Acne: Disease of Civilization

I often focus on the bigger facets of the disease of civilization. Things like cardiovascular disease and cancer, which are major killers and the subject of intensive research. But the disease of civilization is a spectrum of disorders that affects the body in countless ways, large and small.

I recently read an interesting paper written by an all-star cast, including Loren Cordain, Staffan Lindeberg and Boyd Eaton. It's titled "Acne Vulgaris: A Disease of Western Civilization". The paper presents data from two different groups, the Kitavans of Papua New Guinea and the Ache hunter-gatherers of Paraguay. Both were systematically examined by doctors trained to diagnose acne. Out of 1,200 Kitavans and 115 Ache of all ages, not a single case of acne was observed. Hunter-gatherers and other healthy non-industrial cultures have nice skin. I dare you to find a pimple in Nutrition and Physical Degeneration.

In Western societies, acne is a fact of life. The paper states that 79 to 95% of modern adolescents suffer from some degree of acne, along with about 50% of young adults. That's an enormous difference.

The paper presents a very Cordain-esque hypothesis to explain the high incidence of acne in Western societies. In sum, they state that the Western diet causes hyperinsulinemia, which is thought to promote acne. This is due to insulin's effects on skin cell proliferation, its interference with the retinoid (vitamin A) signaling pathway, and its effect on sebum production.

They then proceed to point the finger at the glycemic index/load of the Western diet as the culprit behind hyperinsulinemia. It's an unsatisfying explanation because the Kitavans eat a diet that has a high glycemic load due to its high carbohydrate content, low fat content, and relatively high-glycemic index foods. I think the answer is more likely to reside in the specific types of carbohydrate (processed wheat) rather than their speed of digestion, with possible contributions from refined vegetable oil and an excessive sugar intake.

Puff The Magic Mushrooms

No, not a microscope image of the spaces between my toes but Lycoperdon pyriforme, a tiny version of the Giant Puff-ball so eagerly sought-after on these misty moisty mornings. I discovered this little group lining-up on a piece of rotting tree trunk on the margins of a wood next to the Clipsham Topiary Avenue in Rutland. Puff-balls are extraordinary, distributing their spores all around if gently knocked, or even if gently pattered upon by raindrops. The giant variety is supposed to release seven million million spores, which does make me wonder why I can't readily find them for my breakfast. But I suspect it may be something to do with my neighbour getting up earlier than me. As in blogs passim, I'm finding fungi more and more interesting, not as a supplement to my diet or as a way of radically altering my thought processes, but just for the way they look. They really are like alien invaders, the sinister infants of Ray Bradbury's Boys! Grow Giant Mushrooms in Your Cellars! or the 'powdery prisoners' crowding to the door in Derek Mahon's poem A Disused Shed in Co. Wexford. Right, off to chop a horse mushroom into the Sunday breakfast. I just hope it doesn't squeal as it goes into the pan.

Smoking and flu: Altogether worse for you


Hack, hack, wheeze...achoo? If you or someone you care about is a smoker, you may have noticed that flu season can be particularly trying on your health. But ever wonder why?

Researchers have long observed that smokers suffer much more from the flu and colds than nonsmokers. Symptoms that are mild in nonsmokers can make smokers very sick and even kill them. As if that wasn't scary enough, kids who breathe secondhand smoke also can become sicker when they have viral infections.

But until recently scientists didn't know why smokers have more exaggerated responses to viral infections. The most common idea was that smoking decreases a body’s ability to fight off the virus. However, it turns out the opposite might be true.

A recent study found that smokers don't get in trouble because they can't fight off the virus; they get in trouble because they overreact to it. Researchers from Yale University found that the immune systems of mice exposed to cigarette smoke (as little as two cigarettes a day for two weeks) overreacted when they were also exposed to a mimic of the flu virus. The immune systems of Mickey and his friends cleared the virus normally, but the overblown inflammation caused tissue damage, accelerated emphysema and airway scarring.

More research needs to be done to see if the same reaction is at work in humans. But until then, it's important to remember that we do know that smoking makes the symptoms of colds and flu worse. Along with all the other ways that smoking makes us sick, this is one more reason to squash that cigarette.

Photo credit: iStockphoto

Breakfast With Percy

What is it about blokes photographing their breakfasts? This blog is in response to fellow blogee Ron Combo putting his half English up yesterday, an idle shot snapped whilst I listened to Martin Jones hammering-out Percy Grainger's Dished-Up For Piano Volume 1 over my toast. I also thought it very intercontinental that he has sausages and scambled egg in hot Piedmont as I pour espressos out from my new Bialetti on a foggy autumnal morning in Leicestershire. But none of this explains the need to photograph our food. I put my Sunday breakfast as the frontispiece to More from Unmitigated England, and I once travelled all over Europe with renowned lensman Carl Warner, (who has turned food photography into art, literally), snapping detergent factories, and every morning he got his Hasselblad out to go 'Ker-chunk' over croissants, wild boar salamis and giant handle-less cups of coffee. The only eyebrows that got raised in questioning surprise were in Saffron Walden. Well, it must have seemed a bit much, even there. So Ron, here's mine. The first slice of toast was spread with Gentleman's Relish, and the bottle of Badger Pumpkin Ale was the only thing moved into shot, an homage to Ron's Pedigree. I wonder if my lunchtime boiled egg will be this exciting.

Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) is milder form of NASH, in which the liver becomes enlarged and accumulates fat. Ready for a shocker? The prevalence of NAFLD is thought to be between 20 and 30 percent in the Western world, and rising. It's typically associated with insulin resistance and often with the metabolic syndrome. This has lead some researchers to believe it's caused by insulin resistance. It's a chicken and egg question, but I believe it's the other way around if anything.

There are certain animal models of human disease that are so informative I keep coming back to them again and again. One of my favorites is the LIRKO mouse, or liver-specific insulin receptor knockout mouse. The LIRKO mouse is missing its insulin receptor in the liver only, so it is a model of severe insulin resistance of the liver. It accumulates a small amount of fat in its liver in old age, but nothing that resembles NAFLD. So liver insulin resistance doesn't lead to NAFLD or NASH, at least in this model.

What else happens to the LIRKO mouse? It develops severe whole-body insulin resistance, impaired glucose tolerance, high fasting blood glucose and hyperinsulinemia (chronically elevated insulin). So insulin resistance in the liver is sufficient to cause whole-body insulin resistance, hyperinsulinemia and certain other hallmarks of the metabolic syndrome, while liver and whole-body insulin resistance are not sufficient to cause NAFLD or NASH. This is consistent with the fact that nearly everyone with NAFLD is insulin resistant, while many who are insulin resistant do not have NAFLD.

