What causes heart disease part XXIX, part B.

Alcohol – an update

My last blog on alcohol caused somewhat of a stir, as I suspected it would. To those who did not read it, I recommended that, from a cardiovascular health point of view, those who do not drink alcohol should start. I recommended this because there is strong evidence that moderate alcohol consumption significantly reduces the risk of cardiovascular disease – and can also reduce overall mortality/increase life expectancy.

There were many objections, scientific and, in some ways, moral. Because of this, I felt the need to go over the area again, which is a bit unusual for me. I think there were three main objections that were raised:

1) People who do not drink are not drinking because they have illnesses that have stopped them drinking, therefore they are less healthy than moderate drinkers to begin with. Ergo, you are not comparing apples with apples.

2) None of the studies have been randomised controlled studies, they are purely observational.

3) If people who do not drink, are advised to start drinking, a proportion of them will end up drinking too much and will damage their health.

1) People who do not drink are not drinking because they have illnesses that have stopped them drinking, therefore they are less healthy than moderate drinkers.

This is probably the easiest objection to refute. The massive one million patient study in the BMJ, that I quoted in my previous blog, looked at this potential confouder1. By which I mean that the researchers took care to separate out those who had drunk previously, from those who had never drunk.

Whilst the BMJ study looked at all sorts of outcomes, I shall restrict myself to two here. The ones that are most important. Namely, fatal cardiovascular disease (CVD), and all-cause mortality.

Increased risk of fatal CVD vs. moderate drinking

  • Non-drinker = 1.32 (32% increased risk)
  • Former drinker = 1.44 (44% increased risk)

Increase risk of all-cause mortality vs. moderate drinking

  • Non-drinker = 1.24 (24% increased risk)
  • Former drinker = 1.38 (38% increased risk)

As you can see, there is some merit to the argument that former drinkers are less healthy than never drinkers. However, if you remove former drinkers from the equation, non-drinkers remain at a significantly increased risk of CVD, and overall mortality, compared to moderate drinkers.

2) None of the studies have been randomised controlled studies, they are purely observational.

I cannot really argue too powerfully against this objection, for it is true. No-one has, to the best of my knowledge, taken a large number of people and split them into two groups. One to drink alcohol, the other to abstain. Then, after ten years or so, find out which group did better. I should point that that whilst such a trial could be randomised, and controlled, there is no way it could be placebo controlled, or double blinded (double blinded means that neither the participant or the researcher would know if the participant was, or was not, drinking alcohol). Thus, no perfect trial could ever be done.

The reality is that, in medicine and medical research you just have to roll with what you have got. In recent years, I have seen a growth in a research fundamentalist belief, which is that the only way you can ever prove anything is through a randomised placebo controlled double blind study, with tens of thousands of people in each arm.

I find this somewhat strange, and more than slightly strange. The vast, vast, majority of things that are done in medicine, have no randomised controlled studies to support. Do you think penicillin was subjected to a controlled study before it was used? Um, no. Do you think hip replacements have ever been studied in a randomised controlled trial? Um, no. Do you think breast cancer screening has ever had a single randomised controlled study? Coronary artery bypass grafts, Um, no. Almost any surgical intervention you think of. Um, no. Vaccines. Um, no.

I could keep going on for a long, long, long time on the interventions that are widely accepted, which have far less evidence to support them, than the benefits of moderate alcohol consumption. I worked with the European Society of Cardiology (ESC) at one time, to develop their educational website. By our estimate, around 13% of cardiology interventions had any evidence at all to support them (let alone randomised controlled studies). This statistic may have improved, but I doubt it.

Much of practice was defined by ‘expert consensus’. Which I also call ‘Eminence Based Medicine’.

My view is that, to dismiss all evidence that does not fit into the ‘gold standard’ of placebo controlled randomised double blind study is easy – of course. But if you are going to do this, you would have to also dismiss all the evidence on smoking and lung cancer – for example.

Certain things will never, can never, be studied in randomised controlled studies. So, we must look at best possible evidence, and make decisions based on that. Otherwise what are we to do? We can chuck all antibiotics, and vaccines, into the dustbin for starters.

3) If people who do not drink, start drinking, a proportion of them will end up drinking too much and damaging their health.

This last point is clearly the most difficult to argue against. What if I do advise people to start drinking and a significant proportion become alcoholics. Will I not have done great harm? Well, of course, this is not impossible. However, I consider it highly unlikely, because non-drinkers are almost certainly a very different group of people from already drinkers. Probably highly health conscious and well controlled people.

To be frank, I suspect many non-drinkers do not drink for moral and religious reasons, and would not start drinking even if the evidence for benefit was utterly overwhelming. [Nor would I expect them to, some things are not up for discussion].

There is also the counterargument that if many were to benefit from moderate drinking, this would counterbalance the possible harm of a smaller number becoming alcoholics. The greater benefit for the greater number? Yes, I know, this is one definition of fascism, but hey…

I shall move to the example of sunbathing here. Yes, it is true that sun exposure can cause various skin cancers (probably not malignant melanoma). Doctors urge everyone to avoid the sun, almost at any cost. In doing so, we will prevent a certain amount of skin damage, and certain skin cancers. This is, of course, good.

However, as a study from Sweden demonstrated, the trade-off is that you are far more likely to die from CVD, and you will also reduce your life expectancy by about the same amount as if you smoke ‘Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort.’

OBJECTIVE:

Women with active sunlight exposure habits experience a lower mortality rate than women who avoid sun exposure; however, they are at an increased risk of skin cancer. We aimed to explore the differences in main causes of death according to sun exposure.

METHODS:

We assessed the differences in sun exposure as a risk factor for all-cause mortality in a competing risk scenario for 29,518 Swedish women in a prospective 20-year follow-up of the Melanoma in Southern Sweden (MISS) cohort. Women were recruited from 1990 to 1992 (aged 25-64 years at the start of the study). We obtained detailed information at baseline on sun exposure habits and potential confounders. The data were analysed using modern survival statistics.

RESULTS:

Women with active sun exposure habits were mainly at a lower risk of cardiovascular disease (CVD) and non-cancer/non-CVD death as compared to those who avoided sun exposure. As a result of their increased survival, the relative contribution of cancer death increased in these women. Non-smokers who avoided sun exposure had a life expectancy similar to smokers in the highest sun exposure group, indicating that avoidance of sun exposure is a risk factor for death of a similar magnitude as smoking. Compared to the highest sun exposure group, life expectancy of avoiders of sun exposure was reduced by 0.6-2.1 years.

CONCLUSION:

The longer life expectancy amongst women with active sun exposure habits was related to a decrease in CVD and non-cancer/non-CVD mortality, causing the relative contribution of death due to cancer to increase.2

Why do medics write in such a convoluted way? Is there a course on ‘complete obfuscation of the reader’ that I missed somewhere along the line? Anyway, the point here is that sun exposure meant you very significantly avoid CVD death and live longer (good). But, if you die, you have more chance of dying of cancer (bad?). Of course, if you reduce death from CVD you will, by default, increase the risk of dying of cancer – well you have to die of something. Less of A means more of B.

As a cardiologist once said to me. ‘My job is to keep people alive for long enough for them to die of cancer.’ Sorry, but I do love black humour.

The general point here is that you must look at the greatest benefit to the greatest number. Could I tell a lot of people to avoid drinking alcohol because some people may, I repeat may, turn into alcoholics.

I shall leave you with a quote from an article ‘Ethanol and cardiovascular diseases: epidemiological, biochemical and clinical aspects.’

Conclusion: to drink or not to drink?

‘It is not easy to answer this Hamlet’s question, because alcohol consumption is like a razor-sharp double-edged sword. Current guidelines of the American Heart Association (AHA) state that moderate alcohol consumption is beneficial for cardiovascular health, but the AHA clearly states that non-drinkers should not begin drinking alcohol in middle age due to possible counter-balancing ill consequences of alcohol consumption. Before the definitive decision prospective randomized blinded trials would be important: engage a large pool of non-drinkers, half of whom would commence a moderate drinking regimen, whilst the other half remained abstainers.

The two groups would be followed for years in a search for eventual differences in cardiovascular disease and heart-related deaths. First possible data were available in 2008. King et al observed that of 7697 participants who had no history of cardiovascular disease and were non-drinkers at baseline 6.0% began moderate alcohol consumption and 0.4% began heavier drinking.

After 4 years, new moderate drinkers had a 38% lower chance of developing CVD than did their persistently nondrinking counterparts. Those who began drinking moderately experience a relatively prompt benefit of lower rate of CVD morbidity with no change in mortality rates after 4 years. The collected data make a strong case of the cardiac benefit of controlled drinking.’3

Thank you and cheers. Not that I expect I will have convinced anyone who objected to my last article.

 

1: http://www.bmj.com/content/356/bmj.j909

2: https://www.ncbi.nlm.nih.gov/pubmed/26992108

3: Ginter E, Simko V. ‘Ethanol and cardiovascular disease: epidemiological biochemical and clinical aspects.’ Bratisl Lek Listy 2008: 109(12) 590-4

171 thoughts on “What causes heart disease part XXIX, part B.

  1. Frederica Huxley

    Given the arguments put out by people who will not entertain the use of natural remedies without ‘proof’ of gold standard randomized controlled trials, it is salutary to be reminded how few allopathic remedies have passed the test!

    Reply
  2. Mr Chris

    Dr Kendrick
    Thank you and cheers. Not that I expect I will have convinced anyone who objected to my last article.

    I think you are being a bit pessimistic here. Surely many people who read your blog are openminded? Your blog surely points people to other sources?

    Reply
  3. Jean Humphreys

    Thanks for that. Now where did I put that mini bottle of red: the sun is out and I feel the need of a little something..

    Reply
  4. smartersig

    For a doctor to say ‘live long enough to die of cancer’ is truly a scandalous comment and he should be struck off IMO. What he is saying is that cancer is inevitable which I do not subscribe to. On the idea that most people who go from not drinking to drinking will be mainly careful and types unlikely to excess, this assumes they have a good history of non drinking. If we state that drinking is OK in moderation as a policy then young people will take to drinking and of course this means the full cohort of vulnerables will succumb to drink problems. Is not the sensible way forward to try and isolate the components of drinking that are protective. Of course if its social then that is a little harder to solve but if its chemical then those chemical could be isolated without the alcohol eg resvaratrol. Eevn the social can be encouraged via other means.

    Reply
    1. David Bailey

      Smartersig,

      Absolutely nothing is safe if consumed in excess!

      Some people become addicted to painkillers, so does that mean these should never be prescribed?

      Also you are talking in a vacuum. Very few young people think about heart disease or the dangers of drink. Malcolm is advising people who are of an age where heart disease is a real risk.

      Reply
    2. dearieme

      “For a doctor to say ‘live long enough to die of cancer’ is truly a scandalous comment and he should be struck off IMO.” Your opinion is that of a pompous ass. And the rest of your comment seems just to be unthinking puritanism.

      Reply
    3. Stephen T

      Smartersig, you think a doctor should be struck off for expressing an opinion that you disagree with? How intolerant.

      And young people don’t start drinking because of what doctors say or don’t say. I think I’d rather have a glass of red wine than the synthesised chemicals you’d prefer us to have in order to save us from ourselves.

      Reply
    4. Maureen H

      Smartesig, saying drinking in moderation is beneficial does not encourage young people to take up drinking any more than teaching them the ‘facts of life’ and birth control encourages them to have indiscriminate sex. And what do you mean by ‘a good history of non drinking’? Do you mean it’s good that they don’t drink?

      Reply
    5. Mr Chris

      Smartersig
      The idea of the doctor being struck off for his comment seems over the top to me. You do not know the context, and if, as I suspect, it is quoted very much out of its context, it is is a generalisation which has quite a ring of truth to it, aphoristic OK, but I have read many long papers saying the same thing. Does a bit of truth really harm in these PC days?

      Reply
    6. Martin Back

      One way of discovering if alcohol has a purely chemical effect might be to survey single people with no social life, comparing those who drink alone with those who have a cup of tea or whatever alone.

