What causes heart disease part 44

12th January 2018

I’m going to try and draw some of the strands together at this point, in an attempt to provide some advice as to how to reduce the risk of CVD. Of course, there is massive overlap with other health issues. Smoking, for example, does not just cause CVD; it also causes lung cancer, chronic obstructive pulmonary disease (COPD) and many other unpleasant things.

So, you could call this instalment of the blog: “How to remain healthier and live longer”. Here I am only going to focus on the big-ticket items, the things that have been shown to make a real difference to life expectancy. For example, even if you believe that statins are effective in reducing CVD risk, when you look at the clinical trial data – assuming you believe it, one hundred per-cent – the average increase in life expectancy is around four days, if you take a statin for five years1.

Which means that, if you start taking a statin aged fifty, and keep taking it religiously for thirty years, you could expect to live for an extra: 6 x 4 days = 24 days. Or a bit less than a month. You may think this is worthwhile, you may not. This, by the way is the best-case scenario.

On the other hand, it has been estimated that if you take regular exercise, you could live for an extra four and a half years. Which makes exercise at least fifty-four times more effective than statins. Or, to put it another way 5,400% more effective.

As I hope that you can see, I am trying to give you a sense of the scale of benefits, or harms, that I am discussing here. Most of what is hyped by the pharmaceutical industry, and others, sits on the cusp of completely and utterly irrelevant. Is coffee good or bad for you? Who cares, the effect on life expectancy is in the order of a couple of days – either way.

Looking at preventative cardiovascular medications, the only ones that make a really major difference are anti-coagulants (blood thinners) such as warfarin, rivaroxaban, apixaban and suchlike. These are primarily used to prevent stroke in atrial fibrillation. Here, you can reduce the absolute risk of a stroke by around 50% over ten years. I am not sure how this can be re-calculated into increased life expectancy. I am sure it could be done, but it is complicated. However, this is still a massive benefit, and would mean years, not days, of extra life.

In short, if you have atrial fibrillation, you most definitely should take an anticoagulant. You might want to explore magnesium supplementation, particularly if you are taking an anti-acid PPI such as omeprazole, lansoprazole – or any of the other ’…prazoles.’ These lower magnesium levels. They also lower NO and, vitamin B12 levels and double the risk of CVD death. So, I would recommend never, ever, taking these long-term.

You might also want to try reducing weight, alcohol intake, stress/strain, and carbohydrate intake at the same time to see if you can flip out of atrial fibrillation naturally. It may work, it may not.

Moving away from that slight detour, what are the other real, big-ticket items? Perhaps the most obvious is smoking, or not-smoking. Smoking twenty cigarettes a day will reduce your life expectancy by around six years. Not only that, it will reduce ‘healthy life expectancy’ by far more. By which I mean you may well have ten or twenty years of such nasty things as: difficulty breathing, repeated chest infections, leg ulcers, angina, and suchlike, before you then die – early.

At this point you may be thinking, this is all incredibly conventional. Well, yes, it is. However, there is absolutely no doubt that exercise, and not smoking, have a massive and positive effect on health. Which means that they can hardly be ignored.

Of course, some people smoke and live to ninety, and some people take no exercise and live to ninety. So, what does that prove? Nothing at all. You can play Russian roulette for several rounds without blowing your brains out, but it is going to get you in the end.

My next big-ticket item, however, is not conventional at all. It is sunshine. If there is one piece of mainstream medical advice that I would vote as the single most damaging, it would be the current, ever more hysterical, advice to avoid the sun. If we dare expose ourselves to a stray photon, we are told, then we will vastly increase the risk of dying of skin cancer.

It is true that fair skinned people, living closer to the equator than their skin was designed for, can suffer superficial skin damage with excess solar exposure. There is also a significant increase in the risk of several types of skin cancer: basal cell carcinoma, squamous cell carcinoma and rodent ulcers (non-melanoma cancers). Whilst not pleasant, they can be easily spotted and fully removed. Which means that they are not a major health risk, and will have virtually no impact on life expectancy.

The type of skin cancer of greatest concern is malignant melanoma. Whilst melanomas can also be spotted early, and successfully removed, they can grow deeper into the skin. At which point cancerous cells will break off from the main melanoma ‘body’, and travel about in the blood stream, before getting stuck in various other places and growing (metastases). Five-year survival for metastatic melanoma is around 15 – 20%.

So, this truly is a cancer to be avoided, even if it is not common. But does sun exposure cause, or increase, the risk of, malignant melanoma? Here, from the Lancet:

‘Outdoor workers have a decreased risk of melanoma compared with indoor workers, suggesting that chronic sunlight exposure can have a protective effect. Further, some melanomas form on sun-exposed regions; others do not…

It has long been realised that indoor workers have an increased risk for melanoma compared with those who work outdoors, suggesting that ultraviolet radiation is in some way protective against this (melanoma) cancer. Further, melanoma develops most often on the back of men and on the legs of women, areas that are not chronically exposed to the sun.’3

Essentially states that the more sunlight areas of your skin are exposed to, the less likely you are to develop a malignant melanoma. How does this fit with the fact that there has been a steady rise in the incidence of malignant melanoma (incidence means number of newly diagnosed cases per year).

The first to question to ask is simple. Is this a real rise, or has it been driven by increased recognition and diagnosis? A study in the UK concluded that there has been no true increase in incidence. It is publicity, fear, and misdiagnosis that has created the apparent epidemic of melanoma. As noted in this article in the British Journal of Dermatology:

Melanoma epidemic: a midsummer night’s dream?’

‘We therefore conclude that the large increase in reported incidence is likely to be due to diagnostic drift which classifies benign lesions as stage one melanoma…The distribution of the lesions (melanomas) reported did not correspond to the sites of lesions caused by solar exposure. These findings should lead to a reconsideration of the treatment of ‘early’ lesions, a search for better diagnostic methods to distinguish them from truly malignant melanomas, re- evaluation of the role of ultraviolet radiation and recommendations for protection from it, as well as the need for a new direction in the search for the cause of melanoma.’4

In short, the rise in malignant melanoma is most likely an artefact, driven by diagnostic drift, and an increased recognition of early, benign lesions (‘lesion’ is just a word for an abnormal ‘thing’ found on the body). In fact, if you look at the evidence more closely, it seems that sunlight may, in fact, protect against melanoma. A study in the US looked at people who had already been treated for melanomas, to review recurrence and long-term survival:

‘Sunburn, high intermittent sun exposure, skin awareness histories, and solar elastosis were statistically significantly inversely associated with death from melanoma.’

The conclusion of the paper:

‘Sun exposure is associated with increased survival from melanoma.’5

Maybe not quite what you expected. But then again, vitamin D is synthesized by the action on sunlight on the skin. It converts cholesterol to vitamin D, and vitamin D has potent anti-cancer actions. Remove this from the skin at your peril.

Enough of the fear of the sun and malignant melanoma. I don’t wish to get dragged any further onto the playing field of the anti-sun brigade. Instead, here is a list of benefits that have been found from increased sun exposure. I am giving you the most positive figures here (these are relative risk reductions).:

  • 75% reduction in colorectal cancer
  • 50% reduction in breast cancer
  • Non-Hodgkin’s lymphoma 20 – 40% reduction
  • Prostate cancer 50% reduction
  • Bladder cancer 30% reduction
  • Metabolic syndrome/type II diabetes 40% reduction
  • Alzheimer’s 50% reduction
  • Multiple sclerosis 50% reduction
  • Psoriasis 60% reduction
  • Macular degeneration 7-fold reduction in risk
  • Improvement in mood/well-being.6,7

Well, what do you know. If you raise your gaze from malignant melanoma there is a world of benefits associated with greater exposure to the sun. With all these benefits, you would expect to see a real improvement in life expectancy. Does this happen?

Indeed, it does. There have been a series of studies in Denmark and Sweden looking at the benefit of sunshine. One of them, which looked at overall life expectancy, concluded that avoiding the sun was as bad for you as smoking.

‘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.’’8

This was a twenty-year study. If average life expectancy is around eighty years, we can safely multiply those figures by four, to work out that a decent amount of sun exposure can add somewhere between three, to eight years, to your life expectancy. Let’s call it five.

But it is not just cancer, diabetes and Alzheimer’s that are reduced by sunbathing. Sun exposure is also particularly good for the cardiovascular system, mainly because it increases nitric oxide levels. This, in turn, reduces blood pressure, and the risk of developing blood clots. It also protects the endothelium, and has significant benefits on lowering blood pressure and suchlike9.

Not only that, but lying in the sun is free and enjoyable. So, who could possibly ask for anything more?

At this point, you now know my first three big ticket items for living longer. More importantly, living longer with more ‘healthy’ and enjoyable years.

  1. Do not smoke
  2. Take exercise
  3. Go out in the sun – and enjoy it.

These three things alone can add around sixteen years to your healthy lifespan. Next, the impact of mental health. The biggest hitter of them all.

1: http://bmjopen.bmj.com/content/5/9/e007118

2 http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001335

3: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2804%2915649-3/fulltext

4: https://www.ncbi.nlm.nih.gov/pubmed/19519827

5: https://www.ncbi.nlm.nih.gov/pubmed/15687362

6: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129901/

7: https://academic.oup.com/jnci/article/97/3/161/2544132

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

9: https://www.karger.com/Article/Fulltext/441266

353 thoughts on “What causes heart disease part 44

  1. TheFatEmperor

    Good man Malcolm – the sun has HUGE health benefits !

    Have you got this beauty? I got the hardback, and it’s an absolute treasure…from a wonderful British GP. You just have to get it into your collection:


    Incredible experience and observations on the beneficial effects of the sun. Grimes also covers that w”^*er Keys and all his data – in the context of the all-powerful and life-giving sun ! 🙂



    1. Dr. Malcolm Kendrick Post author

      Cheers Ivor. I know Grimes indirectly, he writes some good stuff. As you can see, I have finally got entirely fed up of the moronic advice to stay out of the sun. It is funny how one group, in this case dermatologists, manage to completely take over an area and rule the roost. Then everyone cowers, fearing their disapproval. i wonder how people have died, and are dying unnecessarily, because of this irrational fear of sunshine? Did no-one ever hear of evolution. That big yellow thing has been up there, in the sky, shining down for four billion years – and we are supposed to believe is is harmful to health…. jeez.

      1. SW

        I am in Australia, I lived in Brisbane and the Gold Coast for 20 years, Melanoma Capital of the world and NMSC too. I am now in Sydney and live on the same street as The Melanoma Institute. Scary watching the number of people who go in and out of that place! I really do not know what to think! I have an oncology nurse friend who is seeing kids as young as 13 with Melanoma. Schools also saw ricketts for the first time in decades with their sunblock policies and play in the shade etc etc. Melanoma is terrifying. One ex- Wallaby friend is on Ketruda for it now as it went into his brain. He had no symptoms until a lump appeared in his groin ie, no outward sunspot or changed mole. You can not always spot them on the skin! My dermatologist told me to avoid the sun during high index hours but get sun every day for at least 20 minutes. He suggests in summer to cover the face and expose the midriff as that is protected most of the time and will not strong incidental sun. I make sure I have sun everyday before UV index goes over 5. I walk or run in shorts, wear no sunblock until it is super high UV rating ie >8. HE also has shown me papers in NEJM demonstrating B3 is good for Non Melanoma skin cancer prevention and that MElanoma and B3 are being trailed now. Here is the link: https://www.cancercouncil.com.au/blog/the-role-of-vitamin-b3-in-reducing-non-melanoma-skin-cancer/ B3 and Melanoma: https://www.sbs.com.au/news/vitamin-b-may-help-prevent-melanoma I wonder if out plant based diets in West are causing lack of B vitamins, I note in HOng KOng, they have low low Melanoma incident and are voracious meat eaters. ( I live part of the year there) Pilot colleagues also take B3 to prevent DNA damage when they fly Polar routes. Pilots get high radiation on those routes and have a higher incidence of Melanoma as well. They call those rouets the Vasectomy Routes due to radiation!
        Sorry so long, this is a topic near and dear to me. http://www.nejm.org/doi/full/10.1056/NEJMoa1506197?af=R&rss=currentIssue#t=article

      2. Dr. Malcolm Kendrick Post author

        In the UK, I only use this as an example because I know the figures better than anywhere else, the number of deaths each year from malignant melanoma is 2,000. The number of deaths from breast, prostate, and colorectal – alone – is 35,000/year. If sun exposure doubles melanoma (which it does not), and halves the risk of other forms of cancer, we have reduced the deaths from cancer by 15,500 per year, in one country alone. Of course, we do not see people not dying from cancer, that they would have died of , had they avoided the sun. The benefits are hidden from view. The harms are trumpeted from the rooftops. In this way, our perception of risk is distorted out of all contact with reality.

      3. AH Notepad

        This is a very useful episode, Dr K. I just hope my keeping out of direct sunlight over the years is not too late to rectify, though I didn’t go in for using sun creams. Arggghhh! I worked in an office with huge windows so got all the benefits of no UVB and all UVA.

        SW thanks fr posting your second link. It is one of the small number of links I bothered to read, and once I found nicotinamide seems to be the same as niacinamide, it now gives me more confidence for using it.

      4. Robert

        I love it! A simple common sense statement ” and we are supposed to believe is is harmful to health” This is similar to my approach with the cholesterol hypothesis with Cardiologist (I’m an Internist). “Please explain to me why my own liver would make poison? (cholesterol) Also, can you explain to me how the liver ignores one of the fundamental laws of physiology i.e. ‘negative feedback’ when it has decided to set out on this suicidal course of toxic cholesterol production?” Not one has been able to answer these two simple questions. In fact, this is usually when they get very angry and stomp away muttering to themselves.

      5. smartersig

        But one could also argue that the body produces insulin and the concensus seems to be that too much is bad

      6. Jan B

        But it only makes too much insulin in response to too high (abnormal) levels of ingested carbs, unlike me who cannot produce enough. Too much/too little is bad news.
        Excuse the appalling grammar.

      7. smartersig

        Let me explain, what I am saying is that stating that the body produces something means it cannot be harmful may be a false and dangerous blanket statement. We produce cortisol but you would not want to be producing too much

      8. Eric

        SW, I was raised in fear of sunburn, growing up in Northern (!) Germany in the early 70s. It was SPF 2-4 lotions then, SPF 6-8 becoming more common in the 80s (all UVB only). The 90s saw SPF 20 to 30, finally included some UVA filtering, and the lotions had all kinds of dubious chemical filters. By the 00s, we were slathering all-mineral SPF30 sunscreen on our kids and ourselves. It go so bad, Weleda – who were making a sunscreen that was really only natural oils and zinc oxide – stopped selling their >SPF20s sunscreens because new EU requirements could only be met by adding chemicals which they refused to do.

        So it was with utter amazement that I read a blog entry by Dr. K several years ago that said sunshine is good for you. I was extremely sceptical at first, but followed the links and did some research of my own. The picture that emerged was completely add odds with what I had been led to believe. I happen to be a research scientist and get paid for drawing the right conclusions from incomplete or contradictory data (fortunately, nobody gets hurt when I get it wrong in my day job which I rarely have).

        Currently, my picture (or rather, my hunch) is this:
        – moderate UVB seems to be good
        – no sun is bad
        – UVA in absence of UVB might well be worse (office and car windows, compounded by years aof using UVB-only sunscreen)
        – who knows what all those chemical filters and preservatives are up to in the skin once they are hit and altered by UV light

        It might be interesting to note that broadband and narrow-band (311 nm only) UVB has been used for a long timeto treat skin conditions such as psoriasis. Apparently, there are no signs of increased skin cancers in folks who have been receiving weekly treatments for decades:

        It is interesting to note that 311 nm sits on the soft tail of the vitamin D synthesis curve. I would still want to combine it with UVA and NIR no make sure competing reactions also take place (e.g. excess pre vitamin D formed in the skin gets destroyed by UVA so it is hard to overdose from sunlight).

        I would be very careful about taking too much B3 (niacin). As ist lowers LDL and raises HDL, there was quite some research into this. It failed to lower MI but raised strokes.

        As for polar routes I looked into that years ago when I had to take the polar route to Japan several times a year and when I had to travel to Fukushima prefecture a few months after the accident. Apparently, there is no indication of increased neoplasms in aircrew even if you take into account bias for preselection (healthy worker phenomenon). Similarly, there are regions where natural exposure is higher than workers in nuclear facilities are allowed to sustain, yet there are no increased cancer rates. Also, there was an apartment building in Taiwan that was built in 1982 with structural steel that had been remelted from scrap that accidentially included a spent medical Cobalt 60 source. These folks spent 10 years, getting exposed to up to 200 mSv/year, i.e. about 200x the natural dose or 10-20x what nuclear workers may get, depending on where you live. While they had chromosome anomalies when tested right after the scandal broke, their cancer rate was nowhere near the predictions from official models. Some sources even say it was lower than in the general population.

        My takeaway is that you don’t want to ingest contaminated stuff but low dose gamma or neutron radiation is probably a lot less harmful than predicted by the LNT model. I can’t quite square this yet with some studies from the US that say that increased cancers from indiscriminate use of CT scans are actually in agreement with models.

