Saturated Fat, Glycemic Index and Insulin Sensitivity: More Evidence

Insulin is a hormone that drives glucose and other nutrients from the bloodstream into cells, among other things. A loss of sensitivity to the insulin signal, called insulin resistance, is a core feature of modern metabolic dysfunction and can lead to type II diabetes and other health problems. Insulin resistance affects a large percentage of people in affluent nations, in fact the majority of people in some places. What causes insulin resistance? Researchers have been trying to figure this out for decades.*

Since saturated fat is blamed for everything from cardiovascular disease to diabetes, it's no surprise that a number of controlled trials have asked if saturated fat feeding causes insulin resistance when compared to other fats. From the way the evidence is sometimes portrayed, you might think it does. However, a careful review of the literature reveals that this position is exaggerated, to put it mildly (1).

The glycemic index, a measure of how much a specific carbohydrate food raises blood sugar, is another common concept in the diet-health literature. On the surface, it makes sense: if excess blood sugar is harmful, then foods that increase blood sugar should be harmful. Despite evidence from observational studies, controlled trials as long as 1.5 years have shown that the glycemic index does not influence insulin sensitivity or body fatness (2, 3, 4). The observational studies may be confounded by the fact that white flour and sugar are the two main high-glycemic foods in most Western diets. Most industrially processed carbohydrate foods also have a high glycemic index, but that doesn't imply that their high glycemic index is the reason they're harmful.

All of this is easy for me to accept, because I'm familiar with examples of traditional cultures eating absurd amounts of saturated fat and/or high-glycemic carbohydrate, and not developing metabolic disease (5, 6, 7). I believe the key is that their food is not industrially processed (along with exercise, sunlight exposure, and probably other factors).

A large new study just published in the American Journal of Clinical nutrition has taken the evidence to a new level (8). At 6 months and 720 participants, it was both the largest and one of the longest studies to address the question. Participants were assigned to one of the following diets:
  1. High saturated fat, high glycemic index
  2. High monounsaturated fat, high glycemic index
  3. High monounsaturated fat, low glycemic index
  4. Low fat, high glycemic index
  5. Low fat, low glycemic index
Compliance to the diets was pretty good. From the nature of the study design, I suspect the authors were expecting participants on diet #1 to fare the worst. They were eating a deadly combination of saturated fat and high glycemic carbohydrate! Well to their dismay, there were no differences in insulin sensitivity between groups at 6 months. Blood pressure also didn't differ between groups, although the low-fat groups lost more weight than the monounsaturated fat groups. The investigators didn't attempt to determine whether the weight loss was fat, lean mass or both. The low-fat groups also saw an increase in the microalbumin:creatinine ratio compared to other groups, indicating a possible deterioration of kidney function.

In my opinion, the literature as a whole consistently shows that if saturated fat or high glycemic carbohydrate influence insulin sensitivity, they do so on a very long timescale, as no effect is detectable in controlled trails of fairly long duration. While it is possible that the controlled trials just didn't last long enough to detect an effect, I think it's more likely that both factors are irrelevant.

Fats were provided by the industrial manufacturer Unilever, and were incorporated into margarines, which I'm sure were just lovely to eat. Carbohydrate was also provided, including "bread, pasta, rice, and cereals." In other words, all participants were eating industrial food. I think these types of investigations may be limited by reductionist thinking. I prefer studies like Dr. Staffan Lindeberg's paleolithic diet trials (9, 10, 11). The key difference? They focus mostly on diet quality, not calories or specific nutrients. And they have shown that quality is king!

* Excess body fat is almost certainly a major cause. When fat mass increases beyond a certain point, particularly abdominal fat, the fat tissue typically becomes inflamed. Inflamed fat tissue secretes factors which reduce whole-body insulin sensitivity (12, 13). The big question is: what caused the fat gain?

Why Did I Bob My Hair?

Source: Beaute'Craft, February 1925

If you want to hear "Why Did I Kiss That Girl?" you can search for the tune on Jazz-On-Line. Some of the lines, like "WHY oh! WHY oh! WHY" come right out of that song. It's pretty catchy.

Celebrate Get Ready Day on Sept. 21 and spread the preparedness message

Help your community become more prepared for pandemic flu, disasters and other public health threats by taking part in this year’s Get Ready Day on Tuesday, Sept. 21.

Held annually on the third Tuesday in September, Get Ready Day is timed to coincide with National Preparedness Month, which urges all Americans to prepare, plan and stay informed. Get Ready Day is part of APHA’s Get Ready campaign, which is helping Americans prepare themselves, their families and their communities for all hazards they may face, including pandemic flu, infectious diseases, disasters and other public health threats.