      Reply
    7. chris c

      I know it’s hard to take but DEATH is inevitable. the WHEN can be adjusted, and the HOW, and that’s it.

      “What is the best outcome you can forsee?”

      “Grandfather dies, father dies, son dies” said the Buddhist monk.

      “Is that the best you can come up with???”

      “Think how much worse it would be in any other order”

      Obviously the doctor was a Buddhist, with a dark sense of humour. Kind of comes with the territory I suspect.

      Reply
  5. Helen Glanville

    Another one that was never tested – levothyroxine. And yet the alternative, natural dessicated thyroid, a grandfathered medicine, is seen as the devil by medics everywhere (certainly in the NHS). I know which I prefer.

    Reply
    1. Anna

      Christ – I didn’t know that Levothyroxine. had not been tested – is that really true? How many zillion people are taking that?

      Reply
  6. aj vosse

    Great post again! Of course, my good lady disagrees vehemently with your suggestion as I now have scientific proof that my very controlled, below moderate drinking is good for me! 😉 But then, she has difficulty seeing the real benefits of LCHF diet too… a battle I’m slowly but surely beginning to prove worthwhile!

    Reply
  7. Jon Wickett

    Malcolm, you continue to be a source of reason and truth in an age of uncertainty. Your articles provoke thought and questions like no other doctor I have come across. Thanks for the work you do and the website.

    May I posit something which could shed some light on this… I’m a non drinker btw (declared interest!) most of the time. A lot of non drinking folks drink soft drinks when they go out (diet or otherwise). Could there be a connection between this and CVD? I.e. those who drink alcohol are less likely to drink soft drinks (soda, orange juice) thereby inadvertently making a less healthy choice?

    Thanks again Malcolm, I’m off to sunbathe now…

    My other observation is that those who wake up a bit ‘bleary eyed’ are much more likely to crave bacon & eggs for breakfast than a bowl is kelloggs & a glass of OJ!

    Reply
    1. Col

      There are confounders all over the place, most of which will increase the lifespan of non drinkers. Active Church participation has been shown to benefit health, and a pretty high proportian of Christians are tee-total. If you were to strip this demographic out I dare say teetolars would be even more short lived.

      Reply
  8. Agg

    Happy Easter Dr K and fellow readers 🙂
    Thank you for another great article esp that bit about double blinded RCTs, not many people realise they haven’t been around for that long.
    Off to 2 hours of fresh air and sunshine – I strongly recommend archery, helps me concentrate and clear my mind, plus a nice bunch of people in our club so it ticks the socialising box too – then guilt free chocolate, Sunday roast, bit of good telly with family and a drink or two, totally stress free.

    Reply
  9. Gay Corran

    It’s a bit like the old randomised, gold standard jump out of a plane with or without a parachute, again, I think. Common sense observation has to come into it somewhere. Happy Easter, and I hope something pleasant is chilling in the fridge to precede the roast lamb before anyone gets to the chocolate…

    Reply
  10. R. Coleman

    One area of non drinkers you didn’t cover is recovering alcoholics. I think I would have appreciated your article more if you’d put in the proviso “unless you have the alcoholic gene” which I’ve seen in another article saying drinking in moderation was good for you.
    As a recovering alcoholic I would never ever drink to reduce my chances of having a CVD as I know drinking would get me back to an alcoholic state and the associated illnesses.

    Reply
    1. Gary Ogden

      AH Notepad: Write your comment as a document (Word with Microsoft, Pages with Mac), then save, highlight, edit, copy, close, return here and right click, then paste.

      Reply
    2. mikecawdery

      AH

      Surround the text you want to bold with html characters “b” (turn on bold) text “/b”(turn off bold) “i” (turn on italic) and “/i”(turn off italic)
      Each b or i instruction has to be placed within “”. text or text
      Hope that helps for direct comment rather than copying

      Reply
  11. AH Notepad

    I hardly drink alchohol because it limits what I can do once I’ve drunk it, for many hours at least. eg driving. I may well die of something, bu tI feel that will be unlikely in the immediate future.

    “The vast, vast, majority of things that are done in medicine, have no randomised controlled studies to support. Do you think penicillin was subjected to a controlled study before it was used? Um, no. Do you think hip replacements have ever been studied in a randomised controlled trial? Um, no. Do you think breast cancer screening has ever had a single randomised controlled study? Coronary artery bypass grafts, Um, no. Almost any surgical intervention you think of. Um, no. Vaccines. Um, no.”

    That these treatments are beneficial in all cases is questionable, and in some cases, very questionable. Antibiotics are certainly not always a good treatment, and have known detrimental effects. With proper nutrition, hip replacements may be unnecessary. There are instances where unnecessary and sometimes damaging treatment has occurred when dealing with tumours that would have had no long term effect on the patient. Coronary artery bypass may have been avoided by proper nutrition, as many of the posts on these blogs suggest. Any surgical intervention? That’s too wide a field for me to comment. Vaccines?!?!? Now there’s a big one. The vaccine manufacturers have given false information regarding the benefits, and more seriously the risks of vaccines. If a RCT was conducted for vaccines, I would suggest they would fail miserably.

    If having a drink makes you feel good, carry on. I just don’t think I would benefit from an increased alcohol consumption.

    Reply
    1. Mr Chris

      AH notepad
      This is a subjective comment”
      I had a hip replacement operation at 76. I had had spent three or four years trying all possibilities for the problem, and being advised I did not need it. It took me about twelve months to get my former strength back. My only regret was to have waited so long.
      The point of the above?
      I am not sure generalisations lead us anywhere.

      Reply
      1. AH Notepad

        The problem with artificial joints is their limited life, and that their replacement becomes more difficult each time. The point I was making about nutrition is that it has to be life long, not as most of us do, change to something reasonable when we discover there is a problem. By then it is too late. Prevention is the only option, a “cure” is second best.

      2. mikecawdery

        Henry Gadsden, chief executive of the drug company Merck, expressed in a candid interview his frustration that the potential market for his company’s products was limited to those with some treatable illness – as ideally he would like to ‘sell to everyone’. Le Fanu, James. The Rise And Fall Of Modern Medicine (p. 503).

        I think that this sums up the general business model of Big Pharma; a treatable illness that drugs can’t cure, only control. IDEAL met

      3. Mr Chris

        Mike
        Reading this site has helped me a lot. I am for specific treatments, cataracts, hips kness antibiotics etc, where you follow a treatment for a short time and it sorts you out. Iam against taking medicines for the rest of my life. I also have small shareholdings in pharmaceutical companies.
        I also totally subscribe to Dr K’s suggestions on alcohol, and am even coming round to slightly peated malts. After midnight mass at Easter I tried Laphroaig. Very good

  12. L Cooper

    As a cardiologist that I was chatting to once said to me, “nothing is off limits for my patients. If their favourite food is chips there is absolutely no point in me telling them that they can never eat them. What they can’t do is eat them every day. The moto is everything in moderation and nothing to excess”. I think that seems eminently sensible don’t you.

    Reply
  13. Tom Welsh

    “Much of practice was defined by ‘expert consensus’. Which I also call ‘Eminence Based Medicine’”.

    Marvellous! That’s cheered me up no end. Almost as much as the conclusions of the article… Slainte mhat!

    Reply
    1. Stephen T

      I find the advice “Everything in moderation” to be meaningless. How much sugar is ‘moderation’? How much wheat or vegetable oils? Is a diet containing 60% carbohydrate moderation or is it 10% I could go on. In my experience this advice is given by people who don’t know what to say and aren’t brave enough to admit the fact.

      Reply
      1. David Bailey

        To live a life without wheat, vegetable oils, or sugar would be really hard. It would be all but impossible to eat out, either with friends or as part of your work.

        A far more practical solution, which I follow, is to cut down a lot on things containing sugar, use olive oil (less polyunsaturates) for cooking at home (my partner is vegetarian, so lard is not an option) and consume butter and full-fat milk. I don’t have a problem with wheat, though I accept that some do.

        Moderation regarding diet is surely essential, otherwise you would avoid all fish because of mercury, your meat, milk, butter and cheese would have to be sourced organically (even while on holiday) to avoid hormone contamination, goodness knows how you could avoid all genetically engineered food, and thus avoid glyphosate residues, etc etc. This isn’t even a modern problem, in times gone by you were far more likely to eat food with heavy fungal or bacterial contamination contamination – life is a terminal disease – accept it!

      2. mikecawdery

        Stephen T
        In my experience this advice is given by people who don’t know what to say and aren’t brave enough to admit the fact.

        Mine too. Usually backed up with a wealth of meaningless jargon.

  14. Roy Firus

    Your analogy of drinking alcohol and sunbathing is extremely simplistic to say the least( and to be very polite ) and is not at all valid in its ramifications for any country and I am sure that you are bright enough to know it.
    We don’t have a “Sunbathers Anonymous” etc. for an obvious reason and we do not have hundreds upon hundreds of millions of people and families worldwide who have been destroyed by sunbathing – as well as sunbathing causing millions of car deaths, crippling accidents, suicides and assaults etc.. As you should -and I am sure do know- any valid logical analogy must have the same negative to positive ratio of benefit to harm value-and in this case for a society.
    Yours does not even come close to that..
    I am very sorry to say that in light of your superb and excellent previous articles that this one is simply a highly defensive joke and not at all informative except to illustrate a false sense of security in light of the massive worldwide serious health problems and deaths that alcohol causes.
    For you to recommend non-drinkers to start drinking alcohol is totally irresponsible and highly dangerous and is insult to both your own intelligence and to your chosen.profession.
    You are in a position do immense good as well as immense harm and I would politely suggest to you that exercise more more care in what you recommend.
    Oh and by the way-I do not object to alcohol on any moral or religious principles -just on the basis of having worked with its victims for over 40 years.

    Reply
    1. David Bailey

      Roy,

      Surely the point is that medical authorities have been telling people that in addition to the things you list, alcohol increases your risk of cancer and heart disease even if taken in moderation. From all the evidence that Malcolm (and others) has presented, this simply isn’t true – indeed it is the reverse of the truth.

      Do we go to the doctor to be lied to?

      Likewise medical authorities have told people that sunbathing is bad for health, and should be avoided or minimised, when in fact, averaging over different possible diseases, it is clearly beneficial. Once again, we have been lied to.

      Lot’s of activities make a person unfit to drive for a period of time. For example, nobody in their right mind would drive after having just run a marathon! If you drive, you have to do so responsibly.

      Reply
    2. Jennifer.

      Oh dear, Roy.
      I am not on your wave length at all.
      Life is for living, and the majority of the population manage to take food and alcohol in moderation. I do not think the unfortunate minority should be allowed to interfere with the majority.
      The trouble with modern medics is that the ‘holier than thou’ message is based on shock tactics, with the minimum of absolute and believable research to back up their messages.
      It is that time of year when I am again being pestered for my annual ‘testing’, despite years of declining the offers for blood tests etc. ( since having changed to LCHF regime).Goodness knows what negative connotations my alcohol consumption would conjure up if I subjected myself to the ‘ticky-box’ regime of recent years. ( again, devoid of research to back up such condemnation).
      I am quite new to consuming alcohol. In my early years as a mother, I did not imbibe, and until I retired from working as a Registered Nurse, I restricted alcohol intake to high days and holidays, so that I kept my mind as clear as possible, and never had any worry of jumping in the car to take me to my place of work. But, I am retired now, and see no reason to not indulge in alcohol with my wonderful husband of 50 years.
      As I say…life is for living.

      Reply
    3. mikecawdery

      Without full details of a proper study on the effects of drink on the variety of people involved from those who cannot stand alcohol through to those that drink a lot(???) into their very old age with apparently no effect, we will never know the full truth for each potential category.

      For one, I am prepared to accept that for the individual a level of drinking (low to high) may or may not be good or bad, it is up to personal preference. I see no point in discussing the unproveable. Too many people try to force their views on others.

