tag:blogger.com,1999:blog-85509196116538420662024-03-13T19:58:25.554-07:00The High-fat Hep C DietHepatitis C viraemia is carbohydrate-dependent because the virus piggy-backs on triglyceride assembly and VLDL exocytosis. This makes a very low carbohydrate diet an effective way to control HCV viraemia, HCV-associated autoimmune syndromes, and steatosis. HCV cell entry is via LDL-receptor complex, therefore diets intended to lower LDL via upregulation of the LDL-receptor by restricting saturated fat and increasing polyunsaturated fat will increase hepatocellular infection.
Unknownnoreply@blogger.comBlogger176125tag:blogger.com,1999:blog-8550919611653842066.post-33713067519306936012022-12-13T14:56:00.004-08:002022-12-13T14:59:46.316-08:00The Prostate and its Discontents<p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span face="system-ui, Roboto, sans-serif" style="font-size: 14px;">
</span><span style="font-family: georgia; font-size: medium;">This post originally appeared for subscribers only on my Patreon blog (October 31). If you appreciate my occasional writing on science and stuff <a href="https://www.patreon.com/hopefulgeranium" target="_blank">subscribe here</a> - it only encourages me to read more science and write about it more often!
<span style="border-color: initial; border-image: initial; border-style: initial;"><img data-media-id="174194865" src="https://c10.patreonusercontent.com/4/patreon-media/p/post/73984564/8a26b77a7a3142fa8f4d07d278b37fed/eyJlbmFibGVfZ2lmX3RyYW5zZm9ybSI6MSwid2VicCI6MH0%3D/1.jpg?token-time=1672185600&token-hash=50xi9zm6VMfJcCsTCUIlGGT3fc1VSxDYcqfHzFg8F5A%3D" style="border: 0px; max-width: 100%;" /></span></span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: georgia; font-size: medium;">The location of the prostate is one of nature's mistakes - like the organization of the eye, it argues against "intelligent design" which in any case was only a philosophical fart that fundamentalist Christianity had to release in order to adjust itself to the widespread acceptance of the evidence for evolution. Because it's ended up wrapped around the urethra for no good reason, it can easily disrupt the flow of urine if it swells for any reason, and, though they don't really tell you this, pissing is essential for life.<br /><br />This essay on the prostate is limited to conditions and cures I have some experience of, and I'll add a bit about cancer at the end.<br /><br />I first became aware of the prostate when I found myself unable to pee after a dose of opium, that is to say, after drinking a tea or slurry made from boiled up opium poppies. I ended up catheterized and being investigated in hospital. I suspected I was allergic in this way to the poppies (though this hadn't happened before) or a pesticide. A quick google search finds no case study of prostatitis - acute urinary retention is a side effect of opioids but also affects women.[1}<br /><br />So it's likely the diagnosis of prostatitis I was given was wrong - or not - I continued having urinary retention on opiates but it was never impossible to overcome as it was on that occasion. Splashing cold water on my abdomen was probably the most effective strategy.<br /><br />But then later in life I came across a different sort of problem, inadequate urination so that the bladder doesn't fully empty and you keep having to get up at night. This the doctor diagnosed as either prostatitis or benign prostatic hyperplasia (if it persisted I'd presumably get a biopsy to differentiate) and I set out to manage it myself.<br />The hyperplasia makes sense retrospectively because I know now that I was highly insulin resistant and hyperinsulinaemic in this days, I'd regularly suffer tinnitus after meals, glaucoma, and various other symptoms. The prostatitis also makes sense because I still had Hep C and various autoimmune complications (eg Sjorgen's syndrome) related to a high viral load.<br />I took all sorts of prostate supplements such as saw palmetto without relief. I did hit on one herbal formula that seemed to work, it contained forskolin and dead nettle, but was expensive and hard to find. What finally worked best was treating the UTI aspect - urine backed up in the bladder, especially if there's glucose in the urine, is going to be a breeding ground for bacteria. I discovered d-mannose, this was expensive but sort-of worked. And then I hit the jackpot - hibiscus flower. Cheap as chips from Middle Eastern food stores, a strong dose worked magic.[2]<br />Around this time I was also going low-carb and staring to fix my hyperinsulinaemia and hep c related autoimmune issues.<br />How would hibiscus work? Its antioxidant phytochemical, the flavonoid or whatever that gives the flower its regal colour,, binds to surface proteins that UTI bacteria use to adhere to the wall of the bladder and urinary track where they can feast on passing nutrients. So you flush them out. And I think these bacteria irritate the prostate. Or maybe they just irritate the urethra and its mechanism for contracting or relaxing under will. PubMed says [3]<br /><br /><strong>Chronic bacterial prostatitis is a subacute infection, may present with a variety of pelvic pain and voiding symptoms, and is characterized by recurrent urinary tract infections. Effective treatment may be difficult and requires prolonged antibiotic therapy.<br /><br /></strong>So I think I'm right - a swollen prostate for any reason increases the risk of UTI, UTI increases the risk of swollen prostate, it's a vicious cycle and the UTI factor is easy to treat if you can find hibiscus flower (the dose in a tea bag is not enough), the overgrowth factor is easy to treat with a very low carb diet if you have hyperinsulinaemia (check the fasting TG/HDL ratio first as a good, cheap proxy for the 2-hour insulin level).<br /><br />As for prostate cancer - it's said the risk of this is rising - I think there are 3 main factors - firstly, hyperinsulinaemia is a modern epidemic, it's a growth promoter and cancer promoter. Secondly, men are living longer and prostate cancer is something that's more likely to get you if you live long enough. Linus Pauling died of it at 93 and I think this can be considered a megadose vitamin C success story, especially considering he was a research chemist and had worked with carcinogens. Thirdly, diagnosis is more aggressive today and much prostate cancer is non-lethal or won't kill you faster than life will.<br /><br />Low carb diets are a promising strategy for treating prostate cancer.[4]<br />In Europe, where cheese and organ meats are significant sources of vitamin K2, vitamin K2 intake is strongly associated with a lower risk of prostate cancer.[5]<strong><br /><br />The association was stronger for advanced prostate cancer (0.37; 0.16, 0.88; P for trend = 0.03).</strong><br /><br />That's a decent, Bradford Hill sized association - Vitamin K1 from plants had no association with risk.<br /><br />ALA, the plant-based form of omega 3 fatty acid, is associated with increased prostate cancer risk.[6]<br /><br />epidemiologic studies also showed an increased risk of prostate cancer in men with a high intake or blood level of ALA (combined relative risk 1.70; 95% CI 1.12–2.58).<br /><br />I suspect this is due to this fatty acid being highly valuable as a synthetic substrate for cancer cells; it's a highly ketogenic fatty acid but only in a keto context, otherwise this same property of interconvertability is less desirable.</span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: georgia; font-size: medium;"><br /></span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: georgia; font-size: medium;">Postscript - H/T Mike Angel who added this comment to the original post:
</span></p><p style="background-color: white; line-height: 1.5; margin: 10px 0px;"><span style="font-family: georgia; font-size: medium;"><span color="rgba(11, 12, 15, 0.95)"><span style="white-space: pre-wrap;">Here is the vulgarized version of the work being done in Israel: <a href="https://news.sky.com/story/prostate-treatment-gives-patients-new-hope-10486442">https://news.sky.com/story/prostate-treatment-gives-patients-new-hope-10486442</a> I think it's compelling.
Apparently the idea came out of fertility treatments. </span></span>
<span color="rgba(11, 12, 15, 0.95)"><span style="white-space: pre-wrap;">This treatment is for testicular varicocele (I was screened for it at one stage) which is a mechanical cause of prostate hypertrophy and low testosterone (and probably the true, non-sexist cause of the "manspreading" phenomenon of a few years ago). A subject for another day perhaps.</span></span></span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: georgia; font-size: medium;">[1] <a href="https://dom.pitt.edu/wp-content/uploads/2021/07/June2013.pdf" rel="nofollow noopener" style="background-color: transparent; cursor: pointer; font-weight: var(--global-fontWeights-body-default) !important;" target="_blank">https://dom.pitt.edu/wp-content/uploads/2021/07/June2013.pdf</a><br /><br />[2] <a href="https://pubmed.ncbi.nlm.nih.gov/30208764/" rel="nofollow noopener" style="background-color: transparent; cursor: pointer; font-weight: var(--global-fontWeights-body-default) !important;" target="_blank">https://pubmed.ncbi.nlm.nih.gov/30208764/</a></span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: georgia; font-size: medium;">[3] <a href="https://pubmed.ncbi.nlm.nih.gov/10190383/" rel="nofollow noopener" style="background-color: transparent; cursor: pointer; font-weight: var(--global-fontWeights-body-default) !important;" target="_blank">https://pubmed.ncbi.nlm.nih.gov/10190383/</a></span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: georgia; font-size: medium;">[4] <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3757152/" rel="nofollow noopener" style="background-color: transparent; cursor: pointer; font-weight: var(--global-fontWeights-body-default) !important;" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3757152/</a><br /><br />[5] <a href="https://pubmed.ncbi.nlm.nih.gov/18400723/" rel="nofollow noopener" style="background-color: transparent; cursor: pointer; font-weight: var(--global-fontWeights-body-default) !important;" target="_blank">https://pubmed.ncbi.nlm.nih.gov/18400723/</a><br /><br />[6] <a href="https://academic.oup.com/jn/article/134/4/919/4757173?login=false" rel="nofollow noopener" style="background-color: transparent; cursor: pointer; font-weight: var(--global-fontWeights-body-default) !important;" target="_blank">https://academic.oup.com/jn/article/134/4/919/4757173?login=false</a></span></p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-18331178988336731982022-12-11T15:21:00.000-08:002022-12-11T17:34:05.229-08:00The Last Days of the Internet<span style="font-family: georgia; font-size: medium;">Before I started writing medical papers and such I was a musician and I'm a musician again. I'm also a big lover of the Internet which has given us many fine things and a place to stay but which one can see is no longer well. In a spirit of concern and heartbreak I wrote this song and recorded it with my band, The New Existentialists. The video was made by Andrew Moore and Hayley Theyers (who made the cover photo) and as you can has been doing fairly well, we even got a <a href="https://au.rollingstone.com/music/music-news/boomer-writes-song-about-internet-you-wont-believe-what-happens-next-43675/" target="_blank">write up</a> in the Australasian edition of Rolling Stone.<br /></span><br /><br /><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/N9uru4LJkps" width="382" youtube-src-id="N9uru4LJkps"></iframe><br /><br /><br /><br /><br /><div style="text-align: left;"><span style="font-family: georgia; font-size: medium;">The complete 5-track Last Days of the Internet EP can be downloaded <a href="https://thenewexistentialists.bandcamp.com/album/last-days-of-the-internet-ep" target="_blank">here</a>, where you can also find the lyrics, and is available to stream in every cool place.<br /></span><br /><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimYUgt32p9mqeEFqjF8T5VkZxdJscD27wrKAAjyJPTR77x-kbDtYEA72wDXw3iN2WDqMFJhuBaDcwYhm35vek8hlTPUuxKjccgF7IPeKVzO97kjaVpnhSCUHMqjAl5psxoPBlYvvLKkOc1RD95Q7Nr29xUSRaHxkGHQq4S-YEvd7p7uQOg2kEyfTwu4g/s1974/last%20days%20tidy29.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1974" data-original-width="1974" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimYUgt32p9mqeEFqjF8T5VkZxdJscD27wrKAAjyJPTR77x-kbDtYEA72wDXw3iN2WDqMFJhuBaDcwYhm35vek8hlTPUuxKjccgF7IPeKVzO97kjaVpnhSCUHMqjAl5psxoPBlYvvLKkOc1RD95Q7Nr29xUSRaHxkGHQq4S-YEvd7p7uQOg2kEyfTwu4g/w400-h400/last%20days%20tidy29.jpg" width="400" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br /></div><br /><br /><br /></div></div><br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-74186607379539746762022-08-23T15:20:00.000-07:002022-08-23T15:20:25.818-07:00Vegetarianism, a warning from history, Pt 3 - John Hartford<h3 style="background-color: white; color: #241e12; font-family: system-ui, Roboto, sans-serif; white-space: pre-line;"><strong>John Hartford</strong> wrote one of the best songs ever written, Gentle on my Mind. For me, the best version of this is Elvis Presley's - The King turns it into an anthem of deluded masculinity, he's a loser who feels insulated from his deprivation and disorganization as long as he has one lover, out there somewhere too far away, being gentle on his mind.<br />The 1968 Hartford song that appeared on the Lady Bird soundtrack, <a href="https://youtu.be/AZ_Eqi56ZZM" rel="nofollow noopener" style="background-color: transparent; cursor: pointer; font-weight: var(--global-fontWeights-body) !important;" target="_blank">This Eve of Parting</a>, made the movie.<br />The usual Hartford album you'll find on Spotify may be one soppy love song after another, but they have a artful flow and playfulness that keeps them enjoyable - some are almost concept albums - and the playing is next-level, Hartford being a bluegrass exponent with few peers.<br /><strong><br />Neil Strauss interviewed Hartford shortly before his death in 2001, a fragment of the interview was included in his fascinating anthology of the telling bits of interviews from his career as a music writer, Everyone Loves You When You're Dead.<br /><br />Strauss says of the interview setting, "It would have been a perfect moment if not for one thing; Hartford's doctors had told him he didn't have long to live. Complications from lymphomas (a cancer of the immune system), combined with anemia, a sinus operation, and a knee problem, had worn him down. In the little time he had left on this planet, Hartford had chosen to concentrate on one thing - fiddling"<br /><br />John Hartford: I tried to get real healthy about twenty or thirty years ago, and I think that's why I got health problems now. I tried to be a vegetarian and all that crap. I think it hurt me: One of my big problems right now is that I have anemia. My daddy was a doctor and he told me to be real careful at the time, and his words have all come true. Cancer has just about emptied my phone book. And I've got it too.<br /><br /></strong><em>A local banjo player enters the house and approaches Hartford, intending to shake his hand. But Hartford greets him by waving instead. Hartford hasn't shaken a hand for as long as anyone can remember. He is scared of someone bruising or breaking his bones.<br /><br />Shortly after this interview, while on tour in Texas, Hartford lost movement in his hands. He continued to host picking parties, which he watched instead of played at, until his death several months later at the Centennial Medical Centre in Nashville. He was sixty-three.<br /><br /></em><strong>What are the odds that Hartford was right? Non-Hodgkins lymphoma (the type Hartford had) is strongly associated with gluten sensitivity.[1] Arthritic conditions may be caused by cross-sensitive autoimmunity to the starch-eating bacteria </strong><em>Klebsiella pneumoniae, </em><strong>or to </strong><a href="https://www.medicalnewstoday.com/articles/325522" rel="nofollow noopener" style="background-color: transparent; cursor: pointer; font-weight: var(--global-fontWeights-body) !important;" target="_blank"><strong>gluten</strong></a><strong> and related proteins (such as zein from corn or casein from unfermented milk). And anaemia is also a possible consequence of gluten intolerance (as well as vegetarianism in general). The vegetarian diet of the 1970s that Hartford and his friends might have followed was a high-starch, low fat diet based on dried grains and legumes.<br />"Even in non-celiac gluten sensitivity, anemia is present in 18.5-22% of patients and appears to be related to ultrastructural and molecular alterations in intestinal microvilli."[2]<br /><br />Of course we'll never know exactly - but I'm willing to take Hartford's word for it.<br /><br />[1] Kane EV, Newton R, Roman E. Non-Hodgkin lymphoma and gluten-sensitive enteropathy: estimate of risk using meta-analyses. Cancer Causes Control. 2011 Oct;22(10):1435-44. doi: 10.1007/s10552-011-9818-4. Epub 2011 Jul 14. PMID: 21755296.<br /><br />[2] Stefanelli G, Viscido A, Longo S, Magistroni M, Latella G. Persistent Iron Deficiency Anemia in Patients with Celiac Disease Despite a Gluten-Free Diet. Nutrients. 2020 Jul 22;12(8):2176. doi: 10.3390/nu12082176. PMID: 32708019; PMCID: PMC7468819.</strong></h3>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-8550919611653842066.post-20558717919516407282022-08-23T14:17:00.000-07:002022-08-23T15:21:18.843-07:00Selenium reduces COVID-19 risk - a back-of-the-envelope Bradford Hill analysis [originally posted 28/09/20, last updated 13/06/22]<i><b><span style="font-family: georgia; font-size: medium;"><div class="separator" style="clear: both; text-align: center;"><a href="https://1.bp.blogspot.com/-JiU6bwt8kWo/X0x0kIXp-bI/AAAAAAAACUk/UGFCnRgQ3dIyt3fjap5BBGI-0Bid7wwFACLcBGAsYHQ/s960/COVID%2B1.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="640" data-original-width="960" height="342" src="https://1.bp.blogspot.com/-JiU6bwt8kWo/X0x0kIXp-bI/AAAAAAAACUk/UGFCnRgQ3dIyt3fjap5BBGI-0Bid7wwFACLcBGAsYHQ/w512-h342/COVID%2B1.jpg" width="512" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><span><br /></span></span></b></i><div><span style="font-family: georgia; font-size: medium;"><br /></span></div><div><span style="font-family: georgia; font-size: medium;"><br /></span></div><span style="font-family: georgia; font-size: medium;"><b>Bradford Hill</b> introduced a checklist for assessing the strength of epidemiological evidence for causality, which is useful in the current pandemic when nutritional factors have been insufficiently tested by experiment in favour of drugs with, so far, relatively weak effects.[1]<br />Remember, a long time has passed and a lot of people have died while Evidence-Based Medicine was facing the wrong way.</span><div><span style="font-family: georgia; font-size: medium;">And asking the wrong question. "What new treatment will save more lives in the ICU?" is an important question, but one with few answers and no great ones - "What can stop people who catch SARS-CoV-2 coming to the ICU?" is a better one in a pandemic, and one that might also lead to better treatment protocols.<br /><br /><br /><b>Selenium reduces COVID-19 mortality: A Bradford Hill analysis</b></span></div><div><span style="font-family: georgia; font-size: medium;"><br /></span></div><div><span style="font-family: georgia; font-size: medium;"><b>1</b>) <b>S</b>trength of association. <b>Very Strong.<br /><br /></b></span></div><div><span style="font-family: georgia; font-size: medium;"><br /><b>a) <i>On inspection of the Hubei data, it is notable that the cure rate in Enshi city, at 36.4%, was much higher than that of other Hubei cities, where the overall cure rate was 13.1% (Supplemental Table 1); indeed, the Enshi cure rate was significantly different from that in the rest of Hubei (P < 0.0001). Enshi is renowned for its high selenium intake and status [mean ± SD: hair selenium: 3.13 ± 1.91 mg/kg for females and 2.21 ± 1.14 mg/kg for males]—compare typical levels in Hubei of 0.55 mg/kg (10)—so much so that selenium toxicity was observed there in the 1960s. Selenium intake in Enshi was reported as 550 µg/d in 2013.</i><br /></b></span><div><i><b><span style="font-family: georgia; font-size: medium;">Similar inspection of data from provinces outside Hubei shows that Heilongjiang Province in northeast China, a notoriously low-selenium region in which Keshan is located, had a much higher death rate, at 2.4%, than that of other provinces (0.5%; P < 0.0001). The selenium intake was recorded as only 16 µg/d in a 2018 publication, while hair selenium in the Songnen Plain of Heilongjiang was measured as only 0.26 mg/kg (Supplemental Table 2).</span></b></i></div><div><i><b><span style="font-family: georgia; font-size: medium;"><br /></span></b></i></div><div><span><i style="font-family: georgia; font-size: large; font-weight: bold;">Finally, we found a significant association between cure rate and background selenium status in cities outside Hubei (R2 = 0.72, F test P < 0.0001; Figure 1, Supplemental Table 2)</i><span style="font-family: georgia; font-size: medium;">.[2]</span><br /><br /><div class="separator" style="clear: both; font-family: georgia; font-size: large; text-align: center;"><a href="https://lh3.googleusercontent.com/-8JSEPYSvrH8/X4z_IvY3OoI/AAAAAAAACWo/7F_zs4DpU6Mq_cv6LbGwgW76t0SyTx6uQCLcBGAsYHQ/image.png" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="365" data-original-width="520" height="281" src="https://lh3.googleusercontent.com/-8JSEPYSvrH8/X4z_IvY3OoI/AAAAAAAACWo/7F_zs4DpU6Mq_cv6LbGwgW76t0SyTx6uQCLcBGAsYHQ/w400-h281/image.png" width="400" /></a></div><br /><br /><br /><img alt="Correlation between COVID-19 cure rate in 17 cities outside Hubei, China, on 18 February, 2020 and city population selenium status (hair selenium concentration) analyzed using weighted linear regression (mean ± SD = 35.5 ± 11.1, R2 = 0.72, F test P < 0.0001). Each data point represents the cure rate, calculated as the number of cured patients divided by the number of confirmed cases, expressed as a percentage. The size of the marker is proportional to the number of cases." src="https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/ajcn/111/6/10.1093_ajcn_nqaa095/1/m_nqaa095fig1.jpeg?Expires=1601586931&Signature=vtS80pHaZbT3O8b8sJLCplryS5D7IzxVWg5vvqj0uePisaSpFU620Pk5DOEw~ILH9ykRp7lYKTVVB5pzk87QzeoTBY96FgOUbiIDSqhzRRp2pY~3GdauppyLDOm2xnFZDYA6QqT616ikAjnpUpJ4AZmZJ5G9mHYhmX3i2OOfZFLO29ghljZo-onrqD0hq1vDhDKE-vsOfq3PtxBsWcccVaQJxhgRS4nQDn9~6HJCFEQEiAxyoKXBDPCIC3OCxpe3ESGtxW-eytAyUwmcsi78x3cXB6kD6RgZAMgvHCtCQK7BT8XO95vLY-EB4fhmjYCEDIXd089ab1K4ycd-F3js5w__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA" style="font-family: georgia; font-size: large;" /><br /><br /><br /><br /><b style="font-family: georgia; font-size: large;">b)<i> Serum samples (n = 166) from COVID-19 patients (n = 33) were collected consecutively and analyzed for total Se by X-ray fluorescence and selenoprotein P (SELENOP) by a validated ELISA. Both biomarkers showed the expected strong correlation (r = 0.7758, p < 0.001), pointing to an insufficient Se availability for optimal selenoprotein expression. In comparison with reference data from a European cross-sectional analysis (EPIC, n = 1915), the patients showed a pronounced deficit in total serum Se (mean ± SD, 50.8 ± 15.7 vs. 84.4 ± 23.4 µg/L) and SELENOP (3.0 ± 1.4 vs. 4.3 ± 1.0 mg/L) concentrations. A Se status below the 2.5th percentile of the reference population, i.e., [Se] < 45.7 µg/L and [SELENOP] < 2.56 mg/L, was present in 43.4% and 39.2% of COVID samples, respectively.</i><br /><i>The Se status was significantly higher in samples from surviving COVID patients as compared with non-survivors (Se; 53.3 ± 16.2 vs. 40.8 ± 8.1 µg/L, SELENOP; 3.3 ± 1.3 vs. 2.1 ± 0.9 mg/L), recovering with time in survivors while remaining low or even declining in non-survivors</i>.[3]<br /></b><br /><i style="font-family: georgia; font-size: large; font-weight: bold;">c) Vitamins B1, B6, B12, D (25-hydroxyvitamin D), folate, selenium, and zinc levels were measured in 50 hospitalized patients with COVID-19. A total of 76% of the patients were vitamin D deficient and 42% were selenium deficient. No significant increase in the incidence of deficiency was found for vitamins B1, B6, and B12. folate, and zinc in patients with COVID-19. The COVID-19 group showed significantly lower vitamin D values than the healthy control group (150 people, age/sex matching). Severe vitamin D deficiency (based on 10 ng/dL) was found in 24% of the patients in the COVID-19 group and 7.3% of the control group. Among 12 patients with respiratory distress, 11 (91.7%) were deficient in at least one nutrient. However, patients without respiratory distress showed deficiency in 30/38 people (78.9%, P-value 0.425). These results suggest that a deficiency of vitamin D or selenium may decrease the immune defenses against COVID-19 and cause progression to severe disease; however, more precise and large-scale studies are needed.</i><span style="font-family: georgia; font-size: medium;">[18]</span><br /><br /><span style="font-family: georgia; font-size: medium;">100% of the patients in this study with severe outcomes, including death, were selenium deficient; 75% were vitamin D deficient; none were zinc deficient.</span><br /><br /><b style="font-family: georgia; font-size: large;">d) </b><span style="background-color: white;"><span style="font-family: georgia; font-size: medium;"><i style="color: #212121; font-weight: bold;">In regression models, serum Se levels were inversely associated with lung damage independently of other markers of disease severity, anthropometric, biochemical, and hemostatic parameters.</i><b style="color: #212121;">[23]</b><br /><br /><b style="color: #212121;">e) </b><span style="color: #212121;"><b>The association between soil Se level and the incidence of COVID-19 was observed in different cities of Hubei Province. The incidence of COVID-19 was more than 10 times lower in Se-enriched cities (Enshi, Shiyan, and Xiangyang) than in Se-deficient cities (Suizhou and Xiaogan).[25]</b></span><br /><br /><span style="color: #212121;">See also refs <b>19</b> and <b>22</b>, discussed below.</span></span></span></span></div><div><span><span style="color: #212121; font-family: georgia; font-size: medium;"><b><br /></b></span></span></div><div><span><span style="color: #212121; font-family: georgia; font-size: medium;"><b><br /></b></span><br /></span></div><div><b style="font-family: georgia; font-size: large;">2</b><span style="font-family: georgia; font-size: large;">) </span><b style="font-family: georgia; font-size: large;">C</b><span style="font-family: georgia; font-size: large;">onsistency - </span><b style="font-family: georgia; font-size: large;">Very</b><span style="font-family: georgia; font-size: large;"> </span><b style="font-family: georgia; font-size: large;">Strong</b></div><div><span style="font-family: georgia; font-size: medium;"><br />All epidemiological data about selenium and COVID-19 is consistent in direction and effect size. However, tests that could be done comparing COVID-19 risk in high and low selenium regions of Brazil, Scandinavia (selenium is supplemented in the food supply of Finland), and the USA would establish consistency further.<br /><br />[edit 13/06/2022] - New study from the USA shows a two-fold higher mortality rate in low-selenium regions.[30]<br />Discussed in more detail on my <a href="https://www.sciencedirect.com/science/article/pii/S1342937X22001733" target="_blank">Patreon blog</a> - the only way I make any part of a living from this work, so help a brother out!<br /><br />[edit 16/11/202o] - New study from South India is consistent with those from Germany, China, and South Korea:<br /><br /><i style="font-weight: bold;">We analysed the blood serum levels in apparently healthy (N=30) individuals and those with confirmed COVID -19 infection (N=30) in the southern part of India. Patients showed a significantly lower selenium level of 69.2 ±8.7 ng/ml than controls 79.1 ± 10.9 ng/ml, the difference was statistically significant (P=0.0003). Interestingly the controls showed a borderline level of selenium, suggesting that the level of this micronutrient is not optimum in the population studied.</i>[19]<br /><br />[edit 14/12/2020] <a href="https://www.cambridge.org/core/services/aop-cambridge-core/content/view/BE3CE5E68CAEE12406F92997A39BC02D/S0007114520003827a.pdf/finlands-handling-of-selenium-is-a-model-in-these-times-of-coronavirus-infections.pdf" target="_blank">letter from Finland</a> in BJN compares death rate with Sweden's.<br /><br />[edit 15/12/2020 deficiency of both zinc and selenium predicts COVID-19 severity in EPIC data]<br />"<i><b>This combined deficit was observed in 0.15% of samples in the EPIC cohort of healthy subjects, in 19.7% of the samples collected from the surviving COVID-19 patients and in 50.0% of samples from the non-survivors</b></i>."[22]<br /><br /><span style="color: #212121; font-family: "Times New Roman"; font-size: medium;"><span style="font-family: georgia; font-size: medium;">Statistically significant and often very strong associations between selenium intake, selenium status, and various COVID-19 outcomes have been reported from China, South Korea, Germany, South India, Russia and Europe. No null association has yet been reported.<br /></span></span><br />Rigorous re-analysis of updated Chinese pandemic data published recently confirms the original observations, this time using the case-fatality rate:<br /><br /><b><span style="background-color: white; color: #333333; font-family: Georgia, Palatino, serif; font-size: 18px;">A total of 147 cities each reporting over 20 cases were included in the current analysis. In these cities, 91% (14,045) of total cases and 85.8% (103) of total mortality from COVID-19 in China had been reported.<br /></span>Totally, 14,045 COVID-19 cases were reported from 147 cities during 8 December 2019–13 December 2020 were included. Based on selenium content in crops, the case fatality rates (CFRs) gradually increased from 1.17% in non-selenium-deficient areas, to 1.28% in moderate-selenium-deficient areas, and further to 3.16% in severe-selenium-deficient areas (P = 0.002). Based on selenium content in topsoil, the CFRs gradually increased from 0.76% in non-selenium-deficient areas, to 1.70% in moderate-selenium-deficient areas, and further to 1.85% in severe-selenium-deficient areas (P < 0.001). The zero-inflated negative binomial regression model showed a significantly higher fatality risk in cities with severe-selenium-deficient selenium content in crops than non-selenium-deficient cities, with incidence rate ratio (IRR) of 3.88 (95% CIs: 1.21–12.52), which was further confirmed by regression fitting the association between CFR of COVID-19 and selenium content in topsoil, with the IRR of 2.38 (95% CIs: 1.14–4.98) for moderate-selenium-deficient cities and 3.06 (1.49–6.27) for severe-selenium-deficient cities</b>.[24]<br /><br /><b>UPDATE 23/11/2021</b><br /><br />A recent review of in-hospital selenium data shows consistent associations between lower Se and adverse outcomes in 9/10 comparisons where the population selenium level is below the optimal range of 130-150 mcg/dL. The outlier is an n=9 study (the smallest) in which length of hospital stay is the outcome and supplementation during the stay may be a confounder. In the one study where Se went over the optimal range a higher Se was found in more severe cases.[26]<br /><b><br /></b></span></div><div><span style="font-family: georgia; font-size: medium;"><b>3</b>)<b> S</b>pecificity -<b> Strong</b><br /><br />Selenium has much weaker or less consistent associations with other diseases, except those caused by other RNA viruses, e.g. when risk of hepatocellular cancer in viral hepatitis patients is compared with risk of osteoporosis.[4, 5]<br /><br /><br /><b>4</b>) <b>T</b>emporality - <b>Strong<br /></b><br />Prospective ecological comparisons are temporal by design.[2] In the German study, the temporal association between low serum selenium levels and COVID-19 symptom severity was closely tracked.[3]<br /><br /><img alt="Nutrients 12 02098 g003 550" src="https://www.mdpi.com/nutrients/nutrients-12-02098/article_deploy/html/images/nutrients-12-02098-g003-550.jpg" /><br /><br /><b>5</b>)<b> D</b>ose-response gradient - <b>Very Strong</b></span></div><div><b><span style="font-family: georgia; font-size: medium;"><br /></span></b></div><div><span style="font-family: georgia; font-size: medium;">A strong, consistent dose-response is seen, even at levels where the risk of selenium toxicity exists, and despite the fact that toxic levels of soil selenium are often a legacy of industrial pollution in China.[2]<br /><br /><br /><b>6</b>) <b>P</b>lausibility - <b>Very Strong<br /></b><br />Reading references 2 and 3, as well as this review of the evidence written before reference 2 was published, should be persuasive.[6] See also ref 17 for antiviral effects. The effects of selenium and selenite align to support the associational results across multiple mechanisms.<br /><br /><br /><b>7) C</b>oherence - <b>Very Strong</b><br /><br />Selenium is well-studied and nothing in its story seems to contradict the idea that higher intakes will protect against COVID-19 mortality and reduce the severity of disease.<br />Dexamethasone, a drug which can reduce COVID-19 mortality in the ICU, enhances 1α,25-dihydroxyvitamin D3 effects by increasing vitamin D receptor transcription.[7] <br />Selenium sufficiency is essential for the function of vitamin D in peripheral blood monocytes.[8] Vitamin D status also correlates with COVID-19 survival.[9]</span></div><div><span style="font-family: georgia; font-size: medium;"><br /></span></div><div><span style="font-family: georgia; font-size: medium;">[Edit: 20/11/20] Two conditions which are associated with selenium depletion through effects on tubular mineral resorption, sickle cell disease (aOR, 1.73; 95% CI, 1.21-2.47), and chronic kidney disease (aOR, 1.32; 95% CI, 1.29-1.36), are the comorbidities most strongly associated with COVID-19 mortality in a large US MEDICARE patient analysis.[20] Selenium status in sickle cell disease is inversely associated with markers of hemolysis, a feature of severe COVID-19 pathology.[21]<br /><br /><br /></span></div><div><span style="font-family: georgia; font-size: medium;"><b>8</b>) <b>E</b>xperiment - <b>Weak (Neglected)</b><br /><br />This is an area of sufficient neglect to make you despair about medical humanity, if you know that there have been thousands of trials of potentially useless drugs for COVID-19 already. However this criteria overlaps with the next section as there are several trials of selenium supplementation in other viral diseases, and animal experiments in analogous conditions, and many mechanistic experiments that are non-specific. The interaction between SARS-CoV-2 and selenoproteins has been confirmed by experiment.[10]<br /><br /><b>UPDATE 23/11/15</b><br /><br /><div>This team in Wuerzburg Germany have ben steadily researching selenium in COVID-19 patients in ICU and have got to the stage of testing an intervention.</div><div>There's no control arm but we have proof of safety for 1mg sodium selenite and proof of concept in that people in whom the intervention raised SelenoP did better.</div><div>We don't yet know that this effect isn't an artifact of disease severity, but such careful work brings the needed RCT closer.</div><div><br /></div><div>"According to intensive care unit (ICU) standard operating procedures, patients received 1.0 mg of intravenous Se daily on top of artificial nutrition, which contained various amounts of Se and Zn. Micronutrients, inflammatory cytokines, lymphocyte subsets and clinical data were extracted from the patient data management system on admission and after 10 to 14 days of treatment. Forty-six patients were screened for eligibility and 22 patients were included in the study. Twenty-one patients (95%) suffered from severe ARDS and 14 patients (64%) survived to ICU discharge. On admission, the majority of patients had low Se status biomarkers and Zn levels, along with elevated inflammatory parameters. Se supplementation significantly elevated Se (p = 0.027) and selenoprotein P levels (SELENOP; p = 0.016) to normal range. Accordingly, glutathione peroxidase 3 (GPx3) activity increased over time (p = 0.021). Se biomarkers, most notably SELENOP, were inversely correlated with CRP (rs = −0.495), PCT (rs = −0.413), IL-6 (rs = −0.429), IL-1β (rs = −0.440) and IL-10 (rs = −0.461). Positive associations were found for CD8+ T cells (rs = 0.636), NK cells (rs = 0.772), total IgG (rs = 0.493) and PaO2/FiO2 ratios (rs = 0.504). In addition, survivors tended to have higher Se levels after 10 to 14 days compared to non-survivors (p = 0.075). Sufficient Se and Zn levels may potentially be of clinical significance for an adequate immune response in critically ill patients with severe COVID-19 ARDS.[27]</div><div><br /></div><div>In comparison to patients with a fatal outcome (n = 8), survivors (n = 14) significantly responded to supplementation with an increase in Se (p = 0.008), SELENOP (p = 0.004), GPx3 (p = 0.039) and Zn levels (p = 0.020) over the course of the ICU stay (Figure 5). Decedents had a median ICU course of 17.5 days (12–22), whereas patients with a favorable outcome were treated for significantly longer (40 days, 20–44; p = 0.025)."<br /><br />There are also two tests of mixtures including selenium for COVID-19 with favourable results, the first is a survey of a clinic's patients already taking selenium, zinc, and vitamin D for Hasimoto's thyroiditis.[28]<br /><br /><i style="font-weight: bold;">After adjusting for age, gender, BMI, smoking status, we found an association between the absence of supplements and the risk of hospitalization, and invasive mechanical ventilation. Patients with Hashimoto’s thyroiditis who had COVID-19 infection and who had previously taken supplements such as selenium, zinc, and vitamin D had milder clinical outcomes, or no symptoms compared to those who did not receive supplements who had a moderate or severe outcome (P <0.05)</i><br /><br />The next is an RCT from the South Indian doctors cited earlier, of a mixed supplement supplying 40 mcg selenium (a very modest dose in this context, but not insignificant), n=100.[29]<br /><br /><br /><i><b>ImmuActiveTM 500 mg capsule containing curcuminoids (100 mg), andrographolides (50 mg), resveratrol (50 mg), zinc (10 mg), selenium (40 mcg), and piperine (3 mg) or placebo was administered orally to subjects once daily after breakfast.</b><br /></i><br /><b><i>Results. The ordinal scale at the end of the study was significantly lower in COVID-19 patients supplemented with ImmuActive (0.57) than placebo (1.0), with a value of 0.0043. The ordinal scale decreased by one unit within 2.35 days in ImmuActive-supplemented patients, while it took 3.36 days in placebo-supplemented patients. Days of hospitalization and time required to turn RT-PCR negative were comparatively lower in the ImmuActive arm than the placebo arm. Change in modified Jackson’s Symptom Severity Score and COVID-19 QOL were significant from screening to the end of the study in both ImmuActive and placebo arms. There were no adverse events observed during the study period.</i></b></div><br /><br /><br /></span><div><span style="font-family: georgia; font-size: medium;"><br /></span></div><span style="font-family: georgia; font-size: medium;"><br /><b>9</b>) <b>A</b>nalogy - <b>Strong<br /></b><br />Selenium intake is protective, and selenium supplementation has been useful, in other viral illnesses.<br />However, the protective effect of high selenium intakes before infection in epidemiology appears stronger than the protective effect of selenium as a late intervention in disease.[6, 11]<br /><br /><br /><br />Those are the nine canonical Bradford Hill criteria. The discussion about selenium suggests that an <i>ad hoc</i> 10th criteria will also be useful:</span></div><div><span style="font-family: georgia; font-size: medium;"><br /></span></div><div><span style="font-family: georgia; font-size: medium;"><b>10)</b> <b>R</b>isk -<b> Weak in short-term, Well-Established in long term.</b><br /><br />We can add the most relevant of extra questions to any given set of criteria - "strength of the alternative hypothesis" would be a good one for any lipid hypothesis.<br />Bradford Hill stated that some interventions are easier to justify than others.<br /><br /></span><div><span style="font-family: georgia; font-size: medium;"><span><b style="font-style: italic;">On fair evidence we might take action on what appears to be an occupational hazard, e.g. we might change from a probably carcinogenic oil to a non-carcinogenic oil in a limited environment and without too much injustice if we are wrong. But we should need very strong evidence before we made people burn a fuel in their homes that they do not like or stop smoking the cigarettes and eating the fats and sugar that they do like. In asking for very strong evidence I would, however, repeat emphatically that this does not imply crossing every ‘t’, and swords with every critic, before we act.</b><b>[1]</b><br /><br />With nutrient intakes there is often an identifiable risk, with a J-shaped curve. With selenium the risk is selenosis, which is a condition that requires chronic high exposure (I have given myself mild selenosis with around 900mcg selenium a day and it was not a terrible condition to experience and was reversible). There could be other risks. Luckily we have an experiment that tells us where the limit is.<br />In a low selenium country, like New Zealand or Denmark, you don't want to take more than 200mcg of extra selenium long term.[12] Pity the low dose arms here weren't retained in the intervention.<br /><br /><br /><img alt="fx1" src="https://ars.els-cdn.com/content/image/1-s2.0-S0891584918300704-fx1.jpg" /><br /><span style="color: #2e2e2e;"><i><b><br />During 6871 person-years of follow-up, 158 deaths occurred. In an intention-to-treat analysis</b></i></span></span><span style="box-sizing: border-box; margin: 0px; padding: 0px;"><span><i><b><span style="box-sizing: border-box; color: #2e2e2e; margin: 0px; padding: 0px;">, </span><span style="color: #2e2e2e;">the hazard ratio (95% confidence interval) for all-cause mortality</span></b></i></span><span style="box-sizing: border-box; margin: 0px; padding: 0px;"><span><span style="color: #2e2e2e;"><i><b> comparing 300 µg selenium/d to placebo was 1.62 (0.66, 3.96) after 5 years of treatment and 1.59 (1.02, 2.46) over the entire follow-up period. The 100 and 200 µg/d doses showed non-significant decreases in mortality during the intervention period that disappeared after treatment cessation. Although we lacked power for endpoints other than all-cause mortality, the effects on cancer and cardiovascular mortality appeared similar.<br /></b></i></span><br /><br /><br /><span style="color: #2e2e2e;">Howsoever that may be, taking extra selenium above 200mcg per day may yet be advised if one becomes ill with COVID-19, but an inorganic salt of selenium like sodium selenite (which is anyhow probably safer than the selenomethionine form long-term, as I'll discuss below) is preferable, according to the selenovirus expert, Ethan Will Taylor. <br /></span></span>(this video link does not show in the mobile version of this post but can be reached through the web view option at the bottom)<br /><br /></span><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/7RfpNVvvXHI" width="320" youtube-src-id="7RfpNVvvXHI"></iframe></div><br /></span></span></div><span style="font-family: georgia; font-size: medium;"><br />[Edit: 1/09/20] There is also very good evidence that intravenous high dose selenite is safe in the ICU setting.<br /><br /><i><b>Totally 19 RCTs involving 3341 critically ill patients were carried out in which 1694 participates were in the selenium supplementation group, and 1647 in the control. The aggregated results suggested that compared with the control, intravenous selenium supplement as a single therapy could decrease the total mortality (RR = 0.86, 95% CI: 0.78–0.95, P = .002, TSA-adjusted 95% CI = 0.77–0.96, RIS = 4108, n = 3297) and may shorten the length of stay in hospital (MD −2.30, 95% CI −4.03 to −0.57, P = .009), but had no significant treatment effect on 28-days mortality (RR = 0.96, 95% CI: 0.85–1.09, P = .54) and could not shorten the length of ICU stay (MD −0.15, 95% CI −1.68 to 1.38, P = .84) in critically ill patients.</b></i>[13]<br /><br />This, and an earlier analysis which found less benefit, did not single out viral illnesses as a subgroup - this is only evidence for safety - but the earlier analysis did find a) slightly lower mortality in trials without an initial bolus dose, b) no increased risk in patients with renal disease.[14]<br /><br />I will hypothesize briefly on selenium increasing mortality at 300 mcg/day in the Danish intervention study, a dose far too low to cause selenosis.<br />(The conventional signs of selenosis result from selenocysteine replacing cysteine in proteins, and the relative weakness of the Se-Se bond compared with the S-S bond.)<br />[Edit - hypothesis improved, 23/09/20]<br /><div>The question of selenium causing insulin resistance and increasing mortality in high-dose supplements, not mirrored as far as I can see in natural high-dose populations, may have a simple explanation - supplements allow us to consume micronutrients without protein.</div><div>If you have no cysteine or methionine coming in when you take Se (either because you're not eating protein, or perhaps it can happen naturally if the Se level is high in a low-protein food and diet) then the selenocysteine formed will be incorporated into all proteins, not just the ones that require it. Including the insulin receptors, which will suffer a relative loss of function.</div><div>(similarly, though for different reasons, <a href="http://hopefulgeranium.blogspot.com/2013/02/pyridoxine-toxicity-and-deficiency-and.html" target="_blank">pyridoxine toxicity</a> can be triggered by supplementing on a low-protein diet)</div><div><br /></div><div>If we think that insulin resistance causes CVD, then the increased risk from (mostly) natural high Se levels is not great, see fig 5 here [15], but the intervention studies have more alarming results, and I think the competition of selenium- vs sulphur-amino acids in protein fed vs unfed states can explain this. There is next to no evidence of Se toxicity from Brazil nuts, which are high in both Se and protein.