So how can you get involved in Get Ready Day? Set up a booth on campus, pass out materials at a health department, sponsor a preparedness talk at a community center or work with a local grocery store to promote preparedness and stockpiling to shoppers. Our Get Ready Event Guide (PDF) has even more ideas, an event checklist and a sample news release. Also available online from APHA is the Get Ready Games Guide, with do-it-yourself preparedness games that can be used at a Get Ready Day event for kids. No time to hold an event? Add the Get Ready logo and link to your website or blog.

This year, the campaign launched the Get Ready Pledge. Pledge to help make your community better prepared and spread the word! Also new to Get Ready is the Get Ready Video, which tells the story of preparedness through a fun, animated story of an ant and a grasshopper. The video can be downloaded to share with friends and family.

You can help spread the word about your Get Ready Day event by posting your activity to our free online Get Ready Calendar of Events. We’d love to hear about how you celebrate Get Ready Day, so drop us a line or send us a photo of your activities. Thanks for helping spread the preparedness message!

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Watch our new Get Ready Video!

Preparedness advocates who want to spread the word about the importance of being ready for disasters have a new tool at their disposal: A free video from APHA’s Get Ready campaign.

Unveiled today, the two-minute Get Ready Video emphasizes that preparedness pays off when an unexpected disaster occurs and provides tips to get ready. The lesson is couched in an entertaining tale of an ant that is always prepared and a grasshopper that is not, and how the grasshopper learns the lesson. Presented in a colorful, animated style, the video is aimed at viewers of all ages.

The video can be downloaded and shared for free. Supporters are encouraged to show the video at their workplace, in schools, at community events or other venues. The video is also suitable for airing at health departments, office lobbies or doctors’ waiting rooms.

Watch, share and download the Get Ready Video now.
With both Get Ready Day and National Preparedness Month just around the corner, now is the perfect time to educate your community about being ready for disasters.

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(Click on images to enlarge.)
Source: American Hairdresser, May 1945

Where's That Then? No 37

I only discovered this sublime place a couple of weeks ago. Yet another thing I love about England- you never know what's around the next corner. A bit like Northern Ireland, when I drove round a bend and found an old man worse for drink lying in the middle of the road in the pouring rain. Passing motorists negotiated me trying to pick him up so that I could lay him over a fence like an old carpet waiting to be beaten, both of us clutching each other in a ghastly dance. Anyway, how about this? Impossibly English, it must have been used as a period film location.

What this warm, dry summer may mean for Maine's water supplies

We’ve been fortunate to enjoy sunny, warm, dry weather this summer, but the limited amount of rainfall we’ve received can have an impact on Maine’s water resources, especially on our water supplies.

The water for public drinking water systems and home wells comes from rainfall, so the less rainfall we get, the less water that is available from our wells. It's always a good practice to use water efficiently, but drier than average summers like this one should serve as a reminder to us all to be conscious of our water usage and encourage us to take steps to conserve water.

Some things you can do to save water:

  • Wash only full loads of dishes and clothes or lower the water settings for smaller loads.
  • Limit the use of lawn and garden spinklers and only water your lawn or garden during the cool morning hours, as opposed to midday, to reduce evaporation.
  • Check your home for leaks and repair any that you find. Leaking faucets and pipes can amount to hundreds of gallons of wasted water every day.
  • Even out your use of water at your home over the course of the day. This can help sustain your water supply, prevent a temporary shortage, and damage to your well pump.

For more information on how you can conserve water, visit EPA’s Water Sense page at

You are what you eat: How not to get sick during a food-borne disease outbreak

When it comes to the food you eat, there could be more than meets the eye. Did you know that foods — from lettuce to peanut butter to breakfast cereal — can contain things that make you sick? Bacteria such as E. coli, salmonella and campylobacter could be lurking in all types of foods and you wouldn’t even know it.

Hundreds of people learned that lesson first-hand recently, when they were sickened by salmonella-contaminated eggs. Almost 300 million eggs have been recalled, which unfortunately is not that uncommon. In fact, more than 1,000 food-borne disease outbreaks are reported to the Centers for Disease Control and Prevention every year, involving everything from beef and poultry to fruits and vegetables. If you aren’t aware of the latest outbreak or don’t know if your food is infected, you and your community could be at risk of a serious food-borne illness.

Luckily, there are ways to be prepared. The key is knowing when food-borne disease outbreaks are out there so you know what foods to avoid. The most common foods linked to food-borne illness include poultry, beef and leafy vegetables. The best way to stay informed is to stay up on recalls. The Food and Drug Administration recall Web page lists the latest info, which you can sign up to receive via e-mail. You can also subscribe to an RSS feed for recalls or follow FDA recalls on Twitter. This way, you’ll be the first to know when an outbreak occurs.