      Reply
    4. Christopher Palmer

      Roy,
      The negative outcomes you describe [mortality rates on the roads, life changing accidents and injuries, suicides, and assaults, etc.] are ones whose patterns of incidence reveal very clear and well understood associations that are dose dependency. They are seen in association with excess (binge drinking), insobriety, chronic excess, and addiction.
      Not for one moment have I sensed that Dr Kendrick has recommended high dose self medication with alcohol in this or other posts. He knows far better than to offer generalised online prescriptions be they licensed or otherwise. Instead he has engaged in discussion that has opened up regard and interest for what the effects of modest consumption of alcohol might be.
      Furthermore, as has been discussed, peoples relationship with alcohol and consumption of alcohol in the field is not one that is knowledge driven. Ask them where, when, why, and how much they consume and you will get as many alternate answers as you ask people. Their actions (together with outcomes) may be based upon conviviality, peer pressure, positive social conditions or negative ones, feelings of security or insecurity, psychosocial stress, work-related stress etc.
      With 40 years worth of field-work behind you surely cannot believe that alcohol alone is the issue for you have been dealing with dose-dependent crises in which a number of further influences may be the driver(s) of high dosage abuse.
      Hence followers can read your comment, take on board your genuine concerns, and be clear-minded that it is not Dr Kendrick is being overly simplistic, but you.

      Reply
      1. AH Notepad

        Christopher, you mention dose dependancy. Do you realise how little alcohol it takes to impair people’s judgement. This includes all those who think they can perform well after a small amount. Many get a surprise. In the days before desktop computers, let alone the internet, we used to play a game on graph paper, (as we worked in an engineering office). It had simple rules. Draw a racing track on the paper, this had no restrictions. The competitors had a position on the start line, and to get round the track the first move was one square forwards. From then on it was possible to move more than one square, but it was possible to increase or decrease “speed” only one square at a time, in any direction, that is forwards, sideways or backwards. If you had built up to, say, 5 squares forwards and you were approaching a corner, you have to slow down, but only one square at a time. This meant the next move could be 4, the next 3, the next 2, and so on. This meant if you were moving at 5 squares to begin with, and you were 8 squares from the corner, you were likely to overshoot the track. Simple you might think. But people who had drunk a pint (sometimes less) of beer at lunchtime often couldn’t stay on the track, and there wasn’t a fast reaction time needed either. Don’t underestimate the effect.

  15. Steve Crook

    I have no idea what ‘moderate’ drinking means in this context. Personally, I’ve never liked alcohol or it’s effects that much, so if I’m going to drink some for my health I’d really like to drink as little as possible…

    Reply
    1. Gary Ogden

      Steve Crook: What I do is sip. Two hours to polish off my 1/4 bottle-size glass. Only the mildest effects of the alcohol, and very pleasant.

      Reply
  16. JanB

    Hey, it’s a beautiful sunny day here in Cornwall, so later today I shall have a nice session in the sun with a glass of Malbec. As a mainly non-drinker though, it’s quite easy to forget and have a cup of tea instead. I am trying though, honest.
    Thank you Dr. K, for this, as ever, illuminating post, arrived in my inbox to brighten already a radiant day.

    Reply
  17. Linda Sanday

    Hi Dr Kendrick,
    I found in my early 20’s that I could no longer stand the taste of alcohol and have been 99% alcohol free since. I’m chronic fatigue amongst other things, and it has been found that more 90% of us can’t take alcohol, presumably as part of the condition.
    What I’m asking is, for those of unable to drink alcohol for one reason or another, when is the alcohol tablet or even in a pastille, or skin rub, shampoo (!) coming out?

    Reply
  18. Nicolai Worm

    Very well done, Malcolm!

    Have you seen my healthy eating pyramid with alcohol and sun as part of a healthy lifestyle?

    Happy Easter!

    Nicolai

    >

    Reply
  19. Gary Ogden

    Thanks again, Dr. Kendrick. My concern now is that you’ve given pharma the idea to develop a prescription alcohol pill for those with moral objections to drinking. Could be one of those rare pharma products that actually increases health and longevity, with assorted flavors, such as whisky, beer, or wine. If they put an x or a z in the name, they’ll sell like hotcakes.

    Reply
  20. Brendan Glass

    I wonder if the Swedish study on sun exposure took in to account the possibly reduced cardiovascular fitness with lower sun exposure by correcting for the seasonal level of activity outdoors?

    Reply
  21. BrianH

    Nice followup post, Dr. Kendrick.

    I wonder if some of the marijuana legalization could help answer the mechanism questions. If moderate (whatever that is) marijuana consumption becomes widespread, it might be possible to look at the rate of CVD for those groups to see how powerful the ‘stress reduction’ factor is in the overall effect. I could certainly imagine the hard charging businessman relaxing before bed with a marijuana edible instead of a few glasses of wine.

    After all, how many chronically stressed out potheads do you know 😉

    Reply
  22. Gretchen

    Some people say alcohol has no benefit for APOE4 carriers. Would be nice if you could comment on this.

    My own opinion, totally without scientific proof, is that if you enjoy alcohol, you should drink it in moderation. If you hate it, you shouldn’t force yourself to drink it in the hopes that it will extend your life.

    Reply
  23. Joyce

    mmm. Okay. Although if after chucking’ the Statins, getting back on the red wine, and suffering sunburn, I have another cardiac arrest……I’m coming to find you, or worse(for me) haunt you MK. 👻 lol

    Reply
  24. mmec7

    Wonderful. Can continue to enjoy my wine and my whisky, not forgetting the excellent Armagnac from Normandy. Thank you Dr Kendrick – Like my alcohol and like the sun, in moderation…

    Reply
  25. Ian Partington

    As ever, an informative and amusing piece, Dr.K. I for one will raise a glass tonight ( but purely to guard against CVD, obviously!). Moderation in all things? Not necessarily, but certainly in red wine consumption! Two glasses a night, coupled with some juicy, fatty roast lamb will do for me. Cheers!

    Reply
  26. Anna

    ” By our estimate, around 13% of cardiology interventions had any evidence at all to support them.” Did I read that right? If so I sm truly dumbfounded. Snake oil salesmen are still doing a roaring trade then.

    Reply
  27. JPA

    I think that most people missed your statements in your last post in which you made the point that you were less likely to believe that the beneficial effect of drinking was from the ethanol, but rather from the stress-reducing properties of the setting in which the person drank.

    You have also emphasized numerous times that stress is a major factor in CVD and that reducing stress is beneficial. So the people getting all stressed out about your statements on alcohol are missing the point (and possibly increasing their CVD risk).

    I have been working to help people reduce stress for the past 20 years. My sense is that when we can shift to a physiologic state of ease and contentment in which we feel connected with what we love then our body repairs and recharges itself much more effectively. Different people will find that different activities work for them: talking with friends, listening to music, gardening, walking in nature, reading an enjoyable book, prayer and meditation, …

    To rest deeply we need to stop keeping score. We need to involve ourselves in an activity that brings us joy without any pressure to do better, to achieve a certain standard, to surpass a prior performance, or surpass anyone else. This is difficult because our mind tends to be fearful of not being “good enough”. It pushes us to do “better”. When I teach meditation the hardest point for students to get is that they need to both put effort into the practice and stop judging themselves for not doing it “right”.

    Play happens when we stop keeping score.

    So if you don’t drink, than play more.

    Reply
  28. JDPatten

    Randomized controlled double blind trials are certainly the mainstay for Science to lift itself from ignorance.
    They can be anathema to a doctor’s effective care of his patient, however.
    For example, ranolazine is a nice little drug designed for and prescribed for angina. Research (just short of RCT rigor) over the last few years has strongly suggested that it is quite effective in suppressing cardiac arrhythmias as well. Being an interested party, I asked my electrophysiologist if a little bitty trial of the stuff would be appropriate for my lingering occasional symptomatic PAC and PVC runs. “No.” “Why not?” “There’s no evidence (RCTs) that it works.” Of course, without expensive RCTs in their numbers, the FDA is not going to condone such use.

    What are the ethical/legal standards for prescribing off-label?

    Fortunately, there’s no such hindrance to self prescribing Ardbeg 10 year. In moderation, of course.

    Also, the flavor of wine “engages more of our brain than any other human behavior.”
    http://www.npr.org/sections/thesalt/2017/04/03/521415892/the-taste-of-wine-isnt-all-in-your-head-but-your-brain-sure-helps

    I would join the fine Doctor in recommending suchlike indulgence – even if only on aesthetic principle.

    Reply
    1. mikecawdery

      Absolutely correct but is also the way to belittle therapies that work. The establishment only has to say “there is no RCT” and thus given the dominance of Big Pharma in pharmaceutical research money is NOT going to be provided without a “perception of profit”. This immediately excludes any non-patentable molecule from receiving research funds from Big Pharma and probably Government and Charities as well.

      Reply
      1. Sasha

        None in the USA, as far as I know. Doctors here routinely prescribe off label. Sometimes a drug company will get caught for pushing a drug off label and pay billions in fines. Since they make much more by the practice, it continues… This all may get fixed by recently passed 21 Century Cures Act which, if rumors are correct, will allow a pharma company to advertise and sell a drug without showing RCTs proving its effectiveness.

      2. AH Notepad

        No change then. Historically they have misrepresented the figures to show the results they want. Not to mention the flagrant bribery.

      3. mikecawdery

        JDPatten

        http://ahrp.org/

        FDA conceals serious research misconduct–fraud, deception, even deaths
        April 17, 2017

        FDA documents obtained under the Freedom of Information Act, revealed that the FDA has been concealing from the medical community and the public serious research misconduct; including fraud, deception, avoidable risks for human subjects — even deaths — that occurred in clinical trials.

        When the “defender of public health”(FDA supposedly) joins with the fox (Big Pharma) what hope is there?

      4. Gary Ogden

        mikecawdery: The FDA has been a captured agency from the beginning. The 1906 Pure Food and Drug Act gave birth to the Bureau of Chemistry, whose only mandate was to ensure that what was on the label was in the product. John D. Rockefeller was the guiding impetus for this, as he wanted a market for petroleum refinery sludge and public trust in the medical products made from that sludge. His descendants are still in charge of much of what goes on in the U.S. In the 1930’s the Act was updated, adding a safety mandate while changing the name of the agency, but the damage had already been done. It is a thoroughly corrupt agency, like the Centers for Disease Control and Prevention. They both function primarily as marketing arms of the pharmaceutical industry, as does WHO.

  29. Cecile

    After reading the Blue Zones by Dan Buettner it became clear to me the longest lived populations are around the world consumed alcohol and meat in moderation, the single exception being the Seventh Day Adventists. Another observation is people over 100 interviewed on TV all seem to espouse alcohol consumption. So, I am one of your readers in complete agreement.

    Reply
  30. Dr. Göran Sjöberg

    Great input again!

    No objections at all!

    I realize that I am just now doing absolutely the right thing – heading towards the most northern parts of Sweden – today we covered 800 km straight north and tomorrow we will cover the final 650 km.

    By then the sun will be shining on us a couple of more hours every day than i the southern parts where we are living.

    By relaxing with a glass of wine tonight I probably also add to my longevity and perhaps I will take a refill after reading your new input 🙂

    Reply
      1. Dr. Göran Sjöberg

        Yes I really enjoy this!

        One meter of snow met us at our house yesterday evening. I have spent most of my time digging into the snow since then. A good heart test!

        The weather is just great with a bright sun. So what I do in between is facing the sun surrounded by the crystal white snow and with a glass “glüwine” (heated red wine). I don’t know if the sun has any effect at this latitude but the wine has.

      2. JDPatten

        Goran,
        If it’s vitamin D you’re after at your latitude, you’ll need to be tough. The general guideline is that if your shadow on the ground is shorter than you are tall, you’ll make plenty of D with your face and arms exposed. Maybe without a shirt for those of us with more accumulated decades. (We’re less efficient.) But that’s just a guideline. UVB does sneak through at your Northern latitude, but you’d need to take at least that shirt off and spend more time out there in the snow.
        Brrrr!

