What causes heart disease part 46

14th February 2018

The mind

The final big-ticket item on my list, of how to avoid CVD and live longer, is poor social interactions, and the strain caused by them, or whatever you want to call this rather difficult to define area. Here we have a whole range of different, interconnected, issues. Childhood abuse, family breakup, abusive partner, financial difficulties, abusive and bullying boss at work, social isolation, mental health issues, loneliness, no sense of being part of a supportive family or group – religious or otherwise.

The simple fact is that we humans are social animals. We require nurture and support by others. We need a sense of belonging, a sense of value and purpose. We need to be loved, not hit, or shouted at, or bullied, or treated with contempt.

When I first started looking at CVD, this was the area that I focussed on. It seemed obvious to me, that there was an enormously important mind/body connection that was simply being ignored by mainstream research into heart disease – and all other diseases. Despite the complete lack of interest by most researchers, whenever and wherever you look, if you chose to see, psychological/mental health issues were standing right there, waving their arms about and shouting me, me, me, me. Look at ME!

The full impact of negative stressors was highlighted in a study that was sent to me a few months back. Researchers found that people who suffer from significant money worries are thirteen times more likely to suffer a heart attack. Yes, thirteen times more likely, or 1,300%. Now that is the level of increased risk where I tend to prick up my ears and pay attention. Relative risk, or not1.

It is also clear that mental health, or mental illness, plays a massive role in overall health and life expectancy, as highlighted by researchers from Oxford University.

‘Serious mental illnesses reduce life expectancy by 10 to 20 years, an analysis by Oxford University psychiatrists has shown – a loss of years that’s equivalent to or worse than that for heavy smoking….

The average reduction in life expectancy in people with bipolar disorder is between nine and 20 years, while it is 10 to 20 years for schizophrenia, between nine and 24 years for drug and alcohol abuse, and around seven to 11 years for recurrent depression.’2

Yes, when your mind goes wrong, your body follows, with disastrous consequences for overall health. Of course, there is overlap between mental illness, drug use, smoking and suchlike. However, you can strip out all the other things, and you are left with the ferocious power of the mind/body connection. The power to nurture, and the power to destroy.

I usually tell anyone, still listening after I have bored them on various other issues, that health is a combination of physical, psychological and social wellbeing. Three overlapping sets. The holy trinity of wellbeing. You must get them all right, or nothing works. As Plato noted, a few years back “the part can never be well unless the whole is well.”

Who are the shortest-lived peoples in the world? Are they the poor? Not necessarily, although poverty can be a clear driver of ill-health. The shortest-lived people in the world are people who live in the places of greatest social dislocation and disruption. Or, to put it another way, people who have had their societies stripped apart. Australian aboriginals, NZ Maoris, North American aboriginals, the Inuit.

‘Indigenous Australians have the worst life expectancy rates of any indigenous population in the world, a United Nations report says. But it’s not news to Aboriginal health expert. They say it simply confirms what Australian health services have known for years.

Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) chief executive officer John Paterson said the findings of the report, which examined the indigenous populations of 90 countries, were no surprise. The UN report – State of the World’s Indigenous Peoples – showed indigenous people in Australia and Nepal fared the worst, dying up to 20 years earlier than their non-indigenous counterparts. In Guatemala, the life expectancy gap is 13 years and in New Zealand it is 11.’ 3

Twenty years earlier. I think that figure is worth repeating. I cannot find anything else, from anywhere, that gets close to that sort of impact on health – on a population basis.

Or, to put it another way, do not be a stranger in your own land. It kills you. The differences in life expectancy in the US or the UK mirror these findings, albeit less dramatically. There are areas, within deprived inner-cities in the UK, where people do almost as badly as Australian aboriginals.

It does not take a genius to guess where they might be. Inner city Glasgow, Manchester, Liverpool. The same thing can be seen in ghetto areas in virtually all cities in the US. Where the marginalised poor live – but not for terribly long.

‘The differences between places [in the US] are sometimes stark. For example, the average person in San Jose (California District 19) lives to 84 years compared to just 73 years for someone from Kentucky District 5, in the rural south east of that state.’4

On a more positive note, living in supporting and positive environments, is exceedingly good for you. The Blue Zones are areas of the world where people live longer than anywhere else. For example: inland Sardinia, Loma Linda California, Nicoya (Costa Rica), Okinawa, Ikaria (Greece), and a couple of others. [I think I should point out here that they are also, sunny, something not mentioned in the book].

The most important factor was a sense of well-being, community, a connection with other people, a sense of purpose, and good relationships with friends and family. As a slight aside, the author of the book “The Blue Zones”, Dan Buettner, was very focused on the benefits of a high vegetable, low meat diet. He tried hard to promote the idea that diet was the primary driver of good health.

For example, in Sardinia, he wrote the following about the food that was eaten there:

‘It’s loaded with homegrown fruits and vegetables such as zucchini, eggplant, tomatoes, and fava beans that may reduce the risk of heart disease and colon cancer. Also on the table: dairy products such as milk from grass-fed sheep and pecorino cheese, which, like fish, contribute protein and omega-3 fatty acids.’

The Sardinians themselves, however, have a completely different view of what they eat, and they protested the misrepresentation of their diet:

‘In 2011, Sardinians called for formal recognition of their diet insisting that “the secret to a long life can be found in their traditional diet of lamb, roast piglet, milk and cheese.”’5

In fact, many years earlier, researchers studied another Italian community that defied all dietary expectations. This was in the town of Roseta in Pennsylvania. This community had moved, virtually lock stock and barrel, from Roseta in Italy, to a new Roseta in the US. It was noted that they had an extraordinarily low rate of CVD. Why? Here, once again, I quote an article from the Huffington Post:

‘What made Rosetans die less from heart disease than identical towns elsewhere? Family ties. Another observation: they had traditional and cohesive family and community relationships. It turns out that Roseto was peopled by strongly knit Italian American families who did everything right and lived right and consequently lived longer.

In short, Rosetans were nourished by people.

In all ways, this happy result was exactly the opposite expectation of well-proven health laws. The Rosetans broke the following long-life rules, and did so with a noticeable relish: and they lived to tell the tale. They smoked old-style Italian stogie cigars, malodorous and remarkably pungent little nips of a cigar guaranteed to give a nicotine fix of unbelievably strong potency. These were not filtered or adulterated in any way.

Both sexes drank wine with seeming abandon, a beverage which the 1963 era dietician would find almost prehistoric in health value. In fact, wine was consumed in preference to all-American soft drinks and even milk. Forget the cushy office job, Rosetan men worked in such toxic environs as the nearby slate quarries. Working there was notoriously dangerous, not merely hazardous, with “industrial accidents” and gruesome illnesses caused by inhaling gases, dusts and other niceties.

And forget the Mediterranean diets of olive oil, light salads and fat-free foods. No, Rosetans fried their sausages and meatballs in lard. They ate salami, hard and soft cheeses all brimming with cholesterol.6

The Okinawan’s, another of the Blue Zone populations are also known as the pig eaters. It is said that they eat every part of the pig, apart from the squeak. In short, you can focus on the diet of very long-lived people around the world, if you want, but you will find little or nothing here. Much in the same way, you can look at the French, with the highest consumption of animal fat in Europe, and the lowest rate of CVD.

Getting back to the main point in hand. What can we really learn about the Blue Zones is that social health is terribly, terribly, important. Perhaps the single most important factor of all. If your social health goes wrong, your psychological health will suffer, followed by your physical health. More recently it has been recognised, finally, that loneliness is a significant driver of ill health and early death.7

Be happy, be friendly, be healthy. Live long and prosper, my friend.

1: https://www.medicalnewstoday.com/articles/320037.php

2: http://www.ox.ac.uk/news/2014-05-23-many-mental-illnesses-reduce-life-expectancy-more-heavy-smoking

3: http://www.sbs.com.au/nitv/article/2010/01/15/indigenous-life-expectancy-worst-world

4: https://www.fastcompany.com/3045495/the-wellbeing-of-all-436-us-congressional-districts-mapped-and-indexed

5: http://www.statinnation.net/blog/2014/8/12/did-dan-buettner-make-a-mistake-with-his-blue-zones

6: https://www.huffingtonpost.com/dr-rock-positano/the-mystery-of-the-roseta_b_73260.html

7: http://journals.sagepub.com/doi/full/10.1177/1745691614568352

278 thoughts on “What causes heart disease part 46

  1. JanB

    A cracker of a post and so so true. As much as I love my husband and (very grown up) children, AND my dog, if I still had one, I hold my girl friends close to my heart and treasure them. The one notable thing we have in common is tennis which we all enjoy several times a week but it’s all augmented by the coffee and talking after playing, the laughter, the tears sometimes and the frequent meals out we have to celebrate birthdays and goodness knows how many spin offs as well – days out, trips etc. When one of us is distressed, for example, Kathy’s husband died last year, Sandra had a cancer diagnosis, we all gather round to offer support. Precious beyond belief.
    Thanks, Dr. K. You have played your part too, affording me a wonderful feeling of belonging in this blog.

    Reply
  2. WST

    My father and his sister — two people with the same diet and sedentary lifestyle. One of them has hypercholesterolemia, extensive cardiovascular disease, and has had two strokes and a heart attack. The other has normal cholesterol levels and no evidence of cardiovascular disease. I just don’t believe the difference between the two has anything to do with stress.

    Reply
      1. BobM

        Including one’s a male and one’s a female. That alone might explain it. Moreover, men (US men, anyway) aren’t known for their bonding, but women (US women, again) are. Men are the loners with no support systems; women aren’t. This is likely why men of faith typically have lower rates of heart disease – they have a support system in both their god and the church.

    1. AnnaM

      Have you thoroughly analyzed their emotional lives, their work history, whether they have had major setbacks or heartaches, disappointments or betrayals, their marriages and friends?

      Reply
    2. LA_Bob

      WST –

      You may be absolutely right that “stress” had nothing to do with your father’s ailments.

      Dr K calls this series, “What Causes Heart Disease”, but the title shouldn’t be a literal read. He’s talking about risk factors, emotional health being the biggest. Not all abused children nor dislocated peoples get heart attacks, and not all ostensibly happy people avoid them.

      If I have a heart attack today (or tomorrow or the next day), there is no one in the world who will ever know why it happened. I think most of us are in that boat.

      Reply
  3. William Perkins

    Re the lifespan of Aboriginals, it was the harshness of their environment that impacted their overall health. The arrival of the British likely was a significant factor, however my understanding is that due to their environment they could only expect 35 years. I spent a week in the Outback and my impression is that is the most severe environment I’ve ever experienced.

    Reply
    1. AH Notepad

      Interesting note about harsh conditions. Though Weston Price found a significant deterioration with the arrival of refined carbohydrates.

      This episode raises in my mind whether people who stir up discontent in a way to encourage violence and hatred towards others (often done by a very senior politician) should be punished for causing potentially fatal distress.

      Problems closer to home is I’m not particularly happy, I have to make an effort to be friendly, but never mind, I can down the supplements in a misguided attempt to be healthy. Just loaded some 00 capsules with lysine.

      Reply
      1. Tom Welsh

        “It seems pretty certain that the people who worry most about themselves, their families, their friends, their work and the rest of the world in general are the ones who suffer most.
        “There is no little irony in the fact that hard-hearted folk who ignore the effects of what they do to other people, animals or the environment do not suffer much in the way of damaging stress. It is the kind, the thoughtful and the sensitive who suffer for them – and whose immune systems take a battering as a result of their actions”.

        – Vernon Coleman, “How To Stop Your Doctor Killing You”

    2. Bill In Oz

      William it is important to get the facts right. Sorry mate but your comment doe snot do this.

      1 The lifespans of pre British settlement Australian Aborigines is not known or indeed very easy to know.
      2: The lifespans of post settlement Aborigines dropped hugely due to the introduction of new infectious diseases.. They had little resistance & a high proportion died rapidly..The guestimate is that the number of Aborigines living in Australia dropped to maybe 20% of the pre settlement figure
      3 In recent decades the Aboriginal population of Australia has been increasing rapidly and so has lifespan.
      4: But unfortunately the lifespan of Aborigines living in remote & rural communities of Australia is still much shorter that the rest of the population. This is because of a number of factors :
      – chronic diseases such as CVD, & Type 2 Diabetes
      – a high intake of alcohol & other drugs like crystal meth
      – poverty and low levels of unemployment
      5 : These remote communities also tend to be places with high levels of domestic violence against women & children.
      6 :As Dr Kendrick states, people living in them have very high stress levels.

      You know Dr Kendrick, this analysis suggests that one way of solving this problem over time, would be to help aborigines in these communities would be to treat them the same as refugees from another country escaping persecution, and assist with their resettlement by assisting them find new homes in urban Australia, with medical assistance, schooling etc; and even English language classes where needed.
      But I guess it would also mean refusing this help to those individual aborigines who continued lives dominated by alcohol and drugs.

      A very controversial policy indeed.

      Reply
      1. Frances

        The majority of Australian aborigines living in remote communities do not want to leave their traditional land move to urban areas to get access to medical care and education. There is a lot of money spent to improve the situation but throwing money on the situation is not improving it.

      2. Bill In Oz

        No Frances, throwing money at the problem has not “Closed the Gap”.
        By the way Dr K. there are 7000 Aborigines living in South Australia…The number of people living in remote, isolated communities is about 1200.

      3. Bill In Oz

        Again by coincidence there is this report today about a small isolated outback township on Crown land in South Australia called Mintabie. It has existed to service the needs of the aboriginal tribal people living on the APY lands. And many of the 60 or so residents are Aborigines from the APY lands.

        The rates of alcohol & drug use are very high. Domestic violence is high. Incidents of theft and house break ins are high. Illegal theft by businesses in Mintabie from the bank accounts of residents is rife. And most of this happens unreported to the police. Cardiovascular disease is high. So too is Type 2 Diabetes; So too is glaucoma. Livespans are short.

        So the South Australian state government has decided to cancel all the leases & licenses of all the people & businesses. The residents will have to move on. In a year the township will disappear !

        http://www.abc.net.au/news/2018-02-15/sa-outback-town-mintabie-to-close-and-residents-to-move/9452370

    3. annielaurie98524

      One must be careful in assessing the statistic that paleolithic populations, various indigenous groups, etc., had that seemingly universal, magic 35-40 “life expectancy”. There is a big difference among average lifespan of members of a population, their life expectancy at birth, and their life expectancy IF they reach adulthood. Much of the 35 year-figure bandied about is caused by high infant (and maternal) mortality, and high mortality among the young due to accidents, infections from accident-related injuries, and the more hazardous environment of paleolithic/”modern paleo” peoples.