If you think you’ve consumed contaminated food, you should follow these guidelines:
• If serious symptoms occur, call your doctor.
• Identify the food product, report the time and date it was consumed and track when symptoms began.
• Inform your local health department if the food was served to a large group of people.

For more information, FDA has dished out some important food handling tips to protect you from food-borne illness. And be sure to check out these podcasts on food safety from the United States Department of Agriculture.

Photo credit: Photo by Julija Sapic, courtesy iStockphoto

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Tropical Plant Fats: Coconut Oil, Part II

Heart Disease: Animal Studies

Although humans aren't rats, animal studies are useful because they can be tightly controlled and experiments can last for a significant portion of an animal's lifespan. It's essentially impossible to do a tightly controlled 20-year feeding study in humans.

The first paper I'd like to discuss come from the lab of Dr. Thankappan Rajamohan at the university of Kerala (1). Investigators fed three groups of rats different diets:
  1. Sunflower oil plus added cholesterol
  2. Copra oil, a coconut oil pressed from dried coconuts, plus added cholesterol
  3. Freshly pressed virgin coconut oil, plus added cholesterol
Diets 1 and 2 resulted in similar lipids, while diet 3 resulted in lower LDL and higher HDL. A second study also showed that diet 3 resulted in lower oxidized LDL, a dominant heart disease risk factor (2). Overall, these papers showed that freshly pressed virgin coconut oil, with its full complement of "minor constituents"*, partially protects rats against the harmful effects of cholesterol overfeeding. These are the only papers I could find on the cardiovascular effects of unrefined coconut oil in animals!

Although unrefined coconut oil appears to be superior, even refined coconut oil isn't as bad as it's made out to be. For example, compared to refined olive oil, refined coconut oil protects against atherosclerosis (hardening and thickening of the arteries) in a mouse model of coronary heart disease (LDL receptor knockout). In the same paper, coconut oil caused more atherosclerosis in a different mouse model (ApoE knockout) (3). So the vascular effects of coconut oil depend in part on the animals' genetic background.

In general, I've found that the data are extremely variable from one study to the next, with no consistent trend showing refined coconut oil to be protective or harmful relative to refined monounsaturated fats (like olive oil) (4). In some cases, polyunsaturated oils cause less atherosclerosis than coconut oil in the context of an extreme high-cholesterol diet because they sometimes lead to blood lipid levels that are up to 50% lower. However, even this isn't consistent across experiments. Keep in mind that atherosclerosis is only one factor in heart attack risk.

What happens if you feed coconut oil to animals without adding cholesterol, and without giving them genetic mutations that promote atherosclerosis? Again, the data are contradictory. In rabbits, one investigator showed that serum cholesterol increases transiently, returning to baseline after about 6 months, and atherosclerosis does not ensue (5). A different investigator showed that coconut oil feeding results in lower blood lipid oxidation than sunflower oil (6). Yet a study from the 1980s showed that in the context of a terrible diet composition (40% sugar, isolated casein, fat, vitamins and minerals), refined coconut oil causes elevated blood lipids and atherosclerosis (7). This is almost certainly because overall diet quality influences the response to dietary fats in rabbits, as it does in other mammals.

Heart Disease: Human Studies

It's one of the great tragedies of modern biomedical research that most studies focus on nutrients rather than foods. This phenomenon is called "nutritionism". Consequently, most of the studies on coconut oil used a refined version, because the investigators were most interested in the effect of specific fatty acids. The vitamins, polyphenols and other minor constituents of unrefined oils are eliminated because they are known to alter the biological effects of the fats themselves. Unfortunately, any findings that result from these experiments apply only to refined fats. This is the fallacy of the "X fatty acid does this and that" type statements-- they ignore the biological complexity of whole foods. They would probably be correct if you were drinking purified fatty acids from a beaker.

Generally, the short-term feeding studies using refined coconut oil show that it increases both LDL ("bad cholesterol") and HDL ("good cholesterol"), although there is so much variability between studies that it makes firm conclusions difficult to draw (8, 9). As I've written in the past, the ability of saturated fats to elevate LDL appears to be temporary; both human and certain animal studies show that it disappears on timescales of one year or longer (10, 11). That hasn't been shown specifically for coconut oil that I'm aware of, but it could be one of the reasons why traditional cultures eating high-coconut diets don't have elevated serum cholesterol.

Another marker of cardiovascular disease risk is lipoprotein (a), abbreviated Lp(a). This lipoprotein is a carrier for oxidized lipids in the blood, and it correlates with a higher risk of heart attack. Refined coconut oil appears to lower Lp(a), while refined sunflower oil increases it (12).

