The Spanish Paradox

      106 Comments on The Spanish Paradox

An article with the title No Room for Complacency in Face of Spanish CV Paradox showed up on Medscape today.  Let’s take a look at some choice bits:

The first study to report population-based data on cardiovascular health across an entire European country has found that the nation in question, Spain, is not performing particularly well and in fact is on a par with the US.

Boy, I’m sorry to hear the Spanish aren’t performing particularly well when it comes to cardiovascular health.  I spent part of my honeymoon in Barcelona and loved the place … the scenery, the food, the friendly people.  If they’re on a par with the U.S., they must have nearly as many people dropping dead of heart attacks as we do.

Surveying a cross-section of Spanish adults, Dr Auxiliadora Graciani (Universidad Autonoma de Madrid, Spain) and colleagues measured “ideal cardiovascular health”–as described by the AHA–and found that only 0.2% of the 11, 408 subjects attained ideal values for all seven CVD health metrics: nonsmoker, body-mass index (BMI) <25 kg/m2, physical activity at goal, diet consistent with recommendations, untreated cholesterol <200 mg/dL, untreated BP <120/80 mm Hg, and untreated fasting glucose <100 mg/dL in the absence of clinical CVD and diabetes. Of those surveyed, 3.4% attained ideal values for at least six of the metrics and 15.4% for five, they note in their report published online January 8, 2013 in Circulation: Cardiovascular Quality and Outcomes.

Wow, that’s just awful.  Barely one-fifth of one percent of the Spanish adults meet the American Heart Association’s ideal values for cardiovascular health.  And I thought the people I saw falling down in Barcelona were just party animals who’d had too much sangria.  Now I realize they were having heart attacks.  In retrospect, I feel guilty for clapping.

“This is the first study to report information on cardiovascular health from Spain, a European country with low coronary heart disease mortality compared with many Western countries,” observe the authors. However, the level of cardiovascular health in Spain “is as low as in the United States, primarily due to poor lifestyles, especially lack of ideal diet,” they note.

Um … uh … but … did I read that correctly?  The Spanish have a low level of cardiovascular health but also low coronary heart disease mortality?  Isn’t that a bit like saying they’re in poor physical condition, but can run for miles and bench-press their own body weights?  I don’t know about these researchers, but I define “good cardiovascular health” as “not dying from cardiovascular disease.”

Although the CHD mortality rate is low in Spain, recent research shows the prevalence of angina there is high, suggesting that atheromatous plaques are stable, the doctors say. Research is needed as to why these plaques do not rupture, translating into a high incidence of acute MI, as is seen in other countries, they state.

Oh, okay.  Got it.  The researchers are speculating that thanks to their stubborn refusal to adopt the American Heart Association’s definition of good health and a good diet, the Spanish actually do have lots of plaque buildup … but for some reason, plaques don’t rupture in Spain.  Must be the weather.  I’m surprised they didn’t say it’s because the Spanish drink wine.

This “paradox” of low CHD mortality and poor cardiovascular health in Spain could be explained by several things other than traditional CV risk factors, such as sedentary behavior, specific dietary components (eg, wine consumption and the Mediterranean diet), psychosocial factors (such as family support), and quality of medical care, among others, say Graciani et al.

Head.  Bang.  On.  Desk.

I see.  So the Spanish suffer from a “lack of ideal diet,” they have poor cardiovascular health because they don’t meet the American Heart Association’s criteria, but they don’t die from heart attacks because they eat a Mediterranean diet.  They have a lousy diet, but their diet saves them from heart disease.   Oh, and because they drink wine.  And because of the quality of medical care.  I guess that means they get treated for their high cholesterol.

And because lifestyles appear to contribute far more heavily than biological factors to poor cardiovascular health in Spain, there is a great need to strengthen the role of public-health efforts in the management of CVD there, they observe. Health services also need to improve, they add, noting that five out of every 10 people with elevated cholesterol are not being treated, and half of those with BP >140/90 mm Hg are unaware of this.