      It’s time we retired the silly old woozle that “primitive people” have/had an inherently low lifespan and are/were mostly dead by forty. It should also be noted that the 35-40 year figure applied not only to “primitive” societies, but also to more “advanced” folk. Did you know that life expectancy in “civilized” regions in Greek and Roman times, the Late Medieval era, and the Victorian era was only 35 – 40 years? It was only in the early 20th century that global human lifespans started to rise beyond the 30 – 40 year range. There is a very interesting chart at the link that follows. Note that the blog owner is not the creator of the chart. https://leonoudejans.blogspot.com/2016/05/tipping-point-technological-revolution.html

      Reply
      1. AnnaM

        Hear hear. That has always been obvious to me. If a man lives to 70 and a baby dies in infancy, their average lifespan is 35, yet no one lives anywhere close to that figure.

  4. JDPatten

    I’ve always been a lone wolf, doing my best work when undistracted by my fellows and friends. My work is rewarding. I get nervous even when one or two workers are responsible to me. They want to rush. They want to compete. Their ideas are “better”.
    Is the fact that I have only my wife as a best friend a death sentence?

    Reply
    1. Gaetan

      hmm i don’t think so no, especially if you have a strong emotional connection with her. Also if you pray God this is like having another best friend.

      Reply
    2. Tom Welsh

      Mr Patten, I am in exactly the same boat – by choice. I don’t know if you are familiar with the Myers-Briggs personality classification, but if not you may find it of considerable interest. It was only five years ago that I discovered that I am an almost perfect example of an INTP – a rather rare type, and often misunderstood. INTPs are introverted, far more interested in ideas than people or the “practical” everyday world, and can seem quite rude due to their pursuit of objective truth. In the terminology of Simon Baron-Cohen, INTPs tend to be quite extreme “systemizers” with relatively low empathy.

      Speaking for myself, I find a week or two of perfect solitude most refreshing. It gives me a chance to think things through, go for long walks (alone of course) and write or study. Going to a party, on the other hand – or, worse still, a trip abroad – makes me quite uncomfortable and nervous. I can converse happily with one to three or four people, as long as I know them or at least feel on the same wavelength. But having continually to juggle facial expressions, topics of conversation, names and faces, family details, and so on is completely beyond me.

      In short, I think you don’t have to worry at all. Surely it’s being relaxed, calm and stress-free that matters – how you achieve that condition varies with the individual.

      Reply
      1. foodnstuff

        Tom, I’m a Meyers-Briggs INTJ; pretty similar to you. I’m also Aspergers; I find a huge overlap between the two. What we do about it I don’t know. One or two special friends maybe, but no large social interactions, which are stressful. I guess it’s the type of stress that’s the problem.

        Thanks Dr K for another excellent post.

      2. chris c

        If I remember correctly I am ENFP and strong on everything except the E. Watching a recent documentary about Chris Packham (BBC nature presenter) made me realise just how many Aspergers/spectrum behaviours I have, like an obsession with patterns and detail and a woeful failure to understand the importance of social conformity and status. This did NOT serve me well during my childhood in Surrey, or my later return there for family reasons, but pretty much everywhere outside of the south east I seem to be capable of relating to people.

        Here in East Anglia I chat to a lot of strangers (and their dogs). People here are much more relaxed, and interesting, and I wonder just how much of the local longevity is down to this, along with the fresh local food.

      3. Tom Welsh

        Hi foodnstuff, I hope this isn’t too late for you to see. I just want to say that I don’t think we need to do anything about it! As the ancient Greeks used to say, “Know thyself”. Having done that, live appropriately. I try to live in a way that suits an INTP – luckily I have a very understanding and kindly wife and two lovely daughters, who give me just about exactly the amount of company I like. My wife sometimes goes to see our daughters, whereas I tend to email them links to Dilbert cartoons! (My way of keeping in touch and showing affection).

    3. AnnaM

      JD,

      The important thing is that you feel satisfied and not lonely. I especially don’t think it is a problem if you prefer to work alone and concentrate. Sometimes smart, deep thinkers really don’t benefit from “teamwork” which is all the rage now. It is quite annoying to certain introverted types who work best alone (I’m one and I’m female) but that very same person may be quite sociable otherwise.

      I also think that we might take into account the importance of being embedded in a long term community, as used to be the norm and may still be in much of Europe. In the USA, people move a lot. They not only aren’t near their relatives, their neighbors are also strangers or people they have not known long. You might think that seeing Mrs. Potter across the street as you get your morning mail is not very important to you, but if she’s been there all you life, she probably is.

      Reply
    4. JDPatten

      Thank you, everyone, for your cogent responses – particularly Anna and Annie.
      Yes, I’m content with the way I live my life (as far as I can tell).
      So, perhaps it’s strife from decades ago that got me my high CAC and atrial arrhythmias??
      Something(s) did!

      Reply
    1. Tom Welsh

      Pork and bacon, certainly – by all means!

      But… sadly nowadays there is usually a “but”…

      From which pig, reared where and fed what? Like most other people, until recently I naively thought that most pigs were still reared outdoors, contentedly snuffling about in fields and orchards and feeding themselves more or less – except maybe in the depth of winter.

      Sadly, nowadays more and more livestock are shut indoors with mud underfoot, no sunlight, and fed hideous synthetic slops such as mixtures of corn, soybeans and organic matter dredged off the sea bottom.

      Pigs fed on such garbage – no, actually, throughout history pigs have thriven on garbage. What is a word for “feedstuff” that makes garbage look like a heavenly banquet? Pigs fed on manufactured mixtures heavy in polyunsaturated oils will tend to have more polyunsaturated fat themselves, and you get that when you eat the pork.

      As far as you can, always try to buy pork and bacon from pigs reared out of doors.

      Reply
      1. Bill In Oz

        Tom I agree with all you say except this ” livestock are shut indoors with mud underfoot”. Actually it’s shit they are standing in. I’ve seen feed lot cattle and pigs standing around in shit about a foot deep. That’s one of the important reasons why they are fed anti-biotics in the feed. The floors of the pens are cleaned out only after the livestock are sold for slaughter.

        So yes stick to free range.

      2. Eric

        Bill, all conventional pig pens I have seen have a slotted floor or a grit and get hosed occasionally, and for the piglets, they usually add straw. Different legal requirement in Oz?

        The feed I agree with is not good for the pigs nor the humans eating them. Organic pigs in Europe must have access to outdoors and get much better feed.

        I still don’t care much for pork (nor chicken and turkey). Beef, mutton duck and goose are probably healthier because the animals are pickier about their food and grow more slowly.

      3. annielaurie98524

        The slotted floors still accumulate sh!t. Much of the sh!t and urine drops into the cesspool beneath the slotted floor. This cesspool is essentially an open septic tank. Hydrogen sulfide, methane, and other explosive/toxic/malodorous gases hang over the liquid surface and rise up into the pigs’ living quarters, as well as into the areas adjacent to the operations (known as CAFOs, “confined animal feeding operations”) . There have been cases where the vapor cloud ignites spontaneously and there is a large explosion, taking out the slotted floor, the pigs, and whatever else stood above.. When the cesspool liquid level rises, the liquid is pumped off and spray-applied to nearby fields. These operations, BTW, disproportionately impact the health of the local, usually low-income, rural populations, causing them the kind of stress that shortens life spans. It is doubtful these living conditions are good for the quality of the meat produced, either.

      4. Bill In Oz

        Thanks for the update on feed lots for pigs having slotted floors. I had a seniors moment I guess.. 😦

        However cattle are definitely managed in feedlots here in Oz with solid compacted clay as the floors of the pens.. All out in the open & often without any shade.. I once visited a large Feedlot abattoir operation in NSW. There were 65,000 head of cattle in a valley with pens that stretch as far as the eye could see. ‘Ideally’ cattle were slaughtered after 65 days but at the time sales overseas were down so that had stretched out to 90 days for some pens…

        Disease outbreaks were managed with anti-biotics in the food delivered by truck into the large troughs just outside the rails of the pens. Curiously the cattle also did best with lots of added salt as well…

        There was a pervasive stench. But the locals never got a whiff as the whole operation was located in an out of the way location…

        For me at the time the question in my mind was “How can ‘food’ grown under such conditions be healthy for humans?” I still try to avoid cuts of beef which comes from such feedlots. Naturally it is mostly sold in the major chain supermarkets…

      5. Tom Welsh

        I just recently read about a single pig “farm” in China that has over 1 million pigs! They do everything by computer, as they aren’t willing to hire enough workers.

        If a city like Beijing (or London) can hold millions of people living in some comfort, and drain and handle all the sewage they generate, why can’t that be done for a pig farm?

        I can’t think of any answer to that except “money”. People would rather eat cheap meat, with all its risks, than cough up to keep livestock in decent conditions eating natural food.

  5. Mr Chris

    Dear Doctor K
    This is á difficult one, since in many ways, unquantifiable. As you have said, one man’s stress is another’s one’s inspiration.
    Can those who follow here, who have had a MI give us any clues. Is the unhappiness quotient cumulative, catching up with one in later life? What is the mechanism which transfers the emotional side to the arteries etc?

    Reply
    1. smartersig

      I had an MI 5 years ago after coming off a customary 2 mile run. I was overweight at 14st (I am now around 11st 10lbs) but as I lay on the angio slab and that bas**** of a cardio and his trainee said to me, ‘we have not found any blockages but this minor artery is slightly pinched and I would suggest a stent although its not mandatory’. Knowing what I know now I would tell him to F off but back then I said yes. Interestingly at the time I said to him that I thought it was stress related. I had just spent the afternoon watching a set of horse racing (I am a pro gambler by profession) and I probably made the mistakes of
      a) Watching racing
      b) Going for a run just afterwards

      If lactic acid plays a part and stress induces it then I was maybe asking for trouble.
      I was also at the time taking on a lot, not only betting but advising clients and running the back office for another fellow pro gambler. All in all I needed to change my diet, lose weight and smell the roses. Do I think stress plays a part, for sure, how much I dont know.

      Reply
    2. Joan Coleman

      I moved from my home district to another part of England when I was offered a post as district nurse in a rural community. The patients were (mostly) lovely and the GPs at the surgery where I was based were excellent. However, although I was made very welcome, I felt isolated and far from home. I was homesick and constantly pining to come back to where I felt I belonged. My accent betrayed my Middlesex roots and I often heard “you’re not from around here are you”. After 22 years of longing to come home, the final blow hit when my beloved Old English Sheepdog died at almost 14 years of age. I was devastated and within weeks collapsed with an MI. I had a healthy lifestyle, ate a Mediterranean style diet, walked miles daily with my dogs, didn’t smoke, was slim and had a cholesterol of 4.9. I think there is something called broken heart syndrome but haven’t got around to looking it up. Sorry for the long post.

      Reply
      1. Sylvia

        Joan, I love the company of animals quite as much as my human friends, when I lose my dogs or cats I grieve for a long time. I was a district nurse and loved to meet the pets on my visits to patients, always put my hat on when it was a home with a certain little bird that used to sit on my head. So yes, animals are so worthy of our love and add to our lives immensly

      2. Marguerite Harris

        What a fascinating post!
        Joan, about Broken Heart Syndrome, see #39 of these posts from Dr. Kendrick… very interesting.
        Losing your beloved dog, on top of the other stresses, must have been too much for you. There is a limit to what we can manage, after all.

      3. chris c

        Several of my late neighbours outlived their husbands by years, but died soon after their dogs. Food for thought.

  6. james

    Great Post and I couldn’t agree more from personal experience. Happily married for over 40 years. Wonderful relationship with our four adult children and our community. A diet with lots of eggs and other animal products. Not a day without. Lots of homegrown vegetables, salads with sauerkraut as dressing and only the good fats of coconut, olive, butter and avocado. Lard and beef tallow grass fed. And as Jordan Person said: ” Walk with a straight back”. Of course you may find fewer dimes that way, but what is your health worth?

    Reply
  7. Antony

    Very good review evidence showing the ill effects of stress on health/longevity . . . and we didn’t even mention the Whitehall Cicil servant study.

    I see the pressures that cause stress on one side, and the weak social network support that allows one to better deal with those pressures, as combining to give a base line or background level of health. How well you fair at your level will depend on to some extent on diet and exercise. So in this crude model . . . imagining 2 people in the same pressure/social situation. . . the one who tries to eat a diet limiting the development of insulin-resistance has a greater chance of better health than the other.

    And of course there is my grandfather-in-law who lasted well into his 90s on his roll-ups and evening whisky . . . he seemed to have a pretty high baseline for a number of reasons.

    Reply
  8. Jillm

    Thank you Dr Kendrick. I wonder how often people who enjoy long lives visit doctors. How much screening? How many medications? When they feel unwell do they sit in the sun and wait for nature to help them. Do they ask Grandma, while they sip her chicken broth? Do people with dark skin get enough Vit D now that most work indoors. Thanks again, Dr Kendrick.

    Reply
  9. Rick Zabrodski

    This reminded me of the phrase “scared to death”. As I recall, the death of a spouse is not good for the remaining partners health as well. In occupational medicine, it has long been recognized that the best predictor of return to work after an episode of low back a pain is “job satisfaction”, and this is best determined by one’s perceived control and support in the workplace.

    Reply
    1. annielaurie98524

      The relationship between stress and the tendency to become ill has been known on a medical basis for more than 50 years. In 1967, two psychiatrists examined the relationship between life stressors and illness. They assigned a stress value to a number of stressors that might occur in one’s life (death of a spouse, which was rated #1; losing one’s job; visit by annoying relatives; etc.). They found the more serious the stress, or the higher the score for combined stressors, the greater the likelihood of illness in the months following.

      To quote wikipedia, “In 1967, psychiatrists Thomas Holmes and Richard Rahe examined the medical records of over 5,000 medical patients as a way to determine whether stressful events might cause illnesses. Patients were asked to tally a list of 43 life events based on a relative score. A positive correlation of 0.118 was found between their life events and their illnesses….Their results were published as the Social Readjustment Rating Scale (SRRS),[1] known more commonly as the Holmes and Rahe Stress Scale. Subsequent validation has supported the links between stress and illness.” The WP reference has citations for those wanting to follow up. There have been numerous other corroborating studies in the intervening decades.

      For folks that hate wikipedia, you’ll only be stressing yourself if this causes you to rant. WP is merely a convenient repository for the summary of a study that occurred, and was vindicated, decades before WP existed.

      Reply
  10. Tom Welsh

    “It seemed obvious to me, that there was an enormously important mind/body connection that was simply being ignored by mainstream research into heart disease – and all other diseases”.

    As I learn more from books like Dr Kendrick’s (passim of course), Barry Groves’ “Trick and Treat”, Dr Mendelsohn’s “Confessions of a Medical Heretic”, Vernon Coleman’s “How to stop your Doctor Killing you”, Dr Davies’ “Wheat Belly” series and many others – my previous innocent acceptance of the medical establishment has morphed into violent cynicism and now into a calm acceptance that, as Kant observed, “Out of the crooked timber of humanity was never any straight thing made”. Even some of the above-cited authors seem (to me) to err from the straight and narrow – for example, Coleman and Mendelsohn state that eating meat is dangerous, Coleman implying that it causes cancer and CVD. Never mind, very few oracles – with the obvious exception of Dr Kendrick! – are always right.

