What causes heart disease part XVIIII


As I have written this series of blogs I have noted with interest the comments that people have come up with, and the discussions that have followed. It is interesting, though not unexpected, that almost everyone has focussed, almost entirely, on diet, and little else.

There are those who are utterly convinced that the cause of cardiovascular disease is a high carbohydrate diet. There are others who argue that this is not the case. There are also many who promote various dietary supplements, and vitamins and suchlike.

Within the mainstream, the discussions also seem to focus almost entirely on diet [and the effect diet has on cholesterol levels in the blood]. Over the years the ‘experts’ have moved on from cholesterol in the diet to saturated fat, to saturated/polyunsaturated ratios, to Omega-6 to Omega-3, to even or odd chained saturated and polyunsaturated fats… and on and on and on.

Sixty years ago Ancel Keys proposed the diet-heart hypothesis of cardiovascular disease. He started by stating that cholesterol in the diet raised cholesterol levels, which then cause cardiovascular disease. He ended up stating that saturated fat raised cholesterol levels and, well, you know that last bit. At least he only changed direction once.

Juhn Yudkin was Keys’ main rival in the diet-heart stakes. He stated that is was sugar in the diet that was the culprit. Unfortunately, Ancel Keys was a far better political operator and self-publicist. So he crushed Yudkin and won the argument. At least he won it for a while. Now, more and more people are saying that Yudkin was right all along.

Whatever you may think of Ancel Keys, and my thoughts should never be put down on paper without significant filtering out of swear words, he certainly managed to set the agenda for all discussions that followed. The agenda being that cardiovascular disease is caused by ‘something’ in the diet. Thus, diet has become playing field, and almost everyone fights here. It is this in the diet, not that. It is that, not this.

The problem I have here is that I do not believe that diet has much of a role to play in cardiovascular disease. There is evidence that vegetarians can live long, long and healthy lives. There is evidence that meat eater live long, long and healthy lives. In the West, we are eating more and more sugar and carbohydrate and the rate of cardiovascular disease falling. France maintains a very high saturated fat diet, and their rate of cardiovascular disease also falling.

I read the Blue Zones, which looked at people who live the longest, and I can see nothing whatsoever in the diet that links them together. Although the authors made various attempt to suggest that a vegetarian diet was healthy, the evidence does not stack up to support their assertions.

Of course I will be told that is not a simple as this. We need to look at sub-fractions of monounsaturated fats, or the glycaemic index, or grass fed this, or grain fed that or the specific impact of fructose on lipogenesis and insulin production…. On and on it goes. I sometimes feel that a complexity bomb has been thrown at CVD the purpose of which is to fractalise the debate.

Big fleas have little fleas,

Upon their backs to bite ’em,

And little fleas have lesser fleas,

and so, ad infinitum.

If there is anything, powerfully linking diet to cardiovascular disease, then I cannot see it. The only link that I can see is that people who eat a higher carbohydrate diet are more likely to become obese and develop diabetes. Or, perhaps I should say, develop diabetes and become obese. [A comment I may have to explain at some point].

As people who have diabetes are more likely to die of CVD then it seems highly sensible for those with diabetes to reduce carbohydrate consumption. This is also true of those who seem to be relatively intolerant to carbohydrates. Perhaps I should rephrase this as ‘people who tend to produce more insulin in response to diabetes.’

Blast, again here I am finding myself dragged into the diet debate. It seems impossible to release the discussion from this intellectual black hole. The meme is firmly entrenched. CVD is primarily to do with diet. Ancel Keys may be, posthumously, about to lose the argument on saturated fat However, he certainly succeeded in anchoring almost all discussions within the wider hypothesis that CVD is primarily due to diet.

It is not.

452 thoughts on “What causes heart disease part XVIIII

  1. jvikse58

    Not even trans fat ? The decline in use of transfat correlate with the decline in CVDs since the «epidemic» (as does smoking)

    In Norway, the incidence of CVD has not declined since early nineties (according to sentral statistical bureau (hospital admittance).
    Source and stats on request.

  2. smartersig

    How would you explain Pritkin’s success with reversing HD of which diet appeared to play a key role. Also I am surprised that you cannot find common denominators within the BlueZones. If nothing else they all appear to eat non processed food although you could go further.

  3. Solomon

    Difficult to take at face value when changing my diet has cleared the excess weight, cleared pre-diabetes, hypertension and a few other issues. But I am here to learn.

    1. Suzie

      I need to address all the issues you have cleared – may I ask how your diet changed? I find myself so confused with so much information flying around and with the health care profession not agreeing with new findings. My heads hurts!

  4. Bob

    Reading your blog is sometimes a very frustrating experience.

    You couldn’t avoid going into diet. What does that tell you?

    You have two excellent pieces on what carbs do to you!

    And I’ll bet you have read your Kraft. If so, and if you disagree that the pathology of heart disease is that of diabetes, maybe you could address that next time, rather than continue this endless series.


    A Frustrated Thicko.

    1. Bob

      I see from the comments on another of your blogs that you think insulin makes a difference. It surely follows that diet does, too.

  5. goransjoberg2015


    Welcome with this entry to the really “hot spot” 🙂

    But why is it so hot?

    Vegan warriors, though, don’t seem to take meat eaters like me lightly. A moral issue rather than a health issue?

    I think I agree with most of what you say and my own stand is here that it is not until you “for whatever reason” has been trapped in the metabolic syndrome, “insulin resistant trap”, that you really will benefit from any low carb deal.

    When you have carried out astonishingly successful experiments on yourself, like me and my diabetic wife, it is easy, even for a “die-hard” natural scientist like me, to nurture a “religious belief” in the benefits of LCHF.

    Anyway Big Pharma doesn’t seem to like us with the falling sales of insulin.

    1. Jennifer.

      Goran, I think your experiences in retrieving the health of you and your wife must surely be due to your diet. From what I understand you both eat food as near as possible as to how it was intended…..that is, fresh and natural. Grown without the addition of any man-made fertilisers and herbicides. The food thus obtained then being eaten raw, or fermented naturally for storage without chemical additives.
      I would say that any food produced naturally is unlikely to cause illness….it is man’s interference with added toxins and unnatural handling that causes the trouble. Since the introduction of man made chemicals to every food process, and the industrialisation of food processing by extreme mechanisation, we can document the decline in a nation’s health.
      P.s. On a personal level, I still can’t get to grips with your sauerkraut, but I am having great success with fermenting fruit and veg ( mainly stoned fruits, onions, cucumbers and garlic), using sea salt and whey obtained from straining my home made yogurt and kefir. I have reintroduced bread into our diet after a gap of 3 years, but I make it using organic flours with natural sourdough, and a very long fermentation time. The detrimental impact of the carbohydrate content of these foods is thus reduced significantly, reducing the strain on our digestive system.
      Natural, organic food, processed using natural conditions, I believe is a step in the right direction.

    2. sasha

      I think it goes both ways. Vegans don’t take meat eaters lightly and LCHFers think they found the Holy Grail…

  6. Håkan

    So when it comes to diabetes, every heath check includes test of blood suger. But wouldn’t it be better to test insulin levels, then you would gain a decade or so in spotting development of metabolic syndrome?

    1. mikecawdery

      But wouldn’t it be better to test insulin levels,

      I tried to get my insulin levels checked in the local NHS Trust. I was told that they never did the test because the treatment was the same what ever the level. One wonders at the logic of this science.

    1. Andy Tindall

      Exactly! Never mind all this CVD mumbo-jumbo, it’s much more important that we learn to wite Roman numerals correctly. If I’ve said it once, I’ve said it M times. 🙂

    2. jgt10

      I was taught 19 should be XIX.

      How can we possibly believe Dr. M if he can’t do his Roman numerals correctly!

      We can because Roman numerals have nothing, zero, zip, zilch, nada, nunca, etc. to do with CVD! 🙂

  7. rdfeinman

    Yes. Great to see it stated explicitly. Perhaps more precise is that we don’t know what factors or subset of people determine whether a person is sensitive to diet in their risk for heart disease. Paraphrasing what you say, if you have diabetes, you are more susceptible to heart disease and therefore you should fix the diabetes which we know can be done through diet. (corollary: don’t take statins just because you have diabetes).

  8. Gerry

    I appreciate your frustration, yet perhaps we also gravitate to diet because it holds out some hope of control or empowerment? The promiss of something we can actually do (eat) or not do (not eat), that will help us to avoid, or ( holy grail) reverse CVD? While your suspected association between large stressors accross populations followed by spikes in CVD decades later may very well prove correct ( and I’m pretty sure you are right from the points you’ve made on this blog ), where do we go from there? Imagine the impact of CVD on migrant populations in decades following the refugee crisis, the arab spring, the war in Syria (the list goes on)….or having to admit that the poor lead shorter lives than the well off not because they cannot afford to eat well, but just from the sheer stress of poverty. I suppose one up side at least is that people will no longer be demonised for eating/not eating meat, lard, tofu blessed in the local temple etc etc…..so maybe we will stop blaming people for getting sick – especially if we aknowledge that those who didn’t just had happier lives, more supportive social networks…..etc etc….

    1. mediapenguin

      I recently read Le Fanu’s Eat Your Heart Out. Very interesting counter response to the 80s hysteria. At the time I ws working as a newspaper reporter in Wigan when Edwina Currie came to town. I took great delight in presenting her with a steak and kidney pie from Greenhalgh’s – in front of the cameras. She had a little nibble and pulled a face. I had pie every day in Wigan and it didnt do me any harm!! At least I don’t think it did….

  9. markheller13

    Thanks again Malcolm for sharing your thoughts with us… Always fascinating and thought-provoking.

    Following a cholesterol ‘scare’, I’ve spent the last 6 months researching diet, CVD, etc. and have become increasingly confused… Like you, I’ve come to the conclusion that either diet has little to do with CVD, or that the dietary influence is very subtle and complex – and so we don’t fully understand it yet.

    My own personal take on this is to limit the amount of carbs I eat (I’m pretty convinced that ‘too much’ sugar is damaging to the body), to avoid processed foods wherever possible, and to eat a wide variety of natural food, with lots of meat, fish, fruit, veg – and wholegrains in moderation.

    I don’t have any specialist knowledge, but my gut feel is that beyond diet, the two most important factors influencing CVD are activity levels, and stress. Inactivity and high levels of stress (both very common nowadays), are I believe, a potentially lethal combination for CVD.

    1. Angela

      Oh Mark (Heller), my brother has been in outdoor pursuits all his life and hasn’t had, so far as I can see, a particularly stressful life, but now at 68 he has had to have two stents fitted. He has a very lean body and the only thing I can see is that he takes after my father who also developed CVD. I’ve been telling my brother LCHF but maybe I’m wrong. Oh dear!

      1. markheller13

        Sorry to hear about your brother Angela… I’m sure your advice was helpful, but I guess sometimes the genetics are not in our favour.

    2. BobM

      I personally have found that reducing carbs and increasing fat, particularly animal fat, has helped me lose a lot of weight and feel much better. Also, starting intermittent fasting has also helped tremendously. I’ve also begun transitioning to a ketogenic diet, and that helps me even more. Will these actions prevent or reduce CVD? It’s hard to say without long studies.

          1. smartersig

            Raed Taubes and others on this topic. My personal experience back there opinions up. I was 11st 4lbs when I was 23 at the age of 56 I was 14st and had been aware of the need to shed a few pounds for a good 2 years. Upping the running did not seem to work but my mistake was thinking that the key was exercise or even calorie count awareness. I never thought I could return to my 23 year old weight but I thought I could perhaps get a stone off. You see I had bought into this as you get older you are bound to put weight on nonsense. I then changed what I was eating still consuming as much as I wanted and being totally unaware of how many calories. The effect was astounding, within 6 months I was down to 11st 5lbs and have remained there ever since. When you change what you eat you auto regulate how much as well as changing insulin response and fat depositing. WHAT you eat is the key, the slimming clubs and health exercise gyms are all based on a lie when it comes to weight loss.

          2. barbrovsky

            The good doctor said:
            WHAT you eat is the key, the slimming clubs and health exercise gyms are all based on a lie when it comes to weight loss.

            So diet IS important. Doesn’t this kinda contradict your earlier statement?

            I’m 5′ 10″, male and 71 and I currently weigh 61 kilos (before I started exercising regularly, I was up to 67 kilos and felt overweight). My BMI if you believe in such things, is apparently 19.3.

            I had a heart attack four years ago which until I got on a physio course, I was very sedentary, not even believing I could get back into real physical activity (bluntly, I was afraid to). Before the heart attack I was about 62-63 ks. Oh, and I smoked Gitanes for 50 years (that might have something to do with it. I gave up about 6 yrs ago).

            As to diet? Well aside from switching to using mostly noodles instead of rice as my main source of carbs, my diet hasn’t changed much at all. Not that it matters that much as all carbs turn to glucose anyway.

            But, I never eat processed foods at all or ready-made dinners etc, or fizzy drinks and I drink booze only rarely. And, never have done (thanks Ma for my Russian/Jewish/Communist upbringing). I’d say at a guess (as I’ve never quantified it) that my diet is 80% vegetable/fruit/grains and 20% meat (fish, free range chicken and a small amount of red meat, mostly lamb), so I’d say I have a very healthy diet. And finances permitting, I buy organic veggies, eat lots broccoli, garlic and ginger and fermented soya as well a range of spices from fenugreek to coriander pretty much every day.

            What strikes me most about the all the fascinating contributions here, is that the common denominator to what ails us is Western, industrial capitalism which has bombarded our bodies (and our minds) with who knows what crap for at least 100 years.

            The worst thing that’s happened to me is the medical industry! This is why I visit this site. Basically, I view my GP (decent person that she is) as a drug dealer for Big Pharma. Basically, since my heart attack I’ve become a victim of pill pushers. I take one pill to counteract another one and now I’m hooked on the damn stuff!

            Yeah, I had a heart attack, I’ve lived a somewhat riotous life on three continents, got involved in a coupla revolutions but up until 4 yrs ago, I’d never been ill (aside from getting all the usual childhood diseases, thank goodness. I rarely ever get colds and never get the flu). I can remember my mum putting a capful of Dettol in the bath as a kid, but that was it. I got my daily dose of cod liver oil, orange juice and (free) milk for my first ten years of life, making me probably part of the healthiest generation of working class kids this country has ever seen (thanks in large measure to the Red, Prof Haldane, who worked out the wartime diet). At high school we had compulsory sports every week (which I hated but I was a promising athlete, who did nothing with it).

            Back then, Asthma was not all common, nor were the allergies so many people suffer from today. Frankly, I say that capitalism has completely poisoned us and our planet. Is it any wonder therefore, that sorting ’causes’ is nigh on impossible, with everything connected to everything else? Thus diet, ‘lifestyle’, stress, war, insecurity, sedentary lives and total pollution of the biosphere, have combined to destroy us, with climate change, the final nail in homo sapiens coffin.

        1. Bob

          And now we’re going to need a – preferably concise – series on obesity, because even the crazy low carbers I follow would raise eyebrows at that statement.

          1. Dr. Malcolm Kendrick Post author

            What, and how much, are two different issues. I would also suggest looking up Per Bjorntorp on pubmed and reading his work. You may also like to look into drugs for psychotic illness and their impact on weight.

          2. Bob

            You really can be an enigma. I’m aware that what is not the same as hndw much, and aware of the reputation of certain medications to lead to weigit gain. Your conclusion still needs explaining.

          3. Mr chris

            Just back from five weeks in Normandy, during which time I ate more bread, fatty meat and fruit and veg than normal, but ate less fish.
            My BP is down as is my weight and slight arrythmias have disappeared.
            Go figure

        2. Sasha

          I think modern American society refutes the notion that being obese has nothing to do with what you eat. As do photos from WWII concentration camps.

          1. sasha

            Yes, WWII wasn’t a good example.

            But I still think that what you eat has effect on weight. As far as I know no one ran an RCT comparing calorie to calorie diet of processed foods vs whole foods but certain things can be inferred. There are a lot of data that gut microbiome is influenced by the type of foods we eat and there are also data that microbiome influences weight.

            Besides, the whole weight debate is academic. Processed foods have so many well documented detrimental effects on the body that it doesn’t make sense debating whether calorie to calorie they make people gain weight or not.

  10. Jean Humphreys

    The thing that has struck me in the mountain of comments is the intense focus on diet, and the attention to detail in the micro-nutrients and supplements. This so clearly parallels the attention to detail of the medical tribe who want to force feed four mutually incompatible chemicals and imagine that will sort the problem.
    There is some good in all approaches, but more in some than others. The worst of it is the elbowing and bullying from the folk who KNOW that they are RIGHT.
    We need more who can lean back and see the big picture.
    I would really laugh my socks off if I were to find that some of my feeling ill was due to a sneaky little cancer, flying below the radar. I mean that: I would laugh.

  11. Gay Corran

    So, what we do or don’t eat has nothing to do with CVD. But diet might well affect Type 2 diabetes. I can corroborate that: after religiously following the GP recommended high carb low fat diet along with simvastatin, I became pre- and then full on T2D. I was told to continue on the same diet and the statin, but that even so, diabetes was always progressive and I would need medication by the end of the year. It seemed utter madness to continue with the same regime that had brought me to this place in the full acknowledgement that my health would deteriorate however strictly I followed the given diet and drug. So I read everything I could about it, and found Dr Bernstein’s book. Immediately stopped the statin and started on his recommended diet, and found that thereafter, to the astonishment of my diabetic nurse, my A1hbc became normal, and stayed in the normal range. Eight years later, annual checkups show no need for diabetic medication, though my BP is “high”. Dr Goran has a similar story of his wife’s diabetes, and also reckons his LCHF diet has prevented the need for further heart surgery, if I read him right. All anecdotal, of course, but many anecdotes make cumulative case history evidence, I think. If diet can have such a strong effect on T2D, which in itself tends to lead to CVD, we could be forgiven for thinking that Keys was wrong with his fat hypothesis, but Bernstein was right with his… We are all agog, Dr K, for what does cause CVD, and what, if anything, we can do to prevent it.

      1. Gay Corran

        Jack, I used to take meds for HBP, but the first one made me cough and the second made me dizzy. And I still had high BP. I then read Doctoring Data and Malignant Medical Myths, in which it was pointed out that lowering BP with drugs didn’t apparently make any difference to how long the patients lived, but tended to make them feel worse while still alive. So I stopped trying to reduce my BP artificially, and tried to improve things with a LBHF diet, which I follow anyway to control my diabetes, (successfully!) For several months I kept track of my BP with thrice-daily monitoring at home, and found that in the evening at bed time, the readings were well below the “high” designation, meaning that medication would be attempting to keep the BP needlessly low all the time. I came to the conclusion that my particular BP needed to be where my body decided it needed to be at any particular time of day…
        So I now refuse to take the drugs with their horrible side effects, and don’t bother measuring my BP any longer, as I’m doing what I can food-wise, and can only hope that the body has its own wisdom!

    1. mikecawdery

      Pretty much my story – hicarb/lofat limited eggs meat etc leading to weight gain then T2D then a MI and stents. This seems to be a common story but totally ignored by the medical establishment; it simply does not fit the gospel, ergo it must be wrong!

    2. Antony Sanderson

      +Gay Coran . . . you have described the exact same pathway I followed. When bit by bit I became diabetic, after taking simvastatin for 3 years, I had to find out why it was that I was that I might end up with amputated limbs. The papers I was reading suggested that it was high, persistent concentrations glucose in the blood damaging the epithelial cells of the capillaries => inflammation => blocking of capillaries => ischemia => sepsis/gangrene => limb loss. So I started on the cut the carb (bread, potatoes, rice, pasta, juices) . . . never letting the glucose level 2hrs after eating get too high. . . . mission: glucose damage limitation. I was well into this when I met with the diabetes nurse. “You must cut down the fat”! ! ! What has fat got to do with my glucose levels? Ignored her advice to eat plenty of pasta (Mediterranean diet) and whole grains. I hadn’t come across LCHF diets but when I did I realized that was sort of where I was at.

      I too gave up statins, in my case because I ended up with muscle damage. At the same time I discovered that one side effect of statins was new onset diabetes. 3 years after giving up statins and sticking to LCHF . . . plus a bit of intermittent fasting I am no longer diabetic.

      On the diet causing CVD: At the time when I read about the dangers of high blood glucose levels the notion of LDL particles invading an artery wall seemed unlikely. But I did wonder if the high glucose levels might be the thing that damaged the epithelium => inflammation and producing something not unlike a pus fill scab in the artery wall. This was all the more likely when I learnt that coronary artery walls have their own capillary system supplying the smooth muscle. So the same scenario as limb-loss might occur in the capillaries in the wall of the artery . . damage by glucose producing an inflammatory response that builds up in the wall, ultimately pushing into the artery lumen like an infected boil pushing to the skin surface. So, on this basis having a diet that leads to a high glucose level seemed to be more of a problem than LDL particles. (Weight is only an issue if it causes glucose levels to rise).

      4 years later I believe there is no one reason why one ends up with CVD. But I believe there must be an initial ‘insult’ to the coronary artery. It seems to me more likely to occur on the capillaries in the wall of the artery. This insult may possibly result from damagingly high glucose levels, damagingly high homocysteine levels, bacterial/viral infection. Then the other elements of inflammatory defence kick-in . . . I see LDL as part of the innate immune system binding bacteria and virus particle, macrophages dealing with the LDL complexes, or instead, damaged epithelial/smooth muscle cells . . . then the repair mechanism kicks in leading to the plaque. I suspect that over-zealous immune processes are the cause of CVD . . .

      1. Gay Corran

        Antony Sanderson, your story does indeed seem very similar to mine. Fortunately my diabetic nurse, although originally following the guidelines on “healthy eating” high carb low fat, is an intelligent and enlightened person, prepared to read widely and listen to her patients. When she discovered how I controlled my diabetes, (dropping statins, going LCHF) she became interested and helpful. Wouldn’t it be wonderful if the whole NHS became similarly enlightened and reversed its long road to becoming mere shills to the pharmaceutical industry?

  12. Mr chris

    Oh dear, and I had convinced myself that diet is the key.
    Somewhere, I have, or used to have, a book called” Type A behaviour and your heart” which suggested that having an agressive character is fatal.
    Should I be rereading it?

    1. MalcolmS

      The topic has actually been cut and dried for decades; the only problem being the medical profession (in general) simply won’t listen. It has been scientifically proven by experiment (as opposed to the usual epidemiological risk-factor tripe) that THE most significant factor in cancer/CVD health is stress.
      The psychologist Ronald Grossarth-Maticek established a study group of people aged approx 50 who were assessed as being prone to stress. An experimental group was given 6 hours of therapy designed to reduce stress levels while an equal sized control group was given the same amount of personal interaction but with no intent to reduce stress. After 10 years the control group had 11 cancer deaths for every one in the experimental group and 5 CVD deaths for every one in the reduced stress group. 10 out of every 11 cancers and 4 out of every 5 heart eliminated due to a talking cure! (well as Dr Kendrick would correctly point out those lucky recipients of stress reduction therapy didn’t become immortal they just survived their sixtieth birthday, probably living on into their 70s,80s,90s). This doesn’t of course prove that diet has no bearing on CVD whatsoever but if a purely psychological interaction can significantly postpone 4 out of every 5 CVD deaths then diet is clearly of low importance in its causation.
      As I’ve said before don’t bother searching the internet for Grossarth-Maticek; his pivotal experiment is entirely ignored by the medical profession. Fortunately all the answers are contained in Sapolsky’s “Why Zebras don’t get Ulcers”.

      1. Eric

        MalcolmS, if it sounds too good to be true, it probably is. I find it hard to believe that 6 hours of talking therapy can result in ~1000% reduction of cancer risk and ~500% CVD risk. Since the good man did most of his work in Germany, there is quite some stuff to be found in German, so I had a chance to read up. It seems he derived some claims about reduced illness risk from the Heidelberg prospective study, but they were more like 10%. I suspect that serious questions about double blinding can be asked.

      2. Martin Back

        Dr. Hans Eysenck had similar results: a marked reduction in cancers among a group who received psychological training on how to deal with stress.

        In his biography he said his results were so obviously beneficial he was surprised the medical profession didn’t follow up on them. But he has always been controversial; maybe they were afraid that adopting his theories would be career-killers.

      3. MalcolmS

        @Eric>”it sounds too good to be true”
        You must appreciate all the detail! The psychological therapy was applied to a group of specially selected “stress prone” (therefore disease prone) individuals. The numerical results from therapy would be reduced by a FACTOR of about 20 if applied to an average (unselected) population.

        @Eric>”I suspect that serious questions about double blinding can be asked.”
        A psychological therapy cannot meaningfully be “double blind” but the study was single blind. However the importance you and everyone else rightly place on “blinding” recognises the huge power of the placebo effect – an entirely psychological effect. If not double blinded, psychological effects typically swamp the therapeutic benefits of so-called powerful drugs when trialled.

        @Martin Back>”Dr. Hans Eysenck had similar results”
        Eysenck performed zero experiments on the topic, he simply reported Grossarth-Maticek’s results as if he (Eysenck) had been involved throughout. More positively, it is unlikely I or any other English speakers would have heard of Grossarth-Maticek’s results without Eysenck’s publication/replication.

  13. Vanessa Schaffeler

    I don’t personally think it’s all to do with diet – I was more interested in your comments in “The Great Cholesterol Con” regarding the emotional state of people, such as displaced groups, ‘social dislocation’, and how people deal with stress. (Although, as I understand it, a deficiency in zinc and/or magnesium can adversely affect how people deal with stress…and it’s said that our modern diet is lacking in both of these. Conversely, stress itself can cause increased depletion of these minerals…hence the need for a daily intake.)

    It’s likely that heart disease, of course, is caused by a combination of factors and that nutrition, rather than diet per se, is one of those factors. Even if we follow a “low-carb diet”, for example, it doesn’t mean it’s going to be more nutritious unless we ensure that its individual components are.

    I love your blogs though – maybe put them into a book? You must’ve written enough to fill one already!

  14. Dr. Göran Sjöberg

    Well, isn’t physiology and pathological issues rather complex per se?

    Our homeostatic system impresses on me!

    In my mind there must though be some connection (Hippocratic?) between what you regularly put in your moth and your state of “health” and a shot of Scotch malt now and then must for sure be to your health.

    1. Mr chris

      Whilst you are on your mountain, I am on my beloved sea, observing, in France if the people in the cafés look happy. They do.
      I have also reed James Le Fanu’s book ” The rise and fall of modern medicine” again, especially the chapter on “Seduced by the social theory” which deals with diet theories. He does make the point that we have little knowledge of what causes diseases, and our ability to treat them has been accidental.

  15. Frederica Huxley

    Okay, you have laid down the gauntlet – if CVD is not primarily due to diet, what is it due to?

  16. Franklin

    Bravo! I come from a family with a terrible history of CVD. 49 seems to be the highest age at which my ancestors experienced CVD. Often it struck as young as 33. My father, a strict vegan for much of his adult life, made it to 47. He too, believed CVD was affected by diet, and that vegetarianism would be the key. Unfortunately, it was not the answer, and he fell a few years short of his father, who made it to the ripe old age of 49. I’m 52… I’m an exercise and gym rat, and I know things are not right with me. My cardiologist has been pumping me full of drugs (diuretics and statins) from my early 30’s. As that’s when I had my first heart “event”. I look great. I feel awful.

    1. smartersig

      Being a strict Vegan does not mean a healthy diet. I would be interested to know more about him and what he ate

  17. Diana

    “CVD is primarily not due to diet.”

    This is a bold statement, suggesting the series is nearing the end…

  18. David Bailey


    After reading this blog for some time, as a non-medical outsider, I think you are absolutely right! I remember joking that those blaming saturated fat would start dissect fats into all their individual fatty acids – and sure enough that is exactly what they are doing!

    Many people claim that carbohydrates are completely evil and unnatural, but then I was given a link to an article in the comments that claimed that honey was beneficial! There are also places that use rice as a staple food. Furthermore, one of the major advances in human history was the cultivation of grain!

    As you also say, CVD rates are still falling – so surely this is where researchers should look for a cause of CVD – it has to be something that we do less of now, or something beneficial that we do more of! I can’t imagine what that would be, because stress levels are presumably on the rise. Maybe CVD rates fall with the rise in the use of electronic equipment!

    Some of the diets on offer here sound awful, and I imagine those who keep to them can never go out for a meal, and probably spend most of their time sourcing the right ingredients. Maybe the feeling that they are doing the right thing for their body, lowers their stress level, which has to be good so I don’t want to knock anybody.

    I think that anybody who advocates a diet hypothesis should think first at the amazing contrast between Scotland and France. If a difference of that magnitude isn’t about diet, then it doesn’t seem reasonable to look at diet for an explanation.

    1. markheller13

      I’ve always assumed the fall in CVD mortality is down to better medical diagnosis and treatment, rather than an indication that we’re living healthier lives…

      1. David Bailey


        Having read Malcolm’s books, I don’t think this is the case, and indeed, if you look at Figures 2.5a, 2.5b, and 2.6b in this link

        Click to access bhf-trends-in-coronary-heart-disease.pdf

        you will see that the rates of CVD have gone down – not just the mortality.

        Remember that Malcolm pointed out that the CVD risk calcuators are now massively pessimistic because they have not been updated to reflect this change.