<br /><div class="separator" style="clear: both; text-align: center;"><a href="https://lh3.googleusercontent.com/-qIHvyeMcEW8/X2p-5E3uGfI/AAAAAAAACVw/GF4mTBcSoqQM2DWiI32WklW2eJ5cHX2CACLcBGAsYHQ/image.png" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="327" data-original-width="500" height="209" src="https://lh3.googleusercontent.com/-qIHvyeMcEW8/X2p-5E3uGfI/AAAAAAAACVw/GF4mTBcSoqQM2DWiI32WklW2eJ5cHX2CACLcBGAsYHQ/image.png" width="320" /></a></div><br /><br /></div><div><br /></div>It makes sense to me that selenomethionine, very useful as it will increase selenoprotein levels quickly if you don't have much time, should be replaced with sodium selenite for long-term coverage.<br /><br />Brazil nuts are a variable quantity, a sample of nuts sold in NZ in 2008 had an average of 19 mcg per nut and increased selenoprotein levels more than selenomethionine.[16]<br /><br /><b style="font-style: italic;">Plasma selenium increased by 64.2%, 61.0%, and 7.6%; plasma GPx by 8.3%, 3.4%, and -1.2%; and whole blood GPx by 13.2%, 5.3%, and 1.9% in the Brazil nut, selenomethionine, and placebo groups, respectively. Change over time at 12 wk in plasma selenium (P < 0.0001 for both groups) and plasma GPx activity in the Brazil nut (P < 0.001) and selenomethionine (P = 0.014) groups differed significantly from the placebo group but not from each other. The change in whole blood GPx activity was greater in the Brazil nut group than in the placebo (P = 0.002) and selenomethionine (P = 0.032) groups.</b><br /><br />[Edit 02/09/20] - thanks to Mike Angell for this link; while all selenium sources are probably protective against death and ongoing harm from COVID-19, only selenite is likely to have an additional antiviral effect, and has low toxicity.[17]<br /><br />A rational protocol for using selenium in prevention and treatment of COVID-19, fully consistent with the evidence discussed here, is described at the end of this paper:<br /><a href="https://www.frontiersin.org/articles/10.3389/fnut.2020.00164/full">https://www.frontiersin.org/articles/10.3389/fnut.2020.00164/full</a><br /><br /><br /><img src="https://1.bp.blogspot.com/-wZroU1D64nA/X0x0EAtlr8I/AAAAAAAACUY/HD2oPSKU4_kNZ-NgxPvy0eqFKTcGgPD5ACLcBGAsYHQ/w512-h342/COVID%2B2.jpg" /></span></div><div><span style="font-family: georgia; font-size: medium;"><br /></span><div><span style="font-family: georgia; font-size: medium;"><i><b><span>All scientific work is incomplete - whether it be observational or experimental. All scientific work </span></b></i><i><b><span>is liable to be upset or modified by advancing knowledge. That does not confer upon us a freedom to ignore the knowledge we already have, or to postpone the action that it appears to demand at </span></b></i><i><b>a given time.</b></i></span></div><div><i><b><span style="font-family: georgia; font-size: medium;"><br /></span></b></i></div><div><span style="font-family: georgia; font-size: medium;">Austin Bradford Hill, 1965.</span></div><div><span style="font-family: georgia; font-size: medium;"><br /><br /><br /></span><div class="separator" style="clear: both; text-align: center;"><span style="font-family: georgia; font-size: medium;"><br /></span></div><span style="font-family: georgia; font-size: medium;"><br /></span></div><div><span style="font-family: georgia; font-size: medium;"><br /></span></div><div><span style="font-family: georgia; font-size: medium;"><b>References:</b></span></div><div><span style="font-family: georgia; font-size: medium;"><b><br /></b></span></div><div><span style="font-family: georgia; font-size: medium;">[1] Hill AB. The environment and disease: association or causation? Proc R Soc Med. 1965;58(5):295-300.</span></div><span style="font-family: georgia; font-size: medium;">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1898525/pdf/procrsmed00196-0010.pdf<br /></span></div></div><div><span style="font-family: georgia; font-size: medium;"><br /></span></div><div><span style="font-family: georgia; font-size: medium;">[2] Jinsong Zhang, Ethan Will Taylor, Kate Bennett, Ramy Saad, Margaret P Rayman, Association between regional selenium status and reported outcome of COVID-19 cases in China, The American Journal of Clinical Nutrition, Volume 111, Issue 6, June 2020, Pages 1297–1299, https://doi.org/10.1093/ajcn/nqaa095</span></div><div><span style="font-family: georgia; font-size: medium;"><br /></span></div><div><span style="font-family: georgia; font-size: medium;">[3] Moghaddam, A.; Heller, R.A.; Sun, Q.; Seelig, J.; Cherkezov, A.; Seibert, L.; Hackler, J.; Seemann, P.; Diegmann, J.; Pilz, M.; Bachmann, M.; Minich, W.B.; Schomburg, L. Selenium Deficiency Is Associated with Mortality Risk from COVID-19. Nutrients 2020, 12, 2098.<br /><br />[4] Yu MW, Horng IS, Hsu KH, Chiang YC, Liaw YF, Chen CJ. Plasma selenium levels and risk of hepatocellular carcinoma among men with chronic hepatitis virus infection. Am J Epidemiol. 1999;150(4):367-374. doi:10.1093/oxfordjournals.aje.a010016</span></div><span style="font-family: georgia; font-size: medium;"><br />[5] Wang, Y., Xie, D., Li, J. et al. Association between dietary selenium intake and the prevalence of osteoporosis: a cross-sectional study. BMC Musculoskelet Disord 20, 585 (2019). https://doi.org/10.1186/s12891-019-2958-5<br /><br />[6] Bermano, G., Méplan, C., Mercer, D., & Hesketh, J. (2020). Selenium and viral infection: Are there lessons for COVID-19? British Journal of Nutrition, 1-37. doi:10.1017/S0007114520003128<br /><a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/selenium-and-viral-infection-are-there-lessons-for-covid19/BE3AC78D5C92725BE83C4E474ECBB548">https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/selenium-and-viral-infection-are-there-lessons-for-covid19/BE3AC78D5C92725BE83C4E474ECBB548</a><br /><br />[7] Hidalgo AA, Deeb KK, Pike JW, Johnson CS, Trump DL. Dexamethasone enhances 1alpha,25-dihydroxyvitamin D3 effects by increasing vitamin D receptor transcription. J Biol Chem. 2011;286(42):36228-36237. doi:10.1074/jbc.M111.244061<br /><br />[8] Schütze N, Fritsche J, Ebert-Dümig R, et al. The selenoprotein thioredoxin reductase is expressed in peripheral blood monocytes and THP1 human myeloid leukemia cells--regulation by 1,25-dihydroxyvitamin D3 and selenite. Biofactors. 1999;10(4):329-338. doi:10.1002/biof.5520100403<br /><br />[9] Martín Giménez, V.M., Inserra, F., Ferder, L. et al. Vitamin D deficiency in African Americans is associated with a high risk of severe disease and mortality by SARS-CoV-2. J Hum Hypertens (2020). https://doi.org/10.1038/s41371-020-00398-z</span><div><span style="font-family: georgia; font-size: medium;"><br /></span></div><div><span style="font-family: georgia; font-size: medium;">[10] Wang, Y et al. SARS-CoV-2 suppresses mRNA expression of selenoproteins associated with ferroptosis, ER stress and DNA synthesis. Preprint, 2020/07/31. 10.1101/2020.07.31.230243</span></div><span style="font-family: georgia; font-size: medium;"><a href="https://www.researchgate.net/publication/343365020_SARS-CoV-2_suppresses_mRNA_expression_of_selenoproteins_associated_with_ferroptosis_ER_stress_and_DNA_synthesis">https://www.researchgate.net/publication/343365020_SARS-CoV-2_suppresses_mRNA_expression_of_selenoproteins_associated_with_ferroptosis_ER_stress_and_DNA_synthesis</a><br /><br />[11] Steinbrenner H, Al-Quraishy S, Dkhil MA, Wunderlich F, Sies H. Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 2015;6(1):73-82. Published 2015 Jan 15. doi:10.3945/an.114.007575<br /><br />[12] Rayman MP, Winther KH, Pastor-Barriuso R, et al. Effect of long-term selenium supplementation on mortality: Results from a multiple-dose, randomised controlled trial. Free Radic Biol Med. 2018;127:46-54. doi:10.1016/j.freeradbiomed.2018.02.015<br /><br />[13] Zhao Y, Yang M, Mao Z, et al. The clinical outcomes of selenium supplementation on critically ill patients: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 2019;98(20):e15473. doi:10.1097/MD.0000000000015473<br /><br />[14] Manzanares W, Lemieux M, Elke G, Langlois PL, Bloos F, Heyland DK. High-dose intravenous selenium does not improve clinical outcomes in the critically ill: a systematic review and meta-analysis. Crit Care. 2016;20(1):356. Published 2016 Oct 28. doi:10.1186/s13054-016-1529-5<br /><br />[15] Angelica Kuria, Hongdou Tian, Mei Li, Yinhe Wang, Jan Olav Aaseth, Jiajie Zang & Yang Cao (2020) Selenium status in the body and cardiovascular disease: a systematic review and meta-analysis, Critical Reviews in Food Science and Nutrition, DOI: 10.1080/10408398.2020.1803200 https://www.tandfonline.com/doi/full/10.1080/10408398.2020.1803200<br /><br />[16] Thomson CD, Chisholm A, McLachlan SK, Campbell JM. Brazil nuts: an effective way to improve selenium status. Am J Clin Nutr. 2008;87(2):379-384. doi:10.1093/ajcn/87.2.379<br /><a href="https://academic.oup.com/ajcn/article/87/2/379/4633360">https://academic.oup.com/ajcn/article/87/2/379/4633360</a><br /><br />[17] Kieliszek M, Lipinski B. Selenium supplementation in the prevention of coronavirus infections (COVID-19) [published online ahead of print, 2020 May 24]. Med Hypotheses. 2020;143:109878. doi:10.1016/j.mehy.2020.109878<br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246001/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246001/</a></span><div><span style="font-size: medium;"><br /></span></div><div><div><span style="font-family: georgia; font-size: medium;">[18] Im, JH et al. Nutritional status of patients with coronavirus disease 2019 (COVID-19) Int J Infectious Diseases, August 11, 2020<br /><a href="https://www.ijidonline.com/article/S1201-9712(20)30647-0/fulltext">https://www.ijidonline.com/article/S1201-9712(20)30647-0/fulltext</a></span></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-family: times; font-size: medium;">[19] Majeed, M et al. An Exploratory Study of Selenium Status in Normal Subjects and COVID-19 Patients in South Indian population: Case for Adequate Selenium Status: Selenium Status in COVID-19 Patients. Nutrition. Available online 11 November 2020, 111053<br /><a href="https://www.sciencedirect.com/science/article/pii/S0899900720303361">https://www.sciencedirect.com/science/article/pii/S0899900720303361</a><br /><br />[20] </span><span style="font-family: times; font-size: medium;">Chen Dun, Christi M. Walsh, Sunjae Bae, Amesh Adalja, Eric Toner, Timothy A. Lash, Farah Hashim, Joseph Paturzo, Dorry L. Segev, Martin A. Makary. A Machine Learning Study of 534,023 Medicare Beneficiaries with COVID-19: Implications for Personalized Risk Prediction.</span></div><div><span style="font-family: times; font-size: medium;">medRxiv 2020.10.27.20220970; doi: <a href="https://doi.org/10.1101/2020.10.27.20220970">https://doi.org/10.1101/2020.10.27.20220970</a></span></div><div><span style="font-size: medium;"><br /></span></div><div><div><span style="font-size: medium;">[21] Delesderrier E, Cople-Rodrigues CS, Omena J, et al. Selenium Status and Hemolysis in Sickle Cell Disease Patients. Nutrients. 2019;11(9):2211. Published 2019 Sep 13. doi:10.3390/nu11092211</span></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">[22] </span><span style="font-size: medium;">Raban Arved Heller, Qian Sun, Julian Hackler, Julian Seelig, Linda Seibert, Asan Cherkezov, Waldemar B. Minich, Petra Seemann, Joachim Diegmann, Maximilian Pilz, Manuel Bachmann, Alireza Ranjbar, Arash Moghaddam, Lutz Schomburg,</span></div><div><span style="font-size: medium;">Prediction of survival odds in COVID-19 by zinc, age and selenoprotein P as composite biomarker, </span><span style="font-size: medium;">Redox Biology, </span><span style="font-size: medium;">Volume 38, 2021</span><span style="font-size: medium;">, </span><span style="font-size: large;">101764,</span></div><div><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574778/" style="font-size: large;">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574778/</a></div><div><span style="font-size: medium;"><br />[23] Skalny AV, Timashev PS, Aschner M, et al. Serum Zinc, Copper, and Other Biometals Are Associated with COVID-19 Severity Markers. Metabolites. 2021;11(4):244. Published 2021 Apr 15. doi:10.3390/metabo11040244<br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8071197/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8071197/</a><br /><br />[24] Zhang, HY., Zhang, AR., Lu, QB. et al. Association between fatality rate of COVID-19 and selenium deficiency in China. BMC Infect Dis 21, 452 (2021). <a href="https://doi.org/10.1186/s12879-021-06167-8">https://doi.org/10.1186/s12879-021-06167-8</a><br /><br />[25] Liu Q, Zhao X, Ma J, et al. Selenium (Se) plays a key role in the biological effects of some viruses: Implications for COVID-19. Environ Res. 2021;196:110984. doi:10.1016/j.envres.2021.110984<br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937041/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937041/</a><br /><br />[26] Fakhrolmobasheri, M., Mazaheri-Tehrani, S., Kieliszek, M. et al. COVID-19 and Selenium Deficiency: a Systematic Review. Biol Trace Elem Res (2021). https://doi.org/10.1007/s12011-021-02997-4<br /><a href="https://link.springer.com/article/10.1007/s12011-021-02997-4">https://link.springer.com/article/10.1007/s12011-021-02997-4</a><br /><br />[27] Notz, Q.; Herrmann, J.; Schlesinger, T.; Helmer, P.; Sudowe, S.; Sun, Q.; Hackler, J.; Roeder, D.; Lotz, C.; Meybohm, P.; Kranke, P.; Schomburg, L.; Stoppe, C. Clinical Significance of Micronutrient Supplementation in Critically Ill COVID-19 Patients with Severe ARDS. Nutrients 2021, 13, 2113. <br /><a href="https://doi.org/10.3390/nu13062113">https://doi.org/10.3390/nu13062113</a><br /><br />[28] Zelija Velija Asimi, Almira Hadzovic-Dzuvo, & Djinan Al Tawil. Selenium, zinc, and vitamin D supplementation affect the clinical course of COVID-19 infection in Hashimoto’s thyroiditis. Presented ePosters 14: COVID-19 Endocrine Abstracts (2021) 73 PEP14.2 | DOI: 10.1530/endoabs.73.PEP14.2<div><a href="https://www.endocrine-abstracts.org/ea/0073/ea0073pep14.2">https://www.endocrine-abstracts.org/ea/0073/ea0073pep14.2</a><br /><br />[29] Muhammed Majeed, Kalyanam Nagabhushanam, Kalpesh Shah, Lakshmi Mundkur, "A Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy and Safety of a Nutritional Supplement (ImmuActiveTM) for COVID-19 Patients", Evidence-Based Complementary and Alternative Medicine, vol. 2021, Article ID 8447545, 9 pages, 2021. <a href="https://doi.org/10.1155/2021/8447545">https://doi.org/10.1155/2021/8447545</a><br /><br />[30] JinsongZhanga, EthanWill Taylorb, KateBennett, Margaret P. Rayman. Does atmospheric dimethyldiselenide play a role in reducing COVID-19 mortality? </div>Gondwana Research, </span><span style="font-size: large;">Available online 6 June 2022 </span><span style="font-size: medium;"><a href="https://doi.org/10.1016/j.gr.2022.05.017">https://doi.org/10.1016/j.gr.2022.05.017</a></span></div><div><br /></div></div></div>Unknownnoreply@blogger.com4tag:blogger.com,1999:blog-8550919611653842066.post-24532638732190288692022-05-24T18:59:00.000-07:002022-05-24T18:59:40.459-07:00The case for Red meat - a Marxist defense of meat-eating<p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">New Zealand schools have introduced a climate change <a href="https://www.reuters.com/article/us-climate-change-newzealand/new-zealands-school-climate-change-curriculum-vexes-farmers-idUSKBN22I0KE" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-weight: var(--fontWeights-body) !important;" target="_blank">resource</a> that suggests children “eat less meat and dairy”, even though teachers will not know how much meat or dairy any child in their care has eaten. Opinion pieces in the papers have called for the reduction of <a href="https://www.stuff.co.nz/national/health/115109489/hospitals-should-start-cutting-out-meat-from-their-menus" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-weight: var(--fontWeights-body) !important;" target="_blank">meat and dairy in hospital menus</a>, not usually generous sources of such foods, despite the well-known risks of undernutrition, especially of protein, in the frail and elderly. Globally, the influential and once-objective medical journal the Lancet has hosted Eat Lancet, a coalition of vegan and vegetarian technocrats backed by processed food manufacturers, and promoted their agenda. The <a href="https://ghgguru.faculty.ucdavis.edu/2019/03/18/guardian-and-opp-ink-deal-to-pen-stories/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-weight: var(--fontWeights-body) !important;" target="_blank">Guardian newspaper</a> accepted an $886,600 grant from the backers of Impossible Foods to run a series of articles against animal agriculture.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">These initiatives, aimed at remodelling our food supply in a way that favours the multinational food processing and seed-and-chemical corporations, whose control of many aspects of farming and diet is already problematic, have run far ahead of the scientific community’s efforts to understand the health effects of such dietary change.<br /><br /><strong>Our hunter-gatherer past</strong></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">The Neolithic Revolution was the first alteration in human affairs that is generally considered worthy of the term Revolution. In Marx’s terms, it saw a change in the means of production sufficient to form new classes aware of their identities, and thus a change in the relations between people. Early humans had fed themselves in an opportunistic, hunter-gatherer fashion that tended to favour a diet of animals supplemented with plants where and when these were available. Large animals made the best meals but gathering activities could collect many smaller ones, as well as eggs, grubs etc.
<img height="121" src="https://rdln.files.wordpress.com/2020/05/screen-shot-2020-05-27-at-2.35.34-pm.png?w=300&h=121" style="border: 0px; max-width: 100%;" width="300" /></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">The people of the Mesolithic era discovered that some animals could be herded and some plants grown in gardens (not usually by the same community, because one activity favours nomadism and the other favours a sedentary habit) but these activities, which greatly improved food security after the decline of the prehistoric mega-fauna due to hunting and climate pressures, tended to occur at the communal level and probably did not create major class differences between the people involved.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;"><strong>The invention of farming<br /></strong><br />The Neolithic Revolution, which unleashed the human potential for war, creativity, and social division, resulted from the identification of the germs of plants (specifically grains and legumes) as durable sources of energy. If grains were grown (I will use grains in the wider sense of “cereals”, after Braudel, including other dried germs such as peas) and there was a surplus, this surplus would still be edible over the next year, a year when drought or pests or diseases might wipe out the other food sources that hunter-gatherers depended on. This advantage was offset by the nutritional poverty of grain-based diets, so that tuberculosis probably became an endemic disease during this period,[1] but the existence of a less-perishable surplus allowed the diversion of part of the population away from food gathering for large parts of the year, and saw the creation of armies and other workforces.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;"><img height="198" src="https://rdln.files.wordpress.com/2020/05/screen-shot-2020-05-27-at-2.43.11-pm.png?w=300&h=198" style="border: 0px; max-width: 100%;" width="300" />
In Europe, the Neolithic Revolution is dated at around 10,000 BC and its arrangements are a matter of prehistory, but in China this change occurred later and the written record around Bi-gu or grain avoidance includes folk-memories of conflict between grain eating and grain avoiding peoples.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">The history of colonisation is the history of the conquest of lactose-intolerant peoples by lactose-tolerant populations, and of non-grain eaters by grain-eaters. In the Indian sub-continent, a combination of dairy herding and a cereal diet high in legumes uniquely allowed the survival of a substantially vegetarian population, and saw the conservation of genes favouring reproduction on such a diet, including genetic polymorphisms still rare in European populations (adaptive mutations only predominate where many individuals without them have failed to survive or reproduce).[2] That the Indian social system became more aggressively class-based than any other is probably no co-incidence; prejudice against meat-eating is still used as a tool of social control against minorities, while meat-eating is one way young Indians today identify as modern and egalitarian. However there were some important exceptions to the trend – the Aztecs were a hunter-gather people who conquered and dominated the Mesolithic agriculturalists of Mexico, and the Mongols were nomadic herders and hunters whose greater stamina and independence allowed them to defeat the rice-fed armies of the Chinese Emperors (after conquering this breadbasket, the successive Mongol Khans seem to have eaten and drunk themselves to death).</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;"><strong>Early vegetarian ideology</strong></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">In the European and Asian cereal-based societies the poorest classes went without meat, supplementing cereals when possible with buttermilk or blood pudding which were more economic replacements. The rich ate as much meat as they could. The idea that an entire society might avoid meat is a recent one with its roots in religious practice, and, insofar as it has any political basis, this flows in two distinct streams – the eco-fascist, in which meat avoidance is a sign of “purity”, most humans are a burden on the Earth, and the Indian vegetarians are of course Aryans. This is something like the vegetarian vision that Adolf Hitler picked up while studying anti-Semitism with Wagner’s heirs at Bayreuth.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">And then there is a Marxist-Anarchist, and latterly Intersectional, version, founded on a valuation of animal rights as inseparable from, and a logical extension of, human rights. Vegetarianism was a frequent obsession of the early British Socialists; G.B. Shaw, who derived most of his energy from dairy fat and lived to the age of 94, made himself into a well-known example, and the idea was sufficiently entrenched among the British Socialists and their milieu that H.G. Wells preserved its internal contradictions for posterity in The Time Machine. In his far-future vision, humanity has evolved into two separate species. The Morlocks are descendants of working-class meat-eaters, the Eloi of leisure-class vegetarians – all Wells’ loathing is reserved for the Morlocks, yet it is obvious they are (still) the engineering brains keeping their world running and the Eloi fed. The Eloi are useless for anything but enjoying the sunshine and feeding the Morlocks, and the discordance in Wells’ progressive values as he describes both species is as shocking as anything else in the story.
<span style="color: #181919; font-family: "Nunito Sans", sans-serif; font-size: 18px;">
"But gradually the truth dawned on me: that Man had not remained one species, but had differentiated into two distinct animals: that my graceful children of the Upper-world were not the sole descendants of our generation, but that this bleached, obscene, nocturnal Thing, which had flashed before me, was also heir to all the ages."</span></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">The first large-scale experiment in plant-based protein was attempted by the Bolsheviks. As usual, it’s hard to separate the roles played by idealism and cynicism in the story, but the bare bones are that the Soviets found their initial attempts to remodel the countryside rebuffed, blamed this on the recaltricance of the kulak class, and set out to destroy them. The problem being that the kulaks, owning most of the cattle and sheep across the Russian Republics, helped to feed the people. Beginning in the 1920s, soy experts from the USA (then the Western world’s leading soy producer) were among the many foreign technicians imported into Russia, and soy processing plants were built and soy production increased to 283,000 tonnes in 1931, the year Stalin unleashed enforced collectivisation and the terror against the kulaks (and also the Kazakhs, a herding people who suffered the largest proportionate loss of life during this period). This led to the loss of millions of animals, either killed by their dispossessed owners or mismanaged by their inexperienced new owners. The soy project was hardly able to prevent the massive famines that followed, and by 1935 soy production had dropped to 54,000 tonnes. Though soy milk would later prove useful during the siege of Leningrad, by the 1930s soy had probably only served one purpose, as a statistic needed aforehand to quell the objections of pragmatic delegates to the destruction of the kulaks and their livestock.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">Today we face the revival of this idea, of plant protein that will create a world with no need for animal protein, and the remodelling of life in the countryside, with the new impetus of climate change as its driver. Livestock cycles natural carbon, meaning there is no net addition of C02 to the atmosphere – and its contribution to the shorter-lived methane precursor has not changed since 2000 (methane rises have been due to fracking, methane itself AKA “natural gas”, landfill, and rice production; methane-emitting animals have always existed on Earth in substantial numbers, and have not created a novel situation in the sense that the discovery of coal, oil and gas did). We have recently seen how much global disruption is required to reduce fossil fuel CO2 emissions to 2006 levels, levels which will still warm the planet if they continue. It could be still be worth reducing agricultural cycling of CO2 through methane, which is more warming than CO2 if this is cost-free, but is it?</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;"><strong>Why humans evolved as meat eaters</strong></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;"><img height="138" src="https://rdln.files.wordpress.com/2020/05/screen-shot-2020-05-27-at-2.46.25-pm.png?w=300&h=138" style="border: 0px; max-width: 100%;" width="300" /> Animal foods, and especially red meat, supply a constellation of nutrients not found together (if they are found at all) in any plant food. Nutrients are those chemicals essential for the functioning of the human organism, and plants, but not livestock, can survive well without nutrients such as amino acids, fatty acids, vitamins and minerals that are essential to humans. Surviving as a vegetarian or vegan is possible for some (perhaps assuming the genetic variants referred to earlier are present) but to thrive requires knowledge of these nutrients, where to find them, how to process the foods that supply them, or how to supplement them. Thriving as an omnivore or even a complete carnivore does not – nutritional sufficiency is the reason we evolved eating meat and other animal foods long before we learned there were such things as essential nutrients.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">The reasons for avoiding meat or all animal foods can have a class basis – veganism may be taken up by educated middle-class adults, more likely to be exposed to “health food” ideas and aware of the need to supplement, some of whom then commercialise their habits as social media “influencers”. Meat avoidance is also being adopted increasingly by educated middle-class children for identity or compassionate reasons, but the poor may also avoid meat because of its cost when a loaf of bread or a packet of flavoured noodles can be bought for a dollar; these two motivations sometimes coincide when students in temporary poverty make a virtue of what they perceive to be a necessity.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">Does the meat-avoiding behaviour of young people have unintended costs? Several observational studies have looked at the characteristics of meat-avoiding populations and found alarming increases in depression, anxiety and self-harm.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">“The majority of studies, and especially the higher quality studies, showed that those who avoided meat consumption had significantly higher rates or risk of depression, anxiety, and/or self-harm behaviors. There was mixed evidence for temporal relations, but study designs and a lack of rigor precluded inferences of causal relations. Our study does not support meat avoidance as a strategy to benefit psychological health.”[3]</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">How can we explain these correlations? Why should we assume that they are causal? There are several lines of evidence to support a causal link:<br /><br />1) several nutrients found in meat and animal foods are important factors in mood and cognition; vitamin B12, iron, carnitine, DHA, choline and tryptophan are some examples.[4]<br /><br />2) the fatty acid mix in dairy and red meat has a similar composition to that of amniotic fluid and breast milk which has anxiolytic (anti-anxiety) effects in young animals.[5]<br /><br />3) soy is a convenient and cheap replacement for animal protein; soy processing in Western diets results in a 10-fold higher level of the estrogenic contaminant isoflavone than that found in Asian diets.[6] Soy isoflavone causes anxiety behaviour in young female animals, and there is evidence supporting psychotropic and hormonal effects in humans.[7,8,9.10] Interestingly, while right-wing critiques of soy eating focus on effects it can have on young men, the scientific evidence for adverse effects in younger females, converting to HRT-like benefits after menopause, is stronger.[11]<br /><br />4) other toxins found in plants, such as salicylates and oxalates, as well as problematic proteins such as gliadin/gluten and zein, may be present at higher levels in meat-free diets (but are not unique to them). A vegan mince sold in Countdown supermarkets is simply a coloured blend of soy protein and gluten, a protein linked to the risk of schizophrenia.[12]<br /><br />In the New Zealand context it would be relatively easy to confirm or dispute some of these associations. Everyone admitted to hospital for longer than a day supplies their dietary preferences. The dietetic preference data from psychiatric admissions could be both linked to outcomes over time and compared with the population average distribution, or the distribution in a ward where diet is least likely to play a role in admissions.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;"><strong>Iron deficiency in women<br /></strong><br />Young women in New Zealand are the most likely to report being vegan or vegetarian in surveys, as elsewhere in the world. Vegans in the Gender Studies field generate papers linking meat to masculinity, with the implication that this masculinity is toxic and might be improved by a plant-based diet.[13] The corollary of this belief – that women may therefore be weakened by meat-avoidance – is never considered. In a 1980 essay by Gloria Steinem called The Politics of Food (in the collection Outrageous Acts and Everyday Rebellions) she describes some of the cultural constructs by which women are deprived of the good nutrition which men use to stay dominant. The belief that men need to eat red meat more often than women may have been valid when the average man was more likely to have to survive an attack by a wild bear than the average woman, but today it is mainly women who suffer from serious iron deficiency. The rate – and the cost to the health system – is <a href="https://www.stuff.co.nz/national/health/108767316/more-spent-on-low-iron-hospitalisations-as-meat-intake-declines" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-weight: var(--fontWeights-body) !important;" target="_blank">increasing in New Zealand</a> as more women give up meat. Iron deficiency anaemia in early pregnancy is associated with neurodevelopmental disorders in children, not an outcome that will increase the mother’s autonomy.[14]</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">In Georg Büchner’s 19th century “working class tragedy” Woyzeck, filmed by Werner Herzog with Klaus Kinski in the leading role and the subject of an opera by Alban Berg, the title character, a soldier, is subject to experimentation by a sadistic army doctor. The experiment involves Woyzeck living on nothing but peas. Peas may supply a complete protein, but Woyzeck goes insane; the deprivation being the final straw in his alienation. James Cameron, the film-maker responsible for Avatar and Titanic, is investing heavily in pea protein as if this were his gift to New Zealand. I am not sure whether he has watched Woyzeck – one would think he has.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;"><strong>Plant-based vs meat-based</strong></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">Again, we have the specificity of plant germs as commodity; their low cost of production, long storage life and versatility of processing outcomes makes them an ideal investment and a robust one, as poverty and adversity increases their consumption, as we saw during the 2020 Lockdown Event. However, a plant-based burger is nutritionally greatly inferior to a meat burger, and that burger is often the most nutritious single food item many will people eat in the course of their day. The current push to eat a plant-based diet for “planetary health” is something that all the multinational food processors have signed up and provided funding for, and why not – Coca Cola, Unilever, Nestlé have always sold us plant-based foods. We notice that while iron-deficiency anaemia increases in New Zealand with the reason in plain sight, Nestlé scientists here in NZ are developing a <a href="http://masseyventureslimited.co.nz/news/nestle-acquires-new-zealand-technology-to-help-fight-iron-deficiency/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-weight: var(--fontWeights-body) !important;" target="_blank">more potent form of supplemental iron</a> to add value to their products as their parent company backs the push to reduce meat. (As usual, it’s hard to separate the roles played by idealism and cynicism in the story).<br /><br />But, you may well ask, isn’t eating meat linked to an increased risk of cancer and heart disease? These associations are small to begin with, but they are also <a href="https://profgrant.com/2019/04/26/the-uk-biobank-study-meat-and-cancer-science-reporting-and-invisible-women/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-weight: var(--fontWeights-body) !important;" target="_blank">intensely confounded</a> by social class and educational status. Supposing a factory that makes a carcinogenic chemical is hiring. Who is more likely to apply for that job – a meat eater (who will likely have a bigger family to support, among other considerations) or a vegan? Who, so to speak, eats all the pies, and needs food that is filling and nutritious without having to give it much thought? Who is more likely to work two jobs and be exposed to the disruptive metabolic effect of shift work? Carcinogen exposure and shift work are just two of the confounding variables ignored in diet epidemiology. (That meat-eating in Western populations may symbolise or associate with labour itself – as it did for H.G. Wells when he wrote The Time Machine – is not a consideration I have found discussed in the epidemiological literature.)</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">Certainly one can think of mechanisms that might link meat to disease, as one can with any food, but one can also think of protective mechanisms; several of the nutrients found mainly or only in animal foods are required for various antioxidant and immune defensive enzymes, and some like carnitine and EPA even have a place in the management of heart disease.<br /><br />The argument against meat-eating should not be confused with the argument for sometimes rationing a valuable food that is in short supply. The wartime rationing of meat in the UK is thought to have improved the health of the poorest by guaranteeing a greater supply than they had had previously, at a more affordable price. In Europe, the peasants who supplied the cities with meat, dairy and luxury foods such as oysters were sometimes forced by network disruptions to consume these foods – which many of them had never tasted before – with benefit to their own health.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">The plant-based agenda can scarcely be expected to recognise these benefits, or understand the argument summarised by Williams and Dunbar (with regard to the vitamin nicotinamide and amino acid tryptophan in their tuberculosis paper), that if better data collection and analysis resulted in us ”…returning to our egalitarian past and redistributing meat or its components that supply NAD (avoiding both the highs and the lows between individuals and over individual lifetimes) [this] may be more effective than subsidizing corn grain (while the increased prosperity from unlocking human potential should pay for the intervention).”[1]<br /><br />Progress – which includes unlocking human potential from the chains of preventable mental and physical disease – depends on good data, and we do not yet seem to collate the data required to know whether or for whom plant-based diets are safe in New Zealand.</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;"><em><strong>George Henderson</strong></em><em> works as a researcher for Professor Grant Schofield and the team behind the </em>What The Fat<em> books and the social enterprise PreKure, which has been running free lifestyle and health programs through the lockdown. He is the author or co-author of several scientific articles and letters published by the </em>BMJ<em>, </em>Lancet Diabetes and Endocrinology<em>, the </em>JAMA<em>, and other journals, including an influential review of low carbohydrate diets in diabetes management for the </em>New Zealand Medical Journal<em>. A musician, songwriter and amateur musicologist, he has recently presented a series of podcasts on 20th century women composers for Karyn Hay’s </em>Lately<em> show on RNZ.</em></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;"><strong>References:</strong></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">[1] Williams AC, Dunbar RI. Big brains, meat, tuberculosis, and the nicotinamide switches: co-evolutionary relationships with modern repercussions?. Int J Tryptophan Res. 2013;6:73‐88. Published 2013 Oct 15. doi:10.4137/IJTR.S12838<br /><br />[2] Kothapalli KS, Ye K, Gadgil MS, et al. Positive Selection on a Regulatory Insertion-Deletion Polymorphism in FADS2 Influences Apparent Endogenous Synthesis of Arachidonic Acid. Mol Biol Evol. 2016;33(7):1726‐1739. doi:10.1093/molbev/msw049</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">[3] Urska Dobersek, Gabrielle Wy, Joshua Adkins, Sydney Altmeyer, Kaitlin Krout, Carl J. Lavie & Edward Archer (2020) Meat and mental health: a systematic review of meat abstention and depression, anxiety, and related phenomena, Critical Reviews in Food Science and Nutrition, DOI: 10.1080/10408398.2020.1741505<br /><br />[4] Frédéric Leroy & Nathan Cofnas (2019) Should dietary guidelines recommend low red meat intake?, Critical Reviews in Food Science and Nutrition, DOI: 10.1080/10408398.2019.1657063<br /><br />[5] Contreras CM, Rodríguez-Landa JF, García-Ríos RI, Cueto-Escobedo J, Guillen-Ruiz G, Bernal-Morales B. Myristic acid produces anxiolytic-like effects in Wistar rats in the elevated plus maze. Biomed Res Int. 2014;2014:492141. doi:10.1155/2014/492141<br /><br />[6] Fernandez-Lopez A, Lamothe V, Delample M, Denayrolles M, Bennetau-Pelissero C. Removing isoflavones from modern soyfood: Why and how?. Food Chem. 2016;210:286‐294. doi:10.1016/j.foodchem.2016.04.126<br /><br />[7] Hicks KD, Sullivan AW, Cao J, Sluzas E, Rebuli M, Patisaul HB. Interaction of bisphenol A (BPA) and soy phytoestrogens on sexually dimorphic sociosexual behaviors in male and female rats. Horm Behav. 2016;84:121‐126. doi:10.1016/j.yhbeh.2016.06.010<br /><br />[8] Tillett T. Full of beans? Early soy exposure associated with less feminine play in girls [published correction appears in Environ Health Perspect. 2012 Jan;120(1):A17]. Environ Health Perspect. 2011;119(12):A525. doi:10.1289/ehp.119-a525b<br /><br />[9] Adgent MA, Daniels JL, Rogan WJ, et al. Early-life soy exposure and age at menarche. Paediatr Perinat Epidemiol. 2012;26(2):163‐175. doi:10.1111/j.1365-3016.2011.01244.x<br /><br />[10] Hibbeln, J.R., SanGiovanni, J.P., Golding, J., Emmett, P.M., Northstone, K., Davis, J.M., Schuckit, M. and Heron, J. (2017), Meat Consumption During Pregnancy and Substance Misuse Among Adolescent Offspring: Stratification of TCN2 Genetic Variants. Alcohol Clin Exp Res, 41: 1928-1937. doi:10.1111/acer.13494</p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px !important; white-space: pre-line;">[11] Patisaul HB, Jefferson W. The pros and cons of phytoestrogens. Front Neuroendocrinol. 2010;31(4):400‐419. doi:10.1016/j.yfrne.2010.03.003<br /><br />[12] Čiháková D, Eaton WW, Talor MV, et al. Gliadin-related antibodies in schizophrenia. Schizophr Res. 2018;195:585‐586. doi:10.1016/j.schres.2017.08.051<br /><br />[13] Jessica Greenebaum & Brandon Dexter (2018) Vegan men and hybrid masculinity, Journal of Gender Studies, 27:6, 637-648, DOI: 10.1080/09589236.2017.1287064<br /><br />[14] Wiegersma AM, Dalman C, Lee BK, Karlsson H, Gardner RM. Association of Prenatal Maternal Anemia With Neurodevelopmental Disorders. JAMA Psychiatry. 2019;76(12):1294–1304. doi:10.1001/jamapsychiatry.2019.2309<br /><br />This article originally appeared on the <a href="https://t.co/x1nBtMt7fP" target="_blank">Redliner</a> blog</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-87082386569924843432022-05-15T18:45:00.002-07:002022-05-15T18:45:21.099-07:00Vegetarianism - a warning from history Pt 2 - Shelly's vegetarian experiments.<p class="MsoNormal"><span lang="EN-US"><span style="font-family: times; font-size: large;">Vegan diets and the risk of deficiency
diseases – the story of Shelly<br />
<br />
One of the earliest objective accounts of the effects of a vegetarian diet in
English is Thomas Love Peacock’s observations of his friend, the poet Percy Bysshe
Shelly. I think these are interesting because Shelly’s ordeal is very similar
to what enthusiastic young people subject themselves to today, and because
Peacock’s dry humour can speak for the rest of us.<br />
Quotes are from Thomas Love Peacock’s Memoir of Percy Bysshe Shelly.<br />
<a href="http://scans.library.utoronto.ca/pdf/2/41/peacocksmemoirso00peacuoft/peacocksmemoirso00peacuoft.pdf">http://scans.library.utoronto.ca/pdf/2/41/peacocksmemoirso00peacuoft/peacocksmemoirso00peacuoft.pdf</a><o:p></o:p></span></span></p>
<p class="MsoNormal"><span lang="EN-US"><span style="font-family: times; font-size: large;"><br />
Shelly had come under the influence of JF Newton, author of The Return to
Nature, or A Defense of the Vegetable Regimen.<br />
<a href="https://archive.org/details/returntonatureor00newt">https://archive.org/details/returntonatureor00newt</a><o:p></o:p></span></span></p>
<p class="MsoNormal"><span lang="EN-US"><span style="font-family: times; font-size: large;"><br />
Peacock wrote of Newton “He was an estimable man and an agreeable companion,
and he was not the less amusing that he was the absolute impersonation of a
single theory, or rather of two single theories rolled into one. He held that
all diseases and all aberrations, moral and physical, had their origin in the
use of animal food and of fermented and spirituous liquors; that the universal
adoption of a diet of roots, fruits, and distilled water, would restore the
golden age of universal health, purity, and peace ; that this most ancient and
sublime morality was mystically inculcated in the most ancient Zodiac, which
was that of Dendera…”[I will spare you Peacock’s lengthy exposition of this
astrological system]<br style="mso-special-character: line-break;" />
<!--[if !supportLineBreakNewLine]--><br style="mso-special-character: line-break;" />
<!--[endif]--><o:p></o:p></span></span></p>
<p class="MsoNormal"><span lang="EN-US"><span style="font-family: times; font-size: large;">“At Bracknell, Shelley was surrounded by a
numerous society, all in a great measure of his own opinions in relation to
religion and politics, and the larger portion of them in relation to vegetable
diet”<br />
Shelley had published the treatise, A Vindication of Natural Diet, in 1813.<br />
<a href="http://www.animal-rights-library.com/texts-c/shelley01.htm">http://www.animal-rights-library.com/texts-c/shelley01.htm</a><br />
But Peacock was skeptical of Shelly’s claims to superior health;<br />
<br />
His vegetable diet entered for something into his restlessness. When he was
fixed in a place he adhered to this diet consistently and conscientiously, but
it certainly did not agree with him; it made him weak and nervous, and
exaggerated the sensitiveness of his imagination. Then arose those thick - coming
fancies which almost invariably preceded his change of place. While he was
living from inn to inn he was obliged to live, as he said, ' on what he could
get '; that is to say, like other people.<span style="mso-spacerun: yes;">
</span>When he got well under this process he gave all the credit to locomotion,
and held himself to have thus benefited, not in consequence of his change of regimen,
but in spite of it. Once, when I was living in the country, I received a note
from him wishing me to call on him in London. I did so, and found him ill in
bed. He said, ' You are looking well. I suppose you go on in your old way,
living on animal food and fermented liquor ?' I answered in the affirmative. '
And here,' he said, ' you see a vegetable feeder overcome by disease.' I said,
' Perhaps the diet is the cause.' This he would by no means allow ; but it was
not long before he was again posting through some yet unvisited wilds, and
recovering his health as usual, by living ' on what he could get '.<br />
<br />
In Edinburgh he became acquainted with a young Brazilian named Baptista, who
had gone there to study medicine by his father's desire, and not from any
vocation to the science, which he cordially abominated, as being all
hypothesis, without the fraction of a basis of certainty to rest on. They
corresponded after Shelley left Edinburgh, and subsequently renewed their
intimacy in London. He was a frank, warm-hearted, very gentlemanly young man.