Head.  Bang.  On.  Desk.

So, to sum up … The Spanish are in poor cardiovascular health because of their lifestyle and lack of an ideal diet, which means there’s a great need to strengthen government efforts in the management of cardiovascular disease.  But they don’t die of heart attacks because of their diet and high-quality medical care.

I want to know how any researcher can make those arguments in a paper without reading what he wrote and thinking, “Wait a minute … I sound like a flippin’ moron here.”

By coincidence, I received a copy of the most recent report from the American Heart Association around the time I was reading the Medscape article.  Naturally, the report includes the AHA’s recommendations on cholesterol  levels:  over 240 is classified as poor, 200-239 is classified as intermediate (with a recommendation to “treat to target”) and less than 200 is classified as ideal.

Let’s look at a graph from one of the American Heart Association’s own documents.  This shows rates of death from cardiovascular diseases (heart attack and strokes combined) for men in several countries, ranked from worst to best.

Notice Spain down there near the bottom?  Notice France down there below Spain?  Now take a look at the top of the chart, where you’ll find Russia with the highest rate of cardiovascular deaths.

A couple of years ago, I downloaded data from the World Health Organization’s MONICA study, which tracks cholesterol levels and cardiovascular death rates around the world.  The average cholesterol level in Russia is 189.  In France, it’s 210.  Romania (near the top of the chart) and Spain (near the bottom) have the same average cholesterol level:  197.  When I ran the correlation function in Excel on all the countries and their rates of cardiovascular deaths, the result was -0.25.  In other words, there’s almost no correlation, and the slight correlation that exists points to cardiovascular deaths going up as cholesterol levels go down.

And so the paradoxes just keep on coming …


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106 thoughts on “The Spanish Paradox

  1. Janet

    I met my American paradox in the grocery store this morning. I bent down to get my 3 dozen eggs from the shelf and next to me searching for the exact right carton of eggbeaters was a rotund lady. I just made the comment that “the real eggs were on sale and they won’t hurt you”.

    She said, “I’d love to, but I can’t have eggs. I’ve had a quadruple bypass”.

    I said, “the eggs still won’t hurt and you might really need them”.

    I told her that I am recovering from an (open chest with full cardio-pulmonary bypass) ascending aortic aneurysm repair 3 months ago. I had to have a carotid artery scan (crystal clear) and an angiogram (also clean) before surgery. Pretty good for a 71 year old hussie like me!! I’ve been LC/HF for over three years. Current ‘meds’ are multivitamins and aspirin. Seems to work for me.

    I looked in her ‘heart attack cart’ and there was whole grain bread, grits, egg beaters, two boxes of whole grain cereal, fake butter, skimmed milk, etc. I looked in my ‘no heart attack’ cart with salad makings, ½ & ½ cream, cheese, sirloin steak, shrimp, fish, 3 dozen eggs, and real butter.

    She said, “But look at you. You are a little skinny thing, you can eat anything you want”. (I’m 5’3” and now weigh 103, but have lost 50 lb during this last 3 years)

    Well duh lady!

    Was this a n=2 observation? Me breaking all the “heart healthy rules” without a heart attack, and her with eggbeaters, skimmed milk, and wheat bread with a quadruple bypass and an extra 60-70 lbs pressing on her hips and knees.

    You were brave for trying, but it’s difficult to convince people the conventional wisdom is wrong.

    Reply
  2. David

    The part about “drinking wine” reminds me of my mom’s friend. I said how I love bacon grease and she believes it will clog my arteries. I said how countries like France eat that stuff and without missing a beat said “yeah but they drink red wine!” “well so do i (as a joke)!” “but that is bad for you anyways!” “well you just said they don’t have problems because of wine! why would i be different?” “because you probably don’t control your portions like the French do!”

    I tell people to do their research and they say “no thanks!” Shows how people don’t like to accept responsibility.

    Clearly the difference is that the French are more likely to have a mistress.