    That said, it seems to me obvious why the role of stress is systematically ignored by the establishment. Because it is largely caused by the social systems that the establishment created and very much wants to maintain. All the talk about how awful bullying and harassment are is, to my mind, just camouflage: the truth is that the rich and powerful have set things up precisely so they can bully and harass the rest of us. You can see this in many workplaces, where I have come to believe that a lot of managers are mainly motivated by their enjoyment of bullying. It may be thinly veiled, just enough to avoid falling foul of the laws and HR guidelines, but it is unmistakable. Indeed, HR is often one of the worst offenders – and quis custodiet ipsos custodes?

    Michael Marmot’s outstanding book “The Status Syndrome” (2004) presents the results of careful and detailed research into the effects of status on health and longevity in the British civil service. It is a real eye-opener by a professor of epidemiology.

    Reply
    1. chris c

      I went to a third rate Grammar School where bullying was rife, and implicitly accepted and even explicitly encouraged by some of the masters. The worst (only) crime you could commit was “grassing”.

      I suspect some of these managers came from the same kind of background, if not from public schools which this place desperately wished it was. (you could of course take Latin and Greek, but not Biology and Chemistry).

      Disclaimer: I have known some excellent managers, and thoroughly competent company directors, often people who rose through the ranks rather than being parachuted in at the top. but these are a distinct minority, which probably explains the dire straits of UK industry and of course the NHS. And the way whistleblowers are routinely treated.

      Reply
  11. Tom Welsh

    “The shortest-lived people in the world are people who live in the places of greatest social dislocation and disruption”.

    Russia in the 1990s provides a classic example, as the following graph shows. Between 1990-1 (when the USSR broke up) and 1994-5, the life expectancy of Russian men plummeted from about 65 to less than 58. It was not until about 2012 that it regained the 1990 level and has since been climbing slowly.

    The charitable people at The Guardian (for example) liked to attribute the huge increase in male deaths to a liking for vodka, but they were careful not to ask why so many Russian men suddenly chose to dive into a bottle.

    Incidentally, this is what Vladimir Putin meant when he said that the collapse of the USSR was a great tragedy. He was not lamenting the decease of the Soviet system, which collapsed under its own weight, but the terrible human cost of its random and uncontrolled consequences.

    Reply
  12. Tom Welsh

    Thanks very much for the surprising and gratifying data about diets, Dr Kendrick. I find that trying to understand nutrition and health is rather like playing “Battleships”. You are trying to piece together a puzzle, but you never know which parts of it have been maliciously changed or hidden. For years I have been puzzled by the “fact”, which I read everywhere, that the traditional Okinawan diet was heavily vegetarian. From what you write, it seems that the solution to my puzzle is simple: it wasn’t. As your fictitious (but entertaining) colleague Dr House always exclaims, “Everyone lies!”

    Reply
  13. Tony Youens

    I’m reminded of one of my favourite quotes (courtesy of Michael J Fox), “Family isn’t an important thing, it’s everything.” Assuming you have a good family of course.

    Reply
    1. Binra (@onemindinmany)

      The work of ‘Family Constellation Therapy’ is very revealing (in my view) of both the traumas and conflicts that pass down through generations, and the deeper movement to a realignment in healing, resolution or reconciliation at a level that cannot always be reached through ‘psychological’ supports or interventions. Our family is within us as we are within our family, not in thought so much as a Field of relation. The patterns of relationship that develop may not be coherent to health and harmony. But family is the nature of our nurture – at least until the state takes over completely.

      Reply
  14. HB

    Much as I like your blog posts usually, Dr Kendrick, this latest one is rather depressing for people like me whose lives have not matched up to your ideal. 😦

    Reply
    1. David Bailey

      I feel that maybe in the modern era many people have a lot of meaningful contacts on the internet. Perhaps this can compensate somewhat if you live on your own, or have marital problems or whatever.

      Reply
    2. Binra (@onemindinmany)

      Surely you err. Depression is when your life has not matched your own ideals. If you assign this power to Dr Kendrick, you become powerless, but as your good self, you yet live! And can envision a life that is not bound to fail – for example.
      Fantasy gratifications are not what they promise to be – but few get to realize that enough to realise that what is here and now is the gift of life and the presence in which to live it.
      Everyone is a unique expression, so why compare yourself with others? However, you may notice when your thoughts align you in qualities you appreciate, and when they condemn you to suffer, and thus learn which thoughts to water and which to neglect.

      Reply
      1. HB

        @Binra

        I made a one-sentence post. You can’t jump to reliable conclusions about my physical and mental health, past and present, on the basis of one sentence!

  15. dearieme

    OK, the Abos in Oz have rotten health. Accepted. But do they get lots of cvd? Because if they don’t you’ve shot yourself in the foot, doc.

    P.S. I was given “Doctoring Data” for Xmas. Excellent read. “The Great Cholesterol Con” is up next.

    Reply
      1. dearieme

        Fair enough. I suppose the rapid decline of heart attacks in middle-aged men (In at least the US and UK) since its peak in about 1968 means that people, or middle-aged men at least, have been getting happier and happier. What a happy thought. But how would we know that it’s true?

      2. smartersig

        The drop seemed to hit gear around 1986 in the UK Lipid lowering seemed to explode somewhere between 1986 and 1991 the big movers in prescription rates around 1986 were

        Nitrates calcium blockers and potassium activators
        Anti platelet drugs really took off too

        Perhaps Nattokinase and Fruitflow should be on all our shopping lists

      3. smartersig

        Since 1987 our consumption of oily fish has gone up year on year pretty much to the point where it had doubled by 1999

      4. smartersig

        And so has our fruit and veg from 1987 at 882 grams per person per week to as high as 1313 in 2006

      5. smartersig

        One final change which started a little earlier than 1987 more like late 70’s was decline in beer drinking and increase in wine drinking which has been sustained, one for the French paradox wine merchants

      6. dearieme

        They stopped smoking too late to explain a peak in 1968. So it’s not that. 1968 also rules out any tosh about being Saved by Statins.

      7. smartersig

        In the UK the death toll from CVD according to the BHF stats was around 50% of total deaths and this was largely due to older age groups. Since the 80’s its dropped so perhaps if you want to stick with stress as a major cause perhaps you could say that the 60’s was the time for WW2 folk to reach the age of CVD toll. Perhaps WW2 was a stressful time and its kickback came in the 1960’s

      8. smartersig

        In addition to this was the clean air act of 1956. The positive effects of this would probably kick in on the stats around when the decline started, slowly in the 70’s and then more pronounced in the 80’s onwards.

      9. Martin Back

        Anti-depressants first became available in the late 1950s, and really took off with Prozac in 1987.

    1. Bill In Oz

      Dearieme, ‘Abos’ is considered abusive now here in Oz… Unless used by aborigines themselves of themselves…

      Reply
  16. Janet B.

    This chapter is my most favorite. I believe with every fiber of my being that this is a very serious and sadly most overlooked cause of heart disease for many myself included. Not only for those who reside in the outwardly recognizable social conditions in various parts of the world that you mention but also for those who live in social isolation in the middle of middle class suburbia. Elaine Aaron writes of the HSP( highly sensitive person) and the causative nature of this being essentially an overactive central nervous system. Approximately 20-25% of the population fall into this category and many of them are introverted and subsequently socially isolated and often highly functioning but just outside of the box. If you combine this with life’s peaks and valleys the possibility of living in the constant state of fight or flight becomes all to real. This in turn can unleash an abundance of reasons the body chemistry goes haywire and causes reason for blockages and Heart attacks, from high blood pressure to endothelial dysfunction. While I think there can be multiple reasons for heart disease I think this is the most overlooked cause and very likely a group that has the highest death rates. I myself tried on several occasions tried to have this conversation with my own cardiologist, who practices at a top teaching hospital, but to no avail. I am an introvert who has been a full time caregiver for a husband with dementia for several years now. The stress is off the charts many days. I am trying to coordinate my own prescription to help myself prevent another heart attack but wouldn’t it be nice if specific resources were already in place to help put all the pieces in place . The upside is INFP’s or INTP’s or whatever other label one may choose to attach to less socially adept humans, we tend to want to “fix” everything and create solutions when none exist so I will continue to bring awareness to this whenever and wherever I can.

    Reply
    1. Sylvia

      How I have seen in my nursing career how carers give so much, often with a smile, but are suffering inside. Used to be respite care which gave them a break, don’t know what happens now, cuts and more cuts. They are unsung heroes in my book.

      Reply
    2. Jennifer.

      Janet…..I am so sorry for the thumbs down….totally unintended, but I cannot reverse it. Hand to eye coordination is not functioning properly this morning.
      I totally agree with your sentiments.

      Reply
      1. Martin Back

        If you ‘thumbs down’, wait a little while then press ‘thumbs up’ and it will change the down to an up. Don’t know how to get it back to ‘no thumbs’.

        Incidentally, most blogs use stars for ratings. The thumbs up and down style is called a ‘Nero rating’. Clearly, Dr K thinks we are gladiators.

  17. Brian Allen

    Maori is plural, no s required. I am a Maori with heart disease and I’ve loved the informative, entertaining, and thought provoking series.
    Thank-you.

    Reply
    1. Fiona Weir

      Neither this Guardian article nor what we were told on BBC Rado 4 today give people any idea of what real foods they should be eating (as we Dr Kendrick fans know) instead of the ultra-processed foods mentioned. How do we get the message to the uninitiated, who are probably also overweight or even obese and liable to suffer from other diseases as well as cancer?

      Reply
      1. AH Notepad

        Fiona, there is only so much most of us can do. Just mentioning it to people you converse with is doing something. Some of thos people will just think you’re nuts. (They’re right in my case, just not as nuts as they are). There are downsides in broadcasting this to everyone. One is getting depressed that people won’t listen as they would rather trust their doctor. Many doctors are very clever and well meaning, but many are overstretched and have no time to read, for example these blogs, which would give them a lot of information. Another downside is there is only so much to go round, and with the best will in the world, the available resources will not stretch to the whole population, and even if they did, how to you support all the people who would then be living? Even now the increase in world population is greater than 85 MILLION!! each year.

  18. Ken MacKillop

    Dr. Kendrick, can you comment on the apparently well-recognized link between medical radiation (especially high-dose, as in cancer “therapy”) and consequent long-term risk of CVD? Radiation damages mitochondria, affecting myocardial function and inducing vascular endothelial apoptosis I would think — this is my own suggestion and admitted confirmation bias.

    Reply
      1. Joyce

        I personally do not doubt the link, having received neoadjuvant, followed by adjuvant chemotherapy, then radiotherapy for breast cancer, 15 years ago. I then suffered a cardiac arrest three years ago, which resulted in a stent being fitted. While in hospital I was in the next bed to a woman who was being treated for heart failure due to previous breast cancer treatment.
        However, what do you do? In my case it was the most aggressive triple negative breast cancer they had ever seen, and without the “poison, slash and burn”(put crudely), I doubt very much whether I would have been around 12 years later to have a cardiac arrest! Damned in you do and damned if you don’t eh?

    1. Eric

      Except that radiation treatment is usually local. You get full body doses only in PET scans and full body CTs.

      On the other hand, chemo is usually not locally confined…

      Reply
  19. Terramuggus

    Malcolm,

    Inner cities lack well stocked markets and are typically serviced by very small stores loaded with mostly crappy high-carb fake food. I’d venture to guess that most of the populations in these zones lack adequate transportation and dollars to access the healthier choices available in the suburbs. Food deserts are a reality and a likely main driver of general un-health, at the very least affecting lifespans at least equally.

    As to the schizophrenic and bipolar diagnosis individuals and their shorter life spans, Bob Whitaker (amongst other journalists) and a growing psychiatric survivor community worldwide have documented the toxic metabolic effects of the typical medication merry-go-round which typically leads to the development of diabetes and heart disease over a very short time. I submit the main reason for such shortened lives has more to do with the multi-medication model being the main driver in our modern mental health model. The rates of CVD in these populations is much higher than would be expected due, in large part, to the prescribing of the modern atypical anti psychotics, which are currently first-line prescribing in treatment guidelines. They are the most insulinemic and thereby cause the most harm. Because of movement and restlessness symptoms they tend to cause benzodiazepines are frequently added on as adjuncts.

    And don’t be too sure that some of the modern medical concoctions don’t create social problems. Yet another wonderful side effect of benzodiazepine’s accidental addiction through prescribers. Dr. Heather Ashton is a hero in the survivor community and has well documented their various negative effects, one being their possible medication induced onset of PTSD and the desire to self-isolate.

    Reply
    1. Rosie

      I think it’s best not to generalise… as an inner city dweller I can assure you that we have access to a wide range of food markets plus every supermarket imaginable and many local shops selling healthy foods both organic and non organic. I am not unusual in also having an allotment where I grow my own fruit and veg. Sure there are pockets of poverty in most cities but these are also to be found in more rural areas. Look up ‘Jaywick’ for example.

      Reply
      1. Terramuggus

        You’re right, of course. I should have been more clear in that here in the American inner cities we generally see terrible poverty and very few services, their residents very often lacking easy affordable access to healthy food choices. There are plenty of fast food restaurants and small Mom and Pop stores to fill the gap that results from large grocery chains’ conspicuous absence.

      2. AnnaM

        I have to agree. I don’t know why poor people seem to love junk food, but they do buy it preferentially even in big grocery stores. To be sure, it is often cheaper, but not so cheap as basic staples such as big bags of beans and rice that would require, you know, cooking. Cooking has become rather unpopular I hear. Sigh. And surely it isn’t poverty that forces people to spend many dollars on soda rather than…water.

        I am suspecting actual addiction.

      3. smartersig

        I suspect there is also the pressure of time, poor people are often holding down more than one job which makes it difficult to fit in cooking. Also couples are now more likely to be both working whereas back in the 50’s and 60’s it was more traditional to have one parent at home.

    2. Stephen T

      I grew up in a poor inner-city area of the UK and still regularly shop there in Aldi or Lidl.

      There’s no lack of healthy and decent food, but people are making very unhealthy choices of sugary junk because it tastes so good. When I see very overweight people, their trolley explains why. It is almost always full of sugary drinks, crisps and junk of every kind. Almost everything on the shelves has added sugar. Anyone who tries hard to avoid added sugar will know that only a small part of the goods on display are available to them.

      The low-fat nonsense has done so much damage. It let sugar pass unnoticed as the fat paranoia grew. The result is that sugar has now almost taken over for many people whose taste buds are completely corrupted by sweet foods. My niece says natural yoghurt is “disgusting” because she’s only used to products with large amounts of added sugar. She’s insulin resistant and on metformin in her late twenties. This isn’t caused by a lack of shops, but by bad choices made in shops packed with processed rubbish.

