Monthly Archives: October 2015

High Cholesterol is Good for You

High Cholesterol is GOOD for Women – the HUNT Study

Published Oct 26th, 2015

Reference: Petursson, Jr Eval Clin Pract. AHA Cholesterol Guidelines

Have you been badgered lately by a health provider who has insisted that you be on a statin? They show you your “numbers” and your cholesterol is high.   You blanche. You’ve seen all the ads on TV for statins. All your friends are on statins. What to do? The last time you tried statins, you had terrible leg pain just walking across the room.

Well, what you do is pull the rug out from the argument and read the article above.   It shows that moderately higher cholesterol is protective. Worse, it shows that mortality is HIGHER if you lower your cholesterol.   What are the details? This is a big research study – following men and women prospectively for 10 years (52,087 Norwegians and a total of 510,297 observation years). It shows a U shaped curve for mortality from cardiovascular disease with the greatest mortality happening in the “mid-range”.

The authors suggest that it’s time to get some nuance into cholesterol guidelines.   The total cholesterol is just not the story line we want to follow.   The authors suggest that perhaps better “numbers” would be to take the Total Cholesterol/HDL ratio and aim to get that below a certain threshold. (Most folks say around 4.5) That would take into account the protective effect of HDLs.   As we talked about in this column, a more recent update on ratios shows that the Trigylceride/HDL ratio is the best predictor of all.   Perfect is when you get to less than one. You have virtually eliminated all risk of vascular disease if you can achieve that ratio.

And you can eliminate it, almost completely with lifestyle change. How?   It’s actually easy. You have to understand the role LDL’s play in your body. If you premise that they represent the fat manufactured in your liver, being transported in the blood to fat cells, where the fat will be stored, you will understand exactly how to change them. The human body was not designed to eat lots of processed carbs. We were designed to eat very coarse, dense carbs, like spinach, broccoli, dandelions, ….whole foods, raw and very low in free carbs.   Our colons’ bacteria digested those “high fiber” foods and released glucose very, very slowly.   When we eat refined bread, our liver is overcome, we cannot process the glucose and we force our blood sugar up, our insulin up, and that turns on the production of fat in our liver. Hence, if you want to get rid of your LDLs try your own experiment.   Stop eating carbs, at least the ones that come in processed foods like bread, cookies, sugar, ice cream, donuts.   Eat meat, animal fat (bacon and butter and eggs) and all the green vegetables you want.   Measure your LDLs before and after two-three weeks. You will be cured in a month of “high” LDLs and your HDLs will climb like a rocket. Even your nervous family doctor will be happy because you wont meet criteria to be treated for your allegedly high cholesterol.

So, just what is the take home of this study? Most women are well served with higher cholesterol, because many, many women naturally have very high HDLs. That is partially genetics, partially estrogen, partially discipline and exercise.

WWW. What will work for me. It’s just so ridiculously obvious and simple.   High LDLs mean you are eating too many processed, free modern carbs. You can prove it to yourself in weeks. I’ve done it so many hundreds of times with my customers, I’m just annoyed that our health care system can’t figure it out for themselves. Just get lab twice, a month apart, and try the experiment for yourself.   Presto.   My problem is that I sin, and when I test myself, my wonderful good results go away pretty fast.   Bummer.   This being consistent is not my strongest suit.

 

Pop Quiz

 

  1. High cholesterol is good for women.   T or F

Yup. And if you aren’t sure, get a CT cardiac scan and prove your calcium score to be zero, and then sleep sweetly.

  1. So women with a cholesterol of 250 may not need a statin. T or F

That’s it. Taking them will cause harm. You are safer without them. At least if you are Norwegian – or believe yourself to be close enough.

  1. If your doctor insists on a statin, you can ask for a one month reprieve, go on a low carb diet (<20 grams a day) and get retested, and then avoid the statin. T or F

True

  1. LDLs represent the consumption of too many carbohydrates, resulting in the manufacture of fat by the liver, being transported to the fat cell. T or F

Presto!