    Reply
  3. Marilyn

    Looking at that AHA chart as whole, I get the impression that deaths from cardiovascular disease are a pretty uniform percentage of total number deaths. More striking is the total mortality from the lowest to highest figures.

    Reply
  4. David

    The part about “drinking wine” reminds me of my mom’s friend. I said how I love bacon grease and she believes it will clog my arteries. I said how countries like France eat that stuff and without missing a beat said “yeah but they drink red wine!” “well so do i (as a joke)!” “but that is bad for you anyways!” “well you just said they don’t have problems because of wine! why would i be different?” “because you probably don’t control your portions like the French do!”

    I tell people to do their research and they say “no thanks!” Shows how people don’t like to accept responsibility.

    Clearly the difference is that the French are more likely to have a mistress.

    Reply
  5. Nads

    Not sure how Australia ended up even better than Spain We have even more of an olive oil and wine “deficiency” than the US, though I must say more of our food appears real.

    Somewhere I saw a graph that the indigenous population in Australia has the lowest cholesterol in the whole world. Their mortality rates are such that our health system officially recognises their health to be 20 years older than their chronological ages.

    That’s right, the Aborignes have screamingly high rates of heart disease despite very low cholesterol.

    Reply
  6. Nads

    And how long before you think we’ll see a Swedish paradox too?

    If lc/hf stays popular there, it won’t be long.

    Reply
  7. Christopher

    The AHA will never admit that the Lipid Hypothesis is wrong. I wish I had seen fat head before we studied blood and cholesterol so I could’ve set my teacher straight :P.

    By the way, what are your thoughts on CSPI’s “The Real Bears” video?

    I haven’t seen it.

    Reply
  8. Namu

    This is just rich. The AHA complains that the Spanish have a very lousy diet which protects them from CVD.

    In the immortal words of Rowan Atkinson as Black Adder, they wouldn’t notice a clue if it painted itself purple and danced on top of a harpsichord singing ‘the clues are here again’.

    LOL.

    Reply
  9. Elenor

    “it’s difficult to convince people the conventional wisdom is wrong.”

    You know what always worries me? I’m (alas) a proselytizer for low carb (everyone needs a hobby;this is mine {eye roll}), but I always worry that the friends and acquaintances I advise (okay, whom I harass…) (and to whom I give my little “hand-out business card” of URLs — which list Fathead and Science for Smart People first! {wink}) will pick up the healthy fats but NOT set down the grains and carbs and I’ll be sending them into a heart attack! I stress and stress that they have to do both — but I worry….

    (And no, I don’t foresee me NOT haras…. er….. educating everyone I know.)
    (And yes, I AM that total PITA at the party…. My cul-de-sac neighbors even call me “Dr. E” — but they, at least, do it with love!)

    Stop stressing. You’ll give yourself a heart attack, and they’ll say your diet killed you.

    Reply
  10. Walter B

    Perhaps this is obvious, but there are *no* paradoxes in reality. To say your weltanschauung has a paradox is saying your truth table is full of lies.

    Re:Graphic In reality the total length of the bar is what’s important. A couple of countries have equal or lower total death rates for that age group. I should care if I die of cardiovascular problems or some other problem? Dead is dead.

    Of course. We want to avoid dying prematurely for any reason. But the CVD death rates are interesting, given that the countries where fat is a bigger part of the diet don’t seem to be dying from heart disease.

    Reply
  11. Nads

    Not sure how Australia ended up even better than Spain We have even more of an olive oil and wine “deficiency” than the US, though I must say more of our food appears real.

    Somewhere I saw a graph that the indigenous population in Australia has the lowest cholesterol in the whole world. Their mortality rates are such that our health system officially recognises their health to be 20 years older than their chronological ages.

    That’s right, the Aborignes have screamingly high rates of heart disease despite very low cholesterol.

    Reply
  12. Christopher

    The AHA will never admit that the Lipid Hypothesis is wrong. I wish I had seen fat head before we studied blood and cholesterol so I could’ve set my teacher straight :P.

    By the way, what are your thoughts on CSPI’s “The Real Bears” video?