He was a great enthusiast, and sympathized earnestly in all Shelley's views,
even to the adoption of vegetable diet. He made some progress in a translation
of Queen Mab into Portuguese. He showed me a sonnet, which he intended to
prefix to his translation. It began — Sublime Shelley, cantor di verdade ! <br />
and ended — Surja Queen Mab a restaurar o mundo. <br />
I have forgotten the intermediate lines. But he died early, of a disease of the
lungs. The climate did not suit him, and he exposed himself to it incautiously.<br />
<br />
On our way up, at Oxford, he [Shelly] was so much out of order that he feared
being obliged to return. He had been living chiefly on tea and bread and
butter, drinking occasionally a sort of spurious lemonade, made of some powder
in a box, which, as he was reading at the time the Tale of a Tub, he called the
powder of pimperlimpimp. He consulted a doctor, who may have done him some
good, but it was not apparent. I told him, If he would allow me to prescribe
for him, I would set him to rights." He asked, ‘What would be your
prescription ? ' I said, ' Three mutton chops, well peppered/ He said, ' Do you
really think so? ' I said, ' I am sure of it." He took the prescription;
the success was obvious and immediate. He lived in my way for the rest of our
expedition, rowed vigorously, was cheerful, merry, overflowing with animal
spirits, and had certainly one week of thorough enjoyment of life.<br />
<br />
(There is a confirmation of Peacock’s statement above in a letter Shelly wrote
to Hogg in September, 1815, 'on my return from a water excursion on the
Thames,' in which Shelley remarks that 'the exercise and dissipation of mind
attached to such an expedition have produced so favourable an effect on my
health, that my habitual dejection and irritability have almost deserted me.’)<br />
<br />
At the time of publishing A Vindication of Natural Diet, Shelly was subject to bizarre
hallucinations and phobias, an example of which is given below by Peacock<br style="mso-special-character: line-break;" />
<!--[if !supportLineBreakNewLine]--><br style="mso-special-character: line-break;" />
<!--[endif]--><o:p></o:p></span></span></p>
<p class="MsoNormal"><span lang="EN-US"><span style="font-family: times; font-size: large;">About the end of 1813, Shelley was troubled
by one of his most extraordinary delusions. He fancied that a fat old woman who
sat opposite to him in a mail coach was afflicted with elephantiasis, that the
disease was infectious and incurable, and that he had caught it from her. He
was continually on the watch for its symptoms ; his legs were to swell to the
size of an elephant's, and his skin was to be crumpled over like goose-skin. He
would draw the skin of his own hands, arms, and neck very tight, and if he
discovered any deviation from smoothness, he would seize the person next to
him, and endeavour by a corresponding pressure to see if any corresponding deviation
existed. He often startled young ladies in an evening party by this singular
process, which was as instantaneous as a flash of lightning. His friends took
various methods of dispelling the delusion. I quoted to him the words of
Lucretius : — <o:p></o:p></span></span></p>
<p class="MsoNormal"><span lang="EN-US"><span style="font-family: times; font-size: large;">Est elephas morbus, qui propter flumina
Nili Gignitur Aegypto in media, neque praelerea usquam. *<o:p></o:p></span></span></p>
<p class="MsoNormal"><span lang="EN-US"><span style="font-family: times; font-size: large;">He said these verses were the greatest
comfort he had. When he found that, as the days rolled on, his legs retained
their proportion, and his skin its smoothness, the delusion died away.<br />
<br />
* the gist of this quote seems to be that elephantiasis is only generated from
the waters of the Nile.</span><o:p></o:p></span></p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-84358351779385976702022-03-21T14:45:00.003-07:002022-03-22T14:20:57.629-07:00Is Acetaminophen (Paracetamol) use making the Covid-19 pandemic worse?<div class="stackable mb-xs" style="background-color: white; color: #241e12; margin-bottom: 0.25rem;"><div class="sc-jrQzAO gCwnPU" style="-webkit-box-pack: justify; align-items: flex-start; box-sizing: border-box; display: flex; flex-flow: row nowrap; margin: 0rem; padding: 0rem; place-content: flex-start space-between; transition: all 300ms cubic-bezier(0.19, 1, 0.22, 1) 0s;"><span class="sc-1di2uql-1 wkoTA" data-tag="post-title" style="font-weight: 700;"><span style="font-family: times; font-size: large;"><br /></span></span></div></div><div class="sc-1sp3zau-0 fhpTsC sc-1di2uql-0 gtWgWV" data-tag="post-content" style="background-color: white; color: #241e12; line-height: 1.5; white-space: pre-line;"><p style="line-height: 1.5; margin: 10px 0px;"><span style="font-family: times; font-size: large;"><img data-media-id="145968316" src="https://c10.patreonusercontent.com/4/patreon-media/p/post/64093352/cd8245e02f3946bfa8aa1f9d1ca56d31/e30%3D/1.png?token-time=1649116800&token-hash=bfk6-r9FvbzgYjmCTIfFD_DtvhtY2Ehh3kTohWJHfnQ%3D" style="border: 0px; max-width: 100%;" /><br /><br />I've written in an earlier post about what's wrong with recommending paracetamol to people with Covid. There are no RCTs to show it's safe, and there are undisputed findings from toxicology and Covid-10 pathology which, taken together, suggest a potential for danger,[1]<br /><br />Paracetamol overdoses used to kill around 200 people a year in New Zealand according to data which was regularly published in the 1970's and 1980's. Today the policy is to censor any information related to suicide. Does this work? On the one hand copy-cat effects are easy to confirm in real life, on the other hand the problem seems to have gotten worse overall under this "hear no evil" policy.<br />At any rate, deaths due to paracetamol fell sharply when Parvolex (NAC) was introduced as an antidote (which happened much later than it should have, and today the standard treatment seems to be reduced glutathione.[2]<br />Paracetamol (acetaminophen) metabolises to a free radical, which peroxidises lipids within the liver, causing liver failure. Glutathione, a reduced antioxidant peptide renewed by selenium enzymes, is the primary defense against lipid peroxidation. Lipid peroxidation is how SARS-CoV-2 destroys the lungs. The toxic metabolite is formed by CYP450 E21 enzyme degradation. In animal models, a diet high in polyunsaturated fat (the most peroxidizable fatty acids) and low in protein (the source of glutathione) accelerates liver damage caused by paracetamol toxicity - diets high in saturated fats and protein are protective.[3]<br /><br />It's been suggested, based on a rational understanding of processes which as I've said are nowhere being disputed, that paracetamol, by increasing glutathione consumption, will have adverse effects on the people most vulnerable to Covid.[1]<br /><br />To be honest I thought these effects were likely to be swallowed up in the noise of covid interactions, and appear as quite small risks in epidemiology until things were better understood.<br />I was wrong.[4]<br /><br /><strong>METHODS:</strong> We conducted a retrospective analysis of patients admitted at Washington Hospital Center between February 2020 and- June 2020. Patients older than 18 years of age, diagnosed with COVID-19 were included in the study. Those who were directly admitted to the ICU were excluded. Acetaminophen exposure was calculated using a formula for average adjusted daily acetaminophen: total acetaminophen divided by number of day’s medication was administered. Groups were stratified to non-exposed and exposed. Within the exposed groups, we further divided them into moderate (100-1000 mg/day) or high exposure(>1000 mg/day). Comparison between groups for continuous variables was conducted using Kruskal Wallis test. Association between two categorical variables was tested using Fisher's exact test.</span></p><p style="line-height: 1.5; margin: 10px 0px;"><span style="font-family: times; font-size: large;"><strong>RESULTS:</strong> The cohort included 524 patients with non-exposed (n=136), moderate exposure (n=256), and high exposure (n=132) categories. Multivariable logistic regression showed that patients who were exposed to acetaminophen had a significantly higher odds of being triaged to a higher level of care [3.01 (CI 1.4-7.07 p <0.007) in moderate exposure group and 3.44 (CI 1.49-8.54 p<0.005) in high exposure groups]. Secondary outcomes included longer length of stay (5 vs 10 days, p < 0.001), higher mortality (5.1% vs 16.5% p = 0.001) and higher risk of requiring the ventilator support (2.9% vs 15.5% p<0.001) in the exposed group.</span></p><p style="line-height: 1.5; margin: 10px 0px;"><span style="font-family: times; font-size: large;"><strong>CONCLUSIONS:</strong> Previous studies have demonstrated that up to 85% of patients with COVID-19 develop fever and acetaminophen is commonly used as a treatment. Our study showed that acetaminophen exposure was associated with worse outcomes. Further studies are required to investigate this association, in particular to see if having a greater number of febrile episodes is independently associated with these same outcomes.[4]<br /><br />Those are huge ORs. It's possible that fever itself, for which the paracetamol is being given, instead predicts the outcome.<br /><br />In this paper, fever is associated with a 4x higher rate of adverse outcomes.[5] This is concentrated in the symptomatic febrile cases, of whom only 4.8% received NSAIDs. Of course some studies say paracetamol is not an NSAID, others say it is, so it's possibly not even recorded correctly. <span style="white-space: pre-wrap;">However, as stated, this is a low correlation between fever and NSAID use, one which would not strongly support confounding-by-indication if it applied to the first paper.. </span><br /><br />So we have an unsatisfactory situation - a drug that WAS NEVER TESTED is being widely used by people with COVID-19. It's now associated with them getting worse. This could be due to confounding-by-indication, but no-one knows yet.<br /><br />It's been three fucking years. I'm trying to follow the science, but it's always nodding off.<br /><br /><br /><i>This post originally appeared on my <a href="https://www.patreon.com/posts/61734175" target="_blank">Patreon blog</a>. If you want to support my researches for a minimal donation, please become a subscriber.</i><br /><br /><br /><br /><b>References</b><br /><br />1]</span><span style="font-size: large;"><span style="font-family: times;"> Sestili P., Fimognari C. Paracetamol-Induced Glutathione Consumption: Is There a Link With Severe COVID-19 Illness? (2020) </span><em style="font-family: times;">Frontiers in Pharmacology</em><span style="font-family: times;">, 11, art. no. 579944</span></span></p><a href="https://www.frontiersin.org/articles/10.3389/fphar.2020.579944/full" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-family: times; font-size: x-large;" target="_blank">https://www.frontiersin.org/articles/10.3389/fphar.2020.579944/full</a>
</div><div class="sc-1sp3zau-0 fhpTsC sc-1di2uql-0 gtWgWV" data-tag="post-content" style="background-color: white; color: #241e12; line-height: 1.5; white-space: pre-line;"><br /><p style="line-height: 1.5; margin: 10px 0px;"><span style="font-family: times; font-size: large;">2] <a href="https://www.ncbi.nlm.nih.gov/books/NBK441917/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://www.ncbi.nlm.nih.gov/books/NBK441917/</a><br /><br /> <br />3] Hwang J. Diets with corn oil and/or low protein increase acute acetaminophen hepatotoxicity compared to diets with beef tallow in a rat model. <em>Nutr Res Pract</em>. 2009;3(2):95-101. doi:10.4162/nrp.2009.3.2.95<br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2788177/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2788177/</a><br /><br />4] Manjani L, Desai N, Kohli A, Arya R, Woods C, Desale S.<a href="https://doi.org/10.1016/j.chest.2021.07.992" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank"> Effects of acetaminophen on outcomes in patients hospitalized with COVID-10</a>. Presented at: CHEST 2021; October 17-20, 2021; Orlando, FL/Virtual. Abstract A1072.<br /><br />5] Chew, N W et al. “Fever as a predictor of adverse outcomes in COVID-19.” <em>QJM : monthly journal of the Association of Physicians</em> vol. 114,10 (2021): 706-714. doi:10.1093/qjmed/hcab023<br /><a href="https://pubmed.ncbi.nlm.nih.gov/33533902/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://pubmed.ncbi.nlm.nih.gov/33533902/</a> </span></p></div>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-8550919611653842066.post-89273970256243420192022-02-02T12:10:00.001-08:002022-02-02T12:10:59.475-08:00 Vegetarianism and the Occult - A Warning from History<p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: CG Times; font-size: large;"><br /></span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: CG Times; font-size: large;"><i>This post first appeared early last year as a paywalled post on my Patreon blog. If you want to support my esoteric dietary researches, become a <a href="https://www.patreon.com/creator-home" target="_blank">subscriber</a>!</i></span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: CG Times; font-size: large;"><br /></span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: CG Times; font-size: large;">The following is an excerpt from a book by Dion Fortune - Moon Magic, most likely.<br />Fortune was an influential UK occultist who codified the esoteric practice of her time for the mass public. Although she died, of leukaemia, in 1948 her books later became widely-read at a time of heightened interest due to the counter-culture and modernist disruption of traditional religious and scientific belief systems.<br />Her observations are drawn from her personal experience of the sector of British society in which vegetarian practice was most common - the lunatic fringe.</span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: CG Times; font-size: large;"><br /> "The question of diet also requires to be considered in this connection. The widespread propaganda of the Theosophical Society has caused vegetarianism to be regarded as a <i>sine qua non</i> of occult training. This, however, is not the case. The Western Esoteric Tradition does not make vegetarianism any part of its system, but teaches that a man should partake sparingly and temperately of the food of the land in which he finds himself. Personally I am inclined to think that occultism and vegetarianism are apt to be an injudicious mixture for a European, the result being a hyper-sensitiveness that makes life very difficult in our hard-driving civilisation.<br /><br /> Vegetarianism has to be thoroughly understood and exceedingly well done if it is to be successful, and even so, there is a goodly proportion of people who are incapable of digesting vegetable proteins, which are not nearly so easily dealt with as animal substances. Nothing but experience and experimentation can show whether a vegetarian diet suits a given person. Indigestion is not the only indication that all is not well. Loss of appetite, loss of energy, loss of weight, or a flabby stoutness are all danger signals which if disregarded will cause chronic ill-health.
Vegetarianism may agree with a person well enough at first, but after a considerable period, possibly years, they may find that they are becoming subject to neuritis, neuralgia, sciatica, or one or another of the nerve pains. This is a sure indication that a vegetarian diet is affording insufficient nourishment, not because it does not contain the necessary food units, but because the digestion is unable to assimilate them and they are passing out of the body unchanged. Wherever there is a history of neuralgic pains complicating a case of psychic disturbance, I should be inclined to suspect chronic malnutrition as the cause of a hypertrophied psychism. In such cases it will probably be found that a gradual return to a nourishing mixed diet will bring about a reduction of the hyper-sensitiveness, the undesirable contacts that have been formed will fade, and the condition return to normal. The change of diet, however, should always be made gradually lest the digestion be upset." </span></p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-66576722227503171722022-01-06T17:14:00.003-08:002022-01-06T17:16:17.307-08:00Yes, but, what will you do when the Covid comes?<div class="stackable mb-xs" style="background-color: white; color: #241e12; font-family: aktiv-grotesk, sans-serif; font-size: 16px; margin-bottom: 0.25rem;"><div class="sc-jrAGrp eYxria" style="-webkit-box-pack: justify; align-items: flex-start; box-sizing: border-box; display: flex; flex-flow: row nowrap; margin: 0rem; padding: 0rem; place-content: flex-start space-between; transition: all 300ms cubic-bezier(0.19, 1, 0.22, 1) 0s;"><span class="sc-1di2uql-1 dKyEuT" data-tag="post-title" style="font-size: 1.3125rem; font-weight: 700;"><br /></span></div></div><div class="sc-1sp3zau-0 iZsGyx sc-1di2uql-0 dMbuTi" data-tag="post-content" style="background-color: white; color: #241e12; line-height: 1.5; white-space: pre-line;"><p style="line-height: 1.5; margin: 10px 0px;"><i style="font-family: aktiv-grotesk, sans-serif; font-size: 1rem;">This post was originally published on Patreon. You don't have encourage the speculations of the likes of me, but if you want to try,<a href="https://www.patreon.com/hopefulgeranium" style="color: #2e2e8a; text-decoration-line: none;" target="_blank"> please subscribe</a>!
</i><span face="aktiv-grotesk, sans-serif" style="font-size: 1rem;">
</span><span style="font-family: times; font-size: medium;">Every day on NZ twitter people are debating what they would do were they the Government about vaccine roll-outs, MIQ, lockdowns, DJ's, and any other thing they can think of that they have absolutely no influence over.<br /><br />Maybe, like me, you're double-chipped, using the app, wearing the mask, and annoying AF. Maybe you're even boostered up the wazoo. Well done. But y'know what? You're probably going to catch covid. Even if you don't, someone you care about is going to, even if you no longer care about the unvaccinated except as targets of your spite.<br /><br />And yet, what no-one is talking about, or better yet arguing about in order to straighten out, is what they're doing now to reduce their risk of taking up hospital space when that happens, and what they're going to do to make themselves feel better once they get sick.<br /><br />The good news is that the symptoms of Omicron are basically flu symptoms - scratchy throat, muscle ache, fatigue, night sweats, no loss of smell of taste. These, apart from the cough, were basically the second shot vax effects for many people. And even for those hospitalised, the average stay is 4 days vs 8 days with Delta. But why go to hospital at all if you can help it? Some people - morons, mostly - posit a false dichotomy between government policy and personal responsibility. But in every area, these are on completely different planes and complement each other. You taking responsibility for your health eases the pressure on a government trying to help those unfortunates who can't or won't.<br /><br />So without further ado, as they say in places where there is an oversupply of further ado, here are the things I do.<br /><br />Firstly, I exercise regularly and keep the sugar, seed oil, and refined starch real low; another way of saying this is that I eat whole food (of the cheapest sort, e.g. eggs, mince, the fruit and vege in season), play frisbee or swim every day, and walk the dog. I get as much sun as I can handle, and will take vitamin D in winter, or after a while during the prolonged cloudy weather typical of much of NZ.<br /><br />Secondly, I eat a little sauerkraut or yoghurt with my meals, or take a cheap probiotic.<br /><br />Thirdly, I take some supplements - Clinicians Selenium drops (Sodium Selenite), around 150 mcgs (three drops) a day, and x4 if I think I'm coming down with an RNA virus. This works out at around $17 a year. The cheapest Zinc tabs from chemist warehouse, one a day, but mostly when exposure is likely. The cheapest chelated magnesium in the supermarket, 150 mg, most days (but I was taking this already).<br /><br />If I get sick or obviously exposed, I'll increase the selenium drops to 300mcg 2x daily and take Sanderson's ViraMax, a mixture of elderberry (great, works for flu), echinacea, (great, works for cold), olive leaf extract (olive leaf extract has never worked for me, ever), and andrographis (works very well for all viral respiratory infections, but has a rare side-effect risk of liver damage, probably in people with compromised antioxidant defenses). When I had the RSV last year this combo eliminated symptoms so quickly I wondered if I'd just imagined coughing, sneezing and snotting all over the place on the first day.<br /><br />Maybe you have different ideas? Please discuss them here or in a public forum.</span><span face="aktiv-grotesk, sans-serif" style="font-size: 1rem;">
More:<br /></span><a href="https://www.newsroom.co.nz/readingroom/book-of-the-week-will-salad-cure-covid" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-family: aktiv-grotesk, sans-serif; font-size: 1rem;" target="_blank">https://www.newsroom.co.nz/readingroom/book-of-the-week-will-salad-cure-covid</a></p></div>Unknownnoreply@blogger.com3tag:blogger.com,1999:blog-8550919611653842066.post-38676127527429446092021-12-01T12:17:00.004-08:002021-12-05T18:06:35.304-08:00My review of selenium, probiotics and vitamin D for COVID-19, meat for mental health, and LCHF for diabetes reversal in MSM<span style="font-family: times; font-size: medium;">Greetings readers!<br /><br />Every so often I am asked to review new or best-selling books related to diet for Newsroom and am encouraged by the Reading Room editor Steve Braunias, a very fine writer indeed, not to hold back.<br /><br />Here's my "review" of two books on vegetables, which is mostly on the role of selenium, probiotics, and vitamin D in the Covid pandemic, as well as the value of meat in the preservation of mental health, and the promise of LCHF, keto and fasting diets for type 2 diabetes remission.<br /><br />The more clicks and readers it gets, the more chance I'll have of presenting these types of ideas in mainstream media forums in future.<br /><br /><a href="https://www.newsroom.co.nz/readingroom/book-of-the-week-will-salad-cure-covid">https://www.newsroom.co.nz/readingroom/book-of-the-week-will-salad-cure-covid</a></span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-30878401320298174112021-11-22T15:39:00.008-08:002022-06-08T21:18:49.213-07:00The Mother of all Conspiracies; Oswald and JFK in the 21st Century.<p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;"><br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--><o:p></o:p></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://1.bp.blogspot.com/-pCw_ioXhHLw/YZwp5hjad_I/AAAAAAAACrI/22n-8B2AJ4sRmyvV8bSNSrDkmD9ipNARQCLcBGAsYHQ/s1901/Oswalds.jpeg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1901" data-original-width="1901" height="320" src="https://1.bp.blogspot.com/-pCw_ioXhHLw/YZwp5hjad_I/AAAAAAAACrI/22n-8B2AJ4sRmyvV8bSNSrDkmD9ipNARQCLcBGAsYHQ/s320/Oswalds.jpeg" width="320" /></a></div><br /><p></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;"> </span></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;">Imagine a counterfactual
America, an alternative history wherein it has always been a well-known and
accepted fact that Lee Harvey Oswald, a lone-wolf Marxist, had assassinated the
President of the United States for rational Marxist reasons as well as
subterranean personal ones. In this America, a school shooting by a paranoid
vegan only encourages logical and evidence-based discussion of gun control and
mental illness, a terror attack by Islamist hijackers is unanimously attributed
to its obvious perpetrators, the Moon is American, and one cannot simply say
that one has won an election which one has lost. It is an America in which Dr
Fauci can sleep easy, and in which, sometimes, a virus is only a virus.<br />
There were conspiracy theorists before JFK of course, indeed Oswald had tried
to kill one of them, General Edwin Walker, the only human target he missed
putting one or more bullets into. Yet the creative JFK theories have had a
wider appeal across American society than the paranoic blend of European
antisemitism and John Birch anti-communism indulged in by Walker and his
contemporaries. Robert Kennedy, as Attorney General, tried to have Walker
committed after he incited the Mississippi University race riots in 1962, but
libertarian psychiatrist Thomas Szasz, opposed to the coercive psychiatry that
was, to be fair, something of a public menace at the time, talked him out of
it. Most people knew Walker was nuts. But with JFK theory you can stay
respectable enough, it’s a hobby that seems to hurt no-one. You can put your
own choice of villain in the frame – the CIA, the FBI, the Mafia, LBJ, the
military-industrial complex, and of course the Cubans or the KGB, though it’s
strange that the Manchurian Candidate option presented in film before the
assassination – because it seemed believable at the time – hasn’t survived in
the modern myth, which is comprised of scenarios entirely discordant with
Oswald’s personal beliefs.<br />
<br />
We know what Oswald’s political beliefs were because he wrote them down, and
expressed them relatively freely to those around him, and we know how he wanted
to express those beliefs because we have a reliable witness to his development
as an assassin, Marina Oswald, née Prusakova, whom he married in Minsk during
his defection to the USSR. A year after Lee’s death, Marina spent several
months with Priscilla MacMillan, author of <i>Khrushchev and the Arts; the
Politics of Soviet Culture</i> <i>1962-1964</i>. (MacMillan, a friend of
Kennedy’s, had also interviewed Lee Oswald during his defection to the USSR, at
which time he told her “I want to give the people of the United States
something to think about” - she was the only person to know both the assassin
and his victim). The book that resulted, <i>Marina and Lee</i>, did not appear
till 1977.<br />
Marina Prusakova, who was not told her father’s identity but came to assume he had
died in a purge, and who was rejected by her mother and step-father, was raised
for a time by her devout grandmother in an Old Regime style. She had sensibly
decided, from her observations of Soviet life growing up, that politics was a
sickness and that anyone interested in politics was sick, but she made a
fateful exception for the young American who was interested in her. Marina may
not have been “political” but she knew a thing or two, as this statement to a
Warren Commission interviewer shows:<br />
<br />
<i>I look at America. It’s all wonderful. But you go to the damn grocery store
and it’s 200 varieties of cereal and basically it’s only oats, corn – how many
things? Just so someone can make an extra million off of that. It’s just so
unnecessary. If that’s progress, if that’s abundance, how stupid is it of us to
want it? Three hundred bags of poison, maybe only two or three good – that kind
of progress…I don’t think we should strive for. </i><o:p></o:p></span></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;"><br />
Lee Harvey Oswald’s solitary Marxism was the ideology that allowed an
intelligent young man to compensate for the loss of his father and an
upbringing by one of history’s more blameable mothers. It provided him with
inspiration for grandiose fantasies and daring acts, as well as a feeling of
intellectual importance that compensated for learning difficulties, diagnosed
posthumously as dyslexia. Oswald had become seriously interested in politics at
the age of 15 or 16 after he was handed a leaflet about Julius and Ethel
Rosenberg, who had been executed some two years earlier for spying for the
Soviet Union, on a street corner in the Bronx (the effect this interaction had
on him may have influenced his later decision to hand out Fair Play for Cuba
pamphlets in New Orleans; it seems to have also triggered a Walter Mitty
fantasy life as an espionage hero which lasted the rest of his life). “I was
looking for a key to my environment, and then I discovered socialist
literature,” Oswald wrote in his diary. “I had to dig for my books in the back
of dusty shelves of libraries,” although according to Priscilla McMillan, he
came across more as the naïve angry young man than a perceptive Marxist in their
5-hour Moscow interview despite using “a good deal of Marxist language”. <span style="background: white; color: #2b2815;">The Oswald that stalks the pages of <i>Marina
and Lee</i> is also a familiar character to readers of criminal profiling books,
a case-study of the violent malcontent male loner. An American outsider who
married a Russian outsider, and who was closer to Russian-speaking outsiders
than to anyone else outside his family back in the USA, Lee Oswald read Orwell
and Dostoyevsky, listened to Rimsky-Korsakoff, Chaliapin, Rachmaninov, and
Tchaikovsky, and in his more constructive activities was inspired by Marxist
newspapers The Worker and The Militant. He is holding copies of both these papers
in the famous photographs Marina took of him with his guns, one of which, with
a Russian inscription on the back – “hunter of fascists – ha ha ha!” in
Marina’s hand, signed by Oswald, was given to their friend George De
Mohrenschildt, the edgelord of the Dallas Russian émigré scene who parodies an</span>
<span style="background: white; color: #2b2815;">éminence grise role in their story.
</span>The Worker was the paper of the U.S. Communist Party, The Militant of
the Trotskyist Socialist Workers Party; Oswald corresponded with both journals,
in a futile attempt to establish credibility as a leader of the organized left;
the March 11 1963 copy of <a href="https://www.marxists.org/history/etol/newspape/themilitant/1963/index.htm">The
Militant</a> he is holding contains a letter headed “News and Views from
Dallas”, signed LH, which was the high point of his association with organised
socialism in America. <br /><br /><a href="https://1.bp.blogspot.com/-tc1fEHnZXBw/YZwo1jOJmYI/AAAAAAAACrA/irhLT7lN76AcnuAdfy6WDr1e_ocOEmHQQCLcBGAsYHQ/s990/Oswald%2BDeath%2Bto%2BFascists.png" style="font-family: "Times New Roman"; font-size: medium; margin-left: 1em; margin-right: 1em; text-align: center;"><img border="0" data-original-height="471" data-original-width="990" height="152" src="https://1.bp.blogspot.com/-tc1fEHnZXBw/YZwo1jOJmYI/AAAAAAAACrA/irhLT7lN76AcnuAdfy6WDr1e_ocOEmHQQCLcBGAsYHQ/s320/Oswald%2BDeath%2Bto%2BFascists.png" width="320" /></a><br /><br />
Lee Oswald was a person who would lie or withhold the truth whenever possible,
so that he moved in a web of misdirection, but also presumably in a state of
tension lest his lies (which include a long list of needless lies on official
forms) be found out. He starved himself and Marina, as his mother had starved
him, and pinched pennies as she had - what conspiracy asset would have been
left as bereft of financial support as the Oswalds were at times, or as
dependent on the kindness of strangers, who liked Marina but rarely liked
ungrateful and ungracious Lee, and sometimes feared him? He was violent and
controlling towards Marina, and beat her often, but became less violent at home
after his attempted assassination of General Walker altered their relationship;
he was also often cruel to her, as if practicing the heartlessness essential in
a great revolutionary leader, and prevented her learning English for his own
reasons (so that much of the evidence in the case of Lee Harvey Oswald is the
record of conversations held in Russian, remembered by someone who thought in
Russian). Yet Lee, who identified as a Marxist, was never a member of the Communist
party, and recognised that the USSR was less successful than the USA – his core
attitude was a juvenile delinquent’s hostility to any authority he was no
longer capable of idealising, and a contempt for almost all other people, but
as a strongly self-entitled person of progressive views he granted, in theory,
everyone else a share in what he himself felt he deserved. As a social justice
warrior, he was capable of admirable performative gestures, such as sitting in
the black section of a segregated courtroom when arraigned in New Orleans,
without seemingly ever going out of his way to perform any act of kindness for
another human being in need.<o:p></o:p></span></p><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><p></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;">There is a Jekyll and
Hyde character to Lee’s politics, in which his violent acts contradict both his
written statements and his progressive activism, resembling an expressionistic
caricature of 20<sup>th</sup> century Marxism. Eleven years after his murder of
Joseph P. Kennedy’s son, the Symbionese Liberation Army, collectivist Marxists
with better childhoods and higher education than Oswald, embarked on a crime
spree which included kidnapping the granddaughter of William Randolph Hearst.