      9. Gary Ogden

        Eric: As I understand it the risk from ionizing radiation is not linear, that low levels equivalent background levels actually have a hormetic effect. Joel M. Kauffman has an entire chapter on this in “Malignant Medical Myths.”

  2. TheFatEmperor

    Exactamundo Malcolm
    – in the unlikely event that you are at a loose end for a few minutes, I gave a rant about it here a few years back; those ignorant dermos have gotten away with murder… 😦

    Just a few minutes of outrage from this point on:

    Note my restrained anger. My 5th child had several issues many years ago, and was finally pronounced to have profound vit D deficiency.

    These people have a lot to answer for – and I’ll make it my business to see that they do… :-[



    1. Linda Cooper

      Sun exposure without burning is, I think, crucial. Here in Queensland Australia the sun in summer is already hot by 8am. Makes it difficult to go out in the sun particularly when you are fair skinned.

      1. Bill In Oz

        @ SW, I looked at the stats in the llink..
        Something really weird is happening. We here in Oz have all been aware of the risks of melanoma since the 1980’s. Remember the ‘Slip, Slap, Slop” TV campaign ?
        ( Slip on a tea shirt, Slap on a hat and Slop on sunscreen ) And that’s what people have done. And kids at school are not allowed out during breaks without hats.

        dispite all this i’s now 2018 and the melanoma rate has been increasing anyway.
        ” Melanoma rates doubled in the 20 years from 1986–2006 and are still on the rise”. And you say that Brisbane & the Gold Coast are the melanoma capitals of Australia.

        The increase in skin cancer supposedly increased in the 1970’s because of the Ozone hole. The Ozone hole is the lack of O3 in the upper atmosphere blocking UV light. And the Ozone hole still exists in the Southern hemisphere every Spring & early Summer. . But it does not extend as far North as Qld. It affects Tasmania, Victoria, and the southerly parts of South Australia & NSW.

        So what the hell is going on here ? Maybe getting out of the sun too much ?

      2. Bill In Oz

        Because it blocks Vitamin D3 or because of what’s in it ? Fortunately I rarely use it..Only if I am swimming at the beach in Summer.

      3. Gary Ogden

        Bill in Oz: What better evidence than this for avoiding the sun at all costs is terrible advice.

      4. Bill In Oz

        Gary, not much ! We are evolved to cope & benefit from sunlight.
        Mind you I don’t go out in the sun that much when it’s 36 degrees C very much. Too dehydrating…

      5. Martin Back

        The hole in the ozone layer is certainly a new factor since the late 1980s, not applicable when I was growing up and tanning a toasty brown.

        In 1991 I visited family in New Zealand and they warned me that New Zealand was particularly badly affected by the hole in the ozone layer. My first day there I spent the afternoon on their deck, reading. The sun was mild by my South African standards, so I just wore shorts and a T-shirt, although I did wear a hat. Mistake! I have never been so badly burned. Red, angry, radiation burns like I was sitting under a nuclear reactor. I have been far more cautious about sun exposure since then. I get plenty of sun, and never wear sun screen, but I stay under cover during the heat of the day.

      6. Jean Humphreys

        My worst case of sunburn was in 1953 – the week before the coronation, when I was taken to the Scilly Isles for a weeks hoiday when it was misty all the time. Other than that one of the occupations on the beach in summer was peeling the skin off the bits of Dad’s back that he couldn’t reach. He wore out at age 89 with no melanomas or other skin cancers. It has to be sunshine plus something else – which we never discover.

      7. Frances

        In Queensland (in the ranges) in the past few years, I have noticed a real sting, a real burn from the sun and wonder if the ozone layer has been depleted and we haven’t been informed.

      1. KidPsych

        Another great addition to your series. However, you clearly erred in not noting how important it is to eat chocolate daily.

      2. SW

        This is how big a problem Melanoma is here in Australia… This is just one Institute dealing with it. https://www.melanoma.org.au/about-the-institute/our-team/#shivalingam Have a look at the team, in particular Prof Georgina Long. I wish that a walk in the sun prevented melanoma, I think there may be more to the story than that. I just can’t string it together all the various factors. Ivor has some v interesting work re Omega 6 seed oils and Melanoma risk. Even SCC’s and BCC’s are terribly disfiguring and sometimes the damn things get away. I have a friend who their ear removed (penectomy) and HUGE skin graft over the site, all from BCC that started behind his ear… horror stories abound here re Skin Cancer of all types. Is it odd that Australia has such a high melanoma rate given the amount of time we spend in the sun ie, not at the beach, just incidental sun ie that is where most of our exposure comes from. Is the sunblock and Vit D deficiency and Seed oil consumption? Is it the DNA damage to the cells… I do have a very good friend with a HUGE family history of it…genes… It is an age old question here! Does the dose make the poison?

      3. SW

        Gotta love spell check! I was saying a friend had his ear removed (a pinnectomy), spell correct gave the poor fellow a penectomy! LOL you will spot it in my comments! SO funny, gotta laugh! SW

    1. SW

      Yes, maybe all the interventions with diet, sunlock etc all add up! Lack of Vitamin D via sunblock may also play in to it ( I mean children started getting rickets again no long ago due to too much sunblock) … BUT the fact the Ultra Long Haul pilots who fly polar routes have twice the rates of Melanoma of general population offers a big clue. ULTRA long haul flights are fairly recent and no big studies on 18 hour flights yet. We shall see, I guess.

      1. Gary Ogden

        SW: Indeed, New York to Hong Kong practically flies over the North Pole. To find an air route it requires nothing more than a globe and a piece of string (except actual pilots, who need all sorts of fancy gizmos). I’ve flown SFO and LAX to various Asian cities, including Hong Kong, and they fly over the Aleutians, which are pretty far north, white as a sheet.

      2. Eric

        So how much UV do do pilots get?

        The Torygraph has this story:

        they generalize about airline pilots but towards the end, it says that measurements were performed in a general aviation airplane with an acrylic windshielt. Airliners, which fly much higher and are pressurized have multiple pane windows consisting of glass, polycarbonate and sticky polymer foils in between. This is the paper they reported on:

        This is the definitive paper that is only briefly mentioned in the first paper:

        It is very complicated but yes, Airbus and Boeing windows have some residual UVA transmission in the range that causes DNA damage, i.e. < 340 nm. The good old MD88 did a better job

      3. binra

        For down below – on pilot exposure. They also live in the recycled ‘air’ that has been associated with toxins leaking from engine seals.
        They also have more exposure to cosmic radiation including UVB – and are whizzing through the magnetosphere, on shift work, sit a lot, etc etc

  3. Floyd Aldrich

    I’ve read that if you live north of the 45 latitude the sun in winter does not help? Is there still a benefit? I live in Maine.

      1. Frederica Huxley

        You may well get a tan, but if the sun isn’t over the Azimuth, there will be no UVB coming through the atmosphere, and therefore no vitamin D. There is a natty app called dminder that gives the times of UVB for your particular latitude. Basically there is UVB coming through if your shadow is shorter than you! Being told to never go out in the midday sun negates any possible vitamin D efficacy! UVB is also unable to penetrate glass.

      2. Mr Chris

        Dminder is a great app, gives you readings wherever you are. Think it was Edward Robinson on this board who told me about it. If you can’t get it to work, the help service is very good.

      3. Eric

        Maybe transient tan from UVA?

        There is this professor Holick in Boston who has carried skin cell samples in fused silica cuvettes around the globe at various times of year and day who concluded that in Boston or north, you cannot make vitamin D even at noon between November and February. And Boston is way south of the wall…

        As a physicist, I would prefer to see calibrated spectrometer readings from these places but have not been able to find them.

    1. JDPatten

      Yes, is there??
      We’re told that above about 45˚ it’s not possible to make D with your skin in Winter.
      How about all those other benefits? Reduced in Winter? Will you wash them away with a shower as with vitamin D?

      1. Gary Ogden

        Sasha: I believe they get quite a bit from food, and evolutionary adaptations play a role. This was mentioned in an earlier Roman numeral, I can’t remember which.

      2. Sasha

        Thanks, binra and Gary. I also think Inuit bodies adopted to produce at least some vitamin D in the environment in which they live.

      3. binra

        But of course they have summer overhead at the poles and reflective surfaces. But then a very long dark winter.
        I read of someone who studied their diet and took it on and lived well on raw meat etc thereafter – even when back in in moderate climes Cant recall his name.
        The same is not true for the Innuit who take on the S.A.D.
        Crap diet is a factor in dysfunctionality?
        But can a crap diet be separated from cultural displacement, loss of cultural or social worth etc? Not entirely.

      4. binra

        They USED to get vitD from the animals they ate – and of course may still do. But western diets are globalism too.
        I hold that the human body is very adaptable to a wide range of conditions. Part of that may be the role of the gut biome. (That which war is being waged upon – along with the consciousness that it supports). But also, adaptive need arises as intuitive discoveries – such as mixing clay with otherwise poisonous new local foods to render them nutritious. I say intuitive – you may prefer trial and error. Which is also guided intuitively – but likely less aware of the promptings.

      5. TS

        Sasha: re “ So what happens to the Inuit without all that vitamin D?”

        White snow increases UV intensity by 100%

      6. Frederica Huxley

        Yes, one can get a dreadful sunburn while skiing, but if there aren’t any UVB rays coming through the atmosphere at high latitude in winter, the reflected rays would all be UVA.

      7. Martin Back

        To be pedantic, in midsummer at the poles the sun is never higher than 23.5 degrees above the horizon, so in theory the Inuit cannot get any vitamin D from sun exposure. Mr Google tells me “their diet of whale, seal, and walrus blubber (vitamin D saturated fat), along with eggs and char (trout) are all rich in vitamin D.” Blubber also provides vitamin C.

        I can understand how seals and walruses generate vitamin D — they spend hours onshore basking in the sun. But where do whales get their vitamin D from? A quick search reveals that whales are like us — they travel to sunny spots and pick up a tan by lolling in the sun, although obviously they stay in the water. http://www.thetanningguru.com/tanning-all/whales-teach-tanning/

        Vilhjalmur Stefansson is the man who ate nothing but meat for a year, closely observed by dietary scientists.
        “Stefansson documented the fact that the Inuit diet consisted of about 90% meat and fish; Inuit would often go 6 to 9 months a year eating nothing but meat and fish… in the end, the one-year project stretched to four years, during which time the two men ate only the meat they could kill and the fish they could catch in the Canadian Arctic. Neither of the two men suffered any adverse after-effects from their four-year experiment.”https://en.wikipedia.org/wiki/Vilhjalmur_Stefansson

        I read his story, which is available online. I remember in the Arctic he craved salt, which the Inuit didn’t eat. They considered it a flavourant, not an essential. Eventually he gave up salt as well, just eating rotten fish for a bit of variety. In fact the only European thing the Eskimos wanted was tobacco.

        Stefansson lived to the ripe old age of 83, to the disappointment of vegetarians everywhere.

  4. Caroline

    Find your blogs so useful and an enjoyable read. Just one thought on this one… sitting In the sun is “free and enjoyable”. I’m not convinced. Well i am of the “enjoyable” but “free”? You need access to time, place, and sunshine. A lot of people’s lives are so constrained that this wouldn’t in practice be free at all. And now I’m thinking, taking my clothes off and sitting on the pavement outside my block of flats in Jan might not be so enjoyable either!

    1. annielaurie98524

      A lot of things in life that are “free and enjoyable” are not recommended/appropriate/practical outside a block of flats, in scanty clothing, in January. That does not make them not free/not enjoyable in an appropriate setting.

  5. ellifeld

    I hate to quibble with all the great info you just presented, but shouldn’t potassium (which you previously devoted an entire post to and I’ve shared many times) be included? Thanks for the great post!

  6. annielaurie98524

    Thank you, Dr. K, for putting all the advice on what to eat, or not eat, into perspective. It appears from you current blog, and from what you’ve promised in the next episode, the top 4 (at least) actions for avoiding CVD are not diet-related.

  7. Robert Dyson

    I thought some sense was percolating through when I saw the headline of this article.
    Although I agree it’s a better test of cholesterol, still heart disease is still the big message.
    Also, this week I saw something called, “trust me I’m a doctor”, where we had some professors at Cambridge saying, “now remember LDL is bad cholesterol, HDL is good cholesterol”. I despair.

  8. Gabriella

    Many thanks for down to earth and sensible advice. Our forefathers and mothers did not have health services and their professionals advising them on what to eat, when to go out in the sun, how much water to drink, how many hours to sleep and to take excercise. They just did it and did what felt right and learnt from experience and from their own forefathers and mothers. Over the millennia humans everywhere discovered what was good and what was not. We’ve somehow lost touch with our nature and handed authority over to Big Pharma and doctors. We’ve forgotten how to be our own experts.

  9. TedL

    If you are interested in preventing influenza, please read this article:

    To cure influenza, please read this article:

    On the prevention of autism, read this:

    All relate to the effects of sufficient Vitamin D.

    Nearly all cells in the body have Vitamin D receptors, which indicates that sufficient Vitamin D is essential for their proper function, and, by extension, the prevention of disfunction and disease.

    1. annielaurie98524

      Several biochemistry researchers feel it’s a mistake to classify “Vitamin” D as a vitamin, as our bodies use and need so much of it. Some classify it as a hormone, since the body actually makes most of what we get, and only a small amount comes from our diets.

    2. TS

      Autism may well be an evolutionary trend. It comes in all shapes and sizes with mishaps and triumphs. In gentle forms it can be a triumph. Some of the best scientists, artists and musicians have or had it. The brain functions in a more linear and focused way. We think it an abnormality simply because people with autism are not quite the same as us.
      In the same way, we underestimate animals. For years we thought of ourselves as being at the peak of evolution (alas, still do) because we could use tools and language. Now we know that a little fish can use tools and plenty of animals talk to each other and show huge amounts of intelligence. We consider their language inferior because we don’t understand it yet it is always sufficient for their needs. We might look at the things other animals do that we can’t do rather than what we can do that they can’t.
      Tectonic plates could rise and we could go the way of the dinosaurs yet the clever little microbes would still be around.
      Looking for an environmental cause of autism may be futile.

      1. Gary Ogden

        TS: The environmental causes of autism are becoming perfectly clear, particularly in research in the last ten years or so. J.B. Handley has an excellent compendium, and a hypothesis, on medium.com. Also see Dr. James Lyons-Weiler’s “The Environmental and Genetic Causes of Autism.” Also watch Professor Exley’s talk, posted above. I also recommend Dan Olmsted and Mark Blaxill’s “Denial: How Refusing to Face the Facts about Our Autism Epidemic Hurts Children, Families, and our Futures.” The autism rate in the U.S. is now 1 in 36. It is a result of neurological injury, a man-made holocaust. The CDC knows this perfectly well. Vaxxed has played in Australia. I suggest you watch it. It explains the fraud perpetrated at the management level at CDC in a study testing the Wakefield hypothesis. Their research validated this hypothesis. They got rid of these findings by excluding the data from a sufficiently large group of children to make the findings not statistically significant. They then met in a room and threw all the original documents in a big garbage can, all except the statistician on the study, Dr. William S. Thompson, who knew it was both unethical and illegal (destruction of government property). He hired the top whistleblower attorney in the U.S., and is awaiting subpoena from the Government Oversight and Reform Committee in the House of Representatives. You can also watch U.S. Representative William Posey on the floor of Congress describing this. Why has nothing been done about this? We have a criminal government, owned by pharma. Autism results from neurological injury caused by environmental toxins, and clearly the main ones are vaccine ingredients.

      2. AnnaM

        Hmm, I’d say you haven’t seen any kids with autism. You’re perhaps thinking of Asperger’s, what they call high functioning.

      3. TS

        On the contrary. I was one of the lone people to draw attention to an autistic continuum many years ago and had trouble getting it recognised. I’ve seen more autistic people than I care to remember and have written and lectured on the subject. That doesn’t make me an expert in citing a possible cause but it entitles me to an opinion.

      4. Gary Ogden

        TS: You certainly are entitled to an opinion, and I respect that. But we cannot mandate public health policies based upon anything but first-rate science. The science involving vaccine injury exists, but is suppressed by governments, media, and social-media algorithms. It also must be privately funded, as all governments have a stake in the well-being of industry, and industry has immense power to shape policy and steer research dollars.

      5. Gary Ogden

        TS: I want to add, also, that I think your posts are of great value in this discussion. Pilots, like doctors and vets, I hold in high esteem. They impress me very much. My all time favorite was an Aussie Cathay Pacific 777 captain whose cheerful banter made for the best flight ever. Booming voice (too often you can’t hear them at all!). Beautiful plane, too (this was in 2006, before the 787).

    3. Nigella P

      Hi Gary Ogden, as the mother of one child with autism (and one without), I’d be really interested to understand more about the environmental causes of autism you refer to, as I can’t fully see what they are in your post.

      1. Gary Ogden

        Nigella P: Here are some sources of good science: Dr. James Lyons-Weiler’s book “The Environmental and Genetic Causes of Autism.” Pretty technical, but comprehensive. A website run by an anonymous scientist: vaccinepapers.org. Ageofautism.com has published a wealth of information over its ten years of existence on both suspected causes and treatment protocols, and the search tool works well. I also highly recommend to anyone interested in the safety and efficacy of vaccines Janine Robert’s “The Vaccine Papers: Findings, as recorded in official expert transcripts.” On Dr. Lyons-Weiler’s website (lifebiomedguru) is an exhaustive list of published papers on this topic.