        1. markheller13

          Thanks for the link David, very interesting that the incidence of MI seems to have decreased since its peak in the mid 1970s…

          Hard to know why this is – the data have been adjusted for changes in the spread of ages, but I wonder if any/part of the change is down to the classification of MI changing?

          My best guess for the decrease would be the reduction in smoking rates since that time, and also possibly that nutrition levels have improved (many of those dying in the 1970s would have grown up during and around the 2 world wars).

          Other than that, who knows?

      2. David Bailey


        I know it seems amazing, but I don’t think this is just about less people smoking! Here is the blog in which Dr Kendrick discusses the risk calculators that are used to estimate someone’s risk of having a CVD event over typically 10 years from where they are now.


        He explains how these risk calculations have not changed over the years, and so are now seriously pessimistic! The risk calculators obviously include whether people smoke or not, and they are still wrong!

        I mean I suppose one wild guess might be that some unsuspected bacteria or virus is involved in the CVD process, and is now less prevalent in the West. The unexpected fact that bacteria cause most stomach ulcers might make that idea a bit more plausible. Also, I seem to remember hearing that people with serious gum infections are more likely to suffer CVD events – which again might implicate bacteria.

        1. Sasha

          While H pylori does cause ulcers and stomach cancer in some people, in others it may actually have beneficial effect, protecting against developing asthma and allergies. Source: “An Epidemic of Absence”.

    2. Dr. Göran Sjöberg

      “Some of the diets on offer here sound awful, and I imagine those who keep to them can never go out for a meal,”

      I ask for the steak and for a garden salads, some extra butter and nothing else and have never had any problem.

      1. David Bailey

        Well I wouldn’t want to just live on steak and salad, or always eat that meal when I go out!

        Quite apart from matters of enjoyment, I also think you are far more likely to miss out on some essential mineral or vitamin on a highly restrictive diet.

      2. Eric

        Real butter though. I suspect the prettily shaped buds of garlic and herb butter that get served are often spreads rather than butter. I also suspect that most frying in restaurants these days is done with “heart healthy” oils. On the other hand, if they used lard, coconut oil or ghee, they’d have much less work scrubbing and washing the pans.

  19. JPA

    Couldn’t agree more. In science we disprove hypotheses. The diet hypothesis has been disproven numerous times. So we need to stop trying to make that hypothesis work and come up with new ones.

    I also agree with you on people becoming diabetic and then obese. Its like the non-fat cells are starved for nutrition so the person feels hungry. They eat and then the nutrition gets absorbed by the fat and the person gets fatter. So the non-fat cells are still starved, so the person eats and the nutrition gets absorbed by the fat and … .

    Its a bit like an organization where the workers are underpaid so they complain and the company is given more money. The administrative department takes the extra money and gets bigger. The workers are still underpaid so they complain and the organization is given more money. And, the administrative department takes the extra money and gets even bigger, … . Societal diabetes maybe? But I digress. Back to diabetes and obesity.

    The obese, diabetic person is in a terrible bind. They are really hungry. A lot of their body cells are not getting nutrition. Their need to eat is not a lack of will-power, it comes from a legitimate need for nutrition. But the cells that need the nutrition are not getting it. The only way out of this loop for the diabetic, obese person is to find a way for the non-fat cells to get more nutrition. Its not about calories in and calories out. Enjoyable physical activity and less psychosocial stress seem to help in this regard.

    Sorry to go off topic. I am enjoying your posts very much. Thank you for all the time you put into them.

  20. John Midgley

    I think it’s a combination of genetics and what is commonly called “the luck of the draw” in the random events that happen in life. Other things may skew the outcome, but I think we’re getting down to “you are born with a certain makeup, and what happens after that can be further skewed one way or the other in your longterm lifestyle”. Diet may or not be important if you have robust genetics.

    1. smartersig

      If you think its all down to genetics ow do you explain the fact that low incidence of HD in Japanese pre 1970 ish was overturned as soon as they moved to Hawai and adopted an American diet. No amount of genetic makeup seemed to safeguard them. The next step of the dug companies is to convince us that genetics is the answer and that they can isolate your achilles heel gene early and hence get you on drugs from a much earlier age

      1. David Bailey

        Yes, but they presumably didn’t just adopt a Western diet, but Western habits too. On top of that, they had to cope with the stress of moving to a vastly different country.

        1. smartersig

          This theory does not really hold with the increase in CD in Uganda where previously it was unheard of. I think stress plays a part but so does diet, the latter is easier to control.

        2. smartersig

          In Ugandan villages increased urbanisation was measured from village to village. These people did not experience displacement. Varying increases in HD were found.

          “increasing urbanicity was associated with an increase in lifestyle risk factors such as physical inactivity (risk ratio [RR]: 1.19; 95% CI: 1.14, 1.24), low fruit and vegetable consumption (RR: 1.17; 95% CI: 1.10, 1.23), and high body mass index (RR: 1.48; 95% CI: 1.24, 1.77).”

          nobody was stressing out because they had moved from Uganda to New York

  21. Sylvia

    So perhaps eventually a higher simple carbs diet will lead to CVD, via diabetes, a route that can be avoided by many. It would seem prudent to eat real food cooked from scratch rather than burgers and chips throughout your lifetime. Maybe there really is something in the diet thing. What else has paralleled the fall in CVD, something in the water, the air. many and varied things. Dr Kendrick, can we ever know, and failing going to live in France, how do we mitigate this debilitating illness in the developed world. Thank you.

    1. David Bailey


      Surely the point is that we tend to talk about CVD as if it were a worsening problem, that could reasonably be associated with something we do differently now – like eating burgers. However we need to explain why CVD incidence is actually going down – not up! Surely burgers and chips aren’t responsible for less CVD!

      The propaganda from the health lobby can give the impression that CVD is becoming more common, but as Dr Kendrick has pointed out, those CVD risk calculators were calibrated many years ago, and are now seriously pessimistic!

      1. Sylvia

        Yes I do take your point. Perhaps I wasn’t clear in my explanation. was trying to say please eat well to avoid type 2 diabetes, which by that route may lead to CVD. Yes I understand it is falling, but is it static, still meet lots of sufferers, some in my family. I am certainly of the view that lifestyle and good nutrition play a large part, stress, my children and many others of course work long, travel far, live with insecurity. Meanwhile Dr Kendrick alias Hercule Poirot is giving us a proper Agatha Christie. Regards.

  22. Lorna

    Could the attraction and persistence of the diet hypothesis be explained by our need to believe we can control disease and ageing? I would guess that a lot of contributors on this Comment Page are of a similar generation and one that looks for hope and some empowerment in the dietary ideas offered by followers of this and similar blogs. Whatever else we may gain from your articles Dr Kendrick, understanding grows when we share and adjust our thinking. Thank you!

  23. Sarah

    Actually, I found your last post regarding stress as a (the?) major cause of CHD the most interesting in this series, in many ways – it will be interesting (if tragic) to see if the major refugee crises we are living through support the thesis.

    I may be obese, but I am nowhere remotely near diabetic, and managing carbs helps manage weight. My father died of a heart attack the day after my mum died of cancer – that was just too much stress!

    1. JPA

      Stress is a major contributor to obesity. Abdominal fat seems to be a way the body tries to protect itself when under stress. Unfortunately, that means that getting stressed about being obese is just going to make it harder to lose weight. We have to implement weight control methods without putting even more stress on ourselves.

    2. John Graham

      Cancers are sugar junkies
      It’s now more than 70 years since Otto Warburg, PhD, won the 1931 Nobel Prize in medicine for discovering that cancer cells have an energy metabolism that is fundamentally different from healthy cells. The crux of his Nobel thesis was that malignant tumours frequently exhibit an in-crease in anaerobic metabolism compared with normal tissues. In other words, they don’t like oxygen.[16] The significance of this is that fat and ketone bodies as a source of energy require oxygen while glucose doesn’t. And that in turn means that cancer cells are dependent on glucose for growth. All cells can use glucose, but cancer cells consume as much as four or five times more than normal, healthy cells. In fact, cancer cells seem to have great difficulty surviving without glucose. A study carried out by Johns Hopkins researchers found evidence that some cancer cells are such incredible sugar junkies that they will self-destruct when deprived of glucose.[17] ‘The change when we took away glucose was dramatic.’ said Dr Chi Van Dang, director of haematology. ‘We knew very quickly that the cells we had altered to resemble cancers were dying off in large numbers . . . Scientists have long suspected that the cancer cells’ heavy reliance on glucose – its main source of strength and vitality – could also be one of its great weaknesses,’ Normal body cells can use fat and ketone bodies derived from fats metabolized aerobically for energy. The waste products of the process are carbon dioxide and water. The process by which cancer cells derive their energy is one of anaerobic fermentation of glucose, with lactic acid as a waste product. The lactic acid produced is then transported to the liver where it is processed into glucose, ensuring the cancer cells have a constant supply of energy. This pathway for energy metabolism is very inefficient in that it extracts only about 5% of the available energy in the food supply and the body’s calorie stores. The cancer is wasting energy, and the patient becomes tired and undernourished. This cycle increases body wasting,[18] which is one reason why as many as 67% of cancer patients die from malnutrition (cachexia).[19] In addition to being dependent on glucose, most tumours also have abnormalities in the number and function of their mitochondria.[20] These abnormalities prevent the tumour cells from using ketone bodies, which require functional mitochondria for their oxidation. The famous 19th century cancer specialist, Dr Stanislaw Tanchou, presented the first formula for predicting cancer risk in a paper delivered to the Paris Medical Society in 1843.[21] It was based on grain consumption and was found to calculate cancer rates in major European cities very accurately. The more grain consumed, the greater the rate of cancer. Can low-carb diets prevent cancer? If cancers cannot survive without glucose, surely it follows that a low-carb, high-fat diet is likely to prevent a cancer starting. Just that piece of knowledge might stop all the heartbreak, pain and misery that cancer causes. Two of the most common cancers are breast cancer – which, incidentally, is not confined to women – and lung cancer. In the context of blood sugar and cancer risk, it may be significant that UK research suggests that people with coeliac disease – and who do not eat wheat and other cereals – have only about one-third the risk of either of these cancers.[22] This adds more weight to the evidence that carbs increase cancer risk. Furthermore, an epidemiological study in 21 industrialized countries in Europe. North America and Asia, revealed that sugar intake is a strong risk factor that contributes to higher breast cancer rates, particularly in older women.[23] Another four-year study at the National Institute of Public Health and Environmental Protection in the Netherlands found that cancer risk associated with the intake of sugars, independent of other energy sources, more than doubled for cancer patients.[24] As cancers need glucose so much, cutting off the source of that energy is similar to cutting off the cancer’s blood supply.

      Insulin and cancer
      Blood concentrations of fasting insulin, glucose, cholesterol and triglycerides in non-obese people suffering from colon, stomach and breast cancer were determined and compared with those of healthy non-obese people. Insulin was also measured in tumours and non-cancerous tissues. Insulin
      and glucose (with the exception of glucose in colon patients) were significantly higher than in healthy people; blood cholesterol and triglycerides levels were lower. Tumours contained 1.9-3.0 times as rich insulin, or insulin-like substances.[25] High insulin levels are the result of eating a high intake of ‘healthy’ carbohydrate-rich foods. Cancer patients don’t need curbs . . . Cancer therapies should encompass regulating blood-glucose levels. This is best done via diet, supplements, and non-oral solutions for those

      References Chapter Twenty – Three – Cancer – disease of civilization
      16. Warburg O. On the origin of cancer cells. Science 1956: 123:309-314.
      17. Shim H, et al. A Unique Glucose-Dependent Apoptotic Pathway Induced by c-Myc. Proc Natl Acad Sci US 1998; 95; 1511-1516.
      18. Rossi-Fanelli F, et al. Abnormal substrate metabolism and nutritional strategies in cancer management. J Parenter Enteral Nutr 1991; 15: 680-683.
      19. Grant JP. Proper use and recognized role of TPN in the cancer patient. A 1990; 6 (4 Suppl): 6S-7S, 10S.
      20. Pedersen PL. Tumor mitochondria and the bioenergetics of cancer cells. Exp Tumor Res 1978, 22:190-274.
      21. Tanchou S. Recherches sur la fréquence du cancer. Gaz d hop Par 1843;2:313.
      22. West J, et al. Malignancy and mortality in people with coeliac population based cohort study. BMJ 2004; 329: 716-
      23. Seeley S, Diet and breast cancer; the possible connection with sugar consumption, Med Hyp 1983; 11:319-327.
      24. Moerman CJ, el al. Dietary sugar intake in the aetiology of biliary tract cancer. Int J Epidemiology 1993:22: 207-214.
      25. Yam D, et al. Hyperinsulinemia in colon, stomach and breast cancer patients. Cancer Lett 1996; 104: 129-132.
      From pages 340 and 341of “Trick and Treat…” by Dr Barry Groves

      1. Eric

        Selective quotatation of of reference [22]. Poeople with Coeliac have a 29% higher risk of any malignancy than the general population, even if they have ~ 2/3 lower risk of breast or lung cancer. This is a very puzzling result. It could mean that only these two cancers exhibit significant Warburg effect, which seems unlikely.

        4732 people with coeliac disease and 23,620 matched controls.
        Hazard ratios for malignancy and mortality.
        Of the 4732 people with coeliac disease, 134 (2.8%) had at least one malignancy and 237 (5.0%) died. The overall hazard ratios were: for any malignancy 1.29 (95% confidence interval 1.06 to 1.55), for mortality 1.31 (1.13 to 1.51), for gastrointestinal cancer 1.85 (1.22 to 2.81), for breast cancer 0.35 (0.17 to 0.72), for lung cancer 0.34 (0.13 to 0.95), and for lymphoproliferative disease 4.80 (2.71 to 8.50). The increased risk was primarily in the first year after diagnosis, with the risk for only lymphoproliferative disease remaining significantly raised thereafter. After excluding events in the year after diagnosis, the hazard ratio for malignancy was 1.10 (0.87 to 1.39) and for mortality was 1.17 (0.98 to 1.38), giving absolute excess rates of 6 and 17 per 10,000 person years, respectively.

    3. Diana

      “Cancers are sugar junkies
      It’s now more than 70 years since Otto Warburg, PhD, won the 1931 Nobel Prize in medicine for discovering that cancer cells have an energy metabolism that is fundamentally different from healthy cells. The crux of his Nobel thesis was that malignant tumours frequently exhibit an in-crease in anaerobic metabolism compared with normal tissues. In other words, they don’t like oxygen.[16] The significance of this is that fat and ketone bodies as a source of energy require oxygen while glucose doesn’t. And that in turn means that cancer cells are dependent on glucose for growth.”

      This is unfortunately not true, or not the whole truth. Cancer cells are also fueled by proteins or fats or ketones. They just need a bit time to adapt from one food source to another.

      1. sasha

        Diana, are you saying Warburg was only partially correct? I just got the book “Stumbling Over the Truth” which makes a similar argument – cut out glucose sources in cancer. I haven’t read it yet…

        Do you have the references for “cancer cells being fueled by proteins, fats, and ketones” once they adapt? Thanks so much.

        1. Diana


          Tumor metabolism is complex and it would be wrong to simplify it into: “fueled only by glucose”. Such an ancient parasite as cancer will eat just anything.

          Some links:

          Lipid metabolic reprogramming in cancer cells (Beloribi-Djefaflia, 2016)

          “Highly proliferative cancer cells show a strong lipid and cholesterol avidity, which they satisfy by either increasing the uptake of exogenous (or dietary) lipids and lipoproteins or overactivating their endogenous synthesis (that is, lipogenesis and cholesterol synthesis, respectively) (Figure 1). Excessive lipids and cholesterol in cancer cells are stored in lipid droplets (LDs), and high LDs and stored-cholesteryl ester content in tumors11, 12, 13, 14 are now considered as hallmarks of cancer aggressiveness.13, 15, 16, 17 Colon cancer stem cells showed higher LD amount than their differentiated counterparts, as revealed by Raman spectroscopy imaging.18 Moreover, LD-rich cancer cells are more resistant to chemotherapy.”

          Glutamine Addiction: A New Therapeutic Target in Cancer (Wise, 2010)

          “Most cancers depend on a high rate of aerobic glycolysis for their continued growth and survival. Paradoxically, some cancer cell lines also display addiction to glutamine despite the fact that glutamine is a nonessential amino acid that can be synthesized from glucose. The high rate of glutamine uptake exhibited by glutamine-dependent cells does not appear to result solely from its role as a nitrogen donor in nucleotide and amino acid biosynthesis. Instead, glutamine plays a required role in the uptake of essential amino acid and in maintaining activation of TOR kinase. Moreover, in many cancer cells, glutamine is the primary mitochondrial substrate and is required to maintain mitochondrial membrane potential and integrity as well as support of the NADPH production needed for redox control and macromolecular synthesis.”

          Ketone use by cancer has been researched by Michael Lisanti group (see link below):

          Ketone body utilization drives tumor growth and metastasis (Martinez-Outschoorn, 2012)

          “Our data provide the necessary genetic evidence that ketone body production and re-utilization drive tumor progression and metastasis. As such, ketone inhibitors should be designed as novel therapeutics to effectively treat advanced cancer patients, with tumor recurrence and metastatic disease. In summary, ketone bodies behave as onco-metabolites, and we directly show that the enzymes HMGCS2, ACAT1/2 and OXCT1/2 are bona fide metabolic oncogenes.”

      2. Eric


        thanks, how do you pull all those unexpected and challenging papers out of your magic hat?

        It’s been a while since I’ve read “Stumbling over the truth”, and I was not overly impressed with its one note sales pitch. This book, and reading a few things about the Warburg effect, still left me with the impression that all PET active cancers can be attacked by lowering glucose levels or disrupting glycolysis, and that those that are not PET active are slowly proliferating anyway.

        The papers you provided show that things are not that simple. Food for thought!

        I wonder if an approach similar to the use of multiple antibiotics is possible, in that the cancer is first driven into specialisation by a dietary change or some disruptor, and then killed off by another change that would not have killed the initial population prior to the first change.

        1. Diana


          How do I do it? To quote Darwin, I have life-long interest in “endless forms most beautiful and most wonderful,” cancer included.
          Yes, there is clearly something else going on than too much glucose. I was not impressed neither with Seyfried’s theory nor results. Clearly some mice fed by ketones live some days longer, and that’s it.

          1. Dr. Malcolm Kendrick Post author

            Thanks everyone for all the comments whilst I have been away. Seems to have been a very interesting discussion. Andy Harcombe had been approving comments for me. So thanks to him for this. More work than he was expecting. It is great that everyone is so engaged and interested.

      3. Eric

        Diana, I was thinking along the lines of e.g. starving the tumor of carbs, and once it has adapted to relying on ketones, switch back to carbs or hit it with a mild chemo that would not have worked before forcing those adaptions.

        Lisanto’s daughter’s idea is completly different. If the Daily Fail didn’t get it wrong, doxycycline and some other antibiotics suppress growth of mitochondria. I was a little surprised at the statement that cancer stem cells (aren’t all cancer cells dividing?) have an usually high number. Don’t they have few and barely functioning mitochondria which is why they need to ferment glucose?

        Still, antibiotics might be part of a staggered attack, just as diet.

        1. Diana


          Lisanti’s paper was reported in other media too, not only Daily Fail 🙂
          Here it is in full, and no, the litle girl is not credited:
          “Antibiotics that target mitochondria effectively eradicate cancer stem cells, across multiple tumor types: Treating cancer like an infectious disease” (Lamb, 2015)

          Calling cancer cells mitochondria “damaged” probably clouded minds of many cancer researchers….

      4. Eric


        Andrew Scarborough at http://mybraincancerstory.blogspot.de/ pulls apart another paper that claims gliomas thrive on fatty acids in his July postings.

        He makes the point that this is more about Omega 6 to Omega 3 ratio.

        At this point, it doesn’t seem to bear any relevance to the papers you posted.

      5. Eric

        Diana, yes she is, as a co-author, just as the Daily Fail wrote.

        Just read up an cancer stem cells, another relatively new and not entirely agreed upon topic that I hadn’t heard of. This is the beauty of this blog, that posts can take one in unexpected directions…

        1. Diana


          The Moor Allerton Preparatory School, Didsbury, Manchester, indeed. I totally missed it, thanks!

          Yes, unexpected directions, but I think we have crossed the line again. Enough of cancer. After all, this blog is called What causes heart disease part MMXVI

  24. Gary Ogden

    Dr. Kendrick: Bravo. Secondarily? Just joking. Very interested to see where your thinking is heading.

  25. Jennifer.

    Dr Kendrick, it seems we are still unable to itemise specific foodstuffs regarding cardiac problems, or many other maladies afflicting human beings.
    By the time I am 70, I will have experienced many forms of illnesses causing death to close family members, young and old, close and distant acquaintances, short-stay and long-term patients in my care, and the countless unknown( to me) individuals who made it into the Times Obits, or the tail end of the BBC news.
    There have been rich and poor. Tall and small. Fat and thin. Active and sedentary. Smokers and non-smokers. Drinkers and abstainers. Intelligent and not-so bright. Saints and sinners. On and on.
    We will all die one day, but we are seeking to find the triggers causing poor health, so that we can avoid them, whilst looking for the elements which keep us healthy for as long as possible.
    I conclude that these 2 lists are unlikely to overlap, and only by reading round the subjects of food and lifestyle choices, are we going to come up with a semblance of truth. After all, it is not that long ago ( maybe 60 years or so), that some patients were being advised by GPs to smoke, making the Ancel Keys contribution to good health seem pretty benign in comparison!
    My point? Please keep stimulating responses to your blog….it can only help us to hone in on where responders choose to place things I.e. in the good or the bad category, especially if documented experiences and explanations sound plausible.
    It is for us to choose who we think is the sincerest.
    Just to throw a spanner in the works though…..the GPs who promoted smoking, and the convincing arguments posed by Ancel Keys, were taken on board by many, unfortunately, to their detriment.
    And even more problematic………
    ..”one man’s meat is another man’s poison”
    Education, Education, Education.

  26. Danny Evatt

    Though I would agree one’s diet may not be a direct cause of CVD, it is most certainly an indirect one. Though not in a way we can generalize.

    Everyone is different. One skinny person can eat ice cream and not gain a pound, whereas if I look at a delicious bowl, I gain 2 pounds! The secret is finding out what diet (and general foods, carbs, meats, etc.) work for your particular body type, metabolism and DNA and sticking to it. If we listen to what our body is telling us, i.e. “Do I feel good today?”, “Am I losing weight, gaining weight?”, etc. we could go a long way in improving our own health and lessen the severity and/or getting CVD.

  27. Keith

    The Roman numeral for 19 is XIX, not XVIIII (LOL!).

    Ancel Keys supposedly changed his mind about saturated fat later in life, according to Dr. Aseem Malhotra, but was never able to get his findings published because they contradicted his earlier proclamation that dietary cholesterol and saturated fat caused CVD (http://doctoraseem.com/true-longevity-secrets-of-the-mediterranean-2/). Dr. Malhotra explores Key’s original Mediterranean Diet in a new documentary film called “The Big Fat Fix” (http://www.thebigfatfix.com), which looks to be very interesting.

    1. ellifeld

      Actually Dr Keys, who was not a follower of the low fat diet himself from what I’ve read, knew all along that cholesterol and saturated fat were not the cause of CVD. His famous 7 country study was really a 22 country study, he just ignored the other 15 which had higher amounts of fat in the diet. Why? Not exactly sure and how he got away with it is even more astounding.

  28. dearieme

    Would it be fair to say that Ancel Keys, abetted by government health propaganda, shortened more lives than Mao? I fear it might be.

  29. dearieme

    Almost everything is caused by genes or germs. Since genes can’t have evolved fast enough to explain the rise and fall of the heart attack epidemic, my money’s on germs.

  30. Kathryn

    WOW!!!! By the word diet are you ruling out nutritional value in our western diet. I am anxious to see the comments on this one.

  31. JDPatten

    Vitamin C, L-arginine and other nitric oxide boosters you’ve suggested as endothelium supporters are dietary factors, are they not?
    If you eliminate diet as a useful tool for controlling heart disease, you take away what we feel we have some direct daily control over. With the loss of the sense that we can be self sufficient, we’re left with the fear of the unknown – probably making it worse.
    So, if not diet, then what? What factors can we actually take control of that will make the most difference? Any difference?
    We’re at XVIIII (XIX) and it seems we have a long way to go, not yet having come to the crux.

  32. Lee

    Diet or not, it’s still Part XIX 🙂

    If it’s not diet then shouldn’t people stop giving carbohydrates a bad reputation and promoting low carbohydrate diets?

    1. Stephen T

      Since low-carbohydrate diets work so well for many people in reducing weight and effectively ‘curing’ type 2 diabetes, I’d say there were very good reasons to promote them. Low carb has huge benefits. Unless you’re the last person supporting Ancel Keys, where’s the harm?

      1. Lee

        I did a low carb diet for nearly two years because of the supposed advantage for endurance sport (I cycle long distances). I felt permanently lethargic and couldn’t get going or mitivate myself to ride and my performance bombed. But worse, it caused my heart rate to reduce and become erratic and for my body temperature to reduce. The final straw was when I collapsed due to the erratic heart rhythm and ended up in hospital. They wanted me to have a pacemaker but I proved on a 5 day ECG Holter monitor that my rate and rhythm are normal on a high carb diet, donthey discharged me. My body temperature is now normal and I’m back doing long rides.
        I couldn’t care less about Keyes; I’ve done the tests on myself and for me, low carb is a very, very bad idea.

  33. Martin Edmundson

    From avidly reading your posts it appears that ‘diet’ is the “Invisibility Cloak” worn by Stress, in one form or another that appears to be the trigger for CVD. Or is that too simplistic?

    1. mistymole

      I’m sure that is where all this is leading. Our obsession with control (through diet and other things in our lives) causes stress which causes issues in the body (CVD, Cancer, etc.). I am reading with great interest.

  34. Andrew

    “There is evidence that vegetarians can live long, long and healthy lives.” Sure, why not. They have done so for thousands of years.

    “There is evidence that meat eater live long, long and healthy lives.” Sure, why not. They have done so for thousands of years.

    “In the West, we are eating more and more sugar and carbohydrate and the rate of cardiovascular disease falling.” Nope. Sugar consumption has stagnated for quite some years now in most Western countries. At a horrendous level, for sure. And *incidence* of CVD and MetS is not falling, but at best stagnating. Mortality is a different story, but here treatment and other factors come into play.

    “France maintains a very high saturated fat diet, and their rate of cardiovascular disease also falling.” Sure, satfat has never been a problem in the first place. But even in France, MetS *incidence* is not really falling.

    “The only link that I can see is that people who eat a higher carbohydrate diet are more likely to become obese and develop diabetes.” Nope. Most traditional high carb societies (60 to 90% carbs) are perfectly lean and healthy. Only in combination with the “Western” diet does high carb lead to obesity, diabetes etc. Not surprising: only in the “Western” diet does high carb also mean high sugar (i.e. fructose).

    Forget a meager plus or minus 10% in starches or satfat. This is well within physiological norms.

    There are only two things that changed *dramatically* with the advent of modern Western diet: sugar (fructose) consumption and Omega-6 (seed) oils both skyrocketed by several 1000%. And both are biochemically known to dramatically worsen our cardiovascular and overall health.

    1. Jennifer.

      Andrew, I agree entirely with you….but I also wish to add, as I mentioned earlier, that excessive use of chemicals, and extreme modes of fast food production, have a part to play.

  35. Sue Richardson

    Catching your drift Dr K. It is very noticeable that diet is the ‘in’ word we can’t seem to get away from. As far as your a posts on heart disease are concerned you must be getting frustrated. Diet does make a difference, but not necessarily here. Wouldn’t it be easier if it did?

  36. Lisa

    So diabetes is not related to diet either? Because of course if diabetes causes obesity/heart disease, and diet is implicated in diabetes …

    Btw, when you talk about rates of heart disease falling, is that above and beyond recent medical interventions that keep people from getting sicker/dying?

    The only things common to all Blue Zones diet-wise are QUANTITY of food (not too much), FRESHNESS of food (very fresh), and the presence of legumes, which presumably help speed food through the system …

    But I can easily believe that CVD is less affected by the particulars of what Blue Zoners eat than by their tight social communities, sunshine, exercise as part of daily life, etc.

    One question: If CVD is caused by clotting problems, and some foods affect clotting (omega 3s, vit K foods, etc.), is that not relevant?

    I guess I still find it hard to imagine that dietary factors make NO difference since we are, to some extent, what we eat. I feel like you are telling me if I put a solution that was half-water/half-gas in my car it would run no differently from putting straight gas in – fuel makes no difference to how the car runs.

    But I’d be happy to be proved wrong! It certainly is true that years of micro-analysis of vitamins, nutrients, antioxidants, etc. has not revealed to the world the ONE best diet – we now have lots of big-name scientist/gurus, each of whom is utterly convinced that the only way to go is low fat, no fat, high fat, gluten free, sugar free, vegan, low carb, etc. No consensus. It gets exhausting!!

  37. Christopher Palmer

    I think it makes good sense to approach the question of health and disease from cell centric perspectives rather than dietary ones. If all our cells remain healthy then so do we. But if cells become sick then the tissues and organs they comprise may trend to sickness and diseases too.

    Might it be the case that one of more factors could compromise cells ability to regenerate in precisely their own likeness? Imprecise regeneration over successive generations of cells could then account for degeneration of cells with cells losing some of their specificity of purpose and function given to that type.