In all fairness, there are reasons why NAFLD is believed to be caused by insulin resistance. For example, insulin-sensitizing drugs improve NAFLD. However, that doesn't mean the initial metabolic 'hit' wasn't in the liver. One could imagine a scenario in which liver insulin resistance leads to insulin resistance in other tissues, which creates a positive feedback that aggravates NAFLD. Or perhaps NAFLD requires two 'hits', one to peripheral insulin sensitivity and another directly to the liver.

In any case, I feel that the most plausible mechanism for NAFLD goes something like this: too much n-6 from polyunsaturated vegetable oil (along with insufficient n-3), plus too much fructose from sweeteners, combine to cause NAFLD. The liver becomes insulin resistant at this point, leading to whole-body insulin resistance, hyperinsulinemia, impaired glucose tolerance and general metabolic havoc.

Agave Syrup

Anna brought up agave syrup in a comment on the last post, so I thought I'd put up a little mini-post so everyone can benefit from what she pointed out.

Agave syrup is made from the heart of the agave plant, which is pressed to release a juice rich in inulin. Inulin is a polymer made of fructose molecules. The inulin is then broken down either by heat or by enzymatic processing. The result is a sweet syrup that is rich in fructose.

Agave syrup is marketed as a healthy, alternative sweetener. In fact, it's probably as bad or worse than high-fructose corn syrup (HFCS). They are both a refined and processed plant extract. Both are high in fructose, with agave syrup leading HFCS (estimates of agave syrup range up to 92% fructose by calories). Finally, agave syrup is expensive and inefficient to produce.

The high fructose content gives agave syrup a low glycemic index, because fructose does not raise blood glucose. Unfortunately, as some diabetics learned the hard way, using fructose as a substitute for sucrose (cane sugar) has negative long-term effects on insulin sensitivity.

In my opinion, sweeteners come with risks and there is no free lunch. The only solution is moderation.

How to Fatten Your Liver

Steatohepatitis is a condition in which the liver becomes inflamed and accumulates fat. It was formerly found almost exclusively in alcoholics. In the 1980s, a new condition was described called nonalcoholic steatohepatitis (NASH), basically steatohepatitis without the alcoholism. Today, NASH is thought to affect more than 2% of the adult American population. The liver has many important functions. It's not an organ you want to break.

This week, I've been reading about how to fatten your liver. First up: industrial vegetable oil. The study that initially sent me on this nerd safari was recently published in the Journal of Nutrition. It's titled "Increased Apoptosis in High-Fat Diet–Induced Nonalcoholic Steatohepatitis in Rats Is Associated with c-Jun NH2-Terminal Kinase Activation and Elevated Proapoptotic Bax". Quite a mouthful. The important thing for the purpose of this post is that the investigators fed rats a high-fat diet, which induced NASH.

Anytime a study mentions a "high-fat diet", I immediately look to see what they were actually feeding the animals. To my utter amazement, there was no information on the composition of the high-fat diet in the methods section, only a reference to another paper. Apparently fat composition is irrelevant. Despite the fact that a high-fat diet from coconut oil or butter does not produce NASH in rats. Fortunately, I was able to track down the reference. The only difference between the standard diet and the high-fat diet was the addition of a large amount of corn oil and the subtraction of carbohydrate (dextrin maltose).

Corn oil is one of the worst vegetable oils. You've eaten corn so you know it's not an oily seed. To concentrate the oil and make it palatable, manufacturers use organic solvents, high heat, and several rounds of chemical treatment. It's also extremely rich in n-6 linoleic acid. The consumption of corn oil and other n-6 rich oils has risen dramatically in the US in the last 30 years, making them prime suspects in NASH. They have replaced the natural (more saturated) fats we once got from meat and milk.

Next up: fructose. Feeding rats an extreme amount of fructose (60% of calories) gives them nonalcoholic fatty liver disease (NAFLD), NASH's younger sibling, even when the fat in their chow is lard. Given the upward trend of US fructose consumption (mostly from high-fructose corn syrup), and the refined sugar consumed everywhere else (50% fructose), it's also high on my list of suspects.

Here's my prescription for homemade foie gras: take one serving of soybean oil fried french fries, a basket of corn oil fried chicken nuggets, a healthy salad drenched in cottonseed oil ranch dressing, and wash it all down with a tall cup of soda. It's worked for millions of Americans!

Change to Parking Bylaw ... so much for Access

The following video is an example of how a policy can be changed with little thought about the end result for people who have a disability. This year, it was turned into a one way street east, which means that the bus has to drop us off across the way. Too far, to make it realistic for wheelchairs to attend anymore.

When the problem was pointed out to the city, the answer was the parking spot was never supposed to be built in the first place - possibly about 30 years ago. The parking spot on the road, closest to the building has been made a legal parking spot and it will remain a legal parking spot.

As a result, those who want to volunteer to help the medical students who are going through med school at Queen's has to wheel too far to be able to attend without someone from inside coming out to help push us in. The reason being is the bus can't be left in the middle of the street so the bus driver can push us in like the usually do.

Specialized transit has been told to drop people off at the fire hydrant, but as you can see from these pictures, cars are often parked there.



Please read my other blogs:
Transit: http://wheelchairdemon-transit.blogspot.com
Health Care: http://wheelchairdemon-health.blogspot.com

Tinplate Saturdays

Saturday saw a beautiful, sunny, placid day on the beach at Brancaster in Norfolk. The tide was in on our arrival, but it soon receded over the vast sandy levels of the Staithe harbour to be a just discernible blue line on the far horizon, leaving shallow channels streaked across the beach. Just perfect for launching one of Mr.Sutcliffe's tin model ships in order for it to bob along over sandworm casts and broken shards of razor shell. Youngest Boy had purloined said ship from the bathroom shelf, but we couldn't find the key that you stick down one of the funnels to get the propeller whirring. But it did provide some excellent photo opportunities as it drifted aimlessly about, Philip Larkin's '...steamer stuck in the afternoon...' from To the Sea. Sutcliffe Models will be remembered from seaside toy shops of the 50s and 60s- pale green Nautilus Submarines and topical Bluebirds. And dad's workshop or garage often had a bright red Sutcliffe Oil Can with its gold label on the shelf. I was fortunate enough to buy my tin liner from Mr.Sutcliffe himself. Having retired he hawked his remaining stock around toy fairs until one Saturday I spied his stall stacked with brightly-coloured tin. Which is all very well but it doesn't shed any light on where the missing key is.