Unfortunately, I haven't been able to find any particularly informative studies on unrefined coconut oil in humans. The closest I found was a study from Brazil showing that coconut oil reduced abdominal obesity better than soybean oil in conjunction with a low-calorie diet, without increasing LDL (13). It would be nice to have more evidence in humans confirming what has been shown in rats that there's a big difference between unrefined and refined coconut oil.

Coconut Oil and Body Fat

In addition to the study mentioned above, a number of experiments in animals have shown that "medium-chain triglycerides", the predominant type of fat in coconut oil, lead to a lower body fat percentage than most other fats (14). These findings have been replicated numerous times in humans, although the results have not always been consistent (15). It's interesting to me that these very same medium-chain saturated fats that are being researched as a fat loss tool are also considered by mainstream diet-heart researchers to be among the most deadly fatty acids.

Coconut Oil and Cancer

Refined coconut oil produces less cancer than seed oils in experimental animals, probably because it's much lower in omega-6 polyunsaturated fat (16, 17). I haven't seen any data in humans.

The Bottom Line

There's very little known about the effect of unrefined coconut oil on animal and human health, however what is published appears to be positive, and is broadly consistent with the health of traditional cultures eating unrefined coconut foods. The data on refined coconut oil are conflicting and frustrating to sort through. The effects of refined coconut oil seem to depend highly on dietary context and genetic background. In my opinion, virgin coconut oil can be part of a healthy diet, and may even have health benefits in some contexts.

* Substances other than the fat itself, e.g. vitamin E and polyphenols. These are removed during oil refining.

And she flipped

(Click on these images to see full-size versions)
Source: Hairset Magazine, May 1964

Tropical Plant Fats: Coconut Oil, Part I

Traditional Uses for Coconut

Coconut palms are used for a variety of purposes throughout the tropics. Here are a few quotes from the book Polynesia in Early Historic Times:
Most palms begin to produce nuts about five years after germination and continue to yield them for forty to sixty years at a continuous (i.e., nonseasonal) rate, producing about fifty nuts a year. The immature nut contains a tangy liquid that in time transforms into a layer of hard, white flesh on the inner surface of the shell and, somewhat later, a spongy mass of embryo in the nut's cavity. The liquid of the immature nut was often drunk, and the spongy embryo of the mature nut often eaten, raw or cooked, but most nuts used for food were harvested after the meat had been deposited and before the embryo had begun to form...

After the nut had been split, the most common method of extracting its hardened flesh was by scraping it out of the shell with a saw-toothed tool of wood, shell, or stone, usually lashed to a three-footed stand. The shredded meat was then eaten either raw or mixed with some starchy food and then cooked, or had its oily cream extracted, by some form of squeezing, for cooking with other foods or for cosmetic or medical uses...

Those Polynesians fortunate enough to have coconut palms utilized their components not only for drink and food-- in some places the most important, indeed life-supporting food-- but also for building-frames, thatch, screens, caulking material, containers, matting, cordage, weapons, armor, cosmetics, medicine, etc.
Mainstream Ire

Coconut fat is roughly 90 percent saturated, making it one of the most highly saturated fats on the planet. For this reason, it has been the subject of grave pronouncements by health authorities over the course of the last half century, resulting in its near elimination from the industrial food system. If the hypothesis that saturated fat causes heart disease and other health problems is correct, eating coconut oil regularly should tuck us in for a very long nap.

Coconut Eaters

As the Polynesians spread throughout the Eastern Pacific islands, they encountered shallow coral atolls that were not able to sustain their traditional starchy staples, taro, yams and breadfruit. Due to its extreme tolerance for poor, salty soils, the coconut palm was nearly the only food crop that would grow on these islands*. Therefore, their inhabitants lived almost exclusively on coconut and seafood for hundreds of years.

One group of islands that falls into this category is Tokelau, which fortunately for us was the subject of a major epidemiological study that spanned the years 1968 to 1982: the Tokelau Island Migrant Study (1). By this time, Tokelauans had managed to grow some starchy foods such as taro and breadfruit (introduced in the 20th century by Europeans), as well as obtaining some white flour and sugar, but their calories still came predominantly from coconut.

Over the time period in question, Tokelauans obtained roughly half their calories from coconut, placing them among the most extreme consumers of saturated fat in the world. Not only was their blood cholesterol lower than the average Westerner, but their hypertension rate was low, and physicians found no trace of previous heart attacks by ECG (age-adjusted rates: 0.0% in Tokelau vs 3.5% in Tecumseh USA). Migrating to New Zealand and cutting saturated fat intake in half was associated with a rise in ECG signs of heart attack (1.0% age-adjusted) (2, 3).

Diabetes was low in men and average in women by modern Western standards, but increased significantly upon migration to New Zealand and reduction of coconut intake (4). Non-migrant Tokelauans gained body fat at a slower rate than migrants, despite higher physical activity in the latter (5). Together, this evidence seriously challenges the idea that coconut is unhealthy.