    Cells start out in life as totipotent types that lack the necessary differentiation to account for the many types of cells that will develop as an embryo advances to become a foetus, as foetus advances to become a baby, and as a baby is born, becomes a child attains status of adult.

    Robert O Becker did much pioneering research work on regeneration. He did so with the hope of being able to stimulate regeneration in the case of fractures where the process of regeneration and healing had stalled. He did enjoy some successful outcomes in last chance patients. He established that the way cells regenerate may be influenced by the electrical environment that persists in the tissues that surround them.

    The above should have the minds of truly interested parties wonder about the part that resting potential of cells may play in the regeneration of cells. When the resting potential of cells is adequate cells regenerate with precision and maintain their allotted differentiation of type. If the resting potential of cells declines it has been suggested they trend away from their allotted differentiation.

    Pertinent to the above is that oxygen is a potent stealer of electrons; while Earth is the great donor of electrons. So when we breath in air (which contains about 20% diatomic oxygen (O2)) and when the oxygen in the air we breathy is utilised to break down metabolites and wastes ready to be exhaled, some of the molecular oxygen containing species that are formed contain additional electrons. They are ions in other words and are typically represented by ions that are negatively charged.

    So if you collect exhaled breath, condense it, and test for pH the test will indicate alkalinity. Exhaled breath condensates (EBCs) are typically alkaline. When a solution tests as alkaline that indicates net electro-negativity. The net electro-negativity suggests oxygen breathing species lose electrons with every exhaled breath. This is the root of oxidative stress.

    If electrons are being stolen from within us as ionised oxygen species because oxygen is a potent robber of electrons then that leaves aspects within us (within our inner soup of biochemistry) deficient in electrons.

    There is simple visual analysis of blood samples that suggests oxidative stress of this kind results in a decline of zeta potential of blood cells. Zeta potential and resting potential of cells amounts to the same thing, albeit set in contrasting contexts. Then when those who participated in this simple study spent time resting on an earthing sheet and blood samples were taken again visual inspection of those samples done with the aid of microscope showed increased dispersal and less ‘coupling’ of blood cells. Blood cells equate to colloidal particles, and its adequate zeta potential that keeps colloidal particles in suspension. Ergo earthing restored zeta potential to blood cells.

    Our progenitors and ancestors never had to concern themselves with oxidative stress. Just so long as they went about business as usual while being barefoot of shod with footwear crafted from natural materials then as fast as electrons exited the body with every exhaled breath replacement electrons could be sucked up through the soles of the feet from natures great electron donor, Earth. Any tendency to assimilate electro-positivity within them and their inner soup was countered by the rise of electrons flowing from ground, through the feet, and into them.

    Of course, the construction of dwellings has changed over the years, as has the extent and means to furnish them, and the construction of modern footwear now rarely utilises natural materials. Instead rubber and plastic dominate. The modern human now has has effective contact with the great electron donor only on the rarest of occasions. What has happened is that technological progress has sealed our fate.

    Oxidative stress is a natural phenomenon attributable to the properties of oxygen and the configuration of electrons in its outer shell. The natural phenomenon that arises in all creatures that breathe air has a natural antidote. That antidote is being gifted with free electrons from the Earth’s surface and its watercourses. But in modernity we have lost the former traces and vestibules of effective contact.

    Oxidative stress is a problem for us now when it never was before. Aspects of our inner soup that ought not to be electro-positive can trend that way so long as we remain so isolated from the great electron donor. One very likely and significant prospect is that cells suffer decline of resting potential. If resting potential is chronically suppressed regeneration of cells will proceed, perhaps, in away that permits degeneration over successive generations. So tissues and organs may suffer degeneration, then when they do we get sick and sicker.

    Now epidemiologist could turn their hand to something useful. Those people who live in parts of the world where it is usual to go about business barefoot, or wearing footwear crafted from more natural materials, could be compared with the rest of us. I’d wager they suffer lower incidence of a whole load of diseases than we do.

    I consider an earthing sheet is a worthy investment. If they were able my cells would thank me for it.

    Time to invest in one Dr Kendrick?

    1. smartersig

      Interesting post Christopher, I have an earthed mouse mat and would love to source leather soled casual shoes, alas I may have to get some made.

    2. Dr. Göran Sjöberg


      Interesting input!

      In my favourite reading of “THE CELL” I am currently completely “knocked out” by the complexity involved at our most fundamental physiology level. The more I learn in this reading (too difficult for medical students?) the less I am inclined towards any categorical statements about our health and, as Malcolm, especially about the connection between our health and our nutrition. (Categorical statements make me revolt!)

      The only thing I would state myself today is “Why don’t you try and see for yourself if anything works?”. If it is a “veggie” diet or a LCHF one is here irrelevant.

      When you have a “hit” you can of course be “hooked”, as me and my wife on the LCHF-one, and sadly turn into some sort of “religious” belief in the actual diet which is absolutely contrary to my fundamental understanding of science.

      Well, well – life is complex at all levels!

  38. Brian Wadsworth

    This issue of the rise and fall of historic, reported CVD rates as a pointer to cause is confounding it seems to me. If stress is a driving factor are we thinking that recent falls in rate reflect a lowering of stress at the population level? It has been suggested that CVD may be communicable and that we are looking at an epidemic that is fading. Hmm.

    It could be that aggregated data over a population is insufficiently granular. CVD is tied to social class, gender etc. Perhaps the falling rate reflects inner shifts in the make up of the measured population? And, of course (as Dr. Kendrick as pointed to) reporting inconsistencies.

    1. David Bailey


      I think your list is extremely valuable, because as far as I can see there is nothing you can click on here to access Dr Kendrick’s earlier blogs. I do wish he would somehow make the full list available – even by simply including a link to your list.

    2. Jacquie

      Igor, thank you ever so much for taking the time to compile this list and for sharing it with the rest of us.

  39. Robert

    Thank you Dr Kendrick, I suspected as much regarding diet. This is a real detective story, and I can’t stop reading it. Totally intriguing.

  40. Kevin O'Connell

    But if it is not, then how to explain/incorporate such things as:
    1. Lyon (Renaud, de Lorgeril, et. al);
    2. Metabolic dysfunction, especially at ETC Complex 1 (main entry point for glucose, while fatty acids mostly/all? head for Complex 2 with little/no ROS);
    3. Hyperinsulinemia & its nefarious impact;
    4. Problem of Linoleic acid being incorporated in cell membranes & knock-on effects;
    all of which (a very incomplete list) are clearly largely/entirely diet related…

    1. David Bailey


      Equally, if CVD is mainly caused by diet, how do you explain the French anomaly, or the fact that rice is a staple food for many people, or the fact that CVD rates have declined over many years?

      I was interested that Malcolm used the expression, “complexity bomb”, because I have long thought that several areas of science suffer from something of this sort. Biochemistry is immensely complex – even before you factor in the bacteria in our guts – and yet something as simple (simple as a cause, but the biochemistry will be complicated) as stress clearly has a huge effect on CVD rates. We are omnivores, and that must mean that our bodies have a lot of tolerance of variations of diet. Some of that has come out in these blog discussions – the innumerable feedback loops in the body that mean, for example, that if we consume more cholesterol, the liver makes less, or if we consume a little more salt, it is excreted etc etc.

      The worrying feature of modern science, is that given some data – be it diet/disease, or climate data (for example) the complexity bomb ensures someone can always fit the data to a model of some sort – whether validly or not. So in this case, because the focus has been on diet, the models all relate to food. If the focus had been on the strict observance of religious rituals, I have little doubt that provided those rituals had enough complexity, someone would have made an excellent case that non-observance of this or that rite explained CVD!

      There is a rough analogy with trying to fit some data to a formula with too many adjustable parameters. You can get a fit, but it doesn’t mean much. That is well understood, of course, but when the ‘parameters’ are tweaked by an army of biochemists and physiologists adjusting this or that theory to get a fit, nobody notices!

  41. bill

    I realize the discussion is about CVD. Keep in mind
    though, there are very good reasons to keep carbs
    within your tolerance and eat more fat. From a
    presentation by Jeff Volek today:

    Higher fat oxidation
    Mediating body fat gain
    Attenuated development of metabolic syndrome/type-2 diabetes
    Mitigating swings in blood sugar after eating
    Lower inflammation and oxidative stress
    Lower blood triglycerides
    Lower SFA levels in blood/tissues
    Lower Palmitoleic acid
    Lower Arachidonic acid
    Higher DGLA in blood/tissues
    Faster recovery
    Longer availability of energy
    Less fatigue after training
    Less susceptibility to colds/flu
    Fat is a more efficient source of fuel than carbs
    Less ROS

    Even if eating Low Carb High Fat doesn’t save
    you from heart disease (the jury’s still out),
    there are plenty of reasons to follow that

    1. Andy

      Excellent series to maintain periodic motivation to search for answers. At 76 years it is important to slow down the ageing process asap. My present beliefs about health (always open to change) is to follow the low carb diet. Then how much and when to eat has to be considered. Thinking at the cell level can provide answers. Intermittent fasting such as Fast-5 gives cells a chance to rest and self clean via mTor regulated autophagy. Keeping mitochondria happy is also important, adequate Mg and avoid linoleic acid. Stressed cells communicate their status to the liver and other organs and get an appropriate response. Very complicated process and not fully understood, much more to learn how the body functions. In the meantime follow some basic principles that work for you.

  42. jack

    Are supplements a waste of time as well. Tried everything to reduce my bp even low carb. trying the 5 2 diet now. nothing seems to work. does alcohol raise bp

  43. smartersig

    Does this mean that the work and results of Dr Dean Ornish and Dr Carl Esseltyn are complete fabricated rubbish. Has Ornish since he published in The Lancet in 1991 been telling a complete load of porkies and diet has had little effect.

  44. TS

    Isn’t a vital clue being ignored that Dr Kendrick has often fed us?:

    Men have far more heart disease than women. (See final chapter of ‘The Great Cholesterol Con’.)

  45. dearieme

    Romans did sometimes use IIII rather than IV, especially in official documents. I’m afraid some of you chaps must have dozed off in your Latin class.

  46. Craig

    I’m still gobsmacked by the mackerel ice cream from part XIIX.

    My intuition is that diet and lifestyle do matter, in complicated ways for different people. Medicine is a special type of food also and while it might not be anywhere near as effective as we have been lead to believe, I would probably not be alive without metformin and big lifestyle changes. I would have died of something, that’s certainly what it felt like with a fasting blood sugar near 20 mmol/l.

    So here’s a discussion about a different area wrt the throw of the genetic dice, orchids vs dandelions


    (I feel like an orchid, physiologically, even though I am no tender wee thing)

    Imagine that a similar pattern was relevant to cvd risk. In a population the genetic variants would be randomly distributed, the susceptibilities all mixed around. Those who had a healthy upbringing even with the high risk genes might live long healthy lives, maximising their potential. Those who have bad diet or unfortunate diseases might not, even with hardier genetics.

    A simple model based on that has two independent random variables ie susceptibility vs environment with the susceptibility heing truly random but the environment governed by lots of strange things that can vary widely by region; culture, diet, disease prevalence, family background, wealth, quality of health care …. many, many things which can only subtract from the potential. It’s hard to find a causative pattern in that lot. You have to rely on population statistics when what you really want to understand is individuals. Tricky! Perhaps even not logical.

    The specific diet/fat/chd model looks pretty broken atm. I’m not so sure that other diet-health models are as broken as that one. It certainly is possible to eat too much of any diet and what if you have a hfhchp (highfathighcarbhighprotein) hotchpotch with lots of badly prepared ingredients of dubious quality? Not to mention a diet of statins.

  47. Brian Wadsworth

    Aha. I get it now. This is Dr. Kendrick as agent provocateur. I predict at least 500 comments for this post.

  48. Martin Back

    Men get it more than women.
    Older people get it more than younger people.
    Something to do with clotting.
    Nothing to do with diet.
    Virtually unknown before 1920.

    Rising to a peak in 1970 and falling away rapidly. I’m discarding my favourite theory that it was something now removed in the secret formula for Coca Cola (all those young Americans killed in the Korean war who had fatty streaks in their arteries), and going with Dr. Grimes that an organism caused the CVD epidemic and it has run its course.

    Just to be clear: what are we trying to explain?

    Is it accepted that coronary artery plaques lead to blood supply insufficiency lead to heart muscle death, therefore it is enough to explain the formation of plaques?

    Or is there a more proximate cause for heart muscle death?

    (Thinks: Why only heart attacks? Why don’t we get bicep attacks or calf muscle attacks?)

    1. Bob Niland

      re: … Nothing to do with diet. … and going with Dr. Grimes that an organism caused the CVD epidemic and it has run its course.

      On a subscription health forum that I follow, none of the heart health enthusiasts are prepared to dismiss the theory that some sort of infection (or other immunological provocation) plays a pivotal role in CVD. On the other hand, I don’t recall anyone there proposing a specific agent or agents yet.

      If a microbe, or gang thereof, is identified, further questions would arise. Why didn’t human immune systems handle it/them? If immune system impairment is implicated, did something in diet and/or personal environments contribute to that, perhaps via dysbiosis? So it could circle ’round to diet anyway.

      It might be something in the water, and that’s not a metaphor.

      «…something now removed in the secret formula for Coca Cola…»

      Wiki says that Coke switched from real cocaine to denatured cocaine in 1903. So it would have to have been something else (and the water they use varies by bottling plant). From a CVD standpoint, the top suspects in Coke are the sugars and the phosphoric acid (the issue being the phosphorus, and not so much that it’s an acid). On dietary phosphorus & CVD:

      1. Bob Niland

        @JDPatten, re: You should find this interesting.

        I do. Thank you. It’s unfortunate that the full article is pay-walled, although all of the Figures and Tables appear to be available.

        That particular table is just bacteria. I was a bit surprised that it omitted toxoplasmosis, as toxo has had a CVD association for decades (in addition to likely neuro effects). There’s another table visible on toxins, but nothing jumped out at me on, say, viruses, fungi or parasites, which also need to be considered.

        Although I have personal opinions of what the top suspects are in CVD, there is very little that I would consider completely ruled out, other than perhaps “statin deficiency”☺. Even “high cholesterol” can’t be dismissed out of hand, as it may be a clue that some lipidemia is afoot that requires more than a standard lipid panel to elucidate.

    2. Jennifer.

      Martin. After a strenuous day of decorating, I have had a dreadful night with muscle cramps….calf and ham strings mainly. I will not present at the GP because it is not life threatening, but the same degree of pain occurring in the heart would have prompted a 999 call. I see a real connection between the muscle attacks you mention. Now, had it occurred in the heart in pre-modern days, I would have had to rest until the agony subsided. ( the other scenario being that the heart muscle died, taking me with it). There was a school of thought a few years ago( and not introduced, I might add), that suggested it might be more beneficial for acute cardiac patients to be settled at home in a quiet environment , ( with nursing, but minimal medical and pharmaceutical intervention), rather than expose them to the severe shock of being blue lighted into the acute and tense atmosphere of A&E. But who would ever take that chance? Seems muscles have a hierarchy of importance, such that the heart muscle cannot be ignored, and left to its own devices to heal. Just saying…….

  49. Barry

    I’ve come to the conclusion that looking for a cause of CVD/CHD is doomed to failure. The fact is that everyone will develop “fatty streaks” and “deposits” in their CVS to a lesser or greater extent and these issues develop early in life – see http://eatingacademy.com/cholesterol-2/heart-disease-begin-tell-us-prevention . For reasons not fully understood these “streaks” and “deposits” will develop to cause health problems in some but not in others (or least not to a degree that presents a clinically observable issue). Bodies that deteriorate as they become older are a fact of life – the best we can hope for is to slow the rate of deterioration. So where to start? If you live in Western/Central Europe or North America I think diet – eating the right foods and avoiding the bad “foods” is most likely to help you remain or become healthy, Topping up with certain vitamins and minerals (those lacking in the normal food supply chain) will help restore the nutritional balance to what it should be. That plus sufficient exercise to keep your body toned should work for most people. That is not to say that diet alone will prevent or resolve issues but that it is the only (non-pharmaceutical) approach that is likely to provide benefit (ignoring the more obscure approaches such as meditation) to a Western citizen. What else can you change that is likely to provide benefit and, if you recognise the harm caused by the SAD, why would you not change? Elsewhere I think diet is a relatively minor factor; look at how death rates from CHD vary around the world http://www.worldlifeexpectancy.com/world-health-rankings and between countries that appear to consume similar diets (note the jump in death rate to the east of Germany). There is no way such differences can be accounted for by diet alone so other factors must be involved. However that is not to say that diet is not important – it is – but it isn’t the deciding factor. Given the problems in the high CHD rate countries in Eastern Europe I suspect stress is a major factor. Stress causes an increase in cortisol levels which, long term, results in impaired health see http://hyper.ahajournals.org/content/33/6/1364.full, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1993964/ and http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0031356 as examples. If not stress then what? As for the rest of the world who knows? So many variables and, as always, the devil is in the detail.
    For those of us that are looking for the holy grail of how to avoid disease or to recover our health we are forced to look at associations or read the work of those we trust (both books and blogs) rather than rely upon the advice of government or public health “experts” – most just repeat the same decades old dogma that originated with Keys and the following diet advice in the USA (Keys was always wrong and the diet advice continues to be). Andrew (July 31) may find this https://proteinpower.com/drmike/2016/02/03/will-the-new-dietary-guidelines-fatten-us-even-more/ & the links to Hyperlipid interesting.

    1. sasha

      Not everyone will develop fatty streaks. My mother died at 57 (not of natural causes) and the pathologist told me that her arteries were completely free of atherosclerosis. She fried everything in sunflower oil (the Russian varieties). She is just n=1 but I’m sure there are plenty of others like her.

      1. Eric

        Interesting. Were high oleic sunflower seeds were not around in Russia long before they were marketed as the newest greatest thing in the west?

        1. Sasha

          No idea. I think sunflower oil has been around in Soviet Union for a while with southern Russia and Ukraine as major producers. I do remember eating lots if it since it was the only oil available – salads, frying, etc. Didn’t seem to harm my mother or any of my relatives, most of whom lived into their mid 80’s, early 90’s and none of whom developed CVD, as far as I know.

  50. stcrim

    Dr. Kendrick – I am a long-standing member of Track Your Plaque (recently renamed) and I am a strong defender and follower of your theories. I strongly believe that diet does not cause CAD but it may contribute to it in the same way swimming in ice cold water doesn’t cause the flu but may make it worse.

    Right now some on Dr. Davis’ program feel your opinions are at complete odds with TYP. (TYP being low carb high fat, no wheat, vitamin D, gut flora) Some members want to dismiss your ideas because they read it as eat anything, diet is not an issue.

  51. mart46

    As a long time adherent of your writings I did wonder how long your phlegm could survive the plethora of diet advice. In my (very humble) opinion it is mostly complete bollocks. I say this purely as an observation and an old person . My most hated concept is ” 5 a day “. Who says so ? And where is the evidence to support this? My brother is to his sixtieth decade, To my knowledge he has never knowingly eaten a vegetable. The odd one might have slipped by him in a late night curry. The same is true of fruit (unless you include fermented grapes). I have vegetarian friends with middle aged children who have been veggies since infancy but by any standard today would be declared “obese” with type 2 diabetes. In my view the human body has evolved to chuck out whatever you like at it. So why the diet obsession ? People need to think they have some control over their health. Real medical research does not exist. Drug companies control it and junk anything that is not profitable. Absurd hypothesis still exists. But worst of all ,GPs are prisoners of NICE. I had a heart attack 7 years ago. My surgery gives an annual MOT. Each time my doctor trots out the same irrelevant questions. If I challenge her on anything she smiles sweetly and moves on to the next question. Frankly I feel embarrassed for her. It is supposed to be a heart clinic but I only go to see if blood test has thrown anything else.

    PS the side effects of statins are even worse than you think

  52. TS

    But haven’t we been told that stress induced disturbances of the hypothalamic-pituitary-adrenal axis are a pathway to type 2 diabetes and obesity? (‘The Great Cholesterol Con’ e.g., page 217-218; or type something like “hpa axis stress and diabetes” into Google Scholar.) This looks to be where heart disease and diabetes are linked.
    I see this series of blogs as a great attempt to involve us not only in understanding the pathways but also the arteries and underlying mechanisms of heart disease.

  53. Lucy

    I wish I could have a doctor like Malcom Kendrick. I just want the doctor to check my thyroid (I have a low thyroid) once a year. I don’t want them to check anything else. I feel fine. I just eat real food and not much sugar. I want them to check my blood pressure once in a while and only medicate it when it’s high, really high, not made up high. I have severe anxiety at my doctors office, and feel unsafe there. I don’t know anyone because I can’t see the same doctor most of the time, and feel like I am being herded like a cattle. I don’t go even when I am sick, and probably should go to doctor, like when I had pneumonia.

    If I have a heart attack, I want to ride it out and be put on medicines. I don’t think angioplasties and bypasses really work. Maybe sometimes, they do. I don’t trust the doctors anymore and that’s sad and scary.

  54. Terry woodlouse

    What I don’t understand is why it’s taken 60 + years for my so called bad cholesterol to hit 5.4.
    My so called bad habits have not changed since the 70s.
    I was put on statin on the grounds that during the next ten years I have a 30 percent chance of having a heart attack.
    I’ve not taken a statin for 10 days and can now walk without leg cramps.

    1. David Bailey

      I have experienced those cramps – it is how I found this blog. Although I gave up statins and am fully recovered, if you read this blog, you will discover that some people don’t recover properly. Please bear this in mind if your doctor puts pressure on you to resume statins.

  55. Nigella P

    Great post, because it gives no answers – just provokes thought.

    My own view is that stress seems to be a significant factor in CVD and eating certain foods / drinks can stress the body. So starvation is a known stressor, high levels of sugar also triggers a huge reaction in the body that could also be considered stressful. What about highly processed novel foods – maybe they are stressful for the body too? We haven’t evolved to deal with them – so this could include trans fats, high fructose syrups, seed oils & other highly processed ‘foods’. That’s why I tend to err towards a more paleo approach (in a non-obsessive way). If we mainly eat the foods that have been available to us for thousands of years, then it is likely that our bodies can deal with those foods in a non-stressful way.

    I feel the same about exposure to pollution, noise, lack of sunlight, sitting at desks all day. I think that we didn’t evolve to deal with that kind of ‘stress’ and therefore if we are exposed to it too much its going to be bad for us.

    I was fortunate enough to hear Sir Harry Burns, the previous Chief Medical Officer for Scotland talk a few years ago about the lower life expectancy in Scotland and he mentioned poverty & dysfunctional lifestyles and how stressful they were. Children growing up with high levels of cortisol & adrenaline coursing through their blood and how this was not a good thing from a life expectancy perspective. Seems to me it all ties in somehow!

  56. mikecawdery

    Once again Dr Kendrick has come up with another thought provoking article. I continue to be amazed and extremely thankful for the mental stimulation.

    The only link that I can see is that people who eat a higher carbohydrate diet are more likely to become obese and develop diabetes.

    And diabetes is frequently associated with hyperglyceamia and high insulin, both of which are contributory factors. Indeed, one piece of confidential information (sorry but this is not in my ability to reveal the source) that suggests that putting diabetics post-MI on insulin increases the risk of death. I would love to reveal the hard data on this.

    There is also the contribution of ROS (reactive oxygen species) in this very multi-factorial condition and indeed in other chronic conditions as well.

    The problem is that “good health” is vitally important and the nutrition that leads to it which as Dr Kendrick so rightly points out is not one “diet fits all”. The attempt to prove that in the form of “food pyramids”, “food plates” etc. and claim its success has failed. The question remains “what is a good diet” leading to good health?

    Unfortunately, nutrition is not something included in a general medical qualification and as I pointed out in a recent BMJ rapid response “The solution lies in the introduction of a full nutritional element into the basic medical degree. Will it happen or will the concentration on pharmaceuticals continue?
    (BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i4095 (Published 25 July 2016)
    Cite this as: BMJ 2016;354:i4095

  57. Sean Coyne

    Try Googling why chimpanzees die of CVD in captivity at a seemingly alarming rate, despite a planned diet.

    1. jgt10

      Hmmm, removed from the wild and put into a totally different environment. Food the same, or better, and yet they have a higher CVD rate. Could it be the stress of the different environment? Could it? Hmmm?

      1. Christopher Palmer

        “Hmmm, removed from the wild and put into a totally different environment. Food the same, or better, and yet they have a higher CVD rate. Could it be the stress of the different environment? Could it? Hmmm?”

        It is not easy to pin down precisely what is at work here, but the analogue with the human experience is still a striking one.

        Our own environment is now one that equates to being ‘man-made’, and few of us are free from the imperative to earn money to feed ourselves. Money is interesting, because in the truly global and holistic sense there is none. All the financial liabilities of all the world equate to, and offset, al the financial assets. Despite our freedom of expression and our freedom of movement we are nonetheless more captive that we can readily perceive. Having to compete so hard for a slice of what amounts to nothing takes its toll upon any ‘breadwinner’, be they man or woman.

        Be assured that the modern environment of modern man, appealing as we think it is, harbours endocrine disruptors than can unsettle hormones, that causes additional oxidation stress, and/or oxidative stress, and that hastens the progress of degenerative states within the body. Even a badly chosen diet (one too low in fat) can promote endocrine disruption and manifest itself as ‘inflammation’. Inflammation being symptomatic as opposed to causal.

        You would not credit it, but because we are light sensitive creatures (many are in one way or another) the ubiquity of artificial light has itself become a mixed blessing that can promote endocrine disruption. We sit up too late, do not get enough sleep, the physiological efficacy of sleep is undermined, and we cannot sustain the kind of health we ought.


        Click to access Ghaly__Teplitz_cortisol_study_2004.pdf

        Click to access Amalu_thermographic_case_studies_2004.pdf

    2. Nigella P

      So what do they die of in the wild? Unless you can compare wild chimps with captive ones, you aren’t going to get a useful answer.

  58. Paul

    Dr K: have you read the intro to Malcolm Gladwell’s Outliers. It tells the story of Roseta in the US where, it seems, sense of community and social structures, protected the inhabitants from heart disease (and other ills). Presumably because they protect against the corrosive effect of chronic stress/cortisol? Diet and genetics were conclusively ruled out, anyway.

  59. Doug

    The hypothesis that diet causes heart disease has died, ……..

    long live the hypothesis!!!!

    Keep up the good work Dr.K, I look forward to XIXIIII

    Maybe there is a correlation to the falling rate of marriage and falling CVD???? I always told my wife she’d be the death of me. 🙂

    1. David Bailey

      The old Puritanical rules about sex probably did put a lot of stress on people one way or another, so you might be right.

      1. Doug

        oppps, my bad, a new study out shows divorce rates going down, maybe all that nagging is keeping me alive………

        One study says up, one says down, I think maybe the Doc’s got it right, ignore the studies: Eat, Drink, Love, and Live…….. and don’t be a d*ck to others.

  60. Bob Niland

    re: …I do not believe that diet has much of a role to play in cardiovascular disease.

    Something is causing it, easily multiple somethings, and/or some acting in concert. It is perhaps not the same bandits in all cases (as the news of the Apollo astronauts last week strongly implies).

    If we posit that “western” cultures used to have less CVD, what changed?

    If we posit that isolated ancestral cultures still don’t, what’s different?

    Yes, in some case the isolated cultures have a genetic adaptation, but when they experience a spike in CVD upon adopting modern diet and/or lifestyle, clues are lurking in very close to plain sight. Just last week we also have: http://cardiobrief.org/2016/07/29/changes-in-eskimo-diet-linked-to-increase-in-heart-disease/

    What’s changed and/or different encompasses a nearly endless list of candidate suspects. Some may turn out to not matter. Many are worth acting upon, on a precautionary basis.

    All of us living in at-risk cultures need to consider matter seriously, and place our bets on what strategies appear to have the highest yield. For the purposes of this comment, I jotted down what I personally think are the top threats, and came up with a list of 13, in 4 categories. Several of them overlap, and most of them break down into a much longer list of individual topics.

    46% of the categories were diet-related
    23% were lifestyle-related
    15% were environmental
    15% were unintended consequences of common consensus medical practices

    It may be necessary for most people to attend to most of them, and for some people to attend to all of them. More likely remains to be discovered, but I expect diet to remain the elephant in the CABG recovery room.

    The National Nutrition Nannies have yet to even look at their results over the last 4 decades, and explain why the issues they were trying to fix have either gotten worse or gone nowhere.

      1. Bob Niland

        @Eric, re: Care to post a link to your list?

        Alas, the list was something I generated ad-hoc while composing that reply, and I managed to destroy it while reducing it to those rough percentages. As soon as I hit (Post Comment), I knew someone would ask for it, sigh.

        Given that I concluded that dietary factors are ~half the problem in CVD, I’m not inclined to make the effort to reconstruct the list, and bury it in a reply on a blog series which is apparently dismissive of that approach.

        It’s easy to see why diet gets dismissed, though. There is so much fouled up in modern diet that anyone trying to study for single-variable diet effects, without also reducing the noise of the other factors, is very likely to conclude that what they were focusing on didn’t matter. If you don’t fix most of it, just tweaking one adverse element is apt to contribute nil.

        No IRB would today approve a Control Diet anything like what I think necessary for a proper nutrition trial. And with CVD, it needs to be run over many years. This leaves the hapless citizenry doing their own research and running their own N=1 experiments.