Their goals, motivations and grievances were, though filtered through the
kaleidoscope of LSD, aligned with Oswald’s. Both Oswald and the SLA were
influenced by what Elizabeth Converse, in <i>The War of All Against All</i>,
called “the irrational Communist belief in ultimate world victory”. At its most
extreme, this belief encouraged the accelerationist heresy - the belief that as
Communism was inevitable, historical upheavals within Capitalist societies
brought it closer, the worse the better. The accelerationist Marxist thinks
like the addict who overdoses because the sooner they reach rock bottom, the
sooner they can begin recovery. Thus the Communists of Weimar Germany were
taught to welcome the rise of Hitler and call the liberal democrats who opposed
him “fascists”, thus Posades welcomed the possibilities of nuclear war and alien invasion, thus the
apocryphal Bernie bro voted for Trump. Sigmund Freud gave us the concept of <i>Thanatos</i>.
the organism’s compulsive drive toward dissolution back into the world; Oswald’s
decisions were often thanatic – his defection to the USSR, which involved
cutting his left wrist and attempting to surrender his US citizenship, his
assault on the Soviet bureaucracy to get both himself and Marina back to
America, the time he shot at Walker, the time he stuck a pistol in his belt and
said he was going to “have a look” at Richard Nixon (defused by Marina), the
similarly defused planning to hijack an airliner to Cuba, the assassination
itself, his refusal to consider that he might become a target afterwards. <o:p></o:p></span></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;"><br />
<br />
On the morning of the 22<sup>nd</sup> of November 1963, Lee Oswald left $170
for Marina, whom he had, up to that point seldom allowed any cash at all, as
well as the wedding ring he never took off, collected his rifle, and went to
work at the Elm street branch of the Texas Schoolbook Depository. There, from a
window on the East side of the fifth floor, he shot dead U.S. President John F.
Kennedy and wounded John Connally, the Governor of Texas; later that day Lee
Oswald would kill Patrolman J.D. Tippit with the cut-off Smith and Weston .38
pistol he had mail-ordered long before the rifle, but which had arrived on the
same day.<br />
Had Lee Oswald stood trial, his guilt would have been presented as a coherent
narrative, and his motivations widely discussed, as he intended. Instead, he
was shot dead two days later by Jack Ruby in an act almost as impulsive and
last-minute as his own. Ruby’s motives are obscure – even more unstable and
violent than Oswald, he was a heavy consumer of phenmetrazine, the new
amphetamine also popular with The Beatles, was only 5 blocks from the
assassination when it happened, and became paranoid that Jews would be blamed
for the assassination, resulting in a pogrom.<br />
<br />
The original complaint filed by the Dallas police department on Lee Oswald,
around midnight on the 22nd of November, said that Lee Oswald did, "in
furtherance of an international communist conspiracy, assassinate President
John F. Kennedy,” but Oswald’s murder, and the lack of evidence against anyone
else he knew, meant that charge would not be tested in a court of law.<br />
<br />
<br />
<i>The possibility that Oswald's political convictions may have played a
decisive part in his shooting John F. Kennedy was down-played in the early
1960s because President Johnson and other officials did not want the
assassination to become a casus belli with the Soviet Union. And to the public,
this explanation, at a moment when capitalism was riding high, appeared
ludicrous. Besides, for a Marxist, killing this president appeared wildly
inconsistent. Kennedy was a liberal.<br />
</i>- Priscilla MacMillan, <i>JFK and Oswald: The Inconvenient Truth<br />
<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--></i><o:p></o:p></span></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;">It may have also have
mattered that no-one wanted to revisit McCarthyism. Sen Joseph McCarthy had
been defeated by censure in 1954 and died in 1957; the House Unamerican
Activities Committee lingered until 1975 but by 1963 was beginning to come
under siege from an emerging counterculture that would become increasingly
Marxist as the 60’s turned to the 1970’s. Overseas, US foreign policy and
covert interventions would ensure the abduction, torture and death of many
thousands of Marxists through the next few decades, yet in the USA the few
leftists who knew Oswald were not persecuted, and the journals of which he said
"you can see what they want you to do by reading between the lines"
were not supressed.<br />
<br />
In December of 1963 Dylan, then in the most activist stage of his folk career,
was an attendee at a dinner event in New York hosted by the Emergency Civil
Liberties Committee, which had awarded him its annual Tom Paine Award.<o:p></o:p></span></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;"><br />
<i>“I’ve got to admit that the man who shot President Kennedy, Lee Oswald, I
don’t know exactly where — what he thought he was doing, but I got to admit
honestly that I too — I saw some of myself in him. I don’t think it would have
gone — I don’t think it could go that far. But I got to stand up and say I saw
things that he felt, in me — not to go that far and shoot.”</i> <br />
<br />
The outraged crowd then expressed its hostility to the speaker.<br />
<br />
<i>“You can boo but booing’s got nothing to do with it. It’s a — I just a —
I’ve got to tell you, man, its Bill of Rights is free speech and I just want to
admit that I accept this Tom Paine Award in behalf of James Forman of the
Students Non-Violent Coordinating Committee and on behalf of the people who
went to Cuba.”</i><o:p></o:p></span></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;"> </span></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;">Fair play for Cuba.<br />
<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--><o:p></o:p></span></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;">Perhaps the first
conspiracy theory about the assassination, after the statement of the Dallas
PD, was held covertly – the branch of the CIA working on mind control research
must logically have begun looking for evidence of a “Manchurian Candidate”
brainwashing of Oswald by the KGB. The MKULTRA program, initiated in 1953, had
failed to find any reliable form of brainwashing – they had been able to
produce “vegetables” among their guinea pigs but not effective agents or
reliable informants. The program’s budget would be reduced in 1964, but if
there was the possibility that the Soviets or Cubans had succeeded in
brainwashing Oswald then it could be kept alive, and perhaps vindicated. It was
probably in this spirit that MKULTRA researcher Louis Jolyon West interviewed
Jack Ruby in 1964, likely with the use of hypnosis and sodium pentothal. During
the visit Ruby experienced a “psychotic break”, revisiting his delusion of a
Kennedy-assassination inspired pogrom. Jolyon West, who killed the elephant
Tusko with LSD and other drugs in 1962 and studied hippies with MKULTRA in
Haight-Ashbury in late 1967, would later testify at the trial of temporary
Marxist Patty Hearst in support of her defence’s brainwashing theory.<br />
<i><br />
</i>As Jolyon West was infiltrating the hippie subculture in search of the
mind-control McGuffin, David Crosby was ending his career in The Byrds on stage
at the Monterey Pop festival, by introducing the song <i>He Was a Friend of
Mine</i>, a tribute to JFK, with a categorical statement of the most enduring
of the JFK theories –<o:p></o:p></span></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;"> </span></p><p class="MsoNormal" style="line-height: 150%;"><i><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;">When President Kennedy
was killed, he was not killed by one man. He was shot from a number of
different directions — by different guns. The story has been suppressed,
witnesses have been killed, and this is your country.<o:p></o:p></span></i></p><p class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 150%;"><br />
This moment marks the overground advent of progressive conspiracy theory, with
its roots in Eisenhower’s Military-Industrial Complex warning, and its
motivation in opposition to the Vietnam war, and more to the point, in
opposition to the drafting of young American men, who naturally adapted
conspiracy theory as a defence against the mass disposal of their minds and
bodies by the State – analogous to the adoption of conspiracy theory defences
today by those whose autonomy and future plans have been threatened by their
conscription in the war against COVID-19. It was widely rumoured that LBJ,
Kennedy’s Vice President and successor, under whom America had become most
stickily entangled in Vietnam, had ordered the hit, but Richard Nixon and Henry
Kissinger were about to show the USA, and the world, how real political
conspiracies are constructed.<br />
<br />
It was in this environment of renewed conspiracy ferment that <span style="background: white; color: #2b2815;">Kerry Thornley, who had known Oswald in
the US Marines and written a book inspired by his personality, <i>The Idle
Warriors</i>, before the assassination, initiated Operation Mindfuck, with the
help of Greg Hill, Robert Shea and Robert Anton Wilson. Operation Mindfuck
introduced the Illuminati, through letters and ads in Playboy and other “hip”
publications, to the US counterculture, with the intent of parodying the
counterculture conspiracy industry and serving up an anti-stupidity vaccine with
a side-order of chaos and fun. But Thornley and his accomplices underestimated
the forces they were toying with, especially the human tendency to believe in
malign machinations that can explain one’s own apparent impotence, dehumanise
those in control, and undermine the achievements of those who have succeeded in
one’s place, the same need to feel one’s weakness justified as cursed and, if
one can do nothing worse, curse back that fed the belief in witchcraft in the
Middle Ages and that in modern Africa.<br />
While the Jews and Freemasons theories of the Right did not go away, they were
quaintly old-fashioned and smelled strongly of old library books by the 1970’s,
unable to keep up with the actual conspiracies and political and cultural developments
of the Nixon-Kissinger period. The Satanic Abuse panic of the 80’s-90’s was the
most successful attempt to upgrade them – arguably this succeeded, to the
extent that it disrupted civil society, because it aligned with Marxist
Feminist agitation against sexual exploitation; sexual Satanism was a predictable
manifestation of the Patriarchy, and vice versa. Meanwhile, Hunter S Thompson had
created new myths of the operation Mindfuck type, giving adrenochrome its
backstory and planting a rumour about senator Eugene Muskie, the
less-progressive Democratic candidate for the 1972 Presidential race, being
high on ibogaine, which destroyed his candidacy. Kenny Thornley, instead of
mocking the operation Mindfuck theories – which he, glimpsing the truth about
Oswald, had started - began acting as if he believed in one or the other or all
of them. And a young Oliver Stone, after serving in Vietnam and disapproving of
the whole thing, began thinking about the assassination of JFK, who was
believed posthumously to have been opposed to the War in some way.<br />
Stone’s 1991 film <i>JFK</i> marks the moment when conspiracy theory passed
over from the counterculture and far-right into the mainstream; it featured an
impressive cast of A-list actors who presumably approved of its message of suspicion.
<i>JFK</i> was followed by <i>The X-Files</i> TV series in 1993, with its
telling slogan “I want to believe”. <i>The X-Files</i> was ironic enough,
unlike Stone’s breathless film, but this didn’t inhibit the mass distribution
and discussion of its ideas. Both <i>JFK</i> and <i>The X-Files</i> posit an
all-powerful, yet successfully concealed Deep State for which the elected US
government is window-dressing and easily removed if it objects. All around the
world, this gave an easy explanation to those who resented US cultural hegemony
and military power but were not the type to organise against them. It helped
that it was a seemingly playful explanation, one that didn’t insist on being
taken seriously enough to really test, even as it established itself in the
zeitgeist. <br />
Prior to 2001 the Deep State conspiracy theories had to co-exist with the rest
of the Fortean world represented in <i>The X-Files</i>. UFOs, Bigfoot, spontaneous
combustion, the Bermuda triangle, vampires - by the end of the 20<sup>th</sup>
century, several different species of UFO-riding aliens were abducting and
probing people all around the world. But after 9/11, Islamist terrorists became
the aliens and monsters we watched out for and it was the US state that began
abducting and probing people everywhere; reports of UFO sightings and alien abductions
went into serious decline. As the plainly venal team of Bush, Cheney and
Rumsfeld openly conspired to roll back freedoms and push the world into another
unwinnable war, a spontaneous conspiracy of sorts arose to undermine their <i>casus
belli</i> by suggesting that the terror attacks had been an inside job. This
also meant not admitting that a Saudi Arabian NGO could get the better of the
mighty USA, so it had cross-party appeal, but the list of progressive
celebrities who endorsed or indulged 9/11 conspiracy theories is almost as
impressive as the cast of JFK, and included Ed Asner, Spike Lee, Woody
Harrelson, Rosie O’Donnell, Marion Cottillard and Graham Nash. Spreading a
rumour like “Bush did 9/11” is a way of cursing the powerful, a displacement
activity born of impotence and frustration, like spreading a rumour that your
local feudal tyrant worships Bahomet because you are powerless to stop him
taking what he wants from you. And 20 years later, Q-Anon is simply the
aggregate of all the progressive counterculture conspiracy theories, including
Kerry Thornley and Hunter S Thompson’s inventions, with a modified Satanic
abuse element, and with the older Jews, Freemasons and Communists theories always
sneaking back in.<br />
<br />
It all began with Oswald and the trauma he induced in the USA on </span>November
22 1963<span style="background: white; color: #2b2815;">. As </span>NBC News anchor
David Brinkley said, as he signed off that night, Kennedy’s death was “just too
much, too ugly and too fast.” In 2007 Priscilla MacMillan summed up the
aftermath of the assassination in a short article for World Policy Journal
titled <i>JFK and Oswald: The Inconvenient Truth</i>.<br />
<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--><o:p></o:p></span></p><p class="MsoNormal" style="line-height: 115%;">
<span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 107%; mso-ansi-language: EN-NZ; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"> <i>Oswald's act of violence indisputably
ushered in an era of unease and suspicion in American life that was not there
prior to the Kennedy assassination. Oswald was not responsible for all of the
damage that has befallen American society since 1963, much as he would have
wished to be. Some of that damage is the result of events related only
tangentially to the assassination of President Kennedy. But some of the injury
can, with justice, be attributed to conspiracy theorists who have gone to
superhuman lengths to avoid facing the truth. They have constructed
wildly-implausible scenarios, far-out, fictitious "conspirators," and
have scandalously maligned the motives of Kennedy's successor, rather than take
a hard look at the man who actually did it. They have, ironically, done more to
poison American political life than Lee Oswald - with the most terrible of
intentions - was able to do.</i><span style="background: white; color: #2b2815;"><br />
</span><i><br />
</i>Kerry Thornley thought that a little light Illuminati hoaxing would make
people immune to conspiracy theories, but conspiracy theories, as <i>The
X-Files</i> and its spin-off <i>The Lone Gunmen</i> have proved, are immune to
spoofing; Q-Anon is a spoof of spoofs, and it has outshone them all.<br /><br />
If the world is ready to give Marina Oswald’s story and Priscilla MacMillan’s
research and analysis the same attention it once gave to Jim Garrison’s speculations,
narrative will replace montage in the JFK storytelling tradition. In the near
future there will be a film, or better yet a TV series, of <i>Marina and Lee</i>,
based on the True Crime book of that name which its viewers will queue to read.
In our contemporary state of <a href="https://harpers.org/archive/2021/09/bad-news-selling-the-story-of-disinformation/">disinformation
hypersensitivity</a>, it should get a more reasoned reception from the comments
section than the PBS Frontline documentary series <a href="https://www.pbs.org/wgbh/frontline/article/8-things-you-may-not-know-about-lee-harvey-oswald/">Who
Was Lee Harvey Oswald</a> did when it rescreened in 2013. We will come to
understand Lee Oswald and the ideological world he inhabited, which is closer
to our own than used to be the case, because the expression of low-constraint
or heretical or otherwise deviationist versions of Marxist ideas is now
commonplace, because <i>glasnost</i> revisionism, 90 Day Fiancé, RT, and Red
Scare have made Marina’s voice more relatable, and because we’re now well-used
to seeing violent malcontent male loners acting out the terrorist fantasies which
they developed through ideological study and travel.<br />
<br />
Imagine a counterfactual America, an alternative history wherein it has always
been a well-known and accepted fact that Lee Harvey Oswald, a lone-wolf
Marxist, assassinated the 35<sup>th</sup> President of the United States.<br />
<br />
<br />
<br />
George Henderson, Auckland, Sept 2021<br /><br />Addendum:<br />The killing of Oswald by Jack Ruby was the real singularity that tipped America down the path to Q-Anon, as it removed Oswald from his own story. I've called Ruby's motives "obscure" above, but obscure as they are they are not beyond all speculation. Here's what I think.</span></p><p class="MsoNormal" style="line-height: 115%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 107%; mso-ansi-language: EN-NZ; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;">Roy Cohn, as a patriotic American Jew trying to succeed in the system, persecuted Jewish American communists because he thought they gave a bad impression of American Jews - he more-or-less framed Ethel Rosenberg and brought about her execution. This was the injustice that led to the radicalization of the young Oswald.<br />The Dallas newspapers had been carrying adverts against JFK that in the opinion of many at the time amounted to hate speech, and some of these were signed by Jewish Republicans (the Republican party still being the old party of tolerance for many, I suppose). Ruby was concerned about this even before the shooting, and when he heard about it panicked that the Jews would be blamed for killing JFK (as, I suppose, they had been for killing Christ) and was compelled to kill Oswald to clear their name, as a kind of sacrificial lamb for his people.<br />Because this involved magical thinking, and because he may have found it embarrassing in his lucid moments, Ruby gave the more innocent explanation that he had killed Oswald to spare Jackie Kennedy the pain of a trial.<br />Roy Cohn would go on to become the mentor of Donald Trump, and Donald Trump would go on to become the patron and beneficiary of Q-Anon.</span></p><p class="MsoNormal" style="line-height: 115%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 107%; mso-ansi-language: EN-NZ; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br /></span></p><p class="MsoNormal" style="line-height: 115%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 107%; mso-ansi-language: EN-NZ; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br /></span></p><p class="MsoNormal" style="line-height: 115%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 107%; mso-ansi-language: EN-NZ; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br /></span></p><p class="MsoNormal" style="line-height: 115%;"><span style="font-family: "Times New Roman",serif; font-size: 14pt; line-height: 107%; mso-ansi-language: EN-NZ; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;">
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<!--[endif]--></span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-34161402492581206382021-07-30T20:26:00.013-07:002021-12-05T18:07:43.017-08:00Virta Health vs Seidelmann - of ketones and COVID-19<span style="font-size: large;"><span style="font-family: times;">You would have seen <a href="https://nutrition.bmj.com/content/4/1/257" target="_blank">this paper</a>; senior author is Sara Seidelmann of the infamous "low carb kills" paper, the reviewers were one vegan propagandist David Jenkins (a friend of the family, so to speak) and an Iranian prof with a decent publications list in the plant-based area - neither with any infectious diseases expertise.</span><br /><br /><span style="background-color: white; color: #333333;"><span style="font-family: helvetica;">There were 568 COVID-19 cases and 2316 controls. Among the 568 cases, 138 individuals had moderate-to-severe COVID-19 severity whereas 430 individuals had very mild to mild COVID-19 severity. After adjusting for important confounders, participants who reported following ‘plant-based diets’ and ‘plant-based diets or pescatarian diets’ had 73% (OR 0.27, 95% CI 0.10 to 0.81) and 59% (OR 0.41, 95% CI 0.17 to 0.99) lower odds of moderate-to-severe COVID-19 severity, respectively, compared with participants who did not follow these diets. Compared with participants who reported following ‘plant-based diets’, those who reported following ‘low carbohydrate, high protein diets’ had greater odds of moderate-to-severe COVID-19 (OR 3.86, 95% CI 1.13 to 13.24). No association was observed between self-reported diets and COVID-19 infection or duration.</span></span></span><div><span style="font-family: times; font-size: large;"><br /></span></div><div><span style="font-size: large;"><span style="font-family: times;">you'll find good criticisms in the rapid responses attached, and my PubPeer comment </span><a href="https://pubpeer.com/publications/FD390A0A9D50482F988A510247FD50" style="font-family: times;" target="_blank">here</a><span style="font-family: times;">.</span><br /><br /><span style="font-family: times;"> The methods state </span><br /><span style="background-color: white; color: #333333;"><span style="font-family: helvetica;">Lastly, we combined ‘low carbohydrate’ diets and ‘high protein’ diets into another category (‘low carbohydrate, high protein diet’, n=483) to evaluate whether these dietary patterns are associated with COVID-19 severity.</span><br /><br /></span></span></div><div><span style="background-color: white; color: #333333;"><span style="font-family: times; font-size: large;">Why? No reason is given for combining these 2 categories. </span></span></div><span style="font-size: large;"><br /><span style="font-family: times;">There was a keto option, so why didn't they add keto + low carb?</span><br /><br /><span style="font-family: times;">Methods state</span><br /><span style="background-color: white; color: #333333;"><span style="font-family: helvetica;">Before analyses, we selected dietary patterns with sufficient ‘yes’ responses (‘yes’ response of at least 100 individuals). To increase precision, we analysed three dietary patterns after combining dietary patterns that are similar in terms of dietary intake.</span><br /><br /><span style="font-family: times;">Perhaps keto had less that 100 responses? But there was no registered protocol, those decisions were post-hoc - even if keto had fewer than 100 responses, adding it would have still increased numerical power, which was presumably the point of combining categories as they did. And there's nowhere it says how many responses, and we also have no way of knowing how similar low carb and high protein really were (everything was pretty similar really, these were for most respondents just the virtue-signaling labels they gave to their eating habits).</span><br /><br /><span style="font-family: times;">Anyway, there was no association once people with a negative or no PCR test were excluded.</span><br /><span style="font-family: times;">That's not in the abstract.</span><br /><br /><span style="font-family: times;">But, you know, people are using the keto and LCHF diets to treat diabetes and reduce COVID19 mortality associated with type 2 diabetes, MetSyn, or obesity, so this is a nasty thing to say if it's not true. It's a bit like trying to get people to stop taking vaccines based on your bias and some shit you didn't understand.</span><br /><br /><span style="font-family: times;">Fortunately Vitra Health have ridden to the rescue with a survey of their own T2D population on a ketogenic diet. We know these people are actually following the diet, or adhering closely to it.</span><br /><br /><div class="separator" style="clear: both; font-family: times; text-align: center;"><a href="https://lh3.googleusercontent.com/-loGb8gJbD1o/YOKDXeKvsPI/AAAAAAAACmY/SKHC5YkQdQURjJvBUfD_We59VXKr3fLGACLcBGAsYHQ/image.png" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="675" data-original-width="1200" height="360" src="https://lh3.googleusercontent.com/-loGb8gJbD1o/YOKDXeKvsPI/AAAAAAAACmY/SKHC5YkQdQURjJvBUfD_We59VXKr3fLGACLcBGAsYHQ/w640-h360/image.png" width="640" /></a></div><br /><br /><span style="font-family: times;">The </span><a href="https://diabetes.diabetesjournals.org/content/70/Supplement_1/40-LB" style="font-family: times;" target="_blank">abstract</a><span style="font-family: times;"> (presented at an ADA conference) is </span><br /></span><span style="color: #0f1419; font-family: times;"><span style="background-color: white; white-space: pre-wrap;">COVID-19 Severity in a Geographically Diverse, U.S.-based, Ambulatory Population with Type 2 Diabetes on a Medically Supervised Ketogenic Diet</span></span></span><div><span style="color: #0f1419; font-family: times; font-size: large;"><span style="white-space: pre-wrap;"><br /></span></span></div><div><span style="background-color: white;"><span style="font-size: large;"><span style="font-family: helvetica;">Data were obtained from medical records and from surveys sent to T2D patients who self-reported COVID-19 diagnosis; 47.8% (294/614) responses and one known COVID-related death yielded a sample of 295 (50% male, 54±9 years, across 41 US states). We observed low reported rates of hospitalization (10.9%), ventilation (2.0%), and death (0.3%) relative to national reports.</span><br /></span></span><span style="color: #0f1419;"><span style="white-space: pre-wrap;"><span style="font-family: times; font-size: large;">
Let's compare with the Seidelmann paper - 1) we know the diet is real. 2) COVID-19 is self-reported (some will have tests some not, as in Seidelmann) but - we do have people being hospitalised, unlike Seidelmann, and we even have one death, so Virta are able to capture events that people weren't able to report directly, because their model includes liaison with primary providers likely to report deaths to them. 3) the event rates are low for a population with type 2 diabetes, as shown by the comparison with <a href="https://care.diabetesjournals.org/content/early/2020/12/01/dc20-2260" target="_blank">this population</a>.
The populations, though much the same age, aren't identical, but the biggest difference seems to long term inclusion in the Virta Health population (note the "baseline" HbA1c data in Virta - before treatment with the ketogenic diet - is similar to the overall HbAic data in the comparator vs standard practice, but many of the Virta Health population have put their T2D in remission.
At this stage, we have to say that the EFFECTS of the keto program are protective - weightloss and euglycaemia, etc. We don't have evidence that keto per se is protective apart from those factors. But that may well be hidden in the data, once the whole set is fully written up.
</span><span><span style="font-family: times; font-size: large;">
But once again, it looks like <a href="https://www.sciencedirect.com/science/article/pii/S0033062021000670" target="_blank">Harvard is a bad actor</a>, an ill informant in the nutrition-and-health space, interfering with effective treatments to preserve its own ill-gotten (by a process of bloviation if not graft) dietary hegemony.</span><span style="font-family: -apple-system, BlinkMacSystemFont, Segoe UI, Roboto, Helvetica, Arial, sans-serif; font-size: 15px;"><br /></span></span></span></span><br /><br /></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-60094885506385998152021-07-07T20:32:00.003-07:002021-12-05T18:08:27.224-08:00The Carb-Fat Food Quality Gradient - a real metabolic advantage<blockquote style="background-color: white; color: #241e12; font-family: aktiv-grotesk, sans-serif; font-size: 16px; white-space: pre-line;"><i>This post was originally published as a subscriber-only post on Patreon. You don't have encourage the speculations of the likes of me, but if you want to try,<a href="https://www.patreon.com/hopefulgeranium" target="_blank"> please subscribe</a>!</i></blockquote><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><img data-media-id="105971562" src="https://c10.patreonusercontent.com/3/e30%3D/patreon-media/p/post/50828764/640eea2e88764790b3e0c1a6b1ead37d/1.png?token-time=1626998400&token-hash=H_Biz82METaLx17RoqaL_AUk5LthJqD20-7HHEF5jcc%3D" style="border: 0px; max-width: 100%;" /></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><br /></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><br /></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px; white-space: pre-line;">By now, we've all seen them - studies that purport to show equivalent effects of LCHF and HCLF diets once diet quality is addressed and people are Eating Whole Unprocessed Foods.<br />The latter is a good thing, the default to go for in terms of population health; macronutrient tweaking is next-level.<br />But here's a question - why were almost all the original studies that validated the efficacy of LCHF diets to a skeptical medical world comparisons of ad lib low carb vs energy-restricted low fat?<br />To make a really low carb high fat diet (unless you want to pretend a high-protein diet is that) you're going to be using some isolated fats (cream) or refined ones (coconut oil, olive oil). There may not be sugar in your chocolate bar, but there will be cocoa butter.<br />This only works if in some way those isolated fats are NOT equivalent to sugar and flour.<br />What is the evidence for a difference?<br /><br />One of the more lasting concepts in carb nutrition is the glycemic index, the average speed at which a food appears as glucose in the system. It's not perfect because sugar is only half glucose so is lower GI, but you get the idea.<br />High GI is worse for you.<br /><br />The PURE study is good for producing null results, which makes whatever it does throw up seem a bit more reliable than most nutritional epidemiology.[1]<br /><br />"In the study population, 8780 deaths and 8252 major cardiovascular events occurred during the follow-up period. After performing extensive adjustments comparing the lowest and highest glycemic-index quintiles, we found that a diet with a high glycemic index was associated with an increased risk of a major cardiovascular event or death, both among participants with preexisting cardiovascular disease (hazard ratio, 1.51; 95% confidence interval [CI], 1.25 to 1.82) and among those without such disease (hazard ratio, 1.21; 95% CI, 1.11 to 1.34). Among the components of the primary outcome, a high glycemic index was also associated with an increased risk of death from cardiovascular causes. The results with respect to glycemic load were similar to the findings regarding the glycemic index among the participants with cardiovascular disease at baseline, but the association was not significant among those without preexisting cardiovascular disease."<br /><br />As I've said before, everything in plants that is supposed to be good for you but isn't actually a real nutrient is probably lowering GI in some way. It's the glucose (glycemic load above) but the way it arrives in your bloodstream (GI) is more pointed.<br /><br />Is there equivalency for fats? Do fats that are rapidly absorbed correlate with disease?<br />That would be the medium chain fatty acids, MCFA.<br /><br />"In comparison to triglycerides containing LCFAs, those containing MCFAs are more rapidly hydrolyzed in the intestinal tract and do not become incorporated into chylomicrons. SCFAs and MCFAs are transported by portal bloodstream to the liver, where they are readily metabolized."[2]<br /><br />And perhaps also the unsaturated fatty acids, UFA.<br /><br />"Although pancreatic lipase hydrolyzes fat only in the 1 and 3 positions of the molecule, it is nevertheless possible for fatty acids in the 2 position of the triacylglycerol to be hydrolyzed. This apparent violation of the specificity of pancreatic lipase occurs because of the relative instability of both the 2-monoacylglycerol and the 1,2-diacylglycerol (Crossley et al., 1959). These molecules rearrange by migration of the fatty acid in the 2 position to the 1 or 3 position, which is readily hydrolyzed by lipase (<a href="https://www.ncbi.nlm.nih.gov/books/NBK209064/figure/mmm00075/?report=objectonly" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">Figure 18–3</a>). This rearrangement is more rapid when the fatty acid is either a short-chain one or an unsaturated one, and a portion of the 2-position fatty acids may be absorbed as fatty acids rather than as monoacylglycerols (Benzonana et al., 1964)."[3]<br /><br />We'll call this the fat index, FI.<br />Are fatty acids with a high FI worse than low-FI fats?<br />No.<br />In epidemiological studies of individual fatty acids and their associations with disease risk, the MCFAs, which are SFAs, are always more benign than the longer-chain SFAs (see table 2).[4]<br /><br />"Two recent studies from the Netherlands reported largely diverging findings. In the European Prospective Investigation into Cancer and Nutrition study, intakes of 4:0-10:0 and 12:0 were inversely associated with ischemic heart disease risk, but no associations were found for 14:0, 16:0, and 18:0. However, in the Rotterdam study, only 16:0 intake was associated with higher risk of coronary heart disease." [see also table 2]<br /><br />In an overfeeding experiment, the benefits of MCFA were obvious.[5]<br /><br />"In conclusion, substitution of a small amount of dietary LCFAs with MCFAs rescues insulin action in conditions of lipid-induced energy excess."<br /><br />This is because high-FI fatty acids are metabolized more rapidly, and, in the case of MCFAs, oxidized with less metabolic and hormonal effort than LCFA.[2,6]<br /><br /><br /><strong>In conclusion</strong> - if you eat carbs in bulk you will need to pay some attention to the speed at which your body absorbs them; this rules out eating purified carbohydrates.<br /><br />If you eat fats in bulk, you need pay little attention to the speed your body absorbs them; you may want more fast-absorbing fatty acids in your food, but this does not rule out eating purified fats.<br /><br />[1] Jenkins DJA, Dehghan M, Mente A, Bangdiwala SI, Rangarajan S, Srichaikul K, Mohan V, Avezum A, Díaz R, Rosengren A, Lanas F, Lopez-Jaramillo P, Li W, Oguz A, Khatib R, Poirier P, Mohammadifard N, Pepe A, Alhabib KF, Chifamba J, Yusufali AH, Iqbal R, Yeates K, Yusoff K, Ismail N, Teo K, Swaminathan S, Liu X, Zatońska K, Yusuf R, Yusuf S; PURE Study Investigators. Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality. N Engl J Med. 2021 Apr 8;384(14):1312-1322. doi: 10.1056/NEJMoa2007123. Epub 2021 Feb 24. PMID: 33626252.<br /><a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2007123" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://www.nejm.org/doi/full/10.1056/NEJMoa2007123</a><br /><br />[2] Schönfeld P, Wojtczak L. Short- and medium-chain fatty acids in energy metabolism: the cellular perspective. <em>J Lipid Res</em>. 2016;57(6):943-954. doi:10.1194/jlr.R067629<br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878196/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878196/</a><br /><br />[3] Institute of Medicine (US) Committee on Military Nutrition Research; Marriott BM, editor. Food Components to Enhance Performance: An Evaluation of Potential Performance-Enhancing Food Components for Operational Rations. Washington (DC): National Academies Press (US); 1994. 18, Structured Lipids: An Overview and Comments on Performance Enhancement Potential. Available from: <a href="https://www.ncbi.nlm.nih.gov/books/NBK209064/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://www.ncbi.nlm.nih.gov/books/NBK209064/</a></p><p style="background-color: white; color: #241e12; font-family: aktiv-grotesk, sans-serif; font-size: 16px; line-height: 1.5; margin: 10px 0px; white-space: pre-line;">[4] Zong G, Li Y, Wanders A J, Alssema M, Zock P L, Willett W C et al. Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies <em>BMJ </em>2016; 355 :i5796 doi:10.1136/bmj.i5796<br /><a href="https://www.bmj.com/content/355/bmj.i5796" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://www.bmj.com/content/355/bmj.i5796</a><br /><br />[5] Anne-Marie Lundsgaard, Andreas M. Fritzen, Kim A. Sjøberg, Maximilian Kleinert, Erik A. Richter, Bente Kiens. Small Amounts of Dietary Medium-Chain Fatty Acids Protect Against Insulin Resistance During Caloric Excess in Humans.<br />Diabetes Jan 2021, 70 (1) 91-98; DOI<strong>:</strong> 10.2337/db20-0582<br /><a href="https://diabetes.diabetesjournals.org/content/70/1/91" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://diabetes.diabetesjournals.org/content/70/1/91</a><br /><br />[6] James P DeLany, Marlene M Windhauser, Catherine M Champagne, George A Bray, Differential oxidation of individual dietary fatty acids in humans, <em>The American Journal of Clinical Nutrition</em>, Volume 72, Issue 4, October 2000, Pages 905–911, <a href="https://doi.org/10.1093/ajcn/72.4.905" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://doi.org/10.1093/ajcn/72.4.905</a></p>Unknownnoreply@blogger.com2tag:blogger.com,1999:blog-8550919611653842066.post-66655628493607814152021-06-27T19:57:00.009-07:002021-12-05T18:08:52.671-08:00Probiotic extracts for PTSD - proof of concept for the gut-brain axis?It is with great pleasure that I can announce results from an experiment I was actually involved with, albeit long ago.<br /><br />It happened like this - having noticed that probiotics were helping with my HCV symptoms, I was theorising about the reasons for this in a Hep C forum with nurse Silvia H, who supplied a lot of my early background on immunity; this attracted the notice of Elizabeth McKenna, who was working with Beth Jones, the senior author of the present paper. Dr Jones had invented a process for producing a cell wall lysate from bacteria that, or so it was claimed, preserved the probiotic immune function to a far greater extent than other lysates and heat-killed probiotic products then available.<br /><br />I knew a bit about these products because a friend with HCV swore by a product called Del Immune V, which had corrected what seemed to be autoimmune symptoms. I tried this product but to be honest was already so saturated with effective herbs and other supps that I couldn't honestly say what it did, though it did appear to be something. But by looking on the interwebs, as they then were, I could deduce a bit about such things. <br /><br />My theory was, still is, that commensal bacteria - as well as herbs like astragalus and some mushroom sp. produce polysaccharides and other PAMP signaling molecules that mimic LPS in a benign way. An agonist-antagonist relationship with PAMP receptors could explain this modified version of the effect (this is why it can be useful having a druggie on the board, pharma execs). This summary minimizes the amount of reading I did on complement and alternative complement pathways, Tregs and Th17, retinoid metabolism and immune cell differentiation, dendrite cell translocation of LPS, and other things that mercifully I only faintly remember now. Anyway, it looked as if the toll-like receptors, a major PAMP recognition pathway, were important.<br /><br />Elizabeth McKenna, by now the CEO of Labyrinth holdings overseeing the patent process for Dr Jones, had the realization that TLR activity was assayable - the tests were done and, as in the current paper, there was significant activity at several PAMP receptors.<br /><br />Soon after I received some test samples of the product, now called ReseT. From Reset T cells - a good concept but as it turned out a very poor name when it came to finding the product in search engines!<br /><br />Anyway, at the time I still had HCV, and that was one possible use for ReseT, so I thought I should try it. Even though at the time my symptoms were under control and I had no idea if I would notice, because that's how I roll, someone has to try things and I was already implicated, as it were.<br /><br />We know know that the dose I took was about twice what's optimal. It's a sublingual lactose-based pill, or was, and the effect was rapid. The pattern on the carpet in front of me softened, life softened, and I felt something very similar to the effect of valium or some other GABA agonist. Well that's quite impressive I thought, but it left me fully functional and I was on my way to a Neil Young concert.<br />While on the way I smoked a couple of strong joints.<br />Then there I was, trapped indoors with thousands of strangers in a swirling mob. <br />This sort of thing is of course a recipe for social anxiety, and it's normal to negotiate this effect, which can get quite harsh, if you're a stoner who wants to be really stoned for, you know, NEIL.<br /><br />But this time things were completely different - I was immune to anxiety. And I remained immune to anxiety from this cause for a long time after I stopped taking ReseT, which I didn't take regularly for long, and it's never really been all that strong ever again.<br /><br />Now, the experiential effects I've described haven't been described by anyone else - that is, no-one else who's benefitted from ReseT since seems to have observed the point at which it happened in the way I did. That's Okay, I'm used to being highly observant of such things, even though it gets me laughed at sometimes. I only noticed the strong GABA effects on the first two or three occasions I took ReseT, fading as I became less prone to anxiety.<br /><br />Anyway I drifted away from the probiotic problem as other work came along, and though Elizabeth McKenna kept in touch I did think the proposed mechanism, that the effect can be explained by the manipulation of oxidative stress, was putting too much onus on the immune system. and too much responsibility on bacteria.<br /><br />But obviously I didn't have all the facts that the people on the ground did, and as it happens there's nothing better than a highly simplistic hypothesis - IF the evidence supports it.<br />If the evidence supports a simple explanation, there is no immediate requirement for terms like complex and multifactorial. To paraphrase William of Occam.<br /><br />In the first of two papers, <b>A pilot study: Innate immune modulation reduces F2-Isoprostanes and improves psychological health in a chronically stressed cohort</b> <br /><a href="https://onlinelibrary.wiley.com/doi/10.1002/hsr2.289">https://onlinelibrary.wiley.com/doi/10.1002/hsr2.289</a><br /><br />Seven male participants (combat veterans aged between 28 and 47 years) with PTSD completed the 70-day study.<br /><br /><b>The study design was a single-arm treatment study, wherein the effects of treatment were assessed and compared to the baseline pretreatment values (Day 1). Once the baseline samples were collected, the study participants were requested to take two 12 mg tablets, sublingually, twice daily (48 mg daily dose) for the duration of the study, and maintain their normal daily routine. Treatment sample collection and the measurements were performed on Days 15 and 70.<br /></b><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://lh3.googleusercontent.com/-yHW5AzrJapQ/YNkyjIVH-LI/AAAAAAAAClc/DZb4knEoBc0g5oMkK3Zlke6nwhoiYt3vQCLcBGAsYHQ/image.png" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="468" data-original-width="500" height="600" src="https://lh3.googleusercontent.com/-yHW5AzrJapQ/YNkyjIVH-LI/AAAAAAAAClc/DZb4knEoBc0g5oMkK3Zlke6nwhoiYt3vQCLcBGAsYHQ/w640-h600/image.png" width="640" /></a></div><br /><br /><b>The graphs demonstrate after 14 days of treatment, most of the participants experienced improved psychological health that were consistent with reduced urinary levels of F2-IsoP (Figure 1A). In case of depression profiles, there was significant improvement observed by Day 15 (Figure 1D). However, with further treatment, the participants continued to exhibit improvement, with significant improvement in the metrics of life satisfaction (Figure 1B) and daytime sleepiness (Figure 1C) by Day 70. The correlation coefficients between the F2-IsoP and mental health parameter values were −0.99, 0.99, 0.95, and 0.96 for life satisfaction, sleepiness, depression, and anxiety, respectively.<br /></b><br />To be sure, the study wasn't controlled. But a placebo effect shouldn't lower F2-IsoP that much, and I think it very unlikely that placebo effects can be maintained this consistently for 55 days, especially given the very minimal interaction between participants and clinicians during the study. But note that the antianxiety effect I noticed is probably only being experienced by one or two participants.<br /><br />Anyway, placebos shouldn't affect drosophila, and there's also a fruit fly study that corroborates that ReseT is bioactive (via NF-κβ).<br /><br /><b>Treatment with Bacterial Biologics Promotes Healthy Aging and Traumatic Brain Injury Responses in Adult Drosophila, Modeling the Gut–Brain Axis and Inflammation Responses</b><br /><a href="https://www.mdpi.com/2073-4409/10/4/900">https://www.mdpi.com/2073-4409/10/4/900</a><br /><div><b><br /></b></div><div>Here we get to compare ReseT with a well-tested live bacteria that is closely related to its source, LGG.<br /><br /><b>Here, we examine the response of adult Drosophila given an inactive bacteriologic (IAB; proprietary lysate preparation of Lactobacillus bulgaricus, ReseT®) and a probiotic (Lactobacillus rhamnosus, LGG). In vitro, the IAB activates a subset of conserved Toll-like receptor (TLR) and nucleotide-binding, oligomerization domain-containing protein (NOD) receptors in human cells, and oral administration slowed the age-related decline of adult Drosophila locomotor behaviors. On average, IAB-treated flies lived significantly longer (+23%) and had lower neural aggregate profiles. Different IAB dosages also improved locomotor function and longevity profiles after traumatic brain injury (TBI) exposure. Mechanistically, short-term IAB and LGG treatment altered baseline nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κβ) signaling profiles in neural and abdominal tissues. Overall, at select dosages, IAB and LGG exposure has a positive impact on Drosophila longevity, neural aging, and mild traumatic brain injury (TBI)-related responses, with IAB showing greater benefit. This includes severe TBI (sTBI) responses, where IAB treatment was protective and LGG increased acute mortality profiles. </b><br /><br />Well. Interestingly there may be a "too much" point here with both interventions where they are no longer great, with a lower tolerance for the live probiotic. These are not placebos. <br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://lh3.googleusercontent.com/-E__d-Xp0TDE/YNk4FXOmVcI/AAAAAAAAClk/QtZXNh9X6J49i3cPT8xZ74WIKuKN8SscgCLcBGAsYHQ/image.png" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="684" data-original-width="1088" height="402" src="https://lh3.googleusercontent.com/-E__d-Xp0TDE/YNk4FXOmVcI/AAAAAAAAClk/QtZXNh9X6J49i3cPT8xZ74WIKuKN8SscgCLcBGAsYHQ/w640-h402/image.png" width="640" /></a></div><br /><br />Anyway L. Bulgaricus was the probiotic that Élie Metchnikoff predicted would extend life in 1907.<br /><br />Just sayin'.<br /><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://lh3.googleusercontent.com/-565xlmJMcf0/YNk5p6usUII/AAAAAAAACls/IJJ176kgxqELNT4R5RPKkpDmLm5b2gwtwCLcBGAsYHQ/image.png" style="margin-left: auto; margin-right: auto;"><img alt="" data-original-height="1075" data-original-width="800" height="640" src="https://lh3.googleusercontent.com/-565xlmJMcf0/YNk5p6usUII/AAAAAAAACls/IJJ176kgxqELNT4R5RPKkpDmLm5b2gwtwCLcBGAsYHQ/w477-h640/image.png" width="477" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Tolstoy and Metchnikoff, </td></tr></tbody></table><br />Disclaimer - my work for Labyrinth in its early days was pro bono, and I've never been paid by anyone involved. I did receive two textbooks.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-38898252829573295872021-05-30T21:45:00.015-07:002021-12-05T18:09:46.165-08:00Bernard Shaw goes to Samoa<h3 style="background-color: white; color: #241e12; white-space: pre-line;"><span style="font-weight: normal;"><span style="font-family: times; font-size: large;">I’ve been lucky enough to have worked as an extra on the latest fantasy series, and this means I have finally had the time and the freedom from digital poisoning to read some of the books I have wanted to finish.</span></span></h3><h3 style="background-color: white;"><span style="font-family: times; font-size: large;"><span style="color: #241e12;"><span style="font-weight: normal; white-space: pre-line;">Like Thomas Mann’s Doctor Faustus. A Thomas Mann book is long and its characters and ideas only really come into focus in the second half. But when they do, wow. Hitler – what were the Germans thinking? Mann describes not the rise of the Nazis but the fall of reason and cults of irrationality that preceded it. And which could precede any form of extreme collectivism anywhere. What he describes isn’t the Popper analysis everyone bandied about cack-handed back when we thought that any reinvigorated conservative critique of progressive radicalism was an impending fascist coup. It’s something more general, something latent in our own instinct to find the self-serving pattern of submission and permission to suit any uncertain times, and also latent in the instinct of intellectuals to make all times seem so uncertain that shit like that can be made to happen in them.</span></span><br /><span style="color: #241e12;"><span style="font-weight: normal; white-space: pre-line;">I also read four plays by Ibsen, all good and Ghosts and Hedda Gabbler being perfect marvels, the best plays I can remember having read. Seeing these plays as a bourgeoise in a Victorian theatre must have felt like finding a bomb under your seat.