Kitchen Room Furniture

Through the years kitchens have evolved from being a small room in the back of the house to being the focal point of the home. To make the kitchen room more comfortable for daily activity, of course we need to design them by putting some kitchen room furniture. There are some Tips how to renovate the kitchen room, what We'll need to do at every stage of the remodeling process:


  • Find Inspiration for Your New Kitchen.
    Open kitchen's design (We can use this design if we want our family and friends enjoy and relax their healthy meals in our home), Closed kitchen's design (Mostly kitchen used only for cooking and put the items).

  • Plan Your Total Remodel Budget.
    We need to calculate and make total how much money we need to spend our budget to design the kitchen room, especially to buy kitchen set furniture.

  • Determine Your Kitchen Layout.
    Which architectural style will guide the transformation of the space? Cape Cod, Farmhouse, Dutch Colonial, Saltbox, Georgian, Federal, Greek Revival, Eastlake, Queen Anne, Gothic Revival, Italianate, Craftsman, Foursquare, Prairie, Art Deco or Modern.

  • Decide Whether to Replace or Reface Your Cabinets.
    Kitchen cabinets will help establish the character for the whole living space, The choice of wood will have an effect on the overall look of your room each having its own unique characteristics. There are many choice of kitchen furniture wood such as ; alder, cherry, beech, hickory, maple, oak, lyptus and paintable wood. Using a light wood such as oak, birch, ash, beech, maple, or chestnut will lighten the kitchen.

  • Complete The Kitchen Room With Proper Lighting.
    Like others room in the house, the ability to adjust light levels in the kitchen is ideal, because when cooking or cleaning up, a bright punch of illumination makes the job easier. Support the lighting with same color of our kitchen room furniture, we can choose one of lighting style such as ; natural lighting, accent lighting, ambient, and task lighting and what types of bulbs will you be using: fluorescent, incandescent or quartz halogen.

  • Decorating the kitchen room should be a priority when decorating a new home, Kitchen room furniture are important item to make the kitchen look beautiful and give us feel comfort when doing an activity. Some of family they will use the kitchen room as dinning room too, It's mean they need to put dinning furniture.

    Furniture item for the Kitchen room are including Baker's Racks, Pie Safes, Buffet's, Kitchen Islands, Kitchen cabinets, wine racks, Dining Room Chairs and Table. All of them it will look nice if they are in one color.

    Working and Disabiltiy Related Costs

    I got my first full-time job in December 2007 and, for the first time in my life, I was able to kiss the Ontario Disability Support program (ODSP) and the social programs goodbye. Fantastic. No more feeling like I am a financial burden to society. No more having to justify my disability related expenses or having to be grounded while I wait for ODSP to approve the cost of repairing my legs (wheelchair).

    There have been a few challenges that have been difficult to overcome though. One is having to pay for the exorbitant costs of fixing my wheelchair now that ODSP is no longer footing the bill. The other is learning that most services are closed in the evening and can only be used for an emergency repair if you are able to pay the premium price.

    The other day I got a flat tire after hours and, because I remembered being told when I was on ODSP that, because I did not have power seating on my wheelchair, I did not qualify for an emergency repair, I didn't try to get the wheel fixed. Instead, I just wheeled to the bus stop on the flat and came home.

    The next day I went to work and arranged for the medical supplier to fix it when I was there. When I saw the bill for the repair was $65 for one hour's work, I asked about the after-hours service. That's when I learned that the cost for the repair would have been a mere $100 plus the cost to repair.

    I was shocked. Thankfully I saved myself this added expense because I didn't realize the "not qualifying part" was a policy of ODSP and not the medical supplier. But I can pretty well guarantee it will never be done either. There is no way I can afford that much to replace a flat tire.

    I wonder how the able-bodied would feel if they temporarily lost the use of their legs and were told they had to fork out this much money before they could leave the emergency room? The analogy I am thinking of is a person breaking both legs and OHIP refusing to pay for them to become mobile again. I highly doubt the majority of the able-bodied public would stand for it. (No pun intended).

    Anyway, the goal of this blog is not to complain, but to raise awareness that there is often more than meets the eye when you look at a person who has a disAbility.

    Please read my other blogs:
    Transit: http://wheelchairdemon-transit.blogspot.com
    Health Care: http://wheelchairdemon-health.blogspot.com

    Washington County Update

    Friday September 12th Representative Anne Perry convened a meeting in Machias to discuss health disparity issues faced in Washington County, along with Commissioner of Maine DHHS Brenda Harvey, Senator Kevin Raye, Representative Donald Soctomah, and a number of others. Lisa Sockabasin, the Director of Minority Health, and I drove together to the meeting. About 25 people attended, including many health and social service providers and representatives from the Maine Department of Economic and Community Development and Maine Department of Labor.

    I presented the health profile data that Maine CDC staff have been working hard helping me compile. The data are found in four documents:

    “Public Health Data Comparison Tables, Washington County” is a Health District Profile with a column for Washington County that provides comparisons between Washington County, other regions of the state, the state as a whole, and the nation;

    “Washington County Data” is a compilation of Washington County data that includes some trend data;

    “Community Health Status Report, Washington County” is a report comparing Washington County health data to peer counties around the country; and

    “Washington County Highlights of the Health Profile” is a summary of some highlights of the above three documents.

    These documents can be found on our new Public Health Data Reports website (http://www.maine.gov/dhhs/boh/phdata/), under the Regional and Local Reports section or directly at http://www.maine.gov/dhhs/boh/phdata/county_level_reports.htm.

    The gathered group then shared observations and ideas. What was most impressive to me was the high level of passion, energy, and thoughtful ideas in the room. From ideas related to economic development, educational opportunities, improving prevention, screening, and treatment of health issues, to infrastructure improvements (yes, the poor condition of Route 1 and lack of internet and cell phone coverage were mentioned several times), to environmental concerns were discussed. Disparities among the poor and minority communities were also recognized.

    However, although “hopelessness” and “poverty” were the two most common words I heard during the two hour meeting, I left with a strong sense of optimism. First, there was the recent news of the US DHHS’ Substance Abuse and Mental Health Services Administration (SAMHSA) award to Washington County’s Community Caring Collaborative of a ~$900,000 per year 5-year grant to help expand prevention programs for underserved communities in Washington County, including the Passamaquoddy tribal members. Marjorie Withers from the Collaborative was at the meeting and her excitement about the impact this grant may have was quite palpable. Cheryl DiCara, Valerie Ricker, Lisa Sockabasin and others from the Maine CDC who assisted on this grant were also bursting with excitement the preceding days. It also looks like Maine CDC may be able to fund a prevention specialist using Fund for a Healthy Maine dollars for the Passamaquoddy Tribe in the coming weeks. And, we are hopeful to be able to soon hire a Maine CDC Public Health District Liaison for the Downeast District, and perhaps locate the person in Machias.