        1. Eugène Bindels

          “This leaves the hapless citizenry doing their own research and running their own N=1 experiments”. A hapless citizen, yes that’s me also.

  61. Bernie

    I have been reading this blog for ages and decided to ditch the statins some months ago. I had a stroke in March 2015 but got through that and am fine and have felt better since ceasing the statin use (I used to feel as if I was in a fog; memory was less sharp etc). My cholesterol is now up at 8.2 and the doc is again pushing statins as secondary prevention. I don’t know what to do – does my stroke history cast a different reflection on this? I know the decision is mine but would be grateful for any comments and further words of wisdom. Many thanks

    1. David Bailey

      After experiencing statin muscle side effects, I will refuse statins in the years to come, whatever happens. We all die eventually, so messing up our bodies in the search for a bit more time seems a bad idea, even if statins made much difference.

    2. jgt10

      Your stroke does put you in the “existing CVD” category. Statins may have a positive secondary effect, but as pointed out by Dr. K, this likely has more to do with the anti-inflammatory effects, not the cholesterol lowering effect. I suspect there are many “better” ways to reduce your risk than statins.

      IMHO, reducing you cholesterol level is NOT going to help reduce your risk of stroke or other CVD’s. I have yet to see any kind of medically or metabolically reasonable process whereby cholesterol is the cause, or a cause of CVD or precursor conditions. I’ve been waiting for the chance to ask a cardiologist to explain how cholesterol “causes” CVD. You might start with that question the next time you are pressured to start statins again.

      I believe that Dr. K has made the argument that high levels of continuing psychological stress, cascades through various systems in the body to increase the risk of CVD and other problems. Yes, diet and exercise can help (or hurt), but I don’t see them as one of the dominant factors.

      If you haven’t read Dr. K’s book, please do so immediately. They might answer your questions and concerns. Anything left over, ask here.

      I’d say stand pat and stay off statins. Make the doctors provide the “proof” of their claims and then check them out.

      1. Bernie

        Thank you for the responses. My stroke was caused by 2 small blood clots in my brain (successfully thrombolised). I was thoroughly checked out in terms of heart health, doppler screen, bloods – all tests came back with no concerns. The risk factors I presented with were HBP and high cholesterol but I think my medical situation was caused by stress, which I am convinced is at the root of so many illnesses. It seems impossible to find a GP who is prepared to look beyond the NICE guidance so, of course, the immediate response to high cholesterol is a statin prescription. I set out my concerns about this to the GP who simply said my level of cholesterol would almost certainly lead to another stroke. That is the entrenched dogmatic view of so many doctors. I am so grateful that people like Dr K have not only challenged the dogma but have presented data to support the alternative view but why is this still not making an impact at establishment level? It is beyond frustrating.

  62. Errett

    Format: AbstractSend to
    Arterioscler Thromb Vasc Biol. 2016 Aug;36(8):1651-9. doi: 10.1161/ATVBAHA.116.307586. Epub 2016 Jun 2.
    Vitamin D Deficiency Accelerates Coronary Artery Disease Progression in Swine.
    Chen S1, Swier VJ1, Boosani CS1, Radwan MM1, Agrawal DK2.

    Author information
    1From the Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE.
    2From the Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE. dkagr@creighton.edu.

    The role of vitamin D deficiency in coronary artery disease (CAD) progression is uncertain. Chronic inflammation in epicardial adipose tissue (EAT) has been implicated in the pathogenesis of CAD. However, the molecular mechanism underlying vitamin D deficiency-enhanced inflammation in the EAT of diseased coronary arteries remains unknown. We examined a mechanistic link between 1,25-dihydroxyvitamin D-mediated suppression of nuclear factor-κB (NF-κB) transporter, karyopherin α4 (KPNA4) expression and NF-κB activation in preadipocytes. Furthermore, we determined whether vitamin D deficiency accelerates CAD progression by increasing KPNA4 and nuclear NF-κB levels in EAT.

    Nuclear protein levels were detected by immunofluorescence and Western blot. Exogenous KPNA4 was transported into cells by a transfection approach and constituted lentiviral vector. Swine were administered vitamin D-deficient or vitamin D-sufficient hypercholesterolemic diet. After 1 year, the histopathology of coronary arteries and nuclear protein expression of EAT were assessed. 1,25-dihydroxyvitamin D inhibited NF-κB activation and reduced KPNA4 levels through increased vitamin D receptor expression. Exogenous KPNA4 rescued 1,25-dihydroxyvitamin D-dependent suppression of NF-κB nuclear translocation and activation. Vitamin D deficiency caused extensive CAD progression and advanced atherosclerotic plaques, which are linked to increased KPNA4 and nuclear NF-κB levels in the EAT.

    1,25-dihydroxyvitamin D attenuates NF-κB activation by targeting KPNA4. Vitamin D deficiency accelerates CAD progression at least, in part, through enhanced chronic inflammation of EAT by upregulation of KPNA4, which enhances NF-κB activation. These novel findings provide mechanistic evidence that vitamin D supplementation could be beneficial for the prevention and treatment of CAD.

    © 2016 American Heart Association

  63. philip watts

    Sorry Doc but I need to go way back with my question it’s been bothering me awhile. You said there is no cholesterol in the bloodstream because it is not water soluble and therefore not soluble in blood, So how is cholesterol transported round the body and why take blood to test for cholesterol levels if there is none there? And why is LDL considered worse tha HDL is it not just a smaller lipoprotein?

    1. Goutboy

      The choles is carried by the LDLs to the cells and the HDLs,it is thought, picks up choles and takes back to liver. If you believe chole not good then reducing LDLs will reduce serum TC hence statins. If you believe in the lipid theory then the sub issue is the size of LDLs. If they oxidise they become small and these attack the arterial wall setting up complex reactions. Too much omega 6 PUFA are thought to be a villain. Statins stop cells from making choles so the cell receptors need to take up choles from the blood stream lowering LDLs. The problem is that they stop other things as well namely coq10 which was at one time going to be part of the statin mix, it is this that is thought to be the cause of muscle damage. See Stepanie Serif. BTW blood tests calculate not measure neither TC or LDLs. Spend 30 minutes on Google there is so much stuff most of it contracting each other it’s all fascinating.
      IMO cvd it’s down to one’s genes.

      1. smartersig

        If it were down solely to Genes then those Japs moving to Hawai would show some degree of protection but alas they do not

  64. Kathryn

    Right On !!! Amen to all you have said. I deal with the same nonsense every Doctor Visit. This blog is shedding light on alot of issues. Dr. K. Thank you for all your time and effort. Our love and prayers go out to you every day.

  65. Gary Ogden

    If psycho-social stress is the primary driver, the demographic changes in the twentieth century, particularly after WWI, have great explanatory power. The development of the Haber-Bosch process allowed the development of industrial farming. People left the farms and moved to the cities, often breaking up multi-generational units. Breaking up the relationships between neighboring farm families. I suspect that multi-generational families, while stress-inducing in their own way, are more resilient, and most of the time the farm produced adequate food, unlike cities.

  66. smartersig

    We are already seeing the damage done here by the Doctor suggesting that diet may play no part in HD. Those desperate to defend their steaks, white flour and sugar products are jumping on the news. Ornish, Macdougal and Esseltyn have been treating and reversing HD for decades with a whole food plant based diet. What have they got wrong, have they simply fluked it, fudged the data ?. Everyone wants a cast iron silver bullet when in fact a best practice probable approximation to best heart health is the best we have but its clearly as lot better than continuing down the traditional western diet path. I come from a betting background and as such I am comfortable betting with best odds and not looking for certainties. Many on here seem to want certainties. I suggest until one comes along you take the best odds

    1. David Bailey

      “Those desperate to defend their steaks, white flour and sugar products are jumping on the news.”
      I guess a lot of people are desperate to defend something – including those who have built up a career and maybe a whole system of ethics around diet advise. When you talk about “damage done here by the Doctor”, you remind me of those who attack Dr Kendrick for endangering lives by encouraging people to abandon their statins! In other words, rather than discuss why you think he is wrong, you attack him for the damage his ideas will bring, assuming they are wrong!

      Incidentally, I know he is right about the statins, because I have personal experience of what those drugs can do, and I have spoken to many others who made the same discovery.

      I have some sympathy for people who say meat eating is morally wrong (though I don’t know what our cat could eat), but that is not the question here – which is whether there is convincing evidence that diet is responsible for CVD.

    2. Stephen T

      Smartersig, who’s defending sugar and wheat? Steak’s a different matter. The problem with vegetarians is that they often put meat in the same category as sugar and processed junk. That’s ridiculous. There’s no remotely good evidence against meat. What does exist are fixed mouse studies, where the mice are genetically modified to be susceptible to cancer. The mice are then fed sugar-rich, carb laden junk with some heavily processed meat. The mice get ill and somehow it’s the meat that’s the problem and we get front-page headlines. Meat eaters might want to look at some real science on the subject


      Low-carb eaters are probably more against sugar and junk than any other group. The message to eat real food is integral to the low-carb diet. The most consistent change reported by low-carbers is eating more vegetables.

      1. Dr. Göran Sjöberg


        “Low-carb eaters are probably more against sugar and junk than any other group. The message to eat real food is integral to the low-carb diet. The most consistent change reported by low-carbers is eating more vegetables.”

        This is an excellent summary of what LCHF is about, at least in Sweden.

        The largest health blog in Sweden is a LCHF-one founded by Dr. Andreas Eenfeldt who now does his best with his team to go international.


        The site is worth exploring if you are seriously interested in the LCHF style of living. The team with six full time employees is supported by the member fees and this seems to work fine since they are expanding their activities. As a member you can watch many high quality videos featuring prominent advocates for this life style.

        Mercola with a much larger team is also for a low carb high fat line and he is, as me, also in favour of alternative medical approaches to restore health. He also do interviews with interesting people like e.g. Professor Seyfried and here everything can be watched for free. Mercola is living on selling supplements.

      2. David Bailey


        That is a wonderfully informative link, which everyone should read. It illustrates yet again, how powerful pressure groups (the WHO in this case) latch on to science and distort the evidence to suit their ends. This is destroying and discrediting science in a most unfortunate way.

  67. Dr. Göran Sjöberg

    As many here may understand I am a very strong believer that what you put in your mouth may affect your health in the short and in the long run. I would like to state that this has been known in all societies and by necessity, except perhaps in our present one.

    But what about diet as a therapy or a remedy in the Hippocratic sense? With my personal family success (double anecdotes here!) on LCHF my belief tends to turn religious although I think I still honour science in my heart.

    A while ago I brought the solid book by Professor Thomas Seyfried,”Cancer as Metabolic Disease”, up for discussion here at Malcolm’s blog and with interesting remarks. Seyfried is for sure putting his neck out when he is challenging the present dogma about cancer as a genetic disease. Another favourite of mine is Dr. Mercola who is taking the same stand as Professor Seyfried about the importance of your food in “healing” and “prevention”, but in a broader “holistic” sense.

    Now there is an interview with Professor Seyfried by Mercola which I think is worth the hour you have to spent on the reading.

    Click to access Interview-Seyfried-CancerAndKetogenicDiet.pdf

    1. Solomon

      There was a conference of Ketogenic researchers recently and fortnately their presentations, 26 videos, are on youtube for the rest of us to enjoy. https://www.youtube.com/channel/UCkUl8S70DCT66YJ30w75d6A
      Increasingly, there are many more researching the Ketogenic diet, many more applications and yet more clinical trials. Listening to these latest insights from the researchers only confirms that we are unto something golden!

      1. Dr. Göran Sjöberg


        Thanks for this youtube link.

        Watching the first talk by the the prominent researcher Jeff Volek was like going to church for a true “believer” like me. Anyway he seems to know what he is talking about in terms of carbohydrate metabolism, a true nutritional scientist to me. Especially how he elaborated on how, among people caught in the metabolic syndrome, it is the dietary carbs not the fat you eat that metabolises in the liver to show up as high levels of palmitic 16:1 monosaturated fat in the blood, hyperlipidemia. Though, this was known already 60 years ago for people interested in science of nutrition which, as it still is today, constitute a minority in medicine.

        I think this talk could possibly impress also on Malcolm if he is able to afford an hour on that.

        Well, I guess I can enjoy a whole week continuously on this conference for free but my garden work takes a heavy time toll today so the conference will probably be enjoyed for a month.

        So thanks again.

        1. Solomon

          I enjoyed most of the videos but the one that blew me away was KetoPet, saving 80% of 15 dogs from cancer with Keto. They had all (100%) been condemned to die within a few months. You simply cannot wish all these theory and evidence away. Yes, from dogs to humans is a long distance, but when the science is right, confidence builds up as you go along. Now keto is not only attracting research funding and scientists, industry is paying attention.

      2. John U

        Yes, thanks for that. I was never even aware of this conference. I know that I will really enjoy listening to all of them.

        1. smartersig

          Just watched the first presentation by Jeff Volek, excellent. Interesting how Carbs with meat are likely to promote fatty blood. Thanks for posting the link.

    2. John U

      Goran, I note that you have mentioned the Mercola site favorably in at least 2 comments. I have to say that the Mercola site is another example of a site I would never recommend to my friends. I almost never go there, so I just went on it to check if it is still the same. I see things like liver detox (a red flag for quackery for me), an article on whether drinking water can help you lose weight (I looked at it and found it full of factually wrong info and unsupportable claims), comments from people who have nothing better to do than spew nonsense or irrelevant material, and on top of it all his site sells stuff that is intended to improve your health but is at best not science based and at worst just plain quackery. And this includes the “Earthing Mat”. No doubt that there are articles on the site which are useful and report the truth, but I have a hard time giving him credit for these when there is so much junk and bad advice on the site.

    3. Eric

      Advocates of the ketogenic diet have impressive results to show, but the links provided by Diana on reverse Warburg effect and cancer cells thriving on ketones demonstrate that there’s more to cancer than just damaged mitichondriae.

      1. Diana


        not only thriving. Ketones in fact seem to increase cancer “stemness.” Not good. Also by Lisanti:

        “Ketones and lactate increase cancer cell “stemness”, driving recurrence, metastasis and poor clinical outcome in breast cancer Achieving personalized medicine via metabolo-genomics” (2011)

        1. joanne mccormack

          There is a rather interesting researcher called Andrew Scarborough who is doing research into brain tumours at present. He has even looked at his own. His is responsive to glucose so he eats a very strict ketogenic diet, and so far it is under control. He tells me that some grow best on glucose, and others grow best on ketones. You can talk to him @ascarbs

      2. Eric

        Yes, this is truly puzzling. I wonder if there are distinct “kinds” of cancer, as the keto disciples have some impressive results to show.

  68. Boelie Hoekstra

    Dr Kendrick mentions the question interestingly, who is intolerant to carbohydrates. That brings us to the pioneer of that field, dr Joseph R. Kraft, who said after measering the insuline response of over 1.400 patients that only 30% are tolerant and 70 % are not. He maintains that generally the people with substantial atherosclerotic issues who are not diagnosed with diabetes, are simply not properly diagnosed yet.


    1. Dr. Göran Sjöberg

      I really appreciate Dr Kraft and his clinical insulin/glucose measurements on metabolically susceptible patients at his hospital under those many years since 1975 when Pharmacia had developed an efficient blood insulin measurement procedure.

      I might remember wrong but wasn’t it about 14 000 patients rather than 1 400?

      Everything today is just “screaming” insulin resistance and hyperinsulinemia in my ears.

    2. mikecawdery

      Boelie Hoekstra.

      When one reads this, one seriously questions the exclusion of insulin testing from the standard testing in diabetes. May be it is because such information would contradict the medical establishment gospel? Many thanks for the link.

  69. jgt10

    Dr. Kendrick, between your books and this blog series, I see a coherent theory on CVD, unlike what mainline medicine is presenting.

    In summary (and please correct me where I’m off track or worse) CVD is the result of the inflammation and repair systems getting knocked out of whack by one or more factors. The result is that the inflammation and repair systems are pushed into counter-productive state of operation. This results in the creation or worsening of potential problems (plaques, for one) that can then “fail” and result in a CVD “event” (stroke or MI or something else.)

    The major risk factor appears to be severe and chronic stress. This single factor appears to be sufficient, by itself, to result in CVD, regardless of the influence of other positive factors.

    Genetics can also be a single sufficient factor for CVD, but appears to have a very limited impact on the overall numbers.

    The other factors that can influence the risk up or down do not appear to have “necessary” or “sufficient” impact to be major risk factors. We have seen that “cholesterol” is neither necessary, nor sufficient by itself to cause CVD. It does appear that a significant lowering of cholesterol levels is implicated in higher mortality at a later date, but not in relationship to CVD. We have seen that diet as a factor can be positive or negative, but not sufficient to cause CVD by itself.

    There is a single mechanism for CVD (inflammation). There are many “factors” (stress, genetics, diet, diseases, environment, etc.) that work on that mechanism over several years to result in CVD events.

    1. barbrovsky

      Absolutely! I too am convinced that inflammation is the most important factor but what causes it? Is it stress? Is it sugar? Is it all the crap people eat? Is it sitting on your arse all day? It sounds like it could be a number of factors that combine to cause a CVD, plus of course, the individual (genetics, ‘lifestyle’ etc).

      1. JDPatten

        Read what Dr. Kendrick writes. If you give him any credence you’ll take to heart his belief that inflammation is a necessary bodily response to injury, the first step of healing. Your target should be the original injury and its causes.

    2. Martin Back

      The problem with using “stress” as a factor is how do you measure it?

      People react to external events in different ways. Some stress out, some don’t. Some can handle personal stress but not job stress. Others are the other way around. Some panic at civil unrest, others are phlegmatic about it.

      You need a measurement something like for smoking. One pack a day for a year is one pack-year. You can get a rough association between pack-years and lung cancer or heart disease.

      If cortisol is the stress hormone, you need to be able to measure something like a cortisol-year.

      Different emotions seem to have different effects on the body. For instance, my mother died in her 40s of colon cancer. She was a healthy woman. I’m sure it was bitterness and resentment at the way my father treated her during and after the marriage that caused the cancer. “Stress” generally implies fear and anxiety. Would bitterness and resentment be counted as stress?

      1. jgt10


        Unfortunately, you are dead on, as Dr. K outlined in “The Cholesterol Con”.

        We can see the kind of “stress” we are talking about, “severe and chronic” and agree when we see it. However, putting an objective medical measurement on it is difficult. Thou, I am sure it will get done somewhere down the road.

        The psychological science can, and does, have objective standards for “stress”. However, the psychological mindset and framework is very different from the main medical ones, that it appears to the untrained as “soft”, subjective or arbitrary. Thus, it appears it can’t be objective and therefore useful in this situation. The main medical professions thus dismiss psychology as not useful for these “hard” issues.

        As an amateur psychologist, I beg to differ. Yes, reading the Diagnostic and Statistical Manual (DSM) can lead to the idea that it is all subjective gobbled gook. It takes training and study to get the underlying mindset and framework assumed in the DSM and the skill to apply it. I know enough about the mindset and framework to see the objective nature.

        I would also like to point out that some previously “soft” defined psychological ailments have since been found to have “hard” medical mechanisms and causes. Think schizophrenia.

        I see the process as starting with “sever and chronic stress” to a psychological definition, to an objective medical measurement, to an understanding of the biological process. As we have seen, “stress” is beginning to get that “hard” description with HPA axis and CRT levels.

        I think it would be very interesting for a psychologist to present on stress and its classification.

      2. barbrovsky

        JD: Well yes, obviously something causes the inflammation eg, smoking, sugar, too much booze or fried bacon or whatever, which in turn somehow makes cholesterol stick to the walls of the arteries (and no doubt other stuff sticks there too). But does stress (whatever that is) cause inflammation? Stress is a necessary component of living but just how much is too much?

        Without a shred of evidence to back it up, I’d say that sugar is probably the major cause of all kinds of diseases. Add in pollution of water, air, land and chemically loaded processed foods, and voila! Synergy. Late capitalism has launched an assault not only on us humans but now on the entire biosphere!

    3. Christopher Palmer

      The difficulty with your coherent theory on CVD, jgt10, is that you reference the term ‘inflammation’.

      In the scientific world of cause and effect ‘inflammation’ can only rank as ‘effect’. The term ‘inflammation’ refers only to the presence of heat. Usually in the context of more ‘heat’ arising in one locality than baseline levels arising in surrounding regions. Thermo-graphic imaging can illustrate the effect quite well.

      The above considered, members of the medical establishment bandy the term about as if it could be a ’cause’, and it has taken on additional connotations such as swelling, damaged tissues, or even visual indications of healing arising in tissues. It cannot be a cause, for in plain English the laws of physics say that heat arises when work is being done, and that work is being done when energy is being expended. To a physicist bruising, swelling, fighting off infection, healing, and regeneration, would each rank as work being done

      Hence the rigours of science and adequate regard for the principles of cause and effect demand that if inflammation is witnessed in association with anything, including aspects of CVD, then that inflammation should be regarded as an ‘effect witnessed in common’. It is a symptom and not a cause. Physics demands the truly curious must wonder what kind of work is being done to gives rise to a localised rise in temperature, ‘inflammation’. Medicine has a history of confusing symptoms with their causes.

      It was Albert Szent-György, who first perceived the pertinence of quantum theory to biology. ‘Life’, he suggested, existed in the difference between two quantum states, or something along those lines, and that was the order of 80 years ago! This direction from a Nobel prizewinning biologist was right on track but the idea was slow to inspire others and hasn’t really caught on, not even now.

      The branch of quantum theory that is today known as Quantum ElectroDynamics (QED) that best describes how heat arises within our bodies and what provides the energy to sustain life. Szent-György offered his thoughts on the pertinence of quantum theory before QED became a coherent theory. QED had to wait for Richard Feynman to gift the theory with a measure of comprehensibility.

      Anyway to keep this comment brief we need to come to some appreciation that much about the biochemical dealings that go on inside of us arise because work of some kind needs to be done.

      Our cells need energy to regenerate, that is business as usual. When cells are involved in the business of healing they need additional energy to remap the epigenome so they can trend to become suitably differentiated and specific cell types. That is an additional workload. Certain cells gift us with the power of locomotion (that’s work). Enzymes go to work breaking molecules down or building molecules up. We have a nervous system that can report and transmit information (signals) about our bodies, and we have the power of thought, speech, language, and reason. All these things are examples of work being done.

      Whenever we are rest, there is work being done, whenever we think, whenever we move, whenever we fight of infection, whenever we need to heal, whenever we get stressed, whenever we take fright, whenever the fight or flight response kicks in, whenever a free radical interacts harmfully, work (of one sort or another) is being done. It may seem radical to uninitiated minds but, whenever and wherever work is done within biochemistry energy is being expended, and the source of that energy is traceable (perhaps stepwise fashion) in every case to electrons shifting from a higher energy state to a lower one.

      ‘Inflammation’ is an incoherent term, or in the least it is term that is used incoherently – even by so-called ‘experts’ – and so any theory built upon the term cannot be coherent. It equates to a house built on dodgy foundations.

      Recognition of inflammation is mere observation and concession. All it informs is that in regions that are acknowledged for being inflamed the amount and nature of the work being done has risen above baseline levels such that the temperature in those tissues has correspondingly risen above baseline levels. Unless you can be more specific about the origin and nature of that additional work, together with what may give rise to it, you are actually no closer to identifying the cause of CVD or anything else.

      Biochemistry and biology are inherently bio-electrical, and the bio-electric aspects owe a great deal to affairs that QED and quantum theory account for. Unfortunately we humans see electricity as a familiar and man-made entity harnessed to our technological advances. We forget that electricity is an entirely natural phenomenon made possible by the very peculiar and enigmatic attributes of a fundamental particle, the electron.

      The new term on the block is ‘quantum biology’, but all of biology is essentially a quantum eventuality, one established above the quantum aspects inherent in biochemistry. Electrons account for all the work being done within biochemistry. He was a clever chap that Albert Szent-György, and so was the charismatic Mr Feynman.

      Medical science makes few concessions to biology, even fewer to biochemistry, and I wonder that the number of doctors (even globally) who can see QED as being pertinent to practice and diagnosis, or to medical science, could be counted on the fingers and toes of one person. Maybe the toes needn’t be called into play!

      ‘Inflammation’ is cannot be a coherent theoretical step forwards, but as theoretical steps go it is great improvement upon the lipid and cholesterol hypotheses, for these represent steps in entirely the wrong direction – that is, backwards and not forwards – and through their popularity and widespread acceptance they account for why much needed progress in the right direction has been so slow arising.

      1. Diana


        I would like to hear more. What carries the electrons within the body?
        I have mentioned some transition metals previously with the focus on Cu, Mn, Zn, Fe… etc. and their “balance” which is related to diet, health and disease.

      2. jgt10

        I was using the medical definition of inflammation, not the physics version. See https://en.wikipedia.org/wiki/Inflammation or google it for various other definitions.

        I do agree that inflammation is not a “cause”. It is a symptom, or a stage in the process, as Dr, K has described in detail elsewhere. I suspect that there isn’t ONE cause for CVD, but several and it may take only one, or it may take two or more to cause CVD.

        1. barbrovsky

          An obvious and logical point (that there maybe multiple causes). It explains much about the (apparent) difficulty in finding a single cause, ‘coz there ain’t one! Thus combine, for example, smoking and stress or sugar and stress, or all three.
          Western medicine looks only for the quick fix and preferably, one that makes a corporation mucho dinero, eg Statins @ $3trillion profits so far.

  70. Martin Back

    Here’s a thought experiment: There are 1,000 young men or women. They are healthy non-smokers who have no genetic abnormalities, take moderate exercise, get vitamin and mineral supplements if required, and neither gain nor lose weight.

    All you know about them is their diets.

    Your mission, should you choose to accept it, is to predict who will get a heart attack in the next 50 years.

    I submit you will do no better than chance. That is the meaning of saying CVD is not primarily due to diet.

    1. markheller13

      Martin, not being able to predict CVD from diet does not mean that diet is not relevant…

      I suspect that diet does play some part (and some clinical trials with control groups have shown this) but it is hugely complex (and multi-factorial), so incapable of being broken down into simple ‘X is bad, Y is good’ type statements.

      1. Martin Back

        If diet is not predictive of CVD, then one cannot with confidence advocate a change of diet and expect it to make a difference.

        Of course, in the real world, diet is usually indicative of many other things such as income level, education, ethnicity, health-consciousness, exercise levels, etc, so it is almost impossible to disentangle the various factors.

  71. John U

    Goran and others,
    I also was impressed with Dr. Seyfried’s work. Then I read a very interesting book called “Sharks Get Cancer, Mole Rats Don’t: How Animals Could Hold the Key to Unlocking Cancer Immunity in Humans” by James S. Welsh, MD. I found his writing style to be somewhat like a detective mystery story, and his ideas to be totally logical. Diet was not discussed at all, just questions about why our own immune system is not attacking foreign tissue (such a cancer cells) with the same ferocity that it attacks so many other foreign cells. It is as if the cancer was veiled in an invisible cloak. An example among many is the case of why our immune system gives an embryo a free pass when the genetic code in the placenta and the embryo is foreign to the mother. Many other examples exist and are discussed. Why does a person with terminal cancer, who receives radiation treatment on his leg to ease the pain, suddenly become completely cancer free throughout his whole body?

    I found the book quite intriguing, and like a good detective story, a real page turner. It opened my eyes to the depth of science in the field of cancer research, way beyond ketogenic diets.

    I am not suggesting that Dr. Seyfried’s work is not important. I just think there is a lot more to be learned in the fight against cancer.

    1. Sasha

      I think the reason our immune system doesn’t attack cancer cells with the same ferocity as foreign invaders is because cancer cells aren’t truly “foreign” to our bodies. To some extent, they are a more “efficient” version of our non-malignant cells.

  72. joanne mccormack

    I think we have always been asking the wrong questions in respect of diet- veggie vs meat eating, low fat vs high fat, and people are too emotionally attached to the results. I would compare a high nutrient density diet with a low nutrient density one, and a highly toxic life with a low toxic life. Except I doubt either approach would be ethical.
    If I compare my patients with the worst health- looking at numbers of drugs taken/advised, numbers of illnesses and ages at death, with those in the best group I note the following. The former group have more financial stress, relationship stress, less social support, less nutrient dense diets( the worst one so far is just sweets), they sleep less , they smoke more, and they do less planned exercise. Note how I randomly put diet at number 4, even though I consider diet so important that I have put it centre stage in my website.
    No clinical trial in the world can allow for these factors. When you consider that stress raises cortisol, adrenaline and noradrenaline and increases insulin resistance, and we are trying to look at the isolated effects of food on how the heart works, we are on a hiding to nothing. We already know our bodies need nutrients to thrive, the pragmatic approach is to try to get as many of those as possible, to watch for any malfunctioning of our bodies, and make reasonable adjustments to what we eat if we can see something is missing. As regards the heart it is one part of a whole, and from a diet point of view should not be viewed in isolation. I have long thought that any ‘heart healthy’ food label ought to be reported to Trading Standards and the products boycotted. Except that I do like porridge.