The Kitavans also eat an amount of coconut fat that would make Dr. Ancel Keys blush. Dr. Staffan Lindeberg found that they got 21% of their 2,200 calories per day from fat, nearly all of which came from coconut. They were getting 17% of their calories from saturated fat; 55% more than the average American. Dr. Lindeberg's detailed series of studies found no trace of coronary heart disease or stroke, nor any obesity, diabetes or senile dementia even in the very old (6, 7).

Of course, the Tokelauans, Kitavans and other traditional cultures were not eating coconut in the form of refined, hydrogenated coconut oil cake icing. That distinction will be important when I discuss what the biomedical literature has to say in the next post.

* Most also had pandanus palms, which are also tolerant of poor soils and whose fruit provided a small amount of starch and sugar.

Where's That Then? No 36

Right then. Sorry for all this mucking about. All will become clear, because I'm bringing a book to its conclusion and my brain is therefore degenerating. More of that later, but in the meantime I give you a London corner turret. Quite spectacular, there are variants all around it. Not the usual quiz monochrome, but I stared and stared at this yesterday, an ample reward for the UE Eleventh Commandment: Thou Shalt Always Look Up.

Where Is It Then?

Having been away I have returned to my computer to find someone's messed about with my photo settings and it's going to take me all day (well, when I'm back from Darkest Essex) to find out what's happened. So. Very sorry. Normal service will probably be in the morning now. Curses.

Don’t let disease cramp your summertime fun

Whether you’re camping, staying hydrated or going for a swim, water is a huge part of summer fun. However, the water that we swim in and drink can sometimes contain disease-causing bacteria or viruses (which can seriously cut into that summertime fun).

To keep yourself from getting sick from contaminated water, follow these tips from APHA’s Get Ready campaign:

• Before you go to the beach, check out the Environmental Protection Agency’s online Beach Advisory and Closing Online Notification system to see if there are any warnings of water contamination or closings at beaches near you. If possible, avoid swimming the day after a heavy rainstorm, when contamination is often highest. That way you can avoid taking a dip in run-off that’s spread into the water from streets or overflowing drains.

• Headed to the pool? Believe it or not, germs can spread even in chlorinated water. To prevent the spread of bacteria and lessen your chance of getting sick, practice healthy swimming behavior. That means no swallowing the pool water. Shower with soap before and after swimming, and wash your hands after using the toilet or changing diapers. Also, please be kind to your fellow pool-goers: No swimming when you have diarrhea.

• If you’re traveling in an area where tap water is not chlorinated or sanitation is poor, be sure to have lots of bottled water on hand. Also, there are several methods for ensuring water is safe to drink, including boiling, disinfecting or filtering the water. Remember: If the tap water is not safe to drink in the area you are visiting, don’t use it to reconstitute juice or to rinse fresh fruits and vegetables. Also, avoid ice made from tap water, otherwise you may end up regretting it later.

Following these steps will help keep you and others healthy as you beat the heat with water this summer. Splash away!

Photo credit: Courtesy iStockphoto

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Be True to Your Types

(Click on the images to see all the details in the full-size versions.)
Source: American Hairdresser, September 1932

Can a Statin Neutralize the Cardiovascular Risk of Unhealthy Dietary Choices?

The title of this post is the exact title of a recent editorial in the American Journal of Cardiology (1). Investigators calculated the "risk for cardiovascular disease associated with the total fat and trans fat content of fast foods", and compared it to the "risk decrease provided by daily statin consumption". Here's what they found:
The risk reduction associated with the daily consumption of most statins, with the exception of pravastatin, is more powerful than the risk increase caused by the daily extra fat intake associated with a 7-oz hamburger (Quarter Pounder®) with cheese and a small milkshake. In conclusion, statin therapy can neutralize the cardiovascular risk caused by harmful diet choices.

Routine accessibility of statins in establishments providing unhealthy food might be a rational modern means to offset the cardiovascular risk. Fast food outlets already offer free condiments to supplement meals. A free statin-containing accompaniment would offer cardiovascular benefits, opposite to the effects of equally available salt, sugar, and high-fat condiments. Although no substitute for systematic lifestyle improvements, including healthy diet, regular exercise, weight loss, and smoking cessation, complimentary statin packets would add, at little cost, 1 positive choice to a panoply of negative ones.
Wow. Later in the editorial, they recommend "a new and protective packet, “MacStatin,” which could be sprinkled onto a Quarter Pounder or into a milkshake." I'm not making this up!