    I haven’t seen it.

    Reply
  13. Namu

    This is just rich. The AHA complains that the Spanish have a very lousy diet which protects them from CVD.

    In the immortal words of Rowan Atkinson as Black Adder, they wouldn’t notice a clue if it painted itself purple and danced on top of a harpsichord singing ‘the clues are here again’.

    LOL.

    Reply
  14. Ulfric M Douglas

    I occasionally spend time in Moscow, Russia living with normal people.
    ALL the men of heart-attack age smoke the most terrible cheapo cigarettes, and (probably less importantly) eat loads of bread. Bread with everything. Not much fish, but plenty of the other high-fat meat products. Not enough eggs and the eggs are of very POOR quality. Eggs are crucial.

    Japan : TONS of fish.

    I tell you, I’m aiming to eat a lot more fish from now on, despite going down from 210lb to 182lb in six months and feeling loads fitter just from diet changes.

    The smoking certainly doesn’t help.

    Reply
  15. Craig

    Re: Heart-Healthy Certified Subway meals

    In the link you gave I noticed this gem about the AHA’s Industry Nutrition Advisory Program tacked on at the bottom of the article:

    “In addition to Subway, some of the other members of INAP are Uniliver, Coca-Cola, Dr. Pepper, Frito-Lay, Hershey, Kellog, Kraft, McDonald’s, Sara Lee, The Sugar Association, Welch’s, and Yum! Brands (Taco Bell, KFC, Pizza Hut).”

    Sounds like a great organization for unbiased nutritional advice, doesn’t it?

    Indeed.

    Reply
  16. Kay

    Wow. This post and the last one, about the USDA, sure are stunners. I’m not completely sold on your idea of what people should eat, and my hubby is still afraid of fat and egg yolks, but these posts at least show that the conventional wisdom is way off. I’m taking my time reading about the insulin theory, before I really commit. (I also have a child that has anaphylactic allergies to milk and eggs, so that makes it hard to make Paleo tasty for her.)

    Sorry to hear about those allergies. That does limit the choices.

    Reply
  17. Elenor

    “it’s difficult to convince people the conventional wisdom is wrong.”

    You know what always worries me? I’m (alas) a proselytizer for low carb (everyone needs a hobby;this is mine {eye roll}), but I always worry that the friends and acquaintances I advise (okay, whom I harass…) (and to whom I give my little “hand-out business card” of URLs — which list Fathead and Science for Smart People first! {wink}) will pick up the healthy fats but NOT set down the grains and carbs and I’ll be sending them into a heart attack! I stress and stress that they have to do both — but I worry….

    (And no, I don’t foresee me NOT haras…. er….. educating everyone I know.)
    (And yes, I AM that total PITA at the party…. My cul-de-sac neighbors even call me “Dr. E” — but they, at least, do it with love!)

    Stop stressing. You’ll give yourself a heart attack, and they’ll say your diet killed you.

    Reply
  18. Walter B

    Perhaps this is obvious, but there are *no* paradoxes in reality. To say your weltanschauung has a paradox is saying your truth table is full of lies.

    Re:Graphic In reality the total length of the bar is what’s important. A couple of countries have equal or lower total death rates for that age group. I should care if I die of cardiovascular problems or some other problem? Dead is dead.

    Of course. We want to avoid dying prematurely for any reason. But the CVD death rates are interesting, given that the countries where fat is a bigger part of the diet don’t seem to be dying from heart disease.

    Reply
  19. Baron Von Cruzer

    Oh my god!!! According to that chart the French have now surpassed the Swiss!

    Swiss people how could could you let this happen?!!!

    Reply
  20. Ulfric M Douglas

    I occasionally spend time in Moscow, Russia living with normal people.
    ALL the men of heart-attack age smoke the most terrible cheapo cigarettes, and (probably less importantly) eat loads of bread. Bread with everything. Not much fish, but plenty of the other high-fat meat products. Not enough eggs and the eggs are of very POOR quality. Eggs are crucial.