  31. Craig E

    As someone who has been combing the internet and other sources far and wide for around 4 years covering a wide range of health/disease/biochemistry/nutrition topics this was the first blog that I gave any credibility…in fact it’s the first blog I ever commented on. Dr K’s articles are informative, funny and above all are consistently based on well researched scientific reasoning. I loved reading The Great Cholesterol Con for the same reasons. And then there’s the generally respectful way that readers add comments/questions and links to other research. The last blog post on alcohol caused a stir, but Dr K wasn’t advocating going out and getting yourself stonkered. There is always a risk that a non drinker who starts drinking in moderation will end up an alcoholic. But I believe the benefits outweigh the risks. Before going in for major surgery a few years back I was told I had a 1% chance of dying during the operation. But the benefit of going through with the op outweighed the risks so I took my chances. I guess people just need to balance risk vs reward before deciding whether to do something.

    Reply
  32. Valerie

    The sun exposure study looks full of confounders to me.
    – Wealth is always a big one. For example, full-time workers not taking vacations in the sun will end up in the low exposure group. Richer poeple with more time to spend outside and more opportunities to travel to the beach in winter will be in the high exposure group.
    – Obesity is another strong confounder. As a fat woman, I can assure you that my sun exposure is drastically reduced by the insults I receive whenever I dare show some skin in public. No sunbathing on the beach for us fat people.

    Similarly, the alcohol consumption studies are probably counfounded in dozens of ways. As an example, about half people in my family enjoy alcohol, the other half barely ever drink any because they feel sick when they drink. Some people just don’t seem to metabolise alcohol right. Maybe that “condition” is linked to general health.

    As for the never-drinkers, they also inlpclude people who were chronically sick young enough to never get a chance to drink regularly. Medication and alcohol must not be mixed, we are told. So that’s another counfounder.

    In short, those epidemiological studies are intriguing, but I think public health advice should rely on much stronger evidence.

    Reply
    1. chris c

      No offence intended, but I assume you eat an “evidence-based” low fat diet. Have you ever considered that it isn’t working?

      Reply
  33. Frances Chaloner

    Thanks for your fascinating and entertaining posts which I very much enjoy and find highly educational.
    I gave up drinking because I started to feel very unwell for days after even with one drink. Later on I was diagnosed with overt hypothyroidism and I take thyroxine for it. I have never done much in the way of alcohol drinking since because I still feel rather unwell afterwards. I do not know why this is but some others with hypothyroidism appear to be likewise afflicted. I’d be interested to know what you think – is it sensible to override my aversion to alcohol or just stay sober and accept my CVD chances will go up. I presume it must be that cultures that have an alcohol taboo
    suffer from higher rates of CVD.
    I understood that increased exposed to sunlight reduces cancer incidence apart from skin cancers (Dr Damian Downing Dayight Robbery). If it is so bad for us why does it feel so wonderful to have sunlight on our skin? Now rampant vitamin D deficiency is causing all sorts of health problems.

    Reply
  34. Mark Johnson

    Hi Dr K!

    I left a similar comment to the following in “Alcohol part 1”, namely that having been largely teetotal all my life (just don’t like the taste of alcohol unless it was masked) I did start drinking port and wine following what I read in, “The Cholesterol Con” and then subsequently in, “The Good News About Booze”. I got down voted. I think you’re right in what you say and I feel I’m highly unlikely to develop into an alcoholic after largely abstaining for decades and not having had a first proper drink until my thirties. Apologies to you and to others, but whisky to me tastes like petrol and yes, I have tasted petrol, but that’s another story!

    I now try and have an evening glass of port with my 86 year old Mum whenever I can who by the way, was also teetotal until about last year when we both started drinking together!

    Reply
  35. Josephine Pretty

    My mother and father did not drink and they lived to be 91 and 99 respectively. I would like to drink a couple of glasses of wine per week but have had my gallbladder removed so I thought that It would be kind to my liver not to.indulge. Who knows? By the way my aunt lived to be 99 without drinking.

    Reply
    1. TS

      Josephine:
      I no longer have my gallbladder either but I still eat plenty of saturated fats and drink a glass of wine daily with lunch and have done for years now. We use small glasses and I far from fill mine but I enjoy what I drink and don’t find I want more. I’m not good at eating or drinking large quantities in the evening and have a light meal then – unless we are being sociable. This suits my digestive system.
      I drink lovely wine which we buy on our motorhome trips, often direct from vineyards – we drink it because we enjoy it, not for health – though it’s good to read of its benefits.
      The wine vacuum pumps are well worth using because there’s never a need to finish a bottle – the wine keeps really well and will do for days if necessary. Sometimes we use wine boxes. I can appreciate that some people may drink more this way with it being on tap but we don’t have a problem with it (and my father was an alcoholic chain smoker).

      Reply
  36. TS

    This makes me think of Dr K:

    How happy is he born and taught
    That serveth not another’s will;
    Whose armour is his honest thought,
    And simple truth his utmost skill!

    This man is freed from servile bands,
    Of hope to rise, or fear to fall:-
    Lord of himself, though not of lands,
    And having nothing, yet hath all.

    Sir Henry Wotton 1568-1639
    Character of a Happy Life

    Reply
  37. Angela

    Now I’m very confused. I’m 73 and I’ve found it increasingly difficult to drink since I had my first baby at 21. Presumably I’m one of those who doesn’t have the right enzyme. So should I persevere even though it will, in short order, give me a headache, upset tummy and diarrhoea? 😉

    Reply
  38. robert lipp

    Dr Kendrick,
    Firstly, to state my position I seldom imbibe and when I do it is usually a glass of red wine with friends. Probably not enough to improve my health.
    Referring to your first “to drink or not to drink, that is the question” article; I read, understood, and assumed that it was a humorous, tongue in the cheek, and light hearted (pun intended) article. After all, you were about to go on a well earned spot of R&R.
    I am sorry that you found it necessary to explain yourself. Though, I found the explanation interesting and informative.
    Thank you

    Reply
  39. dearieme

    “the vast, vast, majority of things that are done in medicine, have no randomised controlled studies to support. … Do you think breast cancer screening has ever had a single randomised controlled study?” True.

    But that explains why mass screening for breast cancer is (probably) a bad idea: the observational studies that suggest this are easily ignored by people with a quasi-religious belief that breast cancer screening MUST be a good thing. They’d perhaps find it harder to recruit allies if a properly controlled study proved them wrong.

    Reply
    1. TS

      dearieme (love your name, by the way!):
      The really dangerous, virulent breast cancers generally occur in young women and tend to be troublesome before they are big enough to show on a mammogram. I had a large but less horrible one which was not even detected by a mammogram. It wasn’t treated for 5 years (when the tumour was egg-sized) but I’m still here 13 years after its removal.
      Having said that, if suspicious groupings of calcium on mammograms were to be biopsied (they tend not to be) atypical cells could be found and dealt with. Certainly if one has already had breast cancer the chances of these becoming malignant must be greater. Even so, the current optimistic stance – “It will probably right itself” tends to be taken because they look at trends in all women rather than the individual. So what is the point of the mammograms?

      Reply
  40. Andy S

    Effect of alcohol in bloodstream: HDL increased, NO increased, TG increased, cell membranes altered, emotional changes. Studies show beneficial effect of moderate alcohol consumption on CVD. “Competing interests: Eric B Rimm (Department of Nutrition, Harvard School of Public Health, Boston) has received both honorariums for speaking at academic conferences and travel expenses from alcohol related organizations.”

    Saccharomyces cerevisiae and mind control, how a simple yeast is taking over human consciousness. Are we underestimating microbial network intelligence?
    The biggest benefit for alcohol consumption is to the yeast cells. Humans are being manipulated and controlled into cultivating grains and grapes to feed the yeast cells. This indicates to me a high intelligence and consciousness on the part of the yeast cells. Scientists’ minds are being controlled by yeast cells, resistance is futile.

    Reply
  41. Martin Back

    Typical alkie. Any excuse to have a drink ;o)

    Alcohol is not a cheap form of medication. My NSAID (Arthrexin 25 mg) used to cost me 40c South African per pill. (I now take turmeric instead.)

    Assuming 12 g is a moderate amount of alcohol, at a density of .79 that is 15 ml pure alcohol.

    Spirits are 43% by volume alcohol, so that is 35 ml spirits, i.e. 21 shots per 750 ml bottle.
    Vodka, gin, brandy, cheap whisky are R105 per bottle, i.e. R5.00 per shot, 12 x the pill price.
    Johnnie Walker Black Label whisky at R280 per bottle comes to R13.30 per shot.

    Wine is 12% by volume alcohol. Assume 6 glasses per bottle, that is 12 g alcohol per glass.
    Say R36 for a decent bottle, but you can pay less or a lot more. that’s R6.00 per shot.

    Beer is 4.5% by volume alcohol. One 340 ml can contains 12 g alcohol at R7.50 per can.

    Reply
  42. Music Attorney

    Has anyone read any of the studies at the links below such that they could offer insight as to the counterarguments against the study that Dr. Kendrick referenced (i.e., “Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort.”)” It seems they are behind a subscription wall. Thanks in advance for any insight

    https://www.ncbi.nlm.nih.gov/labs/articles/28334454/

    http://onlinelibrary.wiley.com/doi/10.1111/joim.12538/abstract

    Or perhaps someone could provide some insight as to the responses at the link below from the original researcher (Lindqvist) who is responding to comments from the president of the American Dermatology Association.

    https://www.researchgate.net/publication/315612925_Are_low_sun_exposure_habits_a_genuine_strong_risk_factor_for_all-cause_mortality_or_the_result_of_bias

    Best,
    MA

    Reply
  43. Jyri Ylöstalo

    Yet one possible confounder that I think nobody has mentioned yet: A large proportion of never-drinkers may be muslim immigrants. You have pointed out yourself that immigrants are are at a very high risk of CVD. Could this explain the results?

    Reply
    1. David Bailey

      My impression from reading the “Good News about Booze” book, is that the beneficial effect of moderate drinking is not a new result, so demographic changes are very unlikely to explain it.

      Reply
  44. mikecawdery

    Dr Kendrick.

    I am afraid that I personally like “FACTS”. I do not appreciate PC Moralisms presented as “facts” along with a strings of manipulated data.

    The presentation of real facts is essentially why I keep returning to your blog because I feel I can rely on the truth insofar as that is ever possible in our state of lack of knowledge. My belief is that you should keep going the way you are. If you raise an issue that my research raises I will put my view and, as you have done, you will dump it. So be it but please keep going the way you are. As far as I am concerned you are one of the few in medicine that appear to think sanely; too many in the medical establishment seem to be little better than drug sellers.

    One minor issue; you give what appears to be ORs/HRs and relative rates. These are, I have found to be often greatly inflated resulting in that claim “treat 3 million with statins and save 10,000 lives p.a. a 1 in 300 efficacy rate (0.3% p.a.). I have had a claim rejected by the VMD because it was < 90% for a generic that has been working at 90+% for 50 years. I would really like to know the real %age benefiting.

    Please, please, keep following your current practice.

    Reply
  45. mikecawdery

    For those with diabetes the HOMA-IR test by Oxford an Dr Naiman (youtube) has been around for a decade or more. Oxford has put on the internet a small stand alone algorithm/program that calculates :
    HOMA2 %B β-cell function
    HOMA2 %S
    HOMA2 IR insulin resistance
    from FBG glucose and fastinf insulin blood level
    https://www.dtu.ox.ac.uk/homacalculator/download.php
    HOMA-IR is closely associated with CHD
    Unfortunately the NHS does not in its wisdom do an insulin test – prefers, like the TV advert to guess.

    Reply
  46. Martin Back

    “I recommended that, from a cardiovascular health point of view, those who do not drink alcohol should start.”

    Would you be more specific on the clinical guidelines? At the moment this is a blanket prescription on the lines of Prof. Collins’s “statins for all”.

    From what age would you recommend starting drinking? Would you wait for indications of incipient heart problems, or should non-drinkers start taking alcohol prophylactically in the absence of symptoms?