      I don’t know about the US, but the food desert argument in the UK is made by well meaning middle-class people who very rarely go anywhere near a poor area.

      Reply
      1. Martin Back

        I shop at a supermarket that serves a working-class clientele. It is horrifying how much sugary, junky food people fill their trolleys with, like salt and vinegar crisps that cost the same as steak per gram! I personally can’t afford steak, but the supermarket sells yummy boerewors full of healthy meat and fat, at about half the price per gram. And all the basic veggies, nice and fresh, refrigerated where needed..

      2. chris c

        And then there’s the wheat, and soy, and the Omega 6 seed oils as the only “acceptable” type of fat.

        Someone used the uncharitable but not inaccurate phrase “lard-zeppelins”to describe a lot of the population. Some of the staff in our supermarket have noted the fat people buying their “low fat!!!” manufactured foodlike substances while becoming inexorably fatter, while the slim fit healthy old folks can be mostly found in the butchers, greengrocers and farm shops. Not so many doctors, and especially not dieticians have noticed this.

    3. Jennifer.

      Terramuggus. Your discription of psychiatric mismanagement by toxic polypharma is excellent.
      It is over 30 years since I did a stint of Nursing in a Regional psychiatric unit, and it was a real eye-opener. I appreciate that my experience is well out-dated, but I believe that many patients were there as a direct result of poverty-induced depression, and the consequent inability to cope with life in general. Many were labled with psychiatric conditions, and incarcerated in locked wards, to safeguard themselves and society (!), and their days were a merry go round of medications. Such medications have now been shown to induce life-limiting conditions, far more extreme than their ‘ psychiatric labels’.
      Had they been given better living conditions, better food, and supported living interventions for those without friends or family, we could have a healthier and happier population. Instead, as shown today, folks are homeless, ill-fed, and without much financial support. What can doctors be expected to do? Eventually, just stick them in a psychiatric bed, prescribe multi meds as you describe, and their miserable lives will be shortened. Legalised drug addiction to boot!
      We have not progressed at all.

      Reply
  20. Lorraine

    Hi
    I follow your blog avidly, and enjoy them very much. I’m so glad someone in the medical profession dares to look ‘outside’ our given teachings.
    I was a psychiatric nurse for over 30 years. I noted to myself before I retired that several of my patients died, for unknown reasons. No post mortems gave à believable cause. These were people who had been receiving psychotropic drugs long term. I believe that the deaths were and probably still, happening because of the huge doses of drugs given, unremittingly. My friend and neighbour who was suffering from bipolar disorder, died when he was 53, again no real causation found, he had also been taking large doses of prescribed drugs.
    None of your links to research tells us how they did the research and what the people suffering from mental health issues actually died from.
    I would be the last person to say that mental illness does not affect one physically, of course it does, and the life span maybe shorter for a sufferer. However I think it’s I portant to keep the research focussed and meaningful, and also pertinent to the issue being discussed.

    Reply
  21. annielaurie98524

    Thank you, thank you, Dr. K! First of all for your commonsense approach to health; then, for all your medical knowledge and experience you’ve shared in your 46 pieces; and for encouraging a relatively high degree of freedom among commenters to pursue their own agendas. And, last, but certainly not least, thank you for debunking the conventional (but ill-informed) “wisdom”. Thanks, in particular, for exposing the bias of the “blue zone” authors and their predecessors, starting with Keyes. I am very tired of providing (actual Okinawan) references for all the LFHC folk to show the Okinawans’ fondness for all things porcine, and their lack of dependence on a diet of sweet potatoes exclusively.

    Reply
  22. corrie

    I thank you Dr. Kendrick for these wonderful informative posts!! The effort to collect, process, and distill all this information, then formulate these blog posts is immense I imagine. Thank you thank you thank you!! Please continue!!!

    Reply
  23. Göran Sjöberg

    Great input as ever!

    Who can deny the effect of social isolation.

    My brother, now 75, lost his wife a while ago but thought that her children would care for him since they had been close for many years. However, they inherited her by law, e.i. the half of the value house he is now living in. They could have chosen to let him stay in the house the few years he has left (he is not in the best of shapes) and to get their money later but insist on now forcing him to sell the house to get their hands on the money.

    This is to him a deceit and now breaking his spirit and heart. Has their friendliness just been faked for 30 years he now asks.

    Reply
    1. AH Notepad

      An all too common story of family behaviour. There are often no morals when money is involved. Don’t expect, you may be disappointed.

      Reply
    2. Bill In Oz

      That would seem to indicate a flaw in Swedish law Goran. Or a flaw is his wife’s will.

      But I agree it will inevitably increase the stress on your brother and reduce his lifespan and enjoyment of life.

      Reply
    3. Göran Sjöberg

      Just to make the point clear. Her two children were from her former marriage and according to Swedish law their right to inherit their mother excludes my brother in their new marriage. They didn’t know that they should have created a reciprocal will to avoid this possible situation.

      Reply
    4. Jennifer

      Goran, that is so sad. Your brother may fortunately get strength from your support.
      President Trump has popularised the word FAKE well and truly into the world’s lexicon, and it perfectly describes your brother’s situation. In earlier times we might have said his wife’s offspring have been ‘living a lie” towards him, but FAKE sums it up far better.

      Reply
  24. Frederica Huxley

    Thank you for your wise words. Alas, allopathic medicine, for all its triumphs, seems unable to treat the person, or even to consider the interactions of every cell in the body.

    Reply
    1. Andy S

      Hi Frederica, allopathic medicine is all about treating symptoms where every symptom is a disease and the prescribed treatment is a drug. Since drugs have side effects new diseases are created. To be healthy is up to the individual. My GP recommended statins which I refused and gave him my reasons. The question is: what would lowering cholesterol cure?

      The focus has now shifted to the “social” part of humans as being “social animals”. The “animal” part dealing with cells is important. Looking forward where this blog will take us.

      Reply
  25. James

    I came to this Blog late, wish I’d found it sooner, hope it’s hasn’t reached a conclusion and that Dr Kendrick continues his investigations, so much useful and thought provoking information here.

    Last year I was sent for an Angiogram for suspected heart problems, My cholesterol level had been 5.8, I took advice and got it down to 4.1 with exercise and change of diet; low fat, more carbohydrates.

    I’ve had a stent fitted, and was told the artery had been 95/99% blocked With Statins my cholesterol went down further to 2.9 so I was very pleased. The Cardiologist on reviewing my case said she would double my Atorvastatin to 40mg. I asked her if there was a limit to how far a cholesterol level should go? She said no, “It can’t go too low.”

    After reading Dr Kendrick’s Blogg and searching the internet I made an appointment to see my doctor to talk about coming off Statins, I was starting to think Statins and low fat high carbohydrate diet was a treatment on very suspect ground.

    I initially asked my Doctor if it was OK to take coenzyme Q10 as a supplement since I was already on blood thinning treatments. He asked me why would I want to do that? He said you don’t need very much cholesterol, it effects the quality of the skin, and that’s about all. He said Cardiologists didn’t see the supplement as a route worth following, so I shouldn’t worry about it.

    He said he understood my reluctance to take Statins, he was no fan of them either, but if he was in my place he would take them.

    And that’s the problem, I really like my Doctor; he’s thorough, approachable, patient and kind – a very nice man. Not taking his advice seems terrible. I don’t think I’m alone in liking and trusting a Doctor.

    I need to come to some decision… and will.

    Meanwhile thank you, this Blog has been, and is brilliant.

    Reply
    1. Bill In Oz

      I was in the same position with my former GP earlier this year. He was my GP for 17 years and I respected him. But his level of knowledge of CVD, diet and the effects of statins was woeful.

      I tried for some months to improve things by providing printed materails on statins which are up to date. But he said at one point about one of Dr Kendrick’s posts : “That’s rubbish”.

      So I changed GP. And wrote to my former one saying why.

      At first it felt awful. As we were sort of friends. When we met outside ‘consults’ we chatted informally. But making the change has proved the best thing I did.

      By the way, this new GP is also a statinologist. But when I first saw him I stated my position very clearly on them.mAnd again provided printed copies of materials like Dr K’s posts. He knows I will not go there. So he is forced to think outside the box.

      As for me, I’m healthy. Losing 10 kg in 8 months made far more of a difference.

      Reply
    2. David Bailey

      James,

      I notice your doctor didn’t say you should not use Q10, so why not give it a try for a month or two to see if anything improves?

      As regards statins, I think the most important thing if you are going to go on taking them, is to watch out for muscle pains/cramps or loss of memory/lack of concentration, because these are two of the nasty side effects of statins (another is raised blood sugar). Also the side effects don’t always come on at once – mine took 3 years before they really started (though I had raised blood glucose before then). All my side effects went off after a while once I stopped taking the statins, but some people on the internet do report permanent damage.

      In my experience, the muscle pains are extremely peculiar and unpleasant, and are worst in the morning because the statin does its work overnight.

      Here is one cardiologist who clearly thinks differently from your doctor!

      Please note that I am not a medical doctor, just someone who discovered what statin side-effects are like!

      Reply
    3. Marguerite Harris

      James, your story is almost identical to my brother’s although his cholesterol is even lower than yours. He was just told by his cardiologist that he needs to stay on the statin (40 mg) because of “inflammation”. He is suffering with extreme depression, anxiety and insomnia, which I understand can be a side effect of very low cholesterol.

      Reply
  26. Judy Baker

    I don’t disagree with your conclusions, but I think there is one other thing that needs to be considered in relation to heart disease. A gene mutation called MTHFr is very common (up to 60 to 70% of people in the world have at least one copy; about 10 to 15% have two). The number 1 risk factor for those who have it is heart disease. They also have much higher rates of bi-polar disorder, schizophrenia, depression, addictions, and other problems, both physical and mental. People who live in traditional societies, made up mostly of people they are related to, may just be genetically lucky. When their diet and/or lifestyle changes from what had worked successfully for them in the past, their risks may increase.

    Reply
    1. Bill In Oz

      Judy, it would be nice if you could provide a source or some sources for your assertions n your comment. I just looked at what Wikipedia says about the MTHFr gene.. And it’s largely goobledegook beyond my understanding..

      Reply
      1. smartersig

        I was curious about this David as one achilles heal I found that I had was elevated Homecysteine, 21 in fact. It came down to around 9 easily with B12 Folate. I could not however find the Gene data in my 21andMe and if I remember rightly they dont actually test for it

  27. Bill In Oz

    Smartersig, the focus of this post by Dr K with the focus on how CVD is magnified by social isolation and destruction of family.

    However I know that diet is a continuing interest to you. So I think you might find this post by a Mad Scientist interesting. It is about how dietary fibre helps prevent Type 2 Diabetes

    https://therantingsofamadscientist.blogspot.com.au/2018/02/dietary-fiber-for-prevention-of-type-2.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed:+TheRantingsOfAMadScientist+(The+Rantings+of+a+Mad+Scientist)

    Reply
    1. smartersig

      Thanks Bill but I was merely responding to another poster who was commenting on the decline of heart disease in the UK and USA. I was offering some stats on why this might be which included happiness via the exit of WW2. With regard to the thread topic I hope Dr Kenrick would not want us to stick to it if the conversation moves elsewhere.

      Reply
      1. Bill In Oz

        As my mother in law suffers badly from T2D I am interested in a bit. Unfortunately so far, she has chosen not to stop eating high sugar, refined carb foods or instead eat lots of saturated fats with her meals….

  28. Eric

    I apologize for again posting something unrelated to the current topic but pertinent to the general topic of this blog.

    https://slate.com/technology/2018/02/the-new-face-of-diabetes-in-the-developing-world.html

    Apparently, they are having a real diabetes epidemic in India but without the obesity. Indians also tend to have a lot more visceral fat even if they look skinny and have a BMI well below 25. But according to the video (which by the way features a John Yudkin who happens to be the the nephew), what really drives type 2 diabetis is low birth weight due to malnourishment of the mother and low vitamin B12 levels, and kids with the lowest birth weight who made good later had the highest risk of developing T2D later on.

    While the video does not talk at all about heart disease, I immediately wondered if this could explain the historical patterns of heart disease we have discussed so many times here.

    Of course, we probably did not have that almost total lack of B12 in the West.

    Irish potato famine -> no effect on CVD (probably due to lack of seed oils and sugar after the famine years).

    Great depression, malnourishment in Europe? probably not, malnourishment in the US? only locally (dust bowl) -> can potentially explain the first increase in CVD in the 40s and 50s.

    Famine during and after WWII, only Europe, and very different by country, not in US -> might explain peak of CVD in 60s and 70s in Europe, but definitely not in US.

    No famine in Soviet Union in 60s and 70s -> cannot explain CVD in the 90s.

    Hmmm….

    Reply
  29. smartersig

    As requested by another poster I today tested blood sugar on 2 slices of toasted buttered higher fibre bread . Ordinary Portugese white bread came in at around 100 whilst today higher fibre bread came in at 85. FYI the fiber content of the bread was 18g per 100g and the sugar was 0.8g per 100g. Not sure if this is particularly high fibre but it certainly seemed to do the trick.

    Reply
    1. Fiona Weir

      Try wholemeal spelt sourdough bread. That toasted and spread with olive oil and tinned wild-caught Pacific samon accompanied by a bowl of blueberries makes a delicious breakfast!

      Reply
      1. Mr Chris

        Smartersig
        I find your experiments very interesting. Do you use a glucose meter? Does this not involve taking a bit of blood? Last blood test I had about a year ago gave blood glucose, fasting at 83, and insulin at 9. Since these figures are within the norms I have never really bothered.
        Following issue 46, I am convinced a lot of these lifestyle diseases CVD etc start in the mind, and the diet kicks in in a secondary phase. When I was younger, I seem to recall two phrases, “it’s all in the mind ” and ” the answer lies in the soil” . At the time I was very mechanistic about these things and pooh-poohed them, now I am not so sure.

      2. smartersig

        Mr Chris, I am a bit clumsy with the old finger prick testing so I go down the local chemist who incidently explained why when testing the eggs,toms,onions and mushrooms it came in at a super low 73 after having to visit an alternative chemist. The alternative chemist had a simpler device which is calibrated to average amongst the general population. My usual chemist uses a more sophisticated machine which first calibrates to your blood sample before he puts the magic two drops of ‘glucose revealer’ in and retests. In other words eggs etc probably came in at around 80 to 85 which is still pretty good. Has this all been bleedin obvious, well some parts eg I expected the egg breakie to be low but I have learnt something unexpected about oats which will result in breakfast modifications for me. In a vain attempt to not give up oats and the fact that I like eggs/toms etc but not every day, I will try Oat bran.

        Apologies if this bores some of you but some posts bore me too but I just dont moan about them, I skip them (not many I may add).