    Japan : TONS of fish.

    I tell you, I’m aiming to eat a lot more fish from now on, despite going down from 210lb to 182lb in six months and feeling loads fitter just from diet changes.

    The smoking certainly doesn’t help.

    Reply
  21. Craig

    Re: Heart-Healthy Certified Subway meals

    In the link you gave I noticed this gem about the AHA’s Industry Nutrition Advisory Program tacked on at the bottom of the article:

    “In addition to Subway, some of the other members of INAP are Uniliver, Coca-Cola, Dr. Pepper, Frito-Lay, Hershey, Kellog, Kraft, McDonald’s, Sara Lee, The Sugar Association, Welch’s, and Yum! Brands (Taco Bell, KFC, Pizza Hut).”

    Sounds like a great organization for unbiased nutritional advice, doesn’t it?

    Indeed.

    Reply
  22. Kay

    Wow. This post and the last one, about the USDA, sure are stunners. I’m not completely sold on your idea of what people should eat, and my hubby is still afraid of fat and egg yolks, but these posts at least show that the conventional wisdom is way off. I’m taking my time reading about the insulin theory, before I really commit. (I also have a child that has anaphylactic allergies to milk and eggs, so that makes it hard to make Paleo tasty for her.)

    Sorry to hear about those allergies. That does limit the choices.

    Reply
  23. Galina L.

    @ Ulfric M Douglas;
    It is the Russian paradox – lean people who eat a lot of bread and have low cholesterol levels have a lot of cardiovascular issues. Not every man in Russia of a heart-attack age smokes cheep cigarettes. My father who died from heart arrest at 51 didn’t smoke and very rarely drank. BTW – the famous Kitovans do smoke, and it is very possible their cigarettes are not the most expensive ones.
    I was impressed by the variety of fish in Russian stores, their food markets are awesome.

    Reply
  24. Baron Von Cruzer

    Oh my god!!! According to that chart the French have now surpassed the Swiss!

    Swiss people how could could you let this happen?!!!

    Reply
  25. Bret

    (that didn’t go through correctly somehow… trying again with different punctuation…)

    “I want to know how any researcher can make those arguments in a paper without reading what he wrote and thinking, ‘Wait a minute … I sound like a flippin’ moron here.'”

    I’m sure the itch to look at yourself in the mirror manages to vanish when you receive that big grant from government bureaucrats for reassuring them that their opinion is correct.

    And besides, how could you ever be inclined to question your accuracy or integrity when the media plasters your “findings” all over the front pages and honors you for nobly exposing the dangers of animal fat?

    Good points.

    Reply
  26. Galina L.

    @ Ulfric M Douglas;
    It is the Russian paradox – lean people who eat a lot of bread and have low cholesterol levels have a lot of cardiovascular issues. Not every man in Russia of a heart-attack age smokes cheep cigarettes. My father who died from heart arrest at 51 didn’t smoke and very rarely drank. BTW – the famous Kitovans do smoke, and it is very possible their cigarettes are not the most expensive ones.
    I was impressed by the variety of fish in Russian stores, their food markets are awesome.

    Reply
  27. Bret

    (that didn’t go through correctly somehow… trying again with different punctuation…)

    “I want to know how any researcher can make those arguments in a paper without reading what he wrote and thinking, ‘Wait a minute … I sound like a flippin’ moron here.'”

    I’m sure the itch to look at yourself in the mirror manages to vanish when you receive that big grant from government bureaucrats for reassuring them that their opinion is correct.

    And besides, how could you ever be inclined to question your accuracy or integrity when the media plasters your “findings” all over the front pages and honors you for nobly exposing the dangers of animal fat?

    Good points.

    Reply
  28. Sonja

    I just got back from three years in Moscow, and it is such an interesting country when it comes to dietary habits. The vast majority of people are thin. I’d look around a crowded street and often I couldn’t find one heavy person. Unfortunately, everyone smokes to include young women who do it to keep thin. Everyone is walking. Fat is encouraged with mayonnaise, quality butter, lard, preserved fat (Salo), liver, full fat creams and milk, sour creams so fatty they taste like thick cream. I loved eating over there! The grocery stores and markets in Moscow really are wonderful.