    Second, the attendees agreed to use the Washington County: One Community initiative as a central point of contact for ongoing efforts. Eleody Libby, their Executive Director and Healthy Maine Partnership Director, is a well known public health professional and has been very involved with statewide public health activities. Representatives from the Passamaquoddy Tribe were present and also invited to join the One Community initiative.

    This effort will clearly take the energy and dedication of many to successfully address the many health-related challenges in Washington County. However, I left with a sense of hope, and was honored to be invited to join them in the journey.

    On the way home we stopped to buy a 10-pound box of wild fresh blueberries that now sits in my freezer with containers of them in the refrigerator. It’s wonderful to have a daily healthy reminder of the great resources in Washington County!

    Dora Anne Mills, MD, MPH


    Washington County Health Profile Documents:
    http://www.maine.gov/dhhs/boh/phdata/county_level_reports.htm.

    Let history be our guide: Get ready

    History reminds us that there are plenty of good reasons to prepare: smallpox, plague, yellow fever to name a few. The list is long and with new threats emerging, it continues to grow. But the past also reveals how people have identified those harmful things and prepared for and protected themselves against health threats.

    Consider the ancient Greeks and Romans who recognized the need for improved sanitation and developed elaborate waterways and drains to safeguard their water supplies. Or the Council of Lyons that in 583 A.D. isolated disease-carrying lepers to keep the rest of the community healthy. Or, more recently, vaccine pioneers like Jonas Salk whose discovery protected generations from polio. All of these illustrate achievements we've made in identifying and getting ready for health threats.

    And what about those "old" diseases like smallpox, leprosy, the plague and yellow fever? Well, the last natural case of someone getting smallpox was in Somalia in 1977. And as for the others, while not entirely gone from the planet, they no longer pose a threat like in the old days thanks to advances in vaccines and other disease control steps. Yellow fever can still rear its head in certain tropical regions of Africa and South America, but the last yellow fever epidemic in the United States took place in New Orleans in 1905. The last U.S. plague epidemic occurred in Los Angeles in 1924-25. Since then, only about 10 to 15 people get the plague each year in the United States. Leprosy may conjure up images from the movie Ben-Hur, but the disease is on its way out. In Angola, Brazil, Central African Republic, Democratic Republic of Congo, India, Madagascar, Mozambique, Nepal and Tanzania, where epidemics can still happen, the governments are committed to eliminating the disease .

    As you can see, we've made lots of progress through the ages, but there's still a long way to go. New threats pop into the picture such as bioterrorism, bird flu, SARS and others. So let's let history be our guide: It’s a good idea to be prepared.

    Chez Moi

    As a blogger of ill repute, I am often asked "Mr.Ashley, you have mentioned Ashley Towers on more than one occasion, and wondered if there was any chance that we may see what your home looks like?". Well, I would have done it sooner of course, but it's been undergoing a lick of paint recently. This has not been an easy task, and I'm afraid that there were a lot of meaningful, if not rather heated discussions, with my decorator about the colours I wanted. As you can see, in my absence he has played a little, if rather expensive, practical joke on me with respect to the house name.

    Of course those of you who are more alert and clear-headed than I am this morning will have spotted that this is in fact one of the fairground attractions at Blackpool's Pleasure Beach, shot yesterday afternoon on my first visit to this Lancastrian resort, having previously narrowly avoided it on my previous journeys to Fleetwood and Lytham St.Anne's. I could talk at much length about what I found, and probably will, but suffice it to say I could have stayed in here all day amongst the roller coaster and ghost train screams, and that sugary scent of candy floss. Roll up! Roll up!

    A New Toy

    I bought a new toy the other day: a blood glucose meter. I was curious about my post-meal blood glucose after my HbA1c reading came back higher than I was expecting. A blood glucose meter is the only way to know what your blood sugar is doing in your normal setting.

    "Glucose intolerance" is the inability to effectively control blood glucose as it enters the bloodstream from the digestive system. It results in elevated blood sugar after eating carbohydrate, which is not a good thing. In someone with normal glucose tolerance, insulin is secreted in sufficient amounts, and the tissues are sufficiently sensitive to it, that blood glucose is kept within a fairly tight range of concentrations.

    Glucose tolerance is typically the first thing to deteriorate in the process leading to type II diabetes. By the time fasting glucose is elevated, glucose intolerance is usually well established. Jenny Ruhl talks about this in her wonderful book Blood Sugar 101. Unfortunately, fasting glucose is the most commonly administered glucose test. That's because the more telling one, the oral glucose tolerance test (OGTT), is more involved and more expensive.

    An OGTT involves drinking a concentrated solution of glucose and monitoring blood glucose at one and two hours. Values of >140 mg/dL at one hour and >120 mg/dL at two hours are considered "normal". If you have access to a blood glucose meter, you can give yourself a makeshift OGTT. You eat 60-70 grams of quickly-digesting carbohydrate with no fat to slow down absorption and monitor your glucose.

    I gave myself an OGTT tonight. I ate a medium-sized boiled potato and a large slice of white bread, totaling about 60g of carbohydrate. Potatoes and bread digest very quickly, resulting in a blood glucose spike similar to drinking concentrated glucose! You can see that in the graph below. I ate at time zero. By 15 minutes, my blood glucose had reached its peak at 106 mg/dL.


    My numbers were 97 mg/dL at one hour, and 80 mg/dL at two hours; far below the cutoff for impaired glucose tolerance. I completely cleared the glucose by an hour and 45 minutes. My maximum value was 106 mg/dL, also quite good. That's despite the fact that I used more carbohydrate for the OGTT than I would typically eat in a sitting. I hope you like the graph; I had to prick my fingers 10 times to make it! I thought it would look good with a lot of data points.


    I'm going to have fun with this glucose meter. I've already gotten some valuable information. For example, just as I suspected, fast-digesting carbohydrate is not a problem for someone with a well-functioning pancreas and insulin-sensitive tissues. This is consistent with what we see in the Kitavans, who eat a high-carbohydrate, high glycemic load diet, yet are extremely healthy. Of course, for someone with impaired glucose tolerance (very common in industrial societies), fast-digesting carbohydrates could be the kiss of death. The big question is, what causes the pancreas to deteriorate and the tissues to become insulin resistant? Considering certain non-industrial societies were eating plenty of carbohydrate with no problems, it must be something about the modern lifestyle: industrially processed grains (particularly wheat), industrial vegetable oils, refined sugar, lack of fat-soluble vitamins, toxic pollutants and inactivity come to mind. One could make a case for any of those factors contributing to the problem.

    Thoughts on personal preparedness: Getting ready for the worst

    Today is Get Ready Day, APHA's observance aimed at helping Americans prepare themselves, their families and their communities for all hazards or disasters. Get Ready Day is held in conjunction with National Preparedness Month. Today's guest blog entry is by William F. Raub, PhD, science advisor to the U.S. secretary of health and human services.