  10. smartersig

    Hi everyone, you want more sun?, here how to do it. I am estimating that your Gas and electric bill per month at this time of year is around £50 per week, maybe more if you are in all day. You can rent say for a month or more if you wish at this time of year a studio or maybe one bed flat for around £60 per week in the Algarve in Portugal. Current temps 18 deg C and lots of daily sunshine. This wont include utility bills but if you can find one with solar then all the better. Nightime is around 8 deg C. Flights are cheap also outside of term times. Bottom line is that you will be slightly worse off maybe even no worse off as eating costs are much lower out there. If anyone wants further advice on this please feel free to ask.

    PS Food is great too, Portugal very low on heart disease league table

    1. Bill In Oz

      Smatersig, do they dance Tango there in Portugal ? Now that would be a big additional reason for me to holiday there. 🙂

    2. Ian Dron

      I managed to get a touch of the sun in the Algarve on the shortest day of the year so there’s plenty of Vitamin D available. There’s plenty of good wine from the Alentejo region just to the north.

  11. goransjoberg2015

    A great summary!

    It fits my CVD-life survival experience!

    When I was a teenager I turned into a very heavy smoker since this was considered so “cool” during the 1950th but finally I was able to quit the smoking at age thirty. Well everyone in my family smoked and they too not in moderation. Sugar was also consumed in quantities in our diet. I guess that my arteries already at that young age were severely damaged by all this environmental “attacks”. To put i mildly I was never a fast runner.

    On the other side I was brought up in the countryside and we were all encouraged to stay out in the sun as much as possible and to get a good tan. Doing hard work in the garden at the same time seems also to have added to my “survival”. I also then established a habit of regular exercise, typically jogging for an hour or so a couple of times each week.

    Surviving my very severe MI, 20 years ago, to the very surprise of the cardiologists involved they concluded that it must have been my regular exercise during all those years which had created a significant amount of collaterals without which I for sure would have turned into a dead man at the age of 52.

    1. Bill In Oz

      Or the Outback in general.. The dry desert areas all get plenty of sun in Winter. And it’s not to hot then.

  12. Charles Gale

    Awesome post and thanks Ivor for your input too on sunlight.

    I bought a UVB meter a few years back and here in Hampshire, England (latitude 51.279) in mid December the readings were pretty low on a clear sunny day (e.g. if memory serves 10 micro watts per centimeter square) compared to mid June on a clear sunny day (300 plus micro watts per centimeter square).

    Not much vit D3 production on the shortest day.

    And it’s cold and inclement a this time of year and you are wrapped up too.

    But I think it’s also being outdoors, getting daylight (if not sunlight), fresh (?!) air and exercise. I was nearly down to a tee shirt the other day working outdoors on a mild sunny mid winter day.

    Well, I tick these 3 big ticket items so they weren’t behind my brush with death.

    Next post – mental health. I agree – THE big hitter and still my contender for my CVD incident.

    And I suspect the hardest one to put right.

    1. Gary Ogden

      Charles Gale: I’ve been pondering 42 ever since. I’m rereading William B. Irvine’s book on stoic joy, and I’ve discovered something remarkable. Early on he talks about the teachings of the stoic school, and one of these was “eliminate negative thoughts and emotions.” I’ve been practicing (actually since 2011, but now with renewed vigor), and have found it pretty effortless. It makes me feel calm and even-tempered all day and helps me accomplish all the activities I’ve planned for the day. When driving I notice the poor driving behavior of other drivers, but no longer respond in any way. I think this is going to be one of the keys to preventing CVD: Notice everything, but do not respond negatively, if possible. Hope I’m making sense.

    2. TS

      As long as there is some uvb, no matter how little, we can be sure our bodies will be clever enough to make full, efficient use of it. We will be using it more efficiently than in the summer months when there is plenty to spare.

  13. Jennie

    Very interesting! I especially like all the information about sun exposure.
    If someone has been advised to take
    Omeperazole to ‘protect’ the gut from other meds ie Prednisilone taken for an inflammatory condition,then what’s to do? It’s very confusing when you’re told one thing but you know It could cause further harm!

  14. Gay Corran

    Thank you again, Dr K. On atrial fibulation, what if the person taking apixaban suddenly starts hemorrhaging from the nose? Is the choice then of dying from a major bleed in the brain on anticoagulants, or from a clot-induced/atrial fib stroke? Would more NO food or supplements, garlic, etc be the option to try, rather than pharmaceutical anticoagulants? Or is it Hobson’s choice?

      1. Gay Corran

        Thank you Frederica. K2 already on the list. Hoping real butter and cheese will suffice instead of natto.

      2. AH Notepad

        Frederica, I get through lots of unpasteurised cheese (K) and I have just received some nutritional yeast flakes (B1) I could easily polish off a packet of yeast in one snack it’s so delicious. I hope it’s difficult to overdose.

        This blog is excellent as a place to get a starting point in good nutrition. If only I had known what to eat decades ago………….

  15. Norma

    A very interesting read is by Dr. F. Batmanghelidj called “Your Body’s Many Cries for Water”.
    He believes that most diseases, including heart disease, begin by Unintentional Chronic Dehydration.

  16. Maureen Berry

    Well, as a non smoking Naturist living in Southern Spain, following a LCHF diet, walking 10,000 steps a day and taking warfarin (admittedly for a DVT rather than AF, although my GP did suspect AF before I went LCHF, when it disappeared) I can confidently expect to live for ever! Thank you Malcolm, you’ve made my day!

  17. Mike Wroe

    For some time I have been totally convinced by your arguments that sunshine is good for health and enjoyable. (Not necessarily free! I’m off to Koh Samui in March and having to pay for my delightful 14 days of basking in Vitamin D). Whenever I can I wear shorts and short sleeved shirts but, like Joan Collins, I use a sun screen only on my face and neck because I believe there is evidence that sunlight speeds up the ageing process in the skin. A pale face with bronzed legs and torso is a good compromise.

  18. Gary Ogden

    Another bull’s eye. And, two birds with one stone: Exercise in the sun. I wonder if there is a paper comparing sun exercisers with gym exercisers.

    1. AnnaM

      An important point in the video linked above, is that getting sunlight through glass (in the gym) is perhaps worse than nothing. The damaging UVA penetrates glass, but the protective UVB is blocked. And I think how in my childhood, few cars had air conditioning, and so people drove around with windows open, thus letting in full spectrum sunlight to at least some extent. But now everyone has air conditioning (summers are hot in the US) and people are in general spending more time indoors and getting the unbalanced UV rays.

    2. Mr Chris

      When I see those gym adverts of people on stationary bicycles looking at fantastic scenery, I ask myself why aren’t they on the other side of the window, on a real bike etc? By the way on rollers I was totally bored after 15 minutes, so I gave them away, and bought better clothing. Fresh air is good for you!

    3. Bill In Oz

      All out in the garden folks ! I spent 2-3 hours yesterday getting dirty digging beds and putting in seeds for winter vegetables..

      1. Gary Ogden

        Bill in Oz: Seeds for winter vegetables in the first month of summer? What vegetables? I never attempt this until the last month of summer, except bunching onions, which don’t mind blazing heat. It makes me happy you’re in the garden! Pruning season for me.

      2. Bill In Oz

        Gary, yes it’s Summer here. But I planted leeks, red onions bulbs and Egyptian onions. I have seeds of peas, daikon, radish, broad beans & bok choi to sow later this week. or next.

        I like to plant & sow my Winter veggies early so they are well on the way to being almost ready come May/June….Good home grown tucker !!

        I also dug the last of the spuds in the garden…They do better here when planted in early Spring and harvested in January. And it’s low GI variety supposedly.

      3. Gary Ogden

        Bill in Oz: Thanks for the information! Potatoes have always been a minor crop for me, but I shall try your method, because this year I had lots of greenery but no spuds in the ground after they died down.

  19. Ian Lucas

    Does your advice hold for fair skinned people living in Australia? Sunscreen is a sacred substance here – should it be?

    1. Frederica Huxley

      Worth researching the effects of diet on sunburn – specifically a non-processed, low sugar regime; various B vitamins, tomatoes and astaxanthin. As long as one covers up before the skin starts to go pink, these can give the skin good protection without using sunscreens.

      1. Gary Ogden

        Frederica Huxley: Very interesting question! I’ve noticed in recent years since my dietary changes I don’t sunburn, although I am of the fair-skinned variety. I tan very gradually.

    2. AnnaM

      According to the video linked above (it looks like it is over an hour but in reality he cuts it in at about the 50 minute mark) sunscreens make things worse because they mostly block the uvb and mostly do not block the uva. Which means you can’t make vitamin D an you still get the damage.

      1. Frederica Huxley

        Google the correlation between melanoma and sunscreen usage to see some interesting graphs. No proof of causation, but given the toxicity of some ingredients, it is an eye opener.

      2. Antony Sanderson

        On the problems of sunscreen: My understanding has been . . .

        – UVA light, although less energetic than UVB, penetrates deeper into the skin, and does the sort of deep damage that can lead to melanoma.
        -UVB light does not permeate as deep as UVA, causes damage in the upper layers which the body is geared to repair; it also causes sunburn; it is the portion of UV light that stimulates the melanocytes to produce melanin. The melanin protects against both UVA and UVB.

        The problem with suncreams is that, until recently, they only protected against sunburn producing UVB. This meant that the damaging UVA could get through deep into the skin . . . At the sametime you were not building up protective suntan because of the missing UVB.

        Over the past 20-30 years we have been exhorted to put stronger factor creams on (less protection-generating UVB gets through). It is not surprising that as take up of suncream increased, along with increased ‘protection’ factor, over the years melanoma levels have increased.

        Since UVA is being partially filtered in the latest suncreams it will be interesting to see if the levels of melanoma decrease.

        My rule is start building a tan as early as English weather allows, eventually getting to more than 1hr both sides. If at anytime I have reached my time limit of safe exposure I never put on suncream . . . I just cover up.

        Suncream will save the pain of sunburn . . . but it gives a false sense of security.

      3. Frederica Huxley

        Yes, gradually building up a tan; it is those who insist on lying out in the midsummer/foreign sun without first acclimatising themselves who do potentially cancer causing damage.

    3. Sasha

      I think fair skinned bodies isn’t an optimal design for living in Australia. There’s a reason Aboriginals are darker skinned. White Australians are suffering from having a wrong body for the climate. Probably similar to the problems black Americans are having in Chicago (except it’s in reverse).

      1. Gary Ogden

        Sasha: This is a possibility worth looking into, although NIH would never fund such an investigation, since they don’t want to know. Another likely factor is over-vaccination. They may have been vaccinated in a mobile clinic. They certainly were fully vaccinated in the refugee camp prior to departure. These would have been the WHO/GAVI vaccines with the full complement of thimerosal. Then, when they arrived here they were likely again fully vaccinated, since the records may not have travelled with them or were not acceptable to the authorities here. Tuskegee, remember Tuskegee.

  20. Marguerite Harris

    So interesting and informative, as usual! Thank you.
    Floyd, I live in a fairly similar climate to Maine (near Ottawa Ontario) and I, like Dr. Kendrick in Scotland, get a tan in winter. I’m outside a lot, in all seasons and even sit out “in a snowbank”… on a lawn chair, in winter and have a cuppa tea. Yes I bundle up, but at least my face is in the sun. I think just going for a walk in the daylight even if it’s not sunny, is good for you.
    I worry about all the little kids who are slathered in sunscreen constantly in the summer. Aside from the effect on vit D, I wonder how all those chemicals affect them.

  21. Jan B

    That’s great. Thank you, once again. We all instinctively rejoice in the arrival of warm Spring sunshine, raise our faces to it and quite simply feel better for it. It saddens me to see children covered up and slathered in nasty sunscreens. A bit of common sense wouldn’t go amiss, as in – tan but don’t burn. Simples.

  22. John Pollard (@jpollard72)

    Excellent blog. Just finished Malcolm’s Data book, highly recommended. Good to hear some prescriptive recommendations as well as his critiques of prevailing opinions.
    What about the benefits of vitamin supplements? B12, D, other?

      1. Sasha

        Thank you, Gary, from you as well)) I haven’t been getting some comments on this post, maybe I haven’t checked off the right boxes…

        I’ve been in Moscow for the past 6 months. Lots of changes in Russia. Some not so good, in big Pharma. Docs are discouraged to prescribe cupping to kids (which does wonders for respiratory illnesses and was practiced in Russia for a long time). Mustard patches have become hard to find in pharmacies. They are also pushing flu shots and HPV vaccines here now. It’s sad…

        Russians are a tough lot, though, and aren’t easily swayed by pharma propaganda. And there’s still lots of good folk medical knowledge among both the laypeople and the docs. One guy I know who developed a heel spur was told by his doctor to go on vacation and kick small stones on the beach ( I think he went to Bulgaria). After a two week vacation and doing that daily his heel spur was gone)). Stories like that make me smile.

        I hope you’re well, Gary!

      2. Gary Ogden

        Sasha: Thank you for the kind words. I am mejor de nunca, as they say south of the border, literally, “better than never,” but in English meaning “better than ever.” It is my 69th birthday, and my gift was a wall-poster periodic table, which I wanted because I’m too lazy to hunt one down in a book. You’re right that Russians are a tough lot. They, along with the Chinese and European Jewry suffered the greatest from the horrors of the Twentieth Century. I’m in the midst of reading an excerpt from Masha Gessen’s “Never Remember: Searching for Stalin’s Gulags in Putin’s Russia.” I’m horrified to hear they’re pushing the flu shot and the HPV. These are the two most worthless and dangerous of all. Good thing Russians are skeptical and have centuries of wisdom to guide them. I will post the link to Professor Chris Exley’s talk about aluminum (he is the world’s foremost authority on the biological effects of aluminum) when I’ve finished this. We should all be concerned.

      3. Gary Ogden

        Here is the link to Professor Exley’s talk (in the U.S.). He freely admits he has put his head on the chopping block. He covers antiperspirants and breast cancer, and aluminum in Alzheimer’s and Autism brains (the last research done with independent funding):

        One of the things he said that struck me was that if you eat processed food (or drink un-purified water or commercial beverages) you are increasing your Al burden; not so with organic food, so smartersig, you’re fine with the free-range squirrels.

      4. Martin Back

        That reminds me of a German girl I knew years ago. As a child she had terrible knock knees. The German doctor advised her parents to force her to walk on a gravelly beach until her knees straightened. I don’t know how long it took, but it worked. She had perfect legs.

      5. Sasha

        Gary: regarding Somali children and vaccines. I think Dr Bruce Ames in Triage Theory talks about diminished Vitamin D and serotonin production in cold climates for blacks vs whites. Kind of common sense even though I never thought about it…
        It may partially explain why Somalis (and black children in general) are pushed into autism in greater numbers following vaccines. It may also be a part of explanation for other health issues that blacks are suffering from in the US, especially in colder states. Their bodies weren’t designed for that sort of climate.

      6. smartersig

        Its wonderful to think that we can get vaccines out to these under developed countries like a shot but food and water thats a bit tricky

      7. Sasha

        Gary: thanks for Chris Exley’s talk, I look forward to watching it.

        Yes, it’s incredible how bloody Russian history is. The memory of it passes through generations and forms much of Russian character and probably lots of their health outcomes (including high rates of CVD). They still manage to produce pretty big people, though. I am 183 cm and about 200 lbs and I barely make it to average size when I ride Moscow subway…

        Prof Geizinger (sp?) in his book “Risk Savvy” gives a chart of European populations and how they overestimate the benefits of preventative mammograms and PSA testing. The numbers are the worst for Britain, get better as you go east and are the best for Russia. He thinks it’s because Russians never used to get as much modern “health” information as Western countries. I think it’s only partially true. Many here are sceptical of official propaganda including pharma news. They also have centuries of folk medicine that never got suppressed to the extent that it happened in the West. They are similar to China in that regard. There are people writing PhD papers for Russian academy of Sciences on benefits of deer antlers…

        Martin: yes, Germans used to have a very good tradition of physiotherapy (maybe still do) so the story about the German girl makes sense))

  23. Jean Humphreys

    Thanks. More useful information, which I will have to try and learn for when the snake oil purveyors start to get obnoxious.

  24. Sukmun

    Dr. Malcolm,

    Can you comment or direct me to some info on conquering familial hypercholesterolemia naturally, and does alternate day fasting make a difference?

    Thank you,

  25. Jeff

    Excellent post, thanks.
    Perfect antidote for several articles appearing in the Australian press in the last few days saying
    “Australian Medical Association NSW president Brad Frankum said irresponsible parents deliberately not applying sunscreen to their kids on multiple occasions was behaviour akin to child abuse”
    “Prof Frankum said people who believed “getting a bit of colour” was good for their child’s skin needed to be re-­educated about the dangers.”

    1. AH Notepad

      Jeff, is this style of parent abuse to be known in future as “Frankum’s Bunkum”? What is the next accusation of child abuse to be? First it was those who were sensible enough to research and then refuse vaccines, now it refusal to apply a detrimental and possibly toxic substance to the skin, I suppose the next could be the refusal to use fluoride toothpaste. Meanwhile there is little admonishment for those who feed carbohydrates.