      3. AH Notepad

        The final big-ticket item on my list, of how to avoid CVD and live longer, is poor social interactions, and the strain caused by them, or whatever you want to call this rather difficult to define area. Here we have a whole range of different, interconnected, issues. Childhood abuse, family breakup, abusive partner, financial difficulties, abusive and bullying boss at work, social isolation, mental health issues, loneliness, no sense of being part of a supportive family or group – religious or otherwise.

        Yet regrettably we still seem to be stuck with smartersig’s and a.n.other’s diet trials and preferences. I know very little about the subject of this blog’s topic, but I know far too much about smartersig’s latest blood test results.

      4. smartersig

        Perhaps Notepad my blood test results will encourage some but not you it seems to put numbers to the various theories expanded in this blog. In my professional life I do not bet anything unless I can measure it and I try to apply the same principles to health. If you prefer to eat, live, socialise by the seat of your pants then that is your business and you are entitled to do so. What your comments really boil down to is that you do not like me or some of my views so pretty much anything I say will be met with a scowl even though you probably would sing the praises of high fat low insulin response as a topic and yet no nothing about the actual numbers behind it.

      5. Dr. Malcolm Kendrick Post author

        Some things do not really need to be tested. Fats/fatty acids do not raise insulin, or blood sugar – by anything rather than a marginal amount. This is basic physiology. The interesting question – interesting to me at least – is whether or now slow release carbohydrates are better, or worse, than fast release. The slower release, more complex carbohydrates, will not raise the blood sugar so dramatically, nor the insulin, but they will raise the blood sugar and insulin levels for longer. Or, to put it another way, is a quick ‘spike’ of blood sugar better, or worse, than a lower, but longer, increase.

      6. Mr Chris

        Malcolm
        You put that so much better than I did. What do you think of my morning slow release carbs theory? If their conversion to glycogen takes place slowly and then the glycogen is used or stocked in the muscles, does this have a negative insulin reaction?

      7. Dr. Malcolm Kendrick Post author

        The problem is that you would have to be careful who you studied it in, and when. For example, I someone ran a marathon the day before, I would imagine their response to a ‘glucose load’ would be markedly different than a week later. Equally people with underlying insulin resistance would be different. People under strain would react differently etc. etc. So many variable, so difficult to control for all of them.

      8. AH Notepad

        But part 46 is about social interactions, and I don’t see the continuing feed of blood tests to be part of this. How about picking the relevant blog no. and put them all there? That would help anybody who wanted a concise reference where they could find a complete history. That would be useful do you think? Every body who had subscribed regularly would still get them, and they would know where to find them.

      9. Bill In Oz

        AH Notepad, I note your criticism of a focus by some of us on diets and CVD.

        And I accept completely Dr K’s emphasis on the role of stress and ‘poor social interactions’ as a cause of CVD.

        But then the question becomes “What to do about poor social interactions ? ”

        I suggest that this needs in each of us a great deal of insight into our own ways of dealing with family, friends, acquaintances and even strangers….And once that personal insight is discovered, a willingness to change our own behaviour and even our own thinking..

        Now that is a profoundly difficult thing to do… And difficult to discuss..It is so personal even here..I find my own thinking shying away from it.

        But on the other hand there are the propositions :’What we eat can effect whether we develop CVD” & ” Certain supplements, vitamins and minerals can prevent CVD”.

        Now these propositions are so much EASIER to think about and gain information about.

        And this becomes a source of frustration for you and for others.. And lead to your comment above.
        To this I would add two suggestions :
        1 Please forgive those of us here who do not measure up on this issue.. Your criticism does not help us change who we are in the direction you want. . And the frustration you feel is probably not good for your stress levels either..
        2: Maybe you could lead by example by offering here the ways that attempt to improve your social interactions and so reduce our stress and potential CVD risk…

      10. smartersig

        Bill you beat me to the keyboard on this. I too wanted to make the point that certain doctors have reversed heart disease via diet and although one could say no they did not it was the Yoga, not all of them adopted the yoga/relaxation. So although I accept stress is important it is far harder to control than diet. My guess is that if you took 1000 heart disease patients and put them on a controlled proven diet and then you took another 1000 heart disease patients and put them on daily Yoga or whatever, then you would get more bang for your buck from the diet group.

      11. Dr. Malcolm Kendrick Post author

        I can see no evidence that any specific macro-nutrient diet has any significant impact on lifespan. Other than from some doctors, or others, who claim to have reversed heart disease on their very specific dietary regime. Something that I do not accept, and will not accept, until someone else with no financial interest in the matter, manages to reproduce their results. At present, to my mind, they are selling the equivalent of modern snake oil. Over the years, I have observed various miraculous agents ‘proven’ to make plaque shrink.

        Here, for example, is Steven Nissen talking about the miraculous effect of ApoA-1 Milano (a form of HDL), on plaques.

        ‘Nissen and his colleagues decided to test this approach (infusing ApoA-1 Milano) in humans, even though they were skeptical that it would work. “It seemed improbable, but it appeared the drug had the potential to cull plaque out of arteries in weeks, not years,” he said. “We thought it was a longshot, not even a 1 in 10,000 chance, but it did work. We were rather pleased, but very surprised.”‘ http://articles.latimes.com/2003/nov/05/science/sci-heart5

        So, here is an agent pulling plaque out of arteries in weeks – in 2003. More recently, in longer and larger trials, ApoA-1 Milano has been found to be utterly useless, described a complete wipe-out.

        ‘..it doesn’t look as if Apo-A1-Milano, as a drug, is able to do anyone any good at all. No one could have believed this outcome back in the early 2000s, but the numbers are the numbers, and (once again) we don’t know as much about human lipid handling and the cardiovascular system as we think we do.’ http://blogs.sciencemag.org/pipeline/archives/2016/11/16/the-long-saga-of-apo-a1-milano

        So, excuse me from failing to fall over myself when someone makes miraculous claims about this, or that. Especially when those miraculous claims appear to contradict everything I know about CVD, human physiology and metabolism. Which, at the risk of self-aggrandisement, is a lot.

      12. smartersig

        Dr Kendrick, I am struggling to see what financial incentive via snake oil the likes of Esseltyn and Ornish can gain. Unless they are financially incentivised by Big Broccoli. The odd book is certainly not a game changer. I see them as essentially honest peddlars of a treatment regime which may or may not be valid but I do not think they have the same motives as anyone with a wonder herb or drug.

      13. annielaurie98524

        Surely you jest! Google Esselstyn, and you’ll get blurbs about his “NY Times Best sellers” (not the occasional self-published book that barely breaks even), links to retain him as a speaker and fee list, how to become a “patient” at his clinic, etc., etc. Let us not be naive about the financial interests the LFHC proponents have. Look at the way the first “blue zone” book blossomed into a whole industry of tourism, diet books, cookbooks, etc. This is not to say that proponents of other dietary regimes don’t also profit from their approaches, but it’s unrealistic, to put it mildly, that the LFHC group is totally altruistic.

      14. smartersig

        Annie he is has been practicing this way before any Blue zone book or his best seller. I can tell you no one go’s into a life of his type of practice ie WFPB on the back of hoping to make a fortune from book selling, take a look at the Math on book sales. Of course if we are to taint Esseltyn with this brush then we must do the same for Dr Kendrick

      15. annielaurie98524

        You seem to be implying that I said these docs advocate the LFHC lifestyle because I think they are motivated to make money selling books. I am not sure where you got that idea, as nothing I wrote even remotely resembles that. And who would even buy a book on diet written by someone that does not have a long history with the subject of said book, and some track record he can claim vindicates his viewpoint?

        I don’t doubt at all that Esselstyn et. al, have been treating their patients with the LFHC regimen for years, nor do I doubt their sincerity and their almost religious belief in their systems. And, aye, there’s the rub. If one’s entire career is inextricably integrated into an idea, it makes it harder for one to look objectively at contrarian positions and evidence in support thereof. It seems that is what made Keyes stick his data in a drawer where he thought they’d never again see the light of day when his own research didn’t support his dogma. Scientists are only human, after all.

      16. Mr Chris

        dear Malcolm,
        is this the Steve Nissen that in this trial reported in 2011, https://www.medpagetoday.com/cardiology/atherosclerosis/29684
        claimed that agressive treatment with Crestor reduced plaque, the article is followed by a list of big Pharma funding that includes all the usual suspects, including, surprise surprise, Astra Zeneca.
        A quick Google search “is it possible to remove arterial plaque” revealed many homespun remedies based on diet, others based on drugs including Repatha, which I take it you found unconvincing?

      17. Dr. Malcolm Kendrick Post author

        This is the same Steven Nissen who regularly reports plaque melting away with various agents that he is involved with. I tend to take his pronouncements with a large pinch of COI.

      18. smartersig

        Dr Kendrick, you ask for someone to repeat the dietary reversal before being convinced, well Esseltyn repeated Ornish’s claim or should I say Ornish repeated Esseltyn. Also Pritkin would be in the same camp although I have not checked whether his approach claims reversal, I am guessing it does. How many repeats do you need to feel curious or convinced ?.

      19. Dr. Malcolm Kendrick Post author

        I am always curious. I am never convinced. Science has two basic functions. One – create hypotheses. Two – attempt to disprove those hypotheses. Anyone who is convinced by any evidence cannot be, by definition, a scientist. When people set up their experiments to ‘prove’ what they believe they already know, they almost always succeed. I pay little heed to their findings.

        Esselstyn, for example, has written. Do not eat ‘Anything with a face or a mother.’ Now, that is certainly emotive, but it sure ain’t science. It does however, reveal his underlying motivations. Perhaps he should be reminded that all plants, too, have mothers and fathers. Which would kind of restrict the consumption, of anything. Maybe I should call him ‘plantist’ as he obviously believes in the superiority of animal life over plant life.

      20. annielaurie98524

        Seriously, smartersig???? Esselstyn and the other LFHC proponents have clinics, do lectures, have published books and get their income from said activities; their entire professional lives are invested in the regimen they espouse. They are synonymous with their dietary approach — it’s the vehicle by which we even know they exist. And you demand that “I” EXPLAIN how they have a financial interest and possible bias in its favor?

      21. AH Notepad

        Bill in Oz, I have merely pointed out the fact that we have a continuation of postings of blood test results. This has been interpreted as frustration. It would appear the replies show more in the way of frustration since I dare to question the posting in each current successive blog. It would be far more useful to have these results posted in a relevant blog, such as the one on nutrition, the number of which I do not have to hand. Since there is a significant question as to whether these tests of the effects of various dietary inputs are relevant to CVD, it makes it more difficult to build a picture if the results are scattered widely.

        As for my leading by example of some social behaviour, that, in my view is a non-starter as I consider myself a bit of a misfit where ever I go. I rarely accept things without question. When I get a satisfactory answer acceptance is forthcoming, but the questioning often highlights the lack of soundness in the original claims. Rather like much of the questioning from posters here about the professed wisdom from “health” professionals.

      22. smartersig

        “Since there is a significant question as to whether these tests of the effects of various dietary inputs are relevant to CVD,”

        Sorry Notepad do I understand you correctly are you questioning whether blood sugar and hence insulin response is relevant to CVD ?

      23. smartersig

        The criticism of posting blood test results as I have been doing as a waste of time may well be perfectly true but not for the reasons stated by Notepad. I have been looking at blood glucose response to various foods but what is really important is insulin resistance. In other words there is nothing wrong with blood sugar going up, we need it to power cells. In fact are we mistakingly villifying insulin in the same way we villify cholesterol. Our bodies create insulin for a very good reason, its not out to get us. The problem arises when our cells are unable to produce insuling receptors resulting in an inability to fuel the cells. When this happens insulin stays high for a length of time. So what causes an inability to create receptors, well not sugar it would seem.

        “So if what I tell you is true then it should work in a randomized control trial and in epidemiologic studies of populations of people. In fact, it does. Dr. Turner-Mcgrievy and Dr. Barnard have put it to the test. They took diabetics and randomized to either vegan diet or the typical ADA, high protein diet recommended by doctors. Despite eating high carbs and lots of fruit, the vegan group had significantly greater drop in A1C.
        We can see this in action in many different epidemiological studies too. The EPIC/Panacea study, which is the largest epidemiological study ever done on food and disease, found no correlation between carb consumption and development of diabetes, but meat had strong correlation to diabetes. In fact, fructose consumption was associated with less diabetes. This becomes more understandable when you know that meat causes inflammation, acidosis, stimulates insulin, and has fat.”

        These studies also measure in end points unlike most HFLC studies which measure in markers like increased HDL.

        Maybe you wish I had just kept on posting blood tests ? 🙂

      24. smartersig

        When the host of the blog takes a hostile position towards Vegans and Veggies I know that its going to be a bumpy ride trying to evaluate any dietary arguments of which plant consumption simply has to be a component. If Vegans are miserable as you hint at in your reply then it kind of contradicts the happiness = longevity argument wouldn’t you say ?.

      25. smartersig

        Jan I am merely pointing out that the statements that Vegans are not very happy people is innacurate and based on no evidence. Also if it were true then why do they live longer and have better track records on most chronic disease

      26. smartersig

        OK I will take it as a joke. The problem I am having Dr Kendrick is that if I were to make a similar joke, lets say all meat eaters are aggressive, I have a feeling that it would be dealt with harshly by the group and perhaps even more harshly by yourself as moderator. Also if I told someone to go give 8 pints of blood I do not think it would have even appeared on the blog.

        Think I need to take a long walk

      27. Andy S

        Dr. K. is laughter more important than diet? As a person that seldom laughs out loud I had to find out. The answer could be that laughter stimulates the vagus nerve.

        May I suggest a blog about stress and the vagus nerve. Nothing to do about diet except that chewing food also stimulates the vagus nerve.

      28. Eric

        Phew, had to scroll way up to find the reply button for this rather lengthy discourse.

        Malcolm said: “Or, to put it another way, is a quick ‘spike’ of blood sugar better, or worse, than a lower, but longer, increase.”

        I think basic chemistry or rather chemical kinetics have the answer. If the reaction that we want to avoid (e.g. glycation of proteins or deposition of fats in the liver) is a simple second order reaction as in A + B -> C and A is e.g. glucose and B protein, then it does not matter, all that matters is the integral of glucose over time, as the reaction speed will be proportional to the concentration of A x the concentration of B.

        If it is higher order in glucose (or insulin), then the reaction speed will be proportional to the square of the concentration of glucose, so short high peaks are best avoided.

        So as long as we consider zero and first order reactions unlikely, there is no way that a low and slow peak can be worse.

      29. JDPatten

        Dr Kendrick,

        The A1C blood test measures the average exposure to glucose over the previous three months.
        “Glycated hemoglobin is a form of hemoglobin that is measured primarily to identify the three-month average plasma glucose concentration.” (From Wikipedia. Fairly straightforward.)