    No person is an island, as a modern-day John Donne might put it. Our everyday routines find us dependent to varying degrees not only upon family, neighbors and friends but also upon a complex web of services and supply chains that provide the electric power, water, food stuffs and other things that we have come to regard as necessities. These services and supplies are ubiquitous and so generally reliable that we regularly take them for granted. They enable lifestyles that Donne and his contemporaries scarcely could have imagined.

    But in the aftermath of a disaster, we may become islands, for the web of services and supplies is far from immutable. A disaster can rend the web quickly and severely and leave it functionally compromised for hours, days and even weeks at a time. This, in turn, can leave us isolated from the supporting infrastructure to which we are accustomed. And, when this happens, how well we fare depends in large measure upon how well we have prepared to fend for ourselves.

    Excellent guidance for personal preparedness is readily available. The Department of Homeland Security, through its Ready.gov Web site, provides a wealth of suggestions that are applicable to many types of disasters. The Department of Health and Human Services, through its Pandemicflu.gov Web site, complements this with detailed advice as to what individuals and families can do to maintain some semblance of normality during a four-, six-week or longer period when a severe influenza is ravaging their community. In particular, a severe influenza outbreak is likely to result in significant absenteeism in all walks of life — which for any given community could translate to about 25 percent of the work force on any given day for the duration of the local epidemic. Thus, services and supply chains, although not completely disabled, probably will be functioning well below their normal levels. Those who do not prepare for this will feel the consequences the most.

    Personal preparedness benefits not only the individuals and families who do it but also their community. Every person who is self-reliant during an emergency means one fewer person seeking help from community agencies. This secondary benefit is noteworthy in that few, if any, communities are equipped to provide emergency services to more than a small fraction of their population at any one time.

    As individuals, we cannot avoid a significant dependency upon governments, utilities and private-sector suppliers of goods and services, and we would be foolish to try. But we can avoid being dependent upon public agencies for every need that a disaster might create. And those who prepare themselves to the extent that their resources allow will help bring about a level of community resiliency that we are not likely to achieve any other way.

    For more tips on how you can be better prepared, visit APHA's Get Ready campaign Web site.

    Behind the Pig-Sty


    So, while the light fails / On a winter's afternoon, in a secluded chapel / History is now and England. T.S.Eliot wrote these lines in 1942, a tiny fragment of the poem Little Gidding that became the fourth of the Four Quartets- ..."turn behind the pig-sty to the dull facade...". This tiny eponymous church was his inspiration, out in the fields of lonely Huntingdonshire. It wasn't winter on my visit, but the light was thinking about failing until I arrived at the door and the sun found its way around the clouds and through a tiny gap in the trees in order to light the west front and the single bellrope, or 'sally' as I now know it's called.Here was once a ruinous medieval church, restored by the religious community founded by Nicholas Ferrar in 1624. Much taken with hand-writing books and embroidery, they kept having to put down quills and needles in order to troop in here three times a day for services. Charles I came here three times, but by the 1650s it was all over. The west facade is of 1714, with a bellcote designed by someone who must have looked at Hawksmoor's London churches. Inside are collegiate-style pews facing the tiny aisle, and a visitors' book with biro'd comments from Eliot afficianados. Here, the intersection of the timeless moment / Is England and nowhere. Never and always.

    March of Dimes - Not Accessible?

    The March of Dimes, a non-profit charitable organization who raises funds to assist adults who have a physical disability, have moved their used clothing store to a building that is not wheelchair accessible. I find this most disturbing.

    The adults, who used to benefit from working in an accessible location, or from the on-the-job skills training, are now cut out.

    This means the physically disabled adults, that this non-profit agency raises funds for, are unemployed, living on ODSP (the Ontario Disability Support Program), and in some cases, very isolated and very depressed.

    And the province says accessibility is improving? I would suggest accessibility has been slowly eroded with cost cutting measures and the lack of public outcry, which demands accountability for the money that has been donated.




    Please read my other blogs:

    Transit: http://wheelchairdemon-transit.blogspot.com
    Health Care: http://wheelchairdemon-health.blogspot.com

    Old Street No 1

    And now the first in an occasional series of what's to be found on England's disappearing, and indeed vanished, highways. Yet another collection, and in collaboration with Commentator Diplomat, his roofless Landrover and battered motion picture camera, may even result in some little films. So I'm sure we'd both appreciate any sober and/or well thought-out comments. For my initial research for these improbable adventures, I drove on Saturday afternoon down the old Great North Road that still runs parallel to the A1(M) from Alconbury to Stilton, where huge tin motorway signs tower over the hedges. At one time this red brick farmhouse once stood right on the verge of the old road; difficult to date but I would say anywhere from the late eighteenth to the mid nineteenth century. The doubtful bay windows would have been plonked on the front at least forty years ago. The farm has gone, broken-up in the sixties, and what you see here is about to be demolished anytime now. A very slow death for what was once a family home with everything from the latest landau to the latest Standard Vanguard speeding past the door. This banner has been up for five years and didn't need planning permission like wooden hoardings do. Look out for it over the hedge just before junction 14 (the A14) on a southbound journey, and pip your horn in recognition of the disappearance of a home from quiet, forgotten Huntingdonshire.

    Bathroom Furniture & Accessories

    Bathroom is one of importance room in our house, We need to create them and design them as we can with some beautiful models of furniture to make us comfortable when entering the bathroom area, especially if the bathroom has more space or large size.


    So, it's good reason to have a well designed and decorated bathroom space with interesting and nice design of furniture because not only for aesthetic reasons but for ergonomics and functionality. Start to make plan, try to create some ideas for your bathroom such as how the bathroom's look and style.


    Bathroom Furniture : Placement

    Which style you want to do with your bathroom, romantic style, cool style or modern style. Many of furniture are design for bathroom use, and you can choose them to make your bathroom look nice and put all item that may you use in the bathroom. There are many accessories furniture that you can select them according to your budged, of course it will help you to design your bathroom more interesting and functional use.

    Bathroom Furniture : Accessories

    Furniture cabinets model has a functional for personalized storage solutions inside the bathroom. If you like to create a contemporary and traditional bathroom, You can chose one of top company that supplying bathroom furniture from top brand manufacturers such as Roper Rhodes and Catalano. Both of these product provided many furniture to help the customer in order to make home design style.

    Hotel Accessibility - What are they thinking?

    Last week I had the pleasure of staying in a luxurious hotel in downtown Toronto, one I was assured would be wheelchair accessible. I made the reservation in early August taking special care to spell out the specifics of what I needed. I had stayed there before so I knew what was available and that my requests would not be unreasonable.