    1. Christopher Palmer

      Oxidative stress:
      see https://drmalcolmkendrick.org/2016/07/31/what-causes-heart-disease-part-xviiii/#comment-59566
      gives rise to assimilated deficiency of electrons in the bioelectric aspects of biochemistry. Such deficiency has the potential (as a function of diminished electrical potential) to undermine biochemical dealings that are ionic by their nature, and many are. Assimilated deficiency of electrons (oxidative stress) diminishes the zeta potential of blood cells . . . and the membrane potential of all other cells . . . and has consequences for the ability of cell types to regenerate in precisely their own likeness . . . thus leading to degeneration in the health and functionality of cell types. . . . The functionality of responsive cells such as contribute to the nervous system may be consequentially linked to variation (falls or reversals) in membrane potentials (oxidative stress).
      The Earth’s own electrical field is natures own antidote to oxidative stress. When we walk(ed) barefoot the Earth and its watercourses can donate electrons that compensate for the assimilated deficiency. Only species that build homes from sophisticated materials and wear shoes with soles made from synthetic materials (non-conductive) attain the level of isolation from the Earth’s electrical field needed for oxidative stress to become a common and lasting problem.
      Oxidative stress and cancer:
      Oxidative stress and blood pressure:
      Blood is both a solution and colloid.
      In colloidal fluids electrical potential resting (charge) on the surface of colloidal particles keeps them a) suspended, and b) dispersed. Such potentials my be the order of millivolts. In colloidal physics the charge is called zeta potential. The decline in zeta potential can result in a decline in even dispersion and a tendency for coagulation. A further decline in zeta potential would give rise to a collapse of suspension. The tendency to coagulate can raise the viscosity of a colloidal fluid. If flow is involved and viscosity rises then flow can only be maintained with a rise in pumping pressure.
      And so it is with blood.
      Several factors may signal the need to raise pumping pressure of blood to cope with alternate circumstances. The rise in viscosity of blood being brought on by decline in zeta potential of blood cells is one of them. And because decline in zeta potential in blood cells can arise because of oxidative stress assimilated via the level of isolation brought on by the wearing of shoes made with soles made from plastic and rubber the prescription could be simple, cause orientated, low cost, and naturally orientated: Go find some pleasant and natural ground, kick off those shies, and go walk barefoot for a while. Alternatively invest in an earthing sheet and sleep on it. Not unsurprisingly, given an understanding, the habit of earthing or grounding as positive impacts upon hypertension.
      Is well maintained zeta potential of blood cells a factor that could discourage thromobogenic tendencies? I should think so.
      Is decline in zeta potential induced by oxidative or oxidation stress a factor that can induce thrombogenesis and clotting? When I slice my finger and not the onions I consider oxidation induced thrombogenesis to be an adaptive aspect of my biochemistry. Wouldn’t you? Similar process arise in leafy plants.

      Regard for oxidative stress, oxidation stress, stress, endocrine disruption, cell health and membrane health, each infer some internal physiological and/or cytological processes or mechanisms behind. Oxidative stress has profound implications for physiology and biochemistry. The habit of earthing or grounding then has profound restorative implications in the face of causal associations. IT’S THE ENVIRONMENT, STUPID! (No, I do not direct this at Joanne). Modern man lives in a modern and man-made environment. His physiology evolved in a natural environment. The differences may be many. But within those differences are those that evolution did not prepare for. It is not us or our genes that are maladapted, it is aspects of the environment and habitat that we humans have created for ourselves. Many of the diseases that plague the times we live in are man-made. Modern medical dogma in the form of the lipid hypothesis or diet-heart idea has added to the driving forces.

      COST EFFECTIVE CAUSE ORIENTED PRESCRIPTION AND PREVENTION: The closest you can get to a a cure for man-made diseases is avoid contact with cause. That should be the prescription. The next best advice that can be given to patients after early diagnosis is remove all contact with cause. Cells may then begin healing through trending back to regenerating in the way nature intended. Because it has such universal implications for cytology and physiology a universal prescription should be to address oxidative stress. In the modern world for the majority of people the best way to address oxidative stress is to equip the bed with an earthing sheet. Ergo, earthing sheets ought to be available on prescription. Grounds for objection? a) scepticism, b) cost.
      The only grounds for being sceptical of the benefits of earthing are a lack of understanding. My advice to the sceptics; Go figure!
      Now lest explore cost:
      If an earthing sheet costs around £100 and lasts ten years the annual cost is £10 per year. It is natures antidote to hypertension. So next consider the cost of licensed hypertensive drugs. It is more than £10 per year or else it would not be worth the while of making and selling them. Now factor in cholesterol lowering drugs such as statins (whose patents are expiring) or the new and emergent patentable cholesterol lowering drugs. Via the dishonesty of quoting reductions in relative risk the efficacy of these drugs has been, and will continue to be, significantly overstated. And because cholesterol is so vital an agent to mammalian physiology interfering with cholesterol synthesis can only to complications or side-effects. And lowering cholesterol can do no good in the name of prevention because cholesterol is not a concentration dependent atherogen.
      Cells are highly tolerant of cholesterol because the molecule itself represents a major transition in the evolution of biochemistry. The animals went in two by tow, hurrah, hurrah. Cholesterol is the overwhelming zoosterol. Before it arrived on the scene via the process of biochemical evolution there were only cholesterols and therefore only plants. The evolution of animals, their emergence, even their trending to diversity and sophistication is not something that could have arisen without evolution produced the first molecule of cholesterol ever. If phospholipids are the building blocks of the membranes of animal cells cholesterol in membranes equates to the mortar. Together they combine to make a membrane that is both semi-permeable in just the right way, maintains ions channels and lipid rafts, gives cells access to factors they need, and deny cells interference from factors they do not need. If, in addition, membrane potentials are adequate cells regenerate and make good copies. Health is maintained.
      Cabbages are consigned to being cabbages BECAUSE A CABBAGE CANNOT SYNTHESISE CHOLESTEROL – It has to make do with brassicasterol and/or some other phytosterols.
      CURIOUSLY THE CABBAGE HAS AS MUCH NEED OF HMG-CoA REDUCTASE AS EVERY CREATURE DOES. it is needed for the synthesis of vital sterols.
      A cabbage is a cabbage because it cannot utilise lipids in the way creatures can. It cannot fashion membranes with lipid bilayers. It cannot transport lipids with the ease that red-blooded species can. It can transport fat soluble vitamins with the ease red-blooded species can. It cannot breath oxygen. It cannot ‘think’. It cannot go in search of food. Its most enviable quality is that it can speak no lies nor take up with errant and harmful beliefs.
      The relative universality of the acetyl and mevalonate pathway coupled to the enzyme HMG-CoA reductase ought to inform something. THAT YOU ARE SO WRONG IN YOUR PEDANTIC PROMOTION OF MEDICAL DOGMA SHOULD TOP YOUR LIST.
      Okay. Rant over. Dignity restored.
      The prescription of cholesterol lowering medications is, has been, and will remain a big drain on the NHS drugs budget. It has been completely unnecessary. The only ‘good’ it has achieved is that it has taken money as taxes from the beleaguered working poor and lined the pockets of the stakeholders of enterprise (shareholders in big-pharma). There has been no gain in all cause end-points to do with health.
      Now starting adding the annual costs of satins to the cost of anti-hypertensive drugs. factor in other aspects of polypharmacy such as metformin prescribed to patients with insulin resistance. Is the cost per patient lees than or more than the £10 per annum of an earthing sheet? Surely it is more, much more.
      The question responsible medical practice ought to be asking is should earthing sheets be available on prescription in the UK? It would be a more cause oriented prescription, certainly, a more naturally oriented step to take, side-effect free, likely more efficacious than the overrated and overstated efficacy of drugs, and costed over ten years its likely a big saving. Quite possibly cancer rates would cease to rise and would actually fall. Think of the savings on cancer therapies and anti-cancer drugs. It would be undeniable cost effective over the longer and medium term to make earthing sheets available on the NHS. No complicated risk assessment is necessary either. Anybody that doesn’t earth will suffer oxidative stress, and anybody that suffers chronic oxidative stress is at increased risk of one or more of several complications of ill health. Oxidative stress and earthing are that fundamental to the delicate balance of health and ill-health. Oxidative stress can be the difference between life and cancer.

      So Joanne, do you think modern medical practice and modern medical insight requires a paradigm shifting shake-up to the extent that I do? Do you think that NICE and the SACN guides health practitioners in the directions they ought? Do you think medical schools and teaching hospitals teach medical students the things they really ought to know? Does your standing in the ecology of medical science and practice discourage you from answering for fear of reprisals? No answer would be as informative as an answer might be.
      Notwithstanding the pressures you work under; workload, standards of care, peer pressure to conform, it is refreshing that you give thought to affairs, probe them, discuss them, and are generally progressively minded towards them.

      You bring a social conscience to your work. Fiona Godlee brings a social conscience to her work and the work of the BMJ. Professor Collins may allow himself to think he brings a social conscience to his work, too, but in this he is totally deluded. There should be no room for delusions in medical science nor in medical practice. Delusions can do nothing for standards of care.

      1. Martin Back

        I don’t understand why it is electrically necessary to have bare feet in contact with bare earth. Surely any time you take a bath or shower, wash the dishes or your hands, or touch a doorknob or railing, you exchange electrons with the earth.

        How about hanging chains from office chairs like motorists used to have anti-static chains attached to the chassis dangling on the road, or maybe a chain fastened to our bare ankles tinkling on the path as we walk? ;o)

        1. Lee

          So true and so funny too, as it’s so obvious really. It would be a very odd existence never touching a sink or a tap or any metal electrical appliance.

    2. Christopher Palmer

      “The fact that Jelly Fish have survived for 650 million years despite having no brains gives hope to some people”

      Despite we humans have brains it is rare to find humans that make optimal use of them. We’d always be the last to level criticisms at ourselves. Levelling criticisms the way of ourselves is how we take the first step on route to more optimal use.

      1. Christopher Palmer

        “Youve nailed it Chris, we think too much”

        No, smartersig, the majority of people actually think very little. We have grown up (evolved) in an environment that rewarded us for making quick decisions, such as running away from nasty carnivorous.

        The hazards of the modern world are more insidious and the most insidious fall into the category of being man-made. They would be less troublesome to fix if only we could identify what gives rise to them. The biggest obstacle to redressing them in this way is the incapacity of many people to think hard enough, slow enough, and long enough to solve the riddles.

        According to Daniel Kahneman who wrote a book on the subject modern life still rewards quick thinking, and this he says is a distracting perversion that prevents people thinker slower on the occasions when slower thinking would be better.

        There is a tale related in the book where Kahneman thinks slower than an Israeli Air Force flight instructor and overturns the instructors logic. I got his point.

        I must have followed Kahnemans advice to the letter because over time I distrusted his direction and that of the instructor. I sensed one could do better, and having come by that sense it actually took me about three weeks to explain an interpretation that showed the artefact in his.

        Rushing to conclusions never did anyone any favours, unless you are in the wilds and see tiger stripes in the long grass.

          1. Mr chris

            Dr K
            I realised, long ago, probably at part VIIII, that there is and will be no easy answer, and that you would teach me a lot,along the way.

        1. Bob

          Or unless, well, countless other situations. I want my surgeon, upon cutting the wrong thing, to think lightning fast.

          1. Sasha

            Thinking slow is what will prevent your surgeon from cutting the wrong thing in the first place. Much more preferable than cutting it and then making a run for it. That’s the nature of Kahneman’s argument, I believe.

    3. David Bailey

      Joanne ,

      ” I have long thought that any ‘heart healthy’ food label ought to be reported to Trading Standards and the products boycotted.”

      Exactly – it seems to me that the whole health promotion process, including the charities like BHF, have just become another obstacle in the way of a rethink of CVD – I mean imagine them suddenly changing message, and saying, “Er, you know those unhealthy saturated fats that we have campaigned about (using your money) for the last few decades, well we were utterly wrong and they have nothing to do with CVD, but we hope this won’t stop you giving to our charity – indeed we need extra funds to fix the error!”

      I suggest you eat your porridge with full fat milk!

    4. John U

      Joanne, I think your comments are true and relevant. However, people with insulin resistance are special cases. When we were young, we ate everything and almost never gained a pound. After half a lifetime of eating a high carb diet, some of us became more insulin resistant than others (genes), and didn’t even know it. Weight increased and continued to increase. Our doctors only measured our fasting glucose levels after about 12 hours of fasting, and they still do this in spite of the works of Dr. Kraft and others. Almost every nascent diabetic will show normal glucose levels after 12 hours, so we were all told that health was excellent. Weight gain was attributed to age and slowing down. The doctors also never measured HbA1C.
      I have to assume that our doctors were either ignorant of the scientific material which I have learned over the last 4 years, or they just ignored it for many diverse reasons which have already been discussed in this forum. A patient who presents with symptoms of metabolic syndrome is almost certainly insulin resistant to some degree. If a doctor senses this, it is not rocket science to verify whether it is so. If indeed the patient has insulin resistance, it is not going to get better by itself, nor will it improve with drugs. It can only be “managed”. Recommending (and insisting in the case of a doctor) that the patient revert to a very low carb diet would be the scientifically correct thing to do. Diet is important for those who are insulin resistant. If you have a peanut allergy you don’t want to eat peanuts. If you cannot properly metabolize the carbs which you eat, you should stop eating them. It seems intuitively obvious to me. The real problem is that the patient has to eat “something” to get calories, so that “something” has to be good FAT, and therein lies the issue. Which doctor is going to recommend that their patients eat more fat when everyone has been told that fat is bad for 40 years or more.
      In truth, there are very many practicing medical doctors who do give the right advice to their patients. Unfortunately, they are in the great minority.
      Diet matters – it might not be the direct cause of CVD or other heart disease, but it sure can be the direct cause of diabetes and blood thickening, neuropathy, retinal degeneration, and stroke.

      1. smartersig

        I agree with pretty much all of this. One of the biggest myths is that getting a little weightier as we get older is inevitable. It simply is not true, there is no reason why we cannot be pretty much the same weight in our 50’s as we were in our 20’s. I had a light bulb moment 3 years ago when I changed my diet for health reasons. I expected a little weight loss but could not believe it when I went in 6 months from 14st to 11st 5lbs the same weight as when I was 23. I am now 59. I did not count a single calorie or restrict how much I ate. By accident I realised that the whole diet industry is built on a lie.

        1. sasha

          I agree with that. I wrote on here earlier that being overweight is largely due to lack of discipline and some took offense at that statement but I still believe it’s true. Sure, people have different metabolic rates and some can afford to eat virtually whatever they want (not necessarily a good thing) and hardly exercise but for the rest of us being sensible with the diet and bringing up the level of physical activity will do the trick. There are cases of metabolic disorders but those are exceptions.

      2. JDPatten

        Is it lack of discipline, or is it a disciplined devotion to wrong ideas that were handed us all from on high years ago? When you’re told by those who should know – those you ought to be able to trust – that fat makes you fat and that the carbohydrate way is the way to go, that discipline can be very hard to break. Far too many are still trusting believers.
        Having said that, I’d agree that there are plenty remaining who just want what they want.

        1. Sasha

          JD, both I guess… I was spared “the expertise” of “the experts” from early on, possibly because I was raised by two physicians, one of whom is an ex-athlete who instilled in me the importance of movement and another was just a smart doc who told me about importance of soups.

          I was talking to a friend the other day about KS Iyengar and Pattabhi Joys – two men who brought Hatha Yoga to the West. Both men lived to be 93-94 and both continued to practice virtually until the end. There are photos of Iyengar doing asanas at 90!

          My yoga teacher was 350 lbs when he was thirty. Now, 22 years later, he’s my complexion and I played sports my whole life.

          There’s no reason why those struggling with weight issues wouldn’t be able to devote an hour a day to physical activity (unless they already do it at work – like farming) and to invest into a large pot, so that they can buy fresh ingredients and cook themselves soups. It would provide them with excellent nutrition for 3 days out of a week, do wonders for their gut biome and save money at the same time!

          Instead, you often hear why people can’t do this, that or the other. But, as my coach always said: “There’s no such thing ‘I can’t’. There’s a thing ‘I don’t want to'”.

      3. mikecawdery

        Three attempts by the CDC to show that overweight was bad. All showed the reverse.

        JAMA. 2005 Apr 20;293(15):1861-7. JAMA. 2007 Nov 7;298(17):2028-37. JAMA 2013;309(1):71-82.

        Excess deaths associated with underweight, overweight, and obesity.
        Flegal KM, Graubard BI, Williamson DF, Gail MH.
        Overweights lived longer than normal weights

        JAMA. 2007 Nov 7;298(17):2028-37.
        Cause-specific excess deaths associated with underweight, overweight, and obesity.
        Flegal KM, Graubard BI, Williamson DF, Gail MH
        Overweights lived longer than normal weights

        Flegal KM, et al. Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index CategoriesA Systematic Review and Meta-analysis JAMA 2013;309(1)
        Overweights lived longer than normal weights

        .MA. 2013 Jan 2;309(1):71-82. doi: 10.1001/jama.2012.113905.

        In all reports those deemed to be overweight lived longer. Also there is the problem of the “obesity paradox” where the obese survive better from hospital care. http://junkfoodscience.blogspot.co.uk/ On the obesity paradox Sandy Szwarc

        One just wonders

    5. Goutboy

      Agree about stress, indeed the social causes of health would back this up. Every local area and local stats will see a difference in health outcomes across that area or what about the north south divide. Also look at social prescribing in its various forms. However does this account for world differences in CVD e.g Scotland, and France.

  73. Dr Robin Willcourt

    I am currently working in a clinic that treats only Native Americans. Their diet is the one defining feature of their myriad illnesses compared to the non Native cohort living around them: obesity, T2D, joint issues, renal, Fatty Liver and CVD. From age 18, these illnesses unfold at an alarming rate: something I have never seen before in any population. They are on at least 5, often 10 or more drugs. It’s heartbreaking to see.

    As Dr Kendrick has pointed out most coherently, there is clearly no ONE item that causes heart disease. There are likely to be multiple factors involved in producing a common single pathway to the final disorder. But ‘something’ in the diet has to be a key factor. I have just been to China and here we see the change to the Western diet paralleling the Native American experience.
    French and Japanese diet where vitamin K2 is likely to be more common. Low rates of CVD.

    The key(s) are hidden in the food: we just got sidelined for 40 years thinking we had nailed it and stopped looking for the real culprit(s). Insulin, toxic as it is, in a diet without K2 would be an interesting path to follow. Who knows?

      1. Dr Robin Willcourt

        Thank you for your question. The basis is bread- toast, sandwiches dominate the start of the day. High sugared cereals are added to that. No bacon and eggs to speak of. Hamburgers, fries and soft drinks = lunch. Some eat Mexican food, which can be very healthy but fries and a large soft drink are added to the taco salad (usually not the first choice) or to deep fried chicken nuggets with salsa, or burritos (all as a ‘meal’ and generally supersized).
        Dinner- all store prepackaged things like macaroni and cheese, burgers and fries, pizza+++, Gatorade or iced tea with lots of sugar. Vegetables? What’s that? Oh- potatoes mashed or fried (store bought) KFC and other fast foods. Home cooking except for the occasional BBQ is rare. Then it’s pasta. It’s a horror show.

        1. Lee

          That’s a dreadful diet but based on the description, I don’t see how òne can lay the door at carbohydrate. The description protrays an extremely fat-laden and generally hypercalorific diet. If you had said it was all fruit, rice, pasta and potatoes then you would have a point but that’s not the diet you are describing. You can bet that the toast and sandwiches will be laced with margerine and mayonnaise, and everything else excessively coated with cheese.

      2. Eric

        Thanks for the reply. Sounds bad enough but not so much different from what I have observed elsewhere in the US:

  74. Christopher Palmer

    Joanne McCormack is a qualified and experienced family practitioner (GP) in practice in the district of Warrington and Halton, UK. Her willingness to think more (widely) and discuss more (broadly) is welcomed for being in contrast to many of her peers.

    ” . . . people are too emotionally attached . . .”
    People who claim a plant-based diet is the better choice on health grounds do so more upon ideological grounds than nutritional ones. They also overlook that significant changes in ecology and diet were the driving force of human evolution . . . and account for how a very primate-like progenitor with modest brain and big guts could trend over time to become more human-like with very modest guts, a big and active brain, sophisticated vocalisations, and be fully bi-pedal in locomotion. Had the base-line diet remained so heavily invested in plant-based ecology throughout that same evolutionary period those progenitors that evolved to become human would have evolved instead to be more chimp-like.

    “I would compare a high nutrient density diet with a low nutrient density one . . “ Those sentiments are excellent. I would compare alternate diets on the basis of antioxidant density, and that’s only a minor refinement.

    ” . . . a highly toxic life with a low toxic life” . . .
    Yup, endocrine disruption being the great unacknowledged toxin attached to life in modernity. Much about endocrine disruption in modernity is man-made.

    ” . . . more financial stress, relationship stress, less social support, . . . sleep less , they smoke more, and they do less planned exercise . . .” Being sedentary and with sub-optimal consumption of truly leafy greens levels of NO in the body are suppressed (?). Levels of cortisol are likely to be high and arrhythmic (both seasonally and diurnally). Stress is disruptive to a leading aspect of the endocrine system – the HPA axis.

    ” . . . stress raises cortisol, adrenaline and noradrenaline and increases insulin resistance . . .”
    (In the body) Epinephrine (adreniline) is synthesised from norepinephrine . . . and the process of biosynthesis is a big consumer of methyl groups (CH3) . . . which can antagonise (reduce) the availability of methyl groups to do good antioxidant work . . . via the all important antioxidant pathway(s) of methylation. Impeded supply of methyl groups (not enough supplied – or too much demand from the HPA-axis) has consequence attached to the metabolism of homocysteine . . . and shows in a rise in levels of homocysteine in patients . . . which can be tested . . . but the test is not advocated by NICE . . . despite the test would me far more informative than that (crappy) lipid profile (cholesterol) test.
    (According to Guyton and Hall) High levels of cortisol (hypercortisolemia) leverage (or ‘agonise’) the process of gluconeogenesis by the order of six to ten times. ‘Gluconeogeneis describes the conversion of proteins to glucose’. hence in English having high or arrhythmic balances of cortisol will convert proteins to glucose and raise the patients insulin levels. Chronic hypercortisolemia is one of the big drivers of chronic hyperinsulinemia as is a high-carb diet. The test for hypersinsulinemia need not require analysis of blood. Weighing scales and tape measure will suffice.
    (Probably, and according to some parties) Insulin resistance involves alterations to the permeability and functional performance of cell membranes. Cells call for glucose but the glucose doesn’t pass through cell membranes (perhaps). The call for glucose and the endocrine disruption adjacent to the physiological state of hyperinsulinemia drives hyperphagia (overfeeding) and promotes craving for carb-rich food groups. This is a viscious spiral . . . and it’s one that human physiology has not evolved an adaptive response to. WHY? Well in the natural world, and prior to the age of agrarianism in human societies, the seasonal variability in the ecological supply of food (allied to competition between and amongst species) enforced seasonal hypophagia (underfeeding) which permitted the state of hyperinsulinemia to swing to hypoinsulinemia . . . and this would arise just about the time leaves fall from deciduous tress.
    Agrarianism spawned merchantism, merchantism spawned media of exchange (money), and fiat currency systems (bank supplied and debt based money systems), spawned financialism, rivalry, and the growth imperative. Together these factors conspired that humble people who go to work to earn wages to put food on the table are seen, not as people needing to eat but, as unit costs in the processes of production. When the vitality of the process of the supply of new money to the market-place (from lending) falters (as is especially the case after liquidity crises in banking) the downward pressure on workers wages is significant. The wealthy preserve their incomes from investment in enterprise while the people who do the work (that generates the profits that swells the pockets of the wealthy) have to survive on bread-line incomes. Wholesome fats are expensive, carbs are cheap and easy. Ergo, the attributes of fiat currency (money) drives high-carb, low fat eating, in lower income groups. Such an effect was reported by George Orwell (a favourite of Dr Kendrick), in Down and out in Paris and London.
    Margarine and vegetable oils are cheaper to produce and sell (even allowing for big marketing budgets) than real and wholesome fats such as butter, dripping, and lard. This appeals to wealthy investors in enterprise as much as it does to low-income consumers) Margarine and vegetable oils contribute to the (over)supply of polyunsaturated fats (PUFAs) in many a diet. These PUFAs find their way into triglycerides (molecules of fat – 3 in number – attached to a molecule of glycerol to from a bigger molecule) . . . which find their way into molecular parcels called lipoproteins . . . which find their way to cell membranes . . . and which get something else attached which converts molecules of triglycerides into phospholipids . . . and provides the basic building blocks for construction of the lipid bilayer that is a cell membrane. BUT: Membranes made from phospholipids made from triglycerides that incorporate saturated fats make for more healthy and more functional membranes. WHEREAS: Membranes made from phospholipids made from tricglcerides that incorporate less saturated fats and more PUFAs are said by some to make for membranes that are less healthy and less functional. They block the passing off glucose into the cell and thus promote insulin resistance. Margarines and vegetable oils should be included as a cytological toxin in our appreciation of the ‘toxic environment’ as may apply to modern man. Diito many GPs . . . because many GPs still insist saturated fats are angiotoxins when in reality they are not. Hence the party line in medical advice given to the prevention of CVD (Eat less fat, avoid saturated fats) has actually promoted the rise in insulin resistance and metabolic syndrome which does show some association with incidence of CVD and admissions or death certs following CVD events (heart attack or stroke).

    Oxidation stress would seem to play a part in the etiology of atherosclerosis. Investigations into homocysteine and methionine cycles infer this. And feeding contaminated cholesterol to rabbits in the name of research gave rise to positive induction of experimental atherosclerosis in mammals.
    Identification and study (later in time) of the those cholesterol contaminants expanded the list of known cholesterol oxides (there are 49, no less!) and expanded what is known about their individual properties. The majority of cholesterol oxides seem to have legitimate purpose in biochemistry and physiology. They behave a bit like primitive hormones . . . and this ought not surprise because a whole class of hormones are steroidal by nature and are derived from cholesterol itself. BUT, a small number of cholesterol oxides seem disruptive by nature. Cholestane-triol induces necrosis of smooth muscle cells. 25-Hydroxycholesterol agonises (increases) synthesis of cholesterol in cells with mention of macrophages (foam cells) in atherosclerosis and mention of hepatocytes where much cholesterol is produced for circulation and distribution.

  75. Dr. Göran Sjöberg

    John U

    I paste your yesterday comment here again about my opinions on the Mercola site since I think it is such a very important comment when it raises the most fundamental issues about our present day health care system.

    “Goran, I note that you have mentioned the Mercola site favorably in at least 2 comments. I have to say that the Mercola site is another example of a site I would never recommend to my friends. I almost never go there, so I just went on it to check if it is still the same. I see things like liver detox (a red flag for quackery for me), an article on whether drinking water can help you lose weight (I looked at it and found it full of factually wrong info and unsupportable claims), comments from people who have nothing better to do than spew nonsense or irrelevant material, and on top of it all his site sells stuff that is intended to improve your health but is at best not science based and at worst just plain quackery. And this includes the “Earthing Mat”. No doubt that there are articles on the site which are useful and report the truth, but I have a hard time giving him credit for these when there is so much junk and bad advice on the site.”

    17 years ago I should, in my status as a “long time researcher in the natural sciences”, have taken exactly the same stand as you do now. By then I firmly believed, as academics with few exceptions still do today, that medicine is about science by the same token as my own super alloy metallurgy research field. Spending some “research” efforts in the new field of medicine trying to understand my very serious MI and the treatment offered to me I very suddenly realised that the official “standard medicine” was very far from the science I had practiced for so many years. If you by quackery mean that some entity offers some treatments as a cure for an acute illness or disease which doesn’t work it was, all those years ago, already very clear to me that I dealt with a very advances quackery system and that was why I declined the comprehensive by pass operation and all the medicines. It was about risk assessment on my part.

    When it comes to Mercola I see much of the same things as you indicate but now in another light – that of precaution since we, as with the evidence based medicine, don’t know if the alternative medicine works out of a scientific perspective (though with the prevailing limited view of what constitutes science). That corruption and abuse of science permeate the official clinical medical research has not increased my confidence during the years which has turned me into favour of alternative medicine – it might work and is “innocent” in comparison not least out of a greed perspective. My precaution list is pretty long today and, as far as I know, approved supplements have not killed anyone while pharmacological substances have millions of lives on their consciousness. To paraphrase: “Statin kills!”

    Someone told me though I am flushing a fortune down the drains but I am surprisingly full of health today for “whatever reason”.

    You mentioned “Earthing mat” and when I first read that I, as you, just staggered since it was contrary to most everything I had learnt during my basic training in physics – nothing could be more quackery to me than that. However, I learnt recently to know the Swedish Professor Emeritus Karl Arfors, at Uppsala University, with 37 doctors on his merit list, and who has spent his life in the research on the inflammation of the epithelium of our finest capillaries and the role of NO and where he did develop a sophisticated optical microscopic device to enable him to do that.

    He told me that when he had to move his lab into a new environment they couldn’t repeat the previous experiments with the same results not only to his own despair but not least to his flabbergasted research students. And, as may well be understood, they tried every conceivable measure to get things in proper order but in vain. Finally as he told me he got the idea from somewhere to earth the whole lab and that was it.

    I asked him if he had any good physical explanation but no! I guess you may speculate in all directions here and since electronic measuring equipments always are properly earthed in any lab it could not be the question of the electronic equipment but reasonably by the earthing of the actual capillary substrates to avoid them being electrically charged.