    Reply
  47. Prudent Libertine

    When we talk about “drinking alcohol” (beer, wine, whiskey, whisky) we talk about ethanol. I wish someday we all can recognize publicly that the functional group of ethanol (the very famous hydroxyl group, a.k.a hydroxide anion) is ESSENTIAL for all life forms. How blind can we get? Of course ethanol is good for you (in the right amount).
    You damned puritans!
    In Europe, a lot of old folks are prescribed “deanol pidolate” in combination with “heptaminol” by reasonable doctors (very few). Deanol is a di-methyl-amino-ETHANOL. Do you get it? The ampules contain also ethanol, sugar and many other preservatives. (By the way, how come doctors are reluctant to recommend Betaine HCl to treat acid reflux or gut disbacteriosis but have no qualms recommending the many other hydrochlorides compounds they routinely prescribe?). This medication is a strong nootropic. Some people say “this is just an ampule of vitamins”. Well, that is one egregious example of a white lie. Even without the ethanol (that is not listed among the active components of the medication) this “drug” works wonders for people who are heavily depressed and experienced anguish because their body aches all over (because they are sick and old). This drug have hydroxyl groups.

    Sensible Doctors use this as a substitute for antidepressants and anxiolytics (same thing) when heart problems and respiratory problems are present and it is a bad idea to start benzodiazepines or suchlike with those (physiologically real) symptoms.
    Why people of all ages are not taking already harmless nootropics instead of antidepressants? Because stupid Puritans are evil, and they work for the very dark forces of the Psychiatric Cabal.
    Please, people: relax. Take some alcohol, read the classics, and invite a Puritan to your table. Make him/her eat a very buttery rib eye steak with cheese sauce, and a pint of beer. That should do away with all the bitternes of life (for a while at least).
    Also, sex (solitary or in company) is **necessary** for good health. I only recommend having sex with a puritan to masochists. A couple made in heaven!
    Also, salt is good to keep your puritans away. Lots of salt. As a rule of thumb, for every mile you walk, add one gram of unrefined salt to your barely cooked red meat.
    No soy should touch the lips of a true Christian (or a true Christianic Atheist)!
    It is a good thing to celebrate life. Eating is good.
    Enjoy!
    Cheers

    Reply
    1. JanB

      Yay! Let’s hear it for Prudent Libertine.
      P.s. I love the oxymoronic name.
      Cheers all. The sun is shining.

      Reply
    2. AH Notepad

      Why people of all ages are not taking already harmless nootropics instead of antidepressants? Because stupid Puritans are evil, and they work for the very dark forces of the Psychiatric Cabal.

      and People please relax

      I like the oxymoron.

      Reply
    3. Martin Back

      “Nootropics — also called smart drugs or cognitive enhancers — are drugs, supplements, or other substances that improve cognitive function, particularly executive functions, memory, creativity, or motivation, in healthy individuals.” — https://en.wikipedia.org/wiki/Nootropic

      I don’t see how a nootropic can help with depression. A cousin told me if she was as smart as I was, she’d be so happy. To which I replied that the smarter you are, the more reasons you can find to be depressed.

      Alcohol is a depressant. The first thing it depresses is the brain’s censor. That’s why it acts as a social lubricant. We relax and behave more freely because we no longer worry so much what other people are thinking of us.

      Ideas flow more freely because we no longer judge our incipient ideas and crush them in their infancy. That’s why many creative people use alcohol. But I wouldn’t call this “improved cognitive function”.

      In any case it takes very little alcohol before people start talking rubbish and behaving like clowns, but believing they are being terribly smart. Just be the only sober person at a party and you’ll see.

      Reply
    4. Dr. Göran Sjöberg

      Yeah!

      Thats the way for a LCHF-adherent and medical sceptic!

      Today there will be grilled rein deer calf liver with a glass of red wine after a new days shuffle fight with the surrounding snow in Northern Lappland. Beginning next week we will make a snow scoter trip to a hunting cabin where we are to enjoy a special Lappish dish – just a large bowl of cooked rein deer meat where the marrow bones are the real treat. Although the broth is what you usually drink with the meal we will for sure bring some wine along.

      As the Greek historian Herodotos pointed out the Ethiopians could live to the age of 140 on just cooked meat while the Persians could reach 80 years on their bread diet and according to the Ethiopians also only because they also drank wine. Well the Bible tells us that the farmers life is full of hard labour with few pleasures.

      Reply
    5. Sylvia

      Dear Prudent, have had a look at nootropics, I am a little alarmed that a person needs any help to be sociable and happy and focused, but know that disparate families now are adrift in this fast and furious world. My family have had their share of emotional despair/ breakdowns, how lucky to sail through life supported and loved. But, being fragile beings, we need help sometimes that a mothers love and home made soup can’t reach. Dont know about these substances and long term use, my approach has been, flower essences and homoeopathy and orthodox treatments, . My, at one time, aggressive rottie was helped enormously with drops from nature. Love your prose. Dr Kendrick, apologies for straying again.

      Reply
    6. David Bailey

      I know this is being a bit picky, but although ethanol contains a a hydroxyl group, it most definitely does not contain any “hydroxide anions”, because it does not ionise, unlike (say) sodium hydroxide, which is very caustic.

      Reply
  48. Mark

    “Do you think breast cancer screening has ever had a single randomised controlled study?”

    Well, yes, I’m quite surprised you weren’t aware that there have been many. There’s a review of some here, and this only goes up to 2005:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1242166/

    And here’s a more recent publication with long-term follow up for a very large trial:
    http://www.bmj.com/content/348/bmj.g366.full

    The point is that we should randomise where it’s feasible to do so and make do with less robust evidence when it’s not feasible. The fact that some treatments, which have been around for decades, have either not been subject to a randomised trial, or have randomised trials which are too small to provide reliable evidence, does not mean that all such treatments are safe and effective. A classic example to illustrate this is the CRASH trial of corticosteroids for head injuries (link below) – prior to this trial corticosteroids had been used for more than 30 years. It turned out they were causing deaths. This shows how important randomised trial results can be in changing established practice, provided they are large enough (and free from bias).

    https://ccforum.biomedcentral.com/articles/10.1186/cc3813

    Reply
  49. JDPatten

    A smart cardiologist writing about recent achievements, but mostly the shortcomings of medical science. It’s brief, but he does nail some reasons and possible fixes. Getting himself in trouble with the establishment? You’d think, but he does have a nice little following.
    (You probably need a medscape password. But you should have one!)
    http://www.medscape.com/viewarticle/878660

    Reply
    1. mikecawdery

      JD Patten
      Thanks for the link. Drs are beginning to query the medical establishment and Big Pharma.
      The following may interest you:
      http://ahrp.org/

      FDA conceals serious research misconduct–fraud, deception, even deaths
      April 17, 2017

      FDA documents obtained under the Freedom of Information Act, revealed that the FDA has been concealing from the medical community and the public serious research misconduct; including fraud, deception, avoidable risks for human subjects — even deaths — that occurred in clinical trials. One just wonders whether the EMA/MHRA are using similar practices. In that most drugs are commonly used on both continents, it would seem to be a possibiility

      Reply
  50. Errett

    © 2017 American Society for Nutrition
    Intake of up to 3 Eggs per Day Is Associated with Changes in HDL Function and Increased Plasma Antioxidants in Healthy, Young Adults1,2,3
    Diana M DiMarco, Gregory H Norris, Courtney L Millar, Christopher N Blesso, and Maria Luz Fernandez*
    + Author Affiliations

    Department of Nutritional Sciences, University of Connecticut, Storrs, CT
    ↵*To whom correspondence should be addressed. E-mail: maria-luz.fernandez@uconn.edu.
    Abstract

    Background: HDL function may be more important than HDL concentration in determining risk for cardiovascular disease. In addition, HDL is a carrier of carotenoids and antioxidant enzymes, which protect HDL and LDL particles against oxidation.

    Objective: The goal of this study was to determine the impact of consuming 0–3 eggs/d on LDL and HDL particle size, HDL function, and plasma antioxidants in a young, healthy population.

    Methods: Thirty-eight healthy men and women [age 18–30 y, body mass index (in kg/m2) 18.5–29.9] participated in this 14-wk crossover intervention. Subjects underwent a 2-wk washout (0 eggs/d) followed by sequentially increasing intake of 1, 2, and 3 eggs/d for 4 wk each. After each period, fasting blood was collected for analysis of lipoprotein subfractions, plasma apolipoprotein (apo) concentration, lutein and zeaxanthin concentration, and activities of lecithin-cholesterol acyltransferase, cholesteryl ester transfer protein, and paraoxonase-1.

    Results: Compared with intake of 0 eggs/d, consuming 1–3 eggs/d resulted in increased large-LDL (21–37%) and large-HDL (6–13%) particle concentrations, plasma apoAI (9–15%), and lecithin-cholesterol acyltransferase activity (5–15%) (P < 0.05 for all biomarkers). Intake of 2–3 eggs/d also promoted an 11% increase in apoAII (P < 0.05) and a 20–31% increase in plasma lutein and zeaxanthin (P < 0.05), whereas intake of 3 eggs/d resulted in a 9–16% increase in serum paraoxonase-1 activity compared with intake of 1–2 eggs/d (P < 0.05). Egg intake did not affect cholesteryl ester transfer protein activity.

    Conclusions: Intake of 1 egg/d was sufficient to increase HDL function and large-LDL particle concentration; however, intake of 2–3 eggs/d supported greater improvements in HDL function as well as increased plasma carotenoids. Overall, intake of ≤3 eggs/d favored a less atherogenic LDL particle profile, improved HDL function, and increased plasma antioxidants in young, healthy adults. This trial was registered at clinicaltrials.gov as NCT02531958.

    Reply
    1. mikecawdery

      Erret

      Thanks you for the link.

      Once again another study refutes the bad press that eggs received. No wonder a hospital consultant recently complained in a discussion with me that the quality of current medical research was going down hill.

      Reply
  51. Doug

    Hello Dr. Kendrick and community.
    RE: similarity between alcohol and honey metabolism overnight to reduce the release of adrenaline and cortisol thus reducing stress and CVD as seen by the alcohol studies referenced by Dr. Kendrick
    I was wondering if the community had any input on the following metabolic process.
    If we take the alcohol studies as accurate could there be another process at work here reducing stress, (which we all now believe is a major player in CVD) that metabolizing alcohol takes part in?
    Since on average we consume our alcohol usually after dinner and into the later parts of the evening could the metabolizing of the ethanol store some of the carbohydrates consumed as part of the alcoholic drink in the liver for brain energy during our overnight fasting period thus eliminating the release of adrenaline and cortisol by the brain overnight, thus reducing CV damage?
    Has anyone looked into taking a tablespoon of honey before bed? I’ve just started and I have to say I’ve had some pretty good night’s sleeps doing so.
    More importantly, I think the alcohol and honey metabolic pathways are very similar and both end up eliminating an overnight release of adrenaline and cortisol which the brain triggers to feed itself.
    Alcohol is metabolized, in part, by the liver using the same pathways used to metabolize fructose. Fructose regulates glucose uptake into the liver by prompting release of glucokinase from the hepatocyte nuclei. Thus, fructose ensures good liver glycogen supply overnight. An adequate liver glycogen supply means that stress hormones need not be released. Recovery takes place, and the body is calm and happy.
    The book The Honey Prescription proposes that there is a honey/insulin/melatonin cycle that promotes a restful sleep by, among other things, providing enough liver storage of glucose to prevent the brain form releasing adrenaline and cortisol.
    My question is could the metabolizing of alcohol mimic this process and as an end result fill up the liver storage of glucose and thus prevent the brain from releasing adrenaline and cortisol and causing stress?
    Regards,
    Doug (ps, To my LCHF brothers, sisters please don’t flame me)
    The Honey/Insulin/Melatonin cycle from the book:
    1. The glucose portion of the honey passes from the gut, through the liver and into the general circulation producing a mild glucose spike.
    2. The mild elevation in blood sugar (from glucose) prompts a controlled release of insulin from the pancreas.
    3. The presence of insulin in the general circulation drives tryptophan into the brain.
    4. Tryptophan is converted to serotonin, a key hormone that promotes relaxation.
    5. In darkness, serotonin is converted to melatonin in the pineal gland.
    6. Melatonin activates sleep by reducing body temperature and other mechanisms. It also inhibits the release of more insulin from the pancreas, thus preventing a rapid drop in blood sugar level.
    7. Melatonin promotes the release of growth hormone. Growth hormone is the hormone governing all of recovery physiology. This is the key first step in the recovery or restorative physiology that occurs overnight (with proper fuel).
    8. A cascade of recovery hormones initiates the repair, maintenance and rebuilding of bone, muscle and other body tissues.
    9. At the same time, the fructose portion of the honey carries out its critical role. The liver takes up fructose where some is converted to glucose and then liver glycogen, thus providing the brain with a sustained supply of glucose for the night fast.
    10. Additionally, fructose regulates glucose uptake into the liver by prompting release of glucokinase from the hepatocyte nuclei. Thus, fructose ensures good liver glycogen supply overnight and prevents a major glucose/insulin spike as referred to in step 1.
    11. An adequate liver glycogen supply means that stress hormones need not be released. Recovery takes place, and the body is calm and happy!