I can't be sure, but I think there's a pretty good chance the authors were being facetious in this editorial, in which case I think a) it's hilarious, b) most people aren't going to get the joke. If they are joking, the editorial is designed to shine a light on the sad state of mainstream preventive healthcare. Rather than trying to educate people and change the deadly industrial food system, which is at the root of a constellation of health problems, many people think it's acceptable to partially correct one health risk by tinkering with the human metabolism using drugs. To be fair, most people aren't willing to change their diet and lifestyle habits (and perhaps for some it's even too late), so frustrated physicians prescribe drugs to mitigate the risk. I accept that. But if our society is really committed to its own health and well-being, we'll remove the artificial incentives that favor industrial food, and educate children from a young age on how to eat well.

I think one of the main challenges we face is that our current system is immensely lucrative for powerful financial interests. Industrial agriculture lines the pockets of a few large farmers and executives (while smaller farmers go broke and get bought out), industrial food processing concentrates profit among a handful of mega-manufacturers, and then people who are made ill by the resulting food spend an exorbitant amount of money on increasingly sophisticated (and expensive) healthcare. It's a system that effectively milks US citizens for a huge amount of money, and keeps the economy rolling at the expense of the average person's well-being. All of these groups have powerful lobbies that ensure the continuity of the current system. Litigation isn't the main reason our healthcare is so expensive in the US; high levels of chronic disease, expensive new technology, a "kitchen sink" treatment approach, and inefficient private companies are the real reasons.

If the editorial is serious, there are so many things wrong with it I don't even know where to begin. Here are a few problems:
  1. They assume the risk of heart attack conveyed by eating fast food is due to its total and trans fat content, which is simplistic. To support that supposition, they cite one study: the Health Professionals Follow-up Study (2). This is one of the best diet-health observational studies conducted to date. The authors of the editorial appear not to have read the study carefully, because it found no association between total or saturated fat intake and heart attack risk, when adjusted for confounding variables. The number they quoted (relative risk = 1.23) was before adjustment for fiber intake (relative risk = 1.02 after adjustment), and in any case, it was not statistically significant even before adjustment. How did that get past peer review? Answer: reviewers aren't critical of hypotheses they like.
  2. Statins mostly work in middle-aged men, and reduce the risk of heart attack by about one quarter. The authors excluded several recent unsupportive trials from their analysis. Dr. Michel de Lorgeril reviewed these trials recently (3). For these reasons, adding a statin to fast food would probably have a negligible effect on the heart attack risk of the general population.
  3. "Statins rarely cause negative side effects." BS. Of the half dozen people I know who have gone on statins, all of them have had some kind of negative side effect, two of them unpleasant enough that they discontinued treatment against their doctor's wishes. Several of them who remained on statins are unlikely to benefit because of their demographic, yet they remain on statins on their doctors' advice.
  4. Industrial food is probably the main contributor to heart attack risk. Cultures that don't eat industrial food are almost totally free of heart attacks, as demonstrated by a variety of high-quality studies (4, 5, 6, 7, 8, 9). No drug can replicate that, not even close.
I have an alternative proposal. Rather than giving people statins along with their Big Mac, why don't we change the incentive structure that artificially favors the Big Mac, french fries and soft drink? If it weren't for corn, soybean and wheat subsidies, fast food wouldn't be so cheap. Neither would any other processed food. Fresh, whole food would be price competitive with industrial food, particularly if we applied the grain subsidies to more wholesome foods. Grass-fed beef and dairy would cost the same as grain-fed. I'm no economist, so I don't know how realistic this really is. However, my central point still stands: we can change the incentive structure so that it no longer artificially favors industrial food. That will require that the American public get fed up and finally butt heads with special interest groups.

Watch out for diseases related to ticks and mosquitoes

Summer is the prime time for mosquitoes and ticks – as well as the diseases they carry. Ticks can cause Anaplasma, Babesia, Ehrlichia, Lyme, Rocky Mountain Spotted Fever, and Powassan. Mosquitoes can carry Eastern Equine Encephalitis (EEE) and West Nile virus (WNV).

Tickborne diseases have already been reported in Maine this summer – and all Mainers should follow these recommendations to prevent illness:
Wear protective clothing
Use insect repellent
Use caution in tick infested areas
Perform daily tick checks

Although EEE and WNV have not been found in Maine yet this summer, there was unprecedented EEE activity in Maine in 2009. Several surrounding states have already seen EEE and WNV activity, including increased risk of EEE in southeastern Massachusetts (more information can be found at

Information this year suggests that even though there may be fewer mosquitoes, a higher percentage of those mosquitoes may be carrying disease. Some ways to minimize the risk of EEE and WNV include:
Wear long sleeves and long pants
Use insect repellent on skin and clothes
Take extra precautions at dusk and dawn
Drain sources of artificial standing water where you live, work and play
Install or repair screens on windows and doors

Physicians should keep these diseases in mind, particularly during the summer months. Early recognition and treatment may help prevent complications. All cases of tickborne (including erythema migrans) and mosquito-borne diseases should be reported to Maine CDC at 1-800-821-5821.