</span></span>
<br /><span style="color: #241e12;"><span style="font-weight: normal; white-space: pre-line;">I was also able to start part 2 (having already read parts 1 and 3) of Michael Holroyd’s biography of Bernard Shaw, covering the years 1898-1918. Shaw, a playwright (and disciple of Ibsen), is an unsympathetic character, with his vegetarianism, chastity, self-regard and urge to pontificate on everything, but he’s also the man who was a tireless cheerleader, inventor, and, behind the scenes, a diligent planner for much of what we call progress in the Western world. Everyone being paid the same amount, men and women being treated by society as if they were physiologically and psychologically identical – these were Shaw’s ideas, expressed frequently enough during an age when they only seemed outlandish and attention-seeking to become familiar, if still attention-seeking, concepts in our own times. And so much more (renewable energy, pacifism, animal rights, the list is quite possibly endless) – Shaw was the original SJW, with the important exception that he could and did laugh at himself, and was prepared to do the grinding political work needed to make civics work well – better schools, better drains, that sort of thing. And not a typical SJW either in that he courted and tolerated opposition in order to better spread his views. Thus he debated G.K. Chesterton, in debates chaired by Hilaire Belloc in a friendly but no-holds barred fashion, for many years.</span></span> <br /><span style="color: #241e12;"><span style="font-weight: 400; white-space: pre-line;"><br /></span></span><div class="separator" style="clear: both; text-align: center;"><a href="https://lh3.googleusercontent.com/-dR8MKuvcA-4/YLRprrJwjhI/AAAAAAAACjY/tOaq-BPMGogvoinz5sIEa8_fkGMSIPGXgCLcBGAsYHQ/image.png" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="372" data-original-width="620" height="240" src="https://lh3.googleusercontent.com/-dR8MKuvcA-4/YLRprrJwjhI/AAAAAAAACjY/tOaq-BPMGogvoinz5sIEa8_fkGMSIPGXgCLcBGAsYHQ/w400-h240/image.png" width="400" /></a></div><br /><br /><span style="color: #241e12;"><span style="font-weight: normal; white-space: pre-line;">And most importantly for our purposes, Shaw was an antivaxxer who debated the most famous vaccinationist of his days, Sir Almroth Wright, regularly for decades. Wright, in fact, sought out Shaw first for publicity purposes.</span></span>
<br /><span style="color: #241e12;"><span style="font-weight: normal; white-space: pre-line;">Shaw’s opposition to vaccination was in part emotional (as an anti-vivisectionist), in part mystical (as a believer in a Life Force which trumped Darwinian evolution), in part envious of the prestige belonging to the freemasonry of Medicine over that of Art.</span></span><br /><span style="color: #241e12;"><span style="font-weight: normal; white-space: pre-line;">But he also sensed the role of bunkum in medicine, the unproven theories presented as fact, the faked experiments presented as proof, the corrupting influence of money, and the hollowness of appeal to authority (when the British government wanted to promote Wright’s serum they gave him a knighthood, then used his “Sir” as a selling point).</span></span>
<span style="color: #241e12;"><span style="font-weight: normal; white-space: pre-line;">
</span></span></span></h3><h3 style="background-color: white; color: #241e12; white-space: pre-line;"><span style="font-family: times; font-weight: normal;"><span style="font-size: large;">“Shaw’s sense of vulnerability to the power of this medical elite, replacing his fear of death, gives his satire its edge…Behind these years of correspondence and controversy with Wright, and the play [<i>The Doctor’s Dilemma</i>] that resulted from their association, there lay a wish to take authority from the orthodoxly educated and give it to outsiders… the medical freemasonry was a closed circle of privileged people whose mesmeric power over other human beings angered Shaw.”
<br /><br />Most relevantly to the present day, he saw vaccination as a shameful cover-up for poverty. No need to fix the drains, supply decent housing, or feed the poor properly if you can stop a pandemic breeding in the slums, or at least the fear of one, or at least reduce the chances of it reaching the bourgeoisie, with a cheap jab. And this point – which perhaps acknowledges that vaccination can be effective, but highlights the social cost of its success – remains valid today.
<br /><br />Modern medical opinion, as reported by Holroyd, seems to be, that Sir Almroth Wright’s tuberculosis serum was worthless. There is even a theory that a similar vaccine technology gave the Spanish flu what it needed to get going. I don’t have the reading or expertise to comment on that. But I do know that Wright’s certainty that women were psychologically unfit to vote was misplaced (because, as Shaw noted, and as we can clearly see today, men are not any less prone to pseudoscientific reasoning) and that his repeated opinion that “the effect of hygiene is aesthetic” was positively dangerous, even if it always gave Shaw the opening to argue the case for Art.
<div class="separator" style="clear: both; text-align: center;"><a href="https://lh3.googleusercontent.com/-lzwrihxsm1c/YLRrBNI29bI/AAAAAAAACjg/rkS1ovmvWVcp0eUHQHfun40QkHMuzZheQCLcBGAsYHQ/image.png" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="806" data-original-width="640" height="400" src="https://lh3.googleusercontent.com/-lzwrihxsm1c/YLRrBNI29bI/AAAAAAAACjg/rkS1ovmvWVcp0eUHQHfun40QkHMuzZheQCLcBGAsYHQ/w318-h400/image.png" width="318" /></a></div><br /><br /><br />Which brings us to today. Diet is an arm of hygiene just as surely as hand-washing and the avoidance of crowded indoor spaces, both effective in reducing the spread of COVID19 and other infectious diseases. We can see from China and other places that an adequate selenium level of the diet alone quite possibly reduces the case fatality rate (CFR) for COVID-19 <a href="https://hopefulgeranium.blogspot.com/2020/08/selenium-reduces-covid-19-risk-back-of.html" target="_blank">by a factor of 4</a>. We can see that higher vitamin D levels (a sign of good diet quality overall, and not only sunlight exposure or vitamin D intake, because vitamin C, iron and magnesium are among the factors contributing to the serum vitamin D level) are associated with a greatly reduced CFR. And that higher levels of unsaturated fat in fat stores (as in the US population) <a href="https://www.medpagetoday.com/reading-room/aga/lower-gi/86940" target="_blank">increase the risk of lung damage</a> and death when infected with SARS-CoV-2. Unsaturated fat is the main component of margarines and the cheap oils used to cook the food of the poor; white bread helps to keep it from being burned for fuel; meanwhile the wealthy eat butter and steak, and are not so prone to the storage of excess fat, despite needing to do less work.<br />Most of these risk factors, as I’ve said before, are actually the unintended consequences of earlier scientific error regarding the risk of skin cancer (which unsaturated oils <a href="https://hopefulgeranium.blogspot.com/2019/01/dont-drink-oil-and-fry-in-sun-link.html" target="_blank">also promote</a>) and heart disease (which is mainly driven by the excessive insulin response to the modern diet).<br /><br />A recent example of how the pro-vax narrative ignores the effects of poverty, and hygiene including diet, appeared in the blog of David Farrier. I’ve mentioned Farrier before in this blog because he’s quite a good bellwether of right-thinking opinion, and because he’s worth reading for his own sake. He’s the creator of an entertaining film, Tickled, about the human capacity for deception, and has a pretty good take on conspiracy theory and its psychology. But it depends whose conspiracy theory, because beneath all his quirkiness Farrier is a bog-standard PMC worrywart and always defers to the interests of his class, acting, on the blog at least, as a gatekeeper who's never met an expert he didn't agree with, or at least submit to meekly.<br /><br />In this <a href="https://www.webworm.co/p/fakenews?token=eyJ1c2VyX2lkIjoxNjIxMzMwNiwicG9zdF9pZCI6MzY5OTgwNjIsIl8iOiJOVk5oRiIsImlhdCI6MTYyMjQzNTM4OCwiZXhwIjoxNjIyNDM4OTg4LCJpc3MiOiJwdWItMzkwODEiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.QxUJ3ISM3x6msvfZEDGkWkKh2TopXDSFl1f4vvmnCFY" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">article on fake news</a> written by Farrier’s friend Byron Coley, which is otherwise an intelligent and insightful guide to the current conspiracy theory and misinformation landscape inside NZ, we get an example of misinformation by omission, regarding the measles epidemic in Samoa, in a section on some Covid grifters who ran for parliament on the New Conservative platform.<br /><br />"</span><span style="font-size: large;"> In April on <em>Talano Sa’o</em>, Tildsley spent an episode interviewing a man she described as “<em>an unsung hero in Samoa</em>” Edwin Tamasese.</span></span></h3><h3 style="background-color: white; color: #241e12; white-space: pre-line;"><span style="font-weight: normal;"><span style="font-family: times; font-size: large;">“<em>During the measles pandemic — which was devastating to our people, killed around seventy of our babies — he was right in the middle of it, and he was part of sharing vitamin D, vitamin A, vitamin C, and he did what he needed to do.</em>”</span></span></h3><h3 style="background-color: white; color: #241e12; white-space: pre-line;"><span style="font-family: times; font-weight: normal;"><span style="font-size: large;">Tamasese, who has no medical training, spread the false claim during the measles outbreak that authorities were “seeding” the country with measles through the emergency mass immunisation program deployed to stem the epidemic.</span><span style="font-size: large;">"
</span></span></h3><h3 style="background-color: white; color: #241e12; white-space: pre-line;"><span style="font-weight: normal;"><span style="font-family: times; font-size: large;">So far, so bad. But the story of the Samoan measles outbreak is being manipulated here. The outbreak happened after Samoa’s regular measles vaccination program was stopped, and it was stopped after two babies died from a botched vaccination. It was the deaths of these two babies, and not the activities of anti-vax grifters, that lead to the deaths of 70 children. The Samoan health service, for reasons that are still not clear, could not run a safe vaccination program. Understandably parents chose not to take further risks, until the cost of not having vaccinated their children became obvious. Samoa has a population of 202,506, and 83 people died in the measles epidemic, among 5,700 confirmed cases. New Zealand has a population of 5 million, the same epidemic was described as the worst since 1938, with 2,194 confirmed cases, and two unborn fetuses in the second trimester died as a result of the outbreak. New Zealand many have higher vaccination rates than Samoa, at least among children, but it also has a thriving population of privileged unvaccinated kids.</span></span></h3><h3 style="background-color: white;"><span><span style="font-family: times; font-size: large;"><span style="color: #241e12; font-weight: normal; white-space: pre-line;">This is a huge difference in impact. It is the kind of inequality of outcomes that is usually attributed to systemic racism, colonization etc. But when we see a difference so extreme that it really can be interpreted as evidence of those things by anyone with eyes to see, everyone is strangely silent.<br />Because systemic racism and neo-colonial exploitation could be real features of life in Samoa, if New Zealand’s experience is anything to go by. What else do we call the replacement of traditional foods with imported rubbish, under a system that promotes Western dietary values? New Zealand has a large Samoan population, and </span><a href="https://www.health.govt.nz/publication/eating-and-activity-guidelines-new-zealand-adults" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-weight: normal; white-space: pre-line;" target="_blank">New Zealand’s dietary guidelines</a><span style="color: #241e12; font-weight: normal; white-space: pre-line;"> are dismissive of all the traditional Pacific energy foods in favour of grains. The use of coconut is confused with coconut oil and discouraged in patronising statements like “The Heart Foundation considers that when indigenous people consume coconut flesh and milk along with fish and vegetables, and they are also physically active, the coconut consumption is unlikely to put them at risk of cardiovascular disease. They are in a very different situation from people who consume coconut oil along with a typical western diet.”<br />Which if true (and the claim is still untested, as Shaw would have recognized, but </span><a href="https://diabetes.diabetesjournals.org/content/70/1/91" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-weight: normal; white-space: pre-line;" target="_blank">likely to be untrue</a><span style="color: #241e12; font-weight: normal; white-space: pre-line;">) would be true of any food supplying energy. Is it also saying that coconut is unhealthy for a sedentary population? That’s also unlikely to be true.<br />Traditional diets, and decent diets aligned with them, have long been disrupted in the Islands by Western-trained medical freemasons and commercial traders of imported goods, often </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116374/" style="color: #241e12; font-weight: normal; white-space: pre-line;" target="_blank">working hand-in-hand</a><span style="color: #241e12; font-weight: normal; white-space: pre-line;">. If you want to call it <a href="https://sites.bu.edu/debiasse/files/2021/03/Burt_MedDiet.pdf" target="_blank">structural racism</a> I won’t stop you. But weird how silent the usual suspects are.<br /><br />Would the grifter’s supplements have saved lives? A silver bullet nutritional approach to systemic deprivation is rarely highly effective, but according to the </span><a href="https://methods.cochrane.org/equity/vitamin-measles" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-weight: normal; white-space: pre-line;" target="_blank">Cochrane Collaboration</a><span style="color: #241e12; font-weight: normal; white-space: pre-line;">, the ultimate in evidence-based medicine “Vitamin A reduces the risk of death from measles by 87% for children younger than 2 years”.<br />Yet the Samoan authorities were telling parents to ignore the grifters. Did they throw the babies out with the bathwater, or were they also supplying the vitamins to the unvaccinated, preferably before they got measles?<br /><br />I don’t know the answers. But I do read the papers, watch the TV news, and look at stories on the internet. If I don’t know then it’s likely that very few people know. They only know what they’re told, and the narrative is owned by people who won’t tell you these important things. It’s still owned by Sir Almroth Wright. There’s an alternative narrative, of course, but you certainly can’t trust the people who own that.<br /><br />Which leaves it up to the people who claim to be investigative – including your David Farriers and Byron Coleys – to find out the truth for us, even if this does rattle their class interests.
</span><span style="color: #241e12;"><span style="white-space: pre-line;">Summary: </span></span>
<span style="color: #241e12;"><span style="font-weight: normal; white-space: pre-line;">I'm always hopeful that my blog posts may attract people not familiar with my preoccupations and body-of-knowledge, such as it is. So to avoid confusion, here is a summing up:</span></span>
<br /><span style="color: #241e12;"><span style="font-weight: normal; white-space: pre-line;">Vaccines, which have been improved since Sir Almroth Wright's day, are a huge contributor to population health. You shouldn't have needed me to tell you that.
However: </span></span>
<span style="color: #241e12;"><span style="font-weight: normal; white-space: pre-line;">There was no Covid vax for a year and most people will still have no Covid vax this time next year. Over 3 million people have died. The drugs are not that effective at preventing this. </span></span>
<span style="color: #241e12;"><span style="font-weight: normal; white-space: pre-line;">Look at environmental factors. The strong associations that exist - selenium, vitamin D and </span><span style="font-weight: 400; white-space: pre-line;">unsaturated/saturated</span><span style="font-weight: normal; white-space: pre-line;"> fatty acid ratios - should have been </span><span style="font-weight: 400; white-space: pre-line;">exhaustively</span><span style="font-weight: normal; white-space: pre-line;"> tested by now. But instead fuck all has happened. Why?
</span></span><span style="font-weight: normal;">Who is in charge of deciding what to test and how, and why have they not heard of Austin Bradford Hill?</span><br /><br /><span style="font-weight: normal;">There was no measles vax in Samoa due to a vaccine disaster. Such accidents are always possible, and antivaxers, paradoxically, will always be with us. Why were nutritional interventions - including those with known value - </span><span style="font-weight: 400;">neglected</span><span style="font-weight: normal;"> and, indeed, scorned?</span><br /><span style="font-weight: normal;">And were the other effective </span><span style="font-weight: 400;">hygiene</span><span style="font-weight: normal;"> interventions - lockdown, masks, hand sanitizer, social distancing, quarantine - used to control spread, and if so, at what stage of the epidemic? They certainly weren't being used in the NZ outbreak.</span><br /><br /><br /><span style="font-weight: normal;">The pertussis vax in DPT is also </span><span style="font-weight: 400;">ineffective</span><span style="font-weight: normal;"> at preventing outbreaks and needs more frequent boosters than most people can manage. Again, </span></span></span><span style="font-family: times; font-size: large;"><span style="font-weight: 400;">lockdown, masks, hand sanitizer, social distancing, quarantine could be used to control spread, for which to work diagnostic criteria need to be more pragmatic and affordable, and environmental factors should be researched.<br /></span></span></h3><h3 style="background-color: white;"><span><span style="font-family: times; font-size: large;"><span style="font-weight: normal;">It's also relevant that the <a href="https://bmjopen.bmj.com/content/2/3/e000707" target="_blank">DPT</a> vaccine is too dangerous to use in sub-Saharan Africa (due to local </span><span style="font-weight: 400;">infectious</span><span style="font-weight: normal;"> disease risks that would not be at all relevant in the Pacific). Think of something else there. Why does the development of a vaccine prevent research into alternatives? They will often still be needed.</span></span></span></h3><h3 style="background-color: white;"><span style="font-family: times; font-size: large;"><span style="font-weight: 400;"><br /><br /></span></span></h3>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-8550919611653842066.post-19682662162728475102021-05-16T21:10:00.003-07:002021-12-05T18:09:26.947-08:00Is cannabis protective against an adverse effect of the modern diet? Cannabinoid signaling in the omega 3/6 hypothesis of obesity and mood disorders.<div class="stackable mb-xs" style="background-color: white; color: #241e12; margin-bottom: 0.25rem;"><div class="sc-jrAGrp eYxria" style="-webkit-box-pack: justify; align-items: flex-start; box-sizing: border-box; display: flex; flex-flow: row nowrap; margin: 0rem; padding: 0rem; place-content: flex-start space-between; transition: all 300ms cubic-bezier(0.19, 1, 0.22, 1) 0s;"><span class="sc-1di2uql-1 dKyEuT" data-tag="post-title" style="font-weight: 700;">(this post originally appeared for subscribers on my Patreon blog in Dec 2020, and is now unlocked. If you want to support my blogging habit and see these posts before they happen, subscribe <a href="https://www.patreon.com/creator-home" target="_blank">here</a>!<br />The rest of you, enjoy.)</span></div></div><div class="sc-1sp3zau-0 iZsGyx sc-1di2uql-0 dMbuTi" data-tag="post-content" style="background-color: white; color: #241e12; line-height: 1.5; white-space: pre-line;"><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;"><br /></span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;"><br /></span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">It’s pretty well accepted that cannabis is an appetite stimulant in the normal dose range. In fact, it’s pretty much been the unofficial standard-of-care drug for the treatment of appetite loss during illness or chemotherapy for a long time.<br />So we’d expect people smoking cannabis to have higher rates of obesity and type 2 diabetes, because of the munchies.<br />Yet it’s been a consistent epidemiological finding that the opposite is true – and the explanation that’s been proposed may give us an insight into why cannabis has become the modern panacea, a drug that has been proposed to treat almost everything and why its legalisation, especially for medical use, is being welcomed by such a large chunk of the population.</span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">How consistent is the association between cannabis use and obesity? In a meta-analysis of BMI data:<br />“Nine studies were included that reported BMI of users and nonusers and met selection criteria, and an additional two studies were identified that reported lower BMI in Cannabis users, but did not provide numerical data. Of these studies, all reported lower values of BMI in Cannabis users, and only one of these did not reach statistical significance. A second study did not report statistical analysis of the BMI data. Of those studies reporting significant negative correlations, two reported that longer duration of Cannabis use was associated with reduced BMI.”(Clark 2018)<br /><br />That’s a convincing association as far as it goes, but is there a mechanism that explains it?<br /><br />In another paper, we read that “Suppressing hyperactive endocannabinoid tone is a critical target for reducing obesity.”(Alvheim 2012) The endocannabinoids, 2-arachidonoylglycerol (2-AG) and anandamide (AEA), promote both appetite and the growth and expansion of fat cells.(Naughton 2013, Banni 2010, Madsen 2012) This is a useful adaptation to store energy after a meal (or in the autumn, when linoleic acid, like sugar, is most easily found in nature) - but if it becomes a constant state can lead to obesity; with higher food (and especially carbohydrate) intake insulin levels also rise, ensuring more synthesis and storage of fat. When this fat exceeds the capacity of the body to store it, type 2 diabetes is one possible outcome, and at this stage it is very difficult to get the appetite to normalise; at which point removing carbohydrate from the diet seems to be the most effective way to reduce food intake without hunger.(van Zuuren 2018)<br /><br />A drug that antagonises 2-AG and AEA, Rimbonabant, looked promising in animal studies but turned out to cause depression in humans.<br /><br />Cannabis, of course, has similar effects to 2-AG and AEA, but the body’s response differs in an important way; we respond to the stimulation of endocannabinoid tone from THC and CBD by downregulating it, and this inhibition lasts longer than the effect of the drug does. In a sense, smoking pot inoculates us against excessive endocannabinoid signalling. This counter effect means that our cells burn more energy, rather than store it, and our appetite decreases, for quite a while after a session, even if we did have the munchies at some point.(Clark 2018) In a recent epidemiological study even historical cannabis use was associated with lower BMI and better insulin sensitivity. The rebound effect seems to last. Users probably don’t want to be saturated in cannabis all the time, but be using it intermittently to benefit.<br /><br />But where does this excess endocannabinoid tone come from in the first place? 2-AG and AEA are made in the body from arachidonic acid, an omega-6 (ω-6 or n-6) fatty acid only found in animal foods – but the amount of AA in these foods is very low. Most AA in the body is synthesised from linoleic acid, the main polyunsaturated fatty acid in cheap vegetable oils (corn oil and soy oil, for example, are around 60% LA).<br /> </span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;"><a href="https://www.hindawi.com/journals/ije/2013/361895/fig1/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://www.hindawi.com/journals/ije/2013/361895/fig1/</a><br /><br />(Pathways for anandamide synthesis, from Naughton et al 2013)<br /><br />So, what counters the obesogenic effect of anandamide and 2-AG naturally? The action of omega-6 endocannabinoids is opposed by omega 3 (ω-3, n-3) endocannabinoids, docosahexanoyl ethanolamide (DHEA) and eicosapentaenoyl ethanolamide (EPEA), which have a weaker binding affinity to CB1 and CB2 receptors.(Naughton 2013, Watkins 2014) The omega-3 cannabinoids are synthesized from DHA and EPA, the fatty acids in oily fish (pastured lamb or mutton is also a pretty good source). EPA and DHA can also be synthesized from alpha-linolenic acid (ALA), the omega-3 fatty acid found in flaxseed, canola oil and hemp oil (and present in small amounts in most green veges). However, it looks as if too high an intake of ALA also suppresses blood levels of EPA and DHA.(Gibson 2018)<br />(There is also an omega-9 cannabinoid, made from the main monounsaturated fat oleic acid, which counters the effects of the omega-6 series, decreasing appetite and increasing fat-burning, but this does not seem to depend on dietary intake. Oleic acid is produced in the body as well as an item of diet; it is synthesised after meals from carbohydrate and other fats, so its cannabinoid probably acts as a fullness signal).<br /><br /><br />It’s been known for a while that a higher intake of LA drives synthesis of AA and inhibits the conversion of ALA to EPA and DHA.(Gibson 2018) This is probably why fish oil became popular as a supplement, but fish oil has had relatively disappointing results in human trials. The only fish oil product approved as a drug (for cardiovascular disease) is VASCEPA, a synthetic variant of EPA which is reliably able to raise the EPA level in the bloodstream.</span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">However, research out of Australia and France shows that saturated fat, especially dairy fat, increases the level of EPA or DHA in the bloodstream, in people fed omega 3 fatty acids from fish oil or canola oil respectively, compared with people instructed to use vegetable oils as per common governmental health advice.(Dias 2016, Dabadie 2005) The Australians achieved a doubling of the EPA level when the other fat in the diet was more saturated. Yet the LDL (so-called “bad cholesterol”) level also increased.(Dias 2016)<br /><br />Why would this be? EPA and DHA trigger the burning of fat in the liver – this is a good thing, lowering triglycerides, but it means these omega-3 fatty acids are destroyed in the process so less will reach the bloodstream in the lipoprotein (“cholesterol”) particles. Some saturated fats, especially the longer medium-chain fatty acids in dairy and coconut, also trigger fat burning and lower triglycerides – and this tends to spare some of the EPA and DHA present, so that other cells in your body can use it.(Drouin 2018) But removing triglycerides from lipoproteins in the liver means they come out with less fat, and therefore more cholesterol. This raises your LDL-cholesterol, yet these cholesterol-rich LDL particles are less likely to harm your blood vessels than cholesterol-depleted ones.(Hirayami 2012)<br /><br />It’s noticeable that the true relationship between dietary saturated fat and omega-3 is thus the opposite of that described in influential early books about omega-3 fatty acids, such as Horrobin’s “The Madness of Adam and Eve” and Allport’s “The Queen of Fats”, which painted them as enemies, based on <em>a priori</em> assumptions.<br /><br />Our diets used to be very low in omega 6 LA. This changed for two reasons – first we were told to replace animal fat with polyunsaturated vegetable oil for cooking because this would lower cholesterol and so reduce the risk of heart disease. But human experiments have never supported this idea. In particular, a meta-analysis of those trials replacing saturated fat with oils and foods high in LA (rather than omega 3 fats) found that the risk of heart disease and death was non-significantly increased in those trials that were properly controlled.(Hamley 2017)<br />The second reason is that more of our animal-based food today comes from animals fattened on grains. The fat of chickens and pigs fed on corn and soy waste can be very high in LA and higher in AA compared with the fat of the same animals in the past, and even ruminant fat gets higher in LA and AA, and lower in EPA and DHA, when sheep and cattle are fattened on grains.<br /><br />Guyenet and Carlson analysed all the different studies done over the years measuring the fatty acid percentages of fat stores in samples from people in the USA and found “that adipose tissue LA has increased by 136% over the last half century and that this increase is highly correlated with an increase in dietary LA intake over the same period of time”.(Guyenet 2015)<br /><br />Adipose LA in Sweden, for example, is significantly lower than in the USA – Scandinavians still eat plenty of meat and dairy fat, and when they do use plant oils prefer canola, which has 1/3 the LA content of soy or corn oil, or olive oil with 1/6 as much; they are also more likely to eat oily fish than Americans. The official recommended limit of saturated intake in some Scandinavian countries is significantly higher than the 10% of energy limit recommended in the USA, UK or NZ. The Swedes enjoy lower rates of obesity, type 2 diabetes, and heart disease than we do with a saturated fat limit which they seem to ignore.</span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">As Clark et al stated in their hypothesis paper,<br /><br />“…populations with diets characterized by a high omega-6/omega-3 ratio will see significantly larger health improvements from Cannabis use than those eating diets with more moderate ratios of omega-6/omega-3 FAs. This may explain some of the inconsistencies in the data on the metabolic impact of Cannabis use; for example, <strong>Cannabis use by Swedish populations may not have the same health impacts as Cannabis use by Americans due to the different dietary backgrounds and obesity rates of these populations.<br />Cannabis use in the United States appears to provide significant public health benefits due to partial or complete reversal of the metabolic dysregulation caused by the strongly elevated omega-6/omega-3 ratio of the American diet</strong>.”<br /><br /><br />(Note: If “cannabis use… appears to provide significant public health benefits” in a preventive sense, then the distinction between medicinal and recreational uses of the drug becomes a little blurred, as some medications, such as aspirin or statins, can be legally be prescribed to perfectly healthy people for their purported preventive effects, despite there not being strong evidence for such effects outweighing harms.)<br /><br /><br />Are governments blind to the possible harms of a high omega-6 intake? The New Zealand MOH is still recommending that high-omega 6 seed oils replace animal fats and coconut oil. Why?</span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">Some public health experts still want us to have low cholesterol levels, despite a lack of evidence that the cholesterol effect of food (as opposed to genes or drugs) has any effect on disease risk.<br />Some also point to epidemiology in which higher linoleic acid intakes appear to be associated with benefit.<br />Unfortunately, this isn’t as reliable as it might be – the only foods that supply zero LA are sugar, alcohol, and highly refined flour. The less of these foods you consume, the better – and the higher your LA intake will be. None of these studies separates out the LA consumed from seed oils, as opposed to chicken or nuts and seeds, foods which might reasonably be expected to keep you healthy for other reasons than the type of fat they contain – there is no epidemiology of seed oils. How do you even measure cooking oil accurately in a questionnaire? Those takeaway chips you ate last week – do you remember what they were fried in?<br /><br />But despite only weak evidence for benefit, plenty of negative evidence, and growing evidence of harm, the push continues. In 1987 the government of Mauritius introduced a raft of health measures, most of which were sensible (smoking, exercise, blood pressure control) but also ordered that soy oil replace palm oil in the cheap “ration” oil used for cooking by most people. 5 years later public health experts applauded a decrease in saturated fat intake, a large increase in polyunsaturated fat, and lower cholesterol levels.(Uusitalo 1996) But what was the outcome 10, 20 years later? Cardiovascular mortality increased a bit, BMI increased– and the prevalence of type 2 diabetes increased from 12.8% in 1987, to 15.2% in 1992, and 17.9% in 1998.(Morrell 2019, Söderberg 2005) Mauritius is now fighting the same type 2 diabetes epidemic seen in most other countries after seed oils were introduced. Yet the government of Fiji imposed a tax on palm oil in 2015 to try to get the same outcome, citing the Mauritius experiment as if it had been successful – because no-one involved had published anything suggesting that it wasn’t.(Coriakula 2018)<br />But while governments and establishment public health experts may appear to be blind to this problem, behind the scenes efforts to lower the amount of omega-6 in the food supply have been going on for decades. These initiatives include the development of canola and more recently the breeding of “high-oleic” oil seeds that are much lower in omega-6. For example, recently Pic’s peanut butter and peanut oil switched to using a high-oleic peanut, and these products now contain a far lower dose of linoleic acid than most other brands.<br />At present high-oleic oils and nut butters cost a bit more. The linoleic acid in the food supply, found in cheap oils, margarines and mayonnaise, and deep fried food, especially chicken (the cheapest meat), is tilted towards the diets of the poor, and alongside the similarly cheap refined carbohydrates is doing them no favours, whatever diet epidemiology, which is generally done in more privileged populations, might say.<br /><br />Is this theory relevant to the psychotropic uses of cannabis in modern society?<br />I haven’t researched this question deeply, but here are some pointers -<br /><br />The omega-3/6 balance also influences inflammation and pain perception; a high omega-3 and low omega-6 diet in people with chronic headache reduced pain. The control group restricting omega-6 alone, with no extra omega 3, had a lesser reduction in pain and saw some raising of EPA in the blood, but did not experience the drop in AA that was seen in the omega-3 arm.(Ramsden 2013, Taha 2014) Of course, pain relief is an important use of cannabis.<br /><br />Omega-3 fatty acids supress some effects of PTSD in animals, and Hibbeln and Gow, writing in the journal of Military Medicine, proposed that improving the omega-3/6 ratio in military rations would reduce depression, suicide, and impulsive aggression among US troops.(Hibbeln 2014) In a case-control study, low DHA status was more strongly associated with suicide in US troops than having witnessed the death or wounding of colleagues in combat (OR 1.62 vs 1.54).(Lewis 2011)<br /><br />There’s an interesting study on the effect of cannabis use during CBT therapy for PTSD and substance use disorders – “results revealed a crossover lagged effect, whereby higher cannabis use was associated with greater PTSD symptom severity early in treatment, but lower weekly PTSD symptom severity later in treatment. Cross-lagged models revealed that as cannabis use increased, subsequent primary substance use decreased and vice versa”.(Ruglass 2017)<br /><br />A high-dose EPA supplement in children with ADHD aged 6-18 significantly improved measures of attention and vigilance in those subjects with low EPA at baseline.(Chang) A trial of Sativex in adults with ADHD found “nominally significant” improvement in some measures tested, not contradicting the anecdotal reports from this population of cannabis users.(Cooper)</span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">Acetaminophen (paracetamol) is a painkiller that enhances cannabinoid signalling through CB1 receptors in the pain centre of the brain.(Klinger-Gratz 2018) Paracetamol also reduces the pain of social rejection, empathy for the pain of others, and the experience of existential angst after exposure to material that provokes what psychologists call a “meaning threat”, defined as “whenever one is assaulted by thoughts and experiences that are at odds with one’s expectations and values” - represented in the experiment by the films of David Lynch played to people who hadn’t seen them before!(Mischkowski 2016, Slavich 2019, Randles 2013)<br /><br />And now we’re getting into deep psychological and sociological territory indeed. Has the remodelling of diets (and reformulation of infant formulas) since the 1970s altered our social functioning? Should it join the long queue of factors proposed to account for our current malaise? Or has David Lynch just made too many films?</span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">More research is needed.<br />But one thing does seem clear – for good or bad, cannabis probably is an appropriate medication for our times, and the widespread modern awareness of its efficacy may have complex roots in the recent history of our society.<br /><br /></span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">References</span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">Alvheim, A. R., Malde, M. K., Osei‐Hyiaman, D. , Hong, Y. H., Pawlosky, R. J., Madsen, L. , Kristiansen, K. , Frøyland, L. and Hibbeln, J. R. (2012), Dietary Linoleic Acid Elevates Endogenous 2‐AG and Anandamide and Induces Obesity. Obesity, 20: 1984-1994. doi:10.1038/oby.2012.38</span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">Banni, S. and Di Marzo, V. (2010), Effect of dietary fat on endocannabinoids and related mediators: Consequences on energy homeostasis, inflammation and mood. Mol. Nutr. Food Res., 54: 82-92. doi:10.1002/mnfr.200900516<br /><br />Chang, J.P., Su, K., Mondelli, V. et al. High-dose eicosapentaenoic acid (EPA) improves attention and vigilance in children and adolescents with attention deficit hyperactivity disorder (ADHD) and low endogenous EPA levels. Transl Psychiatry 9, 303 (2019) doi:10.1038/s41398-019-0633-0</span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">Clark TM, Jones JM, Hall AG, Tabner SA, Kmiec RL. Theoretical Explanation for Reduced Body Mass Index and Obesity Rates in Cannabis Users. Cannabis Cannabinoid Res. 2018;3(1):259–271. Published 2018 Dec 21. doi:10.1089/can.2018.0045<br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340377/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340377/</a><br /><br />Cooper RE, Williams E, Seegobin S, Tye C, Kuntsi J, Asherson P. Cannabinoids in attention-deficit/hyperactivity disorder: A randomised-controlled trial. Eur Neuropsychopharmacol. 2017 Aug;27(8):795-808. doi: 10.1016/j.euroneuro.2017.05.005. Epub 2017 May 30.</span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">Coriakula J, Moodie M, Waqa G, Latu C, Snowdon W, Bell C. The development and implementation of a new import duty on palm oil to reduce non-communicable disease in Fiji. Global Health. 2018;14(1):91. Published 2018 Aug 29. doi:10.1186/s12992-018-0407-0<br /><br />Dabadie H, Peuchant E, Bernard M, LeRuyet P, Mendy F. Moderate intake of myristic acid in sn-2 position has beneficial lipidic effects and enhances DHA of cholesteryl esters in an interventional study. J Nutr Biochem. 2005 Jun;16(6):375-82<br /><br />Dias, C., Wood, L. & Garg, M. Effects of dietary saturated and n-6 polyunsaturated fatty acids on the incorporation of long-chain n-3 polyunsaturated fatty acids into blood lipids. Eur J Clin Nutr 70, 812–818 (2016) doi:10.1038/ejcn.2015.213<br /><br />Drouin G, Catheline D, Sinquin A, et al. Incorporation of Dairy Lipids in the Diet Increased Long-Chain Omega-3 Fatty Acids Status in Post-weaning Rats. Front Nutr. 2018;5:42. Published 2018 May 23. doi:10.3389/fnut.2018.00042<br /><br /><br />Garg ML, Wierzbicki AA, Thomson ABR, Clandinin MT. Dietary saturated fat level alters the competition between α-linolenic and linoleic acid. Lipids 1989; 24: 334–339<br /><br />Gibson RA, Musings about the role dietary fats after 40 years of fatty acid research. Prostaglandins Leukot Essent Fatty Acids. 2018 Apr;131:1-5. doi: 10.1016/j.plefa.2018.01.003. Epub 2018 Jan 6.<br /><br />Guyenet SJ, Carlson SE. Increase in adipose tissue linoleic acid of US adults in the last half century. Adv Nutr. 2015;6(6):660–664. Published 2015 Nov 13. doi:10.3945/an.115.009944<br /><br />Hamley, S. The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease: a meta-analysis of randomised controlled trials. Nutr J 16, 30 (2017) doi:10.1186/s12937-017-0254-5<br /><br />Hibbeln JR, Gow RV. The Potential for Military Diets to Reduce Depression, Suicide, and Impulsive Aggression: A Review of Current Evidence for Omega-3 and Omega-6 Fatty Acids, Military Medicine, Volume 179, Issue suppl_11, November 2014, Pages 117–128, <a href="https://doi.org/10.7205/MILMED-D-14-00153" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">https://doi.org/10.7205/MILMED-D-14-00153</a><br /><br />Hirayama S, Miida T. Small dense LDL: an emerging risk factor for cardiovascular disease. Clin Chim Acta 2012; 414: 215–224.<br /><br />Klinger-Gratz PP, Ralvenius WT, Neumann E, et al. Acetaminophen Relieves Inflammatory Pain through CB1 Cannabinoid Receptors in the Rostral Ventromedial Medulla. J Neurosci. 2018;38(2):322–334. doi:10.1523/JNEUROSCI.1945-17.2017<br /><br />Lewis MD, Hibbeln JR, Johnson JE, Lin YH, Hyun DY, Loewke JD. Suicide deaths of active-duty US military and omega-3 fatty-acid status: a case-control comparison. J Clin Psychiatry. 2011;72(12):1585–1590. doi:10.4088/JCP.11m06879<br /><br />Madsen L, Kristiansen K. Of mice and men: Factors abrogating the antiobesity effect of omega-3 fatty acids. Adipocyte. 2012;1(3):173–176. doi:10.4161/adip.20689<br /><br />Mischkowski D, Crocker J, Way BM. From painkiller to empathy killer: acetaminophen (paracetamol) reduces empathy for pain. Soc Cogn Affect Neurosci. 2016;11(9):1345–1353. doi:10.1093/scan/nsw057<br /><br />Morrell, S., Taylor, R., Nand, D. et al. Changes in proportional mortality from diabetes and circulatory disease in Mauritius and Fiji: possible effects of coding and certification. BMC Public Health 19, 481 (2019) doi:10.1186/s12889-019-6748-7<br /><br /><br />Naughton SS, Mathai ML, Hryciw DH, McAinch AJ. Fatty Acid modulation of the endocannabinoid system and the effect on food intake and metabolism. Int J Endocrinol. 2013; 2013:361895. doi:10.1155/2013/361895<br /><br />Ramsden CE, Faurot KR, Zamora D, et al. Targeted alteration of dietary n-3 and n-6 fatty acids for the treatment of chronic headaches: a randomized trial. Pain. 2013;154(11):2441–2451. doi:10.1016/j.pain.2013.07.028<br /><br />Randles D, Heine SJ, Santos N. The common pain of surrealism and death: acetaminophen reduces compensatory affirmation following meaning threats. Psychol Sci. 2013 Jun;24(6):966-73. doi: 10.1177/0956797612464786. Epub 2013 Apr 11.<br /><br />Ruglass LM, Shevorykin A, Radoncic V, et al. Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders. J Clin Med. 2017;6(2):14. Published 2017 Feb 7. doi:10.3390/jcm6020014<br /><br /><br />Simopoulos AP. Dietary omega-3 fatty acid deficiency and high fructose intake in the development of metabolic syndrome, brain metabolic abnormalities, and non-alcoholic fatty liver disease. Nutrients. 2013;5(8):2901–2923. Published 2013 Jul 26. doi:10.3390/nu5082901<br /><br /><br />Slavich GM, Shields GS, Deal BD et al. Alleviating Social Pain: A Double-Blind, Randomized, Placebo-Controlled Trial of Forgiveness and Acetaminophen. Ann Behav Med. 2019 Dec; 53(12): 1045–1054.</span></p><p style="line-height: 1.5; margin: 10px 0px !important;"><span style="font-family: times; font-size: large;">Söderberg S, Zimmet P, Tuomilehto J, de Courten M, Dowse GK, Chitson P, Gareeboo H, Alberti KG, Shaw JE. Increasing prevalence of Type 2 diabetes mellitus in all ethnic groups in Mauritius. Diabet Med. 2005 Jan;22(1):61-8.<br /><br />Taha AY, Cheon Y, Faurot KF, et al. Dietary omega-6 fatty acid lowering increases bioavailability of omega-3 polyunsaturated fatty acids in human plasma lipid pools. Prostaglandins Leukot Essent Fatty Acids. 2014;90(5):151–157. doi:10.1016/j.plefa.2014.02.003<br /><br />Uusitalo U, Feskens EJM, Tuomilehto J, Dowse G, Haw U, Fareed D, et al. Fall in total cholesterol concentration over five years in association with changes in fatty acid composition of cooking oil in Mauritius: cross sectional survey. BMJ 1996;313:10446.<br /><br />van Zuuren EJ, Fedorowicz Z, Kuijpers T, Pijl H, Effects of low-carbohydrate- compared with low-fat-diet interventions on metabolic control in people with type 2 diabetes: a systematic review including GRADE assessments, The American Journal of Clinical Nutrition, Volume 108, Issue 2, August 2018, Pages 300–331<br /><br />Watkins BA, Kim J. The endocannabinoid system: directing eating behavior and macronutrient metabolism. Front Psychol. 2015;5:1506. Published 2015 Jan 6. doi:10.3389/fpsyg.2014.01506</span></p><p style="font-family: aktiv-grotesk, sans-serif; font-size: 1rem; line-height: 1.5; margin: 10px 0px !important;">.</p></div>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-8550919611653842066.post-11561331621673575762021-04-23T19:32:00.002-07:002021-04-23T19:32:59.993-07:00The most important post - a new Nutrition and Mental Health article and book<span style="font-family: georgia; font-size: large;"><i><b>The Better Brain: How nutrition will help you overcome anxiety, depression, ADHD and stress</b></i> is a new book (not to be mistaken with the David Perlmutter book of similar name) by Bonnie Kaplan and Julia Rucklidge.<br /><br />I was invited to review this very important book - by the authors of multiple RCTs and cross-over studies, who are announcing new findings in nutrition and mental health scientific research in book form for the first time, for NZ mainstream media channel Newsroom, where I've managed to place a few nutrition articles in the past.<br />Basically, the more hits this gets the more likely it becomes that I'll be asked back, and that I'll thus be able to keep placing ideas about LCHF, keto, ancestral diets, and the failings of the food industry and dietary guidelines in the MSM.</span><div><span style="font-family: georgia; font-size: large;"><br /></span></div><div><span style="font-family: georgia; font-size: large;">Please click here:<br /><br /><a href="https://www.newsroom.co.nz/book-of-the-week-the-wrong-diet-makes-you-insane">https://www.newsroom.co.nz/book-of-the-week-the-wrong-diet-makes-you-insane</a><br /><br />My earlier posts in Newsroom can be accessed from the link.</span></div><div><span style="font-family: georgia; font-size: large;"><br /></span></div><div><span style="font-family: georgia; font-size: large;">Thank you</span></div>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-8550919611653842066.post-89085121835984410402021-04-13T16:48:00.008-07:002021-04-13T19:22:07.572-07:00Zombies of the Risk Society<p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-size: large;"><b style="font-family: aktiv-grotesk, sans-serif;">How the Risk Society model of “progress” explains the COVID-19 paralysis, how Zombies were enlisted in the cause, and what hope there is left of not becoming Zombies ourselves.