  1. We humans are better served eating tons and tons of spinach rather than donuts. T or F

True.

Butyrate and Your Gut

Butyrate: Your Colon, Your Microbiome and You

Reference:   Canha 2015, Wikipedia, Whole Health Source, Diabetes 2009, 10% Human

Oct 19, 2015

Let’s accept the fact that you are not an individual, but an organism that houses a whole microbiome of bacteria in your colon, which has 10 times the number of cells and 100 times the amount of DNA variety than you, the human has.   We can’t live well without them. Our colon is not a waste filled tube concentrating water, it is an active, live organ that metabolizes about as many nutrients as your liver. Hmmm.

When you are born, your first breath and swallow come when your mouth is just one inch away from your mother’s rectum, and with natural birth, you immediately inherit a sample of her microbiome.   That microbiome sets up your immune response for the rest of your life.

Now, what do the cells on the walls of your colon eat?   Butyrate.   What’s butyrate? It is a short acid, only 4 carbons long, made from fiber that you couldn’t digest in your stomach and small bowel, but that the bacteria in your colon could. The fact that our colon lining cells are fed solely by butyrate and not be other nutrients suggests that we have been eating the foods that make for butyrate for so long (millions and millions of years) that it remains an indispensible part of our gut, and therefore our health.

What happens when you don’t eat the right food, and change your diet to a very low fiber, high fat diet (aka, the American Fast Food Diet)?   Without fiber, your colonic cells are starving and it becomes much easier for you to get overweight.   A cascade of trouble starts that ends up with colon cancer being the outcome.   The less fiber we eat, the more colon cancer. Colon cancer is rare is parts of the world with more than 50 grams of fiber a day. We Americans eat 15 grams a day.   Recent case control studies have disputed this, but they have only run 3-5 years. What’s equally fascinating is the research showing how fast your microbiome shifts its resident populations when you shift dietary patterns.   Did you know that the effect of a course of antibiotics will linger for up to two years in the form of altered gut populations?

There is good science to show that obese mice, given butyrate, improve their insulin sensitivity, lose weight and improve their cholesterol when fed butyrate as a supplement. The control mice gained weight. Could this mean that butyrate supplementation might be the Holy Grail for weight loss and diabetes control?

Where can you get butyrate from naturally?   This raises the idea of “Resistant Starch”.    Resistant Starch is just that, it resists digestion in your gut and feeds your colon and it’s biome. With a healthy cross talk between your colon and you, your metabolism starts to hum likes it’s supposed to. Dr. Oz has developed his Two Week Weight Loss program that has a surprising amount of carbs in it.   Guess what type of carbs they are…? You bet, resistant starch.

How does that fit with other weight loss plans?   The modified ketogenic diet in the so-called Bullet Proof plan thinks you can. The only way to really lose weight is to open up fat cells with lower insulin. Insulin is the gateway hormone to achieving that.   It’s a hormone. And butyrate increases insulin sensitivity. Full circle.

WWW. What will work for me. I’m learning the nascent science of the gut microbiome. It’s not crystal clear yet. But one thing I understand, our gut needs us to eat fiber to feed our colonic friends called our microbiome. Whether you call it resistant starch, or fiber or just butyrate, I’m getting a handle on it. How to use in in my own life? Hmmm.   Seconds on salad.

 

Pop Quiz

  1. Your gut cells live off butyrate. T or F

Amazing, isn’t it. Just butyrate.

