Even Gary Taubes makes this general assertion in GCBC. T.L. “Peter” Cleave, author of Diabetes, Coronary Thrombosis, and the Saccharine Disease, on which Taubes built a large part of his hypothesis, hit the nail on the head when he stated on page 15 of that book:

“…carbohydrates should not be taken as a single group but as two very different groups; one being natural, unconcentrated carbohydrates, such as unrefined grains, potatoes, and fruits, and the other being unnatural, concentrated carbohydrates, notably refined flour and sugar.”

This was the conclusion he came to after seeing plainly that rural Zulus, eating an extremely high-carbohydrate diet, had none of the health problems of the urban Zulu, who ate a high refined-carbohydrate diet and had every facet of what Cleave called “The Saccharine Disease.” Sounds like metabolic syndrome to me:

“The saccharine disease includes dental decay and pyorrhea; gastric and duodenal ulcer and other forms of indigestion; obesity, diabetes, and coronary disease; constipation, with its complications of varicose veins and hemorrhoids; and primary Escherichia coli infections, like appendicitis, cholecystitis (with or without gall-stones), and primary infections of the urinary tract. The same applies to certain skin condition. Not one of these diseases is for practical purposes ever seen in races who do not consume refined carbohydrates.”

Taubes was right on track to echo this conclusion early on in GCBC (which is one hell of a badass book overall)…

“If cavities are caused primarily by eating sugar and white flour, and cavities appear first in a population no longer eating its traditional diet, followed by obesity, diabetes, and heart disease, then the assumption, until proved otherwise, should be that the other diseases were also caused by these carbohydrates.”

… but veered into Keto Land when he stepped up to the plate in the bottom of the ninth, which is a massive, unfounded, unwarranted, unnecessary, and unfortunate leap.

Yep, it wasn’t until the Epilogue that he sings the praises of a ketogenic diet, which is, don’t say I didn’t warn ya, metabolic suicide if continued long-term. Trust me. My blog has become a sanctuary for low-carbers in metabolic rehab. And I low-carbed for 3 years and felt all the initial benefits too — weight loss, energy, clear skin, fewer allergies — then watched them all fade away, along with my emotional state, and come back with a vengeance. Low-carb is seldom a happily-ever-after, and don’t be stubborn if you start having problems with it. End rant.

The final question is simply, “Where do we go from here?”

If we, as a race of people, are becoming increasingly insulin-resistant — then does that mean that the right “diet for our metabolic type” is a low-carbohydrate diet? Well, it’s a huge step in the right direction that we have good folks like Michael Eades and Uncle Tom Naughton that can at least step outside of the “repeat after me: artery-clogging saturated fat” wacky world of the American Dietetic Association. Finally, we’re getting somewhere at least, and see that our woes are all about hormones, not willpower.

But I think the grandest solution is not to cater to the metabolic disorder known as insulin resistance by running from carbohydrates in fear. Rather, my ambition as a researcher and writer is to truly find the pathways that allow us to topple insulin resistance completely — freeing us to eat whatever macronutrient combo we feel like without compromising our health. We don’t have all the answers yet, but we’re making progress. Dropping my fasting and postprandial glucose levels by 25% recently is a testament to the fact that it can be done. Eating two baked potatoes with my blood sugar peaking at 75 mg/dl one hour later is a metabolic feat few can claim.

Most importantly, people are overcoming hypothyroid symptoms and a low body temperature very quickly, and without medication, by following some of my ideas. I think this is key, as the most successful doctor in history at preventing type 2 diabetes and heart disease (Broda Barnes) did so by keeping the metabolism high, but had to use medication to do it.

And therein lies the true danger of uber-low-carbohydrate diets. All my experience tells me that, the first few years aside, a low-carbohydrate diet and certainly a full-blown ketogenic diet exacerbates a low metabolism. It is not a matter of having a genetically-doomed dysfunctional thyroid gland; it is fixable, and it lies at the core of the health problems we’ve seen explode over the last century. This is why all prolonged restricted diets, low-carb included, in the words of Robert Atkins himself (from page 303 of Dr. Atkins’ New Diet Revolution):

“…tend to shut down thyroid function. This is usually not a problem with the thyroid gland but with the liver, which fails to convert T4 into the more active thyroid principle, T3. The diagnosis is made on clinical grounds with the presence of fatigue, sluggishness, dry skin, coarse or falling hair, an elevation in cholesterol, or a low body temperature.”

To that I will add constipation, bad moods, heartburn, cold hands and feet, and a whole host of other minor but significant health problems. To get an idea of how “shutting down the thyroid” can manifest, Mark Starr’s chapter on Hypothyroidism symptoms is 83 pages long.

This is why the acronym FAD is thrown around 180DegreeHealth quite frequently. The AD stands for All Diets. I’ll leave it up to your imagination as to what the F stands for.

Anyway, if you like compelling health conversation, stop by my blog at www.180degreehealth.blogspot.com. It is a cesspool of agenda-free health information and discussion. It is also free to become a member of my website and access long-winded but very fascinating monthly eZines and podcasts. Go to www.180degreehealth.com to get a piece a that.

Thanks everyone, and best of luck with your health pursuits. I hope that you too can someday achieve that blessed metabolic state that allows you to do what Tom’s son and way-out-of-his-league wife do: sit down and eat whatever they want, until they are full, without becoming obese or diabetic.

Thanks once again to Tom for keeping the conversation going. Clearly mankind hasn’t solved all the riddles of health yet. But thank the Lord Almighty that the low-carb movement got us all eating fatty meat and butter again. What a stupid phase that low-fat thing was!

Thank you, Matt, for sharing your research and your ideas. My wife is indeed out of my league, but fortunately for me, she doesn’t believe it. — Tom