    2. Martin Back

      When I was a child in the ’50s and ’60s in South Africa, we used to spend hours lying in the sun, trying to get a nice deep tan. None of my generation got melanoma, to my knowledge.

  26. topsygirl

    Another great post, thanks for that Here are a couple of links that arrived today and are pertinent to the conversation https://articles.mercola.com/sites/articles/archive/2018/01/13/stubborn-optimistic-people-live-longer.aspx?

    I have always felt better after exercising I walk, and have a gym membership for weight training to keep my muscles going and for core strength here in Australia older folk seem to diminish quickly and as I note from my employment ( I work in a large hospital) that lack of exercise and the very low vitamin D3 seem to be of concern to the clinicians. As previous participants from Australia have noted we are paranoid about sun, I am not and never have been the first link is from Joe Mercola regarding stubborn folk living longer based on that I should make at least 300yrs. I never use sunscreen, the only concession I do and only on very hot days which here in SA as we have the distinction of being the hottest and driest state on the hottest and driest continent is to wear a hat and this is more to catch the perspiration and stop it from getting into my eyes than to protect me from the sun. Just to give you an idea how hot, this week again we are expecting 41 by Thursday. I do not use sunscreen as the ingredients are probably worse for us than any protection they might afford. We too have a huge death toll from other cancers but like many things medical, only some things seem to be targeted and pushed along with a with hysterical determination and they can be confident by telling people that they should not be personally engaged in their own health outcomes (leave it to the experts) that most will obediently comply. Later when and if it all goes wrong what then, I am a stubborn older person I like to make it my business to be informed and I am so thankful for Dr’s like Dr Kendrick who take the time to inform us. As to sun, early morning is my favoured time to go out and garden or walk, I have planted trees so work around them until about 10.30, have your skin checked SCC’s and BCC’s are more prevalent than melanoma and can be just as dangerous if not treated early. I agree with Dr Kendrick melanoma needs more study as noted they just pop us in places that have never seen the light of day with no warning and I guess that makes them so frightening. The second link is from Orthomolecular Medicine and is a comprehensive article on the benefits of Vitamin D.

  27. Sue Richardson

    Thanks for a post full of sunshine and optimism to begin the New Year. Everything you read in the news is doom and gloom: Don’t eat butter, stay out of the sun….. Living in the uk we don’t get as much sunshine as other countries, yet even here, we have been encouraged to feel it is our enemy. When I was a child we were sent out to play in the sunshine every day, and our mothers didn’t expect us to come back in unless we needed feeding. I feel sad for the children today who spend all their time on their devices and phones. They are building up a legacy of bad health, and people are not being made aware of it. Thanks again Dr K. And slightly belatedly: Blein Vaynrey Noa to you (in Manx Gaelic).

  28. Caroline

    D Minder is an app I found to measure when we are able to produce vitamin D. Insert your location and it automatically calculates whether the angle of the sun is great enough (best above 50 degrees but we perhaps make some over 35 degrees) to produce Vit D when UVB rays reach the earth. The advice to go out when the sun is lower in the sky may have inadvertently caused more skin damage as the UVA rays penetrate more deeply but do not produce Vit D. Fairer skinned people appear to make vit D more efficiently than darker skins probably as an evolutionary adaptation to more northerly climes and were also able to supplement with the consumption of oily fish and mushrooms during the Vit D winter. The current advice seems to be to enjoy a short period of sunshine when the sun is high in the sky taking care not to burn. This can be as little as 5-10 minutes for us fair skinned folks.

      1. JDPatten

        If all of the received wisdom available to us is bunk, couldn’t you give us a clue as to what’s not bunk?
        Is it as simple as: You get a tan > you get your D… and other benefits?
        I’ve noticed that since I’ve been taking 5,000 IU D3 daily I tan more readily and burn much less readily. (Painting house in Summer, Massachusetts.)
        D sufficiency activates melanocytes to slow further production?
        My imagination?
        Is it true that only UVB gets us D, gets us tan?

      2. Dr. Malcolm Kendrick Post author

        I have long since reached the point with medical research where I cannot truly tell you what is bunk, and what is not – for sure. This is s why I wrote Doctoring Data, as an attempt to help other people in their analysis of research. But there are no real black and whites here, only shades of grey. In general, the only research that I cling onto, is research where there is no financial pressure behind it.

  29. AH Notepad

    I looked up the potential problem with contaminated Chinese vitamin C. I haven’t really found an answer, though I reasoned, possibly wrongly, that it may not matter too much since we use ascorbic acid to counteract every possible toxin. So if it has some toxin in it, the vitamin C will deal with that. A second thing I noted was how many substances the FDA have hauled manufacturers over the coals for, giving the impression the FDA is protecting people from the possible harms caused. This sounds all well and good until you think this is the same FDA that permits the virtually indiscriminate use of compounds containing a large number of pathogens and toxins, which are collectively known as vaccines!

  30. SW

    Dr MK, Thank you for this very thought provoking blog. It has been such a pleasure to read and try to disentangle everything, esp the sun and melanoma! I am going to suspect that the dose does indeed make the poison…. maybe the thin ozone layer over Aus and NZ adds to it! Once again, thank you so much.

    Some intersting reading re Pilots, cabin crew and Melanoma : The Risk of Melanoma in Airline Pilots and Cabin Crew A Meta-analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4482339/ JAMA 2015

  31. Andrew Dinsmore

    Dear Malcolm,I have followed your updates for some time. They are objective,informative,mostly easy to understand and refreshingly forthright with clear advice.Thank you,keep up this very useful service. Regards,Andrew Dinsmore

    Sent from my iPad

  32. Jeff Cable

    Nicely written and presented, Malcolm. In a tenuous but related piece of news, the Costa Coffee franchise has stopped providing whole milk (blue top) in hospital coffee shops. I normally request this milk for my tea. The shop manager informed me that there was an instruction (from whom was not made clear) to remove whole milk from sale.

    The whole Costa hospital-based franchise chain risked being excluded from NHS premises if compliance was not achieved. Furthermore; from April 2018 it will not be possible to buy any single item from Costa in their hospital franchises, where the item contains more than 200 calories.

    The nanny state clearly have this wrong. I can walk to another Costa or a Macdonalds near to the hospital in which I work and order whatever I want.

    As a clinician, you will appreciate the nonsense of a 30 minute lunch break (in between an endless queue of patients) requiring you to walk for twenty minutes to the hospital canteen and wait to be served for twenty minutes and then rush back to clinic. It is unsurprising to see nurses grab a quick drink of Pepsi, a Mars bar and packet of crisps to maintain their energy levels.

    If the government seriously believes that a teaspoon of whole milk is responsible for the obesity crisis in the UK, they ought to try reading the research.

    1. smartersig

      I welcome this move, I guess they are concerned about the effect cows milk has on prostrate cancer to name but one. I am also happy to see that because NHS hospitals would not come into line and remove sugary soda drinks they are now being forced to do so. Imagine that, hospitals were asked voluntarily to remove soda and they refused and yet we defend the NHS with our last breath literally

      1. Dr. Malcolm Kendrick Post author

        I am greatly against banning things. It suggests that people are too stupid and irresponsible to make their own decisions, and we – the great and good – most tell them what do do, how to live, and suchlike. In the old days, you would call this fascism. A form of thinking about the way to run society that has tended to end rather badly.

      2. AH Notepad

        smartersig, why should it bother you what other people want in their coffee? Is not the coffee also a problem regardless of the milk? I don’t drink tea or coffee, but I do drink unpasteurised whole milk. Presumably they will allow low fat, skimmed and other versions known to have their own problems. As for your hint it might affect prostates perhaps you should watch https://youtu.be/tq3X27c1bTc and then question the whole intervention paradigm.

      3. smartersig

        I will check this out later but the fat doctor makes a good point in the first couple of minutes which perhaps suggests get a car with heated seats and use them to benefit prostrate health

      4. smartersig

        Enjoyed the presentation Notepad, some interesting stuff about Prostate diagnosis. My point is that he would do himself a big favour and lose fewer listeners in the first 60 seconds if when talking about prostrate health and exercise he looked like got the minimum recommended amount

      5. AH Notepad

        Another claim based on no evidence? You have no idea how many people would not watch beyond the first 60 seconds, nor what the reason would be. It would be quite possoble that many viewers were envious that he weighed a lot less than they did, since he is in the US.

      6. AH Notepad

        You must be 100% correct in all your statements then, however sorry to say, I must be able to see something beyond just weight, as I would trust Bergman’s diagnosis and advice in preference to yours. No offense meant.

      7. AnnaM

        But Smartersig, the protective elements (CLA) as well as nutrients like vitamin A are in the milkfat. Consuming skimmed milk at least in some studies, is associated with increased risk.

      8. smartersig

        In many foods you can find a micro nutrient that is on everybody’s wish list but the balance of effect is what counts. My view is get those essential, micro nutrients elswhere

      9. Gary Ogden

        AnnaM: And here in the U.S., low-fat milk is clearly associated with increasing obesity among school children. Goes well with the official rot they pile on their lunch plates.

      10. Jeff Cable

        Well smartersig, this news may come as a shock to you… everyone dies. (even you will die some day) You can spend your life worrying about the various factors which will bring about your own demise. Alternatively you can live your life as fully as your health permits and let the statisticians,GPs, department of health and life insurance actuaries worry about it.

        I dislike the notion that some civil servant or another will decide how I manage my own diet. Furthermore; I don’t wish to be the self-fulfilling statistic which is often presaged by the pharmaceutical companies. These purveyors of “good health” appear to be routinely involved in the wholesale mismanagement of study data; presumably in order to sell more harmful drugs to a somnolent population and a supine medical profession.

      11. smartersig

        How can you be unhappy for drug companies to mismanage us but happy that hospitals do the same promoting coca cola and Dr Pepper. If hospital introduced cigarette vending machines would that be OK because it is all part of free choice and we do not want hospitals managing our choices ?.

      12. LA_Bob

        Dr Kendrick: “I am greatly against banning things. It suggests that people are too stupid and irresponsible to make their own decisions…”

        Hear, hear! I would love to see tobacco companies, for example, along with their toxic products, go out of business. But I prefer to see that happen from people wisely quitting smoking or never starting. Far better than initiatives and legislation to ban the products. And better than taxing them from hell to breakfast, which just takes money out of consumers’ pockets (which may or may reduce their smoking) when they have no intention of quitting. Not to mention the conflict of interest governments incur as they become addicted to toxic revenue streams.

      13. Bill In Oz

        Bob, taxes on tobacco products definitely reduce the number of smokers. That is what has happened here in Australia. The smoking population used to 65% of the adult population here in the 1960’s. It is now just 12% of the adult population. In fact smoking is so rare that I can go for days and not bump into one.
        And the revenue raised contributes towards the health consequences not just of smokers, but all the passive smokers who have been around them, living with them all those decades..

      14. Bill In Oz

        What ? Agreeing with me ? Good grief, I’m attempting to be a contrarian. I shall have to try harder !

      15. thelastfurlong

        Oz also has a massive black market in cigarettes. I think 12% smoking rate is pulled out of very dodgy stats. The SHAME that smokers feel, would induce lying about smoking, so the rate is probably much higher. Oz is extremely backward in it’s Tobacco Control policies – more like a Totalitarian State than a sane one. You can see the insanity exposed by their treatment of vapers and vaping. Shameful! Short-sighted and despicable. Thank God I don’t live there.

      16. Bill In Oz

        Chop Chop has increased in recent years …But growing tobacco is quite distinctive in the way it is farmed. And so very obvious. Also the Australian Federal police actually have excellent access to satellite photography which shows up this distinctive farm crop.
        Attempting to smuggle cigarettes through customs at airports has also increased in recent years. But so have the confiscations of smuggled tobacco products with significant fines being imposed on people doing it.

        And it seems you do not like the Australian governments policy on tobacco & cigarettes.. Tobacco & cigarettes are not banned. But cigarettes are expensive. Also they are restricted to people over 18 years old. And smoking is not permitted in most public places ( including pubs & clubs ) because of the health affects on other people nearby. IE the passive smoking problem.

        All this has seen a massive improvement in the health of millions in this country. And yes it is 12% of the population here who are still smoking. I have lived in other countries with high rates of smoking like the Philippines and Argentina and Indonesia. And I know what I prefer as a non smoker thank you.

        Finally my father died of throat cancer some years ago. Shall I say what caused the cancer ? Should i say that when he did consider stopping his 40 or so a day, the oncologist said “don’t bother, it’s too late”.

        As for you being glad that you do not live here, why so am I. I wonder sometimes if being a smoker should be a reason for denying a visa to people wanting to come here to visit or live. But maybe that is a tad extreme.

      17. Bill In Oz

        Ohhhh I forgot to mention that tobacco advertising is banned in Australia…Has been since the 1970’s..And packets of cigarettes are sols in plain packaging with warnings of the health consequences on the packet.
        And finally cigarettes & other tobacco products cannot be displayed in shops at all. They are stored in closed steel door cupboards until bought by customers.
        All of these policies are supported by all the political parties with the possible exception of the new Conservative party which polls at about 3%…

        Are the tobacco industry upset ? And that is good I think.
        All in all an example of how to reduce smoking rates in countries , without banning it as in a drug war. It is also saving many thousands from the awful disease consequences. And saving the rest of us from paying billions for this ill health via our Medicare system.

      18. smartersig

        So lets continue subsidising the tobacco companies by you and I paying for the care of smokers when the proverbial hits the fan. Taxing sugar worked in Mexico as sugar drink consumption fell. Provided govt channel that tax revenue, should there be any net increase, into care then everybody wins. Banning it along with soda drinks in hospitals is just a no brainer but then hospitals are not there to make us well

    2. AH Notepad

      Jeff Cable, thanks for this piece of information. It gives me a reason for writing another complaint to my useless MP. (He has been in the house for decades and has been a cabinet minister in several posts, so you can gauge he is a brown noser). I will ask why the National Sick Service has removed nutrients in the form of whole milk and why the stupidity of limiting calories to 200 per item, when we know calories per se are irrelevant . As an example I eat typically six to eight ounces of French and Swiss cheeses most lunch times. That is 600 to 800 calories. I eat two or three large (very) eggs for breakfast often and a great dollop (technical term) of unpasteurised cream with fruit to finish off th evening meal, even so I have gradually lost weight to 11 stone from around 12 stone. I am never hungry and sometimes go all day doing physical work without eating until the evening. So who ever is advising the N(Sick)S seems to be lacking knowledge and probably needs hospitalising. That might give them some understanding of the poor nutrition value of hospital food.

      1. Jeff Cable

        I too share the opinion expressed by Malcolm… banning things is an ineffective method of control. Witness drugs and alcohol abuse in every location where humans can be found. I also want to be considered as capable of managing my own life (wright or wrong) and I have no wish for it to be managed by proxy. I am present and fully alert and can make my own decisions.

    3. goransjoberg2015

      It is quite “unbelievable” how the dogma of the “danger of fat” without any scientific foundation can permeate our modern society and take on ridiculous forms.

      In Sweden our hamburger chain MAX announced a “Low Carb Burger” on the menu where the bun was replaced by a large sallad leaf wrapping. This item turned very popular. However our regulating food authorities forbid the use of this name with the threat of very high fines if MAX insisted – actually 10,000 Euros per month if they didn’t yield. “Low Carb” is certainly a red blanket today while “Low Fat” allows any dealer to put on a “Healthy Heart” symbol.

      Now it is called a “Sallad Wrap Burger”

      1. Jeff Cable

        It is saddening to learn that dogma gets any house room in a society that was considered to be at the forefront of human rights and social advancement. In a location where bondförstånd and Jämlikhet abound, it is not easy to understand how dogma can gain any traction among the well-educated populace. Interestingly, I found during my time spent in Finland that the Finns were not inclined to accept nonsense from any source. I know it is merely my own generalisation, based upon self-biased observations but I found Finnish society refreshingly sane, highly civil and remarkably good humoured.

  33. Charles Gale

    Vitamin D3 and also stoicism…

    Readers may like to visit Dr Holick’s (the vitamin D3 guy) website. Here’s the link to the Q&A section and covers vit D and washing your skin (the answer is no – you can’t wash it off):


    Gary Ogden – thanks for the William B Irvine comments – I’ll try get his book. Bad driving was a good example…I always note and respond badly. It just seems to be a Herculaen task to overcome what appears to be an ingrained personality trait. Like those cartoon bumps on the head, you suppress the bump and up it pops again. I saw several hypnotherapists a few years back with the idea/hope that they could plant a response in my brain to respond positively to e.g. slamming doors. Like the stage hypnotherapists do – every time you hear a certain word you will do this or that. Never came to anything – not sure/can’t remember why.

    1. Gary Ogden

      Charles Gale: You’re right, it isn’t easy to change ingrained habits. Takes lots and lots of practice. One thing I do is smile instead of swear (saving that for when I use my thumb for a nail head). I also realize what is the point to getting angry about something I can do nothing about? The result is laughter. The calmness which comes from learning these techniques also has a positive effect on the people we interact with.