    I needed:
    • A lower bed height (they can remove the frame underneath).
    • Wall plugs within reach so I could plug in my battery charger.
    • A shower bench.
    • The shower head hanging down instead of on the peg near the roof and,
    • A loner manual wheelchair.
    I even phoned the day before to confirm it was all put in place and I was told that it was.

    Well it wasn't. When I arrived, I was told that the room had been upgraded to a Gold Suite for the same price! I thought, "Fantastic!" until I saw the room and discovered that none of what I had asked for, was there.

    I spent the next hour trying to find the right people to lower the bed, find the bath seat and manual wheelchair and plug in my charger.

    By 11:30 pm, I thought all was complete, so I tumbled into bed and fell quickly asleep.

    The next day, I got another rude shock. I couldn't take a shower. The towels were placed on a rack that was so high there was no way I could reach them. When I picked up the phone to phone the front desk to ask for help, I discovered it was broken. There was no way I was going to get dressed, go down to the front desk to get help, and then go back and take a shower, so I slogged through the rest of the day feeling most unrefreshed.

    So much for enjoying the full benefits of the $397.95 per night room.

    To see a complete view of the room, along with a commentary, please look at this video.



    Be sure to view my other blogs:
    Transit: http://wheelchairdemon-transit.blogspot.com
    Health Care: http://wheelchairdemon-health.blogspot.com

    Inactivity and Weight Gain

    Most of the papers I read in the field pay lip-service to some familiar stories: thrifty genes; calories in, calories out; energy density; fat intake; gluttony and sloth.

    It may sound counterintuitive, but how do we know that inactivity causes overweight and not the other way around?  In other words, isn't it possible that metabolic deregulation could cause both overweight and a reduced activity level? The answer is clearly yes. There are a number of hormones and other factors that influence activity level in animals and humans. For example, the "Zucker fatty" rat, a genetic model of severe leptin resistance, is obese and hypoactive (I wrote about it here). It's actually a remarkable facsimile of the metabolic syndrome. Since leptin resistance typically comes before insulin resistance and predicts the metabolic syndrome, modern humans may be going through a process similar to the Zucker rat.

    Back to the paper. Dr. Nicholas Wareham and his group followed 393 healthy white men for 5.6 years. They took baseline measurements of body composition (weight, BMI and waist circumference) and activity level, and then measured the same things after 5.6 years. In a nutshell, here's what they found:
    • Sedentary time associates with overweight at any given timepoint. This is consistent with other studies.

    • Overweight at the beginning of the study predicted inactivity after 5.6 years.

    • Inactivity at the beginning of the study was not associated with overweight at the end.

    In other words, overweight predicts inactivity but inactivity does not predict overweight. With the usual caveat that these are just associations, this is not consistent with the idea that inactivity causes overweight. It is consistent with the idea that overweight causes inactivity, or they are both caused by something else.


    Celebrate Get Ready Day on Sept. 16!

    How prepared are you and your community for an emergency or disaster? Sponsored by APHA, Get Ready Day, on Tuesday, Sept. 16, is raising awareness about community preparedness. No matter where you live, there is always a possibility of a public health emergency, from earthquakes and hurricanes to infectious disease or terrorism.

    Bring the Get Ready message to your community during Get Ready Day by holding an event. You'll find plenty of helpful free preparedness planning materials on the Get Ready fact sheet page or via the Red Cross. September is also National Preparedness Month, so check out this great information from Uncle Sam as well. If you hold a Get Ready event, drop us a line and let us know. We'd love to hear what you did.

    Thanks to your help and Get Ready events held around the country, we'll all be a bit more prepared for the worst!

    States using tax breaks to convince residents to prepare for hurricanes

    So what exactly would it take for you to be prepared for a disaster? How about a big fat tax break?

    Two U.S. states are hoping that giving residents a pass on taxes for emergency supplies will convince residents to get ready for hurricanes. This May, Virginia and Louisiana — both states that have recently been in the paths of storms — each held sales tax holidays in anticipation of hurricane seasons.

    Virginia's Hurricane Preparedness Sales Tax Holiday, held from May 25-May 31, took place for the first time, but organizers are planning to hold it annually through 2012. As long as each hurricane preparedness article cost $60 or less, residents could fill their shopping carts with emergency supplies — such as batteries, flashlights, smoke detectors, bottled water, can openers and first aid kits — and not have to pay taxes on them. Portable generators and other power supplies were also tax-free if the sales price was $1,000 or less. Such supplies came in handy in September, as tropical storm Hanna drenched the state with rain and knocked out power in some regions.

    Louisiana, still recovering from the effects of Hurricanes Katrina and Rita in 2005, also held its first Hurricane Preparedness Tax Holiday from May 24-25. Louisiana residents were allowed to purchase a long list of items tax-free as long as the total was less than $1,500. Supplies that qualified for the tax break were many of the same items on the shopping list in Virginia, but also included storm shutter devices, carbon monoxide detectors and more. With Gustav hitting the state this August, the state's tax-free holiday came none too soon.

    Virginia’s and Louisiana's tax-free holidays were both held for the first time this year, but they weren't the first states to cut residents such a break: In the aftermath of the 2004 hurricane season, Florida paved the way by creating a hurricane preparedness sales tax holiday. Unfortunately, the state legislature did not renew the tax holiday for 2008.

    Whether or not you live in a hurricane-prone region, it makes sense to be prepared and to have emergency supplies on hand. And if your state is giving you an incentive to do so, it's a great idea to take advantage of it.

    Classic Bedroom new ideas

    Italian, European and imported Classic bedroom furniture collections.


    Elegance bedroom crafted from birch wood with cherry veneers and burl inlays on the drawer fronts.Decorate leather with individual antique brass nail heads.The dresser and nightstands comes with an attached marble top. The drawers come with drawer stops, dove tailing, single wood glides on the small drawers and double glides on the large drawers plus dust covers.



    Traditional Louis Phillippe bedroom is perfectly interpreted in this timeless design. Excitement comes from functional hidden drawer, classic antique brass handle, and largely scaled case pieces with over-hang top and fluted wood molding on the front and sides. Elegance and beauty are brought to mind when viewing this popular collection. The wood itself is hardwood done in updated warm distressed cherry finish. Dijon II Collection is available in traditional sleigh bed, and panel bed.


    An urban contemporary bedroom in an espresso finish on cherry solids veneers and selected hardwoods. The geometric design in satin nickel further represents the contemporary styling.




    Classic bedroom set. In stock. Lead time is 2-3 weeks. The craftsmanship and timeless elegance of old world European antiques, Valentino has been carefully designed and hand crafted . A beautiful piece of art attains a perfect balance by combining all of its elements. The selection of imported woods detailed with extensive hand carving to the original creation of our multi step "Tuscan Miele" finish.