        Would one be able to differentiate the effect of three months of short-lived spikes from three months of low-and-long with A1C testing?

      30. Eric

        Re: JDPatten, short and high vs. long and low

        Depends on the reaction equation. If it is 1 sugar + 1 homoglobin -> 1 A1C, it won’t make a difference. However, if A1C is doubly glycated (haven’t looked it up), short and high will make it worse, as the reaction rate will be a function [sugar]^2, [] meaning conc() in physical chemistry.

        Note also that I wrote sugar on purpose. At peril of preaching to the converted: regular sucrose is one glucose and one fructose, but fructose has about 10x the glycating activity, starch is just two glucose. So a pasta meal will give you a huge glucose and hence insulin spike, but not much glycating activity, whereas apple juice (about 2/3 fructose, 1/3 glucose) will not spike insulin much but glycate plenty.

        Lastly, it seems that Lustig was wrong and fructose does not entirely get metabolized in liver. In fact, the liver is overwhelmed pretty fast and then you get high plasma fructose levels and cells everywhere start metabolizing fructose, glycation guarantueed:
        http://high-fat-nutrition.blogspot.de/2018/02/systemic-fructose-is-important.html

  30. Charles Gale

    James – cholesterol and “It can’t go too low”.

    The remark by your cardiologist about your cholesterol “It can’t go too low” reminded me of Dr Peter Langsjoen (the CoQ10 guy) addressing zero cholesterol as “crazy”.

    Here’s the link:

    At 32.27 to 33.06 mins he comments on a lab LDL chol normal reference range as 0 to 100 and states that no animal would be alive with zero cholesterol…”crazy”.

    Reply
  31. Bill In Oz

    Dr K, above you wrote “I can see no evidence that any specific macro-nutrient diet has any significant impact on lifespan.”
    What about sugar ?
    It is available at low cost and inserted into a huge range of processed foods and drinks. And is a major change in people’s diet from an evolutionary perspective.

    Also earlier today, Smartersig pointed out this TED talk in another one of your blogs (43 ?)

    This research investigates the question “What is the best diet for humans? ” And reports that the question is NOT a sound one. In fact the question should be “What is the best diet for me ? ” The talk reports the results of recent research measuring in real time the glucose levels for 1000 different people over a period when 50 meals consumed by each person..

    The really interesting thing is that a food which was good for one person ( small glucose spike ) was poor for another. ( Large glucose spike ).
    This suggests that individual genetic factors play a part. Also the character of the microbiome of each person made a huge difference.

    The speaker also suggested that it would be possible to work out what the best diet for each of us is given our genes and microbiome etc.

    And that provides a way to lower chronic diseases like CVD, T2D, Kidney failure etc…

    I wonder what you think about this.

    Reply
    1. Dr. Malcolm Kendrick Post author

      I can see, for example, that mental illness can reduce lifespan by twenty years (yes, there may be other factors involved, such as toxicity of medications). I cannot, and have never seen, any evidence for any diet reducing, or increasing, lifespan by any significant amount. If such evidence emerges I will, of course, adapt my views. I am generally unmoved by surrogate measures e.g. blood sugar spikes. Two very major studies on lowering blood sugar (with drugs of course) demonstrated that the more the blood sugar was lowered, the higher the mortality rate. You can, and no doubt will, argue that it was the drugs that did the damage. However, I would suggest the you would have no proof that this is the case. We all work hard to dismiss evidence we do not like.

      Reply
      1. smartersig

        Dr Kendrick, I assume therefore that you feel the findings within the Eventist health study 1 and 2 have little or nothing to do with diet ?

      2. annielaurie98524

        I assume you mean “Adventist”. And yes, it may very well be the case that diet is a minor factor. There are those confounded confounding factors again, particularly as several commenters have noted several studies showing the longevity-promoting effects of belonging to groups, such as the religious affiliations. And then, there are the pitfalls associated with studies of self-selected groups….

      3. smartersig

        The fact that they were Homogeneous was a strength of the study. Meat eating religous Adventists were outlived by WFPB religous eaters

      4. annielaurie98524

        Homogeneity in one’s research subjects, at least in science, can be a double-edged sword. On the one hand, it may eliminate some confounding factors that are hard to tease out of data relating to a more heterogeneous group. On the other hand, there may be a factor or trait shared by all the subjects in a homogeneous group that causes the result the researcher observes, rather than the factor the researcher postulates is responsible.

      5. AH Notepad

        I like this reply, though my impression is that people who are eating lots of high fructose corn syrup and PUFAs seem to have a problem. Are you saying there is no evidence these factors cause them to die younger than they otherwise might?

      6. Dr. Malcolm Kendrick Post author

        One can strongly support an argument that these things should cause they do die younger than they otherwise might. The problem is that there is no evidence to support that contention. Believe me, if there was, I would not be silent about it.

      7. AH Notepad

        Thank you for the clarification. Is there scientific evidence that people consuming HFCS and PUFAs in rather large amounts have troubled health outcomes? What do I mean by that? Symptoms such as high blood glucose and T2D, or frequent bacterial and viral reactions, or cancers.

      8. smartersig

        “I like this reply, though my impression is that people who are eating lots of high fructose corn syrup and PUFAs seem to have a problem. Are you saying there is no evidence these factors cause them to die younger than they otherwise might?”

        Notepad I am finding your continued posts on diet within a thread about stress and social interactions very stressfull. In fact so stressfull that I feel the need to have a blood test.

      9. smartersig

        Don worry Jennifer I dont think Notepad is really advising me to commit suicide but he is lucky that I am not so inclined to do so and that I take it as humour rather than a death wish upon myself

      10. smartersig

        Your advice to donate 8 pints of blood has troubled me most of today and I would appreciate an apology.

      11. Marguerite Harris

        It would be interesting to know if lowering blood sugar through diet, exercise and stress reduction has the same effect on mortality rate as doing so with drugs. My husband (with type 2 diabetes) has been on a low carb, moderate protein, higher fat diet for around 6 months now and his blood sugar is lower and more stable than it was on a higher carb lower fat diet. He has lost his extra weight and over-all feels pretty good.
        On the subject of the benefits of social interactions (!) I notice a huge difference in small town life in contrast to big city life, since I moved away from the city about 18 years ago. In my small town, there are several people who have serious health problems who are often out and about and interacting with everyone they meet. One man has Huntington’s, and over the years he has done and is still doing amazingly well. He frequently mentions how his community helps him to maintain his health.

      12. AnnaM

        I don’t think it is valid to speak of this diet or that one being healthy, and then measure blood sugar that is controlled by drugs. This is two different things. I suppose that means I am arguing that the drugs were the cause of the mortality. Yes, absolutely I am arguing that. What I am arguing is that once you throw drugs into the mix, it means nothing about actual diets or even healthy blood sugar levels.

        I suppose if you measured those with an average blood sugar in a particular range with people who get that range with drugs, then you would surely find that those who have that level without drugs live longer than those who achieve it with drugs.
        But even then, it doesn’t prove that the drugs are the cause of the higher mortality. If someone needs drugs to keep their sugar in a particular range, obviously their health is compromised, but then the drugs may also contribute, and you can’t know the ratios of each.

      13. Dr. Malcolm Kendrick Post author

        If your hypothesis is that a raised blood sugar is damaging. Then you lower it, and the mortality rate goes up, your hypothesis is disproved – unless you can provide strong evidence otherwise. Merely creating convenient post-hoc rationalisations does not constitute evidence.

      14. Martin Back

        Dr Kendrick,
        You have to qualify by what you mean by “diet”. We know, for instance, that a diet deficient in vitamin C will considerably shorten one’s life. For example, during the Napoleonic wars, 10,000 sailors died from enemy action, and 100,000 from scurvy.

        You also have to qualify what you mean by “lifespan”. You can keep people alive for years in a coma with intravenous feeding, but while someone in a coma may be technically living, they are hardly full of life.

        So I think you mean is, “provided your diet supplies all the essential minerals and nutrients, your healthy lifespan is unaffected by what you eat.”

        Well, maybe. But your lifespan is also affected by how much you eat. Too little, and you will waste away. Too much, and you will “dig your grave with your teeth” as they used to say about my corpulent Uncle Bob.

        So quantity matters. 5 gm of salt is healthy. 120 gm will kill you.

        Calorie restriction has increased healthy lifespan in animal studies, although results with humans are not definitive.

        And there must also be a J-curve with stress. Too much will shorten your life, but too little, as in you are always happy and trusting, and people will take advantage to your detriment.

        So clearly there is some sort of plateau with both diet and stress, upon which we may wander about and find our own personal niches without detriment. It is up to science to warn us where the edges of that plateau might be.

      15. Dr. Malcolm Kendrick Post author

        The ever present problem with words. They often obscure meaning. It is clear that we need vitamins. I suppose that is why they were called vital – amines. Because, without them, we die. You may note I did use the word macronutrient, somewhat deliberately.

  32. Jennifer.

    I think we can agree:-
    1) that diet is but an aspect of mental and physical wellbeing, but one set of rules will never suit everyone. We have to work out what is good for ourselves and value others’ opinions.
    2) we seem to agree that we need sufficient money to provide the physical essentials to survive this hard world; once attained, the mental health will generally fall into place.
    3) Maslow described to us, in his framework for living, what he considered to be the order of importance of everything, ultimately leading up to a state of contentment.
    So….we’re off to the ballet now….all other needs met today, and well content that we have loving offspring who are treating us.( I love freebies).

    Reply
  33. chris c

    I confess to being somewhat leery about “psychiatric” explanations for things mainly because some shrinks are considerably less sane than some of their patients. Look at the guys who think bullying is an acceptable treatment for ME/CFS for example.

    The interaction between “mental” and physical goes both ways across the HPA. My ability to handle stress increased by a magnitude or more once I got my blood glucose into range without the major spikes, followed by insulin spikes, followed by spikes in cortisol etc. Most of my diagnoses, including but not limited to “anxiety and neurosis”, depression and “a Personality Disorder which cannot be treated and will not improve” turned out to be completely bogus and based on the “fact” that I was “obviously” making up my symptoms. A glucometer and some common sense proved what was actually occurring and what I could do about it . . . fifty years too late.

    My father was diagnosed with “depression” in his later years, and prescribed, I think, amitryptiline, which gave him hallucinations, after which he was rediagnosed with “treatment-resistant depression” and sent to a shrink, who probably (I don’t know) blamed his mother, as they do. In retrospect he was a textbook case of hypothyroid, and there was really no excuse for missing this as he was hypERthyroid when he was young, and the treatment consisted of opening up his neck and hacking out most of the gland.

    Having said which, I had a friend who was a psychiatrist (also a part time village GP but sadly not my village, and a local councillor) who was hugely intelligent and very wise and level headed.

    Going even further off topic but related to previous posts about K2, I already knew of the correlation between dental/gum infections and CVD but this mechanism was new to me

    https://www.drstevenlin.com/real-dental-heart-connection-teeth-improve-heart-health/

    Reply
    1. Martin Back

      I worked with an 80-year-old guy, himself very fit, who always maintained that depression was caused by a lack of physical fitness.

      I grew up in a very stressful home, and as a young man I was always depressed, and used to self-medicate with alcohol and cigarettes. Almost every day I’d think of ending it all by committing suicide. Once I gave up the smokes and the booze, watched my diet, and walked a lot to keep fit, the depression vanished. I can’t remember the last time I thought of offing myself.

      Reply
      1. Errett

        Martin—I’ve been a runner for decades—I ‘m probably addicted to endorphins, enkephalins and dynorphins—but I have never been depressed—I run in any weather.

      2. Martin Back

        Errett,
        After basic training in the army I swore I would never run again, and I haven’t. I hate blisters, sweat, and exhaustion.

        These days I can’t run even if I wanted to. Ankylosing spondylitis has seized up my joints to such an extent I run more awkwardly than a woman in high heels and a tight skirt.

      3. Martin Back

        On which is better, frequent small meals or fewer large meals, fewer would appear to be better.

        Promoting Health and Longevity through Diet: From Model Organisms to Humans

        Patterns of eating over the day can also have substantial effects. Limiting daily food intake of an isocaloric diet to a 5 to 7 hr time window in humans can induce health benefits compared with a standard three to five meals per day (Mattson et al., 2014)… Furthermore, 30% calorie restriction by dietary dilution, in which mice ate all day to compensate for the low energy density of the diet, had no beneficial effects on lifespan (Solon-Biet et al., 2014), possibly because of the disrupted meal pattern. Long-lived, hungry DR [dietary restricted] mice and rats consume their restricted portion of food rapidly, with an extended period of fasting (22–23 hr) between meals. Chronic DR may hence improve health at least in part through IF. Similarly, in the Wisconsin Rhesus monkey DR trial, the animals fed mainly once a day—in the National Institute on Aging (NIA) trial twice daily (Table 2)—which may have contributed to the Wisconsin DR monkeys having a 1.8× lowered rate of death from any cause (Colman et al., 2014) in contrast with the absence of a difference in death rate in the NIA study (Mattison et al., 2012) (reviewed in Cava and Fontana, 2013).

        Recent and accumulating work in unicellular and invertebrate model organisms, rodents, monkeys, and humans indicates that diet has a much more pervasive and prominent role than previously thought in modulating mechanisms of aging and its associated diseases. More work is needed to understand the interactions among calorie intake, meal frequency and timing, single-nutrient modifications, the microbiome, and nutritional history in modulating the key mechanisms that maintain cellular, tissue, and organ function during aging.

        They also mention the inter-generational role of diet, which hasn’t been discussed on this blog. Better-fed parents get bigger babies. Bigger babies are healthier.

      4. chris c

        I think “depression” may turn out to be a complex of causes which may lead to similar symptoms. In many ways I had an idyllic childhood, plagued as is now obvious by symptoms of major blood glucose instability and other symptoms of “conditions common in diabetics”. I always walked a lot, though taking care to eat enough carbs to avoid falling over. My self-treatment was caffeine and nicotine, both dopaminergic, and a light went on when I was prescribed an SSRI, which only worked temporarily and made things worse when the dose was increased, and caused me to greatly increase the consumption of both. I dug out some research that while SSRIs work for some people, for many over time they first upregulate serotonin and then downregulate dopamine. Both older and newer drugs also target norepinephrine and dopamine (which are metabolically related). Norepinephrine, epinephrine and cortisol among others are part of the “counterregulatory response” to a rapid drop in blood glucose, probably why the depression went away when I started eating low carb.

        Nowadays I still walk but no longer have to carb up every few hours, my physical energy is better and more constant too because I spend most of the day living off stored energy (including fats and ketones) from the previous day’s meal. Even when I overtreat my trick thyroid and it goes low the resulting “depression” is much milder than it was when Mr Thyroid was completely functional.

        In retrospect it WAS my mother’s fault – because that is the side of my family that the diabetic gene came from, not because of Munchausens By Proxy or any similar claims.