      1. Gary Ogden

        Dr. Kendrick: Me, too. First I swear, then I smile at my folly. What is missing now is the anger. When I examine my own imperfections I think, how can I complain about the imperfections of others? This does not apply in the case of intentional harm, of course, when I can get as righteous as anyone.

      2. binra

        If easy is letting a habit run, making a new one will seem not easy – and open a can of worms in terms of awareness of discomfort. Wanting the bad feelings to go away by the quickest route is often simply assigning them to something else and attacking, shouting, hating it etc. THis also applies to a judgement of ourself in hindsight – the moment after the hammer hits the thumb. Pain is a call in the heart for embrace no matter where in the body it manifests. Attending immediately to the need, by passes the ‘habit’ that is now a choice – to get really MAD at yourself – and try to mitigate the rage on the hammer etc. Persistent curiosity brings the experience of nipping an ‘injury’ in the bud. This can lead to either amazingly quick healing – or lack of injury.
        It is noticeable that if you could have instant release – but have to yield – give up – your STORY …would you? The Corporate PR that engineers our society is all a form of narrative control. Underneath this are collective fears and guilting or blame and shame – not least of which is investment in our story.
        It isn’t the whole truth that we can do nothing about – eg hammered fingers. We can and generally do, reinforce our story, and our wounds then serve a purpose of proof – particularly when making claim of grievance. Hence also, those who have ‘spontaneous remissions’ are not considered real nor followed up by those who depend on the story, the wounds and the interventions by which to find or bolster meaning in their lives.
        I regard a habit that I have become self aware of, as a choice. We tend to make language to evade and escape responsibility for choice… and then ‘see’ such a world …until we wake up to what a nightmare that makes. If in fact we do.

  34. Bill

    Re: warfarin for atrial fibrillation

    Malcolm, I’m afraid you may have overstated the benefit. When compared to nothing, warfarin appears to have only a small benefit and of course harms as well:


    Benefit is much smaller still when warfarin is compared to good ‘ol aspirin:


    A good example, it would seem, of what Dr. Nortin Hadler calls “small effectology.”

    Of course, we’re talking about stroke, so some people might well consider the warfarin a reasonable measure despite all this, but considering the risks, and the myriad uncertainties in the research to date, I doubt warfarin can reasonably be considered a major win. Not remotely in the same league as diet, exercise, sun, etc.

    I looked into all this when my partner’s mother was put on warfarin for a-fib. At the time I had the sense that, were it me, I’d probably stick with the aspirin. After, of course, doing absolutely everything to cure the a-fib. Speaking of which . . . another topic . . . but at my suggestion one of my own doctors tried what would conventionally be considered very high dose iodine supplementation (Dr. Guy Abraham’s iodine protocol). To the astonishment of his big shot Harvard cardiologist, the a-fib promptly resolved and never returned. Others have had the same result. I’m sure this is not the only cause of a-fib, but like many other tissues the heart concentrates and needs iodine, and deficiency is rampant.

    I know you’re interested in thyroid disease, too. Sometime you’d enjoy looking into iodine supplementation there. I personally cut my required dose of T4 for Hashimoto’s in half with the Abraham protocol. Has been shown in thousands of people in the Iodine Project, among many other benefits. At earlier stages of the disease complete and apparently permanent cure is often achieved. The endos remain dead set against what they consider high dose iodine. Ah, well…

    1. smartersig

      My 90 yo mother had a spot of afib 5 years ago and they put her on Warfarrin and statins. I managed to get her off statins but I dont think my powers of persuasion would get her of Warf’. She is of the ‘doctor is right’ age group. Needless to say she is now getting increasingly breathless. I cannot prove that the Warf’ is causing sclerosis of the arteries but as a registered side effect I suspect it is.

      1. Sasha

        Why can’t you prove it? It interferes with vitamin K synthesis and therefore causes calcification of the arteries.

    2. Mr Chris

      I have a friend, who for some reason has thick blood, and was put on Xarelto to which there is no as yet marketed antidote. He asked me what I thought, I said
      One, it is hellish expensive
      Two, keep away from any sharp tools.

      1. Gary Ogden

        Mr Chris: How on Earth do they diagnose “thick blood?” Sounds like something out of Dickens.

    3. JDPatten

      So far, I’m pleased with my apixaban (Eliquis), taken because of occasional arrhythmias to prevent (Read: reduce chances of) stroke.
      As far as the researches can be trusted, it seems that expensive apixaban is modestly best at reducing stroke risk as well as at reducing serious bleeds, putting cheap warfarin at a serious cost disadvantage.
      And it doesn’t screw up your K status.
      Bleeds are worse on aspirin. Combinations of any anticoagulant AND aspirin can be catastrophic.

    4. Terramuggus

      Needed a prostate biopsy several years ago. Decided to try iodine as well. Took it orally in water and applied a couple drops externally to the area once a day. Cut down my PSA back into its historically healthy range and eliminated a couple of suspicious nodules, as in completely gone. Started to tell doc about it but he just rushed me out the door with “great..keep doin’ what you’re doin’, blah, blah, blah..” In other words, he was not interested. Have kept with it @ 3x a week. Don’t know for sure if it was the iodine (though I suspect) but all’s been well since.

  35. Ben Stone

    I think the majority of studies show a protective effect with moderate sun exposure. I haven’t seen any data to contradict the migrant studies etc that suggest increased melanoma risk in those who grew up near the coast or in equatorial climates or who got many sunburns in childhood years

  36. Randall

    Vitamin D (really a hormone) is so easy to measure in the blood. Just ask your doctor for a blood test. I recommend supplementing with D3 not D2. As you get older, it is harder for your skin to make vitamin D. After supplementing for 2 years with D3 , 2000ui a day and at the end of summer with a general sun tan , my vitamin d measured just above adequacy.

  37. Nigel

    I unfortunately allowed a GP to tick the cholesterol box when requesting another blood test. Now I’m labelled with a diagnosis of Hypercholesterolemia, and the inevitable pressure, resisted, to take statins. This among other things means higher travel insurance, even though I’m not convinced of any risk. Any thoughts how to get this diagnosis removed?

      1. Nigel

        Yes, thanks, I was wondering about hacking my cholesterol and have looked at Dave’s method.
        Maybe, I’ll try it with a private cholesterol measure to see how it works for me, and if it does work get it done again with my GP.
        Can anyone suggest a reasonable private cholesterol testing service in the UK?
        I nearly got prescribed blood pressure medication as well because I was called in to discuss my “high” cholesterol like it was a medical emergency so was a little stressed!
        It angers me that I have to declare “high” cholesterol for travel insurance and no doubt pay a higher premium.

      2. AH Notepad

        Why would you want to lower your cholesterol? A substance which is the building block for many processes in the body, and something for the most part is produced by the liver. Do you think your liver is not competent to control the process, and that outside advisors know better?

  38. Andy S

    There appears to be some people who now consider diet not that important anymore (with the caveat “as long as it is healthy” ) since it is not in the top 4.
    Out of curiosity I searched to see if smoking has any benefits and found this:
    “A pensioner, Winnie Langley, who smoked for more than 95 years and only gave up because she could no longer see the end of a match, has died a month short of her 103rd birthday.” One observation would be that there is healthy smoking and unhealthy smoking, like there is healthy and unhealthy sun exposure. Canada will be legalizing marijuana this summer and I am considering growing 4 plants for medicinal use. A great stress reliever apparently. Not interested in smoking the stuff but for culinary use.

      1. Vlad

        Here’s an article you might find interesting: https://www.sott.net/article/338885-A-comprehensive-review-of-the-many-health-benefits-of-smoking-Tobacco

        As the commenter above said, there’s smoking and smoking…it’s one thing to smoke cigars (like the oldest US veteran, Richard Overton, does at 111 years old) or a pipe, the way people in various parts of the world have been doing for at least 10k years, with the conscience that’s a good and relaxing thing for your health to enjoy ‘the gift of the gods’ and a totally different thing to smoke present day commercial cigarettes (which at most have 50% tobacco, the rest being made up of junk and chemicals) feeling guilty, having fully swallowed anti-smoking propaganda and being under the nocebo effect.

      2. smartersig

        How would you feel if I told you that everyone of those smoking outliers died before their time. That every single one would have lived 5 more years if it was not for smoking.

      3. AH Notepad

        Smartersig, you cannot know that. It is merely speculation based on statistics. Anyway, how do you know what caused their death? It might have been anything other than smoking related.

      4. smartersig

        I am making the point that ever time someone makes a statement of the type ‘my next door neighbours uncle smoked until he died at 95’ they are doing no one any favours for two reasons. First they may or may not have lived longer without smoking (stats suggest longer not shorter) and who gives a damn whether we can find a smoker that lived longer than the average person. It proved nothing except the poster has little grasp of statistics. Apologies if the above sounds a bit harsh but I am happy to listen to meat eaters but draw the line at any indirect suggestion that smoking is anything than a proven life loser.

      5. AH Notepad

        But smokers did pay a significant amount of tax which part funded the health service, and their treatment did not cost as much as the tax paid.

      6. binra

        Well if you start that one there’s a long list to follow.

        You can think that way – and use it to justify whatever you want.
        I dont.
        Nor am I advocating smoking for health!
        But whatever you do – why not do it as an expression of health (joy) and it will have a different effect than done in guilt.
        But in your world I will sooner or later have to be gagged, gulagged or culled, because I stand in freedom to learn by our choices – even poor choices.

      7. JDPatten


        I challenge you to do a little simple research.

        Go to your nearest hospital. A large one would get you more numbers.
        Go to the pulmonary ward during visiting hours.
        Politely ask the patient or the patient’s family if the patient is/was a smoker. A certain percentage won’t be able to answer because they’ll be on nebulizers or in oxygen masks. Persist, though. A visitor might be able to inform you.

        Come back here with your results and we can compare.

      8. AH Notepad

        Given how much Dr. K. alresdy does, do you think this “challenge” is a reasonable suggestion? I understood decades ago cigarette smoking was bad for health because of the chemical make up of the cigarettes from the additives and from the processing of the tobacco. A cigarette will deplete vitamin C reserves by 35mg, so 20 a day will use up 750mg. This could be why smokers tend to die from heart problems. It was a stroke that was the first problem for my father, then it progressed for about 12 years. If he hadn’t been a heavy smoker he might have had better health for longer.

      9. binra

        Blanket statements are a false start. To be health serving is not in all times under all circumstances for all people. Or the opposite as a demonsisation in reverse.
        What exactly, why (or in what context exactly) and to what extend under what conditions.
        I have no desire to convince you or anyone of anything you/they are not already opening to embrace and I don’t mean merely believe.
        Look at WHAT first. Has this been consistent through recorded history or does the pesticide toxicity and other additives come into the picture? Along with declining health in other ways (ie lower vit C and vit B levels – both of which have significant effect in clearing or countering toxic effects. Not to mention smoking guilt.
        Modern smoking is probably a death wish – but not so different from a LOT else, except in being openly assigned such a status, but at least it is in slow motion allowing time in which to reconsider and make other choices. It HAS also served a lot of other functions – particularly in wartime. I don’t feel to encourage ANY addictive relationship – but don’t let me stop you – because I cant! Shut one door and some others open. I don’t believe the anti-smoking issue is about health, so much as politics by stealth. It is a kind of ju-jitsu to subvert a movement of the people FOR the people into a weapon to use against them. Instinctively you pick up on this with regard to banning things being the wrong approach. But throw in enough studies, experts and media coverage and some fat pouring out of people’s arteries(?) (GET THAT for a mixed metaphor!) – and who but a fool would speak against the tide?
        First they came for the smokers… https://www.youtube.com/watch?time_continue=51&v=s2E5iGHBWaw (anti smoking ad montage).
        Never mind the truth if we achieve our goal is not science, but politics.

      10. Vlad

        Using your logic, should I also go to the cardiac ward, ask how many patients there have been on heart medications (most of them) – similarly some won’t be able to respond, being in coma after their second or third MI – and conclude that the medication caused their heart problems? 🙂

      11. Martin Back

        I’m currently reading The Secret History of the War on Cancer by Devra Davis. As you can imagine, the tobacco industry is one of the stars of the show. They have been obfuscating, prevaricating, concealing, threatening, bribing, cajoling, advertising, suing, undermining, lobbying, threatening, suborning, doing anything they can, to persuade people that cigarette smoking is not a cause of cancer.

        The Germans knew since the late 1930s that smokers have more chance of getting lung cancer than non-smokers, after correcting for other cancer-causing factors. (A lot of people started smoking in WWI, so 20 years later there was a big jump in lung cancer numbers.)

        Personally I smoked a pack a day for 25 years, always plain cigarettes. (Filters made me cough.) I managed to give up 25 years ago, thank goodness. So far, touch wood, no ill-effects.

        I know a number of people with their voice-boxes removed who talk through a hole in their throats, because of cancer. Ironically, the only person I know who died of lung cancer was a non-smoker (although, being a surfer, I’m sure he smoked pot.)

        Incidentally, how’s this for an own goal? The cigarette industry has tried to come up with a safer cigarette for decades. Better filters were seen as the way to go, and in 1952 Kent came up with a stunningly effective filter made of…. ASBESTOS! Fortunately, it was too effective and filtered all the taste out of the cigarette, so the public eventually rejected it, but only after smoking about 12 billion of them.

      12. JDPatten

        Has Vlad read Dr K? It remains to be seen. It wasn’t enough if he has,

        Smarter & Martin,
        Right! More power to you.

        I can see that you do not want to engage on a level playing field.
        Not my logic. 😦
        I no more believe cardiac medication put people in the cardiac ward than I do that meds like albuterol put people in the pulmonary ward.
        Look upstream as far as you can go for causes.

        Since you don’t want to play, I’ll share unilaterally:
        I visited my COPD afflicted mother in the pulmonary ward of a large N J hospital in the late ’90s. (She had quit Lucky Strikes three years earlier after forty years of regular smoking.) You don’t need cancer to suffer. Imagine drowning in your own mucus.
        I visited the other patients on that ward over a ten day period. The roster varied. Sometimes more than twenty, sometimes less.
        They. Were. All. Smokers.

        Conclude whatever best fits your preferred model.

      13. Vlad

        Your logic in that example is to look at associations (strong as they may be) on a non-randomized (the status smoker/non smoker is not randomly assigned, but self selected) sample of 20 or so patients and jump to the conclusion that there is a causal relationship.
        That the majority of people who smoked for 40years didn’t end up with COPD, and some of them made the world’s longest lived people list, will just call it the ‘healthy smoker’ paradox. 🙂

    1. Gary Ogden

      Andy S: Great story! Jean Calmet, who lived to 122, smoked until her 90’s (in her case perhaps smoking has a French Paradox). Way to go Canada legalizing dope (but not raw milk!). Our Attorney General, Jeff Sessions, is probably having fits, as he hates the stuff.

      1. binra

        Dope/hemp is not one thing either. I suspect GM is used for skunk and with destructive intent. I suspect the ‘liberalisation’ will turn into a highly regulated patent protected industry grab it is a top-down directive.

        Alcohol is not one thing either. etc.

        ‘Reefer’ madness was the PR by which to kill the first billion dollar industry in the USA. The Oil/Energy cartel also founded the pharmaceutical wing of a global but cloaked power. It’s no conspiracy, it is ‘saving lives’. And that nations which seem to be politically at odds are in the same pharma and hi tech infrastructural complicity, reveals – at least to me – that the politics is a sideshow while the erasure of liberty (and consciousness of it) proceeds unchecked.

      2. Gary Ogden

        binra: “Reefer Madness” was an actual movie they showed us in college health science class. Funny thing is probably half the class were already stoners. The black people in the film. who were listening to jazz, looked like they were having lots of fun! You’re likely right about the probable capture of cannabis by industry, sad to say. I haven’t had any in decades, and haven’t the need or wish for it, yet it is clearly a powerful medicinal.

      3. binra

        I was referring to the hemp industry. Not cannabis as such. Far more than recreational highs from some strains. Linen, paper, fuel. Henry Ford made a motor car (body presumably) from hemp that ran on fuel from hemp. If hemp derived products instead of oil and coal derived plastics had been developed, perhaps happier world… but that choice was the road not taken. And yes, the medicinal properties of hemp are wholly worthy of being made accessible.
        Drug habits tend to represent substitution for a lack of connection. When there is a culture of respect, moderation tends to align with that respect with regard to drugs.
        There is more that came from promotion and prohibition of hemp that is an ongoing blight on such societies – for behind the scenes, both ends are played out.

  39. David K Cundiff

    Regarding the supposed benefit of anticoagulants for atrial fibrillation, I systematically reviewed the randomized trials used to support anticoagulants and subsequent observational data. I concluded, “Flaws in the original 6 warfarin versus placebo RCTs together with recent observational study data suggest that warfarin causes net harm for patients with NVAF. Clinical practice guidelines calling for anticoagulant drug prophylaxis for NVAF patients and Food and Drug Administration approval for anticoagulants for NVAF should be retracted.” https://www.regulations.gov/document?D=FDA-2015-P-3410-0001 This analysis is in the form of a petition to the FDA in the USA to retract the approval of anticoagulants for the indication of NVAF. The FDA has not refuted this analysis in over 2 years.