    This Ladya Sleigh-Gondola Bed is a stunning example of how classic Sleigh Bed design has been taken to a completely new level. The curved side rails make a strong statement regarding the character and bold lines of this unique bed and the Oval Marble Medallion accent in the center of the headboard is a signature design element throughout the Ladya Collection.Crafted from Birch Solids Cherry and Mapa Burl Veneers Honey Walnut Finish Queen bed 76''w-99''d-76'' Cal.King 88''w-99''d-78''H East.King 88''- 96''d -79''H Bedside Chest H34.00" W32.00" D20.00" Dresser H42.00" W78.00" D20.50" Dresser Mirror H48.50" W52.50" D2.00" 6 Drawer Chest H66.50" W53.00" D20.25" Armoire H92.00" W54.25" D24.25" Leather Bedside Bench H21.00" W54.75" D24.50"


    Classic bedroom set collection. Decorate with 2 tone wood finish. In stock.


    The Luxury renowned French cabaret , as it represents a multitude of light -hearted, versatile , and memorable sides of France's glamourous epoque .The set is sure to please and allows enough versatility to fill any space.


    Kids Bedroom



    Mahogany finish single bed decorate with victorian shape of furniture.Easy gliding drawers with automatic stops.




    Solid Oak and oak veneers bank bed Full size and Twin. Also avaliable matching Headboard for same collection of kids bedroom.




    Provincial style kids set




    Birch kids of single bedroom set.





    Single bed contemporary style with trundle bed under platform bed.


    Classic collection single bed twin size. High Gloss with picture inlay. Walnut color. Made in Italy.





    Give your kids a cozy place to wind down after a long day of play. This Louis Philippe youth bed collection is in warm light brown finish and features wood on wood glides on drawers. Made of select hardwoods and veneers.



    Contemporary bedroom set .HIgh Gloss. Available in Cherry and Dark Wenge color. In stock in size :FULL and QUEEN platform bed.Matching computer desk.

    Badge Engineering

    Stumbled over this morning, a brochure for Vauxhall Cars celebrating their 1903-1953 Jubilee. The cover sports the six cylinder Velox, seen here with five airbrushed passengers deliberately dwarfed to make the car look bigger, presumably to impress the American market, and of course owners General Motors. But perhaps of equal interest are the origins of the name Vauxhall and their recently re-vamped Griffin badge. It all started with a thirteenth century mercenary soldier called Faulk Le Breant, who inherited land on the south of the Thames in London where he built a house- Faulk's Hall. This evolved over the years via Fawke's Hall and Fox Hall to Vauxhall, the name given to the renowned Pleasure Gardens built on the site of the house. Le Breant's armorial badge used the eagle-headed griffin, which was placed over the gate when the Gardens opened in 1661. In the nineteenth century the badge was appropriated by local manufacturers Vauxhall Ironworks, who retained it when they starting making cars in 1903 and on their subsequent relocation to Luton. The griffin is also used by Saab, and other mythical beasts goaded into service on motor cars must include Alfa Romeo's serpent, Talbot's hunting dog and the Gilbern's Welsh dragon. (That's enough old car badges-Ed.)

    Underground Particles


    As the world was probably going to end this morning, I thought I'd better get out and take some last pictures. (Actually, I can't work this collider thing out at all. If the cosmic ray is travelling at the speed of light, why did it take half-an-hour to go eight miles? Last night I shone my torch from the house to the garden shed and it lit up instantly. The world didn't end but my neighbour did call the police.) Anyway, apocalypse or not I had to travel across the Welland Valley for a meeting, and on the way back photographed these two water troughs served by springs. The top picture is of one set in the wall of East Carlton Park in Middleton, a tiny annexe to the village of Cottingham in Northamptonshire. A stone plaque gives a date of 1844 and the initials 'IHP', so I take the fountain to be an altruistic gesture of one of the Palmer family at the big house. The lower picture is of a less fanciful example just outside the next village, Ashley (no comment). A trough let into the grass verge that has been maintained by local farming families since 1884, built in the same blue engineering bricks that would have featured on the LNWR railway nearby. Locals once brought their cars down here for Sunday car washing. So while electron particles whizz about creating black holes under Switzerland, here by the willow-fringed Welland we'll just stick to staring at water gushing out of damp walls.

    Hedge Fund

    A muddy rain-sodden walk in the woods on Saturday afternoon revealed exciting discoveries on the margins. Wakerley Great Wood, seven miles south west of Stamford, is a rich mixture of deciduous and evergreen trees that conceal a number of steep-sided dips in the ground called 'swallow holes' where the limestone crust under the soil has collapsed. These were of course of great fascination to my boys, who crashed about in the undergrowth with big sticks in order to lay claim to them as I knelt trying to focus the camera on oozing clumps of bright red berries. Researches have been carried-out in the Ashley Towers Library, and the most likely creator of the eyeball-popping display shown here is the honeysuckle. I simply had no idea that such a headily-scented plant could suddenly produce fruit like this in the autumn. For botanists and gardening buffs I believe it to be Lonicera periclymenum, and certainly you wouldn't want to eat it unless you fancied a few days in casualty. I hope I've got this right and it doesn't just kill you outright if you look at it for too long, but I'm more certain about it than I was about that horror film fungus creeping out of the ash tree.

    A Practical Approach to Omega Fats

    Hunter-gatherers and healthy non-industrial cultures didn't know what omega-6 and omega-3 fats were. They didn't balance nutrients precisely; they stayed healthy by eating foods that they knew were available and nourishing. Therefore, I don't think it's necessary to bean count omega fats, and I don't think there's likely to be a single ideal ratio of n-6 to n-3. However, I do think there's evidence for an optimal range. To find out what it is, let's look at what's been done by healthy cultures in the past:
    • Hunter-gatherers living mostly on land animals: 2:1 to 4:1

    • Pacific islanders getting most of their fat from coconut and fish: 1:2

    • Inuit and other Pacific coast Americans: 1:4 or less

    • Dairy-based cultures: 1:1 to 2:1

    • Cultures eating fish and grains: 1:2 or less

    It looks like a healthy ratio is between 4:1 and 1:4 n-6 to n-3. Some of these cultures ate a good amount of n-3 polyunsaturated fat, but none of them ate much n-6 [One rare exception is the !Kung. SJG 2011]. There are three basic patterns that I've seen: 1) low fat with low total n-6 and n-3, and a ratio of less than 2:1; 2) high fat with low total n-6 and n-3 and a ratio of 2:1 or less; 3) high fat with low n-6 and high n-3, and a low carbohydrate intake.