        How do you prove that you actually DO have symptoms when you have been accused of making them up? And worse, how do you prove they went away? Obviously I must have just stopped making them up. Next patient please!

      5. chris c

        “They also mention the inter-generational role of diet, which hasn’t been discussed on this blog. Better-fed parents get bigger babies. Bigger babies are healthier.”

        Not too big though! Someone came up with a classic line about obese people being “marinated in insulin since before birth”

        Yes agree on the eating pattern, I tend to alternate between one large or two smaller meals per day with long periods in between. Not deliberately as in fasting, it’s just how my body works when I don’t eat until I am hungry and then stop when I’m replete. This was completely impossible on a high carb diet. Reducing spikes in glucose, insulin and nutrients to one or two a day vs. eating three meals and three snacks as per current advice which results in insulin levels never dropping to where you can access the stored food (fat) if you are in the least insulin resistant. Between-meal autophagy also.

      6. Errett

        Martin–A friend of ours has —- Ankylosing spondylitis—-truly a serious battle—-he found some relief from Yoga—-for whatever it is worth to you — I will include you in my prayers—-we don’t quit—-semper fi.

  34. John

    The good doctor uses his words with care.
    He is clearly a man who likes evidence from valid research.
    In relation to diet he uses the word ‘lifespan’.
    If we look at average lifespan then yes I am sure that the majority are living for 70 or 80 years. Use the words ‘ life quality’ and personally I feel a considerable number of people are living and adding years in a state of pain or ill health, propped up by drugs etc.
    The huge increase in obesity and ill health will take its toll. When I get to seventy I want to climb the hill to see the view of the west coast of Scotland that I love, not be at the bottom looking up. We may have the same lifespan but the quality is not the same.
    A great blog and discussion, long may it continue.

    Reply
    1. David Bailey

      Somewhere Dr K points out that mortality (and hence lifespan) is definite, whereas, for example, cause of death may be vague or incorrect. So he prefers lifespan to measure medical consequences!

      Quality of life is obviously potentially even vaguer to define. I guess the real problem is to measure quality of life in a sufficiently objective way. If you don’t, those who like to bend statistics to mean what they want, have a wonderful toolbox to explore!

      BTW, I know a man of 78 who still climbs cliffs, so maybe your ambition is a little modest!

      Reply
    2. AH Notepad

      John, it maybe the people who are being propped up by drugs are being crippled by those drugs, and continually needing more. That seems to be the big pharma business model.

      Reply
    3. Errett

      John—‘Life quality’—reminds me of a book I read in 1983—“Life Extension” by Durk Pearson. He was promoting the idea of “squaring the curve” of life—-the curve being a function of quality of life to quantity. Goal was to keep as high on the “y” axis—quality—as long as possible and then drop like a brick—-that became my goal—-I follow two basic rules—-everything in moderation and use it or you will most definitely lose it. Good Luck

      Reply
  35. Martin Back

    “is a quick ‘spike’ of blood sugar better, or worse, than a lower, but longer, increase.”

    This is a very good question, and I’m amazed that there doesn’t appear to be a scientific study that answers it. There are a few that examine meal frequency and weight gain or loss, but I don’t see any that examine meal frequency in connection with health or disease.

    It may be hard to do with humans, but with animals it should be easy to arrange feeding equal calories to one group in one shot, and to another group in small spaced-out amounts, and observe the effects over the life of the animal.

    A number of websites advise small and frequent meals, particularly for diabetics, but there doesn’t appear to be any science backing it up.

    My gut feel (heh) is that few and big is healthier than many and small. Pre-historically, as foragers in a social group we would bring our gleanings to a central place once a day then share them out. Probably with a little light snacking on tasty berries during the day, but nothing substantial, because that would be cheating your fellows. Plus once cooking was invented, it would be more convenient to cook meals once a day, given the need to gather enough firewood.

    Also, overweight people seem to be permanently snacking and nibbling. Their digestive systems never seem to get a chance to reset and reboot.

    Reply
    1. smartersig

      They may not be mutually exclusive, did not the Krafft experiments show that people who have higher blood spikes also have longer to normal downturns ?

      Reply
    2. Jennifer.

      By fasting for a mere 18 hours, there are certain bacteria in the colon which actually thrive on having a rest from food, and then get to work on improving the gut microbiome. Only problem seems to be, very few of us have the will power to put it into practice. My husband would like to fast for a full day once a week, but I do all food prep, and that puts pressure on his will power, as I eat small portions, and often. I feel that he has the right idea, so maybe I should make the effort and give a one day a week fast a try.
      Sorry if this constant discussion about food is irritating some folks, but judging by the numbers talking about food in relation to physica and, ultimately, mental health, it is an important topic.

      Reply
    3. annielaurie98524

      The evolutionary approach you note (“feast or famine”) is the basis for the intermittent fasting regime that many holistic docs recommend. One keeps a 14-16 hour interval between one’s last meal of the day and the first meal of the following day, and confines one’s daily food intake to a 4-6 hour window. Some studies have shown superior weight loss and improvement in blood sugar control and other markers (yes, I know, these are just “markers”, but are measurable) with this approach, especially when combined with the HFLC diet. Dr. Joe Mercola is a proponent in his blogs and in his book “Fat for Fuel”. Drs. Dale Bredesen and Thomas Seyfried have successfully used it to treat Alzheimer’s and intransigent cancers, respectively.

      Reply
      1. Jennifer.

        Sorry, once again Annie…..I certainly went to give you a thumbs up…..2nd time this week it has happened to me….I tried to reverse it as advised by a fellow blogger, but to no avail….will now stop rating blogs as it is getting embarrassing.

      2. smartersig

        And I have been blaming Annie for mine when in fact it was your big clumsy thumbs 🙂

        Dont worry about 75% of my spelling mistakes are clumsy fingers.

      3. annielaurie98524

        I seldom rate comments, and have not rated any of yours in quite some time. I fail to understand why you assume those of us that do not share your views are downrating your posts, or otherwise trying to discredit you; or why your replies reflect such a sensitivity to what are obviously humorous comments regarding vegans (which you claim you are not). Your responses in regard to same throw in non-germane, provocative claims, with no supporting sources, such as “vegans live longer”, “vegans have better biomarkers”, etc., which have no basis in science whatever, and seem designed to continue the diet controversy.

        However, I am not among those that want to ban any reference to diet, particularly in light of some of the recent dietary trials that are trying to be more evidence-based, such as those of Bredesen and Seyfried. I suspect that, ultimately, the impacts of one’s diet will be found to be the result of micronutrients, more than macronutrients, a possibility to which Dr. K has already alluded.

      4. annielaurie98524

        smartersig, I lived near Loma Linda for almost 29 years, worked with several Adventists, and am very familiar with the studies. Sorry, they do not “prove” what you claim, i.e., that vegans live longer than omnivores. Nor do they prove that vegans have better markers. I don’t even know where to start elucidating, since, if you don’t know the limitations of these “studies” by now, nothing I say will convince you. They are very limited, relatively short-term (for longevity studies), population-limited, correlational studies. In addition, the Adventists were not all vegan. My question to you is this: If you find the Adventist studies, and other studies you’ve cited, so very compelling in support of the vegan lifestyle, why don’t you, an admitted non-vegan, convert to veganism?

      5. smartersig

        Because evidence suggests that Pesco vegans do even better so I dont eat dairy or meat but I do eat fish. I also eat nuts even though Dr Ornish would frown because the data on nuts looks pretty compelling. In other words I read the data and cobble together what I think is best. Hey my wife who is from Ghana makes a Goat curry from time to time and I even eat that, mainly because I am pretty sure its grass fed and I know its only kind of twice a year. It also saves her the hassle of making two dishes and me the hassle of washing two lots of pots. One thing the study surely shows to even you is that Vegans/pescos etc get less heart disease, on that we can take shorter studies and make extrapolations. All one has to do is control and measure occurrances after x years. After all if you take x pretty much life long Vegans and y pretty much life long non vegans and then track for x years if the outbreak of heart disease is statistically significantly more in one than the other then we should sit up and take notice.

      6. Andy S

        smartersig, had a look at the vegan study sponsored by the Loma Linda University Church of Seventh-day Adventists. Did not convince me that meat consumption causes diabetes. They compared vegan diet with “western” diet.

      7. smartersig

        No they did not Andy, they compared Seven Day Adventists who ate according to the specified categories (Vegan Pesco etc) controlling for the usual suspects. Further more

        “The incidence of diabetes increased incrementally among vegans, lacto ovo vegetarians, pesco vegetarians, semi-vegetarians and non-vegetarians”

        In the statistical world this would be even more compelling, when I look at Sports data incremental evidence is more compelling than a destination I would like to see but arrived at haphazardley

      8. smartersig

        Annie, I too try to eat a high fat low carb diet but with me its low net carbs and the high fat is non animal fat. The reason for this is best summed up

        “What food choices are best in a low-carbohydrate diet?
        The choices of fat and protein sources in a low-carbohydrate diet may affect the risk of subsequent cardiovascular disease. Indeed, a prospective cohort study of 82,802 U.S. nurses reported that a low-carbohydrate dietary pattern which incorporated a high intake of vegetable protein and unsaturated fat was associated with a lower risk of coronary heart disease over 19 years of follow-up [74]. In contrast, a low-carbohydrate dietary pattern accompanied by a high intake of animal-based protein and fat was not associated with a lower risk of cardiovascular disease, but associated with higher all-cause mortality in both men and women [75].”

        Taken from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351995/

      9. Martin Back

        “why don’t you, an admitted non-vegan, convert to veganism?”

        Because veganism is its own punishment ;o)

      10. smartersig

        Some think life is the punishment and death is the reward, we will all find out Vegan or not but lets not encourage it

      11. Martin Back

        smartersig,
        Zoe Harcombe analyses the Nurses’ Health Study, and shows that, depending how you analyse the data, you could actually prove the opposite, i.e. that red meat is good for you. Either way, the effect is small.
        http://www.zoeharcombe.com/2012/03/red-meat-mortality-the-usual-bad-science/

        What I found really interesting was a comment on her article from mistert:

        “All you have to do to realize that these studies are basically worthless is to look at the example of HRT therapy and heart disease. Back in the early 1990s, the Nurses Health Study (Yes, the exact same data that was part of this meat study) was analyzed with similar methods as was done in the meat study. And, there was a correlation between hormone replacement therapy and lowered incidence of heart disease. To be clear, the study took the data from the NHS and corrected for various factors (just like in the meat study!) and found that nurses who were on HRT were 50% less likely to die from heart disease.

        “To make a long story short, some real science was done a decade later, and this showed that HRT therapy actually leads to a 30% increase in risk of heart disease.

        “So, the observational study showed a large benefit to having HRT, which was subsequently shown to be completely incorrect.

        “It seems that there might be a lesson in that somewhere.”

      12. smartersig

        Her article is very sloppy, first of all she is comparing baseline Q1 category relationships from the confounder adjusted study with her own raw overall ratios, this means the numbers are immediately apples and oranges. More importantly she is not attempting any Multi variate analysis or even has knowledge to how they performed their multi variate analysis. She would have been better served finding out if possible how they performed their analysis and then trying to show how they may have under compensated. If you are a meat eater and even if you want to trust her shaky analysis it still shows that Q5 meat eaters are worse off than Q1 meat eaters and if she wants to suggest that increasing the allowance on confounders would bring Q5 down below Q1 then she really is in make it up land

  36. Martin Back

    Social Relationships and Mortality Risk: A Meta-analytic Review

    “These findings indicate that the influence of social relationships on the risk of death are comparable with well-established risk factors for mortality such as smoking and alcohol consumption and exceed the influence of other risk factors such as physical inactivity and obesity. Furthermore, the overall effect of social relationships on mortality reported in this meta-analysis might be an underestimate, because many of the studies used simple single-item measures of social isolation rather than a complex measurement. Although further research is needed to determine exactly how social relationships can be used to reduce mortality risk, physicians, health professionals, educators, and the media should now acknowledge that social relationships influence the health outcomes of adults and should take social relationships as seriously as other risk factors that affect mortality, the researchers conclude.”

    Reply
    1. Göran Sjöberg

      Martin,

      “It doesn’t take a rocket scientist” to figure out that social isolation, being an integral part of our present day rational society, is incredibly destructive to our common health.

      I have just read a book about shamanism (ARCHAIC TECHNIQUES OF ECSTASY” by Mircea Eliade) and the shamans were the GPs of the prehistoric times. What is striking me reading this book is that there was in those times a total commitment not only by the shaman but also a participation of the surrounding society when a person got seriously ill.

      From that perspective I am convinced the the health care system was superior in those times. And in essence no-one was ever alone in these “primitive societies” while loneliness is a disaster of today – 10 % on SSRI pills!

      Reply
      1. Göran Sjöberg

        I usually agree with most of what Malcolm claims although I am now hesitant about his strong position on the unimportance of macronutrients but probably I misunderstand something here. Why I am hesitant on this point are the dramatic personal health benefits my seriously T2 diabetic wife experienced when we ten years ago turned 180 degrees from a rather high carb vegetarian type of diet into a strict LCHF diet based on animal products.

        Looking for the simple “explanations” which we all tend to look for, bad blood sugar control was a reasonable culprit but probably poor “insulin level control” might be a more fundamental pathogenic “explanation” but insulin we cannot easily measure.

        Well, there are more prominent advocates for the importance of a LCHF-diet on T2D than me and who are within the medical profession. (Metallurgist has not much of a say in this profession except as an “anecdote” or a “case” as the “word” Malcolm prefers.) I am now first thinking of prof Noakes in SA who seems to be on an incredible never ending trial put up by the dietitians with Big Pharma hovering in the background. In Sweden we have our LCHF-pioneer Dr. Dahlqvist who was accused in the same way by the dietitians as Noakes when giving LCHF advice to her T2D patients and she then lost her job but was finally cleared by the medical authorities 10 years ago and could continue her practice.

        Perhaps it may be as simple as it is not before you have been trapped in the metabolic syndrom (the pathological state of insulin resistance?) you need to start worry about the amounts of different macronutrients in your diet.

      2. Dr. Malcolm Kendrick Post author

        Goran. Personally I strongly believe that for those with metabolic syndrome an LCHF diet is most certainly the best thing to do. I would love for there to be evidence (on lifespan) for me to quote. But there is not. There is improvement in metabolic markers, in many. However, on the other side, there is a rise in LDL which can and will be used as evidence against it – for those who remain convinced by the cholesterol hypothesis. My view is that, without evidence, we are simply believing in what we wish to believe in. Which is fine, and I will be very surprised if LCHF does not prove to extend life – at least in those who are, to one degree or another, carb resistant. As a hypothesis, it makes perfect biochemical and physiological sense.