    Reply
  52. Doug

    Further to my comment and to give props where they are deserved,

    I think the first reference to the consumption of honey comes from the book: The hibernation diet

    This diet was developed by an Edinburgh pharmacist and sports nutritionist Mike McInnes, Stuart McInnes, Maggie Stanfield

    Doug

    Reply
    1. TS

      Interesting!

      The honey in our cupboard has come direct from beekeepers both home and abroad except for a jar from the supermarket – good honey with a “Great Taste award” but with this on the jar:
      ‘Best before 13/07/21’

      Compare this with a couple of sentences from National Geographic:
      While excavating Egypt’s famous pyramids, archaeologists have found pots of honey in an ancient tomb. The honey, dating back approximately 3,000 years, is the world’s oldest sample – and still perfectly edible.23 Nov 2015
      Honey In The Pyramids – National Geographic
      http://www.nationalgeographic.com.au/history/honey-in-the-pyramids.aspx

      Oh well, at least it doesn’t tell you to keep it in the fridge!

      Reply
      1. Doug

        Ya, if they have to tell you it tastes great that’s usually the first warning it doesn’t .

        I would go with local, not heat extracted for best taste. Support local bees.

        Also, the best buy date is just the date the manufacturer can guarantee the same freshness as the day it left the factory, and even then, in some cases i think it is more of an arbitrary way to get you the throw out good food.

      2. Frederica Huxley

        Bought a bag of Himalayan salt – touted to be millions of years old – to find a use by date in 2019,

      3. Gary Ogden

        Frederica Huxley: I bought some, too, since the health food store was out of the celtic. Mine says “BEST BY 12 2025.” Silliness, no? ‘Twill be long gone by then. I actually like it better because those fat crystals will grind in my salt grinder, whereas the celtic clogs it up. By the way, I will be eternally grateful to you for the information about fermentation. My kraut came out beautifully. Seven jars (to go with fifteen of kimchee, which I prefer), one given to a neighbor. Ten to fourteen days, and it was ready; interesting that the different jars fermented at different rates. But what I learned from you is that you have to actively monitor the ferments daily until finished. And you’re right about kimchee-two days max!

    2. Doug

      As an aside Dr. Kendrick,

      The new book based on your countryman’s work titled “The new honey revolution” has 22 pages of references, not bad for a book of less than 200 pages; many are as you would expect, rat studies etc….. but still an impressive count for a food that will never be under patent.

      After reading it and practicing honey consumption I would go as far as suggesting that you may one day add consumption of honey at bedtime to your list of CVD protective measures.

      Please give it a quick read through, after everything you have discovered would it surprise you to find out honey does help?

      Regards,
      Doug

      Reply
  53. Andy S

    Just discovered why ETHANOL is beneficial for CVD and much more. The reason is METHANOL. Ethanol’s benefit is derived from assisting in elimination of toxic byproducts of methanol metabolism.
    Gut bacteria produce methanol. Canned fruits, vegetables, juices and fresh tomatoes contain methanol. Aspartame is a big source on methanol.

    Ethanol contained in 1/2 to 1 alcoholic drink is perhaps adequate if exogenous sources of methane are avoided. Possibly dose should be spread over 24h for best results. Humans apparently have a very low tolerance for methanol.

    I will now start to implement ethanol therapy @ 1/2 dose per day strictly for medicinal reasons only.

    Reply
    1. gollum

      Your experimental therapy, sir, has already succeeded in improving function of my humour glands.

      However shall I advise a word of caution, alcoholic beverages actually contain methanol themselves.

      There have been hints that much of the “alcohol” toxicity is in fact, methanol and higher alcohols toxicity. In other branches of medicine, these hints would be called evidence, but well, people like alcohol so we cannot say a good thing about it.

      Methanol is byproduct of fermentation, from the roughage (cellulose, pektin) in fruits, thus present everywhere, but especially in fruity wines and spirits. Spirits that are distilled to tastelessness (vodka) or that started with primasprit anyway have less of it.

      Reply
      1. Andy S

        Hi gollum, yes vodka is the medicine that I am using as an antidote to methanol.
        PECTIN + gut bacteria = methanol > converted to FORMALDEHYDE
        Formaldehyde does nasty things to ocular and brain cells.
        Alcohol helps to excrete methanol, I am using 1T in coffee 2x per day. Hopefully this will take care of endogenous methanol production.
        Aspartame also converts to methanol, never touch the stuff.

        Could not understand why alcohol consumption showed benefits when compared to abstainers until I stumbled upon the methanol connection. Study was only for CVD but many other systems are probably involved. Homemade blackcurrant jam and apple sauce are my favourites and are high in pectin. Tomatoes, cherries, oranges and other fruits also produce endogenous ethanol.
        Anybody for 5 servings of fruits and vegetables?

      2. Mr Chris

        Andy S
        Other good sources of pectin, apple peel home made marmalade, make sure the peel goes in.

      3. Martin Back

        Andy,
        You got me really worried about methanol poisoning, since I have joined the ranks of the non-drinkers. But on reflection, and after doing some research, I don’t think it’s a cause for concern.

        A) Vegetables might convert to methanol in the gut, but I’ve never observed rabbits reeling about drunkenly in the cabbage patch, so presumably the effect is small.

        B) Methylated spirits is 95% ethanol, so one might expect the poison to contain the antidote, but I know someone who went temporarily blind from drinking the stuff, and others who complain of the monumental hangover it gives you, so maybe ethanol is not as effective as it’s cracked up to be.

        C) Ethanol doesn’t flush methanol from the system, it merely blocks methanol metabolism. If you have enough ethanol in your system the methanol won’t convert to formaldehyde but will slowly be excreted via the breath and urine. Problem is, the ethanol dosage required is relatively high at 1000 – 1500 mg/L. At 1000 mg/L (i.e. 0.01 blood alcohol concentration) you are already showing “Slurred speech, poor coordination, slowed thinking” per WebMD. A teaspoon of vodka in the coffee will not do the trick.

        D) The UK Committee on Toxicity concluded “we conclude that exposure to methanol at the levels found in the diet, both naturally occurring and from currently permitted levels of aspartame, would not be expected to result in adverse effects.”https://cot.food.gov.uk/sites/default/files/cot/cotstatementmethanol201102revjuly.pdf page 15.

      4. Andy S

        Hi Martin Back, perhaps rabbits can tolerate higher levels of methanol than humans.
        From the alcohol consumption studies and cvd there seems to be disadvantage to zero consumption. One drink per day affords protection by several possible mechanisms. These mechanisms can also be activated by non- alcohol means. The methanol connection seems plausible.

        Doing some googling on optic nerve damage. My right eye has visual field defects. Eye doctor believes problem is due to IOP (currently 22). My approach is to use prescribed eye drops and supplement with folic acid, B12, E, etc. plus 2T vodka per day for the methanol.
        Another possibility is medical marijuana. Not a smoker, could oral consumption work?

  54. Mark Johnson

    So maybe the previously oldest person alive (she sadly died four days ago on April 16, 2017) was right!

    The world’s oldest woman has cracked the secret to her longevity: eggs.

    Emma Morano, who will turn 117 on November 27, gobbles up at least two eggs a day, and has done so for 90 years — for an egg-streme lifetime total she says is over 100,000.

    Born in 1899, Morano, of Verbania, Italy began eating eggs religiously when she was 20 years old, after a doctor diagnosed her with anemia and told her to consume two raw eggs and a cooked one each day.

    Nowadays the hard-boiled Italian eats two eggs a day.

    “And that’s it,” she told Agence-France Press. “And cookies. But I do not eat much because I have no teeth.”

    Her doctor, Carlo Bava, confirmed that his patient didn’t follow conventional nutritional advice.

    “Emma has always eaten very few vegetables, very little fruit. When I met her, she ate three eggs per day, two raw in the morning and then an omelette at noon, and chicken at dinner,” said.

    https://www.mangalorean.com/worlds-oldest-woman-dies-aged-117-2/

    Reply
  55. Sean

    I’m an OAP. I smoked, both tobacco and cannabis. I enjoyed both, but drank only rarely back then, mostly because for me alcohol sucked by comparison to weed. I now drink. Somewhat to excess.

    “My job is to keep people alive for long enough for them to die of cancer.”

    Well, fuck dying of cancer. I’ll be quite happy(-ish) to drop dead like my grandfather and father of CVD rather than live longer and spend a few months to years of chemo, radiation therapy and depression, especially if it’s of the remission, re-occurrence, rinse and repeat variety. What do so many doctors do when they are diagnosed with a likely terminal cancer, like pancreatic or esophageal? Go on chemo or say “bugger it” and go on holiday, knowing they have the keys to the morphine cabinet (as do I).

    Life expectancy is not the whole ball game. The ball game is, by which I mean the whole of life fun factor (and just to be clear, I hate sports and sports analogies).

    Cheers dears.

    Reply
    1. Andy S

      Hi Randall, need a follow-up study DIET COKE vs DIET COKE WITH RUM
      need to test hypothesis that ethanol mitigates damage from aspartame and other endogenous sources of methanol
      aspartame= methanol > bad results

      Reply
  56. Errett

    Format: AbstractSend to

    Alcohol. 2016 Dec;57:29-34. doi: 10.1016/j.alcohol.2016.10.006. Epub 2016 Oct 11.
    Moderate alcohol consumption after a mental stressor attenuates the endocrine stress response.

    Schrieks IC1, Joosten MM2, Klöpping-Ketelaars WA3, Witkamp RF4, Hendriks HF5.
    Author information

    Abstract
    Alcohol is often consumed to reduce tension and improve mood when exposed to stressful situations. Previous studies showed that moderate alcohol consumption may reduce stress when alcohol is consumed prior to a stressor, but data on the effect of alcohol consumption after a mental stressor is limited. Therefore, our objective was to study whether moderate alcohol consumption immediately after a mental stressor attenuates the stress response. Twenty-four healthy men (age 21-40 y, BMI 18-27 kg/m2) participated in a placebo-controlled trial. They randomly consumed 2 cans (660 mL, ∼26 g alcohol) of beer or alcohol-free beer immediately after a mental stressor (Stroop task and Trier Social Stress Test). Physiological and immunological stress response was measured by monitoring heart rate and repeated measures of the hypothalamic-pituitary-adrenal axis (HPA-axis), white blood cells and a set of cytokines. After a mental stressor, cortisol and adrenocorticotropic hormone (ACTH) concentrations were 100% and 176% more reduced at 60 min (P = 0.012 and P = 0.001, respectively) and 92% and 60% more reduced at 90 min (P < 0.001 and P = 0.056, respectively) after beer consumption as compared to alcohol-free beer consumption. Heart rate and dehydroepiandrosterone (DHEA) were not influenced by alcohol consumption. Plasma IL-8 concentrations remained lower during the stress recovery period after beer consumption than after alcohol-free beer consumption (P < 0.001). In conclusion, consumption of a moderate dose of alcohol after a mental stressor may facilitate recovery of the endocrine stress response as reflected by decreasing plasma ACTH and cortisol.