</b><span face="aktiv-grotesk, sans-serif">(Note: this article was originally posted on Pearl Harbor day 2020, as a subscriber-only post on my </span><a href="https://www.patreon.com/hopefulgeranium" style="font-family: aktiv-grotesk, sans-serif;" target="_blank">Patreon account</a><span face="aktiv-grotesk, sans-serif"> - to stay up-to-date with my research (except matters of urgent public interest, such as selenium and Covid-19 theories, which will always be free) in these low-employment times, please subscribe!)</span><b style="font-family: aktiv-grotesk, sans-serif;"><br /><br /></b><span style="font-family: times;">“<em>Whereas the utopia of equality contains a wealth of substantial and positive goals of social change, the utopia of the risk society remains peculiarly negative and defensive. Basically, one is no longer concerned with attaining something ‘good’, but rather with preventing the worst.</em></span></span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: times; font-size: large;"><em>The dream of the old society is that everyone wants and ought to have a share of the pie. The utopia of the risk society is that everyone should be spared from poisoning.</em>”<br />Ulrich Beck, Risk Society, 1986</span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: times; font-size: large;">In the summer of late 1968, two years after I arrived in New Zealand with my family as an 8-year old, what would become known as the Hong Kong Flu arrived. We were all sick and could barely move to feed ourselves. I remember to this day the feeling of one’s sinuses and bronchial passages being encased in and fossilized by concretions of phlegm day after day. Getting back to normal, if I ever did, took forever. The Hong Kong Flu killed a million people world-wide; 100,000 of these were in the USA. When mortuary room ran out, bodies were stacked in the subways in Berlin. Given that there are many more people alive today than in the 60’s who can be killed by such an infection, the Hong Kong Flu seems a decent approximation of the virulence of COVID-19.<br />Yet, Woodstock, and Altamont, went ahead in 1969, at the height of the epidemic in the USA. I’ve never seen the flu mentioned in any hippie memorial. The Vietnam War went on – if the flu is mentioned in histories of the Tet offensive, it doesn’t seem to have influenced strategy or logistics.<br />This wasn’t a result of ignorance. In the 1966 Star Trek episode The Naked Time (series 1, episode 4), Lt (jg) Joe Tormolen is infected by an alien virus while inspecting facilities on the planet Psi 2000. We first see Lt (jg) Joe wearing a biohazard suit (with an oddly feminine-patterned facemask – the props crew, probably, having used offcuts of material bought to scantily clad the green-skinned dancing girls on some other planet) then see him put his hand under the mask to scratch his face. Even though this will not be the route of infection, the scene is included to signal that Lt (jg) Joe is the crew member who is going to catch something.
</span></p><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><span style="font-family: times; font-size: large;"><a href="https://1.bp.blogspot.com/-rJ8bfC_HfWk/YHYvfAXoMJI/AAAAAAAACfo/O5E0jiFZfZQFqPPWxN5JaCD7h6jFeW2NQCLcBGAsYHQ/s1009/Star_Trek_The_Naked_Time.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1009" data-original-width="800" height="320" src="https://1.bp.blogspot.com/-rJ8bfC_HfWk/YHYvfAXoMJI/AAAAAAAACfo/O5E0jiFZfZQFqPPWxN5JaCD7h6jFeW2NQCLcBGAsYHQ/s320/Star_Trek_The_Naked_Time.jpg" /></a></span></div><span style="font-family: times; font-size: large;"><br /><div class="separator" style="clear: both; text-align: center;"><br /></div></span></div></div><span style="font-family: times; font-size: large;"><br /><br /><br />If people weren’t any more stupid in the past than they are today – always a safe bet – then how do we explain the difference in the world’s reaction to today’s pandemic?<br /><br />In my day job, I have helped a Professor of Public Health stay up-to-date with the evidence, and most of this evidence is conceptualised in terms of risk. Risk influences policy – will taxing sugar, or <a href="https://hopefulgeranium.blogspot.com/2020/11/mauritius-when-effects-of-saturated-fat.html" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">fat</a>, improve population health? Hugely complicated rearrangements of hopelessly confounded data are lobbied at politicians who want to be seen to be doing something that will add a few extra days to the average lifespan, which, by the miracle of statistics, can then easily be sold in far more grandiose terms. The data sets are riddled with class bias – does eating red meat reduce your risk of cancer? I cannot tell you that, because in Western societies <a href="https://rdln.wordpress.com/2020/05/27/the-case-for-red-meat/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">red meat signifies labour</a>, labourers are more likely to be exposed to workplace carcinogens than academics and clerical workers, and no-one measures carcinogen exposure in diet epidemiology.</span><p></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: times; font-size: large;">The differences in risk that appear are usually small, and the certainty is low, so why do we care so much? A few years ago I came across a blog post by documentary maker <a href="https://www.bbc.co.uk/blogs/adamcurtis/entries/a2094c9d-9864-348e-a241-7aa93adf0c09" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">Adam Curtis</a> which explains this important change in the function of society through the “risk society” predictions of Ulrich Beck, quoted above. Curtis says:<br /><br /><em>That was written in 1986 - and it is remarkably prescient. Because that short paragraph pretty much describes the present day mood in our society. A world where individuals are constantly calibrating risks in their lives, while politicians are expected to anticipate and avoid all future risks and dangers.</em></span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><em><span style="font-family: times; font-size: large;">And everyone gives up on the idea of creating equality, which allows inequality to increase massively.</span></em></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: times; font-size: large;"><em>Beck’s book is extraordinary - because he came from the liberal left. Yet he is basically saying that in the face of these new potential risks we will have to move away from the political idea of progress and social reform - and instead hunker down in the brace position and try and anticipate all dangers that might be coming at us out of the darkness.<br /></em><br />In 1968 a lot of people, from Ho Chi Min to LBJ to the crowd at Woodstock, had progress and social reform on their minds. Lockdown after MLK’s murder? Good luck with that. Suspend flights to and from Vietnam? Not going to happen for other reasons. The world’s machinery was simply being applied to different ends, and few thought it could or should be diverted to stop a pandemic.<br /><br />At some point faith that the world could be radically changed, and that wars could be convincingly won, faded away. And science, perverted by the political and economic demands placed on it by the Cold War and the opportunities of consumerist capitalism, became a source of extra risk – leaky nuclear reactors, persistent pollutants, dodgy drugs, instead of the engine and arbiter of progress.<br /><br />Curtis again:<br /><em>“I think the truth probably is that it was the baby boomers losing their youth - and finding themselves unable to face the fact of their own mortality - they started to project their fears onto the rest of society. But somehow people like Beck transformed this into a grand pessimistic ideology.”</em><br /><br />Beck’s original risk society theorem was about limiting man-made risk, but a pandemic, once you can do something about it, easily becomes such a risk; for example, jet aircraft are man-made vectors for transmitting pathogens rapidly around the world. Just as Godzilla represented the risk of nuclear power to a generation of Japanese, the Centres for Disease Control decided, about a decade ago, to use Zombies in their <a href="https://www.cdc.gov/cpr/zombie/index.htm" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">pandemic education programs</a>.<br />You heard me right – Zombies. Imaginary monsters of undead human lineage derived from Afro-Caribbean folk tradition, and introduced to modern audiences by some relatively progressive film-makers who side-stepped any possible racist implications to create a more generalized myth of “the Other”. The Zombie film is basically an exercise in imagining genocide at a remove. You wake up one day and your neighbours are mindlessly intent on killing you and there’s nothing you can do about it – a common enough experience in mid 20th-century Europe. In the usual Zombie film, the tables will be turned, as they were in Europe. There will then be a genocide of Zombies, but it’s ethical because Zombies, though in human form and formerly known to us as our fellow humans, have become convincingly subhuman. It may be cathartic, but it’s not reassuring.<br />
<br /></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://1.bp.blogspot.com/-rbXODAj_pd8/YHYwVQLV5aI/AAAAAAAACfw/ODvSOjZU_Ps9DyLHUbDIWtroPbLecwoJQCLcBGAsYHQ/s591/Zombies.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-size: large;"><img border="0" data-original-height="591" data-original-width="430" height="640" src="https://1.bp.blogspot.com/-rbXODAj_pd8/YHYwVQLV5aI/AAAAAAAACfw/ODvSOjZU_Ps9DyLHUbDIWtroPbLecwoJQCLcBGAsYHQ/w466-h640/Zombies.png" width="466" /></span></a></div><span style="font-size: large;"><span style="font-family: times;">(Table from Walter Dehority, </span><a href="https://jamanetwork.com/journals/jama/article-abstract/2765300" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer; font-family: times;" target="_blank">Infectious Disease Outbreaks, Pandemics, and Hollywood—Hope and Fear Across a Century of Cinema</a><span style="font-family: times;">., JAMA 2020)</span></span><p></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: times;"><span style="font-size: large;"><br /></span></span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: times; font-size: large;">But the Zombie idea appealed to educators globally, as a way of getting kids interested in scientific concepts like exponential spread. And just as a way of pleasing kids and keeping them entertained – “look up from your video game, because this lesson’s like a video game!” – which is what education is turning into (anything too rigorous rapidly becomes financially and socially “risky”). I remember the kids coming home from school and talking about their Zombie lessons and wondering WTAF?<br /><br />As discussed in an <a href="https://www.researchgate.net/publication/304629785_Zombie_pandemic_preparedness_A_cautionary_observation" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">NZ Medical Journal</a> article in 2018, the evidence that teaching kids about Zombies improves their preparedness as young adults is lacking. But it certainly allows them to see pandemics in <a href="https://www.marketwatch.com/story/contagion-philadelphia-and-resident-evil-what-movies-about-infectious-disease-outbreaks-have-in-common-2020-04-28" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">dehumanizing terms</a>, because no-one cares what happens to Zombies.<br />And so New Zealand went, overnight, from being a society where any expression of concern about immigration numbers for any reason was automatically flagged as “racist” and shouted down, to being the most “Build the Wall!” society on earth, a Hermit Kingdom jealously guarding its borders, with those members of society most progressive in normal times tending to be most vocal in defence of the new isolationism and any other restrictive measure needed to eliminate risk.<br />Not, I should add, that NZ’s approach has been overtly repressive – unlike Australia we haven’t implemented large fines, and have avoided violent arrests, for breaches of Covid decorum. Police are more likely to tell you that your behaviour is very disappointing and they expected better from you - and no-one wants to hear that.<br />As Prime Minister Jacinda Ardern says, “Be Kind”. You can take this as a reference to Albert Camus’ The Plague or Ellen DeGeneres’ The Ellen Show, or both, depending on your background, but it’s been useful advice to fall back on. Like most of the government’s messaging so far, it’s on point, easy to conceptualise, and leaves little room for confusion.<br /><br />Nor has the NZ government’s reaction been entirely regressive. The slow claw-back of workers’ rights by a Labour party which famously surrendered to neo-liberalism in the 1980s has if anything strengthened under Covid; wages and benefits have been increased as more workers have lost their jobs and small businesses have failed. The idea that everyone is in the same boat here – a kind of Covid-class consciousness - is generally accepted.<br />NZ is a small country, we all know each other, and back in the early 90’s now-finance minister and deputy Prime Minister Grant Robertson, then head of the Otago Student’s Union, asked my band to play at his 21st. As bandleader I shared a common mission with Grant as host, that of keeping the party going and the inevitable Nazi skinhead gatecrasher contingent peaceful, which when you think about it is not unlike the mission of any successful left-leaning government in a democracy.<br /><br />Talking about gatecrashers, QAnon and the associated plandemic theorists have indeed made inroads here. A few thousand people attended an illegal “Freedom” march in Auckland during the brief second lockdown of that city. And the right-thinking rest of NZ society – the <a href="https://damagemag.com/2020/03/25/it-might-take-a-while-before-history-starts-again/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">Lockdown Liberals</a>, to use Anton Jäger’s phrase, are being taught to see the spread of QAnon – a lab-grown virus if ever there was one - as another kind of Zombie pandemic.<br /><br />(Since I wrote the first draft of this essay, NZ investigative journalist David Farrier, who is well-informed on QAnon, has begun sharing comics by Dan Vernon portraying conspiracy theorists as Zombies. <a href="https://www.webworm.co/p/a-eulogy-for-pete-evans" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">One of these</a> portrays cancelled, delusional chef Pete Evans* as a Zombie and describes the MAGA hat as a “neo-Nazi” symbol. More realistically, and more in keeping with the neo-Nazi cartoon shared by Evans that the comic was an outraged response to, the MAGA hat will go down in history as the symbol of a grifter-capitalist grab at political power - “say what you like about the tenets of National Socialism, Dude, at least it's an ethos.”)</span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: times; font-size: large;"><br />Lockdown liberals also look askance on another group in NZ known as <a href="https://www.covidplanb.co.nz/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">Plan B</a>, academics who warn that we can’t stay hermits forever, that lockdowns have both predictable and unforeseen consequences, and that we should be openly debating the alternatives whether we choose to embrace them or not.<br />The argument against these Covid-relativists is that it is heartless to consider the economy when lives are at stake - as if poverty no longer kills, as if life-extending medical treatments are cheap.<br />It's a trolly problem where the view on both lines is obscured by distance, and the categorical imperative is to preserve the lives that seem closest in time – those that would be lost to Covid – by diverting the runaway trolly off towards the lives unseen.<br /><br /><br />We’ll open the country when “we” have a vaccine, even though that will inevitably result in the infections we’ve been postponing, albeit hopefully at a lower rate. In the meantime, we seem to have done nothing in New Zealand to identify and quantify, let alone treat, the risk factors that are most likely to influence the virulence of COVID-19; from here these look like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275153/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">vitamin D</a> deficiency, <a href="https://www.mdpi.com/2072-6643/12/7/2098" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">selenium</a> deficiency (endemic in New Zealand), diabetes and obesity, and the <a href="https://www.medpagetoday.com/reading-room/aga/lower-gi/86940" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">polyunsaturated fat</a> content of one’s fat stores – <strong>most of which are unintended consequences of earlier Risk Society initiatives</strong> - all of which are metabolically interlinked in their interaction with the virus, and all of which can easily be modified in whatever time we have - if the Risk Society so decides.</span></p><p style="background-color: white; color: #241e12; line-height: 1.5; margin: 10px 0px; white-space: pre-line;"><span style="font-family: times;"><span style="font-size: large;">Ironically, we’d know a lot more about the factors influencing SARS CoV-2 virulence if we used more often the methods of the father of risk epidemiology, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1898525/" rel="nofollow noopener" style="background-color: transparent; color: #3a2ab3; cursor: pointer;" target="_blank">Austin Bradford Hill</a>. In the 1960’s, Hill conceptualised the scientific argument against cigarettes in a way that could be seen as conclusive. Hill’s criteria are neglected today (or sometimes rewritten in order to weaken them as a form of special pleading) because, taken as a whole, they tend to screen out the small, confounded, possibly imaginary, and practically meaningless risks that are so popular for generating media articles and influencer pay-days today, like the story that inspired Curtis’s Vegetables of Truth.<br /><br />We can become more like Bradford Hill, and less like Ulrich Beck, if and when we decide to stop being Zombies and start living.</span><span style="font-size: medium;"><br /><br /><br />* It’s a theme for another day, what caused Pete Evans, who did help expose one Big Lie and was pilloried for it by the corrupt Aussie dietetics establishment and the predatory press, to start seeing Big Lies everywhere and malign “elites” behind everything till his mind turned to mush.</span></span></p>Unknownnoreply@blogger.com2tag:blogger.com,1999:blog-8550919611653842066.post-78639194446635464342021-03-04T16:03:00.006-08:002021-04-13T19:22:48.537-07:00Letter – Selenium supplementation may improve COVID-19 survival in sickle cell disease.<p class="MsoNormal"><br /><br /><br /><span style="font-family: times; font-size: medium;">Further to Ulfberg and Stehlik’s letter of Sept 29<sup>th</sup>,
further evidence supports the role of selenium in COVID-19 virulence.[1] <br />
<br />
In their pre-print analysis by machine learning of Medicare patients Dun et al.
found that the leading comorbidity associated with COVID-19 mortality, adjusted
for age and race, was sickle cell disease (aOR, 1.73; 95% CI, 1.21-2.47),
followed by chronic kidney disease (aOR, 1.32; 95% CI, 1.29-1.36).[2]<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">Both SCD and kidney disease can lower selenium levels by
decreasing tubular selenium resorption, and are associated with deficient
selenium status.[3,4] <br style="mso-special-character: line-break;" />
<!--[if !supportLineBreakNewLine]--><br style="mso-special-character: line-break;" />
<!--[endif]--><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">Selenium status or intake has been correlated with COVID-19
outcomes, including mortality and recovery rates, in four patient groups in
China, Germany, South Korea, and southern India.[5,6,7,8] SARS-CoV-2, like
other RNA viruses, sequesters selenium causing selenium levels to drop during
infection.[6,9] SARS-CoV-2 may infect cells in bone marrow, suppressing red
blood cell formation.[10] Selenium status is inversely associated with
haemolysis in SCD, and selenium may both inhibit haemolysis and enhance erythropoiesis
in SCD.[3,11] <br />
<br />
Selenium is required for the actions of both vitamin D and dexamethasone.[12,13]
Selenite infusion is safe, including in critically ill and dialysis patients,
and selenium supplementation has had favourable effects in other RNA virus
infections.[14,15,16]<br />
<br />
It should be noted that vitamin C and magnesium are also commonly deficient
nutrients and are required for the activation of vitamin D3 by hydroxylation.[17,18,19]
Deficiency of ascorbate has been associated with COVID-19 and COVID-19 outcomes
in hospital populations.[20]<br />
<br />
Selenium, supplemented if necessary with its cofactors in vitamin D metabolism,
is proposed to be an important protective factor in the general population, but
has the potential to reduce mortality from SARS CoV-2 infection in the sickle
cell disease population to an even greater extent.<br />
<br />
<br />
[1] Ulfberg, J., & Stehlik, R. (2020). Finland’s handling of selenium is a
model in these times of coronavirus infections. British Journal of Nutrition,
1-2. doi:10.1017/S0007114520003827<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> <br /></span></o:p><span style="font-family: times; font-size: large;">[2] Dun C, Walsh CM, Bae S et al. A Machine Learning Study of
534,023 Medicare Beneficiaries with COVID-19: Implications for Personalized
Risk Prediction. medRxiv 2020.10.27.20220970; doi: </span><a href="https://doi.org/10.1101/2020.10.27.20220970" style="font-family: times; font-size: large;">https://doi.org/10.1101/2020.10.27.20220970</a></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;">
<!--[if !supportLineBreakNewLine]--><br style="mso-special-character: line-break;" />
<!--[endif]--><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[3] Delesderrier E, Cople-Rodrigues CS, Omena J, et al.
Selenium Status and Hemolysis in Sickle Cell Disease Patients. Nutrients.
2019;11(9):2211. Published 2019 Sep 13. doi:10.3390/nu11092211<br />
</span><span style="font-family: times; font-size: large;"><br />[4] Iglesias P, Selgas R, Romero S, Díez JJ. Selenium and
kidney disease. J Nephrol. 2013 Mar-Apr;26(2):266-72. doi: 10.5301/jn.5000213.
Epub 2012 Sep 18. PMID: 23023721.</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;">
<br />
[5] Zhang J, Taylor EW, Bennett K, Saad R, Rayman MP. Association between
regional selenium status and reported outcome of COVID-19 cases in China, The
American Journal of Clinical Nutrition, Volume 111, Issue 6, June 2020, Pages
1297–1299, https://doi.org/10.1093/ajcn/nqaa095<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[6] Moghaddam A, Heller RA, Sun Q et al. L. Selenium
Deficiency Is Associated with Mortality Risk from COVID-19. Nutrients 2020, 12,
2098.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[7] Im, JH et al. Nutritional status of patients with
coronavirus disease 2019 (COVID-19) Int J Infectious Diseases, August 11, 2020<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[8] Majeed, M et al. An Exploratory Study of Selenium Status
in Normal Subjects and COVID-19 Patients in South Indian population: Case for
Adequate Selenium Status: Selenium Status in COVID-19 Patients. Nutrition.
Available online 11 November 2020, 11105<br /></span><span style="font-family: times; font-size: large;"><br />[9] Wang, Y et al. SARS-CoV-2 suppresses mRNA expression of
selenoproteins associated with ferroptosis, ER stress and DNA synthesis.
Preprint, 2020/07/31. 10.1101/2020.07.31.230243</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;">
<br />
[10] Reva, I., et al. Erythrocytes as a Target of SARS CoV-2 in Pathogenesis of
Covid-19. Archiv EuroMedica. 2020. doi.org/10.35630/2199-885X/2020/10/3.1<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><br />
[11] Jagadeeswaran R, Lenny H, Zhang H et al. The Impact of Selenium Deficiency
on a Sickle Cell Disease Mouse Model. Blood 2018; 132 (Supplement 1): 3645.
doi: https://doi.org/10.1182/blood-2018-99-111833<br />
<br />
[12] Schütze N, Fritsche J, Ebert-Dümig R, et al. The selenoprotein thioredoxin
reductase is expressed in peripheral blood monocytes and THP1 human myeloid
leukemia cells--regulation by 1,25-dihydroxyvitamin D3 and selenite.
Biofactors. 1999;10(4):329-338. doi:10.1002/biof.5520100403<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[13] Rock C, Moos PJ. Selenoprotein P regulation by the
glucocorticoid receptor. Biometals. 2009;22(6):995-1009.
doi:10.1007/s10534-009-9251-2<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[14] Zhao Y, Yang M, Mao Z, et al. The clinical outcomes of
selenium supplementation on critically ill patients: A meta-analysis of
randomized controlled trials. Medicine (Baltimore). 2019;98(20):e15473.
doi:10.1097/MD.0000000000015473<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[15] Manzanares W, Lemieux M, Elke G, Langlois PL, Bloos F,
Heyland DK. High-dose intravenous selenium does not improve clinical outcomes
in the critically ill: a systematic review and meta-analysis. Crit Care.
2016;20(1):356. Published 2016 Oct 28. doi:10.1186/s13054-016-1529-5<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[16] Steinbrenner H, Al-Quraishy S, Dkhil MA, Wunderlich F,
Sies H. Dietary selenium in adjuvant therapy of viral and bacterial infections.
Adv Nutr. 2015;6(1):73-82. Published 2015 Jan 15. doi:10.3945/an.114.007575<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><br />
[17] Cantatore FP, Loperfido MC, Magli DM, Mancini L, Carrozzo M. The
importance of vitamin C for hydroxylation of vitamin D3 to 1,25(OH)2D3 in man.
Clin Rheumatol. 1991 Jun;10(2):162-7. doi: 10.1007/BF02207657. PMID: 1655350.<br />
<br />
[18] Dai Q, Zhu X, Manson JE, et al. Magnesium status and supplementation
influence vitamin D status and metabolism: results from a randomized trial. Am
J Clin Nutr. 2018;108(6):1249-1258. doi:10.1093/ajcn/nqy274<br />
<br />
[19] Cooper ID, Crofts CAP, DiNicolantonio JJ, et al. Relationships between
hyperinsulinaemia, magnesium, vitamin D, thrombosis and COVID-19: rationale for
clinical management. Open Heart. 2020;7(2):e001356.
doi:10.1136/openhrt-2020-001356<br />
<br />
[20] Carr, A.C.; Rowe, S. The Emerging Role of Vitamin C in the Prevention and
Treatment of COVID-19. Nutrients 2020, 12, 3286.<br />
<br />[3] Delesderrier E et al. Selenium Status and Hemolysis in Sickle Cell Disease
Patients. Nutrients. 2019;11(9):2211. Published 2019 Sep 13.
doi:10.3390/nu11092211</span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[4] Iglesias P et al. Selenium and kidney disease. J
Nephrol. 2013 Mar-Apr;26(2):266-72. doi: 10.5301/jn.5000213. Epub 2012 Sep 18.
PMID: 23023721.<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p><span style="font-family: times; font-size: large;">[5] Zhang J et al. Association between regional selenium
status and reported outcome of COVID-19 cases in China, The American Journal of
Clinical Nutrition, Volume 111, Issue 6, June 2020, Pages 1297–1299,
https://doi.org/10.1093/ajcn/nqaa095</span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[6] Moghaddam A et al. L. Selenium Deficiency Is Associated
with Mortality Risk from COVID-19. Nutrients 2020, 12, 2098.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[7] Im, JH et al. Nutritional status of patients with
coronavirus disease 2019 (COVID-19) Int J Infectious Diseases, August 11, 2020<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[8] Majeed, M et al. An Exploratory Study of Selenium Status
in Normal Subjects and COVID-19 Patients in South Indian population: Case for
Adequate Selenium Status: Selenium Status in COVID-19 Patients. Nutrition.
Available online 11 November 2020, 111053<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[9] Wang, Y et al. SARS-CoV-2 suppresses mRNA expression of
selenoproteins associated with ferroptosis, ER stress and DNA synthesis.
Preprint, 2020/07/31. 10.1101/2020.07.31.230243<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[10] Reva, I., et al. Erythrocytes as a Target of SARS CoV-2
in Pathogenesis of Covid-19. Archiv EuroMedica. 2020.
doi.org/10.35630/2199-885X/2020/10/3.1<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[11] Jagadeeswaran R et al. The Impact of Selenium
Deficiency on a Sickle Cell Disease Mouse Model. Blood 2018; 132 (Supplement
1): 3645. doi: https://doi.org/10.1182/blood-2018-99-111833</span><o:p></o:p></p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-7612480533950106452020-11-16T12:00:00.004-08:002020-11-17T11:42:04.908-08:00Mauritius - When the effects of saturated fat replacement failed to conform to the modelling, no-one cared.<p class="MsoNormal"><span style="font-family: times; font-size: medium;">There may be no country in the world in which a suggested
limit on saturated fat has not been followed by a relatively rapid increase in
the incidence of diabetes and obesity.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">Of course this is a matter of observation not experiment,
but so is most of the evidence that various dietary guidelines organizations have relied on over the years.<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><span style="font-family: times; font-size: medium;"><a href="https://lh3.googleusercontent.com/-QRO3pVTN9GQ/X7LX5sYrSGI/AAAAAAAACYE/0Axb1X1OLBs7_sYnydb1ITDnPXlibLWBgCLcBGAsYHQ/image.png" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="500" data-original-width="500" height="320" src="https://lh3.googleusercontent.com/-QRO3pVTN9GQ/X7LX5sYrSGI/AAAAAAAACYE/0Axb1X1OLBs7_sYnydb1ITDnPXlibLWBgCLcBGAsYHQ/w320-h320/image.png" width="320" /></a></span></div><span style="font-family: times; font-size: medium;"><br /></span></div><span style="font-family: times; font-size: medium;"><br /></span><p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">A particularly egregious case seems to have occurred in
Mauritius, after the Mauritian Government changed the fat content of ration
oil, a cheap cooking oil used by most of the population, by decree. In 1987 it
had been 75-100% (median 87.5%) palm oil, with (by then) some soybean oil – overnight
this was changed to 100% soybean oil. This change was based on predictions from
the research of Ancel Keys into heart disease, in particular the 7 Countries
study and the intervention in East Finland. <o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">This took PUFA intakes (almost all linoleic acid) to 8.6%E
for men and 8.8%E for women, and lowered SFA intakes to 7%E and 7.5%E respectively. These were, as reported, not high fat diets, and it may be
relevant that Mauritius is a sugar-producing nation.[1,2]<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> </o:p>5 years later, in 1992, researchers, including experts from
Finland and the WHO, measured the changes in fat intake and cholesterol in the
Mauritian population, focusing on Hindu Indians.</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><i><b>"In the 5-year survey of lipids and other biomarkers,
mean population serum total cholesterol concentration fell appreciably from
5.55 mmol/l to 4.7 mmol/l (P<0.001). The prevalence of overweight or obesity
increased, and the rates of glucose intolerance changed little."</b></i>[1] <o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;">However, in a letter to the BMJ, N Chandrasekharan, a
consultant chemical pathologist and Kalyana Sundram, senior research officer of
the Palm Oil Research Institute of Malaysia disputed these findings -</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> </o:p><i><b>"On the purported fall in serum cholesterol
concentration from 5.7 mmol/l in 1987 to 4.6 mmol/l in 1992, it is not evident
whether the samples were from the same subjects.</b></i></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><i><b>The data for 1992 on the per caput fat intake of 56.2 g per
day based on a 24 hour dietary recall is a far cry from the 73.7 g reported by
the Food and Agriculture Organisation. The figures for edible oil intake seem
erroneous. In 1987 palm oil accounted for only 27.5% of the edible oils
consumed and its saturated fatty acids contributed 1.89% of the total energy
intake and this fell to 0.33% in 1992."</b></i>[3]<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">However, we have previously found FAO fat consumption
estimates to be unreliable, overestimating NZ butter consumption in recent
years <a href="https://profgrant.com/2017/02/02/rebuttal-to-rod-jackson-are-new-zealanders-the-worlds-leading-butter-eaters/" target="_blank">by a factor of 4</a>. And Chandrasekharan and Sundram’s letter contains this
statement:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> </o:p><i><b>"Although we are also concerned about the need to
reduce the prevalence of noncommunicable diseases in Mauritius, we disagree on
the kind of simplistic thinking and draconian measures advocated.</b></i>"[3]</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">In other words, whatever the effect on fat intakes or
cholesterol, the change was a radical one. It put more linoleic acid into the
Mauritian food supply, and as in other places, the change in mandated fats
would have been accompanied by voluntary changes along the same lines. We may
doubt whether cholesterol levels changed, but not that people began to consume
more soybean oil.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><span style="mso-spacerun: yes;"> </span>So what happened? The 1987 intervention included several
good ideas – exercise more, smoke less, drink less – as well as less certain
ones – eat less salt, eat less saturated fat and more soybean oil.</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> </o:p>However, it seems unlikely that CVD went down – circulatory
mortality as a percentage of mortality increased after 1987. [4]</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> </o:p><i><b>"Over 1981–2004 the proportion of circulatory disease
mortality rose from 44% to 49% in males, and from 46% to 57% in females."</b></i></span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">Mauritius is now #2 in the world for diabetes mortality.