  1. The food you eat alters the microbiome in your gut dramatically? T or F

Within days

  1. Antibiotics will alter your gut balance for years afterwards.   T or F

True

  1. Butyrate from your gut bacteria alters your natural insulin resistance? T or F

True

  1. We humans must have eaten green plants with lots of fiber in them for millennia, as our guts are just so designed. T or F

True

 

 

Calcium Heart CT Scoring Can Improve your Statin Decision Making

Heart Calcium Scoring and Statin Use

Reference: New York Times, Journal of the American College of Cardiology Oct 2015

The use of statins for reduction of risk in coronary artery disease is controversial, in part because of the appearance of commercial conflict of interest.   It is BIG business in BIG medicine. And lots of folks have pretty horrible side effects.   And you have to treat 1000 people to prevent 7 heart attacks a year, for which you have one death.   Hmmm.   Math seems to be a bit dubious at times.   And your doctor is graded and paid “quality assurance” bonuses based on the percentage of patients in his or her practice that are taking statins when they meet guidelines.   It is all well intentioned, as a method of promoting quality, but it results in a certain intensity of persuasion and coercion when you say you don’t like the side effects.

With all that emotion and coercion, is there a better tool that might refine the ability to make a decision?   What would happen if you could get an additional risk scoring procedure done for $ 99 that showed you didn’t need to be on a statin? Wouldn’t that be handy?

That’s what this study asked.  The MESA study is 6,814 multiethnic folks between 45 and 84 without evidence of coronary artery disease who were whittled down to a pure group of 4,758 folks without confounding items like missing data, or complete lack of lousy LDLs, etc.   They were followed for 10.3 years and observed for the development of coronary artery disease events.   The new cholesterol/statin guidelines were applied to this group, of whom 2,377 qualified to be on them.   The majority of them (77%)qualified because according to the ACC risk calculation tables, they had a greater than 7.5% risk of having a heart attack/event over 10 years.   Was that really their risk?   From that group who were supposedly meant to be on statins, 41% had a calcium score on CT scan of “0”. That was ZERO.   No calcium in their arteries.     They did have heart attacks.   Yes, they did. At a rate of 1.5% per 1,000 years. Pretty small.   More than lightning, or shark attacks.  But not enough to take on the risk of statins.     And not at the 7.5% rate that is the acknowledged rate for being enough risk for taking a statin.

What are the risks of taking statins? Well, Mayo’s opinion is measured and valid. At the other end is Dr. Mercola, who would be less measured, but possibly more honest because he’s not in the system and there by maybe speaks a bit more honestly, albeit off the walls.   Or just read the FDA’s concerns.

What does the CT scan find?   Well, it can add up the calcium in plaque in your arteries and actually find calcium that is in the wall of the arteries rather than just bulging out. It takes years for calcium to build up, so it is old plaque. Recent new, raw dangerous plaque is not seen on calcium scanning. It get missed. And the CT does find all sorts of other tidbits, like lung nodules that you don’t know what to do with. But on balance, it’s information.

WWW. What will work for me. I’m dancing a jig. I’m thrilled. I’ve been doing this for four years and I now have literature support that what I’m doing makes sense. Now, if you have risk, you want to know how to turn it off.   That’s were it gets really interesting.   The fine art of getting rid of LDL’s actually isn’t that hard. I can show you how in about a month. And then there is TNF-α, CRP, sdLDL, HDLs and other blood cytokine and risk factors that can show you how to improve your score and get out of risk, without the statins. If you are interested, start by not eating sugar and white flour, and come let me show you how. I’ve been on vacation for a week here in Italy. The gelato has been wonderful. I’m going to measure my HDLs when I get home. I think I just accumulated a bit of risk. Stay tuned.   I’m back in the saddle.

 

 

Pop Quiz

  1. You can measure your risk of heart attack by an inexpensive CT scan of your heart that measures your calcium load? T or F

That’s it.

  1. If your score is zero you have a greater than 10 % risk of having a heart attack in 10 years. T or F

Are you kidding? You didn’t read the column. Go back. Read it again. Score of zero means your have a 1.5% chance in 1,000 years. That’s low.