      3. smartersig

        I sincerely hope that everyone who is taking a punt at LCHF is as you think, on the right track for end outcomes, but lets be clear it is at the moment a punt

      4. smartersig

        Goran, what exactly happened to you blood sugar and insulin levels when you went on a high carb veggie style diet. What did your diet consist of ?

      5. Göran Sjöberg

        By the way.

        There is an almost incredible witch hunt now going on in SA against Prof. Tim Noakes now rekindled. In my eyes every sane person needs to support him.

        http://foodmed.net/2018/02/noakes-hpcsa-appeal-evidence-dietitians-setup/

        There is a petition in support – please sign it! I think it is very important to stand up to stop the bullying from Big Pharma through our medical authorities.

        https://www.change.org/p/health-professions-council-of-south-africa-support-dr-tim-noakes?recruiter=630234806&utm_source=share_petition&utm_medium=twitter&utm_campaign=share_twitter_responsive

      6. Dr. Malcolm Kendrick Post author

        I would urge everyone to sign this petition. Whether or not you believe in LCHF the actions against him are a clear attempt to crush dissent and free speech. It is like something out of the Soviet Union. A show trial with a clear intent to ‘punish’ dissent.

      7. Göran Sjöberg

        smartesig,

        To your specific question about those rather vegetarian times (great tasting food though), more than ten years ago before we “converted”, we didn’t have the faintest idea about our blood sugar levels. What we noted was that my wife was severely struck by peripheral neuropathy, had lost her night vision and that her gut system was in a ruin. And when in the forest not only she herself but also the ants noticed the sweet smell when she “watered” the ground and saw the ants came running.

        On her own she realized that she was obviously severely diabetic which the health care system had not been able to figure out on her repeated visits. Total mistrust here!

        From one day to the other we decided to ditch ALL carbs (there was for sure a simple blood sugar “science” behind that decision) and with unbelievable and immediate health improvements. Her thirty years of gut problems basically disappeared in a few days, the peripheral neuropathy improved steadily and had completely gone into remission in one year when her night vision also had come back. Her two eye diagnosis, cataract and glaucoma, are now history and the eye bottoms are just perfect according to the optician who recently took nice pictures of them.

        To relate to the topic of this blog of the importance of the mind on the health she also turned very happy which is not bad. And she is still alive which is contrary to the statistics for T2D of her previous serious condition where sever peripheral neuropathy is an indicator of a late stage of this disease.

        By the way no medicine has been involved during these years – poor Big Pharma 🙂

      8. smartersig

        I am very pleased for her Goran and her experience ties in with my topic of personalized diets. I hope it continues to work for both of you but its not for me. Thanks for the detailed reply

      9. chris c

        Signed! It’s science vs. dogma and all the money is behind dogma, and most of the publicity.

        They should dig up Franz Kafka. He would sign it too.

      10. Göran Sjöberg

        Malcolm,

        Talking about “controversial” medical practices and how practitioners deviating from the official standard of practice approach are harassed, as Dr. Dahlqvist and Dr. Noakes, I find Dr. Mercola’s newsletter of today very revealing.

        https://articles.mercola.com/sites/articles/archive/2018/02/20/medical-board-sued-for-harassment.aspx?utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20180220Z2&et_cid=DM187634&et_rid=220239639

        It is here encouraging to note that independent justice and an open court system may work in favor of the offended practitioner as it also did in the case of Dr. Noakes in SA where the integrity of a judge was evident.

      11. Jennifer.

        Goran, many thanks for the link…I urge readers to watch the link, especially regarding Dr Neides, via Dr Mercola’s blog today.

    2. Bill In Oz

      Yes Martin. This confirms what Dr K has already told us. But nothing will change unless individuals each change what they do..

      Further research is NOT needed. There is no pill or capsule or tablet or supplement or food, which will make any difference. Though I suspect many are still searching for the ‘silver bullet’. cure.

      Reply
    1. Gay Corran

      I agree about Lierre Keith, Goran. She opened my eyes to the fact that we humans destroyed the most wonderful, complex, interdependent ecological system, from hundreds of square miles of wild grasses and flowers supporting an infinity of creatures from tiny insects to thundering herds of vast animals: all gone, as the American prairies were turned into vast tracts of faceless wheat for the junk food industry. I don’t believe that was good either for us, or the planet!

      Reply
  37. Bill In Oz

    Well I see that the blog has been hijacked ( once again ) by the discussion about diet and it’s etc/s…I feel so tired of this discussion… We seem to be going round and round in circles……

    Meanwhile yesterday I spent time in the garden; planting seedlings and herbs for Winter.. And then it rained a kittle. What joy, in this long hot Summer, to stand out in the gentle rain..
    Later last night I was at a tango milonga.. I had the joy of dancing in close embrace, with about 15 lovely women as well as my wife..I even danced with a new beginner who was willing to surrender her private space and dance in close embrace as well…I think that this aspect of tango ( Argentine tango ) is deeply healing and reassuring; lowering the stress of daily life greatly. And in the breaks from dancing,some dark chocolate and a glass of red wine..

    I know that for beginners tango is exactly the opposite : it is a major source of stress. I remember those times very clearly even now years later…It is especially stressful for males who have the ‘leader’ role to learn.. with the great risk of being seen as complete clutz. Poor teaching processes can increase this stress as well. Yet I persisted. I came to love the music very early and now there is this huge wonderful health generating reward…

    I suppose other dances can do something similar but I did try out ballroom & latin for a while. It was slick and so forth..But there was not the joy that comes with dancing close embrace..And I do not dance with every women at the milonga. I dance with those who are friendly.. I no longer dance with women who make me feel uncomfortable while dancing even though they may be experienced and lovely tangueras. And refuse to invite to dance those who try to bully me or shame me, in the dance pista…

    I write all thi sin the hope that others here will write about what they do to create

    Reply
    1. Bill In Oz

      An apology ! I pressed ‘post reply’ before I had finished my sentence…..”more joyful social interactions and less stress filled ones.”

      Reply
    2. smartersig

      Bill a friend of mine says the best fun he has ever had is engaging in Salsa, I am sure you are right (Disclaimer – He is not a Vegan)

      Reply
      1. Bill In Oz

        Occasionally I dance with female beginners who have learned salsa. Mostly they hear the music and thus wish to dance the rythym. And that is exactly what dancing tango well needs.But given that the embrace is far closer, it is far more difficult..

        Last night I was at 2 classes with 30 minutes of practica in between.. So I danced again for a few hours. Again there was the deep satisfying joy of connection and the joy of helping others dance well.. This is what draws me and indeed was brings people to tango….

        And why I mention it here.. It is deeply satisfying and healing..

  38. Bill In Oz

    Dr K you wrote ” It may be because Vegans are such a happy and cheerful group of people, who laugh and laugh. …Then again, given the Vegans that I have met. Maybe there is another explanation. ”
    My personal experience of vegans and many vegetarians, ( I was once for a while ) is that life is viewed seriously & with solemnity.After all there just so much wrong with the world which needs fixing. And that all of them indulge in constant judging of others…
    And Laughter ? It is a rarity !

    Reply
      1. smartersig

        You are writing a blog entry Doctor about social isolation, depression etc and you are labelling Vegans as miserable people. I really think you should back track on this. What happened to the Scientific rigour ?

      2. smartersig

        There is a lot of hostility on here Dr Kendrick to Veganism of which a Scientific perspective would only be ‘is it beneficial ?’, not are they a pain in the arse preaching about animal rights or are they less happy as a bunch or what ever you do dont sit next to one at a dinner party (teasing myself). This fuels the anti vegan group on here when the blog owner joins them, they feel they have licence to attack veganism. I had hoped therefore that you would stay with the data on this and not some preconceptions of Vegans as people.

      3. Mr Chris

        Dear Malcolm
        What is happening to this blog?
        It used to a cheerful open-minded friendly place, now it resembles a a battle zone, trench warfare, and take no prisoners environment
        I am glad I am not the moderator!

      4. smartersig

        Thanks Dr Kendrick, I am pretty thick skinned but being told to donate 8 pints and having anything plant based dealt with aggressively as if I am peddling some secret rule the world society is starting to take its toll a bit on my mental state. I dont mind saying that I felt a bit down this morning

      5. Bill In Oz

        Dr K I suggest that you moderate out ALL comments that relate to diet for this post.

        I make this suggestion knowing that I too have made a few comments that are about diet.

        But given the standoff which seems to be developing in this post ,let us return to the discussion you opened with : the social factors that cause CVD & the social factors that help to prevent it and maybe even cure it ?

        Diet remarks have been given a good airing in other posts. And no doubt they will be aired again in future posts.

      6. JDPatten

        Dr Kendrick,

        Harshness, ruthlessness: Welcome!

        The happiest, most firmly based children come from stable families having clearly defined and strictly enforced boundaries.

        As far as this blog is concerned, we are ALL your children. Thank you.

  39. Linda Cooper

    Eat food, laugh heaps, exercise most days, have lots of love, companionship, have hobbies and a job you like doing and enjoy. Recipe for life really. If you have heart disease like I do it is about managing it. Simplistic ? Maybe.

    Reply
  40. Göran Sjöberg

    Talking veganism versus full nutritional eating I found myself “The Vegetarian Myth” by Lierre Keith a very illuminating reading. She seems to know what she is talking about not least from her own disastrous health experiences with a vegan life. She is well read scientifically in my eyes and an incredible writer in the Rachel Carson’s poetic style.

    Reply
  41. Martin Back

    OT: Giving a ‘thumbs up’ or ‘thumbs down’ by mistake.

    This feature is supported by a crowd called Polldaddy. I wrote to them and said you can change an upvote to a downvote and vice versa, but how do you cancel your vote? Here is their reply:

    Hi Martin,

    How do I cancel my vote, rather than changing it to the opposite vote?

    You’re correct that there is currently no way to un-vote or cancel your vote. I’ve forwarded this message to our developers as a feature request and we’ll look into adding this in the future.

    Till then please let us know if there’s anything else you need help with? 🙂

    Best,
    Omkar B. – Happiness Engineer

    [A Happiness Engineer? Whatever next — a unicorn wrangler?]

    Reply
  42. Nigella P

    Excellent piece Dr K, thank you. It takes me back to Sir Harry Burns and his attempts to understand why some people in Scotland had such short lives. He thought it was largely to do with social deprivation. Yes, poverty was a part of it, but only in so much as it linked to dysfunctional families, social instability and very insecure and stressful lives which started badly and never improved.

    Most humans need security and stability and some half-decent connections with other humans. For some people that may just be one or two people that they have strong, meaningful, stable connections with, whereas for others they may need a broader social framework around them. However, everyone needs someone!

    People who are isolated and stressed are vulnerable – that’s why isolation and stress are used as methods of torture. So, make time for the people who mean the most to you and enjoy being with them – they are your very own ticket to a healthier life. 🙂

    Reply
  43. Joyce

    Mr. Chris, you took the words right out of my mouth. I’ve thoroughly enjoyed this blog for a number of years after wanting to research what best to do after a cardiac arrest, and a horrifying episode with atorvastatin. However lately, I am sad to say it’s becoming akin to the Daily Mail Website, i.e. Overly aggressive and argumentative,(not that I don’t enjoy a good sensible scrap). Sad, but maybe that’s what has become of us eating all those doughnuts and blue smarties. 😉 Not to worry Malcolm, they won’t chase me away!

    Reply
  44. Eric

    Bizarre article:

    Maybe this pertains to the topic: it’s all in the mind…

    For sure, nonalcoholic beer has no fructose unlike Gatorade but is also isotonic. I just worry about the huge amount of starch in beer. I thought we were past carb loading for endurance sports?

    And lest anyone ask, I prefer a decent wine over a beer any time.

    Reply
  45. Andy S

    Is the mind more important than diet? Does what we eat affect the mind?
    1. healthy mind in sick body
    2. sick mind in healthy body
    3. sick mind in sick body
    4. healthy mind in healthy body

    There is a connection between the mind and the body and that is the vagus nerve. Stimulate the vagus nerve by singing, laughing, exercise, chewing, talking and the parasympathetic nervous system and HPA axis is also affected. Some societies place great emphasis on singing as a tool for survival, the social connection.

    A healthy microbiome (diet related) produces up to 80% of serotonin for a happier brain.

    A poor diet can result in a dysfunctional mind.

    https://www.selfhacked.com/blog/28-ways-to-stimulate-your-vagus-nerve-and-all-you-need-to-know-about-it/

    Reply
    1. Sylvia

      Just listen to a Welsh male voice choir singing Mfanwy, bliss. Singing does give a feel good factor, singalong together on a coach trip as we did many years ago. Music is wonderful therapy, Ella Fitzgerald or Kiri Te Kanawa. Often when visiting residential homes for the elderly there would be some singing encouraged, soothing it is. Better than a tranquilliser anyday
      Singing and a Guinness I say.

      Reply
  46. JDPatten

    Perspective:

    “smartersig” appears in 23.5% of the replies on this blog page, postings and responses to postings, as of tonight.

    (We’re all struggling here.
    I, myself, don’t feel that I have close to a quarter of this group’s brilliance to contribute.)

    Reply
      1. Mr Chris

        Malcolm
        Following my post the other day about thechanges that have taken place in this blog, I could have mentionned The prolifération of comments. I see a certain need for self discipline here, as part of my Zen 2018 and non grumpy old man approach each time I feel tempted to post, I ask myself if my comment really adds to the discussion or is just metooism, are people likely to be interested in what I had for supper last night? Since there is a lot of great potentially life changing stuff here, I worry that those who could be helped might be put off by the garbage.
        It is noteworthy that part 46, in itself is receiving little deep comment, even though it could be the meat of the matter.

    1. Bill In Oz

      JDP, Brilliance is ok sometimes. But I suggest that far more important is the capacity to sense when the bullshit is baffling our brains..Often the chosen modus operandi is ‘brilliance’.

      Reply
    2. Linda Cooper

      Yes, we are struggling but the question is why? We are part of a small community, a community I hope are here for the common good aka supportive network with regards to a subject that either we are interested in or suffer from. To my mind, it is like any other community. There will be consensus at times and there will be divisions. Let’s just concentrate on supporting each other and to do so, we need to accept our differences. We are here to learn from each other. Be patient, be kind.

      Reply
    3. smartersig

      I think its time for me to leave this blog. I am feeling the pressure from members and even recently feel a degree of bullying but only from one or two I may add. I would like to wish everyone a very healthful long life regardless of your chosen path. I would also like to thank all contributors who have engaged with me. As I said many blogs ago engaging with people of an opposite point of view usually drives you to a better place of understanding even if you dont change your perspective and this has been the case for me with this blog. The uncensored suicide suggestion was however a bit too far and has troubled me. No one can no another persons background and history and they should take more care with comments or at least place a 🙂 at the end. Keep up the good work Dr Kendrick, I agree with 90% of your messages but its the 10% that is always the more interesting.

      Reply

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