However, a coding change in 2004 meant that much of what had been recorded as
circulatory disease mortality was shifted to diabetes mortality. What we do
know is that diabetes prevalence increased, as has incidence of pre-diabetes.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> </o:p><i><b>"The prevalence of Type 2 diabetes increased
significantly during the period studied, from 12.8% in 1987, to 15.2% in 1992,
and 17.9% in 1998."</b></i>[5]</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">Note that this contradicts the 1992 claim – by some of the
same authors – that “the rates of glucose intolerance changed little” between
1987 and 1992, a discordance not mentioned in the 2002 paper.[1]<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> </o:p><i><b>"The age-standardized prevalence of diabetes in 2009
was 22.3% (95% CI 20.0–24.6) among men and 20.2% (18.3–22.3) among women,
representing an increase since 1987 of 64 and 62% among men and women,
respectively"</b></i>.[6]</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">The Mauritius fat change paper has been cited just 17
times in 25 years, and not one of the citing papers includes any follow up on the
consequences of the change there. For example, an AHA paper mentions the
Mauritius change in glowing terms without following up whether benefit or harm
ensued, beyond the claimed 5-year drop in cholesterol.[7] Palm oil reduction
was modelled for India in 2013, and a doubled palm oil tax has been implemented
in Fiji since, all in papers citing the 1987-1992 Mauritius cholesterol
drop.[8, 9] <br />But none follows that citation up with any hard outcomes.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> </o:p>Conversely, none of the papers on health in Mauritius since 1992,
charting worsening trends, and in which the Finns still feature as authors,
mentions the oil change of 1987. However, the earlier paper had contained a
warning:[2]</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> </o:p><b><i>"Whether the replacement of palm oil by soya bean oil,
rich in n-6 polyunsaturated fatty acids, is the optimal dietary change may be
questioned... the consumption of fats high in polyunsaturated fatty acids may
lead to increased concentrations of free radicals and oxidised low-density
lipoprotein, which may promote the progression of atherosclerosis. Therefore,
notwithstanding the apparent success of the intervention in Mauritius, an oil
high in monounsaturated fatty acids, such as olive oil or rapeseed oil, might
be preferable if such an oil substitution were currently being planned."</i></b></span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">It appears now that both saturated fat in the diet, and a
low intake of omega 6 linoleic acid,<span style="mso-spacerun: yes;"> </span>are
beneficial in terms of the incorporation of the omega 3 fatty acids EPA and DHA
into circulating lipids and cells.[10, 11, 12, 13] EPA in particular is anti-inflammatory,
and is an approved drug for the prevention of CVD.[14]<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><i><b><o:p> </o:p>"These observations indicate that the efficacy of n-3
fatty acids in reducing arachidonic acid level is dependent on the linoleic
acid to saturated fatty acid ratio of the diet consumed."</b></i>[11]</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> </o:p><i><b>"The results suggest that dietary substitution of SFA
with n-6PUFA, despite maintaining low levels of circulating cholesterol,
hinders n-3PUFA incorporation into plasma and tissue lipids."</b></i>[13]</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">The conversion of linoleic acid to arachidonic acid, and the
peroxidation of arachidonic acid to aldehydes which interfere with insulin
signaling, as well as its conversion to cannabinoids which increase adipocyte
growth, in a context of decreased omega 3 availability from high LA and low SFA
diet, are pathways that may explain the eventual adverse outcomes in Mauritius,
especially in a population with high sugar availability.[15,16]<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> </o:p><i><b>"Our recent finding that sucrose and other high
glycemic index carbohydrates abrogate the antiobesity effect of n-3 PUFAs
might, at least in part, provide an explanation to the apparent discrepancy
between human and rodent intervention studies, and the lack of effect in some
human trials. In addition to the amount and type of carbohydrates, the levels
of n-6 PUFAs, linoleic acid in particular, in the background diet might
influence the antiobesogenic effect of n-3 PUFAs."</b></i>[15]</span></p><p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">It seems that, in the matter of diet, public health experts
cannot be relied on to investigate the possibility that they have made a
mistake. They control the narrative so that a (questionable) historical change
in cholesterol within a 5-year period is considered evidence that a lifetime
intervention is valuable, yet a nation-wide worsening of hard endpoints after
that intervention can be ignored. Certainly the diabetes disaster in Mauritius
can have had many causes, but the possibility that the soya bean oil
intervention was one of them has not even registered in the medical literature
over a 30 year period, let alone been tested.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p> H/T Louise Stephen @LouiseStephen9 author of </o:p> '<a href="http://eatingourselvessick.com/" target="_blank">Eating Ourselves Sick</a>' for bringing this intervention to my attention.<br /><br /><b>Postscript</b>: it will be obvious to students of evidence-based medicine that the quality of evidence used to create this argument has left much to be desired. With the exception of the date and intent of the intervention and the diabetes incidence data, nothing here tells us quite what we want to know. For example, circulatory disease as a percentage of mortality is a suggestive but imperfect measure, even before the coding change. So there will be those who read this article and feel justified in dismissing the need for it. <br />But I ask them to look at things another way - the data in this page is, to the best of my knowledge, the sum total of the published, peer-reviewed evidence on the subject. The Mauritius intervention - a legal disruption of the saturated fat supply to replace it with unsaturated fat within an entire community, in a way designed to target its most vulnerable members - has been the masturbation fantasy of a certain type of public health epidemiologist for as long as I can remember. There is a constant supply of peer-reviewed publications <i><b>modelling</b></i> the long-term effect of such an intervention on the putatively preventable causes of mortality, and there have been <i><b>none</b></i> directly investigating the impact on those causes in this case - where the long-planned intervention actually happened.<br />The reasons for this neglect are a matter for conjecture; we may hear future tales of suppressed data and publication bias as we did with the Sydney Heart Study and Minnesota Coronary Experiment studies (both of which also involved changes of fat products given to a population, rather than the less certain changes of mere advice given in most other diet-heart studies)[17] but the conclusion ought surely to be that the modelling should stop until the facts have been checked. <br /><br /><br /><br /></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><b>References<br /></b><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;"><o:p><span>[</span></o:p>1]<span style="mso-spacerun: yes;"> </span>Dowse GK, Gareebo
H, Alberti KGMM, Zimmet P, Tuomilehto J, Purran A, et al. Changes in population
cholesterol concentrations and other cardiovascular risk factor levels after
five years of the noncommunicable disease intervention programme in Mauritius.
BMJ 1995;311:12259.</span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[2]<span style="mso-spacerun: yes;"> </span>Uusitalo U,
Feskens EJM, Tuomilehto J, Dowse G, Haw U, Fareed D, et al. Fall in total
cholesterol concentration over five years in association with changes in fatty
acid composition of cooking oil in Mauritius: cross sectional survey. BMJ
1996;313:10446. <o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[3]<span style="mso-spacerun: yes;"> </span>Chandrasekharan N,
Sundram K. Fall in cholesterol after changes in composition of cooking oil in
Mauritius. BMJ. 1997;314(7079):516. doi:10.1136/bmj.314.7079.516<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[4]<span style="mso-spacerun: yes;"> </span>Morrell, S.,
Taylor, R., Nand, D. et al. Changes in proportional mortality from diabetes and
circulatory disease in Mauritius and Fiji: possible effects of coding and
certification. BMC Public Health 19, 481 (2019) doi:10.1186/s12889-019-6748-7<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[5]<span style="mso-spacerun: yes;"> </span>Söderberg S,
Zimmet P, Tuomilehto J, de Courten M, Dowse GK, Chitson P, Gareeboo H, Alberti
KG, Shaw JE. Increasing prevalence of Type 2 diabetes mellitus in all ethnic
groups in Mauritius. Diabet Med. 2005 Jan;22(1):61-8.<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[6]<span style="mso-spacerun: yes;"> </span>Magliano DJ,
Söderberg S, Zimmet PZ, et al. Explaining the increase of diabetes prevalence
and plasma glucose in Mauritius. Diabetes Care. 2012;35(1):87–91.
doi:10.2337/dc11-0886<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[7]<span style="mso-spacerun: yes;"> </span>Mozaffarian D,
Afshin A, Benowitz NL, et al. Population approaches to improve diet, physical
activity, and smoking habits: a scientific statement from the American Heart
Association. Circulation. 2012;126(12):1514–1563.
doi:10.1161/CIR.0b013e318260a20b<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[8]<span style="mso-spacerun: yes;"> </span>Basu S, Babiarz
KS, Ebrahim S, Vellakkal S, Stuckler D, Goldhaber-Fiebert JD. Palm oil taxes
and cardiovascular disease mortality in India: economic-epidemiologic model.
BMJ. 2013;347:f6048. Published 2013 Oct 22. doi:10.1136/bmj.f6048<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[9]<span style="mso-spacerun: yes;"> </span>Coriakula J,
Moodie M, Waqa G, Latu C, Snowdon W, Bell C. The development and implementation
of a new import duty on palm oil to reduce non-communicable disease in Fiji.
Global Health. 2018;14(1):91. Published 2018 Aug 29.
doi:10.1186/s12992-018-0407-0<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[10]<span style="mso-spacerun: yes;"> </span>Gibson, Robert A.
Musings about the role dietary fats after 40 years of fatty acid research.
Prostaglandins, Leukotrienes and Essential Fatty Acids, Volume 131, 1 – 5<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[11] Garg ML, Thomson ABR, and Clandinin M T. Interactions of
saturated, n-6 and n-3 polyunsaturated fatty acids to modulate arachidonic acid
metabolism.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">The Journal of Lipid Research, February 1990 , 31, 271-277.<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[12] Dabadie H, Motta C, Peuchant E, LeRuyet P, Mendy F.
Variations in daily intakes of myristic and alpha-linolenic acids in sn-2
position modify lipid profile and red blood cell membrane fluidity. Br J Nutr.
2006 Aug;96(2):283-9.<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[13] Dias Cintia B, Wood LG, and Garg Manohar L. Effects of
dietary saturated and n-6 polyunsaturated fatty acids on the incorporation of
long-chain n-3 polyunsaturated fatty acids into blood lipids. European Journal
of Clinical Nutrition. 2016; 70: 812-818<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[14] Budoff M, Brent Muhlestein J, Le VT, May HT, Roy S,
Nelson JR. Effect of Vascepa (icosapent ethyl) on progression of coronary
atherosclerosis in patients with elevated triglycerides (200-499 mg/dL) on
statin therapy: Rationale and design of the EVAPORATE study. Clin Cardiol.
2018;41(1):13–19. doi:10.1002/clc.22856<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[15] Madsen L, Kristiansen K. Of mice and men: Factors
abrogating the antiobesity effect of omega-3 fatty acids. Adipocyte.
2012;1(3):173–176. doi:10.4161/adip.20689<o:p></o:p></span></p>
<p class="MsoNormal"><o:p><span style="font-family: times; font-size: medium;"> </span></o:p></p>
<p class="MsoNormal"><span style="font-family: times; font-size: medium;">[16] Clark TM, Jones JM, Hall AG, Tabner SA, Kmiec RL.
Theoretical Explanation for Reduced Body Mass Index and Obesity Rates in
Cannabis Users. Cannabis Cannabinoid Res. 2018;3(1):259-271. Published 2018 Dec
21. doi:10.1089/can.2018.0045<br /><br /><br />[17] Ramsden Christopher E, Zamora Daisy, Majchrzak-Hong Sharon, Faurot Keturah R, Broste Steven K, Frantz Robert P et al. Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73) BMJ 2016; 353 :i1246<br /><a href="https://www.bmj.com/content/353/bmj.i1246">https://www.bmj.com/content/353/bmj.i1246</a></span><o:p></o:p></p>Unknownnoreply@blogger.com3tag:blogger.com,1999:blog-8550919611653842066.post-17241307489919392242020-07-02T15:54:00.004-07:002020-07-02T16:03:17.783-07:00A Reading List, and I Shill for a New Cookbook<span style="font-size: large;"><br /><span style="font-family: "times" , "times new roman" , serif;">It's been a time for reading lists; in lockdown I enjoyed discovering the books of T.H. White (The Goshawk and The Age of Scandal) and Evan S. Connell (Mrs Bridges) and reading Hillary Mantel's memoir (Giving Up the Ghost).<br />Sam Kriss also has a great <a href="https://damagemag.com/2020/04/23/pinned-to-a-rock-the-coronavirus-reading-list/" target="_blank">reading list</a> in Damage magazine, which features some of the best political writing I've read in ages - kind of a Leftist Spectator, if you get my drift, i.e. an honest journal, in a time when honesty is a rare and dangerous thing.<br /><br />This is a reading list I compiled for <a href="https://prekure.com/" target="_blank">PreKure</a> a while back, of books most worth reading if you're interested in the nutrition-and-health ideas this blog has covered over the years.<br /></span></span><br />
<span style="font-family: "times" , "times new roman" , serif;"><span style="font-size: large;"><br /></span>
<span style="font-size: large;"><b>The Perfect Health Diet</b>, Paul and Shou-Ching Jaminet, 2012</span></span><br />
<span style="font-family: "times" , "times new roman" , serif;"><span style="font-size: large;"><br /></span>
<span style="font-size: large;">This was one of the first “Paleo” books I read and, in my opinion, still one of the best. There are all sorts of sensible ideas, lots of references, and it’s not exclusively low carb. Some of their theoretical objections to keto diets haven’t come to much, and can be taken with a grain of salt, but there’s so much of value here to compensate. As far as population health goes, this is a clever and coherent interpretation of the evidence.</span></span><br />
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<span style="font-size: large;"><b>The Daughter of Time</b>, Josephine Tey, 1951</span></span><br />
<span style="font-family: "times" , "times new roman" , serif;"><span style="font-size: large;"><br /></span>
<span style="font-size: large;">This amusing 1950’s British detective story is a “research thriller”. The action, such as it is, takes place in a hospital bed as an injured detective sends his friends to libraries in search of the evidence in the case of a well-known historical mystery. Tey’s genius, and the lasting appeal of this book (Christopher Hitchens called it one of the most important ever written) is to show us how the most cherished received beliefs can be based – if we look closely – on lies and hearsay, the suppression of evidence, and self-serving propaganda. (*cough* saturated fat *cough*) And when Tey’s detective comes around to her alternative hypothesis, he oversells it – we suspect the author’s bias by now, and already know the evidence is too corrupt to accept; so its very flaws help to make this book perfect. If you want to inoculate young adults against fake news without getting mired in any modern controversies, convince them to read The Daughter of Time.</span></span><br />
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<span style="font-size: large;"><b>Foods of the Foreign Born in Relation to Health</b>, Bertha M. Wood, 1922</span></span><br />
<span style="font-family: "times" , "times new roman" , serif;"><span style="font-size: large;"><br /></span>
<span style="font-size: large;">Wood was a US dietitian and wrote this book at a time when the US was receiving migrants and refugees from all over Europe, as well as Mexico and the Middle East; some had brought political terrorism with them, xenophobia was if anything more extreme than it is today, and in this climate Wood wanted to familiarise nursing and dietetic students with the variety of immigrant diets so that they could help these populations in what we would today call a culturally appropriate manner. Thanks to her research we can learn about the real Mediterranean diets of 100 years ago, and that Hungarians gave children whiskey instead of milk on their cereal. A feature of this book is that Wood tells us how to adapt each population’s diet for diabetics by removing the starchy carbs. Foods of the Foreign Born is available free online at <a href="https://archive.org/details/foodsforeignbor00woodgoog/page/n6">https://archive.org/details/foodsforeignbor00woodgoog/page/n6</a></span></span><br />
<span style="font-family: "times" , "times new roman" , serif;"><span style="font-size: large;"><br /></span>
<span style="font-size: large;"><b><br />Biochemistry</b>. Mathews, van Holde, Ahern. 3rd edition. 2000.</span></span><br />
<span style="font-family: "times" , "times new roman" , serif;"><span style="font-size: large;"><br /></span>
<span style="font-size: large;">This is a second-hand biochemistry textbook. I recommend older editions like this, which you can sometimes find in op shops, because they give less space to the biochemistry of the genome, which isn’t useful information if you’re interested in nutrition, and thus have more nuts-and-bolts detail than whatever they’re selling today. It also says on page 841 that “Adult onset diabetes can often be controlled by dietary restriction of carbohydrate”. Only experts in biochemistry were allowed to tell us something that simple and true in 2000 - the rest of the world back then only cared about saturated fat and felt that the Mediterranean Diet was quite daring.</span></span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">This book is, amongst other things, your essential guide to what functions vitamins and minerals really perform in the body. Disclaimer – I understand few of the many mathematical formulas in this book that are an essential part of a real biochemistry education, but enjoyed this book nonetheless, making especial use of the index.</span><br />
<span style="font-family: "times" , "times new roman" , serif;"><span style="font-size: large;"><br /></span>
<span style="font-size: large;"><b><br /></b></span>
<span style="font-size: large;"><b>The Meat Fix: How a Lifetime of Healthy Living Nearly Killed Me!</b> John Nicholson, 2012</span></span><br />
<span style="font-family: "times" , "times new roman" , serif;"><span style="font-size: large;"><br /></span>
<span style="font-size: large;">This is a light, funny read by a UK sports journalist who wrecked his gut and metabolic health by trying to be a good vegetarian. I recommend it as a consumer’s eye view of the path many are on today, and also an insight into what popular low-carb science looks like to an ordinary convert – a bit pseudoscientific from our perspective, but still thoroughly effective.</span></span><br />
<span style="font-family: "times" , "times new roman" , serif;"><span style="font-size: large;"><br /></span>
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">And, of course, <b>The Big Fat Surprise</b> (Nina Teicholz) and <b>Why We Get Fat</b> (Gary Taubes) – these are the books that best explain how we got to where we are today.</span></span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /><br />Now, I've never run advertising on this blog. I did try at one stage, when I ran out of money, but Google weren't interested. Their loss, my escape.<br /><br />However, given a chance to sell out in a good cause, in a time when paid work ain't what it used to be, I've leapt at it.<br /><br />Ally Houston from PaleoCanteen has written "<a href="http://bit.ly/puddlegcookbook" target="_blank">Low Carb on a Budget</a>" with chef John Meechan and this is the book I've long meant to write but never had time for.<br />Lower income people are most likely to suffer from the conditions for which low carb is the specific cure, from metabolic syndrome to obesity to type 2 diabetes to depression, anxiety and chronic pain.<br />Yet low-carb cookbooks are often written by foodies and include a wide variety of expensive, hard to find, and - not to put too fine a point on it - unnecessary - ingredients. Even without these, there is still some extra cost over white bread, sugar, margarine and processed meat, but nothing you won't soon make back from your dentist, doctor, pharmacy and snack bills.<br />Low Carb on a Budget gets high praise from those most worth listening to in the UK diet-and-public health debate; if you don't know the names of some of those praising it, check out their work.<br />Another great selling point is that I'll get a pound, whatever that is, for every copy sold through the link above, and the Public Health Collaboration, a very effective lobby group in the UK, will get 50p.<br /></span><br />
<span style="font-family: "times" , "times new roman" , serif;"><img src="https://paleocanteen.co.uk/wp-content/uploads/2020/06/recipe-book-design-with-badge-600x783.jpg" /></span><br />
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Unknownnoreply@blogger.com6tag:blogger.com,1999:blog-8550919611653842066.post-70679353680145664142020-05-27T14:56:00.002-07:002020-09-27T13:18:41.428-07:00My Letter to Cochrane on the Hooper 2020 saturated fat meta<span style="font-family: "times" , "times new roman" , serif; font-size: large;">I submitted this on the Cochrane form at<br /><a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011737.pub2/comment">https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011737.pub2/comment</a><br /><br />Others will have points to add about study quality and other factors, I have stuck to what I know (not wanting to waste my life battling an opponent who can obviously be reanimated an unlimited number of times).<br /><br /><br />The introduction to this meta-analysis includes an error uncorrected from the 2015 version.</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">Oliver 1953 measured total cholesterol, not LDL cholesterol. Further, it is relevant that every subject in Oliver 1953 had been eating the same hospital diet for at least 5 weeks before the cholesterol samples were taken, which does not support a diet-heart interpretation of the results.[1] (The presence of FH in the sample, and/or survivorship bias, are probably more reasonable interpretations)</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">[1] The Plasma Lipids in Coronary Artery Disease. Oliver MF, Boyd GS. Br Heart J. 1953 Oct;15(4):387-92. </span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">The section headed "Agreements and disagreements with other studies or reviews" has not addressed any written after 2014, meaning that this section has not been updated. There are several analyses of the diet heart trials since 2015 that should have been addressed (indeed, that should have been read before the current Cochrane review was designed). Some are listed below.[2,3.4]</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">[2] Hamley, S. The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease: a meta-analysis of randomised controlled trials. Nutr J 16, 30 (2017). https://doi.org/10.1186/s12937-017-0254-5</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">[3] Thornley S, Schofield G, Zinn C, Henderson G. How reliable is the statistical evidence for limiting saturated fat intake? A fresh look at the influential Hooper meta-analysis. Intern Med J. 2019;49(11):1418‐1424. doi:10.1111/imj.14325</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">[4] Jeffery L Heileson, Dietary saturated fat and heart disease: a narrative review, Nutrition Reviews, Volume 78, Issue 6, June 2020, Pages 474–485, https://doi.org/10.1093/nutrit/nuz091</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">The discussion of Siri-Tarino 2010 in "Agreements and disagreements with other studies or reviews" claims that adjustment for lipids has confounded its null result, however Siri-Tarino at al had already addressed this by isolating studies not adjusted for lipids with no difference in their null result. This is quite understandable as adjusting for lipids also means adjusting for TG and HDL, cardiometabolic risk markers which can be beneficially infuenced by saturated fat and worsened by carbohydrate.</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">Studies which do not adjust for lipids can be favourable to saturated fat, for example the Malmo DCS, a high-quality observational study using a 7-day food diary and more rigorous exclusion criteria than is usual, or the 2019 dose-response meta-analysis of observational studies by Zhe et al.[5,6]</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">[5] Leosdottir M, Nilsson PM, Nilsson JA, Månsson H, Berglund G. Dietary fat intake and early mortality patterns--data from The Malmö Diet and Cancer Study. J Intern Med. 2005;258(2):153‐165. doi:10.1111/j.1365-2796.2005.01520.x</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">[6] Zhu, Y., Bo, Y. & Liu, Y. Dietary total fat, fatty acids intake, and risk of cardiovascular disease: a dose-response meta-analysis of cohort studies. Lipids Health Dis 18, 91 (2019). https://doi.org/10.1186/s12944-019-1035-2</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">The claim that greater lowering of LDL in trials being associated with greater reduction of events supports the diet-heart hypothesis may be unsound. Persons in good metabolic health are at significantly lower risk of CVD events despite other risk factors.[7] Persons who are obese, have diabetes, or the metabolic syndrome do not usually experience drops in LDL cholesterol when fat in the diet is changed; the subjects in the feeding studies cited, who did experience such drops, were healthy volunteers.[8,9,10]</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">[7] Jeppesen J, Hein HO, Suadicani P, Gyntelberg F. Low triglycerides-high high-density lipoprotein cholesterol and risk of ischemic heart disease. Arch Intern Med. 2001;161(3):361‐366. doi:10.1001/archinte.161.3.361</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">[8] Flock MR, Green MH, Kris-Etherton PM; Effects of Adiposity on Plasma Lipid Response to Reductions in Dietary Saturated Fatty Acids and Cholesterol, Advances in Nutrition. 2011;2,(3):261–274, https://doi.org/10.3945/an.111.000422</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">[9] Benatar JR, Sidhu K, Stewart RAH. Effects of High and Low Fat Dairy Food on Cardio-Metabolic Risk Factors: A Meta-Analysis of Randomized Studies. Tu Y-K, ed. PLoS ONE. 2013;8(10):e76480. doi:10.1371/journal.pone.0076480.</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">[10] Lefevre M, Champagne CM, Tulley RT,et al. Individual variability in cardiovascular disease risk factor responses to low-fat and low-saturated-fat diets in men: body mass index, adiposity, and insulin resistance predict changes in LDL cholesterol. Am J Clin Nutr. 2001;82(5):957–963, https://doi.org/10.1093/ajcn/82.5.957</span><br />
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<a href="https://1.bp.blogspot.com/-CNaw6Tnukd0/Xs7h5XpzRZI/AAAAAAAACQQ/MfNZDCdJY0kHduUsytwyIrE7IuynZwOAwCLcBGAsYHQ/s1600/AMI%2BSweden.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: "times" , "times new roman" , serif; font-size: large;"><img border="0" data-original-height="562" data-original-width="950" height="236" src="https://1.bp.blogspot.com/-CNaw6Tnukd0/Xs7h5XpzRZI/AAAAAAAACQQ/MfNZDCdJY0kHduUsytwyIrE7IuynZwOAwCLcBGAsYHQ/s400/AMI%2BSweden.png" width="400" /></span></a></div>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">It is also relevant that from 2004 the Swedish population began to reject diet-heart advice, to such an extent that butter sales rose and margarine sales dropped; cholesterol levels also rose.[11] Yet as recently as 2018 mortality from, and incidence of, AMI was continuing to decline in Sweden. In fact incidence of AMI had stayed stable from 1987 to 2005, after which it began to drop from 42,263 PA to 25,789 PA in 2018.[12]</span><br />
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[11] Johansson I, Nilsson LM, Stegmayr B, Boman K, Hallmans G, Winkvist A. Associations among 25-year trends in diet, cholesterol and BMI from 140,000 observations in men and women in Northern Sweden. Nutr J. 2012;11:40.<br />
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[12] Data accessed from Swedish Social Registry website 28/05/20 https://sdb.socialstyrelsen.se/if_hji/resultat.aspxUnknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-20727111903569444842020-04-02T16:56:00.000-07:002020-09-27T13:17:56.802-07:00Probiotics for the prevention of Upper Respiratory Tract infections - a back-of-the-envelope Bradford Hill analysis<span style="font-family: "times" , "times new roman" , serif; font-size: large;">“With most people, disbelief in a thing is founded on a blind belief in something else" </span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"> G. C. Lichtenberg<br /><br /><br />The Cochrane Collaboration found low-quality evidence that probiotics prevent UTRIs, and moderate-quality evidence that probiotics reduce antibiotic prescriptions for UTRI.<br />Because the antibiotic finding is most robust (aside from bearing the higher-quality GRADE score, it's also not a self-reported outcome), we'll take this as our baseline and see if it is strengthened or weakened by a Bradford Hill analysis.<br /><br />1) Strength of association: for antibiotic use, RR 0.65 (0.45 to 0.94), n=1184.[1]<br />The true association is subject to type 2 confounding by two factors - by intention-to-treat analysis, and potentially by the random consumption of yogurt and other fermented foods supplying similar effects.<br /><br />2) Consistency of association: the association is consistent, with similar (but slightly larger) effect sizes for all other measures of URTI. The association is reasonably consistent between different trials (there is no major contradiction). The association is strongly consistent with the effects of probiotics on vaccination immunity (RCTs using independently measured serum makers so more robust than the UTRI trials). The association is consistent with results for sambucus (effect size 1.717)</span><span style="font-family: "times" , "times new roman" , serif; font-size: large;"> (see 9, "analogy").[1,2,3,4]</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br />3) Specificity: Probiotics have had no consistent association with several other outcomes predicted for them. Probiotic treatment of mothers during pregnancy only results in better immunity after vaccine for mother, not infant, consistent with dendrite cell pathway for effect.[2]<br /><br />4) Temporality: Implicit in trial design<br /><br />5) Biological gradient: dose-reponse is seldom tested in probiotic experiments perhaps because of assumption that a living organism can replicate, however a dose-response for duration of treatment is seen in the vaccine studies.[3] The analogous effect of echinacae purpurea in zebrafish is strongly dose-dependent.[5]<br /><br />6) Plausibility: effect of probiotic on immune tone is well-studied, insofar as the immune system is currently understood the effect is plausible. Increased innate immunity around infection improves the acquired immune response. "A significant property of these bacteria is their ability to mimic natural infections, while intrinsically possessing mucosal adjuvant properties".[6] Dendrite cell presentation provides plausible pathway.[7]<br /><br />7) Coherence - laboratory and field work are strongly coherent, animal experiments support human, herbs with similar immune effects to probiotics in experiments tend to have similar associations with URTIs in RCTs.[4]<br /><br />8) Experiment - the association is experimental, the mechanism holds across a wide range of experiment types, including those with lowest risk of confounding or placebo effect.<br /><br />9) Analogy - herbal effects are analogous, as when plant polysaccharides mimic bacterial lipopolysaccharides. Vaccine adjuncts are also analogous. Probiotics and herbal antivirals are researched as adjuvants.</span><br />
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<span style="font-family: "times" , "times new roman" , serif; font-size: large;">Bradford Hill analysis allows us to see an association within its complete scientific context, to test whether it is causal.<br />It was originally designed to test the low-quality evidence that arises from purely observational, non-interventional studies, but is also useful to test the results of experiments where one considers these inadequate by themselves.<br /><br />Here's what I think is the parsimonious way to explain the association: In the vaccine research, probiotics double the odds of lasting immunity after vaccination. Many infections are "repeats" of infections we have had before but lost immunity to. If probiotics prevent "repeat" infections by maintaining antibody responses, this can account for the effect, even without a direct effect on immunity to any new pathogen (although this is also plausible).<br />Immunologists are currently worried that many exposed to COVID-19 have not had a sufficient or lasting antibody response and are at risk of re-infection. The less re-infectious COVID-19 is, the sooner we can safely end our current economic restrictions, which will also take a toll on human life if maintained indefinitely.</span><br />
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<span style="font-family: "times" , "times new roman" , serif; font-size: large;">1] Cochrane Database of Systematic Reviews. Q Hao, RB Dong, T Wu.</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">Probiotics for preventing acute upper respiratory tract infections</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006895.pub3/full</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">2] Zimmermann P, Curtis N. The influence of probiotics on vaccine responses - A systematic review.</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">Vaccine. 2018 Jan 4;36(2):207-213. doi: 10.1016/j.vaccine.2017.08.069. Epub 2017 Sep 18.<br /><a href="https://www.ncbi.nlm.nih.gov/pubmed/28923425">https://www.ncbi.nlm.nih.gov/pubmed/28923425</a><br /><br />3] Lei WT, Shih PC, Liu SJ, Lin CY, Yeh TL. Effect of Probiotics and Prebiotics on Immune Response to Influenza Vaccination in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2017;9(11):1175. Published 2017 Oct 27. doi:10.3390/nu9111175<br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707647/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707647/</a></span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /></span>
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">4] Hawkins J, Baker C, Cherry L, Dunne E. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complement Ther Med. 2019 Feb;42:361-365. doi: 10.1016/j.ctim.2018.12.004. Epub 2018 Dec 18.</span><br />
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<span style="font-family: "times" , "times new roman" , serif; font-size: large;">5] Guz L, Puk K, Walczak N, Oniszczuk T, Oniszczuk A.</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">Effect of dietary supplementation with Echinacea purpurea on vaccine efficacy against infection with Flavobacterium columnare in zebrafish (Danio rerio). Pol J Vet Sci. 2014;17(4):583-6.</span><br />
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<span style="font-family: "times" , "times new roman" , serif; font-size: large;">6] Benef Microbes. 2020 Mar 27:1-14. doi: 10.3920/BM2019.0121. [Epub ahead of print]</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">Immune modulatory capacity of probiotic lactic acid bacteria and applications in vaccine development.</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">Mojgani N, Shahali Y, Dadar M.</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br />7] Gallo PM, Gallucci S. The dendritic cell response to classic, emerging, and homeostatic danger signals. Implications for autoimmunity. Front Immunol. 2013;4:138. Published 2013 Jun 10. doi:10.3389/fimmu.2013.00138</span><br />
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8550919611653842066.post-12691057461112036692020-03-25T16:03:00.004-07:002020-09-27T13:19:05.106-07:00You can't Boost your Immunity? or, Debunking the COVID-19 Skeptics.<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://1.bp.blogspot.com/-bKt66g7p-ZE/XnwKOBMK5pI/AAAAAAAACMU/UHQvHYyctNYFPttcAri38jy7J2UEgrggwCLcBGAsYHQ/s1600/elderberry.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1600" data-original-width="1067" height="400" src="https://1.bp.blogspot.com/-bKt66g7p-ZE/XnwKOBMK5pI/AAAAAAAACMU/UHQvHYyctNYFPttcAri38jy7J2UEgrggwCLcBGAsYHQ/s400/elderberry.jpg" width="266" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Kate's elderberry concoction, photograph by Hayley Theyers</td></tr>
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<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br /><br /><br /><br />Is there anything as useless as the professional Skeptic community in a health crisis? Some people are paid to be roadblocks, others are educated professionals going well outside their lanes after the witches they despise for getting in their lanes at other times, others are just the sort of people who get an existential thrill from negating what they don't understand, or journalists with a "tough" reputation to uphold and a grab-bag of empty rhetoric.<br />In the history of science no-one has been wrong more often than the skeptic. What we usually call scepticism in the scientific method is just BEING CAREFUL. <br />"The first principle is that you must not fool yourself and you are the easiest person to fool." Richard P. Feynman<br />This is nothing like rushing into print with a negative opinion and a few pejoratives on a subject you haven't studied until now so you're either linking to the first blog that agrees with you on an emotional level, instead of looking at the literature, or you're scanning the literature quickly for reasons to dismiss it.<br /><br />It's far more useful to point to what we DO know. And the first thing to be said, quite clearly, is that you CAN boost your immune system. See the evidence below. And a fast-acting, broad-spectrum immune response is how we get on top of new pathogens.</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">Straight up, it needs to be stated that COVID-19 is a new virus, with some specific features. Not everything that applies to previous colds, flus, or pneumonial diseases may apply. So all older evidence needs to be evaluated carefully. But it's not completely new, this isn't smallpox in the New World, it's a nasty variation on the cold viruses we've seen before and the healthiest immune systems can usually react appropriately, as we see when we consider the high rate of mild cases and the low symptom load in the very young. The pattern so far is characteristic of other pandemics; people with no or light symptoms seem to have had a strong initial immune response and are producing antibodies to COVID-19. Here is a COVID-19 immunological case study of a mild infection, which concludes:</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">“our study indicates that robust multi-factorial immune responses can be elicited to the newly emerged virus SARS-CoV-2 and, similar to the avian H7N9 disease, early adaptive immune responses might correlate with better clinical outcomes.“</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><a href="https://www.nature.com/articles/s41591-020-0819-2.pdf">https://www.nature.com/articles/s41591-020-0819-2.pdf</a></span><br />