For more information:

Prevent Dropping of Permanently Waved Neck Curls

(Click on images to see the full-size version.)
Source: American Hairdresser, April 1937

Where's That Then? No 35

I used to pass through here fairly regularly, which is no use at all. I went through it three weeks ago or so and it hasn't changed that much from the picture, just more traffic. What more useful clue can I give? I know. Think Mary and Eliza.

The Coronet Coif

(This image links to the full-size version.)
Source: American Hairdresser, May 1945

Whither the Beard and the Bush?

(Click on images to see these beards in all their glory.)
Source: Hairdo Magazine, July 1972

National Immunization Awareness Month: The value of vaccination

August is National Immunization Awareness Month, which means it’s the perfect time to make sure you and your family are up to date on vaccinations. It’s also a great time to recognize the many benefits of immunization, which is one of the most significant public health achievements of the 20th century.

Before vaccines were available, people could have expected diseases such as polio to have lifelong negative impacts on their lives. Today, however, diseases that can be prevented through vaccines are at record lows (PDF). However, the bacteria and viruses that cause these diseases still exist. So if people decide to stop getting vaccinated, the diseases can spread.

That’s a lesson that California residents have learned lately with a recent outbreak of whooping cough, also known as pertussis, which has killed at least seven infants and caused more than 2,000 cases of illness this year. Health officials in the state are reminding residents that both children and adults who come into contact with those who are sick need to keep up on their pertussis vaccinations, which is a message that should resonate with everyone.

"The pertussis epidemic is a sobering and tragic reminder that diseases long-thought controlled can return with a vengeance," said Mark Horton, director of the California Department of Public Health.

With both school and the flu season just around the corner, August is a great time to remind family, friends and co-workers to catch up on vaccinations. To find out what vaccinations you and your family need, check out CDC’s immunization schedules for children and teens or for adults. Remember: Keeping a community healthy and safe from infectious disease involves everyone.

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Where's That Now Then

This is my very recent shot of the Cley-next-the-Sea windmill featured in last Tuesday's quiz. I managed to get down into someone's tiny boat moored on the water, almost exactly where the boat is in the original picture. You can immediately see how much silting and general narrowing has gone on in the last 60-odd years. My trouble was that I had great difficulty in getting out of the boat, and ended up going in the River Glaven. In obvious distress that naturally involved a lot of very loud cursing, Tess of the D'Urbervilles, who shall be nameless, couldn't do anything for laughing, and when I finally got back up onto dry land by squelching up a wooden ladder, I found people patting her on the back because she was crying and choking at the same time.

Saturated Fat Consumption Still isn't Associated with Heart Attack Risk

The American Journal of Clinical Nutrition just published the results of a major Japanese study on saturated fat intake and cardiovascular disease (1). Investigators measured dietary habits, then followed 58,453 men and women for 14.1 years. They found that people who ate the most saturated fat had the same heart attack risk as those who ate the least*. Furthermore, people who ate the most saturated fat had a lower risk of stroke than those who ate the least. It's notable that stroke is a larger public health threat in Japan than heart attacks.

This is broadly consistent with the rest of the observational studies examining saturated fat intake and cardiovascular disease risk. A recent review paper by Dr. Ronald Krauss's group summed up what is obvious to any unbiased person who is familiar with the literature, that saturated fat consumption doesn't associate with heart attack risk (2). In a series of editorials, some of his colleagues attempted to discredit and intimidate him after its publication (3, 4). No meta-analysis is perfect, but their criticisms were largely unfounded (5, 6).

*Actually, people who ate the most saturated fat had a lower risk but it wasn't statistically significant.

Be Exact in Building Pin Curls

(Click on images to enlarge.)
Source: American Hairdresser, May 1945

Summer Seasonal Influenza Outbreaks Across Country

Across the country there have been some recent outbreaks of influenza, not the H1N1 pandemic type but a seasonal (H3N2) variety. We've not seen outbreaks in Maine, but the link to this morning's health alert describes what people in Maine should be on the lookout for.

Smart for Summer

(Click on images to enlarge.)
Source: American Hairdresser, May 1945

I love the smooth rolls. So pretty...

Where's That Then? No 34

Deceptively simple. Probably. All I'll say is that although this view today still has the mill, a river and boats (and very little else), it looks very different. Think silting up, as you do on a Tuesday morning.

Dirtiest Find in the Hospital: Cell Phones

Several years ago I raised the issue of a problem related to infection control directly related to the cell phone use of doctor's in hospital.