    Anyway, this talk with professsor Arfors made me more humble in my earlier stubborn view of the “Earthing Mat” mentioned by Mercola as the epitome of medical quackery. By the way my wife is claiming that her electric heating blanket (“quackery balnket!”) helps when her bowel hurts and I guess the blanket is properly earthed 🙂

    My current stand is “Don’t be categorically dogmatic if you don’t know!” and if something works: “It probably works!”

    That I think the hard work I will soon carry out in my garden when the cold rain eventually will stop is good for my ailing (?) health is not any of my dogmas but a pleasant belief! When I get back in I believe that I will feel fine and healthy as always after such activities. The cracking fire in my heater is then even more enjoyable.

    1. Stephen T

      Goran, that was interesting. A couple of years ago I rejected the standard dietary advice and started eating fat again. I immediately had a boost to physical and mental health. I no longer accept the NHS view on statins or blood pressure medication. I think their dietary advice to diabetics is astonishingly damaging and stupid. After listening to Seyfried and others, I seriously question the current approach to cancer, chemotherapy and radiation treatment. And Dr Kendrick has changed my view on cholesterol and coronary bypass. I now question a great deal, but I hope I do so with an open and rational mind. We can close our minds too easily. I watched a brief talk on Robert Atkins from the 1970s and the whole medical audience were collectively abusing the call for research into the diet. It was close to murder to recommend a high-fat diet as far as their qualified and closed minds were concerned. I wonder if those people ever consider the harm done by condemning fat and recommending a high carbohydrate diet?

      Once disillusioned with official advice, Pandora’s box is open. Where does it end? Earthing mats are very fringe for me, but I found your entry intriguing. I draw the line at homeopathy, with its laughable theories and bogus claims of scientific support, entertainingly ripped to bits by Ben Goldacre. I suppose we all have to look and decide for ourselves. My approach to supplements is that what I spend on them isn’t significant and they won’t do me any harm. I think one or two are certainly helping me.

    2. John U

      Dr. Goran, I appreciate everything that you write, and indeed I recognize the need to not categorize advice as unscientific or as quackery when we don’t know enough. We all know how often such events have happened in the historical tribulations of medical research, from the acceptance of helicobacter to hand washing before surgery. So many scientific advances were dismissed as nonsense soon after being reported by those who discovered them only to be fully accepted after many years.
      However, there still exist today plenty of pseudo-medical treatments that are totally without merit – homeopathy comes to mind, as does wearing a copper bracelet, and of course the earthing sheet, notwithstanding the story you mentioned above, which may have had perfectly rational reasons for the outcomes. There are many, many more.There are lots of people who are selling “snake oil” and preying on those of us who are not skilled in science. That is why, when I suggest to others to educate themselves on nutrition, I offer the sites I know, as well as suggesting that they avoid sites which 1) are not hosted by a well qualified person, 2) do not accept commentary, which is a “must” to keep the site honest, and 3) are selling lots of products, because that is clearly a sign of potential bias. (There are some sites which are exceptions). This is one of my ways of sharing with others what I have learned. Making comments on things that I believe are wrong is another. We all have to use our best scientific knowledge to make judgements about processes which are based on scientific principles, and that is what I try to do. I stay away from Relativity or Quantum Mechanics and most of Biochemistry, so I don’t think that I am being “categorically dogmatic” when I offer my advice on matters which I believe to be true based on my life long knowledge. If something works, then I might agree it works, for whatever reason. Of course, homeopathy “works” for a lot of people, as does acupuncture. Not for me, and I would be categorically dogmatic here. Cold Fusion “worked” until it didn’t. If you personally believe that some scientific principle is being broken, then being silent about it is, in my book, acceptance more or less, or, at least, admitting ignorance when you should not. Sometimes, we CAN be categorical and dogmatic about some things, and then take our lumps if we find evidence to the contrary. That is what discussion is all about.

      1. Mr chris

        Hell John
        I slightly take issue with you as regards what “works” for others and our attitudes to that. There are enough recitals in all these comments of treatments that seem to be zany to me but apparently work for others. For example I am sceptical about homeopathy, but am told that it works for horses, where any placebo effect should probably be excluded. I am also told that in experiments on the placebo effect, peoples knees were opened up, and the resown, but the patients were told that there knees had been operated on, and apparently felt better.
        Placebo effects are very little mentionned here, but perhaps it is all in the mind?

      2. Dr. Göran Sjöberg

        John U

        Thank you for your appreciation!

        You are quite right that you must use your inquiring (sceptic?) mind to the best of you ability before catching up on some alternative treatment. My research background perhaps make me better equipped than most lay people and to be clear I have always used that “equipment” before e.g. exposing myself to the present high doses of vitamin E to treat my angina or the large doses (6 g per day) of vitamin C for “general” health purposes. I here trust “guys” like Linus Pauling – the greatest “quack” all time according to the medical establishment. He belongs to my own realm of solid physics and chemistry and where he acquired his first Noble Prize. With such a background a profound despise for the official criminal quackery of the health care system easily comes about.

        And of course I did my “homework” before refusing the bypass and the medication. As you indicate personal successful experiences is something you can communicate with people around who might have become interested and few actually argue with what I have done when they see me chopping my firewood except of course my last cardiologist who considered what I had been up to as “almost criminal” – a great medical expert in his own opinion.

        But as you mention there are many charlatans out there and definitely less sophisticated than those charlatans who populate the criminal part at the highest levels of the medical establishment. I though guess that the mindset must be the same – basically a total lack of moral/integrity and with a mind completely devoid of empathy for those that suffer from the ignoble actions they carry out.

      3. David Bailey


        Unfortunately medical science doesn’t seem to have done very well in determining what is or is not bad for us re CVD (and probably many other medical problems).

        With that in mind, I have become more and more wary of ‘scientific’ arguments against pseudo-scientific ideas. A lot of people find homoeopathic arnica useful, and I think it would be more useful if people were more focussed on why these treatments (appear) to work, rather than scoffing at them. After reading Malcolm’s “Doctoring Data”, it really grates to hear of efforts to shut down alternative medicines because they aren’t scientific – and I say that as a former chemist!

        At the very least, alternative medicine has a good chance of exploiting the placebo effect to the maximum, and if someone recovers, or gets significant relief, it doesn’t matter how that is a achieved.

        I actually used arnica (C30, which is a dilution of 10^60 – rather larger than Avogadro’s number!) for a while. I was interested in whether it worked or not I don’t know for sure if it did or not, because along the way, I discovered that I was suffering from statin side effects!

        1. Mr chris

          I have to admit to agreeing with you about placebo effects and other “non evidence based ” treatments. If it makes you feel better and does no harm whats not to like?
          How did we get into a position where doctors don’t welcome disagreement and debate?
          Excepting Dr K of course.

        2. Jean Humphreys

          Unable to commment on homeopathic arnica, but the Cream in a tube produced by the major homeopathic suppliers actually has a therapeutic dose of tincture of arnica in it, and I have always found it to be effective – it is old enough. As a remedy, it is mentioned in “What Katy Did”

      4. mikecawdery

        The placebo effect is real! Furthermore it can be personal. “the bedside manner” of a good doctor can be vital if it inspires faith in the prescribed therapy, Personally I believe in the wonderful ability of the human body to heal itself despite the “snake oil” therapies prescribed by both NDs and MDs. When I find drugs proposed on the basis of an efficacy rate of 0.3% better than a placebo and an adverse reaction rate ~60 times greater I get a bit peeved.

    3. sasha

      Great post Dr. Sjoberg. I was always sceptical of supplements also but I’m beginning to change my opinion after starting to read “Malignant Medical Myths” and Ottobanis’ book. Both of them make a strong case for certain supplements in certain conditions. And the authors of both books have excellent scientific background to analyze and interpret data concerning supplements.

      I also think we can get a lot of “earthing” mileage by working barefoot in the garden or spending time walking barefoot in nature.

    1. smartersig

      I found some of this unconvincing. Epidemi’ studies are not cast iron but then her assessment of the WHO cited research is littered with perhaps and maybe’s. I would not be happy with gut mutations if someone assured me that my body should be able to handle it. Excuse me but I dont want to ask it to ‘handle it’. She also did not bother to mention the meat with high fibre was still showing mutations.

  76. Stephen T

    Priyanka Wali is an engaging young doctor in the US, who was a vegetarian for ten years. She’s now changed her views. I enjoyed her short talk with Ivor cummins and perhaps you might too.

    1. John U

      “I enjoyed her short talk with Ivor cummins…..”
      Wow, what an understatement. I absolutely loved it. So refreshing to hear a new doctor in practice embrace the LC way of eating. She spoke so well, and her comments were right on point.. She even confirmed that student doctors just don’t learn about nutrition and such things as insulin resistance in medical school. Right from the “horse’s mouth” as they say.
      Thanks for this link – I will share it far and wide. And good on Ivor Cummins for doing this interview.

      1. Stephen T

        John U, glad you liked it. It was refreshing but her comments show how far there is to go. For example, Dr Gary Fettke is an othopaedic surgeon and low-carb advocate. He has been banned by the Australian medical authorities from discussing diet with his patients or on social media. So, dietitians telling diabtetics to eat 50% carbohydrates (glucose) is approved and telling them to avoid whet they can’t deal with is heretical and banned. I think Australia is becoming a laughing stock.

    2. mikecawdery

      This sums up the failure of medical training to include a full course on nutrition.
      Thanks for your contribution

  77. JDPatten

    Dr. Kendrick,

    You’ve been very quiet in these replies – other than your small bit of Roman humor.
    Just letting us, your public, blather on to get it out of our systems before moving on?

  78. Randall

    I believe the key word is nutrition. I will include only 2 studies and one video. This analysis includes 1,063,023 people and the follow-up period was 7 years. Men and women in our study who reported taking vitamin supplements at baseline generally had lower rates of death from ischemic heart disease and stroke than did people who did not report vitamin use… http://aje.oxfordjournals.org/content/152/2/149.long Even better study – Use of oral nutrition supplements decreased length of stay, episode cost, and probability of 30-day readmission on adult inpatient episodes at 460 sites during the years 2000 to 2010. 1.2 million episodes, ONS patients had a shorter length of stay by 2.3 days (95% confidence interval… http://www.ajmc.com/journals/issue/2013/2013-1-vol19-n2/Impact-of-Oral-Nutritional-Supplementation-on-Hospital-Outcomes/ Also – Bruce Ames: Vitamin and Mineral Inadequacy Accelerates Aging-associated Disease https://www.youtube.com/watch?v=ZVQmPVBjubw

    1. mikecawdery

      Randall Many thanks for the links. I take it that Bruce Ames is the Ames of the Ames test?

      Very Interesting. It all adds up to the target of good health which of course is not part of the medical industry’s bottom line. Where would they be if everyone was in good health?

    2. John U

      DR. Kendrick, I started a response to Randall’s post but I hit a key and lost what I wrote. Please DELETE whatever I wrote as I was not finished. I will restart my response later. Thanks,

  79. John U

    I just finished listening to Dr. Westman present at the 2016 Metabolic Therapeutics Conference at the link provided by Solomon. Very interesting, especially that he said that he did not believe that insulin evolved to primarily reduce glucose levels in the blood and to STORE fat. I can’t speak for you all, but I found this statement quite profound. I have been lead to believe just that. What Dr. Westman appears to be saying is that way back in our evolution, it was the Glucagon which acted primarily to ensure that we had enough blood glucose, and that insulin was there just to ensure that glucose levels did not go too high. The distinction is subtle, but it does emphasize that our practice of using insulin as the major player to bring glucose level down (T2D), is really a consequence of our current world, where it is easy to have sky high glucose levels, and then be in trouble. Presumably, this was not likely to be the case 50,000 years ago.

      1. David Bailey


        I worry more about your stress levels than your vitamin D levels! Here is yet another Daily Mail article about statins, and your website is mentioned prominently in the comments:


        While this is great news, I am sure the growls from the likes of Professor Sir Rory Collins must be growing louder by the day – and your cortisol levels must be through the roof!

        BTW, If you ever want a relaxing bike ride up the Middlewood Way, and a laugh about all this, I might be your man!

  80. richard spicer

    Re The issue of France versus Scotland..indeed the general apparent similarity of diet composition between UK France Germany etc…Is there not a point to be raised as to the nature of the ‘fat’ content ? It seems to me that there is some evidence that fish oil (fat) and Olive oil (fat) have a different effect on the vascular system (probably in terms of blood thinning ala aspirin, as well as other means) than other fats..?
    Also I feel that perhaps there may be an evoultionary explanation for such (at least in terms of fish eating diet)…this would square with the apparent benefits of Glucosamine Sulphate ( in terms of joint health.. ? I know ‘inflamation sounds a dubious culprit via Dr Kendriks argument..BUT immune systems are often prone to overreact are they not?-reflected in a variety of ailments…! and could it be that we as humans evolved in conjunction with a diet which suppressed such immune system sensitivity ? (ie a fish biased diet)
    ..In moving away from such a diet/environment could our systems trigger inflamation to a degree not required..? This would square with the theory of Elaine Morgan (Descent of Woman) who argued very well to my mind that humans went through a prolonged period of aquatic development in the formative aeons of our evolution…(Quite apart from the fact that life seems to developed originally.in an aquatic environment) Hence Inflammation without due cause could be the factor that compounds the damage to artery walls and leads the build up of clots/plaques…. thus differences in the intake of anti-inflammatory elements in the diet could explain the different rates of dvd..alongside factors like stress ? In short inflammation might not be entirely innocent?….As cvd generally hits after our current breeding age, evolution would not reflect an adaption to the changed environment -?

  81. Brian Wadsworth

    Regardless of the direct level of importance of diet to CVD per the original post, the idea that a ketogenic/LCHF/paleo/ancestral diet strategy assists health in general seems well-supported by research and actual experiences in the field. The arguments against seem to lack substance when examined in detail.

    Thus, it makes sense to eat this way as a first step in avoiding CVD. At least I hope so given I have been doing it for 16 years!

    Now back to CVD specifically. Seems like there is a lot of research connecting CVD to diabetes and other members of the degenerative disease family. Is this yet compelling Dr. K?

    1. John Scott

      This is as usual, a great read.
      Just what the doctor ordered or would like to see, public debate.
      As a sailor I envy the thought of topping up Vit D in Greece. I will just have to enjoy living on the West Coast of Scotland.
      There are again numerius comments on diet here. Many are stating that Dr K says diet has nothing to do with Cvd.
      If you read what he writes… He states it is not the primary cause.
      I may have missed his complete dismissal of diet so happy to be directed to that blog post.

  82. Eric

    Couldn’t resist sharing this little gem. Hopefully, soon all will consider this a blast from the past:

    Other than that wants to treat nearly everyone with statins, his chemistry is interesting:
    “Each triglyceride particle contains a saturated, a monounsaturated, and a polyunsaturated fatty acid. There is no such thing as a pure saturated fatty acid or a pure monounsaturated or a pure polyunsaturated fatty acid.”

    1. barbrovsky

      Eric said:
      Couldn’t resist sharing this little gem. Hopefully, soon all will consider this a blast from the past:

      Something in is fascinating and makes sense of something that happened to me eight years ago. I went to see my gp as I had a bladder infection, so I had a blood test and by accident I found out that I had an underactive thyroid and probably had had it for years. My only symptoms were feeling cold all the time (since I was a kid) and brittle nails but I wasn’t overweight.

      So I was put on levothyroxine (pretty much the only treatment you get on the NHS). Within a day of starting the hormone, whenever I walked I got terrible leg pains. I assumed that there was a connection between the thyroxine and the leg pain but the doc said no. The thyroxine also put me in what I can only call a nightmare for about three years, until one morning I woke up and it was as if I’d been in a bad dream all that time! Weird.

      So I had an ultrasound test and I was informed that I had intermittent claudication (why don’t they call it atherosclerosis?), mostly in my left thigh (I’m very left-handed).

      But the piece you referred to mentions the connection between atherosclerosis and a wonky thyroid. Is there really such a connection? I do know that there is a relationship between raised cholesterol and an underactive thyroid (something my original gp denied).

      But Eric. you seem to be saying that the article is rubbish?

      BTW, I had a heart attack 4 yrs ago and have two stents. My current cholesterol levels are overall 5.1 of which the ‘bad’ one is 1.1 and the rest the ‘good. BP 128 over 81 (I’m 71 yrs old and weight 61 kilos). I go to the gym 5 days a week mostly to try and reduce the pain in my leg but also for my heart. I eat healthily, packed up smoking almost 7 yrs ago and aside from the fact that I hate getting old, I’m in pretty good health. I don’t take statins and I stopped the Bisoprol (that’s one evil drug!).

      1. Eric

        Let’s put it this way: it was written in the enthusiastic spirit of the late 90s, early 2000s when it seems statin could cure about anything at close to no penalty at all. Even the most ardent advocates of statination probably would not repeat some of the claims.

        And the section about fatty acids is a case of sleeping through (advanced placement high school) organic chemistry class and then claiming to know it all.

      2. Martin Back

        Eric, I used to work as a programmer for a small industry-specific medical aid. When Lipitor first came out we good a flood of claims for Lipitor prescriptions. Our medical adviser instructed me that the system was not to pay out for Lipitor, because in his opinion statins were valueless and the only reason people were taking them was that everyone else was taking them.

        There was such a storm of protest from our members we had to change the policy pretty damn quick. As far as the general public were concerned, statins were miracle drugs and it was absolutely essential to take them to ward off imminent heart attacks. I must confess I myself believed that at the time, although I never took them, being young and healthy at the time.

  83. Dr. Göran Sjöberg


    What is “eating healthily” according to you?

    I am probably in a much more precarious situation than you are since any stents, according to the “experts”, 17 years ago would just have been a waste of efforts. i just don’t trust these guys.

  84. John U

    Stephen T – Yes I was shocked to learn that Dr. Fettke (Tasmania) was silenced by the medical profession authorities from offering so-called “medical advice” (really dietary advice) on his Facebook page. So now his wife is managing the page in his stead. Clearly it is OK for someone who is NOT a medically trained doctor (at least not one who belongs to the medical association which does the accreditation), but it is quite OK for his wife who is a nurse by profession. How ridiculous this is. I hope you all have an opportunity to go on Facebook and do a search for Dr. Gary Fettke and read some of the hundreds of comments.
    What’s next? Clearly the Pharma groups are stepping up the pressure and trying to use all possible legal means to silence the medically trained skeptics, certainly those who have some credibility. Will a US doctor such as the one interviewed by Ivor Cummins on the you-tube link you provided above be next to be victimized somehow? I think it is the “thin edge of the wedge” if we, the public, allow professional organizations to dictate who may practice their profession and how, based on, not WHAT they profess, but on some dictate in the organization’s charter of conduct. Surely, the content of the advice should be the primary concern of any professional society, and not how this advice is being offered.

    1. Dr Robin Willcourt

      Gary Fettke is a fantastic doctor, but to fill you all in, the Australian authoritarian system is simply corrupt. The ‘experts’ who set policy often do so in a de facto manner, acting via a closed group, often a little ‘boys’ club, meaning that clinicians with experience are NOT the ones who are involved in suggesting policies to governing bodies. Thus the stupidity yesterday of the ‘suggested protocol’ for testosterone therapy by The Endocrine Society. If anyone has read my website you will know I am a proponent of this naturally occurring hormone. It is not evil or deadly but rahter has very positive attributes and there is ever increasing clinical evidence for enlarging its widespread use. If it were as bad as the Endocrine Society says it is, then to be consistent and not hypocritical, that body should recommend castration (after puberty after the collection and storage of semen) for every male in Australia.
      By their recommnedations they are playing into the politics of TRT, which is all aimed at trying to keep anabolics out of the hands of athletes. By all criteria, that attempt has failed dismally.
      Experts in Australia have almost never earned their stripes but have infested academia, formed a close knit club and gained political clout and prestige. They have never let good patient care get in their path to glory if some political gain and fame can be achieved by sprouting BS. Hence the vicious attacks on Pete Evans for promoting a Paleo diet. Imagine if all T2D and CVD plummeted as a reult of his advice . Oh my! We couldn’t possibly allow that to happen.

      1. Stephen T

        Tim Noakes, Jennifer Elliot and now Garry Fettke. The proceedings against all three are characterised by a complete lack of transparency and regularly moving the goalposts. The Australian system seems to be a shocking combination of arrogance and backwardness. But they can only surpress the truth for so long. The reputations of the fools involved in this surpression will eventually be completely destroyed. They clearly prefer not to upset their friends in the pharmaceutical and processed food industries.

      2. Craig E

        And let’s not forget the merciless vilification of Ms De Masi in the wake of the ‘heart of the matter’ episodes on the ABC. I am still gobsmacked that the ABC removed these episodes from their website despite a thorough investigation into the shows revealing nothing that was “factually incorrect”. It’s no wonder I have a hard time convincing family and friends that the ‘establishment’ aint always right when those brave people who dare to question the mainstream (with robust science) are relentlessly attacked

    1. barbrovsky

      “I think my comment should rather be addressed to barbrovsky.

      About stents?

      I actually wasn’t aware that there were differing opinions on their efficacy. Last August, I was sent to see a consultant at a leading London hospital simply because I stopped taking Atorvastatin. He tried to persuade me to switch to two other drugs instead. One was some powerful alternative statin (Rosuvastatin) that you take once a week and the other was Ezetimibe (which I think is pretty useless). I declined. At the time my total cholesterol was 7.1 (forgotten the ‘good’ versus the ‘bad’ ratios).

      Today it’s a hair over 5 with about 1.0 being the ‘bad’. Exercise I think brought it down. In any case, the consultant told me that after about three years, the ‘entry’ side of the stent can get blocked (assuming I still have inflammation?). The point is, getting everyone over 50 to take a statin is a political decision, not a medical one.

      1. Mr chris

        Ezetimibe is the big thing in the cardiology world. Taken with a statin it is alleged to have a multiplier effect. When I asked my lipids man how it had got FDA approval{ thank you doctor K for teaching me the right questions} he suggested he would give up seeing difficult patients.

      2. Sasha

        Not just political, also monetary. As are stents. There’s no evidence they work in primary prevention. And in secondary the NNT is about 100, if I am not mistaken.

      3. barbrovsky

        Hah! I (sometimes) feel sorry for doctors here. Two yrs ago I registered with a new practice and got a newly qualified gp who was sympatico and quite open-minded. When I first raised the issue of the statin and how bad it made me feel (I was on it for 2 yrs following my heart attack), it was obvious she was caught between a rock and a hard place and I told her so and unlike your gp, she didn’t tell me to find another gp, she just said, well neither nay or yay! But she knew! I got the same response when I told her about the consultant and HIS drugs!

        I have one, final visit to the consultant at the end of this month (it’s taken nearly a year of visits, tests and cajoling to get me back on the stuff). I’ve also had a DNA test to see if I’m genetically disposed to a heart attack (my father died at 47), assuming that there is a connection.

  85. Dr Robert Proietto

    Sorry, but diet is absolutely a risk factor (if not the biggest) in CVD. Most diet studies are junk, so it is not surprising that a connection is hard to find. We would all love to have a clinical trial of thousands of people over 20+ years on strict diets, monitored by physicians on a regular basis. However, we all know that is never going happen. So, what do we use in place of clinical studies? Biochemistry. If you study the biochemistry of carbohydrate metabolism, arterial plaques and connective tissue creation and repair, you will have your answer to the true cause of CVD. The answer is so simple that most refuse to believe it. It is not just what is in the diet (excessive carbohydrates) but, more importantly, what is lacking (a macronutrient). You need to take the time (for me, over 2 years) to review the biochemistry, histology, and pathophysiology of CVD, and then you will see the truth as it comes up over and over again. Everyone of the risk factors for CVD are tied to the lack of this macronutrient in some way. Even the increase in heart attacks in the winter months is neatly tied to it, as its consumption decreases. It is not Vitamin D, or Omega 3s. I will leave the punch line to Dr Kendrick. As, after all, it is his blog.

    1. Kevin O'Connell

      Is that Dr Robert Proietto DO or Dr Robert Proietto VMD. In general (with some notable exceptions, e.g. Dr Kendrick, Dr Fettke, Dr Eades, Dr Gerber, Dr Malhotra, … ) I have found vets to be more reliable than medical doctors. Maybe it has something to do with treating many different animals rather than just one and therefore having a better understanding of nutrition & biochemistry, not having wasted so much of their time learning about which medications to prescribe for which markers.

      In any case, I’m inclined to agree with you, although I’m far from sure that consumption of this macronutrient decreases in winter (source?).

    2. JDPatten

      Dr. Proietto,
      Classic Gestalt Therapy would have called this “bear-trapping”.
      You apologize for Dr. Kendrick’s error, stating that you know the solution. You describe to us all how simple yet elusive it is and how you worked to find this truth… and then you withhold it.
      What could your purpose be other than self-aggrandizement?

    3. David Bailey

      “Sorry, but diet is absolutely a risk factor (if not the biggest) in CVD. Most diet studies are junk, so it is not surprising that a connection is hard to find.”
      How can you combine those two thoughts together like that? If most diet studies are junk, we don’t have the evidence to assert your second sentence.

      I have been amazed (looking at this from outside) that people can see through decades of claims that saturated fat was the cause of CVD, but not see that that means that science simply isn’t up to making these connections!

      As for using biochemistry, well people used levels of cholesterol – LDL and HDL as useful biochemical markers, and most still do, but these now seem to be in doubt!

      I hate to say it, but this seems to be an area of science that seems uncomfortably close to snake oil.

  86. Errett

    Linus Pauling’s specific therapy for cardiovascular and heart diseases are high dosages of two essential nutrients; vitamin C and the amino acid lysine.
    Vitamin C is required to strengthen arteries so that the body does not try to patch arteries with “plaster casts” (atherosclerosis).

    Lysine is an Lp(a) binding inhibitor, meaning at sufficient dosage it can reverse the plaster cast build-up (atherosclerotic plaques.) Lp(a) is the sticky form of LDL cholesterol that Pauling/Rath identified as the primary risk factor.

    “Knowing that lysyl residues are what causes Lp(a) to stick to the wall of the artery and form atherosclerotic plaques, any physical chemist would say at once that to prevent that put the amino acid lysine in the blood to a greater extent than it is normally. – 92-year-old Linus Pauling

    1. JDPatten

      “stick to the wall”?? The harm is done within the wall, is it not?
      It would be nice to get some knowledgeable feedback on lysine — other perspectives. Am I gonna take yet another supplement on this advice alone? Prob’ly not.

    2. barbrovsky

      “Vitamin C is required to strengthen arteries so that the body does not try to patch arteries with “plaster casts” (atherosclerosis).”

      Ok, but what’s making the stuff stick to the arteries? You talk about a ‘plaster cast’ but not why such a thing happens. Is it inflammation (which seems to be the most logical explanation eg, sugar etc causing it)?

      As I have atherosclerosis, and aside from the exercises I do to try and get other arteries to ‘take up the slack’ ( reduce the pain when walking/climbing), I was told there’s nothing I can do about it. But you’re saying that lysine and vit C will solve the problem or at least alleviate it? If so I’m off down to the health shop!

      1. JDPatten

        I suggest again that you read Dr. Kendrick. Start with “What causes heart disease” on this page, kindly provided by another of our commenters:
        It’s just below “What causes heart disease part II”. Don’t bother with all the replies. Dr Kendrick is the brilliant one here. Just a few paragraphs each of straightforward logic. It’s easy. Really.

      2. Dr. Göran Sjöberg

        What I have learnt about vitamin C, not least from Linus Pauling, is that you can tolerate large amounts although your stomach can get upset if you take it as ascorbic acid. Ascorbate is a neutral alternative if you are sensitive. My daily dose is 6 grams of ascorbic acid in a large glass of water which I am sipping now and then.

        It is a rather cheap “treatment”, I buy it by the kilo, and which may “help”. Anyway, my own severe atherosclerosis doesn’t seem to have gotten worse so if “an apple a day can keep the doctor away” the 6 grams vitamin C may even help to keep the cardiologist “experts” far away. I have been successful “on my own” for a couple of years now. For me I though more strongly believe in my daily 1600 IU dose of natural vitamin E , also after “consulting” Pauling’s books and references, and which made my very unpleasant unstable angina disappear almost completely and rather soon after the commencement of the “treatment”. Adding to this there are no side effects which is perhaps logic since these vitamins are undoubtedly something we require naturally.

        But no dogmas here – just what I believe when using my own body as a test bed. I am just an anecdote or “case records” as Malcolm prefer to name us dissidents.

      3. barbrovsky

        Smartersig said:
        I collected some stuff here on Vit C Lysine and Lp(a)

        Hey thanks for this! Very encouraging. Have you any idea about what kind of doses I should take? And in the light of the article, should I continue with my 30mg aspirin each day (I have to take a proton pump inhibitor as well (Omeprazole), which doesn’t agree with me either and really messes up my digestion). and the idea of a chemical messing about with my protons is not very appealing.

      4. barbrovsky

        Dr. Göran Sjöberg Said:

        What I have learnt about vitamin C, not least from Linus Pauling, is that you can tolerate large amounts although your stomach can get upset if you take it as ascorbic acid.

        So that’s just under a 1/4 of an ounce per day (6gms) of vit C. Thanks for this and, for the other info I’ve gotten here. I wish I’d known about this site 4 yrs ago!