    1. Bill

      David, as a followup to my earlier comment regarding the unimpressive RCT’s for warfarin in AF . . . your very interesting analysis confirms one of my big skepticisms about the rampant “small effectology” in “evidence based medicine”: even if you think the small benefit (here, stroke prevention) is worth the hazards of the intervention, you first have to believe the small beneficial effect is real.

      That means putting a lot of trust in the research methods used to demonstrate it. Like Nortin Hadler, I just cannot believe current clinical trial methodologies are even close to good enough to merit that trust. A small effect size, the norm in “evidence based” medicine, can so easily result from chance, conscious or unconscious manipulation by researchers, bias, etc. In serious scientific fields small effects like this have to demonstrated over and over to be taken seriously.

      When a medical intervention really works, all of this is moot. Every single hypothyroid person benefits from hormone replacement, for example. No statistical smoke and mirrors required to demonstrate it. Thanks for you look at all this. Except that it only deepens my already tragic level of cynicism about official medical protocols and my fervent hope I’ll remain health enough not to have to consider them.

      1. Sasha

        Actually, many hypothyroid people suffer from underperforming thyroid, not NOT performing thyroid. There’s lots they can do to correct it’s function (Thyroid Secret available on the web goes into some of it). Once people start taking synthetic hormones, it shuts down their thyroid completely.

    2. Bill

      If the secret data used to justify all the cholesterol/statin small effectology at the heart of this blog ever becomes public, I doubt even those very small effects would survive much independent analysis. A very good reason for the medical establishment to let them stay secret for a good long time to come.

    3. goransjoberg2015


      As a CVD-victim myself, how admirable I find your fight against the corruption of the medical research and in the health care system. It is though unbelievable for me that it must take individual MD’s like you and who are willing to pay with their license and their job to take the fight against the “criminal” influence of Big Pharma.

      I think the corruption of the medical system is everywhere and here i Sweden even our renowned Karolinska Institutet (Caring for the Nobel Prize) now having been tarnished.

    4. Sylvia Brooke


      Thank you so much for your comments re the use of anticoagulants for anyone with AF. I was diagnosed with AF two years ago and was initially prescribed Warfarin, which I refused point blank. I had witnessed how badly it had affected friends’ day to day lives who were taking it, and decided that it was just not for me! It has since been suggested that I take Apixaban which, after much consideration, I have also refused to take.

      I have felt bullied on occasion and been passed on to two other doctors in the same practice who persisted in giving me the same advice on a number of occasions. Your comments have made me feel more comfortable with my decision to avoid any
      medication which I do not feel happy about taking. I hasten to add that I am already on other blood-thinners which leave me with bruising most of the time, but do not have any ill-effects that I am aware of.

      Statins and beta-blockers made life a misery for some considerable time before I came upon Dr Kendrick’s blog and decided to take more control over my medication and not be frightened about doing so.

      Thank you for making me feel more confident about my decision. I wish you the very best of luck with your petition.

      1. Gay Corran

        Most interested to read your comment, Sylvia. May I ask what other blood thinners/anticoagulants you are taking?

  40. SW

    Here is an example of how much sun Sunblocks actually provide: My daughter who lives in NY was in Mexico City for 6 weeks, then Sydney for 3 weeks over XMAS, ( 9 weeks sunny climes) on return to Brooklyn she blood-tested D3 at 30! OMG! That is the power of sunblock! She covered so much in Mex and Sydney that she sent her D3 levels thru the floor! Now she is on supplements when she could have gotten her stores built up naturally over the last 9 weeks! GRRRR SHe grew up with Slip Slop Slap, old habits die hard!

    1. Bill In Oz

      Slightly off topic : Philip Adams has a lot to answer for ! He was the advertising guru here in Oz who came up with the ‘Slip Slap Slop’ TV & radio adverts back in the 1980’s…But he’s been managing a huge organic/biodynamic farm near Newcastle for the past 20 odd years..I wonder if he still believes in the value of it now.

  41. mand Season

    Really glad that someone pointed me to this blog! I followed my instinct and came off statins, and *since* then have learnt more and more about why I was right. Also omeprazole and other things, and despite ticking lots of “high risk” boxes I make my own decisions. Recently discovered I have Vit D deficiency as well as increasing blood pressure and the wrong kind of cholesterol… I was always a bookworm, not an outdoorsy type, but in the last 10-15 years have wanted to be out of doors with a desperation like an unfed addiction.

    In the UK we’re even getting less sun than we used to because of climate change. Summers are greyish and dampish, winters do have blue skies on some days but it isn’t warm enough to sit out, you need to be walking. I love walking but various factors prevent me getting out there as much as I want. My question is, do “daylight lightbulbs” and other artificial lighting do any good? If so, how to choose? A sunbed is out of the question, but I save up and could stretch to a daylight lamp or two – IF I know that I’m buying the kind that will actually help. Any advice?

    1. Gary Ogden

      mand Season: Simply search “vitamin D lamps,” and you will find no end of choices in a wide variety of price ranges. I decided this winter to supplement with D3 (2,000 IU/day) rather than purchase a lamp. Between March and October I expose large areas of skin to the sun in the middle of the day, beginning with 10 minutes or so, and working my way up to an hour or more. In the blazing heat of summer I go out by about 10:00 a.m. or so to avoid the heat and still get plenty of vitamin D.

      1. mand Season

        Thanks Gary. I have done that search and there are SO many – I’m not sure if you get what you pay for, or whether to get the cheapest possible… and which claims to believe, etc etc. I got overwhelmed with too much information. I do get outside as much as I can, about 20 minutes is probably my average. Usually between 11am and 3pm. But it’s very rarely warm enough to expose more than face and hands. It’s a few years since I saw any “blazing heat of summer” around here. 😉

    2. thelastfurlong

      I would like to know too. Thanks for mentioning this.

      Virus-free. http://www.avast.com

      On 14 January 2018 at 10:43, Dr. Malcolm Kendrick wrote:

      > mand Season commented: “Really glad that someone pointed me to this blog! > I followed my instinct and came off statins, and *since* then have learnt > more and more about why I was right. Also omeprazole and other things, and > despite ticking lots of “high risk” boxes I make my own ” >

    3. binra

      All through my life I see different weather patterns. These days – it seems anything can happen any time of the year. I think what you truly want can be prioritised above habits of convenience.
      Supplementing sunlight may be worth it in some situations. If you want vit D – and it may be your body DOES – (you can get tested to check your D levels), you have to get the appropriate UV spectrum lamp. These are regulated and expensive but only need short regular sessions daily. Or you can supplement Vit D orally (but at a dose that can make a difference and with Vit K2). However, there is more to a Sum than any of its parts, and fresh air, activity (even a stroll and a sit in a sheltered place) is GETTING OUT of the box and goes under the heading ‘recreational’. It is said that at a cellular level our body is constantly recreating itself. I think Vit D is part of serving that function. If we box ourself off from our larger field of being, within artifice of our own thinking, then we may interpret the call to wholeness as a violation of our ‘peace’ and necessitate a crisis to break through to our attention.
      I sense that it is not un unfed addiction that drives you – so much as a life being put aside while attending other things. The patterns of attention in ‘bad’ habits are more likely the addiction – but of course are normalised and seem ‘easy’ because we have done the learning that made the habit run for us.

      I haven’t gotten UV lighting – but we have invested in NIR lighting – and appreciate it. But we have a sun facing conservatory where we can often open our doors without the wind blowing in. As for exposure risks; I say that if you make a relationship with anything, you find your own way with it.
      I have hardly ever used sunscreens, especially in the last decade or so – and believe susceptibility to damage is also associated with malnourished or toxic diet and etc. Cover, and shade and timing do not have to resort to toxic chemicals.
      In SE England I enjoy more sunny weather than the rest, but the stuff that is being atomised into the atmosphere in criss-cross patterns for ‘weather modification’ is also operating a ‘sunscreen’. There’s a can o’worms. Live this day well anyway – and any way that you actually and practically can.

  42. gollum

    What I always wondered: no Vit.D in winter cause, angle too low.

    It is not the angle but the cosine of the angle, multiplied to the sun-watts per area, getting too low.

    Now if I was to hold my belly at a 30 deg angle, say, on a seat, striving for perpendicular-ness to the sun?

    There will be effects of longer way through the atmosphere of course.. but it would be noon not dawn.

    1. Gary Ogden

      gollum: It is the amount (thickness) of atmosphere that blocks UVB, so I’m afraid your method won’t work. If, on the other hand, you move to the top of Mt. Everest, you can get vitamin D every day of the year.

      1. AH Notepad

        But your heating bills increase, and it’s difficult to get FedEx to deliver supplies on time.

  43. gollum

    oh and Warfarin, isnt that a K antagonist?

    I do seem to recall Vitamin K being pretty important to not having a calcium mine in the main arteries.

  44. Charles Gale

    Found this on Mark Sisson’s Daily Apple:

    Sadly, I know it’s a CVD scenario familiar to some readers here (me included). But, lp(a) and it’s role will be familiar to most readers so we are ahead of the game on Dr Kendrick’s website. No mention of vitamin C deficiency (Pauling/Rath and others) in triggering the production of this repair molecule (but Big pharma could be riding to the rescue!) but Bob Harper does highlight stress and enjoying life.

    1. Gary Ogden

      Charles Gale: I saw that, too. What I wanted was a graph showing risk levels. They say that the beginning threshold of risk is 30 mg/d, and those at 150-200 have a big risk. Mine is 30.4. I’m not concerned. By the way to convert nmol/L to mg/dL divide by 2.5, and likewise to convert mg/dl to nmol/L, multiply by 2.5 (mine was in nmol/L, and it was 76, above the range of <75).

    2. Craig E

      Funny in that article it refers to PCSK9 drugs that lower lp(a). However they should have also said…as covered by Dr K in an earlier blog post…that the Repatha trial was a miserable failure for hard end points. So PCSK9 inhibitors are good at lowering ldl but hopeless at saving/prolonging lives.

      1. Gary Ogden

        Craig E: I also recall in the article them implying or stating that they have no idea what lp(a) is for, or why it is high, but Dr. Kendrick explained that clearly a few Roman numerals ago. The major newspapers now have four spin doctors for every reporter, so reporters have little time to check anything.

  45. Brian griffin

    I subscribe to another blog that I find interesting but not as researched and committed as our Dr. Malcolm, however he has just posted something that strongly supports the second of Malcolm’s 3 big ticket items for living longer…exercise. Here is the link to it and to the referenced study. Not sure how to make these active hyperlinks sorry.



    1. Mr Chris

      Brian Griffin
      Thanks for that. A very informative article. I have printed out the table, and regret to say that I fall between moderate and vigorous. Will crank the machine up.

    2. Andy S

      Brian, exercise is good but what causes arterial stiffness?

      Aspects of Hyperglycemia Contribution to Arterial Stiffness and Cardiovascular Complications in Patients With Type 1 Diabetes
      “one possible mechanism could be a negative effect of glucose on the arteries resulting in a stiffening of the arteries and ultimately in vascular complications”

      Adequate K2 might also be beneficial in preventing ossification of arteries.

  46. Craig E

    Following up on the comment from Bill from Oz the sun exposure policy in Australian schools is totally mad. In Canberra in August (Winter month with an average daytime max of 13 degrees C), the children must wear a hat for the roughly 40 minutes they are outside. What the….??? No hat…no play outside. I think I will put together an evidence brief to the Department of Education…although I am fairly sure that my efforts will be in vain. I don’t know about anyone else but when I walk out on a Winter day and the sun hits me it feels so good and uplifting. Despite having had numerous BCCs frozen off/cut out I am sun addicted (although more careful to to burn these days).

    1. Bill In Oz

      Utter madness Craig !!
      But the school teachers think they are protecting children from the sun…And could be guilty of ‘lack of care’ if the kids played in the sun.

    2. Gary Ogden

      Craig E: I’ve had at least 6 BCC’s and SCC’s, all but one on the face, and removed with Moh’s surgery. For years I drove more than an hour with the sun streaming through the window to my left side in the morning and right side in the afternoon. Interestingly, all but two of these were on the right side.

      1. Craig E

        Gary my BCCs have been shoulder, neck, leg and arm. I have never been overly concerned about BCCs and now I get them frozen off before they are big enough to need cutting out. I’d rather get my VitD and avoid worse outcomes. I am glad I stumbled across this blog 3 or so years ago. Makes great reading!

    1. KidPsych

      Wouldn’t there be confounds at the population level for that review? Fairer skinned people who are seeking darker skin (and thus using tanning beds) are also more likely to develop melanomas, no?

  47. Frances

    When growing up in NL, Canada, in primary school, we students were issued with a bottle of cod liver oil; certainly, no vit. D in the Canadian winter sun. Some bottles got accidentally broken on the way home. Not mine. The Inuit got their vit. D from eating the livers of the fish/animals they consumed.

  48. Frances

    I subscribe to a newsletter re Vit. D and appreciate its info.; however, I am timid when it comes to supplementing with a Vit. D supplement, e.g. an oil like olive oil or lanolin which is irradiated. I know I am Vit. D deficient having had a urine test and despite living in a sunny climate year around. https://grassrootshealth.net/

    1. smartersig

      Vit D3 with K2 supps work very well, in my case a 5,000iu took me from 70 to 123 before I had to cut back to 1,000iu per day

    2. binra

      Deaths and illness from overdosing Vit D?
      Deaths and illness from iatrogenic ‘health care’?
      I don’t need the exact figures to make an informed decision!
      There are studies I haven’t a handle on at present that used astronomical dosage of Vit D over significant periods of time – with no ill effect. Unless shown otherwise, I lean to Vit D being ‘demonised’ without substance of fact and installed into the mainstream medical mind. As a result, even those who know the official ‘recommended dosage’ is too low to effect significant help, are unlikely to openly share what they believe is more effective.
      Just as with sunshine, just as with medical advice on anything, a host of corporately effected inhibitions and disincentives keep everyone in line by repeated editing to whittle away, rephrase and effectively neuter or dilute any report that would upset business as usual.
      But regardless what I choose for myself, you are the arbiter of your own choice and if you have fears,but also obviously some attraction to considering Vit D as a factor in your wellbeing, then continue to educate yourself as part of gaining the clarity with which to stand in what you choose – and of course review your own experience alongside that of others.

      1. Mr Chris

        I supplement with 5000 units a day in the winter, with no obvious or visible side effects, excepting a certain intolerance of some of the posts on here.
        Trying to be a Stoic for 2018

      2. binra

        Yes that is probably enough to be helpful.
        The vit D issue is – I believe – deliberately sown with disinformation, because in adequate levels it reduces the incidence of sickness and consequently works against the pharmaceutical capture. Levels indicated vary hugely – ie 400 through to 5000 iu. Just as with sun exposure, there is professional reticence to openly recommend what would otherwise be suggested. The Vitamin D council suggests 5000 with upper limit of 10,000 iu daily. But there are all sorts of details:
        Setting standards that then get locked in is rarely science.
        I read that because Vit D was originally associated with bone health, that the serum level was moved from 20-30 because no further bone benefit was associated with going higher. So if this is the case, one facet of vitD determined a level without regard to other now known benefits.
        My skim of Vit D side effects did not convince me that these are significant. The official line suggests that to reach such adverse reaction would require over 10000iu for many months. Looking at the list of symptoms is looking at signs that would allow easing off – and there is blood testing to support a higher dose regime.
        I have read that very high vitD has been used under fancy made up names – and no doubt pricing – as cancer drugs.

      3. smartersig

        I agree Bill but I would just like to make one other point which some seem to be missing with their compartmentalized view of choice and industries. These seemingly disparate industries work synergystically (spelling ?) , the Pharma industry will be happy to support the food industry because they keep people sick. The food industry will reward those hospitals that keep coke on the corridors because they keep people sick. That does not mean coke rep walks into the Hallamshire and slaps a cheque on the directors table but if you follow the money. Big Pharma and Big food are the same people

      4. Mr Chris

        I suspect that Hallamshire hospital received á visit from á rep who said
        Look we will put vending machines on every floor, stock them up, and give you a certain percentage of the take. The hospital, like many institutions was one war behind, and was still fighting the healthy fats battle, not realising that sugar was now seen, by some, as a bigger danger. In addition thanks to the UK government’s war on the NHS, the hospital is strapped for cash, and needs all the money it can get.
        On the subject of sugar, have you ever looked at the sugar content of children’s cereals?

      5. Bill In Oz

        Finally I can not only understand your comment, I agree with you.
        D3 has been maligned as a supplement since the 1930’s despite having no ill effects. In 2014 I read Jeff Bowles book “The Miraculous Results of extremely High does of D3”. Since then I have been taking a goodly amount every day. Currently I take a 10,000 IU capsule each day. At one point last year I had a blood test which included D3. It was 400. And no ill effects at all.

      6. binra

        Well there you go Bill – we have both read the same book and are both taking 10,000 iu daily without noticing any unwanted effects. As mentioned in the book, I had a slightly racy reaction that disappeared on changing our vit K2 source.
        I cant list all the issues I haven’t had as a result… 😉
        And don’t know if its is hugely significant or not. I’m alive here and now – and have not had significant relationship with pharma over the most part of my not unchallenging adult life. So as someone who never took anything for anything, it felt weird taking supplements at first but worthy of the exploration and discovery in light of uncovering an awareness of such lies, deceits and general poisoning/denaturing in our current social milieu.