EMF generated by cell phones and other similar EMF producing appliances creates a static charge that draws bacteria to these units. As the doctors go from patient room to patient room they collect and transport ever more dirt!

I liken this to the Ignatz Semmelweiss discovery that hand washing between patient visits reduced hospital infection rates. Disinfecting the cell phone in between rooms might help too, in the more modern health outpost.

A year or so ago some attention was drawn to computer keyboards in the MRSA discussion, and this article supports the issue -
Keyboard that warns users when it is dirty could banish hospital superbugs
By Daily Mail Reporter, 18th June 2008

Health chiefs are spending £1 million on the latest weapon against superbugs - "infection-resistant" computer keyboards.

Experts at University College London Hospital have developed a keyboard which is easier to clean than conventional designs.It also includes an alarm to warn staff when it needs cleaning.

The flat silicone keyboards will be rolled out in hospitals across England, and it is hoped they will save the NHS millions cut rates of MRSA by 10 per cent.

Microbiologist Dr Peter Wilson helped develop the keyboard. Just last month he found the average keyboard was five times dirtier than a toilet seat. Swabs taken from office and hospital desks revealed 150 times the recommended limit for bacteria.

"Should somebody have a cold in your office, or even have gastroenteritis, you're very likely to pick it up from a keyboard," the professor said.

The NHS spends more than £1.6 billion a year on combating superbugs.

There has been a huge drive to encourage nurses and doctors to wash their hands between examining patients but a persistent problem is staff spreading infection by touching keyboards, picking up bacteria and then transferring this to other surfaces.

Research by microbiologists at UCLH has shown bacterial levels on the new style keyboards fall by 70 per cent if they are cleaned every 12 hours.

UCLH microbiologist Dr Peter Wilson, who helped invent the keyboard, said: "Doctors and nurses were going from patient to keyboard without washing their hands.

"That's quite understandable because you would wash your hands between patients but not between a patient and a keyboard."

Traditional keyboards are high-risk areas in hospitals because they can harbour bacteria and cannot be cleaned with water or fluids.

Keyboard covers are also to blame for spreading infection because they are rarely cleaned so hospital workers who use them spread potentially lethal bacteria.

The new type of computer keyboard has hidden sensors to make sure its surfaces are cleaned properly with alcohol wipes.

Manufactured by American company Esterline and distributed by British firm Advanced Power Components, it has incorporated a warning light system that activates every three or 12 hours.

The keyboard is also covered with a hypo-allergenic material resistant to bacterial growth.

Artificial fingernails also became part of this discussion.

And now over six years later, the dirty phone issue raises once more its ugly head.
Mobile phones have 18 times more bacteria than toilet handle

By Andrew Levy
Last updated at 8:51 AM on 30th July 2010

They are pretty much essential, but you may want to ditch your mobile phone for ever after reading this.

The average handset carries 18 times more potentially harmful germs than a flush handle in a men's toilet, tests have revealed.

An analysis of handsets found almost a quarter were so dirty that they had up to ten times an acceptable level of TVC bacteria.

One of the phones in the test had such high levels of bacteria it could have given its owner a serious stomach upset.

While TVC is not immediately harmful, elevated levels indicate poor personal hygiene and act as a breeding ground for other bugs.

The findings from a sample of 30 phones by Which? magazine suggest 14.7million of the 63million mobiles in use in the UK today could be potential health hazards.

Hygiene expert Jim Francis, who carried out the tests, said: 'The levels of potentially harmful bacteria on one mobile were off the scale. That phone needs sterilising.'

The most unhygienic phone had more than ten times the acceptable level of TVC and seven were above the threshold.

This worst handset also had 39 times the safe level of enterobacteria, a group of bacteria that live in the lower intestines of humans and animals and include bugs such as Salmonella.

It boasted 170 times the acceptable level of faecal coliforms, which are associated with human waste.

Other bacteria including food poisoning bugs e.coli and staphylococcus aureus were found on the phones but at safe levels.

Which? researcher Ceri Stanaway said: 'Most phones didn't have any immediately harmful bacteria that would make you sick straight away but they were grubbier than they could be.

'The bugs can end up on your hands which is a breeding ground and be passed back to your phone. They can be transferred back and forth and eventually you could catch something nasty.

'What this shows is how easy it is to come into contact with bacteria. People see toilet flushes as being something dirty to touch but they have less bacteria than phones.

'People need to be mindful of that by observing good hygiene themselves and among others who they pass the phone to when looking at photos, for example.'

Which? has previously found that some computer keyboards carry more harmful bacteria than a lavatory seat.

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I'd suppose this might give you pause for reflection. It should to the health care CEOs who have a head in the sand approach to the MRSA concern.