      5. barbrovsky

        Dr. Göran Sjöberg wrote:

        What I have learnt about vitamin C, not least from Linus Pauling, is that you can tolerate large amounts although your stomach can get upset if you take it as ascorbic acid. Ascorbate is a neutral alternative if you are sensitive. My daily dose is 6 grams of ascorbic acid in a large glass of water which I am sipping now and then.

        OK, the ascorbate just arrived. On the pack they say 1gm 2 or 3 times a day in water which is half the dose you’re taking but I suspect it’s pretty hard to overdose on it?

  87. Errett

    Fatal Blood Loss Through the Scorbutic (scurvy)
    Vascular Wall – An Extraordinary Challenge
    to the Evolutionary Survival of Man

    Scurvy is a fatal disease. It is characterized by
    structural and metabolic impairment of the human
    body, particularly by the destabilization
    of the connective tissue. Ascorbate is essential for
    an optimum production and hydroxy-lation of
    collagen and elastin, key constituents of the
    extracellular matrix. Ascorbate depletion thus
    leads to a destabilization of the connective tissue
    throughout the body. One of the first clinical
    signs of scurvy is perivascular (around a blood vessel) bleeding. The
    explanation is obvious: Nowhere in the body does
    there exist a higher pressure difference than in the
    circulatory system, particularly across the
    vascular wall. The vascular system is the first site
    where the underlying destabilization of the
    connective tissue induced by ascorbate deficiency
    is unmasked, leading to the penetration of blood
    through the permeable vascular wall. The most
    vulnerable sites are the proximal arteries, where
    the systolic blood pressure is particularly high.
    The increasing permeability of the vascular wall
    in scurvy leads to petechiae (small red spots caused by bleeding into the skin)
    and ultimately hemorrhagic blood loss.
    Scurvy and scorbutic blood loss decimated the
    ship crews in earlier centuries within months. It is
    thus conceivable that during the evolution of man
    periods of prolonged ascorbate deficiency led to a
    great death toll. The mortality from scurvy must
    have been particularly high during the thousands
    of years the ice ages lasted and in other extreme
    conditions, when the dietary ascorbate supply approximated
    zero. We therefore propose that after
    the loss of endogenous ascorbate production in
    our ancestors, scurvy became one of the greatest
    threats to the evolutionary survival of man. By
    hemorrhagic blood loss through the scorbutic
    vascular wall our ancestors in many regions may
    have virtually been brought close to extinction.
    The morphologic changes in the vascular wall
    induced by ascorbate deficiency are well
    characterized: the loosening of the connective
    tissue and the loss of the endothelial barrier
    function. The extraordinary pressure by fatal
    blood loss through the scorbutic vascular wall
    favored genetic and metabolic countermeasures
    attenuating increased vascular permeability.

  88. Errett

    1. CVD is the direct consequence of the inability
    for endogenous ascorbate production in man
    in combination with low dietary ascorbate

    2. Ascorbate deficiency leads to increased
    permeability of the vascular wall by the loss
    of the endothelial barrier function and the
    loosening of the vascular connective tissue.

    3. After the loss of endogenous ascorbate
    production scurvy and fatal blood loss through
    the scorbutic vascular wall rendered our
    ancestors in danger of extinction. Under this
    evolutionary pressure over millions of years
    genetic and metabolic countermeasures were
    favored that counteract the increased
    permeability of the vascular wall.

    4. The genetic level is characterized by the fact
    that inherited disorders associated with CVD
    became the most frequent among all genetic
    predispositions. Among those predispositions
    lipid and lipoprotein disorders occur
    particularly often.

    5. The metabolic level is characterized by the
    direct relation between ascorbate and virtually
    all risk factors of clinical cardiology today.
    Ascorbate deficiency leads to vasoconstriction
    and hemostasis and affects the vascular wall
    metabolism in favor of atherosclerogenesis.

    6. The genetic level can be further characterized.
    The more effective and specific a certain
    genetic feature counteracted the increasing
    vascular permeability in scurvy, the more
    advantageous it became during evolution and,
    generally, the more frequently this genetic
    feature occurs today.

    7. The deposition of Lp(a) is the most effective,
    most specific, and therefore most frequent of
    these mechanisms. Lp(a) is preferentially
    deposited at predisposition sites. In chronic
    ascorbate deficiency the accumulation of
    Lp(a) leads to the localized development of
    atherosclerotic plaques and to myocardial
    infarction and stroke.

    8. Another frequent inherited lipoprotein
    disorder is hypoalphalipoproteinemia (famailia HDL deficiency). The
    frequency of this disorder again reflects its
    usefulness during evolution. The metabolic
    upregulation of HDL synthesis by ascorbate
    became an important mechanism to reverse
    and decrease existing lipid deposits in the
    vascular wall.

    9. The vascular defense mechanisms associated
    with most genetic disorders are nonspecific.
    These mechanisms can aggravate the
    development of atherosclerotic plaques at
    predisposition sites. Other nonspecific
    mechanisms lead to peripheral forms of
    atherosclerosis by causing a thickening of the
    vascular wall throughout the arterial system.
    This peripheral form of vascular disease is
    characteristic for angiopathies associated with
    Type III hyperlipidemia, diabetes, and many
    other inherited metabolic diseases.

    10.Of particular advantage during evolution and
    therefore particularly frequent today are those
    genetic features that protect the ascorbate deficient
    vascular wall until the end of the
    reproduction age. By favoring these disorders
    nature decided for the lesser of two evils: the
    death from CVD after the reproduction age
    rather than death from scurvy at a much
    earlier age. This also explains the rapid
    increase of the CVD mortality today from the
    4th decade onwards.

    11.After the loss of endogenous ascorbate
    production the genetic mutation rate in our
    ancestors increased significantly. This was an
    additional precondition favoring the advantage
    not only of apo(a) and Lp(a) but also of many
    other genetic countermeasures associated with

    12.Genetic predispositions are characterized by
    the rate of ascorbate depletion in a multitude of
    metabolic reactions specific for the genetic
    disorder. The overall rate of ascorbate
    depletion in an individual is largely determined
    by the polygenic pattern of disorders. The
    earlier the ascorbate reserves in the body are
    depleted without being resupplemented, the
    earlier CVD develops.

    13.The genetic predispositions with the highest
    probability for early clinical manifestation
    require the highest amount of ascorbate
    supplementation in the diet to prevent CVD
    development. The amount of ascorbate for
    patients at high risk should be comparable to
    the amount of ascorbate our ancestors
    synthesized in their body before they lost this
    ability: between 10,000 and 20,000 milligrams
    per day.

    14.Optimum ascorbate supplementation prevents
    the development of CVD independently of the
    individual predisposition or pathomechanism.
    Ascorbate reduces existing atherosclerotic
    deposits and thereby decreases the risk for
    myocardial infarction and stroke. Moreover,
    ascorbate can prevent blindness and organ
    failure in diabetic patients, thromboembolism
    in homocystinuric patients, and many other
    manifestations of CVD.

      1. smartersig

        Simple, get your Lp(a) measured and then try a regular dose of Vit C. Measure Lp(a) again and see if its reduced enough, if not increase vit c and repeat

        1. smartersig

          I would be concerned if it was above 30. On two occasions mine spiked to 31 when I was away for a while and stopped taking Vit C. As soon as I resumed it came back down to an average 20. I do two things to boost Vit C in addition to generally trying to eat plenty of veg and fruit. I eat a pink grapefruit every morning as part of my breakfast and I take a 1000 mg supp

      2. barbrovsky

        Smartersig said:

        “Sorry that should have read 1000mg not g”

        That’s better!

        “Also I take Fruitflow in preference to Aspirin”

        Does that mean I could stop the Omeprazole?

        1. smartersig

          Omeprazole is for your gastric problems eg acid so unless a switch from Aspirin to Fruitflow helped with acid production you would be unwise to immediately give up Omeprazole. Its best not to switch or add lots of things on mass because when it he,ps or doesn’t you are never really sure which factor played a part.

          1. barbrovsky

            Smartersig said:

            “Omeprazole is for your gastric problems eg acid so unless a switch from Aspirin to Fruitflow helped with acid production you would be unwise to immediately give up Omeprazole. Its best not to switch or add lots of things on mass because when it he,ps or doesn’t you are never really sure which factor played a part.”

            I currently take Omeprazole (20mg) daily to counteract the acid in the aspirin but it messes up my digestion and makes me sweat buckets (along with the Ramipril). There’s no way I’d take Fruitflow AND aspirin!

            But if I replace the aspirin with Fruitflow does that mean I don’t need the Omeprazole?

          2. smartersig

            How do you know its the Omeprazole doing this ?. Fruitflow is an alternative to Aspiring and is kinder to the stomach

          3. Cindy C

            My family reports less burning when taking acids, that is lemon juice or apple cider vinegar. As for blood thinners, omega 3s will break up clots, to an extent I was taking a tbs of cod liver oil a day,, and my platelets were on the low side. Some medical sites say not to combine Omega 3 and blood thinners. Aspirin hurts my stomach. I think the cod liver oil is enough for me. 2 of my family members were put in the hospital -one due to brain bleeding(blood thinning drug). and another with a bleeding ulcer(NSAIDS)

            This study used Omega 3 and blood thinners.


      3. barbrovsky

        “Omeprazole has many effects that do not help with CVD. Magnesium loss, Vitamin B12 deficiency and problems with electrolyte balance. Also reduced NO synthesis. It is well known that PPIs (including omeprazole) increase CVD risk.”

        So Dr Kendrick, what’s the alternative? Fruitflow? (I already asked the question, do I need Omeprazole with Fruitflow?)

        I take VitB12 every other day, concentrated beetroot twice a day and vitD3/K2 every other day. So the Omeprazole is wiping them out?

      4. JDPatten

        Omeprazole is a proton pump inhibitor. It’s really insidious stuff. I’ll detail just a bit of my experience and knowledge:
        I was on a combination of omeprazole and the anticoagulant dabigatran after my ablation for arrhythmia a few years ago. After six days I quit both because of violent diarrhea that lasted three months. The dabigatran is formulated with tartaric acid for better absorption. So, the theory was that doubling the usual omeprazole dose was the thing to do. Not. I opted for another anticoagulant – rivaroxaban (To reduce the risk of post-procedure clotting and stroke!). No more omeprazole.
        I then looked into the stuff. If you’re unhappy with it and quit cold turkey, you’ll likely experience rebound: Extreme acid distress. You must taper off.
        Some people take it for acid reflux. It actually makes the situation worse. Decreased acid allows your esophageal sphincter (The “valve” at the bottom of the esophagus) to relax. Milder acid is allowed up. Mild acid still burns! Actually increasing stomach acid with supplements stimulates the sphincter to close more tightly. Counter-intuitive? Depends on your intuition.
        The lower acid caused by omeprazole allows for the survival of some very nasty microbes. Omeprazole users are distinctly more likely to experience an infection of Clostridium difficile. It produces diarrhea that causes bowel and rectal lesions.
        Users are more likely to be infected by Helicobacter pylori, the bug responsible for stomach ulcers. (Some might tell you there are benefits to H. pylori. Look it up.)
        Recent research suggests that users are more likely to develop certain cancers. Etc, etc…

        1. Eugène Bindels

          I want to quit pantoprazole. I’m currently taking 40mg a day. Which rate whould you recommend to tapering it off?

          1. barbrovsky

            Eugène Bindels:

            Are you taking Aspirin (which is why I was prescribed Omeprazole)? I found that it took me about two weeks or so to get off the damn stuff, it’s addictive! So I started skipping days and not taking the Aspirin on the days I skipped.

          2. Eugène Bindels

            Barbrovsky: I was taking aspirin for about 3 to 4 weeks. Then I got severe stomach pains. I stopped taking it and was given 40mg pantoprazol by my GP. When my stomach was feeling ok again, I took half the dose for about 2 weeks and then quit.

          3. barbrovsky

            Barbrovsky: I was taking aspirin for about 3 to 4 weeks. Then I got severe stomach pains. I stopped taking it and was given 40mg pantoprazol by my GP. When my stomach was feeling ok again, I took half the dose for about 2 weeks and then quit.

            Eugene: My GP was pretty clueless about the situation and suggested the tailing off approach. What it does reveal is the general ignorance that GPs have about the (dangerous) drugs they regularly supply to us guinea pigs. I found out I was allergic to Bisoprol purely by accident, I had no idea the symptoms I had were caused by the Bisoprol!

      5. barbrovsky

        JD Patten said:
        “I then looked into the stuff (Omeprazole). If you’re unhappy with it and quit cold turkey, you’ll likely experience rebound: Extreme acid distress. You must taper off.”

        What a depressing read. Are you sure about all those ‘side effects’? If true, how does such a drug make it onto the market? I know what the drug is meant to do and no doubt it does what it says on the label but at what cost to me? I know I’m very suspicious of anything that interferes with my normal digestion.

        I stopped taking it about a week ago as it was messing with my digestion (I’ve been on it for about 4 yrs) and sweating is one of ‘side effects’ (as with Ramipril, which I’m still on). Since stopping, I think you’re right on about the reflux as my stomach has been churning ever since and I never get indigestion normally, but I’m getting it now and I’m feeling quite distressed.

        You say I must taper off? What every other day? Please advise (I took it this am).

        Also, I’ve been taking it after eating breakfast along with the aspirin (B12, D3/K2, Beetroot extract every other day). So maybe before eating? The label with the horrid stuff says nothing about when except before or after food, whatever that means.

      6. JDPatten

        FIRST: make sure the original reason you got prescribed isn’t going to be of greater harm without the pantoprazole.

        Proton pump inhibitors inhibit the “pumps'” production of stomach acid. When the inhibition is removed, they overproduce in compensation.

        These meds should be taken only on a short term basis to get over difficult periods, but people unknowingly get themselves trapped by quitting cold turkey, getting “burnt”, then going back to the stuff for a “save”, fearing to ever try that again.

        I was only on my stuff a few days, so it was easier for me.
        My best guess is to just do it very gradually. Do you use the packets with powder? Easier to do. Measure, reducing bit-by-bit. Let your tummy be the guide.

      7. JDPatten

        I told you what I know from my own experience.
        If I were you, I’d go back to the GP who suggested the aspirin. If you trust him.
        Aspirin is a fairly good anti-platelet agent. Helps keep vessel clots from forming. There are others.
        Aspirin is also notorious for causing gastro-intestinal bleeds. Is that why you had pains?
        It’s never the best idea to cover side effects of one med with yet another, Where does it stop?
        If you “need” an anti-platelet agent, talk to your GP or cardiologist, but make sure you trust the person. Ask where they stand on “polypharmacy”.

        1. Eugène Bindels

          Yes, the aspirin gave me the stomach pains. They disappeared after stopping them and taking pantoprazol for a few weeks. Now pantoprazol stopped and no more stomach pains. My GP talked about switching to plavix. Any thoughts on this?

      8. JDPatten


        Sorry, I have no personal knowledge of the anti-platelet clopidogrel ($trade$ name Plavix).

        Two thoughts:

        When I asked Dr Kendrick about my use of the anticoagulant apixaban, he figured that any way to avoid excess clotting was probably beneficial.

        I refuse to use trade names when discussing meds with docs. The scientific name (In this case clopidogrel) is specific and what is used in research papers. The trade name is too close to $ and drug reps for my comfort. By all means, have a conversation with your doc. Good luck!

    1. Eric

      Holy cow, 10 – 20 g of ascorbate per day?!?

      You can achieve full saturation of plasma vitamin C within a few days if you take 1 g/day orally, but only if you split this into five doses of .2 g. You just can’t absorb more orally.

      I was once treated by a quack MD for recurring colds (actually, it was nothing but regular subfebrile winter colds stretched out over 2- 3 weeks), and she gave me 7.5 g of buffered ascorbate intravenoulsly. I had a mad pulsing headache for several hours afterwards and a nasty acidic taste on my tonge for three days. The cold went away after a few days, as it probably would also have without the injection.

    2. Sasha

      Errett, what are the best sources of Vit C in your opinion? I hear that naturally occurring (like the one derived from acerola cherries) is better than synthetic. Is that your understanding? And what are the sellers you recommend if any? Thanks.

    3. Sasha

      A question about #10: If the “Nature kills you off after you can no longer reproduce” hypothesis is correct, how come CVD kills men earlier than women even though men retain ability to reproduce for longer than women?

      1. Martin Back

        “how come CVD kills men earlier than women”

        Sexual selection. Women like the bad boys. They live riskier lives, hence more stress, hence more CVD. And they impregnate more than their fair share of women, hence their genes spread.

        1. Dr. Malcolm Kendrick Post author

          A see a bit of stretch here. The fact is that women do not, always, have different rates of CVD than men. Or at least, the difference can be close to zero. Brazilian women and men, and black African Americans – for example.

        2. Sasha

          It’s an interesting thought but it works off a couple of assumptions that may or may not be true. First, there probably have been plenty of CVD events in men fathered by good boys. Also, we don’t know if being a bad boy always means more stress. One could argue that expressing your desires is less stressful than supressing them. Exhibit A: Keith Richards.

  89. Errett

    Am J Clin Nutr. 2015 Jun;101(6):1135-43. doi: 10.3945/ajcn.114.104497. Epub 2015 May 6.

    Genetically high plasma vitamin C, intake of fruit and vegetables, and risk of ischemic heart disease and all-cause mortality: a Mendelian randomization study.

    Kobylecki CJ1, Afzal S1, Davey Smith G1, Nordestgaard BG2.
    Author information

    High intake of fruit and vegetables as well as high plasma vitamin C concentrations have been associated with low risk of ischemic heart disease in prospective studies, but results from randomized clinical trials have been inconsistent.

    We tested the hypothesis that genetically high concentrations of plasma vitamin C, such as with high intake of fruit and vegetables, are associated with low risk of ischemic heart disease and all-cause mortality.

    We used a Mendelian randomization approach and genotyped for solute carrier family 23 member 1 (SLC23A1) rs33972313 in the sodium-dependent vitamin C transporter 1 in 97,203 white individuals of whom 10,123 subjects had ischemic heart disease, and 8477 subjects died. We measured plasma vitamin C in 3512 individuals and included dietary information on 83,256 individuals.

    The SLC23A1 rs33972313 G allele was associated with 11% higher plasma vitamin C. The multivariable adjusted HRs for highest compared with lowest fruit and vegetable intakes were 0.87 (95% CI: 0.78, 0.97; P = 0.01) for ischemic heart disease and 0.80 (95% CI: 0.73, 0.88; P < 0.001) for all-cause mortality. Corresponding HRs for rs33972313 GG (93%) compared with AA plus AG (7%) genotypes were 0.95 (95% CI: 0.88, 1.02; P = 0.21) and 0.96 (0.88, 1.03; P = 0.29), respectively. In an instrumental variable analysis, the OR for genetically determined 25% higher plasma vitamin C concentrations was 0.90 (95% CI: 0.75, 1.08; P = 0.27) for ischemic heart disease and 0.88 (0.72, 1.08; P = 0.22) for all-cause mortality.

    High intake of fruit and vegetables was associated with low risk of ischemic heart disease and all-cause mortality. Although the 95% CI for genetically high plasma vitamin C concentrations overlapped 1.0, which made certain statistical inferences difficult, effect sizes were comparable to those for fruit and vegetable intake. Thus, judging by the effect size, our data cannot exclude that a favorable effect of high intake of fruit and vegetables could in part be driven by high vitamin C concentrations.

    © 2015 American Society for Nutrition.

    1. Mr chris

      Interesting stuff, especially as todays fruit and veg are alleged to have lower concentrations of all vitamins, including vitamin C. Presumably supplementing 1gm per day would/should have the same effect?

    2. Craig

      Reasonable consumption of fresh meat lowers your requirement for vitamin C by sparing it for uses other than making or repairing the metabolites which meat can also provide eg carnitine. One thing the scurvy ridden sailors of old didn’t have was a high intake of fresh meat. or anything else fresh, not just vit C containing plant material. Any ancestors in the times of the ice ages were no more likely to suffer scurvy than the Innuit did more recently on a traditional diet, getting what they needed from animal parts, mostly.

  90. Martin Back

    Could one use temperature as a measure of stress that could be put into numbers?.

    I ask because years ago I was visiting family in New Zealand, and at a gathering someone handed around a temperature sensor that looked like a white plastic credit card. The way you used it was to press your thumb firmly against it for a few seconds. The resulting thumb print depended on the temperature of your thumb, ranging from orange at the warmest point in the middle of the print through red and green to blue on the outer edges (I forget the exact colours).

    The guy who had the card was a salesman, and they were instructed not to call on a client if their thumbs weren’t warm. The theory was that if you are stressed, blood rushes to the middle of your body and your extremities become cooler. A warmer print indicates a more relaxed salesman. Clients are more trusting of someone who is relaxed; a stressed person makes them suspicious.

    We passed it round. Everyone had slightly different temperature profiles, some warmer than others.

    In my own experience, when I am stressed my hands are cooler. At one stage in my life I attended a group where we all held hands and said the Serenity Prayer. I noticed my hands were colder than everyone else’s. After a couple of years things were better for me and my hands had warmed up and the newcomers’ hands felt cold. Recently, possibly as a result of financial stress, my hands cooled to the extent that I bought gloves for the first time. I also put on weight because of eating a lot of sugary junk food, presumably in an effort to self-medicate.

    At airports they have remote temperature sensors to pick up people with virus infections. Maybe have a similar remote sensor for picking up stress, or possibly a Fitbit type band that gives a continuous reading.

  91. TS

    Re: “Omeprazole is for your gastric problems eg acid”

    As I understand it, stomach acid production rends to DECLINE with age. Seems a bit risky to assume we have too much if we get heartburn and/or acid reflux! (May have a hiatus hernia or a little bit of one – another thing which can come with age!)

    1. Dr. Malcolm Kendrick Post author

      Omeprazole has many effects that do not help with CVD. Magnesium loss, Vitamin B12 deficiency and problems with electrolyte balance. Also reduced NO synthesis. It is well known that PPIs (including omeprazole) increase CVD risk.

      1. David Bailey

        I discovered that Omeprazole is also addictive. I was taking it to counter Diclofenac’s side effect, and when I no longer needed the latter, I found that without Omeprazole I was getting acid reflux. I took Gaviscon for some weeks before the problem subsided.

        Since Omeprazole was/is used so often in conjunction with Diclofenac, I do wonder if it was possible to separate the two in the studies that implicated Diclofenac as a CVD risk.

        1. smartersig

          Yes stop taking the Aspirin as I mentioned before I take Fruitflow I also take Kyolic Aged Garlic. Doctors will not mention these alternatives because they do not fall within there strict drug company formulated guidelines. They also probably feel that we are all too stupid or weak willed to stick with dietary approaches.

      2. barbrovsky

        Yes stop taking the Aspirin as I mentioned before I take Fruitflow I also take Kyolic Aged Garlic. Doctors will not mention these alternatives because they do not fall within there strict drug company formulated guidelines. They also probably feel that we are all too stupid or weak willed to stick with dietary approaches.

        This for Dr Kendricks reply as well. I’m astounded (or maybe not about the lack of knowledge?). Actually, it was the hospital that put me onto it after taking me off Ranitidine & Clopidogrel, and, finally, the consultant I saw last year, took me off that awful Bisoprol Fumarate that caused growths on the bottom of my feet and on my head! Within a couple of days, they’d all gone. And, I didn’t need to take it in the first place! I didn’t and I don’t suffer from Angina. I’m appalled, honestly, not only by the way they dish out this stuff like candy but the incredible cost to the NHS!

        When my stepdad’s wife died, they cleared out wardrobe full of prescriptions! I mean hundreds and hundreds of boxes of ‘medicines’!

        I did a search on proton pump inhibitors and PPIs are actually mentioned as a problem for my gut bacteria, including c difficile. I’m also depressed by this knowledge and can’t wait for my delivery of fruitflow and ascorbate so I get off this poisonous stuff! But first I’m going to have to confront my GP, so I need to be well armed first.

        As to the ‘tapering off’ of Omeprazole, I never did get a response on how best to do this. Every other day? For 2 days then a break, or what? All I know is that just stopping it was not a good idea!

        But thanks for the info


        1. smartersig

          Its conveyor belt medicine, everybody gets exactly the same treatment and bag full of goodies that you are supposed to be on for life. Little dietary advice is offered and the little that is offered is flawed.

          1. barbrovsky

            Re Fruitflow (Lycopene)
            I’m kinda annoyed. I was led to believe that Fruitflow was a replacement for Aspirin (for thinning the blood), at least that was my original understanding but after researching it, it does nothing of the sort!

            Worse still, the dosage you get taking Fruitflow, is way, way, way over the recommended limit (which seems to be around 30-35mg a day). But Fruitflow says 1 GRAM, three times a day! Whaaaat? That’s like 10 times the recommended dosage! Take too much and your skin goes orange and who wants to look like Donald Trump?

            Worse still, it does just what I was trying to avoid with Omeprazole as Lycopene is acidic and has given me no end of problems with my stomach. I’ve had to discontinue it. And, it’s incredibly expensive! In fact, I’d say it’s a ripoff. You’re better off making tomato sauce and cooking with it (apparently it’s only cooked tomatoes that work).

            Yes, it appears to lower Cholesterol but I’ve done that with exercise and diet changes (now down to 4.9 total). And in any case, that’s not why I tried it. ‘My’ lipid consultant says, “It (Lycopene) doesn’t work”, period.

            So, I’m back to taking Aspirin but I’ve discovered that Gaviscon is a replacement for Omeprazole! In fact, my GP will prescribe it! So why was I given Omeprazole in the first place?? What don’t I know about Gaviscon?

            PS: I really hate this WordPress style the good doctor’s using, and I’ve run a WordPress site for over six years and my comments don’t behave like their crazed. I have to wait whilst the page goes up and down and then the comment part is hidden right at the end of the page. Weird.

      3. barbrovsky

        “Omeprazole has many effects that do not help with CVD. Magnesium loss, Vitamin B12 deficiency and problems with electrolyte balance. Also reduced NO synthesis. It is well known that PPIs (including omeprazole) increase CVD risk.”

        What are the symptoms of such things? I know that NO relaxes the blood vessels and that B12 also helps lower pressure (I think).

  92. Errett

    In fact, all it takes to ward off scurvy is a daily dose of 10 milligrams, says Karen Fediuk, a consulting dietitian and former graduate student of Harriet Kuhnlein’s who did her master’s thesis on vitamin C. (That’s far less than the U.S. recommended daily allowance of 75 to 90 milligrams—75 for women, 90 for men.) Native foods easily supply those 10 milligrams of scurvy prevention, especially when organ meats—preferably raw—are on the menu. For a study published with Kuhnlein in 2002, Fediuk compared the vitamin C content of 100-gram (3.55-ounce) samples of foods eaten by Inuit women living in the Canadian Arctic: Raw caribou liver supplied almost 24 milligrams, seal brain close to 15 milligrams, and raw kelp more than 28 milligrams. Still higher levels were found in whale skin and muktuk.

    As you might guess from its antiscorbutic role, vitamin C is crucial for the synthesis of connective tissue, including the matrix of skin. “Wherever collagen’s made, you can expect vitamin C,” says Kuhnlein. Thick skinned, chewy, and collagen rich, raw muktuk can serve up an impressive 36 milligrams in a 100-gram piece, according to Fediuk’s analyses. “Weight for weight, it’s as good as orange juice,” she says. Traditional Inuit practices like freezing meat and fish and frequently eating them raw, she notes, conserve vitamin C, which is easily cooked off and lost in food processing.

    We really aren’t talking about only avoiding scurvy—

    Era—–Life expectancy at birth in years
    Life expectancy at older age
    Paleolithic—-33—- Based on the data from recent hunter-gatherer populations, it is estimated that at 15, life expectancy was an additional 39 years (total 54), with a 0.60 probability of reaching.

    Neolithic 20 -33

    Bronze Age and Iron Age 26

    Classical Greece 28

    Classical Rome 20–30 If a child survived to age 10, life expectancy was an additional 37.5 years, (total age 47.5 years).

    Pre-Columbian North America 25-30

    Medieval Islamic Caliphate 35+

    Late medieval English peerage 30 At age 21, life expectancy was an additional 43 years (total age 64).

    Early Modern England 33–40

    1900 world average 31

    1950 world average 48

    2010 world average 67.2

  93. Errett

    Lp(a) and the Lysine Binding Sites

    “Many investigators contributed to demonstrating that it is lipoprotein(a) that is deposited in plaques, not merely LDL, but lipoprotein(a), or Lp(a) for short. If you have more than 20 mg/dl in the blood it begins to deposit plaques and causes atherosclerosis. The question then is: What causes Lp(a) to stick to the wall of the artery and form these plaques?

    “Countless biochemists and chemists discovered what in the wall of the artery causes Lp(a) to adhere and form atherosclerotic plaques and ultimately lead to heart disease, strokes, and peripheral arterial disease. The answer is that there is a particular amino acid in a protein in the wall of the artery – lysine – that binds the Lp(a) and causes atherosclerotic plaques to develop.

    “Knowing that lysyl residues are what causes Lp(a) to stick to the wall of the artery and form atherosclerotic plaques, any physical chemist would say at once that to prevent that put the amino acid lysine in the blood to a greater extent than it is normally. You need lysine, it is essential, you have to get about 1 gram a day to keep in protein balance, but we can take lysine, pure lysine, a perfectly non toxic substance as supplements, which puts extra lysine molecules in the blood. They enter into competition with the lysyl residues on the wall of arteries and accordingly count to prevent Lp(a) from being deposited, or even will work to pull it loose and destroy atherosclerotic plaques.”