    Reply
  29. Sonja

    I just got back from three years in Moscow, and it is such an interesting country when it comes to dietary habits. The vast majority of people are thin. I’d look around a crowded street and often I couldn’t find one heavy person. Unfortunately, everyone smokes to include young women who do it to keep thin. Everyone is walking. Fat is encouraged with mayonnaise, quality butter, lard, preserved fat (Salo), liver, full fat creams and milk, sour creams so fatty they taste like thick cream. I loved eating over there! The grocery stores and markets in Moscow really are wonderful.

    Reply
  30. Rachel

    Bit off-topic but I gotta get this out.

    My partner’s father has recently been diagnosed with Type 2 diabetes. He then complained of chest tightness and testing revealed a partially blocked artery.

    I am terrified for him. In his future I see metformin and statins, I see joyless low fat taste free meals, I see well-meaning interventions causing a premature decline and death.

    The difficulty is that I don’t know him very well. We visit maybe two, three times a year- birthdays, Christmas, that kind of thing. I so desperately want to throw books and videos like yours at him, but don’t feel I can. I don’t know that he’d believe me if I did. You have to understand- British politeness and reserve + respect for elders + don’t know each other well…I can’t argue to his face, and if I tried he’d likely say “Oh, really?” and think I was a nut.

    It’s awful to feel this helpless. I feel like I’m going to have to sit back and watch him receive harmful medication and advice, and get slowly worse and worse. My own father was put on statins some years ago (when I was still a True Believer in mainstream nutritional advice), but had the good sense to realise they were making him ill, and stopped. He still believes high cholesterol = bad, though. He even believes the populist tabloid junk science about berries being “cholesterol-busting”.

    Should I anonymously mail them both a copy of Fat Head? Would they even watch it? My dad didn’t read any of the books I left for him (Malcolm Kendrick, Zoe Harcombe, Gary Taubes). I dunno. I’ve been so pleased with myself for getting my own diet sorted out and feeling so much better, but now the folk for whom it really counts- the older men in my life who are struck down with heart disease and diabetes- are in the firing line. And it feels bad. Really bad.

    Sure, you could try mailing them copies of Fat Head, but in my experience if people are determined to believe the “experts,” you’ve got to just let go.

    Reply
  31. Rocky Angelucci

    FrankG summarized it perfectly:

    It’s all about fitting the square data into their round hole.

    Clinging desperately to a failed model requires Lewis Carroll-esque twists in logic to make the data appear to fit. And because very few nutritional “experts” (i.e., the information gatekeepers for the average person) ever read past a study title or abstract, the horribly failed logic goes unchallenged and the fallacies continue to propagate.

    Like my college physics professor told us: Learn math. Math is how you know when they’re lying to you.

    Reply
  32. Rocky Angelucci

    Kay,

    I have a colleague who is allergic to chicken eggs but finds that duck eggs are not a problem at all. With a reaction as severe as your daughter’s, however, I’m not sure how one would safely test her tolerance, but it may be an avenue for consideration.

    Reply
  33. Rachel

    Bit off-topic but I gotta get this out.

    My partner’s father has recently been diagnosed with Type 2 diabetes. He then complained of chest tightness and testing revealed a partially blocked artery.

    I am terrified for him. In his future I see metformin and statins, I see joyless low fat taste free meals, I see well-meaning interventions causing a premature decline and death.

    The difficulty is that I don’t know him very well. We visit maybe two, three times a year- birthdays, Christmas, that kind of thing. I so desperately want to throw books and videos like yours at him, but don’t feel I can. I don’t know that he’d believe me if I did. You have to understand- British politeness and reserve + respect for elders + don’t know each other well…I can’t argue to his face, and if I tried he’d likely say “Oh, really?” and think I was a nut.