    Copyright © 2016 Elsevier Inc. All rights reserved.
    KEYWORDS:
    Alcohol; Cortisol; Immune system; Psychological stress; Trier Social Stress Test
    PMID: 27916140 DOI: 10.1016/j.alcohol.2016.10.006

    Reply
  57. Charles Gale

    Hi Doug

    As someone who has trouble sleeping, I read with interest your comments about honey/CVD/sleep.

    For example, I’ve been gulping down mugs of Valerian tea for months with no real impact, and not very tasty either.

    Interesting science to back it up too.

    Googling “The Honey Prescription”, there were references to medicinal honey. I’m not sure if this is special honey or just a reference to honey being used for medicinal purposes – could you let me know what honey you are taking?

    Thanks.

    Reply
    1. Doug

      Hi Charles,

      I found the metabolic similarities between the alcohol and fructose pathways too tempting to not post here. I have a high regard for the good doctor and the community he has spawned.

      I’ve only been doing this for a little over a week but the results have been promising. Great night’s sleep and very even days. I even took to taking a little spoonful in the morning for energy. My wife who ALWAYS woke up at 4 now sleeps till 6 – 7 and isn’t dog tired at 3 pm.

      I never read the book, my understanding is it promoted grain consumption which I am against. The science seems sound although I think each person would need to self-experiment with dose.

      I found a local producer that extracts honey using a non-heated method, not cold extraction just room temp extraction. It does impact taste beneficially.

      I would recommend looking locally and good luck.

      Doug

      Reply
    1. Antony Sanderson

      This news made my weekend. In fact I was so high on Saturday that I couldn’t settle to anything. Since I heard the news I have now been going through his testament. It is amazing – a brilliant synopsis of where we are (or should be) with respect to the effect of diet on our health. It is a history lesson, science philosophy lesson, dietetics lesson, physiology lesson. It shines a clear light on the corruption of proper science . . whether through influence of vested interests of industry/establishment or through vested interested of the powerful science leaders afraid to have their long held ideas questions. (I always get the image of the latter, when confronted with fresh perspectives, with their fingers in their ears, eyes tight shut and loudly shouting “Nya, nya, nya” – hoping it will all go away.)

      Nina Teicholz (Big fat surprise) was devastating as was Zoë Harcombe (Dietary fat, cholesterol and Heart disease) – haven’t got to Caryn Zinn’s bit yet.

      In a perverse, ironic way I am grudgingly grateful to my statin experience because, having given me diabetes, I felt compelled to do research. I now realize that before the statins and the diabetes I was not in the best healthiest place, even though I was already losing weight and eating better. My research including measurement of my triglycerides, told me I had to do better if I was to stave of that heart attack.

      Similarly, in a perverse, ironic way the Johannesburg dietitian Claire Julsing Strydom who lodged a complaint against Noakes has done the the world of health a great service in giving Tim Noakes a world platform where he can expound his ideas (and other likeminded peoples’ ideas). After hearing the devastating testimony it will be difficult for the institutions to ignore the evidence so clearly presented. . . . `Or will it? . . . Do I hear distant sounds of “Nya, nya, nya”?

      I have been following the play list below . . .

      Reply
      1. Stephen T

        I’ve watched Nina Teicholz’s evidence and it’s an excellent summary of how we got into the current dietary mess. Caryn Zinn’s evidence follows next, and Zoe Harcombe must be on there.

    2. David Bailey

      This is really excellent news! I keep waiting for the moment when the mountain of misinformation that we get about this and a number of related issues comes crashing down.

      I really hope the press scent blood here and go into attack mode.

      Reply
      1. AH Notepad

        The press are wedded to big pharma. They only start attacking when their paymasters are threatened. A doctor telling the world the facts is more likely to be the subject of an attack.

      2. mmec7

        Correct. Over 60 holistic doctors were removed (!) between Father’s Day 2015 and end 2016. Appalling. Several were directly involved in alternative, and very successful, treatments of cancer. One is appalled.

      3. chris c

        What press?

        This trial has obviously been all over Twitter and the Blogosphere but have you seen word one about it on the BBC? Or most other mainstream media?

        Claire Julsing Strydom and the HPCSA have already announced they are not going to change a thing. She is going to remain fat and they are going to remain stupid, and malicious, while collecting their sponsorships.

  58. Gary Fine

    I was hoping that someone might be able to help provide some additional information about the “sun” study Dr. K referenced in this article.

    The study that Dr. K mentioned was done by a researcher named PG Lindqvist. The published article was called “Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort.” Here is a link https://www.ncbi.nlm.nih.gov/pubmed/26992108

    As Dr. K stated, the report by Lindqvist concluded that: “avoidance of sun exposure is a risk factor for death of a similar magnitude as smoking.”

    Obviously, that claim caught the attention of many people. One initial response to Lindqvist’s report was from the President of the American Dermatology Association http://onlinelibrary.wiley.com/doi/1…12538/abstract.

    A more recent response can be found here https://www.ncbi.nlm.nih.gov/labs/articles/28334454/

    I was just wondering whether anyone on Dr. K’s website had read any of the studies at the links above such that they could offer insight as to the counterarguments being made to Lindqvist’s conclusion? Everything seems to be behind a subscription wall.

    Alternatively, perhaps someone could provide some insight as to the responses at the link below from the original researcher (Lindqvist) who is responding to comments from the president of the American Dermatology Association.

    https://www.researchgate.net/publica…result_of_bias

    Thanks in advance for any help you can provide.

    Best,
    GF

    Reply
  59. Christopher Palmer

    Many are the times that I am happy I am not teetotal, and many are the times that I wish I was.

    Many are the times I regret working nights and many are the times I am pleased that I do. However I do concede that night-working is bad for my cortisol and what’s bad to my cortisol can be bad for me.
    I never regret not being a vegan.
    I never regret that the bed I sleep in is one that I have fitted with an Earthing sheet. Studies have established that the habit of Earthing helps normalise the secretion of cortisol, a hormone, and helps normalise its circadian aspects.
    I never regret that the room I sleep in is dark one whose darkness owes something to the combination of vertical blinds, black-out roller-blind, and curtains lined with black-out lining. This means that it is adequately dark by night (shutting out the street-lighting) and just about the most favourable compromise (short of bricking up the window) I can achieve for when I must sleep in hours of daylight.

    That hypercortisolemia is amongst the several states which can contribute to oxidative stress seems reasonably plausible to me but I regret that as yet I do not know enough to understand the mechanism at work, if there is one.
    Oxidative stress can bring on risks of becoming ill in any one of several ways and increasingly it seems the mechanism at work involves corruption of aspects of gene-switching which then in turn seems to result that cells don’t go about business precisely as they should. That the habit of ‘earthing’ could counter ‘oxidative stress’ used to incite scepticism in me. After five years at least of critical thinking and reasoning it no longer does.

    Whatever is the genetic inheritance of being human and howsoever we came by it I am pretty certain that genetic inheritance is not something that tolerates the ubiquity of artificial light that well nor the general ubiquity of man’s modern isolation from ground.

    Demand for beer (small beer) used to be driven by the pitiful state of the water which, as supplied to early growing and industrialising cities, was not safe to drink. Cognition came in revelations proposed by John Snow in relation to an outbreak of cholera in persons who drew their water, in 1854, from the Broad Street pump in London’s Soho. I mention this because 1854 seems such a long time ago when it isn’t really.

    Might it be the case that times have changed a lot, much of that change is for the better, especially where the supply of water fit for drinking is concerned. But might it be that times and circumstances have changed so much in so short a space of time and yet we, in the present, readily overlook just how much times and circumstances have changed?

    Might it be that not all the changes suit our genetic inheritance?

    There is of course the matter of changes to the modern diet: Aspects of a poorly chosen modern diet can bring on complications. How unfortunate it is that a false hypothesis surrounding lipids and CVD, further compounded by unhelpful implications originating with the calories balance principle, could lead to people modifying dietary habits in ways that have proved unhelpful. I feel so much better eating more fat but consuming far less margarine and vegetable oil.

    The cells that maketh me have membranes in which fats are important components. I am an animal. Darwin proposed that and modern genetics affirms it. The preferred fats for my cell membranes are those we label ‘animal fats’. That’s one facet of my genetic inheritance. Now I see clearly, ‘animal fats’ being toxic to animals is the most preposterous thing I have ever heard.

    But could it also be the case that our genetic inheritance is feeling adverse effects from changes (and associated consequences) that are not associated with diet alone and that have escaped general attention? It suits me to work nights but does working nights suit my genetic inheritance and physiology? It does not.

    It’s funny how times change, how soon we forget the nature of change, and funny how ideas struggle to adapt to the possible consequences of change. Ideas that oughtn’t gain traction do while others that may deserve more traction gain too little.

    At least some persons are waking up to wonder that bright lights on wards at night may impair patients recoveries. perhaps when they write up their results they’ll explain the detrimental effects of hypercortisolemia and cortisol arrhythmia better.

    Oxidative stress is unavoidable for any species that breath in air and metabolise food. It’s effects can be limited and/or mitigated to a certain extent. The more a person can do to limit it or counter it the longer they may live, and the longer they may enjoy life free from complications of chronic disease.

    Company, convivial surroundings, relaxing in the company of friends, family, sharing a glass of wine, partaking of a wee dram, may be the relaxation, escape, and release from more stressful aspects of modern living that we need. When we ‘unwind’, feel more at home, and more at ease, so too do aspects of our endocrine system and physiology also revert to the state of being ‘more at ease’. That a relaxation of key hormones and physiological factors might diminish the amount of oxidative stress being generated makes perfect sense to me. Perhaps it isn’t the alcohol alone that works the magic but the entire package. I’ll drink to that.

    Whisky for the heart, and whiskey for the soul.
    Whisky stands for friendship, and stories to be told.
    And all around the world whenever whisky’s proured,
    oh, the hatred of the past can end at last and peace can be restored.

    From the lowlands to the Highlands . . .
    From Orkney to Kentucky . . .
    . . .
    There’s a world of whiskey out there so let’s have another dram.

    [Robin Laing]
    [https://www.youtube.com/watch?v=Ms3xIE9l67E]

    Reply
  60. mmec7

    We are not meant to be meat eaters –

    They say it is bad for RA, AS & OA – is an inflammatory food, and now we know why; plus, red meat has recently been ticked as a possible cause of cancer – again, the inflammatory factors. Ho-Hum –
    Wonder how eating red meat might impact on other autoimmune diseases : MS; diabetes; thyroiditis; scleroderma; Graves Disease; Celiac disease; SLE; etc etc In addition, heart disease. As Dr Malcolm Kendrick opines : inflammation causes heart disease, nowt to do with cholesterol. (Cholesterol is pharma’s big red herring.)

    http://thehealtheducation.com/scientist-finally-discover-eating-red-meat-causes-cancer/

    Scientist Finally Discover Why Eating Red Meat Causes Cancer – A new study out of the University of California, San Diego has discovered the culprit behind why eating red meat leads to higher instances of cancer – and it all has to do with a sugar.
    Humans are the only animals that have a higher risk of cancer when it comes to eating red meat, as other carnivores eat red meat naturally with no ill side effects. The study, which was published December 29 in the “Proceedings of the National Academy of Sciences,” discovered that a unique sugar named Neu5Gc, found in most mammals but not in humans, triggers an immune response that in turn causes inflammation.
    Ajit Varki, who led the study, explained the effect Neu5Gc had in mice: “Until now, all of our evidence linking Neu5Gc to cancer was circumstantial or indirectly predicted from somewhat artificial experimental setups … This is the first time we have directly shown that mimicking the exact situation in humans – feeding non-human Neu5Gc and inducing anti-Neu5Gc antibodies -increases spontaneous cancers in mice.”
    This particular sugar can be found in red meats (using the nutritional definition of red meat, which includes pork and other livestock), cow’s milk and certain cheeses. Unfortunately for humans, our bodies can’t produce this sugar naturally, so when it is absorbed into our tissues, it is seen as a foreign invader. This then leads to the activation of our immune systems.

    The result is inflammation.