  94. Cindy C

    L-arginine,- Here is a bit from the abstract:

    Several human and experimental animal studies have indicated that exogenous l-arginine intake has multiple beneficial pharmacological effects when taken in doses larger than normal dietary consumption. Such effects include reduction in the risk of vascular and heart diseases, reduction in erectile dysfunction, improvement in immune response and inhibition of gastric hyperacidity.


  95. Dr. Göran Sjöberg

    I have now decided to write another chronicle at the Swedish blog of our LCHF pioneer Dr. Annika Dahlqvist who, with the severe risk of losing her licence, in fact changed the rules to now allow LCHF-advice for the treatment of obese and diabetic patients through the official verdict 2008. She paid though a stiff price as a “rule changer” but survived to the enjoyment of us adherents of this way of “cultural” life.

    The chronicle I have just begun writing has now the working title “LCHF and healthy teeth”. The reason is that I , myself, after 40 years of intermittent struggle now finally seem to have regained my full tooth health together with the health of my heart as far as this may be possible and with the dubious strong departure point at the heart emergency department 17 years ago.

    To refresh my memory I have now pulled some books from the shelves and most notably the one written by the acknowledged “best dentist in the world” during the first half of the past century, Weston Price, who in the spirit of the probably equally acknowledged best physiologist of the world during the late 19th century (or ever?), Claude Bernard, worked against the ignoble practices of the dentistry of his time and with a scientific attitude to finding out the cause for the disastrous state of affairs at that time and he arrived at the most likely culprit being the “white man’s food” after his famous endeavour to visit all remaining indigenous people remaining during the 1930th. The title of his master piece book is “Nutrition and Physical Degeneration” and to resist the overwhelmingly convincing photographs accompanying the text you have to be as immune to science, and the advocates of this science like Dr. Kendrick, as the present day advocates of the statins.

    Another book I am just now consulting for my chronicle is that of Dr. Kraft, “Diabetics Epidemic & You”, where I again learn that hyperinsulinemia is probably a much better word for this disease than diabetic and since CVD goes hand in hand with diabetes he, with his wast clinical experience in the field categorically claims “Those with cardiovascular disease not identified with diabetes are simply undiagnosed”. What I though cannot understand is that Dr. Kraft can keep almost completely clear of how what we eat contributes. I noted the same avoidance with Professor Unger in his great “game changer” and price-awarding talk about the interaction between insulin and glucagon in the pancreas to regulate blood sugar levels among diabetics.

    Could it be that the topic of nutrition and disease is such an incredibly big Hippocratic “elephant in the room” that you, as a part of the medical community, better ignore it if you want to survive in although Dr. Dahlqvist “made it” – but of course she is our “hero” and heroes get scars if they survive and knowing this could be a reason to keep away.

    That tooth health and heart health goes

      1. Dr. Göran Sjöberg

        Looks interesting!

        As previous “bread lover” (the one who “cleaned the bread basket”) I don’t touch the stuff since 7 years now just out of precaution but with the typical attitude of everyone suspecting having been exposed to food poisoned from somewhere.

        I have now sent my chronicle, “LCHF-culture and our healthy teeth”, to Annika Dahlqvist to be soon published on her blog, though in Swedish although there is a translation button to the right named “Översätt”. We’ll se when it appears.

  96. Martin Back

    As they say, you can tell who the pioneers are — they’re the ones lying face down in the dirt with arrows in their backs ;o)

  97. Christopher Palmer

    John U, above, criticized my devotion to earthing theory. Thinking himself clever he drew attention to an article by Joe Schwarcz, a chemist and a Professor no less.
    Schwarcz cannot be that progressive, nor inquiring, in his thinking because I found a recent article that revealed his acceptance of, and adherence to, wrongful guidance originating with the diet-heart idea. The idea that saturated fat and cholesterol raise the risks of CVD is, of course, something that discussion, evidence, and plain absence of evidence in support can indicates is quite wrong.
    The link John U supplied is a poor target, I think, if this was the article he was referring to:
    But thanks to John U I have emailed Professor Joe Schwarcz indicating the erroneous precesses behind his reasoning and sceptical stance.
    Below is that email:

    Hi Joe,

    Someone directed me to your critique upon the theory and practice of earthing.
    I have to say it made me smile, and goodness how much did I smile?
    I have submitted comments beneath the online article.

    You set yourself up as a critic of junk science with the ambitions that we shall be defended from it’s consequence, making you our saviour and you rubbish what is a sound theory of utmost pertinence to the needs of modern man.
    You have not read the book, and certainly not read it with an open mind, all you have done is speed read it to extract quotes you could use in support of an unjustified sceptical stance on the theory. Clinton Ober may not have been grounded in science but as the rediscovered of the health promoting aspects of electron donation from ground he was tenacious to the extreme, and all in the face of adversity and people insisting he was wrong.
    Ober wasn’t wrong.
    Maurice Ghaley agreed to run a trial on the basis of proving Ober wrong yet his trial established that earthing has beneficial physiological effects on cortisol and melatonin. As beginnings go that is a good start and Ghaley must have been aghast at those results that indicate substance sitting within what Ober was directing.
    Ghaleys results have proved a springboard for additional research and commentary, and additional trial results and accounts can be found via http://www.earthinginstitute.net/

    BUT YOU ARE A CHEMIST, GODAMMIT. You might have been minded to think about the elemental properties of oxygen.
    Oxygen is a potent electrophile. That’s what makes it the universal reactant. Oxygen is first arising truly potent electrophile arising within the periodic table. Oxygen is so reactive that elemental oxygen is rare. We sometimes allow ourselves to forget how rare elemental oxygen is . . .
    . . . because we overlook that diatomic oxygen is, in effect, and oxide of oxygen. O2 may be commonplace (20% of air) but O is oh so rare in the Universal scheme of things.
    Oxygen’s rarity is testament to the the extent to which it will steal electrons, which is testament to the configuration and number of electrons in it’s outer shell, which stand as explanation for how it can be the universal reactant.

    Did you not pause to wonder if electrons could be spirited out of the body with every exhaled breath? Did you not pause to wonder about the pH of exhaled breath condensates (EBCs)?
    In people without underlying health complications EBCs are typically less than 7. And with physical exertion the pH of EBCs trend even lower.
    Did you not pause to think to test your own voltage with voltmeter? The book provides content that could stand as incentive to do this. When I did this I returned +5.25V on the voltmeter and it was a while before I could accept this over disbelief. But content in the book implies this is possible and propels a view that +3.25V may be commonplace. Earthing for long enough has readings fall to less that +10mV. Ya gotta concede, ya chump, that a four-hundred-fold difference needs some thought and consideration.

    If you thought about oxygen and about oxygen stealing and about what a pH of less than 7 has to say you could have reasoned that electrons are evacuated from the body with every exhaled breath and that such an eventually is tantamount to a ‘current’ that would leave the inner body, the body’s inner soup depleted of electrons to the extent that such deficiency may be revealing itself on a humble voltmeter.
    Next you could so something that I haven’t done yet. You could investigate the rise from +10mV to +3.25V and wonder is the effect of physical exertion would be to hasten the rise. I would have done this for myself but I have been so occupied trying to describe the concept of oxidative stress, as opposed to oxidation stress, and promote it here and there, and so busy countering the mad-cap objections people raise in the face of early encounters with the theory of earthing that I just did not have the time yet.
    It took me four years to get from realizing that the book doesn’t probe a question it needed to the business of having probed it, returned and answer, and being able to explain the answer with economy of effort. I am disappointed – WITH YOU – for you should be able to do the work and make the connection that took me four years achieve with about four hours of contemplation.

    Earthing is the most amazing health discovery ever because being isolated to the extent that we are has far reaching ramifications for what goes on inside us and I do not discount that isolation could be detrimental to the epigenome – whose maintenance is so crucial to genetic expression within cells.

    One possibility I cannot discount is that isolation over the long term might bear upon the methylation status of the gstm1 gene that has control over the synthesis of glutathione. Glutathione is good, with especial emphasis of risk reduction in relation to CVD. For low risk you would want the gstm1 gene to be switched on. If that status may be converted in vivo to the ‘off’ state then you lose the protection that glutathione may afford you and thus are at increased risk. The epigenome is sensitive to the electrical environment of cells and to the electrical environment that surrounds cells. You optimise the electrical environment associating with cells under those same conditions where that voltmeter reads +10mV. You undermine the electrical environment associating with cells under those conditions where the voltmeter may read +3.25V.

    The book and theory should not be judged by what you know, or by what you think you know, because the book and theory is an exposition of things we would all do well to learn. People need to give themselves the opportunity to read on and learn without fat-headed jerks directing they would be wasting their time.

    Trust me Joe Schwarzc you are the one who is in for a shock if you ever grasp the truth in this and gain some sense of the consequence of your sceptical stance upon it.

    John U, the theory of earthing does present the mind with challenges. The biggest challenges are experienced by those individuals who think they know best without ever reading the book or thinking about its content. Scepticism should always be rooted in being informed about something. I regret to inform you that earthing theory and practice breaches no rules of physics, but the levels of physics of physics I learned in high school I found turned my head against the theory initially. I was sceptical for at least six months before I would buy the book on the subject.
    When I did buy the book and read it I had a severe elbow strain. The pain had eased and then flat-lined whilst still at a high threshold.” What could the harm in testing the theory”, I thought. So I rigged a way to earth my elbow that cost me nothing. I didn’t notice anything. I slept like that for three nights and on the forth night I didn’t bother. You see this injury had remained painful for ten days, but after three nights of sleeping with that elbow earthed I returned to the duties that made me wince and I did not wince. So by the forth night there was no need. as such.
    But after that I graduated to a simple antistatic wristband that could be slipped over the foot while in bed. The effect upon sleep and upon the efficacy of sleep was marked and positive. Some time after I sourced an earthing sheet.
    If only you permitted yourself the opportunity to become better informed you would have greatly diminished reasons in support of your scepticism.

    1. Eric

      I’ll try to get to you once more though I am afraid it may be difficult to get through to you. Please get yourself a high school physics text book and read up on electrostatics, fields and potentials. Electrons are not something that you can dissolve like any chemical compound.

    2. Eric

      Also, if the man takes a stance on one subject that you don’t agree with (even if most of us might), does this utterly discredit him on all other subjects, even those high might happen to know a good deal more about?

    3. Martin Back

      Earthing theory says we breathe out an excess of electrons, which would be in the form of negative ions (unless we emit beta radiation which I doubt we do). So a negative ion generator will enable us to breathe in negative ions to counteract the losses.

      Do negative ion generators have positive health effects? Maybe. There was a huge vogue for them in the 1950s but they seem to have fallen out of favour. Mark’s Daily Apple researched them http://www.marksdailyapple.com/negative-ions-health/

      But hang on a moment. If we are all breathing out negative ions, then effectively people are negative ion generators, so if you are in a crowded office all day breathing in other peoples’ negative ions, you should be healthier! Hmmmm. Can’t see that happening.

      Maybe earthing via direct contact with Earth works differently that via breathing charged air. Is there any epidemiological evidence?

      Little township kids who grow up barefoot then get their first pair of shoes: any change in health status? Don’t know.

      Agricultural field workers compared with their cousins in insulated city offices? Don’t know, and any way the small electrical effects are surely swamped by other factors affecting health.

      How about experiments?

      A simple test would be to have two matched colonies of mice, one in earthed cages and one in insulated cages, but otherwise identically treated, and observe any health differences over time. I can’t find a reference to any such experiment. Christopher Palmer, here’s your chance for medical immortality.

    4. John U

      I do hope you share with us Dr. Schwarcz’s response to you should he decide to respond. I have found in the past that his comments on the subject of nutrition were not to my liking most of the time (just not based on good science, nor on PROPERLY ANAYLYSED evidence. I also think that he is biased when it comes to nutrition. However, his reports in the field of general chemistry and physics I have found to be sound. Just my opinion.

      1. Christopher Palmer

        Dr Schwarcz and I have had brief exchanges. Something that invoked concern in me was the speed of reply. The other concern was the lack of substantive objection and/or the absence of specific challenges to any of my specific points, John.
        Another thing set alarm bells ringing was that common academic defence of asking who you are, what institution do you associate with, and what qualifications do you have. If you present somebody of Dr Schwarcz position with an ansatz that has some substance within it they should be able to engage with that substance (be it correct or incorrect) without first having to wonder what ‘stripes’ you have. Wanting to judge a book by its cover is a giveaway.

        On nutrition Dr Schwarcz still seems to think cholesterol and saturated fat are bad for us, so he could learn from Dr Kendrick, others or myself, who disagree with that stance and do so upon substantive grounds.
        Joe sets himself up to challenge junk science in the popular press, radio airtime, web-cast and video-cast etc., and is thus a ‘defender’ of the people. But this caped crusader is not so good a judge of science as his perception may have it.
        In the online edition of the Montreal Gazette I found discussion of a synthetic blue dye and Alzheimers, and one championing 10 super foods. Even if I didn’t have reason to challenge what he said I found I had objections as to why those directions were on offer.

        Joe Mercola is an acquired taste. I don’t follow closely. What I will say is that Joe is progressive and liberal towards the new theories on the block. That means new theories get airtime and people get to hear of them. The thing that matters is the democratisation of ideas and debate, because the experts, and even the process of peer review, can have a nasty habit of rejecting new ideas that just need that bit of extra consideration.
        All I can offer you is my experience which is this. I have responded sceptically to three theories in succession, and when I actually took the trouble to venture in they each then seemed sound to me. Even when I thought I had learned my lesson and the benefits of retaining an open mind, i did it again and rebelled against the theory of waters fourth phase. Then when I read in I had to concede what a fat-head I had been.
        Scepticism and informed scepticism are two quite different things. When you have lived both you can soon spot the distinction in others.

        1. smartersig

          When you count calories you may get your weight down but too often the nature of the food means you put it back on. Exercise requires almost pro sportsman like adherance to make any meaningful dent in weight gain before we even consider the inflamation often promoted by various forms of exercise. Focusing on what you eat wins hands down when it comes to getting you back to your natural weight.

    5. John U

      Regarding trying an earthing mat to determine its “benefits” is like trying a homeopathic potion. We all know there are virtually no molecules of any active ingredient present in the potion – well maybe some of don’t know that. Nevertheless, some of us feel better anyway after taking such a potion. We are told that viral infections do not respond to antibiotic treatment, but some of us are convinced they do, and beg our doctor for a prescription. Sometimes our bodies just heal by themselves, in fact very often. I do believe in the placebo effect, but only with my eyes wide open, so what would trying an earthing mat prove?
      Let me tell you of an anecdotal incident which I experienced. I developed a pain in my heel. It was very unpleasant, and I tried all kinds of foam inserts for my shoe to alleviate the discomfort. This went on for about 3 months during which time I tried to find causes and cures for my malady. I came across a potential remedy which consisted of a compress using horseradish to be applied to the heel at night for a few days. I was ready to try anything, but I just had to find some horseradish to shred. I happened to visit my sports medicine doc to ask about what to do about this condition and mentioned the horseradish treatment. He told me to try it and let him know if it worked, because he was unaware of any suitable remedy. About one week after the visit with the doc, and having been to lazy to source any horseradish to try, I suddenly noticed that my pain had gone away. I also realized that if I HAD tried the horseradish compress, I would have been convinced that it worked and would have been telling anyone who would listen about this wonderful discovery. But in truth, the pain just went away and never recurred.

      1. Christopher Palmer

        In your rush to be so dismissive, did you consult with the growing body of evidence? Or did the magnitude of your scepticism prevent you from even bothering?
        The theory of earthing, so far as I can tell, violates no laws of physics. Somthing I did find is that it put to the test how many laws of physics I actually knew, together with testing how deftly I could apply or deploy them

  98. Christopher Palmer

    Because I have not encountered terms such as ‘deletion polymorphism’ or ‘null-genotype’ then I have difficulty understanding what is being directed in the discussion of the following article:
    If the terms reference genes that are present in the genome but whose methylation state in the epigenome has them ‘switched off’ then I think I get it.
    Anybody know?

  99. Steve


    Thanks for your service to this subject and the community.
    Keep up the study and look for other issues like cmv. Treating cancer through treating cmv increases life expectancy from 1 to 5 years for the most aggressive brain cancer this is clearly a huge breakthrough. Could chd be similar? Could gut bacteria or other interesting microbes be an influence on blood clotting factors? How about prevalence of childhood diseases like mumps or hpv? I would guess due to the multi variate environment there might be something here that is synergistic with other blood factors.

  100. TS

    If diet is a major player in heart disease then surely the following question would have to be answered:

    What is the huge difference between the male and female diet or male and female dietary requirements?

  101. Håkan


    Eventhough you downplay the role of diet, you still recognize the link diet-diabetes-CVD. How does this process work?

      1. Craig

        It would be interesting to know if there is any data, whether the Pima are just hyperglycaemic or if they are also hyperinsulaemic. What type of type 2? It seems obvious that they do have different genetics in this area.

  102. Brian Wadsworth

    Or perhaps a good question is…

    Where a population of men and a population of women have measurably comparable diets, what is the difference in degenerative disease in general and CVD in particular?

    Because comparisons within a general population between men and women does not assure comparable diets.

  103. Errett

    m J Cardiovasc Dis. 2015 Mar 20;5(1):53-62. eCollection 2015.
    Hypoascorbemia induces atherosclerosis and vascular deposition of lipoprotein(a) in transgenic mice.
    Cha J1, Niedzwiecki A1, Rath M1.
    Author information
    Lipoprotein(a), a variant of LDL carrying the adhesive glycoprotein apo(a), is a leading risk factor for cardiovascular disease. Lipoprotein(a) (Lp(a)) is found in humans and subhuman primates but rarely in lower mammals. Better understanding of the evolutionary advantage of this molecule should elucidate its physiological role. We developed a new mouse model with two characteristics of human metabolism: the expression of Lp(a) and the lack of endogenous ascorbate (vitamin C) production. We show that dietary deficiency of ascorbate increases serum levels of Lp(a). Moreover, chronic hypoascorbemia and complete depletion of ascorbate (scurvy) leads to Lp(a) accumulation in the vascular wall and parallels atherosclerotic lesion development. The results suggest that dietary ascorbate deficiency is a risk factor for atherosclerosis independent of dietary lipids. We provide support for the concept that Lp(a) functions as a mobile repair molecule compensating for the structural impairment of the vascular wall, a morphological hallmark of hypoascorbemia and scurvy.

    Gulo-/-; Lipoprotein(a); Lp(a); Lp(a) transgene; atherosclerosis; cvd risk factors; hypoascorbemia; vascular plaques; vitamin C
    PMID: 26064792 PMCID: PMC4447075

    1. Dr. Malcolm Kendrick Post author

      Yes. But the problem with Matthias Rath is that he is a complete and utter scientific pariah. He was the man who advised the South African Govt not to treat AIDS with AZT. (In my opinion pretty good advice, given the mammoth toxicity of AZT). He was attacked from all sides and his name is complete mud. So, the Lp(a) hypothesis will not see the light of day for many years. In my opinion Pauling and Rath clearly identified one of the processes that leads to CVD. Good thinking, good work, pity that Rath is a bit of a agent provocateur.

      1. mikecawdery

        Reminds me of DR Barry Marshall. Buck the official line and one is in trouble with the medical establishment. I always wonder at how you have survived – probably you are simply writing what is common sense and good science and they dare not challenge you for fear of making fools of themselves and their dogmas.

      2. JDPatten

        You mean, Dr. Kendrick, that there’s never going to be any sort of solid bottom line to this whole series??

        1. Dr. Malcolm Kendrick Post author

          I think I would look at it more like weather forecasting. You can predict a certain amount of what will happen, but the variables create so much uncertainty that to provide absolute predictive power for any hypothesis in this area is simply not possible. I feel I know all (or almost all) of the variables, that you can input into the CHD model. What I do not know is how to weight these, nor how all the interactions add, multiply, subtract or divide. If, say, there are twenty factors involved. Ten causal, ten protective, and you have seven causal and three protective… are you fully protected, or not? Smoking, for example, is a causal factor. But the Japanese smoke a great deal and have very little CVD. What, exactly, is protecting them. One thing, two things… I can give you a list of all the things that are possibly causal, and vice-versa. What I cannot do is provide you with a mathematical formula that tells you how they all interact. Nor can I tell you what test, or tests, will conclusively prove that you are safe from developing CVD. I do not know if that answers your question, or not.

          1. smartersig

            I think what would help people is a list of what certainly adds to protection and what certainly deducts. By how much, who knows but at least avoiding or adhering to such as list will swing the odds a little in your favour

      3. JDPatten

        Dr. Kendrick,
        Thanks. That sounds more hopeful. More realistic than strict protocol!
        It would be good to know all the possible causals and all the possible protectives and an educated-guessing technique as to how to weigh them.
        I guess “strain” is the heaviest, . . .

      4. Soul

        FYI, when I saw your mention on AIDS and AZT I thought that could lead to trouble. In my experience the British press are the most aggressive at protecting the HIV hypothesis. I wasn’t terribly surprised to see this article today. How lucky, there is now a cure for AIDS with the new expensive medications. Be careful.

        EXCLUSIVE: HIV-positive Charlie Sheen praises new doctors’ advice that says meds make risk of spread negligible


    1. Lee

      “Being obese has very little to with with what you eat.”

      This implies that high carb doesn’t make one obese and that low carb doesn’t make you obese.

      So does that mean it comes down to excess calories or is it driven by anabolic hormones?

  104. TS

    From Diabetes uk:

    Children with Type 2 diabetes
    In 2000, the first cases of Type 2 diabetes in children were diagnosed in overweight girls aged nine to 16 of Pakistani, Indian or Arabic origin. It was first reported in white adolescents in 2002.
    According to the National Paediatric Diabetes Audit in 2012, children of Asian origin were 8.9 times more likely to have Type 2 diabetes than their White counterparts and children of Black origin were 5.8 times more likely.

  105. Christopher Palmer

    “Being obese has everything to do with WHAT you eat”
    “Do you have any evidence to support that statement?”

    Richard Feinman is an oncologist who sometimes reads your blog. The evidence?: He has left remarks.
    He and colleagues ran a trial upon hospitalized cancer patients with poor prognoses. They wanted to trial carbohydrate restriction. So they devised two sets of eating plans. One was high fat, one was low fat. They went to great lengths to be satisfied that each plan supplied calories in the same amounts.
    What I recall from this is that was that the low carb (high fat) plan was judged to have positive impacts upon cancer prognosis, howsoever that was to be judged.

    For me the meaty bit is lies in something they considered to be an artefact. Let me explain:
    The high fat group ended up eating less. They consumed fewer calories. Despite the eating plans were devised to present the same number of calories the group on the high fat plan did not consume all the calories on offer. Accordingly I recall it was mentioned they lost weight.
    Yes. I do believe the groups exchanged diet plans at the half-way stage, and yes the outcome was the same each time. Check in the links.

    In the discussion that followed their write-up the authors raised the point of caloric inequality. They had devised the plans and the trial to exclude this variable, but in execution this variable came along to scupper their hopes. You can see how they might regard the inequality as an artefact that might undermine the proposition than cancer may respond to treatments involving carbohydrate restriction. ”Nonetheless, we cannot exclude a contributory role of calorie restriction to our findings”

    Cancerous cells cannot burn ketones (fats), and that’s the principle they wanted to put on evidential basis. But what they got in reality was more bang for their buck. What is included in an eating plan can encourage hypophagia (eating less) and theory would go on to say that by bringing a decline in secretion of insulin and perhaps by rebalancing other hormones in accord, folks could fee less compulsion to snack, and this form of compulsion usually leads to sugar and carbohydrate.

    The explanation comes from examples in Nature. At latitudes increasingly removed from the equator there is increased variability ion the supply of food. Many creatures need to find a way to store food for winter. Some create a larder. Some over eat during summer, stash the reserves as body fat, and supplement with this during winter.

    Long days and bright light leverages cortisol, cortisol leverages gluconeogenesis, gluconeogenesis blood sugar, blood sugar leverages insulin, insulin leverages lipogenesis, and those fats get shipped to adipose tissues. Of course, that’s an outline, there may be other hormones following the leads. But that is nonetheless how mammals of certain size may prepare for winter, they do not have to think about this, they are commanded by endocrine balance.

    Physiology does vary from species to species, this more to do with ‘adjustments’ than to any reversal of principles.

    Yup, evidence, biology, and theory support smartersig, in this.


    1. Martin Back

      I’m sorry, but this supports Dr. Kendrick, not smartersig.

      WHAT you eat affects HOW MUCH you eat. HOW MUCH you eat affects your WEIGHT.

      You can cut out the middle man and say what you eat affects your weight, but it creates the impression that there is a magical food that you can eat as much as you like of and you won’t gain weight. Unless it’s sawdust or grass-fed unicorn or Himalayan berries pooped out by yetis, there is no such food. Anyway, anything you can eat unlimited quantities of and not gain weight cannot be defined as food, IMO.

      I don’t know why the Taubeses of this world are so resolutely determined to obscure the fact that their diets A) increase satiety so there is little temptation to eat too much at a sitting or snack between meals; and B) are too much trouble to prepare or eat so you are not tempted to mindlessly much on them while doing something else, or turn to them as a compensation for disappointment or stress in your life.

      1. Bob

        Dr Kendrick, before pointing out to me that what and how much are different things, used the word “what”. You accept that what you eat matters, as does Dr Kendrick (see his two posts on carbs).

      2. Christopher Palmer

        “I’m sorry, but this supports Dr. Kendrick, not smartersig.
        WHAT you eat affects HOW MUCH you eat. HOW MUCH you eat affects your WEIGHT.”

        I am sorry, Martin, but that was what my comment directed:
        Let me explain: The high fat group ended up eating less. They consumed fewer calories. Despite the eating plans were devised to present the same number of calories the group on the high fat plan did not consume all the calories on offer. Accordingly I recall it was mentioned they lost weight. [Endquote]

        1. Bob

          Indeed. But it does seem perfectly possible that x calories is too much on this diet, but not that one, and we know a lot about the metabolism of the different macronutrients.

  106. TS

    A couple of studies which could have relevance:

    Does Depression Cause Obesity?
    A Meta-analysis of Longitudinal Studies of Depression and Weight Control
    Bruce Blaine
    St John Fisher College, USA, bblaine@sjfc.edu
    To evaluate the causal effects of depression on obesity, longitudinal tests of the effect of depression on follow-up obesity status were meta-analyzed. Combining data from 16 studies the results confirmed that, after controlling for potential confounding variables, depressed compared to nondepressed people were at significantly higher risk for developing obesity. The risk among depressed people for later obesity was particularly high for adolescent females (odds ratio: 2.57, 95% CI: 2.27, 2.91). These findings highlight the importance of depression screening and treatment programs, especially among adolescents, to assist in the prevention of adult obesity.

    Depression, Anxiety, and Severity of Obesity in Adolescents

    Is Emotional Eating the Link?

    Claudia K. Fox, Amy C. Gross, Kyle D. Rudser, Allison M. H. Foy, Aaron S. Kelly University of Minnesota USA


    The purposes of this study were to characterize the impact of depression and anxiety on the severity of obesity among youth seeking weight management treatment and to determine the extent to which emotional eating mediates the relationship between depression and/or anxiety and degree of obesity. This cross-sectional, retrospective chart review of 102 adolescent patients from a weight management clinic analyzed demographics, body mass index, depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder Scale-7) screens and the Child Eating Behavior Questionnaire, Emotional Over-Eating subscale. After adjusting for demographics and emotional eating, the odds of having severe obesity versus obesity were 3.5 times higher for patients with depression compared with those without (odds ratio [OR] = 3.5; 95% CI = 1.1, 11.3; P = .038) and nearly 5 times higher for those with anxiety (OR = 4.9; CI = 1.2, 20.9; P = .030). Emotional eating, however, was not a mediator between depression/anxiety and degree of adiposity.

  107. Dr Robin Willcourt

    The PIMA though are showing an interesting trend among the diabetics.

    In the nondiabetic participants, the rate of death from natural causes declined gradually over time (20.4, 17.3, 17.3, and 16.0 deaths per 1,000 persons/year; P=.11); deaths from ischemic heart disease (IHD) were uncommon (n=22), and the rate did not change appreciably, remaining as the fifth leading natural cause of death. In the diabetic participants, the rate of death from natural causes was unchanged over time, but the rate of death from IHD (n=141) increased nearly twofold (3.3, 4.2, 6.4, and 6.4 deaths per 1,000 persons/year; P<.01), becoming the leading cause of death in the third and fourth time intervals.
    J Diabetes Complications. 2006 Jan-Feb;20(1):8-13. Trends in heart disease death rates in diabetic and nondiabetic Pima Indians. Hoehner CM(1), Williams DE

    I would love to see if there are any later data.

  108. lucy

    I find this report very informative, never new that meat eaters live a very long and healthy life, I thought only the vegetarian did. I would like to learn more

  109. smartersig

    The argument put forward by cholesterol advocates is that damage takes place over many years which explains why lower cholesterol amongst the young seems to favour lower CHD risk, whilst higher is bad.


    But does inflamation cause increased cholesterol or can we assume that a life of high cholesterol is indeed bad news ?


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