    It’s awful to feel this helpless. I feel like I’m going to have to sit back and watch him receive harmful medication and advice, and get slowly worse and worse. My own father was put on statins some years ago (when I was still a True Believer in mainstream nutritional advice), but had the good sense to realise they were making him ill, and stopped. He still believes high cholesterol = bad, though. He even believes the populist tabloid junk science about berries being “cholesterol-busting”.

    Should I anonymously mail them both a copy of Fat Head? Would they even watch it? My dad didn’t read any of the books I left for him (Malcolm Kendrick, Zoe Harcombe, Gary Taubes). I dunno. I’ve been so pleased with myself for getting my own diet sorted out and feeling so much better, but now the folk for whom it really counts- the older men in my life who are struck down with heart disease and diabetes- are in the firing line. And it feels bad. Really bad.

    Sure, you could try mailing them copies of Fat Head, but in my experience if people are determined to believe the “experts,” you’ve got to just let go.

    Reply
  34. Rocky Angelucci

    FrankG summarized it perfectly:

    It’s all about fitting the square data into their round hole.

    Clinging desperately to a failed model requires Lewis Carroll-esque twists in logic to make the data appear to fit. And because very few nutritional “experts” (i.e., the information gatekeepers for the average person) ever read past a study title or abstract, the horribly failed logic goes unchallenged and the fallacies continue to propagate.

    Like my college physics professor told us: Learn math. Math is how you know when they’re lying to you.

    Reply
  35. Rocky Angelucci

    Kay,

    I have a colleague who is allergic to chicken eggs but finds that duck eggs are not a problem at all. With a reaction as severe as your daughter’s, however, I’m not sure how one would safely test her tolerance, but it may be an avenue for consideration.

    Reply
  36. Walter B

    RE: Math and how you know when they are lying
    (Besides if their lips are moving.)

    _How to Lie with Statistics_

    A must read, for all, for nutrition and everything else.

    I’ve read it. Good book.

    Reply
  37. Walter B

    RE: Math and how you know when they are lying
    (Besides if their lips are moving.)

    _How to Lie with Statistics_

    A must read, for all, for nutrition and everything else.

    I’ve read it. Good book.

    Reply
  38. Fred Hahn

    Tom, don’t you know that taking out your frustrations out on large pieces of furniture with your head can cause a temporary inability to blog?

    We mustn’t let this happen to you! You need head protection! I know what to buy you for your birthday:

    http://api.ning.com/files/1DMazCIX9zIrVzBaCxSxjY7crAIIej108vT9S2ILhrHldk2KmyXDXs3p8Z-3NL4AWrnChtMEOmEEahggqZoRrGIkjgxq*Vrn/BaconHelmet.jpg

    I love it! But I’d probably eat it before I really needed it.

    Reply
  39. Michael Fox

    Hey Tom,
    Fabulous and insightful as always!! Hey I’m worried now, I checked my cholesterol and it’s about 150. Do you know any ways to raise it?? Sounds like I’m in trouble. Happy New Year!!

    If you’re on a good diet, I wouldn’t worry about it. Your body knows what it’s doing.

    Reply
  40. Michael Fox

    Hey Tom,
    Fabulous and insightful as always!! Hey I’m worried now, I checked my cholesterol and it’s about 150. Do you know any ways to raise it?? Sounds like I’m in trouble. Happy New Year!!

    If you’re on a good diet, I wouldn’t worry about it. Your body knows what it’s doing.

    Reply
  41. Ken

    I recently served on a jury and one of the other jurists (whose family are largely Spanish) visited Spain for three or four weeks. When she came back she commented on the huge amount of pork they ate — it was EVERYWHERE, she said.
    I have seen stat’s indicating the same thing — modern (i.e. since 1970s or so) Spaniards likely have one of the highest consumptions of pork in the world. Their health (including CVD, or lack of it) has markedly improved since their standard of living has increased along with their pork consumption.
    Praise the lard!

    Praise the lard and pass the ammunition.

    Reply

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