        But I also have a sense of embracing who I am and that to some degree means (for me) opening to what is going on for me currently at another level than assuming health is an absence of symptoms. The suppression of symptoms is perhaps something that loads up a jack-in-the-box for later in life.
        So I open into what comes up in the trust that it – or indeed I – seek release or reconciliation. Peace is a quality of acceptance for self and other – in my sense of gratitude for being.

      7. Bill In Oz

        Binra, you wrote ” Well there you go Bill – we have both read the same book and are both taking 10,000 iu daily without noticing any unwanted effects.”
        Yes no unwanted ill effects…Jeff Bowles presents a strong case in his book that back in the 1920-30’s US pharmceutical companies were alarmed at the ‘healthiness’ of people taking large doses of D2 ( There was no D3 available then ) a natural substance which could not be patented.
        Jeff suggests that they mounted a scare campaign & persuaded the USA government to restrict it’s availability…

        I think he is correct. It is hard to obtain here in Oz in the dose I take from any pharmacy. But the web is a wonderful tool. We can avoid them completely.

        ( PS ..The later lines of your comment wandered off into the clouds for me…And as we all know who have flown in cloud, we cannot see anything at all.)

  49. KidPsych

    Interesting study that popped up on Mark Sisson’s blog: https://www.nature.com/articles/ijo2017231
    In conclusion, we showed that triglycerides cross the BBB and induce central receptor resistance to leptin and insulin, with resulting effects on feeding and cognition. These results suggest that targeting triglyceride levels in blood could be a strategy for treating obesity and the cognitive problems associated with CNS resistance to leptin and insulin.

    1. Craig

      Insulin resistance is a very complex phenomernon with many facets some of which are regulatory and some pathological. In this case perhaps you could think about it thus: If you have high levels of energy supply molecules circulating then it is a very good idea that some cells should become insulin resistant, as a way of turning away the excess. It is like a sophisticated battery charging system. You want less current going into cells that are already charged. Battery cells or human cells.

      Eating a diet which is high in fats and also high in sugars/starches is probably not a good idea anyway.

      1. Dr. Malcolm Kendrick Post author

        Thank you Joe. This is exactly what I have been banging on about for some time. I recommend that everybody reads this article by Jason Fung. It will stop me having to write on this topic again, at least for a while.

      2. Bill In Oz

        Sorry Malcolm, I disagree. I find your own writings far easier to understand than Jason Fungs. I just went & reread that link…And it is not as clear and easy to understand as your own.

  50. Eric

    I apologize again for posting something mostly unrelated:
    do all NSAR now cause MI and stroke? We know aspirin has a net benefical effect which is down to its anticoagulant and antiinflammatory action as well as probably a few less researched effects. It stands to reason that other NSAR, which are at least anti-inflammatory even if not antocoagulant should also exert some beneficial effect on the endothelium. This article seems to condemn all NSARs:


    translated quote:
    NSARs have been known to cause stomach issues for a long time, but it is only recently that we have learned that they may promote mycardial infarction and stroke says Tania Schink, head of the group for pharmaceutical risk reasearch at the Leibniz institue for Prevention Research and Epidemiology. Schink is part of a worldwide project that has already taken a closer look at side effects of NSARs. MI and stroke, Schink says, aren’t just long term effects. Patients with CVD may take harm even from short term usage and are already counseled by many doctors not to take any medication from this class.

    “Von den Magenproblemen unter NSARs weiß man schon lange. Aber seit Kurzem wissen wir auch, dass sie Herzinfarkte und Schlaganfälle begünstigen können”, sagt Tania Schink. Sie leitet am Leibnizinstitut für Präventionsforschung und Epidemiologie die Arbeitsgruppe Arzneimittelrisikoforschung leitet. Schink arbeitete an einem weltweiten Projekt, das sich die Nebenwirkungen der NSARs genauer angeschaut hat. Herzinfarkte und Schlaganfälle, sagt Schink, sind nicht nur langfristige Nebenwirkungen. “Herzkranken Patienten kann auch der Kurzzeitgebrauch schaden.” Ihnen raten die meisten Ärzte inzwischen, auf derlei Schmerzmittel zu verzichten.

  51. Charles Gale

    Nigel – high cholesterol/hypercholesterolemia

    Was this a one off blood test you had? Don’t forget, a one off result/test is a snapshot in time. Further testing may provide a clearer picture of your cholesterol levels. And on the subject of testing, further to Philip Thackray’s link to Dr Mike Eades’ blog on the Feldman protocol, here’s another link to another Dr Mike Eades blog:


    Interesting info on how they measure LDL cholesterol. If you have had a full lipid profile done, and have really low trigs, you may want to put the results into a Friedewald/Iranian converter and get a more accurate, lower LDL reading. Better still, get a direct measure from your blood if possible.

    Also, not sure if you mean familial hypercholesterolemia (FH) when you say hypercholesterolemia. A genetic test is needed for the diagnosis of FH. Zoe Harcombe has blogged on this – visit her website and put familial hypercholesterolemia into the search engine.

    I, too, have high (apparently!) total cholesterol (double figures mmol/L) and been diagnosed as FH based on just the blood test/high tot chol. So, I had a genetic test done and the result was not FH: “the laboratory has not been able to identify a gene alteration that is known to be associated with FH”.

    Plenty for you to think about.

    Perhaps breaking into the surgery might be a good idea.

  52. Charles Gale

    Frances – vit D3 urine test

    Could you provide further details on this test? I thought it had to be a blood test to check your levels: 25 (OH) D. I followed your link but could only spot info on a pin prick blood test.

  53. Charles Gale

    Frances/ Binra – criss cross patterns in the sky

    I presume this is a reference to either vapour trails and/or chem trails?

    Despite living about 15/20 miles from both Gatwick and Heathrow, in the last couple of years the flights flying over my house are pretty much 24/7 and low enough to see and hear. Never used to be any – all very sly and subtle how it builds up.

    And linking this comment to the theme of this blog part 44, it makes being outdoors very unpleasant from a noise point of view and the pollution issue too.

    But people must have their holidays! Reminds me of a sticker I saw on a lorry which said something like: don’t get impatient because I’m in front of you and slowing you down – you are the ones ordering the parcels.

  54. Wayne Hutchings

    There’s an interesting chapter in Barry Groves book “Trick and Treat: How ‘healthy eating’ is making us ill” where he discusses sun rays and vitamin D. Here’s a short snippet:

    “The polyunsaturated fat connection. Since the 1960s, linoleic acid and vegetable margarines and cooking oils that contain it, have been shown time and again to increase the risk of many types of cancer, including skin cancers. Drs B. S. and L. E. Mackie, working on Australia’s Sunshine Coast, have a great deal of experience in skin cancers. As long ago as 1988 they said: ‘In view of the work of Black and Erickson in mice and our own work in humans, we believe that human subjects who are at high risk of melanomas and other solar-induced forms of skin cancer should be advised to be moderate in their intake of dietary polyunsaturated fats.’”

    He also tells of a living in Singapore in the 60s as a fair-skinned chap.

    “Nobody used a sunscreen. If we used anything at all –which most of the time we did not –it was a well-shaken mixture of coconut oil and vinegar, a concoction used at the time by naturists. We smelled like a fried fish shop, but my skin never burnt while I lived there. Today, it seems, all that has changed. Why? What has happened in the last 40 years?”

    1. Craig

      Wayne Hutchings – likewise, growing up in southern Australia in the sixties we only ever used coconut oil. Often there would be someone at the beach with a spray gun who would cover you with the stuff for a small fee. Coconut oil is a saturated mct too – skin seems to do well with saturated fat for a ‘moisturiser’.

    1. Joe

      He preaches a high-carb low-fat diet, with many small meals per day. Plus a lot of exercise. And somehow he had a 95% blockage.

      I hope he does okay, but he should probably put his diet book on hold and write one on controlling stress. getting enough sleep, etc., instead.

      1. Andy S

        Joe, exercise guru’s MI convinced me that diet will now be #1 on my list of things to get right. It is relatively easy to correct a fatty liver or metabolic syndrome with diet, exercise not required. Practice healthy sun exposure and healthy smoking (if such a thing exists).

        My concept of exercise now (78 yr) is to move in order to keep the lymph from stagnating. Purchased a rebounder for my birthday and keep it in the living room. Use it a few minutes multiple times a day.

    2. Martin Back

      – Bob Harper was the picture of health, a celebrity fitness trainer who whipped people into shape each week on the hit TV show ‘The Biggest Loser’… But last February, Mr. Harper, 52, suffered a massive heart attack at a New York City gym and went into cardiac arrest.

      – Sandra Revill Tremulis was a health-conscious medical device executive who moonlighted as an aerobics instructor, followed a strict diet, and maintained 16 percent body fat, equivalent to that of an elite athlete… had a 95 percent blockage in one of her coronary arteries.

      They say hard work never killed anyone. They lied! These people are typical examples, striving to achieve, driving themselves into the ground. Now they want to lecture me about Lp(a). They should shut up and listen to me. I didn’t get a heart attack, so obviously I know more about it than they do.

      Here is my advice: Go to a game reserve and look at the animals. Really study them for several hours each, don’t just note them and drive by. See the king of the jungle? He’s hard to spot. His camouflage is amazingly good, and he doesn’t move much. He mostly spends his day snoozing in the shade of a thorn tree, digesting his last meal. And those donkeys in the hi-viz jackets, the zebras? They stand around munching grass all day. They don’t exert themselves.

      The only creatures fighting each other and striving to get more than the next guy are the vultures squabbling over a carcass. Do you want to be a vulture? I hope not. And what happens to a vulture who manages to eat the whole carcass? He’s too heavy to fly, so he becomes easy prey.

      I think we were put on earth for a purpose. I don’t know what it is, but I think a study of the natural world provides pointers to the right direction to take. And a heart attack is a sign you’re on the wrong path.

      1. Gary Ogden

        Martin Back: How right you are that a study of the natural world is instructive. I met up with a robin on the trail this summer, at a time when there would either have been eggs or young in the nest. She exhibited all the normal behaviors one would expect: feigning injury, attempting to draw me away from the nest. A few weeks later I saw her again, at the same spot on the same trail, and she paid no attention to me.

      2. Mr Chris

        You will note that Bob Harper didn’t follow your advice, but convalesced writing a book called ” super Carb Diet”
        Was his experience really caused by high lp(a)?

  55. smartersig

    While working though the references on an olive oil meta study I came across this interesting one. There has been comments before as to what is the Med diet, does it exists. Well who cares I am only interested in what your med diet is or in this case what the Attica study med diet is and does it offer any benefits. Warning, read with caution if you are meat eater (squirells excluded of course)


    1. KidPsych

      I don’t see anything in there that truly implicates meat as a negative factor in regard to inflammation. You seem bizarrely determined to show that your diet is correct, and those leaning more toward keto are wrong.

      1. smartersig

        There is plenty in there to chew on whether you are a meat lover or not, but on the subject of meat

        “However, it could be argued that the benefits of the Mediterranean diet on atherosclerotic markers are confounded by several social or lifestyle factors, like the presence of physical activity or the absence of smoking habits. Therefore, we repeated the data analysis after controlling for age, gender, smoking, physical activity, financial and education status, body mass index, presence of hypertension, diabetes, hypercholesterolemia, and family history of coronary heart disease. The multiple regression analysis confirmed the aforementioned associations (Table 4). Furthermore, an additional multivariate analysis revealed that consumption of fruits (Hotelling’s trace = 3.7, p < 0.001), vegetables (Hotelling's trace = 3.4, p = 0.02), and moderate alcohol (Hotelling's trace = 5.4, p = 0.001) were inversely associated with the spectrum of the investigated inflammatory markers, whereas consumption of meat (Hotelling's trace = 4.1, p = 0.02) and increased alcohol intake (Hotelling's trace = 5.2, p = 0.001) had the most positive effect on the investigated biomarkers, after controlling for the previous set of covariates and factors."

      2. SW

        Hi Kid, I did Dr Shawn Baker’s ( Orthopedic Surgeon) 90 day meat trial, my CRP ( inflammation) was was 1.9 before Low Carb High Fat Change, at start of all meat it was 1.4 at the end of the 90 day trial it was 0.8! I posted all my labs with Shawn Baker. Virtually every bio marker was improved. My meat diet included ribeyes, lobster, prawns, lamb, offal, goat, … virtually Zero Carb and all meats were included. no plants. I was very amazez and hae remained pretty close to Zero Carb since the trial. Interesting Serum Ferritin went down, Crp down, Cholesterol ratios improved ie trig/hdl etc. Troponin 2 … you name it was improved or remained the same! I did not die of scurvy. Glucose and Carbs v Vitamin C compete with each other and meat and offal actually has enough Vit C! All in the name of science!

      3. smartersig

        I do not have a problem with any of those markers Gary so I am not sure what good it would do me. The only markers I have had trouble with are Homocysteine, now OK with B12 and Folate and LPLAC 2 which has dropped a bit but still too high.Even if it dropped that I would not want to effect some possibly irrelevant marker at the expense of other problems.

      4. goransjoberg2015


        I am for sure a meat eater on strict LCHF and in ketosis since some years now. When I was in touch with the health care system a few years ago regarding my CVD “innumerable” tests were taken, not least on the inflammation markers, and basically everything was just perfect.

      5. Bill In Oz

        Curious how some folks not yet joined the rest of us over in the different playing field as suggested by Dr K on a quite a few occasions. I guess food & diet of one kind or another is an obsession for some folks. 🙂

      6. smartersig

        I do not think it is solely about diet but I do think its a huge player. Too often people who want preach that it plays littler part simply dont want to hear bad news about their bad habits.

      7. Mr Chris

        Dear Smartersig
        people don’t want to hear about their bad habits
        I take it you meant to write “people don’t want to hear what I smartersig, consider are their bad habits!

      8. smartersig

        Not at all, I suggest you take no notice of me but only the research behind anything I may say or reference

  56. Randall

    From – The BMJ: leading general medical journal with an archive back to 1840.
    Subclinical magnesium deficiency is a common and
    under-recognised problem throughout the world. Importantly,
    subclinical magnesium deficiency does not manifest
    as clinically apparent symptoms and thus is not easily
    recognised by the clinician. Despite this fact, subclinical
    magnesium deficiency likely leads to hypertension,
    arrhythmias, arterial calcifications, atherosclerosis, heart
    failure and an increased risk for thrombosis.

    1. Gary Ogden

      Randall: Thank you very much for that link. One of out favorite scientists. One thing that I found concerning is that those on long-term diuretics (as I was) can develop Mg deficiency, which raises BP. How often do doctors advise a Mg supplement with a diuretic prescription?

    2. Bill In Oz

      Randal, I take Magnesium tablets each night. So that’s an interesting article to me. Thanks for the link ! Also open access so I am printing it of to go through in detail later…
      Have you ever read Dr Dennis Goodman’s book ” Magnificent Magnesium” ( Square One Publishers, 2014.) ? Goodman recommends Magnesium for CVD patients also.

      PS It’s important to take thr right type of Magnesium supplement > Magnesium Oxide is dead cheap but cannot be absorbed & gives us all diarhorrea ! Magnesium citrate or orarate is the way to go as both are easily absorbed. .

  57. AnnaM

    I have always been suspicious of the medical model of radiation that only worries about total yearly dose.
    A CT or PET scan gives you all the radiation at once, whereas those people in the apartment building took (if I got it right) about one CT’s worth of radiation over a year’s time. Since these radiations are energies, why assume that a slow gentle exposure is the same as a big hit? It’s like you could tap your bumper against a wall going 5 miles per hour any number of times, but hit that wall once at 60 and it’s a whole other game.

  58. Jeff Cable

    smartersig said… “How can you be unhappy for drug companies to mismanage us but happy that hospitals do the same promoting coca cola and Dr Pepper. If hospital introduced cigarette vending machines would that be OK because it is all part of free choice and we do not want hospitals managing our choices ?.”

    smartersig; If you wish to debate with me, please would you be kind enough to do so honestly. Your example is not a like for like exemplar of the issue under examination. I fail to understand how you don’t see the difference between knowingly and dishonestly manipulating research data for pecuniary advantage (the pharmaceutical industry) q.v…



    …and selling the freely available substance that is known by many people as whole milk.

    I should not need to spell it out smartersig. Because you are apparently having difficulty with understanding the issue at hand, I will do so. There is a world of difference between breaking the law for profit (creating fake medical journals to sell more pharmaceutical products) and selling a product (whole milk) which is not illegal… yet.

    I don’t want (nor do I need) any clinician, hospital, benevolent organisation, or any other body with a vested interest in the outcome of their own deliberations to manage my choices. Good health is a partnership between the patient and the treating clinician. It can NEVER be a partnership when the power to choose is removed from the patient.

    You also have missed the point which was being made by a very large country mile. At no point in the history of the in-hospital Costa coffee house franchise… were the Costa company promoting or attempting to push whole milk onto an unsuspecting or unwilling populace. It was merely a choice to be made by people/customers such as myself; who have not bought into the cholesterol/heart disease hypothesis.