    I think there's a simple way to interpret all this. Number one, don't eat vegetable oils high in n-6 fats. They are mostly industrial creations that have never supported human health. Number two, find a source of n-3 fats that can approximately balance your n-6 intake. In practical terms, this means minimizing sources of n-6 and eating modest amounts of n-3 to balance it. Some foods are naturally balanced, such as grass-fed dairy and pastured lamb. Others, like coconut oil, have so little n-6 it doesn't take much n-3 to create a proper balance.

    Animal sources of n-3 are the best because they provide pre-formed long-chain fats like DHA, which some people have difficulty producing themselves. Flax oil may have some benefits as well. Fish oil and cod liver oil can be a convenient source of n-3; take them in doses of one teaspoon or less. As usual, whole foods are probably better than isolated oils. Weston Price noted that cultures throughout the world went to great lengths to obtain fresh and dried marine foods. Choose shellfish and wild fish that are low on the food chain so they aren't excessively polluted.

    I don't think adding gobs of fish oil on top of the standard American diet to correct a poor n-6:n-3 ratio is optimal. It may be better than no fish oil, but it's probably not the best approach. I just read a study, hot off the presses, that examines this very issue in young pigs. Pigs are similar to humans in many ways, including aspects of their fat metabolism. They were fed three diets: a "deficient" diet containing some n-6 but very little n-3; a "contemporary" diet containing a lot of n-6 and some n-3; an "evolutionary" diet containing a modest, balanced amount of n-6 and n-3; and a "supplemented" diet, which is the contemporary diet plus DHA and arachidonic acid (AA).

    Using the evolutionary diet as a benchmark, none of the other diets were able to achieve the same fatty acid profile in the young pigs' brains, blood, liver or heart. They also showed that neurons in culture require DHA for proper development, and excess n-6 interferes with the process.

    With that said, here are a few graphs of the proportion of n-6 in common foods. These numbers all come from nutrition data. They reflect the percentage n-6 out of the total fat content. First, animal fats:


    Except salmon oil, these are traditional fats suitable for cooking. Except schmaltz (chicken fat), they are relatively low in n-6. Next, vegetable oils:


    These range from very low in n-6 to very high. Most of the modern, industrially processed oils are on the right, while most traditional oils are on the left. I don't recommend using anything to the right of olive oil on a regular basis. "HO" sunflower oil is high-oleic, which means it has been bred for a high monounsaturated fat content at the expense of n-6. Here are the meats and eggs:

    n-3 eggs are from hens fed flax or seaweed, while the other bar refers to conventional eggs.

    A few of these foods are good sources of n-3. At the top of the list is fish oil, followed by n-3 eggs, grass-fed butter, and the fat of grass-fed ruminants. It is possible to keep a good balance without seafood, it just requires keeping n-6 fats to an absolute minimum. It's also possible to overdo n-3 fats. The traditional Inuit, despite their good overall health, did not clot well. They commonly developed nosebleeds that would last for three days, for example. This is thought to be due to the effect of n-3 on blood clotting. But keep in mind that their n-3 intake was so high it would be difficult to achieve today without drinking wine glasses full of fish oil.

    Omega Fats and Cardiovascular Disease

    I noticed something strange when I was poring over data about the Inuit last month. Modern Inuit who have adopted Western food habits get fat, they get diabetes... but they don't get heart attacks. This was a paradox to me at the time, because heart disease mortality typically comes along with the cluster of modern, non-communicable diseases I call the "diseases of civilization".

    One of the interesting things about the modern Inuit diet is it's most often a combination of Western and traditional foods. For example, they typically use white flour and sugar, but continue to eat seal oil and fish. Both seal oil and fish are a concentrated source of long-chain omega-3 (n-3) fatty acids.The 'paradox' makes much more sense to me now that I've seen
    this:

    It's from the same paper as the graphs in the last post. Note that it doesn't take much n-3 to get you to the asymptote. Here's another one that might interest you:

    The finding in this graph is supported by the Lyon diet heart study, which I'll describe below. One more graph from a presentation by Dr. Lands, since I began by talking about the Inuit:


    Cardiovascular disease mortality tracks well with the n-6 content of blood plasma, both across populations and within them. You can see modern Quebec Inuit have the same low rate of CVD mortality as the Japanese. The five red triangles are from
    MRFIT, a large American intervention trial. They represent the study participants divided into five groups based on their plasma n-6. Note that the average percentage of n-6 fatty acids is very high, even though the trial occurred in the 1970s! Since n-3 and n-6 fats compete for space in human tissue, it makes sense that the Inuit are protected from CVD by their high n-3 intake.  [Update: I don't read too much into this graph because there are so may confounding variables.  It's an interesting observation, but take it with a grain of salt.. SJG 2011].

    Now for a little mechanism. Dr. Lands' hypothesis is that a high n-6 intake promotes a general state of inflammation in the body. The term 'inflammation' refers to the chronic activation of the innate immune system. The reason is that n-3 and n-6 fats are precursors to longer-chain signaling molecules called eicosanoids. In a nutshell, eicosanoids produced from n-6 fatty acids are more inflammatory and promote thrombosis (clotting) more than those produced from n-3 fatty acids. Dr. Lands is in a position to know this, since he was one of the main researchers involved in discovering these mechanisms. He points out that taking aspirin to 'thin' the blood and reduce inflammation (by inhibiting inflammatory eicosanoids) basically puts a band-aid over the problem caused by excess n-6 fats to begin with.
      [Update- this mechanism turns out not to be so straightforward. SJG 2011]

    The
    Lyon Diet Heart Study assessed the effect of n-3 fat supplementation on CVD risk. The four-year intervention involved a number of diet changes designed to mimic the American Heart Association's concept of a "Mediterranean diet". The participants were counseled to eat a special margarine that was high in n-3 from alpha-linolenic acid. Overall PUFA intake decreased, mostly due to n-6 reduction, and n-3 intake increased relative to controls. The intervention caused a 70% reduction in cardiac mortality and a large reduction in all-cause mortality, a smashing success by any measure.

    In a large five-year intervention trial in Japan,
    JELIS, patients who took EPA (a long-chain n-3 fatty acid) plus statins had 19% fewer cardiac events than patients taking statins alone. I don't know why you would give EPA by itself when it occurs with DHA and alpha-linolenic acid in nature, but it did nevertheless have a significant effect. Keep in mind that this trial was in Japan, where they already have a much better n-6/n-3 ratio than in Western nations.

    In my opinion, what all the data
    (including a lot that I haven't included) point to is that a good n-6 to n-3 ratio may be important for vibrant health and proper development. In the next post, I'll talk about practical considerations for achieving a good ratio.