    And, while inflammation is not a great thing, in and of itself, it gets worse. If the immune system is subject to Neu5GC frequently, chronic inflammation will result. This inflammation can then lead to cancer. Those who regularly consume red meat will definitely suffer a stronger reaction than those who ingest red meat on an occasional basis.
    Other animals, strict carnivores, who can make the Neu5GC sugar can eat red meats. Humans, not being strict carnivores, can’t. Therefore it seems clear that humans must avoid red meat consumption or face inflammation and possible cancer. At the minimum, reducing red meat ingestion will boost health.

    If for some reason you believe eating red meat every day (even if it is grass-fed) isn’t a bad thing, well now you have proof. Sorry, meat eaters, humans just aren’t built to be true carnivores.”

    Reply
    1. JDPatten

      mmec7,
      Dr Kendrick has said no such thing about inflammation. I believe you’ll find – if you look – that he indicates that inflammation is a necessary aspect of the healing process that addresses the injury, infection, or insult of some sort that is the actual root of the problem. It is a symptom of healing from illness, not the illness itself. The problem is in finding and addressing the root.

      Reply
    2. Gary Fine

      1. The study involved modified laboratory animals. It’s a big jump to suggest this is conclusive as to humans.
      2. The research looked at liver carcinomas, but most supposed associations with red meat consumption concern colon cancer.
      3. The study does not have baseline human intake levels nor does it discuss meat preparation. Therefore, relevance of the study to normal intake levels is not established.
      4. Two authors of the study are co-founders and advisors to SiaMab Therapeutics, Inc., which holds a license with UC San Diego technologies related to anti-Neu5Gc antibodies in cancer.

      There are many additional questions and concerns about that study, but if you choose not to eat meat based on a study that produced a one-time measurement of inflammation and was done by conflicted researchers giving large does of a foreign substance to a limited number of genetically prepared mice, then feel free to do so.

      Reply
      1. mmec7

        Gary, well, thank you for your response. For myself, I choose not to eat beef. Very little of lamb – mebbe one or twice a year. When I do eat meat, I prefer wildfowl.
        Should you be interested, you can check on inflammatory foods (red meat is an inflammatory food). Also check out anti-inflammatory foods. As a ‘spondy – ankylosing spondylitis, with a myriad of comorbidities – I sure do prefer to follow an anti-inflammatory diet. Like many a spondy, I take no biologics nor other meds. Diet and a few supplements. Works for us. But thank you for your input – interesting. Will pass it on.

      2. mmec7

        There are many additional questions and concerns about that study, but if you choose not to eat meat based on a study that produced a one-time measurement of inflammation and was done by conflicted researchers giving large does of a foreign substance to a limited number of genetically prepared mice, then feel free to do so.”

        I have followed my ‘spondy’ diet for some 14 years – little red meat and low or no starch diet. This article only passed my desk earlier today. So, no, it has no influence on my diet ! Nor does it influence those who have been following – what for brevity, I choose to refer to as the ‘spondy’ diet – for some 25 and more years.
        You might find Prof Alan Ebringer’s findings of interest.
        With respect –

    3. Martin Back

      Is there any food you can eat that doesn’t have some sort of health risk? Red meat has vit B, iron, saturated fat, protein, etc etc, but also this Neu5GC.
      Fruit has vit C but also fructose.
      Leafy vegetables have oxalic acid.
      Starchy vegetables have carbohydrate.
      Fish has mercury.
      Water kills you if you drink too much.
      Only those who eat and drink nothing can be perfectly healthy, it seems.

      Reply
    4. Stephen T

      I think most of us on here are adults and this is an insult to our intelligence. I’ve read enough rigged mouse studies carried out in a desperate attempt to frighten mean eaters. Vegetarian credibility on this issue is less than zero.

      Reply
    5. David Bailey

      Mmec7,

      It might be worth watching the extended version of Professor Noakes’ video, recorded after he was acquitted of malpractice (see above). In it he deals directly with the evidence that humans have evolved eating meat. In other words that we are evolutionarily adapted to eat meat. This was relevant to his trial because of the question as to whether saturated fat (mainly found in meat) is bad for you.

      This link is also interesting because it dissects some of the ‘evidence for meat causing cancer:

      http://www.diagnosisdiet.com/meat-and-cancer/

      Obviously the subject of this entire blog revolves around the prevalence of shoddy science in modern life – so I think that analysis is believable.

      Some people don’t want to eat meat because of the cruelty involved. I respect that position, and while my partner is vegetarian, I am not (but then neither are you).

      Reply
    6. Gary Fine

      Mmec7 said: “You might find Prof Alan Ebringer’s findings of interest.”

      Thanks for the recommendation. In fact, I did find it of interest.

      For example, here is a study where Ebringer was an author https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810322/ In this study, I found the following diet recommendations for Ankylosing Spondylitis patients:

      1. “Decreased Intake of High-Starch-Containing Foods” (i.e., avoid bread, pasta, rice, flour, etc.)
      2. “Increased Intake of None-Low-Starch-Containing Foods” which specifically said “Meat: beef, pork, lamb, bacon, salami, corned beef, luncheon mean, potted meat, ham, and veal as well as chicken, turkey duck, or any other poultry meat.”

      Another thing I came across connected to Ebringer was “Kick AS” which claims it’s “The largest Ankylosing Spondylitis support site on the Web!” At the Kick AS website they have something called “The London Diet” http://www.kickas.org/londondiet.shtml

      It says the London Diet essentially means to “REDUCE BREAD, POTATOES, CAKES and PASTA and INCREASE the intake of MEAT, FISH, FRUITS and VEGETABLES.” The summary is then followed by these two references:

      1. Ebringer and Wilson C. The use of a low starch diet in the treatment of patients suffering from ankylosing spondylitis. Clinical Rheumatology 1996; 15 Suppl. 1, 61-65.

      2. Ebringer A. Ankylosing spondylitis is caused by Klebsiella. Rheumatic Disease Clinics of North America, 1992 1/105-121

      Another chart on the Kick AS website lists what it calls “Generally Safe Foods.” Those foods include “beef, lamb, turkey, pork etc.”

      Apart from AS specific information, here is one study I found that contradicts your assertion: “Increased Lean Red Meat Intake Does Not Elevate Markers of Oxidative Stress and Inflammation in Humans http://jn.nutrition.org/content/137/2/363.long

      Another study where inflammation did not increase from red meat consumption can be found here http://jn.nutrition.org/content/137/2/363.long “Our results suggest that partial replacement of dietary carbohydrate with protein from lean red meat does not elevate oxidative stress or inflammation.”

      Here is an article from someone I enjoy reading. It’s called “Does Red Meat Cause Inflammation?” https://chriskresser.com/does-red-meat-cause-inflammation/ Of course, your interpretation of the article may differ, but the author made his view clear: “Red meat and inflammation: another myth bites the dust.”

      This website focused on arthritis seemed on point and so I found it interesting that the article listing foods to avoid did not include red meat. http://www.arthritis.org/living-with-arthritis/arthritis-diet/foods-to-avoid-limit/food-ingredients-and-inflammation-12.php

      Dr. K has spent countless hours making a case for why conventional “wisdom” is wrong as it relates to the cause of heart disease. I think if you look a little closer at the research, the quality of meat being discussed, and other factors, you’ll find your broadstrokes comments about meat and inflammation.

      To be clear, I do not subscribe to the one-size-fits-all model. I believe some people can thrive on one kind of diet that causes damage to another. As for me, I am a heavy “quality” meat eater and my HS CRP test never comes back higher than .1 (to the extent that test means anything).

      Food for thought and thought for food.

      Reply
  61. Mark Johnson

    If for some reason you believe eating red meat every day (even if it is grass-fed) isn’t a bad thing, well now you have proof. Sorry, meat eaters, humans just aren’t built to be true carnivores.”

    That’s right, humans built to be true omnivores.
    And “real meat” is concentrated vegetables, as Dr K reminds us.

    All the studies linking “meat” with cancer barely pass into statistical significance, and that’s after all the usual statistical manipulations and contortions associated with “scientists” wanted to achieve the desired result from an observational study. Humans have eaten meat “forever” and suddenly it’s bad for us. Complete and total utter bollocks. And yes, they’re good for us to eat as well.

    (I’ve put “meat” into inverted commas since what passes for meat in the diets of many in reality hardly qualifies as such.)

    Reply
    1. AH Notepad

      There are also the protective mechanisms of a properly developed immune system. It learnt to deal with what were were mild diseases in childhood and in so doing was able to deal with some cancer cells. This may be severely compromised nowadays with the overuse of vaccines, which, as the supreme court in the US stated, are “unavoidably unsafe”. These are toxic and damage the immune system so meat may well be a trivial cause cause of cancer. No doubt this is music to big pharma’s ears as they will have yet another customer base.

      Reply
  62. Randall

    Maybe a down side – “Not only is alcohol devoid of proteins, minerals, and vitamins, it actually inhibits the absorption and usage of vital nutrients such as thiamin (vitamin B1), vitamin B12, folic acid, and zinc. Thiamin (vitamin B1) is involved in the metabolism of proteins and fat and the formation of hemoglobin. “ https://www.google.ca/search?q=what+vitamins+and+minerals+does+alcohol+deplete&sa=X&hl=en-CA&gbv=2&sei=sDr-WOmSH8XejwTAqrLgBg&gws_rd=ssl

    Reply
  63. Dr. Göran Sjöberg

    Mark

    I understand that I am in a very bad position having just devoured some thick slices of the most fat smoked pork I could find up here int the North of Sweden. Not to speak about my luncheon today on rein deer meat and a sallad – God bless me!

    To this I gobbled a glass of white wine and now I am turning my attention to a glass of red wine to be on the safe side 🙂

    Reply
  64. Mark Johnson

    Dr Göran

    I suggest you repent immediately and forthwith prostate yourself in front of your local supermarket’s vegetable counter. You will need to prostate yourself five times (or however many daily vegetable portions your country currently recommends) to receive vegetable absolution. To be absolutely certain repeat the above but in front of your local pharmacy’s statin counter.

    On the other hand, carry on doing exactly what you’re doing. 🙂

    Reply
      1. Dr. Göran Sjöberg

        Well, I am a profound sinner!

        We just had a dinner on a rein deer soup made on 2 kg of rein deer meat (the soup will last for a couple of days). I though added a carrot and an onion.

        The Sami gods will forgive me although probably not the Christian God who drove us out of the paradise to eat the daily bread.

        Tomorrow we will head out on a snow scoter tour to a hunting cabin where we are to feast on another rein deer meat cooking dish.

        The Sami gods will help us to survive.

  65. Mark Johnson

    I agree Craig. Prostrating is what should have been suggested!

    That simple loss of an “r” could result in an “aargh”! 🙂

    Reply
  66. Jennifer.

    I like to follow up on many suggestions found on this wonderful blog, but being female allows me to pass on this one, fortunately.

    Reply
  67. Zack

    Hi all. I saw this study from March 22, 2016.

    http://www.jsad.com/doi/10.15288/jsad.2016.77.185

    It seems straightforward, but given my new-founded skepticism toward those conducting studies I’m wondering if someone can add additional perspective. It’s A Meta-analyses of 87 previous studies which had all indicated decreased mortality for moderate drinkers. After adjusting for abstainer bias and study quality, results showed that low-volume alcohol consumption has no net mortality benefit compared with lifetime abstention or occasional drinking and risk estimates for occasional drinkers were similar to those for low- and medium-volume drinkers.

    As a light / moderate drinker–6-9 glasses of wine per week—I was rather hoping I had added a few months to my life expectency!

    Reply
    1. Karl Pettersson

      It has been claimed that “occasional” drinkers (in this meta-analyis <1.3 g alcohol/day) are a better reference group than abstainers, because they may be less afflicted with biases. And if they are used as reference group, moderate alcohol consumption neither seems to decrease nor increase total mortality.

      But this may hinge on the distribution of different causes of death in the population. For example, in the BMJ study discussed in the previous post, there seems to be a dose-response connection between alcohol and myocardial infarction, with the lowest incidence among "heavy drinkers". (even though these have increased incidence or mortality from other cardiovascular causes). This may be a causal effect which does not translate into lower total mortality in the general population, but it may perhaps do so in certain groups with high risk of myocardial infarction.

      Reply

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