  1. Current ACC guidelines say it is worthwhile to treat you is your risk is greater than 7.5% chance in 1,000 years.

Yup

  1. About 50% of people who currently meet the current guidelines for statins have a calcium score of zero.   T or F

True. (Makes you feel pretty confident in those guidelines, doesn’t it)

  1. You get some radiation from a CT scan of your chest.

Also true. But in the world of risk benefit, I’ll take that risk over taking statins for 1,000 years.

 

 

 

Using Worms to Fix Illness

Using Worms to Fix Illness

Reference:   Healing the Biome, Anna Cheng, Journal of Evolutionary Medicine

Oct 5th, 2015

Are you ready for some really far-out ideas? I mean, stretch the envelope a little? Ok. Here goes.

For most of human history, we have lived with a whole host of critters on and in us. We are now becoming accepting that our bowels contain 100 times the amount of DNA and 10 times the number of cells than our own bodies contain in the form of the “bacterial biome”.   Ok, so far so good. How about other creatures? How about worms, for example? We have sterilized our environment in the last 200 years in ways that we don’t even think about. We have clean public water so that we don’t get ravaging epidemics of typhoid and cholera. On face value, that’s good. We also wear shoes, so that we don’t get pin worm and other worms that live in the soil and in the feces of our animals.   That sounds good too. We have fridges that keeps food cold and safe. We can our farm products, ship them frozen, sterilize them.   All sounds good, right.   Hmmm. Then we got inventive and got antibiotics that reamed out the bacteria in our guts, our spit, our saliva.   Then we moved indoors and lost Vitamin D. We started eating grain fed animals, and lost Vitamin K2. We genetically altered our grains and made them lectin rich and gluten rich….. it keeps getting worse!

Reconsider for just a bit. We have dramatically reduced the interplay of immune system and environment. There are now more and more studies showing that farm kids have less asthma. And taking antibiotics early results in more asthma. Asthma is an autoimmune disease. But that’s not the only autoimmune disease that has exploded in frequency. There are now beginning to be more and more anecdotal studies of folks who have treated themselves with worms as a means of turning on their immune system to inspire their “natural immune response”.  But it’s not just anecdotal.   A few brave early researchers have looked at multiple sclerosis and tryposomiasis.   This is no mild parasite! It causes severe and maybe fatal disease. But Dr. Correale has looked at MS patients infected with flatworms and tapeworms and showed that they had much lower rates of exacerbation than those without those infections. And, on investigation, they had markedly enhanced protective immune responses that would provide the explanation as to why this would occur. In fact, Dr. Correale noted that there were no helminthes that didn’t work.

This review article looks over the 6-7,000 cases of world wide self treatment that people have reported on in one fashion or another, and suggests we have a fertile ground for research.

The question is raised that perhaps our well-intentioned environment of clean living has a dark side to it. Perhaps our obsession with cleanliness has gone a bit too far.   There is a rich science to be explored here that is in its infancy.   And I’m totally fascinated by it.

WWW. What will work for me. I’m not sure I’m ready to walk around barefoot to cure my asthma with hookworm, but it sure looks interesting.   I grew up in India and swam in cryptosporidium rich water for years. When cryptosporidium made 300,000 people sick in Milwaukee, I was in the thick of it, drank the water, and never got sick.   Hmmm. For now, I’m reading everything I can get my hands on about this. There has to be a worm we can use for a brief period, and then cure ourselves when our autoimmune illness is better. Volunteers?

 

Pop Quiz

  1. A worm free environment is not natural? T or F

True. We have spent most of human history itching one part of ourselves or another, some more indelicate than others.

  1. 70 % of our immune system is in our gut. T or F

True, even though I didn’t mention it in the text.

  1. Lectins in wheat explain most autoimmune illness. T or F

False. It’s just one theory. The whole cause is likely much more complex with loss of many players.

  1. You can make MS better with worms. T or F

Maybe false. Not better, but you can stop it from getting worse.

  1. It may be a good idea to get out there and walk around barefoot in rural India if you have asthma. T or F

You would not be the first. But it would not be recommended by traditional medicine. But you might end up fixed.