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<span style="font-family: "times" , "times new roman" , serif; font-size: large;">In humans, we can test whether a compound (or organism) improves the recognition of new pathogens by giving it with a vaccine.<br />Consistently, acetaminophen (tylenol, paracetamol) suppresses this function in infants. <br /><span style="line-height: 107%;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/19837254">https://www.ncbi.nlm.nih.gov/pubmed/19837254</a></span></span><span style="font-family: "times" , "times new roman" , serif; font-size: large;">Effects are dose- and drug-dependent - low-dose aspirin doesn't impair immunity in elderly given flu vaccine, ibuprofen doesn't impair it compared with paracetamol in infants.</span><span style="font-family: "times" , "times new roman" , serif; font-size: large;"><span style="line-height: 107%;"><br /></span>Probiotics enhance it.<br /><a href="https://www.sciencedirect.com/science/article/pii/S0264410X17311672">https://www.sciencedirect.com/science/article/pii/S0264410X17311672</a><br /><br />We know that probiotics enhance the immune response in vaccinated infants, but we can't take those infants and then expose them to the disease to learn how significant this is - herd immunity means that the risk is low in a vaccinated population even for people whose vaccines didn't work. We can however do this in animals.<br />Here's an experiment where zebrafish were vaccinated against a bacterial pathogen, Flavobacterium columnare, then bathed in said pathogen, with varying amounts of echinacea purpurea in their diets.<br />It's a tough test with, you might think, little possibility of a placebo effect.<br />The first point is that this vaccine doesn't really work. Only 5% of vaccinated fish are surviving exposure to Flavobacterium columnare. But add the echinacea to their feed, and we see survival climb dose-dependently. 5g echinacea per Kg is the same as none - 5% survival. 10g/Kg = 6%. 20g/Kg = 30%. 30g/Kg = 36%.<br /><a href="https://www.ncbi.nlm.nih.gov/pubmed/25638970">https://www.ncbi.nlm.nih.gov/pubmed/25638970</a><br />That link is down at sci-hub, so here is a similar study by the same team - without the vaccine.<br /><a href="https://www.researchgate.net/publication/230257632_Effect_of_Echinacea_purpurea_on_growth_and_survival_of_guppy_Poecilia_reticulata_challenged_with_Aeromonas_bestiarum">https://www.researchgate.net/publication/230257632_Effect_of_Echinacea_purpurea_on_growth_and_survival_of_guppy_Poecilia_reticulata_challenged_with_Aeromonas_bestiarum</a><br /><br />You're not going to get ethics approval to try this in humans, so make of this what you can. Firstly, why echinacea? The active ingredient is a polysaccharide, and it likely activates a variety of TLR and NOD receptors much as pathogen lipopolysaccharides do. <br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140398/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140398/</a><br />Similarly with probiotic cell wall lysates. A company I worked for tested a lysate from a lactobacillus rhamnosus strain many years ago and found it had ligand activity at TLRs 2,4,7,9, and NOD2, which latter is a gamma-interferon pathway.<br />This is going to enhance the response to a pathogen, which relies on you recognising quickly that it IS a pathogen via PAMPs and DAMPs (q.v.), a signal which compounds with such activity are amplifying.<br />This is well-known in human vaccine research - such compounds are called <a href="http://www.iayork.com/MysteryRays/2008/06/19/adjuvants-quality-as-well-as-quantity/" target="_blank">adjuvants</a> and play a poorly-understood role in establishing immunodominance (the identification and proliferation of the "right" antibody-producing (B, Th2) immune cell).<br /><br />Another commonly used herbal supplement, andrographis, has similar adjuvant effects given with vaccines in animal experiments<br /><a href="https://www.ncbi.nlm.nih.gov/pubmed/17321475">https://www.ncbi.nlm.nih.gov/pubmed/17321475</a>.<br /><br />Elderberry has AFAIK not been tested as an adjuvant but has direct antiviral effects in mice exposed to human influenza A.</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><a href="https://pdfs.semanticscholar.org/8850/575f0665e98360dc6386ad828e66f573d270.pdf">https://pdfs.semanticscholar.org/8850/575f0665e98360dc6386ad828e66f573d270.pdf</a><br /><br />So what is the human evidence? Elderberry (sambucus) is effective for seasonal URT infections in a meta-analysis. The studies only add up to n=180, but the effect is large and consistent (you don't need a high-powered study when something has a decent effect - we're not counting crumbs here, there's a loaf on the table). <br /><a href="https://www.ncbi.nlm.nih.gov/pubmed/30670267">https://www.ncbi.nlm.nih.gov/pubmed/30670267</a><br /><br />This is likely due to cytokine effects, and some people might ask "what about cytokine storm?"<br /><a href="https://pubmed.ncbi.nlm.nih.gov/11399518/">https://pubmed.ncbi.nlm.nih.gov/11399518/</a><br /><br />Cytokines early in infection are the immune system's alert response. If viral levels are controlled early, there is a lower risk of cytokine storm. <br />The analogy here is the phase one insulin response, which, if inadequate to manage glucose levels, may be followed by an exaggerated and hyperinsulinaemic phase 2 response.<br />There is some question as to whether COVID-19 mortality is really due to cytokine storm, as in SARS or swine flu, or due to a direct effect of the virus on the lung, where cells producing pulmonary surfactant (Type II alveolar epithelial cells) are damaged by the virus and reduce normal lung function.<br /><br />Andrographis is effective for reducing cough.<br /><a href="https://www.karger.com/Article/FullText/442111">https://www.karger.com/Article/FullText/442111</a><br />It has an opposite effect on TNF-alpha from sambucus, so if you are worried that sambucus is too inflammatory use a combined supplement, in my experience these are effective enough for easing the misery and shortening the course of the usual cold and flu.<br /><a href="https://www.ncbi.nlm.nih.gov/pubmed/22026410">https://www.ncbi.nlm.nih.gov/pubmed/22026410</a><br /><br />An AI-type analysis of data found that andrographis suppressed ACE2 expression most; sambucus and the TCM staple astragalus (another adjuvant) were also on the list.<br /><a href="https://www.preprints.org/manuscript/202002.0047/v1">https://www.preprints.org/manuscript/202002.0047/v1</a><br /><br />Now, you may not want ACE2 suppressed if you are in extremis. It is a normal feature of lung function, and vitamin D supplementation (25 ug/Kg) increases ACE2 expression but prevents LPS-induced lung injury in this Wistar rat example.<br /><a href="https://www.researchgate.net/publication/316630691_Effect_of_Vitamin_D_on_ACE2_and_Vitamin_D_receptor_expression_in_rats_with_LPS-induced_acute_lung_injury">https://www.researchgate.net/publication/316630691_Effect_of_Vitamin_D_on_ACE2_and_Vitamin_D_receptor_expression_in_rats_with_LPS-induced_acute_lung_injury</a><br />The jury is very much still out on ACE inhibitors (which may increase ACE2 expression) and risk.<br /><a href="https://jamanetwork.com/journals/jama/fullarticle/2763803">https://jamanetwork.com/journals/jama/fullarticle/2763803</a><br /><br />However - if you use these medicines, the idea is to use them around exposure, or PRN for symptoms, as advised. If they work, the disease will be less serious, if they don't and you do experience pneumonia you're not going to be taking them in the ICU.<br />Never keep taking something that makes you feel worse.<br /><br />Interestingly, echinacea, which is a star in the animal studies, has only weak effects in human trials.<br /><a href="https://www.ncbi.nlm.nih.gov/pubmed/24554461">https://www.ncbi.nlm.nih.gov/pubmed/24554461</a><br />Yet these studies were just as small and had the same potential for bias as the elderberry and andrographis trials. That quite distinct effects or strength of effect appears consistently when different compounds are tested answers the specificity test of a Bradford Hill analysis of the "immune boosting" question. In fact every Bradford Hill criteria is being well-met, whatever the limitations of the human research.<br /><br />The weak effects of echinacea may be due to its relative fragility and variation as an extract, inadequate dosage, or to the timing of its use as a prophylactic. I use these extracts only when I am either obviously exposed, "coming down with something", or actually sick. My opinion, not necessarily what the science says and just the voice of experience, is that echinacea and elderberry, if good extracts in adequate doses, both work if taken soon enough (elderberry was very effective taken within 24 hours in the swine flu but had no effect when given more than 48 hours after symptoms started). Perhaps echinacea is better for colds and sambucus for flus, but even if that were true COVID-19 is not necessarily playing by all rules. I also use Sanderson's <a href="https://www.sandersonvitamins.co.nz/products/1-a-day-viramax-tablets" target="_blank">Viramax</a>, a mixed supplement of sambucus, andrographis, echinacea and olive leaf extract when I'm sick for PRN symptom relief, on the basis of past satisfaction with its effects. There is some evidence for olive leaf extract, but the active ingredient seems to be found in extra virgin olive oil.<br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6412187/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6412187/</a></span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;"><br />Apart from herbs and probiotics, what else is there evidence for?<br /><br />Malnutrition impairs antibody production, obviously, so eat a sensible diet that includes minimally processed animal products, including meat, if you're skeptical about supplements.<br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033455/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033455/</a><br /><br />Apart from that, it's well worth supplementing selenium (by Brazil nuts or supplements). A pre-2019 coronavirus encoded for 60 selenocysteine residues per core protein. This is a common viral adaptation and protects the stability of the viral genome (a good thing) while depressing host immunity (a bad thing). <br /><a href="https://www.sciencedaily.com/releases/2001/06/010608081506.htm">https://www.sciencedaily.com/releases/2001/06/010608081506.htm</a><br />Wuhan, Northern Italy, the UK and NZ are all low-selenium areas where deficiency is common. Check the data for your region or county, which is usually available online.<br /><br />The jury's still out on supplementary vitamin C, and I seemed to stop responding to it when my metabolic health improved, but it's cheap and can't hurt.<br />Update: high dose vitamin C is being used in New York hospitals.<br /><a href="https://www.dailymail.co.uk/news/article-8149191/New-York-hospitals-treating-corona-patients-6000-milligrams-VITAMIN-C.html">https://www.dailymail.co.uk/news/article-8149191/New-York-hospitals-treating-corona-patients-6000-milligrams-VITAMIN-C.html</a><br />It's the end of winter in the Northern hemisphere so I'd be supplementing vitamin D3 if I lived there.</span><br />
<span style="font-family: "times" , "times new roman" , serif; font-size: large;">Inorganic zinc lozenges (especially zinc acetate) seem to have a role to play here, but may be a lot of trouble to maintain for the duration. It might be worth it depending on your level of risk, as the effect is strong enough.<br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5418896/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5418896/</a><br /><br />The spread and virulence of viral infections is in large part a numbers game. Needlestick exposures to HCV had a higher clearance rate than exposures to contaminated blood transfusions. Every line of defense matters, and every proven or even just most-likely barrier to the pathogen establishing dominance over the immune system can be worth investment.<br /></span><br />
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<br />Unknownnoreply@blogger.com8tag:blogger.com,1999:blog-8550919611653842066.post-65374365726106794302020-03-10T12:32:00.002-07:002021-04-13T19:23:33.465-07:00The Official COVID-19 protocol from Shanghai, China, in English<span style="font-size: large;">This detailed protocol, which appeared online last week on an official Chinese Govt website, includes high-dose Vitamin C within the SOC drug recommendations. So far, when this has been pointed out to anyone in the "evidence-based medicine" community who has been busy online dismissing nutrient protocols for viral illnesses, they have pretended not to notice. Nor does there seem to be any reporting or discussion in the western mainstream media.<br />What about prophylaxis? The blood concentrations of vitamin C from IV use are higher than we can get from oral dosing.<br />I think, if you read the Cochrane reviews of vitamin C for the common cold or pneumonia, there is a clinically significant advantage in high-risk subcategories (people stressed by cold or rigorous exercise for cold, seriously ill elderly for pneumonia). There is heterogeneity in exposure methods, some of which will replicate natural coronavirus exposure better than others. And the general advantages - reduced symptoms and duration - are reductions in COVID-19 transmission factors that could have a meaningful impact at a population level. Read them closely, don't just look for the first limitation that you think might allow you to dismiss a whole body of evidence.<br /><a href="https://www.ncbi.nlm.nih.gov/pubmed/23925826/">https://www.ncbi.nlm.nih.gov/pubmed/23925826/</a><br /><a href="https://www.ncbi.nlm.nih.gov/pubmed/23440782">https://www.ncbi.nlm.nih.gov/pubmed/23440782</a><br />"Nevertheless, given the consistent effect of vitamin C on the duration and severity of colds in the regular supplementation studies, and the low cost and safety, it may be worthwhile for common cold patients to test on an individual basis whether therapeutic vitamin C is beneficial for them."<br /><br />If you disagree that EBM, for a lot of proponents, stands for emotionally biased medicine, consider this: New Zealand has had to ration acetaminophen (Panadol, Tylenol) prescriptions due to a run on pharmacy stocks.<br />There is no human RCT of the safety of acetaminophen in pneumonia (we know vitamin C is safe from the Cochrane review), but antipyretics, including acetaminophen, cause a 37% increased risk of mortality in animal models.<br /><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951171/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951171/</a><br />Yet there is no EBM push online to warn about this and to mock the people buying or prescribing antipyretics.<br />EBM - it ought to be essential, it's lovely in theory, yet it seems to be toxic at the level of science communication.<br /><br />I can't tell you what to do, but here's what I'm doing, besides all the washing and contact common sense stuff - I'm making sure I'm replete in selenium, zinc, retinol, and vitamin D. I'm taking 500mg vitamin C a day. If I start to get ill, I'll take a standardised elderberry extract and a standardised andrographis extract. I may increase the dose of vitamin C.<br /><br /><br /><br />The Shanghai Protocol, from <a href="https://mp.weixin.qq.com/s/bF2YhJKiOfe1yimBc4XwOA">https://mp.weixin.qq.com/s/bF2YhJKiOfe1yimBc4XwOA</a><br /><br /><br />[Editor's note] </span><br />
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<span style="font-size: large;">On March 1st, the Chinese Journal of Infectious Diseases, which was hosted by the Shanghai Medical Association, pre-published the "Expert Consensus on Comprehensive Treatment of Coronavirus in Shanghai 2019" (http://rs.yiigle.com/m/yufabiao/1183266 .htm), which has attracted widespread attention in the industry. Shanghai TV also reported on the news last night. This consensus was reached by 30 experts representing the strongest medical force in the treatment of new-type coronavirus pneumonia in Shanghai. Through the research and summary of more than 300 clinical patients, and fully drawing on the treatment experience of colleagues at home and abroad, the "Shanghai Plan" was finally formed. At the end of the article, the list of 30 subject experts (18 writing experts and 12 consulting experts) from various medical institutions in Shanghai is attached.</span><br />
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<span style="font-size: large;">Corona virus disease 2019 (COVID-19) was first reported on December 31, 2019 in Wuhan, Hubei Province. COVID-19, as a respiratory infectious disease, has been included in the Class B infectious diseases stipulated in the Law of the People's Republic of China on the Prevention and Control of Infectious Diseases and managed as a Class A infectious disease.</span><br />
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<span style="font-size: large;">With the deepening of understanding of the disease, COVID-19 has accumulated a certain amount of experience in the prevention and control of COVID-19. The Shanghai New Coronary Virus Disease Clinical Treatment Expert Group follows the National New Coronary Virus Pneumonia Diagnosis and Treatment Program and fully draws on the treatment experience of colleagues at home and abroad to improve the success rate of clinical treatment and reduce the mortality rate of patients, prevent the progress of the disease, and gradually reduce the disease The proportion of patients with severe disease improves their clinical prognosis. Based on the continuous optimization and refinement of the treatment plan, expert consensus has been formed on the relevant clinical diagnosis and treatment.</span><br />
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<span style="font-size: large;">I. Etiology and epidemiological characteristics</span><br />
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<span style="font-size: large;">2019 novel coronavirus (2019-nCoV) is a new coronavirus belonging to the genus β. On February 11, 2020, the International Committee on Taxonomy of Viruses (ICTV) named the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients with COVID-19 and asymptomatic infection can transmit 2019-nCoV. Respiratory droplet transmission is the main route of transmission and can also be transmitted through contact. There is also the risk of aerosol transmission in confined enclosed spaces. COVID-19 patients can detect 2019-nCoV in stool, urine, and blood; some patients can still test positive for fecal pathogenic nucleic acid after the pathogenic nucleic acid test of respiratory specimens is negative. The crowd is generally susceptible. Children, infants, and young children also develop disease, but the condition is relatively mild.</span><br />
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<span style="font-size: large;">Clinical characteristics and diagnosis</span><br />
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<span style="font-size: large;">(A) clinical characteristics</span><br />
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<span style="font-size: large;">The incubation period is 1 to 14 d, mostly 3 to 7 d, with an average of 6.4 d. Main symptoms are fever, fatigue, and dry cough. May be accompanied by runny nose, sore throat, chest tightness, vomiting and diarrhea. Some patients have mild symptoms, and a few patients have no symptoms or pneumonia.</span><br />
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<span style="font-size: large;">The elderly and those suffering from basic diseases such as diabetes, hypertension, coronary atherosclerotic heart disease, and extreme obesity tend to develop severe illness after infection. Some patients develop symptoms such as dyspnea within 1 week after the onset of the disease. In severe cases, they can progress to acute respiratory distress syndrome (ARDS) and multiple organ dysfunction. The time to progression to severe illness was approximately 8.5 days. It is worth noting that in the course of severe and critically ill patients, there may be moderate to low fever, even without obvious fever. Most patients have a good prognosis, and deaths are more common in the elderly and those with chronic underlying disease.</span><br />
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<span style="font-size: large;">The early CT examination showed multiple small patches or ground glass shadows, and the internal texture of the CT scans was thickened in the form of grid cables, which was obvious in the outer lung zone. A few days later, the lesions increased and the scope expanded, showing extensive lungs, multiple ground glass shadows, or infiltrating lesions, some of which showed consolidation of the lungs, often with bronchial inflation signs, and pleural effusions were rare. A small number of patients progressed rapidly, with imaging changes reaching a peak on days 7 to 10 of the course. Typical "white lung" performance is rare. After entering the recovery period, the lesions are reduced, the scope is narrowed, the exudative lesions are absorbed, part of the fiber cable shadow appears, and some patients' lesions can be completely absorbed.</span><br />
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<span style="font-size: large;">In the early stage of the disease, the total number of white blood cells in the peripheral blood was normal or decreased, and the lymphocyte count was reduced. Some patients may have abnormal liver function, and the levels of lactate dehydrogenase, muscle enzyme, and myoglobin may increase; troponin levels may be increased. Most patients had elevated CRP and ESR levels and normal procalcitonin levels. In severe cases, D-dimer levels are elevated, other coagulation indicators are abnormal, lactic acid levels are elevated, peripheral blood lymphocytes and CD4 + T lymphocytes are progressively reduced, and electrolyte disorders and acid-base imbalances are caused by metabolic alkalosis See more. Elevated levels of inflammatory cytokines (such as IL-6, IL-8, etc.) may occur during the disease progression stage.</span><br />
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<span style="font-size: large;">(Two) diagnostic criteria</span><br />
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<span style="font-size: large;">1. Suspected case: Combined with the following epidemiological history and clinical manifestations. Suspected cases were diagnosed as having any one of epidemiological history and meeting any two of the clinical manifestations, or having no clear epidemiological history but meeting three of the clinical manifestations. ① Epidemiological history: travel history or residence history of Wuhan City and surrounding areas, or other communities with case reports within 14 days before the onset; history of contact with 2019-nCoV infection (positive nucleic acid test) within 14 days before the onset ; Patients with fever or respiratory symptoms from Wuhan and surrounding areas or from communities with case reports within 14 days before the onset of the disease; cluster onset. ② Clinical manifestations: fever and / or respiratory symptoms; with the above-mentioned imaging features of the new coronavirus pneumonia; the total number of white blood cells is normal or decreased in the early stage of onset, and the lymphocyte count is reduced.</span><br />
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<span style="font-size: large;">2. Confirmed cases: Those with one of the following etiology evidence are diagnosed as confirmed cases. ① Real-time fluorescent reverse transcription PCR detected 2019-nCoV nucleic acid positive. ② Viral gene sequencing revealed high homology with the known 2019-nCoV. ③ Except for nasopharyngeal swabs, take sputum as much as possible. Patients undergoing tracheal intubation can collect lower respiratory tract secretions and send viral nucleic acid test positive.</span><br />
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<span style="font-size: large;">(Three) differential diagnosis</span><br />
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<span style="font-size: large;">It is mainly distinguished from other known viral pneumonias such as influenza virus, parainfluenza virus, adenovirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, severe acute respiratory syndrome (SARS) coronavirus, etc. , Different from Mycoplasma pneumoniae, Chlamydia pneumonia and bacterial pneumonia. In addition, it must be distinguished from non-infectious diseases such as pulmonary interstitial lesions and organizing pneumonia caused by connective tissue diseases such as vasculitis and dermatomyositis.</span><br />
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<span style="font-size: large;">(Four) clinical classification</span><br />
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<span style="font-size: large;">1. Mild: The clinical symptoms are slight, and no pneumonia manifestations on imaging examination.</span><br />
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<span style="font-size: large;">2. Ordinary type: fever, respiratory tract symptoms, etc. Pneumonia manifestations on imaging examination.</span><br />
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<span style="font-size: large;">Early warning of severe cases of common patients should be strengthened. Based on current clinical studies, elderly (aged> 65 years) with underlying diseases, CD4 + T lymphocyte count <250 2="" 3="" and="" blood="" days="" found="" il-6="" imaging="" increased="" lesions="" levels="" lung="" on="" progress="" significant="" significantly="" to="" were="">50 %, lactic dehydrogenase (LDH)> 2 times the upper limit of normal value, blood lactic acid ≥ 3 mmol / L, metabolic alkalosis, etc. are all early warning indicators of severe disease.</250></span><br />
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<span style="font-size: large;">3. Heavy: Any one of the following. ① Shortness of breath, respiratory rate ≥ 30 times / min; ② In resting state, arterial oxygen saturation (SaO2) ≤ 93%; ③ arterial partial pressure of oxygen, PaO2) / fraction of inspired oxygen (FiO2) ≤ 300 mmHg (1 mmHg = 0.133 kPa). At high altitudes (above 1 000 m), PaO2 / FiO2 should be corrected according to the following formula: PaO2 / FiO2 × [Atmospheric Pressure (mmHg) / 760].</span><br />
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<span style="font-size: large;">Pulmonary imaging examination showed that the lesions progressed significantly within 24 to 48 hours, and those with more than 50% of the lesions were managed as severe.</span><br />
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<span style="font-size: large;">4. Dangerous: A person who meets any of the following conditions can be judged as critical. ① Respiratory failure occurs and requires mechanical ventilation; ② Shock occurs; ③ Combined with other organ failure, ICU monitoring and treatment is required.</span><br />
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<span style="font-size: large;">(5) Clinical monitoring</span><br />
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<span style="font-size: large;">The patient's clinical manifestations, vital signs, fluid volume, gastrointestinal function and mental state are monitored daily.</span><br />
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<span style="font-size: large;">All patients were dynamically monitored for terminal blood oxygen saturation. For critically ill and critically ill patients, timely blood gas analysis is performed according to the changes in the condition; blood routine, electrolytes, CRP, procalcitonin, LDH, blood coagulation function indicators, blood lactic acid, etc. are tested at least once every 2 days; liver function, kidney function , ESR, IL-6, IL-8, lymphocyte subsets, at least once every 3 days; chest imaging examination, usually every 2 days. For patients with ARDS, routine ultrasound examination of the heart and lungs at the bedside is recommended to observe extravascular lung water and cardiac parameters. For monitoring of extracorporeal membrane oxygenation (ECMO) patients, refer to the implementation section of ECMO.</span><br />
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<span style="font-size: large;">Treatment plan</span><br />
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<span style="font-size: large;">(A) antiviral treatment</span><br />
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<span style="font-size: large;">You can try hydroxychloroquine sulfate or chloroquine phosphate, or Abidol for oral administration, interferon nebulization and inhalation, interferon κ is preferred, and interferon α recommended by the national scheme can also be applied. It is not recommended to use 3 or more antivirals at the same time. The viral nucleic acid should be stopped in time after it becomes negative. The efficacy of all antiviral drugs remains to be evaluated in further clinical studies.</span><br />
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<span style="font-size: large;">For patients with severe and critical viral nucleic acid positives, recovery patients can be tested for recovery plasma. For detailed operation and management of adverse reactions, please refer to the "Clinical Treatment Program for Recovery of New Coronary Pneumonia Patients During Recovery Period" (trial version 1). Infusion within 14 days of the onset may be more effective. If the viral nucleic acid is continuously detected at the later stage of the disease, the recovery period of plasma treatment can also be tried.</span><br />
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<span style="font-size: large;">(Two) treatment of light and ordinary patients</span><br />
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<span style="font-size: large;">Supportive treatment needs to be strengthened to ensure sufficient heat; pay attention to water and electrolyte balance to maintain internal environment stability; closely monitor patient vital signs and finger oxygen saturation. Give effective oxygen therapy in time. Antibacterials and glucocorticoids are not used in principle. The patient's condition needs to be closely monitored. If the disease progresses significantly and there is a risk of turning into severe, it is recommended to take comprehensive measures to prevent the disease from progressing to severe. Low-dose short-course glucocorticoids can be used with caution (see the application section of glucocorticoids for specific protocols) ). Heparin anticoagulation and high-dose vitamin C are recommended. Low-molecular-weight heparin 1 to 2 per day, continued until the patient's D-dimer level returned to normal. Once fibrinogen degradation product (FDP) ≥10 µg / mL and / or D-dimer ≥5 μg / mL, switch to unfractionated heparin. Vitamin C is administered at a dose of 50 to 100 mg / kg per day, and the continuous use time is aimed at a significant improvement in the oxygenation index. If lung lesions progress, it is recommended to apply a large-dose broad-spectrum protease inhibitor, ulinastatin, at 600 to 1 million units / day until the pulmonary imaging examination improves. In the event of a "cytokine storm", intermittent short veno-venuous hemofiltration (ISVVH) is recommended.</span><br />
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<span style="font-size: large;">(III) Organ function supportive treatment for severe and critically ill patients</span><br />
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<span style="font-size: large;">1. Protection and maintenance of circulatory function: implement the principle of early active controlled fluid replacement. It is recommended to evaluate the effective volume and initiate fluid therapy as soon as possible after admission. Severe patients can choose intravenous or transcolonic fluid resuscitation depending on the conditions. The preferred supplement is lactated Ringer's solution. Regarding vasoactive drugs, noradrenaline and dopamine are recommended to maintain vascular tone and increase cardiac output. For patients with shock, norepinephrine is the first choice. It is recommended to start low-dose vasoactive drugs at the same time as fluid resuscitation to maintain circulation stability and avoid excessive fluid infusion. Cardioprotective drugs are recommended for severe and critically ill patients, and sedative drugs that inhibit the heart are avoided as much as possible. For patients with sinus bradycardia, isoprenaline can be used. For patients with sinus rhythm, a heart rate of <50 80="" about="" and="" at="" beats="" dopamine="" font="" heart="" hemodynamic="" instability="" intravenous="" is="" isoproterenol="" low-dose="" maintain="" min.="" min="" of="" or="" pumping="" rate="" recommended="" the="" to=""></50></span><br />
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<span style="font-size: large;">2. Reduce pulmonary interstitial inflammation: 2019-nCoV leads to severe pulmonary interstitial lesions that can cause pulmonary function deterioration. It is recommended to use a large dose of a broad-spectrum protease inhibitor ulinastatin.</span><br />
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<span style="font-size: large;">3. Protection of renal function: Reasonable anticoagulant therapy and appropriate fluid therapy are recommended as soon as possible. See chapter "Cytokine storm" for prevention, protection and maintenance of circulatory function.</span><br />
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<span style="font-size: large;">4. Protection of intestinal function: Prebiotics can be used to improve the intestinal microecology of patients. Use raw rhubarb (15-20 g plus 150 ml warm boiling water) or Dachengqi decoction for oral administration or enema.</span><br />
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<span style="font-size: large;">5. Nutritional support: parenteral nutrition is preferred, via nasal feeding or via jejunum. The whole protein nutrient preparation is preferred, and the energy is 25 to 35 kcal / kg (1 kcal = 4.184 kJ) per day.</span><br />
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<span style="font-size: large;">6. Prevention and treatment of cytokine storm: It is recommended to use large doses of vitamin C and unfractionated heparin. Large doses of vitamin C are injected intravenously at a dose of 100 to 200 mg / kg per day. The duration of continuous use is to significantly improve the oxygenation index. It is recommended to use large doses. Dose of the broad-spectrum protease inhibitor ulinastatin, given 1.6 million units, once every 8 h, under mechanical ventilation, when the oxygenation index> 300 mmHg can be reduced to 1 million units / d. Anticoagulation The treatment protects endothelial cells and reduces the release of cytokines. When FDP ≥ 10 µg / mL and / or D-dimer ≥ 5 μg / mL, anticoagulation is given to unfractionated heparin (3 to 15 IU / kg per hour). Heparin is used for the first time. The patient's coagulation function and platelets must be re-examined 4 h later. ISVVH is used for 6 to 10 h every day.</span><br />
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<span style="font-size: large;">7. Sedation and artificial hibernation: Patients undergoing mechanical ventilation or receiving ECMO need to be sedated on the basis of analgesia. For patients with severe man-machine confrontation during the establishment of an artificial airway, short-term application of low-dose muscle relaxants is recommended. Hibernation therapy is recommended for severe patients with oxygenation index < 200 mmHg. Artificial hibernation therapy can reduce the body's metabolism and oxygen consumption, and at the same time dilate the pulmonary blood vessels to significantly improve oxygenation. It is recommended to use continuous intravenous bolus medication, and the patient's blood pressure should be closely monitored. Use opioids and dexmedetomidine with caution. Because severely ill patients often have elevated IL-6 levels and easily cause abdominal distension, opioids should be avoided; 2019-nCoV can still inhibit sinus node function and cause sinus bradycardia, so it should be used with caution on Inhibitory sedatives. In order to prevent the occurrence and exacerbation of lung infections, and to avoid prolonged excessive sedation, try to withdraw muscle relaxants as soon as possible. It is recommended to monitor the depth of sedation closely.</span><br />
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<span style="font-size: large;">8. Oxygen therapy and respiratory support: ① nasal cannula or mask oxygen therapy, SaO2 ≤93% under resting air condition, or SaO2 < 90% after activity, or oxygenation index (PaO2 / FiO2) 200-300 mmHg; With or without respiratory distress; continuous oxygen therapy is recommended. ② High-flow nasal cannula oxygen therapy (HFNC), receiving nasal cannula or mask oxygen therapy for 1-2 hours, oxygenation fails to meet treatment requirements, and respiratory distress does not improve; or hypoxemia during treatment And / or exacerbation of respiratory distress; or an oxygenation index of 150 to 200 mmHg; HFNC is recommended. ③ Noninvasive positive pressure ventilation (NPPV), receiving 1 to 2 h of HFNC oxygenation does not achieve the treatment effect, and there is no improvement in respiratory distress; or hypoxemia and / or exacerbation of respiratory distress during treatment; or When the oxygenation index is 150 ~ 200 mmHg; NPPV can be selected. ④ Invasive mechanical ventilation, HFNC or NPPV treatment does not meet the treatment requirements for 1 to 2 hours of oxygenation, and respiratory distress does not improve; or hypoxemia and / or exacerbation of respiratory distress during treatment; or oxygenation index <150 a="" are="" as="" be="" body="" considered.="" core="" font="" ideal="" invasive="" kg="" mass="" ml="" mmhg="" preferred.="" protective="" should="" small="" strategies="" the="" tidal="" ventilation="" volume="" with=""></150></span><br />
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<span style="font-size: large;">9. Implementation of ECMO: Those who meet one of the following conditions may consider implementing ECMO. ① PaO2 / FiO2 < 50 mmHg for more than 1 h; ② PaO2 / FiO2 < 80 mmHg for more than 2 h; ③ Arterial blood pH < 7.25 with PaCO2 > 60 mmHg for more than 6 h. ECMO mode is preferred for intravenous-venous ECMO.</span><br />
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<span style="font-size: large;">(4) Special problems and treatment in treatment</span><br />
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<span style="font-size: large;">1. Application of glucocorticoids: Use glucocorticoids with caution. Imaging showed significant progress in pneumonia. Patients with SaO2 ≤ 93% or shortness of breath (respiratory frequency ≥ 30 breaths / min) or oxygenation index ≤ 300 mmHg in the state of no oxygen inhalation. Glucocorticoids can be added at the risk of intubation. Patients are advised to withdraw promptly from glucocorticoid use when intubation or ECMO support can maintain effective blood oxygen concentrations. For non-severe patients using methylprednisolone, the recommended dose is controlled at 20 to 40 mg / d, severe patients are controlled at 40 to 80 mg / d, and the course of treatment is generally 3 to 6 days. Can be increased or decreased according to the body weight.</span><br />
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<span style="font-size: large;">2. Use of immunoregulatory drugs: Subcutaneous injection of thymosin 2 to 3 times per week has certain effects on improving patients' immune function, preventing the disease from becoming worse, and shortening the time of detoxification. Due to the lack of specific antibodies, high-dose intravenous immunoglobulin therapy is currently not supported. However, some patients have low levels of lymphocytes and the risk of co-infection with other viruses. Human immunoglobulin can be infused intravenously at 10 g / d for 3 to 5 days.</span><br />
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<span style="font-size: large;">3. Accurate diagnosis and treatment of combined bacterial and fungal infections: clinical microbiological monitoring of all severe and critically ill patients. The sputum and urine of the patients are kept daily for culture, and the patients with high fever should be cultured in time. All patients with suspected sepsis who have indwelling vascular catheters should be sent for peripheral venous blood culture and catheter blood culture at the same time. All patients with suspected sepsis may consider collecting peripheral blood for molecular diagnostic tests for etiology, including PCR-based molecular biology testing and next-generation sequencing.</span><br />
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<span style="font-size: large;">Elevated procalcitonin levels have implications for the diagnosis of sepsis / septic shock. When patients with new type of coronavirus pneumonia get worse, there is an increase in the level of CRP, which is not specific for the diagnosis of sepsis caused by bacterial and fungal infections.</span><br />
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<span style="font-size: large;">Critically ill patients with open airways are often prone to bacterial and fungal infections at a later stage. If sepsis occurs, empirical anti-infective treatment should be given as soon as possible. For patients with septic shock, empirical antibacterial drugs can be used in combination before obtaining an etiological diagnosis, while covering the most common Enterobacteriaceae, Staphylococcus and Enterococcus infections. Patients with infection after hospitalization can choose β-lactamase inhibitor complex. If the treatment effect is not good, or the patient has severe septic shock, it can be replaced with carbapenem drugs. If considering enterococci and staphylococcal infections, glycopeptide drugs (vancomycin) can be added for empirical treatment. Daptomycin can be used for bloodstream infections, and linezolid can be used for lung infections. Attention should be paid to catheter-related infections in critically ill patients, and treatment should be empirically covered with methicillin-resistant staphylococci. Glycopeptide drugs (vancomycin) can be used for empirical treatment. Candida infection is also more common in critically ill patients. Candida should be covered empirically when necessary. Echinocin drugs can be added. With the length of hospitalization of critically ill patients, drug-resistant infections have gradually increased. At this time, the use of antibacterial drugs must be adjusted according to drug sensitivity tests.</span><br />
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<span style="font-size: large;">4. Nosocomial infection prevention and control: ① In accordance with the Basic System for Infection Prevention and Control of Medical Institutions (Trial) of the National Health and Health Commission in 2019, actively implement evidence-based infection prevention and control clustering intervention strategies to effectively prevent ventilator-related pneumonia and intravascular Multidrug-resistant bacteria and fungal infections such as catheter-related bloodstream infections, catheter-related urinary tract infections, carbapenem-resistant gram-negative bacilli. ② Strictly follow the National Health and Health Commission's "Technical Guide for the Prevention and Control of New Coronavirus Infection in Medical Institutions (First Edition)", "Guidelines for the Use of Common Medical Protective Products in the Prevention and Control of Pneumonitis Due to New Coronavirus (Trial)" During the epidemic period, the technical guidelines for protection of medical personnel (trial implementation), strengthened process management, correctly selected and used personal protective equipment such as masks, gowns, protective clothing, eye masks, protective masks, gloves, and strict implementation of various disinfection and isolation measures Minimize the risk of nosocomial infections and prevent 2019-nCoV infections in hospitals by medical staff.</span><br />
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<span style="font-size: large;">5. Treatment of infants and young children: Only mild symptomatic oral treatment is needed for mild children. In addition to symptomatic oral administration for children with common type, treatment with syndrome differentiation can be considered. If combined with bacterial infection, antibacterial drugs can be added. Severely ill children are mainly symptomatic and supportive treatment. Ribavirin injection was given antiviral therapy empirically at 15 mg / kg (2 times / day). The course of treatment did not exceed 5 days.</span><br />
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<span style="font-size: large;">(V) Treatment plan of integrated traditional Chinese and western medicine</span><br />
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<span style="font-size: large;">The combination of traditional Chinese and western medicine for the treatment of new coronavirus pneumonia can improve the synergistic effect. For adult patients, the condition can be improved through TCM syndrome differentiation. For light patients, those with a syndrome of wind-heat type are given the traditional Chinese medicine Yinqiaosan plus and minus treatment; those with gastrointestinal symptoms and those with damp-wetting and yang-type syndrome are given the addition and subtraction of Zhipu Xialing Decoction and Sanren Decoction. For ordinary patients, those with syndromes of hot and evil stagnation of lungs can be treated with Chinese medicine Ma Xing Shi Gan Decoction; those with syndromes of dampness and stagnation of lungs can be treated with traditional Chinese medicine Da Yuan Yin, Gan Lu Fang Dan, etc., which can be controlled to some extent Progression of the disease, reducing the occurrence of common to severe; for anorexia, nausea, bloating, fatigue, anxiety and insomnia, the addition and subtraction of Chinese medicine Xiao Chai Hu Tang can significantly improve symptoms. For severe patients, if the fever persists, or even the high fever, bloating, and dry stools are closed, and those who are heat-tolerant and the lungs are closed, give the Chinese medicine Dachengqi Decoction enema to relieve fever or reduce fever, or use Chinese medicine. The treatment of Baihu Decoction, Shengjiang San and Xuanbai Chengqi Decoction were added and subtracted to cut off the condition and reduce the occurrence of heavy to critical illness. Children with light patients, when the disease belongs to the defender, can be added or subtracted from Yinqiaosan or Xiangsusan. Ordinary children, those with damp heat and closed lungs, are given Ma Xing Shi Gan Decoction and Sanren Decoction; those with moderate scorching dampness and heat such as bloating and vomiting with abdominal distension can be added or subtracted without changing Jinzhengqi San. For severe patients with epidemic and closed lung (currently rare in the country), please refer to adult Xuanbai Chengqi Decoction and Manna Disinfection Danjiao; if the poison is hot, the gas can't pass, and the medicines are not good, the Rhubarb Decoction is given to enema for emergency.</span><br />
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<span style="font-size: large;">(6) Discharge standards</span><br />
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<span style="font-size: large;">Patients who meet the following conditions at the same time can be considered for discharge: ①The body temperature returns to normal > 3 d; ②Respiratory symptoms are significantly improved; ③ Imaging examination of the lungs shows that the acute exudative lesions are significantly improved; At least 1 d); ⑤ After the nucleic acid test of the respiratory specimen is negative, the fecal pathogen nucleic acid test is also negative; ⑥ The total disease course exceeds 2 weeks.</span><br />
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<span style="font-size: large;">(VII) Health management of discharged patients</span><br />
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<span style="font-size: large;">1. For discharged patients, close follow-up is still required. Follow-up is recommended from 2 weeks and 4 weeks after discharge to the designated follow-up clinic.</span><br />
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<span style="font-size: large;">2. When the patient is discharged from the hospital, the place of residence and address in the city should be specified.</span><br />
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<span style="font-size: large;">3. Patients should rest at home for 2 weeks after leaving the hospital, avoid activities in public places, and must wear masks when going out.</span><br />
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<span style="font-size: large;">4. According to the patient's address (including hotel or hotel), the relevant district health and health committee will organize the corresponding medical institution to do a good job of health management. Professionals will visit the patient's temperature twice a day for 2 weeks, ask their health status, and carry out related health education.</span><br />
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<span style="font-size: large;">5. If fever and / or respiratory symptoms recur, the corresponding medical institution shall report to the District Health and Health Commission and the District Centers for Disease Control and Prevention in a timely manner, and assist in sending them to the designated medical institution in the area for treatment.</span><br />
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<span style="font-size: large;">6. After receiving the report, the District Health and Health Committee and the District Centers for Disease Control and Prevention report to the superior department in a timely manner.</span>Unknownnoreply@blogger.com0