    I suggest that stocking a product in a shop does not necessarily require the stockist to promote the item. They need only stock it and sell it to willing purchasers. It does not imply agreement in any particular with the item sold or the company ethos of the manufacturing company.

    1. smartersig

      The thrust of my argument was not around Milk, on that topic I made a brief mention of why they may have removed it. My main gripe is with Cocal Cola, Dr Pepper etc sold on every ward in the Sheffield Hallamshire hospital and other hospitals around the UK. Now I am going to put this in very strong terms, I understand you choice argument on Milk and would actually agree with it as Milk is a more contentious subject with some pro and some con arguments. But anybody who defends the widespread sale of Coca cola in hospitals after they have been politely asked to remove it is an idiot of the highest order. You see the people who want you to buy this crap need to appeal to some sort of vulnerable nerve that will bypass the argument that the stuff will lead to an early death. They do this by suggesting that in the land of the free and the brave your freedom is eroded if we allow health centres to dictate what we can buy on their premises. You are better off with a fully functioning sense of freedom even if it means less than fully functioning liver. Only the brain dead and half asleep members of society of course fall for this marketing speak. If I had a pound for every time some highly educated dumb person responded with an ‘erosion of freedom’ argument on this issue of how the health service is killing us I would be able to at least by a controlling share of coca cola (Warren Buffet dont worry just exaggerating a little).

      1. Dr. Malcolm Kendrick Post author

        I still favour education vs. legislation. Freedom also includes the freedom to do stupid, an/or, dangerous things. Such as the freedom to climb Mt Everest, which carries a one in thirteen chance of death – for each expedition. I think that makes it more dangerous that drinking a can of Coke?

      2. Sasha

        Especially if you do it in shorts only as Wim Hoff has recently done. And he almost got all the way to the top! Shows how little we know about our hidden abilities…

      3. Dr. Malcolm Kendrick Post author

        Of course. However smoking, unlike most other things, has a direct effect on other people – who are forced to breathe in the smoke. So I would not support smoking in hospitals, or smoking in other public places. Do what you like to yourself, but don’t harm others at the same time.

        I would re-iterate that banning is always an easy option, and it fulfils a deep seated need present in many people to control the actions of other people. However, the history of banning things e.g. prohibition, or the war drugs, has not been a resounding success. If there has been a war on drugs, for example, then I thinks drugs won.

      4. smartersig

        Malcolm you are extrapolating my point to try and make a point. I did not suggest prohibition on cigs nor would I ever. What I am saying is organisations supposadly invested in health should take a stand and say what you do in your own time is your business but we will not endorse it by selling the stuff to you. It never fails to shock me when I find doctors who dont agree with this stance

      5. Dr. Malcolm Kendrick Post author

        It becomes a short step from once stance to another. It always shocks me when doctors refuse to treat people who smoke. As doctors we are not here to enforce our standards, or beliefs, on anyone. We can try to convince – and I am all for that. But once you step onto the banning bandwagon – where do you stop? Ban everything you disagree with, and consider unhealthy? Then, most authorities would ban sunbathing, and cholesterol and saturated fats. Then you can move onto mandatory health checks and mandatory statin prescribing – and suchlike.

        ‘If people let the government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny.’ Thomas Jefferson.

      6. AH Notepad

        Sorry, that is irrelevant as there is legislation prohibiting smoking in any building with public access, and the hospitals now even prohibit anywhere on hospital grounds. If you want cigarette machines you will have to get the legistlaton changed. But then I suppose you meant something else.

      7. AH Notepad

        smartersig, I think you might find most, if not all, objections to your original comment were to do with removing whole milk. Indeed, you went on to imply it is signigicant in the development of prostate cancer. If this was not the case, it illustrates why being clear in posts is important. I don’t remember Dr. Pepper being mentioned in that post, now here we find this mentioned as a primary product to be removed.

      8. smartersig

        It can be a little tricky, they may have been on seperate threads but were connected by a common theme, should hospitals be banning items eg coke, dr pepper, milk …. etc.
        I was simply explaining why hospitals may have taken the stance on Milk namely the research showing a connection with amongst other things prostrate cancer. Now if people want to take a balance of research and come to the conclusion that milk is fine then OK but that does not mean the negative research has gone away. Personally I dont use the stuff I prefer to follow the good advice offered on here by another poster namely that we should all look at those smart animals in the wild taking it easy and by the way drinking only their own milk up to an age when they can tolerate solid food

      9. Bill In Oz

        Smatersig, there is an alternative explanation. The stuff is legal & addictive. Perhaps they stock these crappy high sugar drinks to prevent folks there getting agitated from withdrawal as a hospital ‘safety’ measure ?

      10. Bill In Oz

        The operative question is whether the hospital management & staff think this way.

        There are also the patients visitors to consider. Many of them are addicted to sugar or salt. So Sugary drink and chips helps keep them calm as well.

  59. Randall

    Hypomagnesaemia (abnormally low levels of magnesium in their blood) can impair the release of nitric oxide from the coronary endothelium, Since nitric oxide is both a vasodilator and an inhibitor of platelet aggregation, this makes magnesium supplementation a promising therapy in the treatment of hypertension and coronary artery disease. Indeed, magnesium therapy may enhance prostacyclin release from the vascular wall. Magnesium deficiency and magnesium depletion in soft tissues can cause calcifications in the heart, liver and Magnesium deficiency may be a leading cause of kidney disease skeletal muscles. A greater intake of magnesium is associated with having a lower risk of an elevated coronary artery calcification score, Magnesium treatment for 3 months in patients with ischaemic heart disease increases the apolipoprotein A1:apolipoprotein B ratio by 13%, decreases the apolipoprotein B concentrations by 15%, and decreases very low- density lipoprotein concentrations by 27%. Magnesium supplementation significantly decreases total cholesterol, low-density lipoprotein and total cholesterol: high density lipoprotein ratio. ‘…low heart muscle magnesium may contribute to sudden death after myocardial infarction. intravenous magnesium to healthy volunteers significantly inhibits both ADP-induced platelet aggregation by 40% and binding of fibrinogen or surface expression of GMP-140 by 30%. http://openheart.bmj.com/content/openhrt/5/1/e000668.full.pdf

      1. Mr Chris

        Dr K
        Could you please republish your comment about diet say every 50 posts, so it might just be taken in. It is said that when learning a foreign language, you have to see a new word seven times times to remember it. Would that the same applied to diet!

  60. Errett

    Now, a collaborative team of researchers from the Division of Hemostasis and Thrombosis at Beth Israel Deaconess Medical Center (BIDMC) and the Wyss Institute at Harvard University have discovered that synthetic APC-mimicking small molecules called “parmodulins” provide anti-inflammatory and anti-thrombotic protection to endothelial cells on par with APC’s without interfering with normal blood clotting and coagulation, making them attractive new drug candidates. This work was enabled by leveraging the Wyss Institute’s Organ-on-a-Chip technology to model thrombosis within a human blood vessel in vitro. The results are reported in this week’s issue of Proceedings of the National Academy of Sciences.

    “We essentially performed a mini pre-clinical trial of parmodulins’ effect on the endothelium, and not only determined the pathway through which parmodulins function, but also demonstrated that they help protect endothelial cells from inflammatory damage,” says former Wyss postdoc Abhishek Jain, Ph.D., who is now an Assistant Professor and director of the Bioinspired Translational Microsystems lab at Texas A&M University.

    The target protein on which both APC and parmodulins act is the transmembrane protein protease-activated receptor 1 (PAR1), which is present on both endothelial cells and platelets that circulate through the blood and promote clotting, making mechanistic analysis difficult. PAR1 was originally identified as a receptor for thrombin, which is a crucial part of the inflammatory process. However, when PAR1 is activated by APC on endothelium, it triggers anti-inflammatory, anti-apoptotic, and barrier-fortifying pathways, all of which help protect cells from the negative effects of inflammation.

    In addition to activating PAR1, APC also independently inhibits the generation of thrombin, which is an essential component of healthy blood clotting — but inhibiting thrombin too much leads to uncontrolled bleeding. Knowing that parmodulins bind to PAR1, the team of scientists and clinicians set out to find a way to activate endothelial PAR1 and reduce thrombic responses without thinning the blood, and thus provide a better alternative to APC.

    To evaluate the activity of parmodulins on endothelium, Karen De Ceunynck, Ph.D., postdoctoral research fellow at BIDMC and first author of the paper, incubated human endothelial cells with parmodulin 2 in vitro for 4 hours and then exposed them to the thrombin-inducing inflammatory agents lipopolysaccharide (LPS) or tumor necrosis factor-α (TNF-α). In the parmodulin-exposed cells, both agents’ ability to generate thrombin was reduced by over 50% compared with non-parmodulin-exposed cells. However, parmodulin 2 did not inhibit the activity of factor V or factor X, proteins that function in blood coagulation. “We were intrigued by the notion that parmodulin 2 inhibited LPS- and TNF-mediated prothrombotic effects on the endothelial surface without impairing blood clotting” says De Ceunynck.

    To confirm this theory, the team used a Wyss-developed blood-vessel-on-a-chip consisting of microfluidic channels embedded in a clear polymer chip, coated with collagen, and lined by human endothelial cells. Whole blood was perfused through the chip to simulate the flow conditions within human blood vessels, to which were added different pro- and anti-inflammatory compounds to evaluate the response of the endothelium.

    When the endothelial cells were exposed to TNF-α before being perfused with whole blood, platelets accumulated on the endothelium in a typical inflammatory response; if the cells were first exposed to parmodulin 2 and then TNF-α, platelet accumulation was inhibited and the endothelium resumed its normal function. These results indicated that parmodulin exposure blocks the thrombotic response of endothelium to inflammatory stimuli without affecting blood coagulation in humans — a significant improvement over APC.

    A series of tests in vitro performed by co-first author Christian Peters, Ph.D. at BIDMC, confirmed that parmodulin 2’s activation of PAR1 also induces cytoprotective responses in endothelial cells by inhibiting apoptosis (programmed cell death) induced by thrombin, TNF-α, and the apoptotic alkaloid staurosporine through a signaling pathway that begins with parmodulin 2’s binding to a specific site on the cytoplasmic side of PAR1. “We observed that the cytoprotective response induced by parmodulin 2 happened very quickly, and confirmed its rapid onset in time course and gene expression assays,” says Peters.

    Additionally, in vivo studies in mice showed that parmodulin 2 reduces the binding of white blood cells to blood vessels and impairs platelet and fibrin accumulation at injury sites during the inflammatory response, confirming the anti-thrombotic and anti-coagulant activity of parmodulin 2 observed in vitro. Additionally, parmodulins do not interact with many of APC’s other binding partners, making it much more targeted to PAR1 and reducing other side effects.

    “The discovery of an anti-inflammatory molecule that prevents endothelial thrombosis but also preserves normal blood coagulation is a major step toward an alternative and better approach to treating inflammatory disease,” says Rob Flaumenhaft, M.D., Ph.D., Professor of Medicine at Harvard Medical School, Chief of the Division of Hemostasis and Thrombosis at BIDMC, and corresponding author of the paper. “Furthermore, nearly all other pharmaceuticals that target transmembrane PAR1-like receptors bind to the exterior side of the receptor; parmodulin 2 represents a paradigm shift for compounds targeting these receptors because it acts on the cellular side of the protein. We are excited to see if we can advance it to clinical trials.”

    “This work provides another example of how organ-on-a-chip technology can enable faster and safer development and evaluation of drugs that could help patients around the world,” says co-author and Wyss Institute Founding Director Donald Ingber, M.D., Ph.D., who is also the Judah Folkman Professor of Vascular Biology at HMS and the Vascular Biology Program at Boston Children’s Hospital, as well as Professor of Bioengineering at Harvard’s John A. Paulson School of Engineering and Applied Sciences (SEAS).

    Additional authors of the paper include Sarah Higgins, Ph.D., also a Research Fellow at BIDMC; Omozuanvbo Aisiku, Ph.D, former Postdoctoral Research Fellow in the Division of Hemostasis and Thrombosis at BIDMC and currently a scientist at Instrumentation Laboratory; Jennifer Fitch-Tewfik, Ph.D., former Postdoctoral Research Fellow in the Division of Hemostasis and Thrombosis at BIDMC and currently a teacher at Southeastern Regional Vocational Technical High School; Sharjeel Chaudhry, a Predoctoral Fellow in the Division of Hemostasis and Thrombosis at BIDMC; Chris Dockendorff, Ph.D., Assistant Professor at Marquette University; and Samir Parikh, M.D., Associate Professor at HMS.

    This research was supported by the National Heart, Lung, and Blood Institute and the Wyss Institute for Biologically Inspired Engineering at Harvard University.

    Story Source:

    Materials provided by Wyss Institute for Biologically Inspired Engineering at Harvard. Original written by Lindsay Brownell. Note: Content may be edited for style and length.

    1. Dr. Malcolm Kendrick Post author

      A bit tough going for many people. My problem with it, is the obsession with inflammation as the ’cause’ of anything. Inflammation is the result of damage – it is also called ‘healing.’ Be careful if you block healing responses, things may not turn out as you would wish.

  61. Bill In Oz

    There is an assumption in almost all our discussions about the causes of CVD : that we make reasoned & scientifically based decisions in our lives…But is it in fact actually so ?

    Dr Peter Attia has launched his new website with a very relevant article on why we are NOT programmed to think scientifically…

    The human species is a couple of hundred thousand years old. But logic as a formal skill dates from 2500 hundred years ago while the ‘scientific method’ dates from the 1500’s. And prior to the development of logic & scientific method other methods were used to survive, especially that of imitating the ‘successful’ & ‘powerful’….

    Mostly we imitate authority figures and absorb the views and facts of these authority figures.
    A poor precis !
    Here is the link

    1. Dr. Malcolm Kendrick Post author

      True, of course. However, the scientific method is all we’ve got really. It is imperfect, most humans twist and bend facts to suit themselves, and suchlike – doctors are probably the very worst at this. Actually, no probably about it. In the end, though, we have to cling to the scientific method – or else what is there to do? Throw it away. Then what?

      1. smartersig

        I was tempted to say superstition might make a comeback but then again it never went away, just look at the religions of the world

      2. Bill In Oz

        Dr. K. I was not suggesting that we throw the baby out with the dirty bath water !.. The ‘Scientific Method’ is indeed all we have got…But it is helpful to know just how rare it is among the general human population still operating on the older ‘imitation method’ of going about life.This is Illustrated by the so common use of deciding arguments from ‘authority’, instead of the facts known.

        Peter Attia at the end of his post has this say :
        If you’re reading this, and you’re saying to yourself that you want to increase your mastery of critical thinking, I promise you this much—you can do it if you’re willing to do the following:
        1 Start reading (see starter list, below).
        2 Whenever confronted with a piece of media claiming to report on a scientific finding, read both the actual study and the media, in that order. See if you can spot the mistakes in reporting.
        3 Find other like-minded folks to discuss scientific studies. You need a good group of peers who share your appetite for sharpening their critical thinking skills. ”

        And that is what we have here mentored and moderated by yourself.

        And thanks for that !

    2. Sasha

      I disagree. Every successful inventor throughout history practiced a scientific method even if unknowingly. They had an idea and they tinkered with it until it became successful. From people who domesticated plants and invented the wheel to those who codified the principles of yoga, Auyrveda and Traditional Chinese Medicine. Or invented gunpowder, the compass or built ships. All those things happened long before 1500s. In 1500s the scientific method became crystallized and practiced on the large scale in the West, at least, but I think the idea that science didn’t exist before then is largely a fallacy.

      1. Bill In Oz

        Sasha, you are right about inventions predating the ‘invention’ of the scientific method. But such technological developments were always the result of a suck it & see incremental approach. And until the 15th Century, progress was slow. The scientific method permitted greater understanding and much quicker progress…

        But as Dr Attia says even now in modern western societies, the actual percentage of the population that understands and uses the scientific method, is still quite low.

  62. smartersig

    I was quite taken by the doctor/researchers pioneering personalised dietary guidelines via blood sugar testing that I posted about recently. I have therefore started a personal experiment to find out what how foods effect me. Started today with bread which I normally do not eat but I need to find out whether that is a wise decision or not. My fasting blood glucose is normally 81/82 ish. A couple of years ago I tested after 6 bananas in the morning and it came in at 92. Today I had two slices of toast with butter and my blood sugar reading came in at 100!. I can assume therefore that I am doing the right thing avoiding bread and that maybe the customary samdwich lunch many people have with 4 or 6 slices would send my blood sugar higher than 100. On Thursday I will move onto rice followed by my customary oats and kiwi and then of course fasting. Here in Portugal a blood glucose test is 2 euros.

    1. Bill In Oz

      But Smartersig, what kind of bread ? Plain white wheat flour ? ? Whole Grain ? Mixed grains ? Rye ? Oat ? Sourdough or chamicalised ?

  63. info326vmt

    Adolph Zukor, founder of Paramount Pictures, said on the approach to his hundredth birthday ‘If I’d known how old I was going to be I’d have taken better care of myself.’ Zukor died in 1976 having been born in 1873.”

    I don’t know if he smoked or not.


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